bluuebunny/crossref_metadata_2025 huggingface dataset:
Low Tibial Valgization Osteotomy for More Severe Varus Ankle Arthritis
Authors: Choi Jun Young , Kim Kun Woo , Suh Jin Soo
Published: July 2020

Background:

Low tibial valgization osteotomy with medial opening wedge (LTO) is generally indicated for ankle arthritis with a small talar tilt (TT). We addressed the following research questions: the efficacy of LTO for more significant varus ankle arthritis, the effect of additional inframalleolar correction followed by LTO, and the preoperative or operation-related factors influencing postoperative TT decrease.

Methods:

We retrospectively reviewed the radiographic and clinical findings of 31 patients with more significant varus ankle arthritis (≥8 degrees) who underwent LTO or LTO plus inframalleolar correction. We grouped the included patients according to combination with inframalleolar correction and postoperative decreased TT. Furthermore, a binary logistic regression analysis was performed to determine the factors influencing postoperative TT decrease.

Results:

Even though the mean TT was unchanged postoperatively (from 12.1 to 9.9 degrees, P = .052), clinical parameters were significantly increased. In the group with concomitant inframalleolar correction, we found that TT was more corrected (3.9 vs 1.8 degrees, P = .023) with a greater lateralization of the talar center and a greater correction of the hindfoot alignment to valgus. The results of the binary logistic regression analysis showed a significant relationship between postoperative decreased TT and preoperative talar center migration ( P = .016), hindfoot alignment angle ( P = .033), hindfoot moment arm ( P = .041), and hindfoot alignment ratio ( P = .016).

Conclusion:

LTO in more significant varus ankle arthritis could result in clinical improvement, although TT was not significantly changed. We recommend adding inframalleolar correction after LTO for the patients with more significant varus ankle arthritis.

Level of Evidence:

Level III, comparative series.
COVID-19-Associated Coagulopathy: An Exacerbated Immunothrombosis Response
Authors: Jayarangaiah Apoorva , Kariyanna Pramod Theetha , Chen Xiaoyi , Jayarangaiah Amog , Kumar Abhishek
Published: July 2020

Since the onset of the global pandemic in early 2020, coronavirus disease 2019 (COVID-19) has posed a multitude of challenges to health care systems worldwide. In order to combat these challenges and devise appropriate therapeutic strategies, it becomes of paramount importance to elucidate the pathophysiology of this illness. Coronavirus disease 2019, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), is characterized by a dysregulated immune system and hypercoagulability. COVID-associated coagulopathy (CAC) was recognized based on profound d-dimer elevations and evidence of microthrombi and macrothrombi, both in venous and arterial systems. The underlying mechanisms associated with CAC have been suggested, but not clearly defined. The model of immunothrombosis illustrates the elaborate crosstalk between the innate immune system and coagulation. The rendering of a procoagulant state in COVID-19 involves the interplay of many innate immune pathways. The SARS-CoV2 virus can directly infect immune and endothelial cells, leading to endothelial injury and dysregulation of the immune system. Activated leukocytes potentiate a procoagulant state via release of intravascular tissue factor, platelet activation, NETosis, and inhibition of anticoagulant mechanisms. Additional pathways of specific relevance in CAC include cytokine release and complement activation. All these mechanisms have recently been reported in COVID-19. Immunothrombosis provides a comprehensive perspective of the several synergistic pathways pertinent to the pathogenesis of CAC.
A second administration of glucarpidase in a different cycle of high-dose methotrexate: Is it safe and effective in adults?
Authors: Domingo-González Amalia , Osorio Santiago , Landete Elena , Monsalvo Silvia , Díez-Martín Jose L.
Published: July 2020

Introduction

Methotrexate intoxication following high-dose methotrexate-induced acute kidney injury is a life-threatening complication. Glucarpidase can quickly reduce extracellular methotrexate to safe levels, but the effectiveness and safety of its use in different episodes of nephrotoxicity remain an unknown area.

Case Report

A 30-year-old male diagnosed with acute lymphoblastic T-cell lymphoma received methotrexate 5 g/m2 intravenous (IV) as part of the first consolidation cycle. On Consolidation 3, he restarted methotrexate at a dose of 3 g/m2 IV showing slow methotrexate elimination, associated myelosuppression, and hepatic toxicity. Glucarpidase was administered (total dose of 2000 International Units (IU)). No adverse events were observed, and his renal function returned to normal. One hundred and six days later, he was diagnosed with leptomeningeal and cerebellar relapse and treatment with methotrexate 3,5 g/m2 IV day 1 and cytosine arabinoside (Ara-C) 2 g/m2 IV twice per day days 1, 3, and 5 was started. At 36 h from methotrexate infusion, serum creatinine increased up to 1.89 mg/dL and methotrexate concentration was 100 µmol/L. Management and Outcome: Ara-C was suspended, and a second administration of glucarpidase (2000 IU) was dispensed. No adverse events were noticed, methotrexate levels decreased and renal function progressively improved, recovering completely three weeks later.

Discussion

The effectiveness and safety of the use of glucarpidase in different episodes of nephrotoxicity remain an unknown area, and the rate and consequences of antiglucarpidase antibody formation remain poorly understood. This case report is, to our knowledge, the first case of a second administration of glucarpidase in a different cycle of high-dose methotrexate in an adult patient.
Exploring Hostility Toward Women in High-Risk Rapists: The Relevance of Ambivalence and Relational Experience
Authors: Schippers Eveline E. , Smid Wineke J.
Published: July 2020

Hostility toward women is an established risk factor for sexual violence and is often found to be present in men prone to sexual transgression. There are also clinical indications that high-risk rapists may have more ambivalent attitudes toward women, including the strong desire to be positively evaluated by women. We investigated attitudes toward women in high-risk male rapists ( n = 42), nonsexual male offenders ( n = 65), and matched male community controls ( n = 42), by means of self-report (hostility toward women, benevolent sexism, hostile sexism) and implicit measures assessing associations (Implicit Association Test [IAT]) with “women are deceitful” and “women are prestige objects,” and the approach tendency (Approach–Avoidance Task [AAT]) toward women. Results showed that high-risk rapists had a lesser implicit notion of women as deceitful and more explicit benevolent sexism than the community controls. These differences seemed most prevalent in the subgroup of high-risk rapists without any relationship history. It is hypothesized that unrealistically positive attitudes toward women may lead to rejection and frustration, which may influence sexual offending.
The Future of Hospitality Management Programs: A Wakeup Call
Authors: Dev Chekitan S.
Published: July 2020

Since the founding of Cornell’s Hotel School—the world’s first, and arguably the finest, collegiate hospitality management program—almost 100 years ago, hospitality management programs have served millions of students and executives worldwide and turned what was simply an occupation into a profession. Our programs are now in jeopardy of declining and ultimately becoming irrelevant. To secure our future, we must deal immediately and effectively with the threats to our existence and seize the opportunities to strengthen our programs. In this article, I present 10 trends that foretell the future decline of hospitality management programs and offer some suggestions to reenergize hospitality management education, research, and engagement.
Two Tachykinin-Related Peptides with Antimicrobial Activity Isolated from Triatoma infestans Hemolymph
Authors: Diniz Laura Cristina Lima , Alves Flávio Lopes , Miranda Antonio , Silva Junior Pedro Ismael da
Published: July 2020

Antimicrobial peptides and proteins (AMPs) are molecules that can interact with microbial cells and lead to membrane disruption or intracellular molecule interactions and death. Several molecules with antimicrobial effects also present other biological activities. One such protein group representing the duplicity of activities is the tachykinin family. Tachykinins (TKs) form a family of neuropeptides in vertebrates with a consensus C-terminal region (F-X-G-Y-R-NH2). Invertebrate TKs and TK-related peptides (TKRPs) are subfamilies found in invertebrates that present high homology with TKs and have similar biological effects. Several of these molecules have already been described but reports of TKRP in Hemiptera species are limited. By analyzing the Triatoma infestans hemolymph by reversed-phase high-performance liquid chromatography, biological assays, and mass spectrometry, two antimicrobial molecules were isolated and identified as TKRPs, which we named as TRP1-TINF and TRP2-TINF (tachykinin-related peptides I and II from T. infestans). TRP1-TINF is a random secondary structure peptide with 9 amino acid residues. It is susceptible to aminopeptidases degradation and is active mainly against Micrococcus luteus (32 μM). TRP2-TINF is a 10-amino acid peptide with a 310 helix secondary structure and is susceptible to carboxypeptidases degradation. It has major antimicrobial activity against both Pseudomonas aeruginosa and Escherichia coli (45 μM). Neither molecule is toxic to human erythrocytes and both present minor toxicity toward Vero cells at a concentration of 1000 μM. As the first description of TKRPs with antimicrobial activity in T. infestans, this work contributes to the wider comprehension of the insects’ physiology and describes pharmacological relevant molecules.
Noncoplanar Radiation using Tomotherapy: A Phantom Study
Authors: Yuasa Masahiro , Kurosaki Hiromasa
Published: July 2020

Background:

There are very few studies on noncoplanar radiation in tomotherapy because deformable image registration is not implemented in the TomoTherapy Planning Station, a treatment planning device used in tomotherapy. This study examined whether noncoplanar radiation can be performed on the head using a tilt-type head and neck fixture and deformable image registration.

Methods:

Planning target volume spheres with diameters of 2, 3, and 4 cm were set on a head phantom, and computed tomography images were taken at 0° and 40° using a tilt-type head and neck fixture. Irradiation plans were created in the Tomotherapy Planning Station. Noncoplanar radiation was simulated, and the dose volume was evaluated by adding the 0° dose distribution and 40° dose distribution using the deformable image registration of the RayStation treatment planning system.

Results:

The ratio of the phantom volume to the irradiation dose for 20% to 30% of the planning target volume in noncoplanar radiation was smaller than that for 40% to 90% of the planning target volume in single-section irradiation at 0° or 40°.

Conclusions:

Noncoplanar radiation on the head region using tomotherapy was possible by using a tilt-type head and neck fixture, and the dose distribution could be evaluated using deformable image registration. This method helps reduce the dose of the organ-at-risk region located slightly away from the planning target volume.
The Changes in Pharyngeal Constrictor Muscles Related to Head and Neck Radiotherapy: A Systematic Review
Authors: Grepl Jakub , Sirak Igor , Vosmik Milan , Tichy Ales
Published: July 2020

It is well known that radiation damage of the pharyngeal constrictor muscles, the glottic larynx, and the supraglottic larynx may lead to dysphagia, an unwanted effect of head and neck radiotherapy. The reduction of radiotherapy-induced dysphagia might be achieved by adaptive radiotherapy. Although the number of studies concerning adaptive radiotherapy of head and neck cancer is continuously increasing, there are only a few studies concerning changes in dysphagia-related structures during radiotherapy.

The goal of this review is to summarize the current knowledge about volumetric, dosimetric, and other changes of the pharyngeal constrictor muscles associated with head and neck radiotherapy. A literature search was performed in the MEDLINE database according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The conclusions of 8 studies that passed the criteria indicate a significant increase in the volume and the thickness of the pharyngeal constrictor muscles during radiotherapy. Moreover, the changes in magnetic resonance imaging signal intensity of the pharyngeal constrictor muscles correlate with the absorbed dose (typically higher than 50 Gy) and also with the grade of dysphagia. This systematic review presents 2 variables, which are suitable for estimation of radiotherapy-related pharyngeal constrictor muscles changes—magnetic resonance imaging signal intensity and the thickness. In the case of the thickness, there is no consensus in the level of the measurement—C2 vertebra, C3 vertebra, and the middle of the craniocaudal axis are used. It seems that reference to a position associated with a vertebral body could be more reproducible and beneficial for future research. Although late pharyngeal toxicity remains a challenge in head and neck cancer treatment, better knowledge of radiotherapy-related changes in the pharyngeal constrictor muscles contributes to adaptive radiotherapy development and thus improves the treatment results.
A Novel Technique to Achieve Rapid Wound Healing of Donor Site Wounds in Split-Thickness Skin Grafts of a Patient Undergoing Anticoagulation Therapy
Authors: Uoya Yuichiro , Ishii Naohiro , Sakai Shigeki , Kiuchi Tomoki , Uno Takahiro , Kishi Kazuo
Published: July 2020

Split-thickness skin grafts constitute an established and widely used procedure for treating skin ulcers. However, in patients on anticoagulation therapy, wound healing abnormalities can prevent smooth epithelialization of their donor site. We aimed to investigate the usefulness of a technique to facilitate smooth wound healing through partial dimension reduction, and spared skin grafts back of donor sites with split-thickness skin grafts for patients undergoing anticoagulation therapy and investigate its usefulness. Partial dimension reduction and spared skin grafting back was performed on the donor site in 4 cases (group A), and the conventional method (moist dressing) was performed in 3 cases (group B). We compared the time to achieve complete epithelialization, the degree of pain, the frequency of dressing changes during the perioperative period, and the cosmetic results 6 months after surgery in both groups. The spared skin graft achieved good circulation. The time to achieve complete epithelialization was 3.1 weeks (2.5-4 weeks) in group A and 5.7 weeks (3-8 weeks) in group B; group A tended to experience less pain and fewer dressing changes during the perioperative period than group B. In addition, group A yielded superior cosmetic results to group B. Our technique can contribute to increasing the defense against physical stimulation in the donor site. Therefore, rapid wound healing and easy wound management can be achieved. We believe that it may be useful in split-thickness skin grafts for patients undergoing anticoagulation therapy.
Fundamentals of Data Collection in Clinical Studies: Simple Steps to Avoid “Garbage In, Garbage Out”
Authors: Derraik José G. B. , Parklak Wason , Albert Benjamin B. , Boonyapranai Kongsak , Rerkasem Kittipan
Published: July 2020

Many fundamental steps underpin the delivery of high-quality clinical research. In this article, we provide a brief commentary on some important aspects associated with the collection and management of data during clinical studies, which, if overlooked, will lead to poor-quality research. In particular, we discuss the key aspects that should help early career researchers maximize the relevance and impact of their clinical research.
Comparison of Collagen Granule Dressing Versus Conventional Dressing in Patients With Diabetic Foot Ulcer
Authors: Colak Bayram , Yormaz Serdar , Ece Ilhan , Çalişir Akin , Körez Kazım , Çınar Mahmut , Sahin Mustafa
Published: July 2020

Background. Diabetic foot ulcer (DFU) is a difficult, chronic wound with a significant long-term influence on the morbidity, mortality, and quality of life of patients. There is much information about the biochemical features of collagen and its function in wound healing. The aim of this study was to compare the results of DFU patients treated with and without collagen. Methods. A retrospective evaluation was made of the data of patients with DFU who underwent collagen treatment and physiological serum (PS) treatment. The patients were followed-up for a minimum of 12 weeks, and all complications, healing process, and wound characteristics were recorded. Results. Of the total 64 DFU patients included in the study, 30 were treated with PS and 34 with collagen. Complete closure was achieved in 17 (56.6%) of the PS group patients after 12 weeks of treatment. The rate was 25 (73.5%) in the collagen group. The mean duration of treatment was 9.2 weeks (range = 6-12 weeks) in the PS group and 8.08 weeks (range = 5-12 weeks) in the collagen group. The recovery time and recovery rates were determined to be better in the collagen group than in the PS group. Conclusion. A significant reduction in wound size was seen in the collagen group compared with the PS group. The results of this study demonstrated that collagen dressings are better than conventional dressings with regard to early granulation tissue and shorter hospital stay.
Applying Intravenous Immunoglobulin and Negative-Pressure Wound Therapy to Treat Refractory Pyoderma Gangrenosum: A Case Report
Authors: Jin Shi-Ying , Chen Mei , Wang Feng-Yuan , Wang Fei
Published: July 2020

Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis that causes undermining ulcers. Unfortunately, standardization of PG treatment remains a challenge. In this article, we describe a case in which a 69-year-old man presented with a painful ulcer on the right lower leg. The diagnosis of PG was made after excluding other diseases. He had a history of PG on his left lower leg 2 years earlier and was cured by the treatment of systemic corticosteroids and cyclosporin A for 43 days. However, such a treatment was not effective this time. Hence, we applied intravenous immunoglobulin and negative-pressure wound therapy, and the patient was cured. Altogether, this case supports the use of intravenous immunoglobulin as an effective adjuvant for refractory PG, and indicates negative-pressure wound therapy as a treatment option to advance ulcer healing under adequate immunosuppression.
Freire’s vision of development and social change: Past experiences, present challenges and perspectives for the future
Authors: Suzina Ana Cristina , Tufte Thomas
Published: July 2020

This article proposes to view Freire’s thinking beyond a pedagogical method and rather as a model or even paradigm of development and social change. To build this as an original argument we firstly outline Freire’s ontological call, presenting and discussing his underlying five principles, of which one in particular, dialogue, situates Freirean thinking within communication theory. Secondly, we trace Freire’s legacy by presenting and discussing how Freire inspired three significant Ibero-American thinkers and practitioners within performing arts (Augusto Boal), communication (Juan Diaz Bordenave) and epistemology of change (Boaventura de Sousa Santos). This analysis underscores Freire’s significant legacy along global intellectual pathways both within humanities and social sciences. Finally, we deepen our analysis of Freire’s vision of development and social change, unpacking how he navigates between a normative vision grounded in a utopian aspiration for change, and a very systematic and rigorous methodology, his liberating pedagogy.
Recent developments in MOG-IgG associated neurological disorders
Authors: Hegen Harald , Reindl Markus
Published: July 2020

In the past few years, acquired demyelinating syndromes of the central nervous system associated with antibodies against myelin oligodendrocyte glycoprotein (MOG) have evolved into a new inflammatory disease entity distinct from neuromyelitis optica spectrum disorders or multiple sclerosis. The meticulous clinical description of patients with MOG IgG antibodies (MOG-IgG) has been achieved by development and use of highly specific cell-based assays. MOG-IgG associated disorders comprise a wide spectrum of syndromes ranging from acute disseminated encephalomyelitis predominantly in children to optic neuritis or myelitis mostly in adults. In recent studies, phenotype of MOG-IgG associated disorders has further broadened with the description of cases of brainstem encephalitis, encephalitis with seizures and overlap syndromes with other types of autoimmune encephalitis. In this review, we provide an overview of current knowledge of MOG-IgG associated disorders, describe the clinical presentations identified, highlight differences from neuromyelitis optica spectrum disorders and multiple sclerosis, summarize clinical outcome and concepts of immune treatment, depict the underlying mechanisms of antibody pathogenicity and provide the methodological essentials of MOG-IgG assays.
Successful treatment with avapritinib in patient with mucosal metastatic melanoma
Authors: Cocorocchio Emilia , Pala Laura , Conforti Fabio , Guerini-Rocco Elena , De Pas Tommaso , Ferrucci Pier Francesco
Published: July 2020

Metastatic vulvar melanoma is a rare and aggressive disease and survival is usually poor. Vulvar melanomas harbor BRAF V600 mutations only infrequently; consequently, target therapy is a rare therapeutic option and immunotherapy usually has only a weak effect. On the other hand, KIT mutations are rare in cutaneous melanomas, but relatively frequent in mucosal melanomas, particularly in vulvar-vaginal melanomas, and can be a therapeutic target. Herein, we report a clinical case of a patient with metastatic vulvar melanoma, harboring an exon 17 c-KIT mutation, treated with avapritinib (BLU-285) – a highly potent and selective oral kinase inhibitor designed to treat imatinib-resistant gastro-intestinal stromal tumors (GIST) by targeting KIT/PDGFRα activation loop mutants (exons 17/18). After failure of the combination of ipilimumab + nivolumab first and then nivolumab alone, the patient received avapritinib 300 mg/daily for central nervous system (CNS), lymph-nodal, right adrenal gland, lung, and subcutaneous metastases. Best response was partial remission, according to RECIST 1.1 criteria. Time to treatment progression was 11 months. Main toxicities were grade 2 cutaneous vasculitis that required avapritinib discontinuation, and grade 2 uveitis of unknown origin, treated by vitrectomy and empiric antibiotic and antiviral therapy due to negative cultural tests. Uveitis was detected at the time of progression and therapy was definitively discontinued. In conclusion, avapritinib proved to be effective even in the presence of a pretreated disease, a high tumor burden, and brain metastases. In our experience, treatment was feasible and toxicity manageable. Considering the lack of effective therapies and the poor outcome of the disease, determination of c-KIT mutations should be performed routinely in cases of metastatic mucosal melanoma.
Exploring early childhood educators’ experiences of teaching young children with disability
Authors: Munchan Leanne , Agbenyega Joseph
Published: July 2020

This paper argues that whilst inclusive education in early childhood is gaining wider acceptance in the equity and diversity movement, the value and contribution of educators’ voices about what is working and challenging are frequently ignored. This small-scale research explored five early childhood educators’ understandings and experiences of inclusive education in two kindergartens in Victoria, Australia. A thematic analysis of the data highlights inclusion as a right to belong and fully participate; the need for modifications to orchestrate a culture of acceptance, diversity and inclusion; a lack of support and inadequate professional learning; and supporting effective practice through relationship with families, experts and children. The findings draw implications of evidence-based professional learning that is less focused on the interests of academic researchers and policy makers and more on the everyday needs of early childhood educators.
Clinical Utility and Cost of Inpatient Transthoracic Echocardiography Following Acute Ischemic Stroke
Authors: Moores Margaret , Yogendrakumar Vignan , Bereznyakova Olena , Alesefir Walid , Thavorn Kednapa , Pettem Hailey , Stotts Grant , Dowlatshahi Dar , Shamy Michel
Published: July 2020

Background and Purpose:

It is unclear whether it is clinically necessary or cost-effective to routinely obtain a transthoracic echocardiogram (TTE) during inpatient admission for ischemic stroke.

Methods:

We assessed consecutive patients presenting with acute ischemic stroke at a comprehensive stroke center from 2015 to 2017 who underwent TTE. We assessed for findings on TTE that would warrant urgent intervention including cardiac thrombus, atrial myxoma, mitral stenosis, valve vegetation, valve dysfunction requiring surgery, and low ejection fraction. Subsequent changes in management included changes in anticoagulation, antibiotics, or valve surgery. We calculated in-hospital resource utilization and associated costs for inpatient TTE using individual direct cost details within a case-costing system.

Results:

Of 695 patients admitted with acute ischemic stroke, 516 (74%) had a TTE and were included in our analysis. TTE findings were potentially clinically significant in 30 patients (5.8%) and changed management in 17 patients (3.3%). Inpatient admission was prolonged to expedite TTE in 24 patients, while TTE occurred after discharge in 76 patients. After correcting for the cost of TTE, the mean difference in cost to prolong an admission for TTE was $555.52 (USD), or $16 832 per change in management.

Conclusions:

Given the low clinical utility of inpatient TTE after acute ischemic stroke and the costs associated with prolonging admission, discharge from hospital should not be delayed solely to obtain TTE.
Case report: An atypical dengue rash involving the soles
Authors: Tan Boon Hian , Stacey Simon
Published: July 2020

The cutaneous manifestation of dengue is a maculopapular blanchable erythema over the body that spares the palms and the soles. We report a case of serologically proven, uncomplicated dengue fever in a lady who developed macular morbilliform erythema with islands of sparing over the plantar regions of the bilateral soles on day 8 of disease. This phenomenon has not yet been reported in dengue literature.
Regulation of inflammatory microenvironment using a self-healing hydrogel loaded with BM-MSCs for advanced wound healing in rat diabetic foot ulcers
Authors: Bai Haotian , Kyu-Cheol Noh , Wang Zhonghan , Cui Yutao , Liu He , Liu Hou , Feng Yubin , Zhao Yue , Lin Quan , Li Zuhao
Published: July 2020

A diabetic foot ulcer (DFUs) is a state of prolonged chronic inflammation, which can result in amputation. Different from normal skin wounds, various commercially available dressings have not sufficiently improved the healing of DFUs. In this study, a novel self-healing hydrogel was prepared by in situ crosslinking of N-carboxyethyl chitosan ( N-chitosan) and adipic acid dihydrazide (ADH) with hyaluronic acid-aldehyde (HA-ALD), to provide a moist and inflammatory relief environment to promote stem cell proliferation or secretion of growth factors, thus accelerating wound healing. The results demonstrated that this injectable and self-healing hydrogel has excellent swelling properties, stability, and mechanical properties. This biocompatible hydrogel stimulated secretion of growth factors from bone marrow mesenchymal stem cells (BM-MSCs) and regulated the inflammatory environment by inhibiting the expression of M1 macrophages and promoting the expression of M2 macrophages, resulting in granulation tissue formation, collagen deposition, nucleated cell proliferation, neovascularization, and enhanced diabetic wound healing. This study showed that N-chitosan/HA-ALD hydrogel could be used as a multifunctional injectable wound dressing to regulate chronic inflammation and provide an optimal environment for BM-MSCs to promote diabetic wound healing.
What is digital literacy? A comparative review of publications across three language contexts
Authors: Pangrazio Luci , Godhe Anna-Lena , Ledesma Alejo González López
Published: July 2020

Many scholars across the world have studied the knowledge, skills and dispositions needed to use digital media. Yet as digital texts have proliferated and evolved, there has been much conjecture over what it means to be ‘digitally literate’. As literacy researchers from Australia, Sweden and Argentina we are concerned with the drive to standardise definitions of ‘digital literacy’ despite notable differences in the cultural politics of education in each country. This paper analyses how the term digital literacy has been conceptualised and applied by scholars in these three language contexts. To do this, we analyse the most cited publications on digital literacy in the English-speaking; Scandinavian; and Spanish-speaking contexts. In the analysis the variety of definitions across and within each context, the key tensions and challenges that emerge and the implications for digital literacy education are explored. Our findings reveal that similar tensions and challenges exist in all three contexts, however, the path to resolution varies given contextual differences. The article concludes with suggestions for educational research that acknowledges and advocates the need for local conceptualisations of digital literacies in increasingly globalised educational systems.
How to manage an athlete with mitral valve prolapse
Authors: Cavarretta Elena , Peruzzi Mariangela , Versaci Francesco , Frati Giacomo , Sciarra Luigi
Published: July 2020

Introduction

Under the term degenerative mitral valve prolapse different pathophysiological and clinical entities coexist in a spectrum ranging from Barlow’s disease to fibroelastic deficiency, and represent the most common cause of mitral regurgitation in the general population and in athletes. Carrying a mitral valve prolapse is usually considered a benign condition for athletes, but recently the scientific literature has focused on the malignant, thus rare, arrhythmic mitral valve prolapse and its dramatic association with sudden cardiac death, so that specific features should be considered a red flag and prompt additional exams before clear for competition.

Discussion

As the athlete’s heart is morphologically accompanied by remodelling and dilatation of the cardiac chambers induced by exercise, it may be challenging to differentiate the degree of left ventricular and atrial dilation induced by significant mitral regurgitation from physiological remodelling, especially in endurance athletes.

Conclusion

This how-to article provides clinical and useful data to manage athletes with mitral valve prolapse and to distinguish high-risk athletes carrying the features of arrhythmic mitral valve prolapse.
Veterans’ interests, perceptions, and use of mindfulness
Authors: Herrmann Tracy , Marchand William R , Yabko Brandon , Lackner Ryan , Beckstrom Julie , Parker Ashley
Published: July 2020

Objective:

Mindfulness-based interventions are an evidence-based approach utilized in health care. There is developing evidence for effective use with military Veterans. However, little is known about Veterans’ view of mindfulness. This study aims to understand their interests, perceptions, and use of mindfulness to enhance educational outreach and treatment engagement.

Methods:

A cross-sectional study was conducted across the Veterans Health Administration in Salt Lake City, UT by administering a questionnaire to military Veterans. The questionnaire included the following themes: (1) demographics and respondents’ mindfulness practice; (2) respondents’ perceptions and beliefs about mindfulness; and (3) respondents’ knowledge and interest in learning about mindfulness.

Results:

In all, 185 military Veterans were surveyed; 30% practiced mindfulness in the past year, mainly for stress, posttraumatic stress disorder, sleep, and depression. Over 75% who practiced reported perceived benefit. Veterans rarely reported negative beliefs about mindfulness; 56% perceived an understanding of mindfulness and 46% were aware of Veterans Health Administration mindfulness offerings. In all, 55% were interested in learning about mindfulness, 58% were interested in learning how it could help, and 43% were interested in combining mindfulness with a pleasurable activity.

Conclusion:

Educational engagement approaches should be directed toward the benefits of mindfulness practice with minimal need to address negative beliefs. Outreach including education, with an experiential component, about mindfulness classes, availability of evening and weekend classes, individual sessions, and virtual offerings into Veteran’s homes, may enhance engagement in mindfulness-based interventions. Mindfulness-based interventions that combine mindfulness training with an experiential pleasurable activity may be one mechanism to enhance treatment engagement.
Blood pressure control practice and determinants among ambulatory hypertensive patients attending primary health care facilities in Addis Ababa
Authors: Amare Firehiwot , Nedi Teshome , Berhe Derbew Fikadu
Published: July 2020

Background:

Hypertension is the major risk factor for cardiovascular diseases related morbidity and mortality. Blood pressure is often not adequately controlled in clinical practice. Information regarding blood pressure control in primary care settings is limited in Ethiopia.

Objectives:

This study aimed to assess blood pressure control practice and determinates among hypertensive patients attending primary health care facilities in Addis Ababa.

Methods:

A cross-sectional study was conducted on 616 hypertension patients in 12 health centers in Addis Ababa city. Data were collected by interviewing patients and reviewing their medical records. Data were collected from 3 August to 30 October 2015.

Results:

A complete information was obtained from 616 patients’ medical records, and patients were then interviewed. The mean age was 58.90 (SD ± 13.04) years, and most of them (n = 321, 52.1%) were 60 years old or above, and more than three-fourth (n = 485) were on monotherapy. Methyldopa was the most monotherapy medication prescribed, 128 (20.8%). Only 31% (n = 191) of the patients had controlled blood pressure. Determinants for poor blood pressure control were age less than 60 years (adjusted odds ratio (AOR) = 3.06, 95% confidence interval (CI): 1.96, 4.78); work status: government employee (AOR = 2.41, 95% CI: 1.18, 4.90), retired (AOR = 1.79, 95% CI: 1.01, 3.18), and private business (AOR = 2.09, 95% CI: 1.17, 3.74); and being hypertensive for 10 or more years (AOR = 1.96, 95% CI: 1.11, 3.43). Significant predictors of achieving controlled blood pressure were weekly blood pressure measurement practice (AOR = 0.57, 95% CI: 0.36, 0.90) and tertiary-level education (AOR = 0.26, 95% CI: 0.13, 0.54).

Conclusions:

Only one-third of the patients had controlled blood pressure. Efforts should be made to address identified determinants including age, regular blood pressure monitoring practice, and level of education.
Fighting the ‘Infodemic’: Legal Responses to COVID-19 Disinformation
Authors: Radu Roxana
Published: July 2020

Online disinformation has been on the rise in recent years. A digital outbreak of disinformation has spread around the COVID-19 pandemic, often referred to as an “infodemic.” Since January 2020, digital media have been both the culprits of and antidotes to misinformation. The first months of the pandemic have shown that countering disinformation online has become as important as ensuring much needed medical equipment and supplies for health workers. For many governments around the world, priority COVID-19 actions included measures such as (a) providing guidance to social media companies on taking down contentious pandemic content (e.g., India); (b) establishing special units to combat disinformation (e.g., EU, UK); and (c) criminalizing malicious coronavirus falsehood, including in relation to public health measures. This article explores the short and potential long-term effects of newly passed legislation in various countries directly targeting COVID-19 disinformation on the media, whether traditional or digital. The early actions enacted under the state-of-emergency carve new directions in negotiating the delicate balance between freedom of expression and online censorship, in particular by imposing limitations on access to information and inducing self-restraint in reporting. Based on comparative legal analysis, this article provides a timely discussion of intended and unintended consequences of such legal responses to the “infodemic,” reflecting on a basic set of safeguards needed to preserve trust in online information.
More Than Just Privacy: Using Contextual Integrity to Evaluate the Long-Term Risks from COVID-19 Surveillance Technologies
Authors: Vitak Jessica , Zimmer Michael
Published: July 2020

The global coronavirus pandemic has raised important questions regarding how to balance public health concerns with privacy protections for individual citizens. In this essay, we evaluate contact tracing apps, which have been offered as a technological solution to minimize the spread of COVID-19. We argue that apps such as those built on Google and Apple’s “exposure notification system” should be evaluated in terms of the contextual integrity of information flows; in other words, the appropriateness of sharing health and location data will be contextually dependent on factors such as who will have access to data, as well as the transmission principles underlying data transfer. We also consider the role of prevailing social and political values in this assessment, including the large-scale social benefits that can be obtained through such information sharing. However, caution should be taken in violating contextual integrity, even in the case of a pandemic, because it risks a long-term loss of autonomy and growing function creep for surveillance and monitoring technologies.
Online Temptations: COVID-19 and Religious Misinformation in the MENA Region
Authors: Alimardani Mahsa , Elswah Mona
Published: July 2020

During the coronavirus pandemic, religious misinformation has been found on social media platforms causing fear, confusion, and polluting the Middle East and North Africa (MENA) region’s online sphere. Exploring cases of religious clickbait in the form of false hadiths and viral religious advice from religious figures entrenched in the MENA’s political elite, this essay discusses how new dynamics for religion in the age of the Internet are contributing to a uniquely regional and religious form of misinformation. This essay looks at how the phenomenon of religious misinformation is a defining characteristic of the MENA’s online sphere, becoming even more acute during the COVID-19 pandemic.
One Platform, a Thousand Worlds: On Twitter Irony in the Early Response to the COVID-19 Pandemic in Italy
Authors: Vicari Stefania , Murru Maria Francesca
Published: July 2020

On 22 February 2020, 11 municipalities in Northern Italy became the first COVID-19 red zone of Europe. Two days later, when it became evident that the virus had been spreading in the country for weeks, Italy entered a “buffer zone,” a temporal zone between normality and pandemic. The buffer zone lasted around 2 weeks and thrived with irony flowing on social media through memes, multimedia remixes, and jokes. As a collective ritual, irony allowed people to temporarily background the mounting feelings of bewilderment and uncertainty by foregrounding the familiar scripts of playful and grassroots expressivity typical of networked publics. While giving the country a way to breathe before grieving, irony delivered both traditional political satire and new symbolic arrangements to frame “us” versus “them”: Northern Italy versus Southern Italy, Italy versus China. We advance initial reflections on irony and its functions during what we call Italy’s COVID-19 buffer zone and argue for the need of more platform research interested in how users appropriate devices and vernaculars in ways that are culturally bound. In other words, can we rethink “The Platform” (e.g., Twitter, Facebook, Instagram) as a constellation of small-world-platforms—sometimes overlapping, other times segregating—each shaped by local hopes and fears, histories and events?
A Motivation Perspective on College Admission Reform in Shanghai: The Effect of Providing More Choices and Multiple Evaluation Criteria
Authors: Wang (汪靖) Jing
Published: July 2020

Purpose:

This study offered insights into how Chinese college admission reform brought about school changes and influenced students’ motivation and learning behaviors.

Design/Approach/Methods:

Four classes in one public high school in the Shanghai Municipality were observed in their homeroom activities and during class breaks. Students and teachers were purposively selected and interviewed.

Findings:

Due to the more choices on national college entrance examination-examined subjects, career development courses and internships were offered to give students guidance on subject selection. A class shifting system was adopted. In response to the comprehensive evaluation criteria, more free time and club activities were offered so that students can develop their own interests in nonacademic areas. While the reform promoted some students’ intrinsic motivation and mastery goals—that is, students reported their intention to develop interests and improve competences—some students made strategic decisions (e.g., avoiding choosing Physics, intensive preparation, and extracurricular academic tutoring) to maximize college admission possibilities at the cost of ignoring their personal interests.

Originality/Value:

This is a timely study that provides insights into school changes and impacts on students’ learning in a changing educational context. Implications for future research and practices are discussed.
Fulfilling the Basic Psychological Needs of Esports Fans: A Self-Determination Theory Approach
Authors: Qian Tyreal Yizhou , Wang Jerred Junqi , Zhang James Jianhui , Hulland John
Published: July 2020

This study examines esports fans’ psychological processes and pertinent behaviors through the lens of the self-determination theory (SDT). The extent to which the esports fans’ basic psychological needs—that is, competence, autonomy, and relatedness—are satisfied were assessed by using a composite latent variable model. Findings derived from the data analyses confirmed the relevance of the SDT in explaining pertinent information on need satisfaction, motivation, and related consumption behaviors. In particular, relatedness was identified as the most salient basic psychological need dimension, suggesting that satisfying this need is critically important for esports consumption. Both the inquiry protocol and the findings of this investigation contribute to the existing literature on motivation by developing an SDT model in esports media studies. Further discussions were made on deciphering the opportunities and challenges associated with the burgeoning esports industry.
Comparative Analysis of 30-Day Readmission, Reoperation, and Morbidity Between Lumbar Disc Arthroplasty Performed in the Inpatient and Outpatient Settings Utilizing the ACS-NSQIP Dataset
Authors: Katz Austen David , Perfetti Dean Cosmo , Job Alan , Willinger Max , Goldstein Jeffrey , Kiridly Daniel , Olivares Peter , Satin Alexander , Essig David
Published: July 2020

Study Design:

Retrospective cohort study.

Objective:

Spine surgery has been increasingly performed in the outpatient setting, providing greater control over cost, efficiency, and resource utilization. However, research evaluating the safety of this trend is limited. The objective of this study is to compare 30-day readmission, reoperation, and morbidity for patients undergoing lumbar disc arthroplasty (LDA) in the inpatient versus outpatient settings.

Methods:

Patients who underwent LDA from 2005 to 2018 were identified using the ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database. Regression was utilized to compare readmission, reoperation, and morbidity between surgical settings, and to evaluate for predictors thereof.

Results:

We identified 751 patients. There were no significant differences between inpatient and outpatient LDA in rates of readmission, reoperation, or morbidity on univariate or multivariate analyses. There were also no significant differences in rates of specific complications. Inpatient operative time (138 ± 75 minutes) was significantly ( P < .001) longer than outpatient operative time (106 ± 43 minutes). In multivariate analysis, diabetes ( P < .001, OR = 7.365), baseline dyspnea ( P = .039, OR = 6.447), and increased platelet count ( P = .048, OR = 1.007) predicted readmission. Diabetes ( P = .016, OR = 6.533) and baseline dyspnea ( P = .046, OR = 13.814) predicted reoperation. Baseline dyspnea ( P = .021, OR = 8.188) and ASA (American Society of Anesthesiologists) class ≥3 ( P = .014, OR = 3.515) predicted morbidity. Decreased hematocrit ( P = .008) and increased operative time ( P = .003) were associated with morbidity in univariate analysis, but not in multivariate analysis.

Conclusions:

Readmission, reoperation, and morbidity were statistically similar between surgical setting, indicating that LDA can be safely performed in the outpatient setting. Higher ASA class and specific comorbidities predicted poorer 30-day outcomes. These findings can guide choice of surgical setting given specific patient factors.
The Virtual Spine Examination: Telemedicine in the Era of COVID-19 and Beyond
Authors: Satin Alexander M. , Lieberman Isador H.
Published: July 2020

Study Design:

Narrative review.

Objectives:

Describe a comprehensive spine telemedicine examination.

Methods:

We discuss telemedicine examination techniques for commonly encountered spine conditions.

Results:

Techniques to evaluate gait, the cervical spine, the lumbar spine, adult spinal deformity patients, and adolescent scoliosis patients via telemedicine are described. We review limitations of the spine telemedicine examination and discuss special considerations such as patient safety and criteria for in-person assessment.

Conclusions:

While there are limitations to the spine telemedicine examination, unique strategies exist to provide important information to the examiner. Efforts have already been undertaken to validate and expand the capabilities of the spine telemedicine examination.