bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relevance of the Dual Systems Model for Social Learning Theory: Testing for Moderation Effects
Authors: Wojciechowski Thomas
Published: May 2021

Social learning theory is one of the most prominent criminological theories of the 20th century. The dual systems model represents an emerging framework in recent years, which may help to better understand how social learning processes are influenced by sensation-seeking and impulse control. This study utilized data from all waves of the Pathways to Desistance study. A series of mixed-effects models were utilized to test for moderating effects of these constructs on offending outcomes. Impulse control moderated the relationship between deviant peer association and offending frequency, indicating that high levels of both constructs predicted increased offending frequency. Sensation-seeking moderated the relationship between deviant peer association and odds of offending, indicating that high levels of both constructs were associated with greater odds of offending although this moderation effect was only marginally significant.
Numerical simulation on coal loading process of shearer drum based on discrete element method
Authors: Tian Zhen , Jing Shuangxi , Zhao Lijuan , Liu Wei , Gao Shan
Published: May 2021

The drum is the working mechanism of the coal shearer, and the coal loading performance of the drum is very important for the efficient and safe production of coal mine. In order to study the coal loading performance of the shearer drum, a discrete element model of coupling the drum and coal wall was established by combining the results of the coal property determination and the discrete element method. The movement of coal particles and the mass distribution in different areas were obtained, and the coal particle velocity and coal loading rate were analyzed under the conditions of different helix angles, rotation speeds, traction speeds and cutting depths. The results show that with the increase of helix angle, the coal loading first increases and then decreases; with the increase of cutting depth and traction speed, the coal loading rate decreases; the increase of rotation speed can improve the coal loading performance of drum to a certain extent. The research results show that the discrete element numerical simulation can accurately reflect the coal loading process of the shearer drum, which provides a more convenient, fast and low-cost method for the structural design of shearer drum and the improvement of coal loading performance.
How managers and students view public service: The theoretical vs. practical divide
Authors: Wood John R , Kickham Kenneth
Published: May 2021

This paper examines existing management concepts and practices that make up three contemporary approaches to public policy and public administration. We attempt to understand whether municipal public administrators and public administration graduate students validate these perspectives in “reality” versus “ideally.” Addressing the extent to which practicing public administrators and students identify with theoretical frameworks, which one(s) they deem most prominent, and how closely their preferred frameworks correspond to what they see in practice, we offer an exploratory analysis of results from 176 respondents through descriptive statistics, paired-sample t-tests, and analysis of covariance (ANCOVA). We hypothesize significant differences with respect to 1) what is preferred and what is perceived in the workplace, 2) group membership (administrator, graduate student, or undergraduate student), and 3) gender (female or male). This research will help public administration educators bridge the gap between theory and practice and narrow the distance between the “is” and the “ought.”
Parent Ratings of Generalized and Indirect Effects of Functional Communication Training for Children with Autism Spectrum Disorder
Authors: O’Brien Matthew J. , Pelzel Kelly E. , Hendrix Nicole M. , Schieltz Kelly M. , Miller Kenzie , Call Nathan A. , Tsami Loukia , Lerman Dorothea C. , Berg Wendy K. , Kopelman Todd G. , Wacker David P. , Lindgren Scott D.
Published: May 2021

Functional communication training (FCT) is a behavioral treatment that has been shown to reduce problem behavior and increase appropriate communication in young children with autism spectrum disorder (ASD). In this study, we assessed the effects of FCT on targeted and nontargeted problem behaviors outside of the training context, as well as parent stress, for 30 young children with ASD and their parents. Indirect measures of generalization treatment effects were administered prior to and following FCT treatment delivered via telehealth. Children demonstrated significant improvement on both targeted (measured via observation) and nontargeted (measured via checklist) problem behaviors, both within and outside of the training context, and parent stress was significantly reduced following treatment. These results suggest that the impact of FCT may extend beyond the training context for both the children being treated and the parents delivering treatment, even when generalization is not specifically programmed for during treatment.
Does Performance Breed Slack? Ownership as a Contingency to the Performance Feedback and Slack Relationship
Authors: Titus Varkey , O’Brien Jonathan P. , Dixit Jaya
Published: May 2021

Although organizational slack is a prominent construct in strategic management, it is often treated as an antecedent or enabler of other organizational outcomes, and thus our understanding of where slack comes from is underdeveloped. We draw on the behavioral theory of the firm to develop a better understanding about the antecedents of organizational slack. In so doing, we address a gap in the literature on the antecedents of slack by developing base models showing how and why performance feedback influences the three most common types of slack studied in the literature. Moreover, we contend that ownership is an important contingency that influences these relationships because different types of owners are motivated by different norms. Within a “communitarian” culture such as Japan, domestic owners generally have a multifaceted relationship with the firm and hence are motivated by norms of reciprocity and embeddedness, thereby allowing managers to adopt a stakeholder perspective. In contrast, foreign investors typically have only an arm’s-length relationship with the firm and are thus motivated by stock price, thereby putting “contractarian” pressures on managers to adopt a shareholder perspective. This domestic/foreign ownership distinction influences how resources are allocated and therefore the relationship between performance feedback and different types of slack in the firm. We further emphasize that these relationships will vary in accordance to where the slack resides: internal or external to the firm. We find general support for our hypotheses.
Human Dignity and Power: Worker Struggles against Precarity in U.S. Agribusiness
Authors: Fischer-Daly Matthew
Published: May 2021

While precarious employment expands, instances of workers improving employment standards motivate examination of the dynamics of advancing decent work. This article analyzes cases of workers shifting from precarious toward decent work in U.S. agribusiness. Building on bargaining-power theory from industrial relations and human development theory from sociological philosophy, it finds that workers build power resources sequentially and by demanding human dignity. The cases reveal a framework of power building by workers facing precarious work in which progress is catalyzed by the recognition of workers’ capacity to participate in the rules to which they are subjected. The framework suggests an explication for precarious employment’s growth and decline.
Gender Differences in Disease, Function, and Behavioral Symptoms in Residents with Dementia
Authors: Resnick Barbara , Galik Elizabeth , McPherson Rachel , Boltz Marie , Van Haitsma Kimberly , Kolanowski Ann
Published: May 2021

The purpose of this study was to consider gender differences in depressive symptoms, agitation, resistiveness to care, physical function, and use of psychotropic medications in older adults with moderate to severe dementia in nursing homes. Sixty-seven nursing homes and 889 residents from two states were included. The majority of the participants were female (n = 640, 72%) and White (n = 618, 70%) with a mean age of 86.58 years ( SD = 10.31). Differences by gender with regard to age, physical function, depressive symptoms, agitation/aggression, and resistiveness to care were tested using multivariate analysis of variance. Older females with moderate to severe dementia present with more depressive symptoms (anxiety, sadness, and somatic complaints) than males. Males present with more aggressive behavior and are more likely to receive anticonvulsants. Caregivers should focus on preventing and managing depressive symptoms including anxiety, sadness, and somatic complaints among older females and aggressive behavior in older males with dementia.
Towards an eco-literate tertiary music education: Notes from a South African context
Authors: Jorritsma Marie
Published: May 2021

On 20 September 2019 in Cape Town, as part of the global protests on inaction on climate change, the African Climate Alliance submitted a memorandum of demands to South African government representatives, one of which was ‘the creation of a mandatory climate-education curriculum for South Africa’. This raises the question of how this imperative would be met within a tertiary music education context. Does the justified insistence on decolonised curricula in the period following the national #FeesMustFall protests of 2015–2016 allow space for inclusion of climate education? Given the links between social justice and environmental justice, there is certainly an argument for a focus on eco-literate education. What, then, would this include at South African tertiary music level? There are several (mostly United States based) course syllabi available online which focus mainly on themes and case studies in the field of ecomusicology. Daniel J. Shevock’s work on eco-literate music pedagogy strongly advocates for a place-based approach, but Greg Garrard’s critique would indicate otherwise. This article examines eco-critical and eco-literate theories and their application to music and uses the author’s own teaching context to outline ideas for integrating a more climate-related educational approach.
Book review: Subrahmanyam Jaishankar, The India Way: Strategies for an Uncertain World
Authors: Goel Bharatt
Published: May 2021

Subrahmanyam Jaishankar, The India Way: Strategies for an Uncertain World (New Delhi: HarperCollins India, 2020), xiv + 226 pp.
Book review: Tahir Hussain Ansari, Mughal Administration and the Zamindars of Bihar
Authors: Sinha Jagdish N.
Published: May 2021

Tahir Hussain Ansari, Mughal Administration and the Zamindars of Bihar (New Delhi: Manohar, 2019), 299 pp.
Book review: Saloni Mathur, A Fragile Inheritance. Radical Stakes in Contemporary Indian Art
Authors: Jerrentrup Maja
Published: May 2021

Saloni Mathur, A Fragile Inheritance. Radical Stakes in Contemporary Indian Art (Durham and London: Duke University Press, 2019), 235 pp.
Book review: Aijaz A. Wani, What Happened to Governance in Kashmir?
Authors: Hussain Maqsood
Published: May 2021

Aijaz A. Wani, What Happened to Governance in Kashmir? (New Delhi: Oxford University Press, 2019), 387 pp.
Book review: Declan Walsh, The Nine Lives of Pakistan: Dispatches from a Divided Nation
Authors: Yousuf Muneeb
Published: May 2021

Declan Walsh, The Nine Lives of Pakistan: Dispatches from a Divided Nation (London: Bloomsbury Publishing, 2020), xx + 332 pp.
Book review: Saleemul Huq, Jeffrey Chow, Adrian Fenton, Clare Stott, Julia Taub and Helen Wright (Eds.), Confronting Climate Change in Bangladesh: Policy Strategies for Adaptation and Resilience
Authors: Mallick Priyanka
Published: May 2021

Saleemul Huq, Jeffrey Chow, Adrian Fenton, Clare Stott, Julia Taub and Helen Wright (Eds.), Confronting Climate Change in Bangladesh: Policy Strategies for Adaptation and Resilience (Cham: Springer, 2019), xi + 210 pp.
Poverty Definition in Sri Lanka: Beyond Traditional Binary Classification
Authors: Deyshappriya N.P. Ravindra
Published: May 2021

Despite poverty being a multi-dimensional concept, binary poor/non-poor classifications and money-metric poverty measures remain prominent in calculating official poverty figures. This article highlights that conventional two-way poverty classifications ignore the huge disparities within ‘poor’ and ‘non-poor’ groups. The study thus argues for a new approach in the context of Sri Lanka to recognise four poverty types, namely ‘extremely poor’, ‘poor’, ‘vulnerable non-poor’ and ‘non-poor’, along with calculations of poverty incidence based on these new criteria. This allows for the development of policies to alleviate poverty in general, while paying special attention to the ‘vulnerable non-poor’ category, which has not been addressed in most development policies.
Emotional disclosure in palliative care: A scoping review of intervention characteristics and implementation factors
Authors: McInnerney Daisy , Kupeli Nuriye , Stone Paddy , Anantapong Kanthee , Chan Justin , Flemming Kate , Troop Nicholas , Candy Bridget
Published: May 2021

Background:

Emotional disclosure is the therapeutic expression of emotion. It holds potential as a means of providing psychological support. However, evidence of its efficacy in palliative settings is mixed. This may be due to variation in intervention characteristics.

Aim:

To derive a greater understanding of the characteristics of potentially effective emotional disclosure-based interventions in palliative care by: (1) Developing a taxonomy of emotional disclosure-based interventions tested in people with advanced disease and (2) Mapping and linking objectives, outcomes, underlying mechanisms, and implementation factors.

Design:

A scoping review drawing on Intervention Component Analysis to combine evidence from studies’ methods, results, and discussion sections.

Data sources:

Six databases were searched to May 2020 including CINAHL, PsycINFO, and MEDLINE. Studies of emotional disclosure in adults with advanced disease were included. Study quality was appraised using an established tool.

Results:

Seven thousand seven hundred ninety-two unique records were screened, of which 25 primary studies were included. Intervention characteristics were grouped into classes within three domains: topic of disclosure, format, and dose. Evidence was not available to determine which, if any, of the characteristics is most effective. Thematic synthesis of evidence from methods and discussion sections identified factors to consider in tailoring an emotional disclosure-based intervention to this setting, including: population characteristics (e.g. time since diagnosis), providing a safe environment, and flexibility in format.

Conclusions:

This review approach facilitated a clearer understanding of factors that may be key in developing emotional disclosure-based interventions for palliative populations. Intervention Component Analysis has potential for application elsewhere to help develop evidence-based interventions.
The COVID-19 pandemic: A tipping point for advance care planning? Experiences of general practitioners
Authors: Dujardin Janneke , Schuurmans Jaap , Westerduin Dieke , Wichmann Anne B , Engels Yvonne
Published: May 2021

Background:

In 2020, the COVID-19 pandemic caused an acute risk of deterioration and dying for many, and an urgent need to start advance care planning.

Aim:

To explore how general practitioners (GPs) experienced discussing values, goals and preferences with patients during COVID-19.

Design and setting:

Qualitative research in general practice.

Methods:

Semi-structured interviews for which Dutch GPs were recruited via purposive sampling. Content analysis was used.

Results:

Fifteen GPs were interviewed. Six themes were identified: (i) urge of advance care planning, (ii) the GP’s perceived role in it, (iii) preparations for it, (iv) (proactively) discussing it, (v) essentials for good communication and (vi) advance care planning in the (near) future. Calls for proactively discussing advance care planning in the media and in COVID-guidelines caused awareness of it’s importance. GPs envisaged an important role for themselves in initiating it, especially with patients at risk to deteriorate or die from COVID-19. Timing advance care planning appeared difficult but crucial. The recommended digital way of communication was considered problematic due to missing nonverbal communication and difficulties in involving relatives. It was noted that admission to the ICU, which was hardly discussed before the COVID-19 pandemic, should remain a topic during advance care planning.

Conclusion:

The COVID-19 pandemic brought advance care planning into a new light, GPs were more experienced with discussing it and patients were more aware of their frailty. Because of the nearing ‘grey wave’, advance care planning should remain top priority. Therefore, it should be central in GP and post-academic training.
Conserving dignity and facilitating adaptation to dependency with intimate hygiene for people with advanced disease: A qualitative study
Authors: Morgan Deidre D , Marston Celia , Barnard Elizabeth , Farrow Caroline
Published: May 2021

Background:

People at the end of life experience increased dependence with self-care as disease progresses, including care with intimate hygiene. Dependence with intimate hygiene has been identified as a factor that may compromise dignity at the end of life. However, adaption to increased dependency and subsequent impact on dignity with intimate hygiene is an under-researched area.

Aim:

This study sought to understand how people at the end of life experience dignity with intimate hygiene when function declines and how people adapt to increased dependence with intimate hygiene needs.

Design:

A qualitative design was employed using a hermeneutic phenomenological perspective which privileges participant perspectives. Findings were mapped against occupational therapy and dignity literature.

Setting/participants:

Participants were people with advanced disease receiving inpatient or community palliative care.

Results:

Eighteen interviews were conducted with people about their experiences and perspectives of dignity with intimate hygiene. The following themes were constructed from the data: (1) There’s a way of doing and a way of asking, (2) Putting each other at ease, (3) It’s just how it is, (4) Regaining and retaining control. How people adjust to dependence with intimate hygiene is individually mediated. Patterns of occupational adaptation to increased dependence with intimate hygiene and practical implications for care are discussed.

Conclusion:

Adaptation to increased dependence with intimate hygiene is facilitated by enabling moments of micro-competence and agency over how care is received. Carers play a pivotal role in compromising or conserving the dignity with intimate hygiene at the end of life.
Assessment of cognitive and psychomotor impairment, subjective effects, and blood THC concentrations following acute administration of oral and vaporized cannabis
Authors: Spindle Tory R , Martin Erin L , Grabenauer Megan , Woodward Thomas , Milburn Michael A , Vandrey Ryan
Published: May 2021

Background:

Cannabis legalization is expanding, but there are no established methods for detecting cannabis impairment.

Aim:

Characterize the acute impairing effects of oral and vaporized cannabis using various performance tests.

Methods:

Participants ( N = 20, 10 men/10 women) who were infrequent cannabis users ingested cannabis brownies (0, 10, and 25 mg Δ-9-tetrahydrocannabinol, THC) and inhaled vaporized cannabis (0, 5, and 20 mg THC) in six double-blind outpatient sessions. Cognitive/psychomotor impairment was assessed with a battery of computerized tasks sensitive to cannabis effects, a novel test (the DRiving Under the Influence of Drugs, DRUID®), and field sobriety tests. Blood THC concentrations and subjective drug effects were evaluated.

Results:

Low oral/vaporized doses did not impair cognitive/psychomotor performance relative to placebo but produced positive subjective effects. High oral/vaporized doses impaired cognitive/psychomotor performance and increased positive and negative subjective effects. The DRUID® was the most sensitive test to cannabis impairment, as it detected significant differences between placebo and active doses within both routes of administration. Women displayed more impairment on the DRUID® than men at the high vaporized dose only. Field sobriety tests showed little sensitivity to cannabis-induced impairment. Blood THC concentrations were far lower after cannabis ingestion versus inhalation. After inhalation, blood THC concentrations typically returned to baseline well before pharmacodynamic effects subsided.

Conclusions:

Standard approaches for identifying impairment due to cannabis exposure (i.e. blood THC and field sobriety tests) have severe limitations. There is a need to identify novel biomarkers of cannabis exposure and/or behavioral tests like the DRUID® that can reliably and accurately detect cannabis impairment at the roadside and in the workplace.
Binding characteristics of [18F]PI-2620 distinguish the clinically predicted tau isoform in different tauopathies by PET
Authors: Song Mengmeng , Beyer Leonie , Kaiser Lena , Barthel Henryk , van Eimeren Thilo , Marek Ken , Nitschmann Alexander , Scheifele Maximilian , Palleis Carla , Respondek Gesine , Kern Maike , Biechele Gloria , Hammes Jochen , Bischof Gèrard , Barbe Michael , Onur Özgür , Jessen Frank , Saur Dorothee , Schroeter Matthias L , Rumpf Jost-Julian , Rullmann Michael , Schildan Andreas , Patt Marianne , Neumaier Bernd , Barret Olivier , Madonia Jennifer , Russell David S , Stephens Andrew W , Mueller Andre , Roeber Sigrun , Herms Jochen , Bötzel Kai , Danek Adrian , Levin Johannes , Classen Joseph , Höglinger Günter U , Bartenstein Peter , Villemagne Victor , Drzezga Alexander , Seibyl John , Sabri Osama , Boening Guido , Ziegler Sibylle , Brendel Matthias
Published: May 2021

The novel tau-PET tracer [18F]PI-2620 detects the 3/4-repeat-(R)-tauopathy Alzheimer’s disease (AD) and the 4R-tauopathies corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP). We determined whether [18F]PI-2620 binding characteristics deriving from non-invasive reference tissue modelling differentiate 3/4R- and 4R-tauopathies. Ten patients with a 3/4R tauopathy (AD continuum) and 29 patients with a 4R tauopathy (CBS, PSP) were evaluated. [18F]PI-2620 PET scans were acquired 0-60 min p.i. and the distribution volume ratio (DVR) was calculated. [18F]PI-2620-positive clusters (DVR ≥ 2.5 SD vs. 11 healthy controls) were evaluated by non-invasive kinetic modelling. R1 (delivery), k2 & k2a (efflux), DVR, 30-60 min standardized-uptake-value-ratios (SUVR30-60) and the linear slope of post-perfusion phase SUVR (9-60 min p.i.) were compared between 3/4R- and 4R-tauopathies. Cortical clusters of 4R-tau cases indicated higher delivery (R1SRTM: 0.92 ± 0.21 vs. 0.83 ± 0.10, p = 0.0007), higher efflux (k2SRTM: 0.17/min ±0.21/min vs. 0.06/min ± 0.07/min, p < 0.0001), lower DVR (1.1 ± 0.1 vs. 1.4 ± 0.2, p < 0.0001), lower SUVR30-60 (1.3 ± 0.2 vs. 1.8 ± 0.3, p < 0.0001) and flatter slopes of the post-perfusion phase (slope9-60: 0.006/min ± 0.007/min vs. 0.016/min ± 0.008/min, p < 0.0001) when compared to 3/4R-tau cases. [18F]PI-2620 binding characteristics in cortical regions differentiate 3/4R- and 4R-tauopathies. Higher tracer clearance indicates less stable binding in 4R tauopathies when compared to 3/4R-tauopathies.
Perfusion and permeability as diagnostic biomarkers of cavernous angioma with symptomatic hemorrhage
Authors: Sone Je Yeong , Li Yan , Hobson Nicholas , Romanos Sharbel G , Srinath Abhinav , Lyne Seán B , Shkoukani Abdallah , Carrión-Penagos Julián , Stadnik Agnieszka , Piedad Kristina , Lightle Rhonda , Moore Thomas , Li Ying , Bi Dehua , Shenkar Robert , Carroll Timothy , Ji Yuan , Girard Romuald , Awad Issam A
Published: May 2021

Cavernous angiomas with symptomatic hemorrhage (CASH) have a high risk of rebleeding, and hence an accurate diagnosis is needed. With blood flow and vascular leak as established mechanisms, we analyzed perfusion and permeability derivations of dynamic contrast-enhanced quantitative perfusion (DCEQP) MRI in 745 lesions of 205 consecutive patients. Thirteen respective derivations of lesional perfusion and permeability were compared between lesions that bled within a year prior to imaging (N = 86), versus non-CASH (N = 659) using machine learning and univariate analyses. Based on logistic regression and minimizing the Bayesian information criterion (BIC), the best diagnostic biomarker of CASH within the prior year included brainstem lesion location, sporadic genotype, perfusion skewness, and high-perfusion cluster area (BIC = 414.9, sensitivity = 74%, specificity = 87%). Adding a diagnostic plasma protein biomarker enhanced sensitivity to 100% and specificity to 85%. A slightly modified derivation achieved similar accuracy (BIC = 321.6, sensitivity = 80%, specificity = 82%) in the cohort where CASH occurred 3–12 months prior to imaging after signs of hemorrhage would have disappeared on conventional MRI sequences. Adding the same plasma biomarker enhanced sensitivity to 100% and specificity to 87%. Lesional blood flow on DCEQP may distinguish CASH after hemorrhagic signs on conventional MRI have disappeared and are enhanced in combination with a plasma biomarker.
Addressing Health Literacy in Patient Decision Aids: An Update from the International Patient Decision Aid Standards
Authors: Muscat Danielle M. , Smith Jenna , Mac Olivia , Cadet Tamara , Giguere Anik , Housten Ashley J. , Langford Aisha T. , Smith Sian K. , Durand Marie-Anne , McCaffery Kirsten
Published: May 2021

Background

There is increasing recognition of the importance of addressing health literacy in patient decision aid (PtDA) development.

Purpose

An updated review as part of IPDAS 2.0 examined the extent to which PtDAs are designed to meet the needs of people with low health literacy/socially-disadvantaged populations.

Data Sources

Reference lists of Cochrane reviews of randomized controlled trials (RCTs) of PtDAs (2014, 2017, and upcoming 2021 versions).

Study Selection

RCTs that assessed the impact of PtDAs on low health literacy or other socially-disadvantaged groups (i.e., ≥50% participants from socially-disadvantaged groups and/or subgroup analysis in socially-disadvantaged group/s).

Data Extraction

Two researchers independently extracted data into a standardized form including PtDA development and evaluation details. We searched online repositories and emailed authors to access PtDAs to verify grade reading level, understandability, and actionability.

Data Synthesis

Twenty-five of 213 RCTs met the inclusion criteria, illustrating that only 12% of studies addressed the needs of low health literacy or other socially-disadvantaged groups. Grade reading level was calculated in 8 of 25 studies (33%), which is recommended in previous IPDAS guidelines. We accessed and independently assessed 11 PtDAs. None were written at sixth-grade level or below. Ten PtDAs met the recommended threshold for understandability, but only 5 met the recommended threshold for actionability. We also conducted a post hoc subgroup meta-analysis and found that knowledge improvements after receiving a PtDA were greater in studies that reported using strategies to reduce cognitive demand in PtDA development compared with studies that did not (χ2 = 14.11, P = 0.0002, I2 = 92.9%).

Limitations

We were unable to access 13 of 24 PtDAs. Conclusions. Greater attention to health literacy and socially-disadvantaged populations is needed in the field of PtDAs to ensure equity in decision support.
Effectiveness of Face Masks in Reducing the Spread of COVID-19: A Model-Based Analysis
Authors: Rao Isabelle J. , Vallon Jacqueline J. , Brandeau Margaret L.
Published: May 2021

Background

The World Health Organization and US Centers for Disease Control and Prevention recommend that both infected and susceptible people wear face masks to protect against COVID-19.

Methods

We develop a dynamic disease model to assess the effectiveness of face masks in reducing the spread of COVID-19, during an initial outbreak and a later resurgence, as a function of mask effectiveness, coverage, intervention timing, and time horizon. We instantiate the model for the COVID-19 outbreak in New York, with sensitivity analyses on key natural history parameters.

Results

During the initial epidemic outbreak, with no social distancing, only 100% coverage of masks with high effectiveness can reduce the effective reproductive number [Formula: see text] below 1. During a resurgence, with lowered transmission rates due to social distancing measures, masks with medium effectiveness at 80% coverage can reduce [Formula: see text] below 1 but cannot do so if individuals relax social distancing efforts. Full mask coverage could significantly improve outcomes during a resurgence: with social distancing, masks with at least medium effectiveness could reduce [Formula: see text] below 1 and avert almost all infections, even with intervention fatigue. For coverage levels below 100%, prioritizing masks that reduce the risk of an infected individual from spreading the infection rather than the risk of a susceptible individual from getting infected yields the greatest benefit.

Limitations

Data regarding COVID-19 transmission are uncertain, and empirical evidence on mask effectiveness is limited. Our analyses assume homogeneous mixing, providing an upper bound on mask effectiveness.

Conclusions

Even moderately effective face masks can play a role in reducing the spread of COVID-19, particularly with full coverage, but should be combined with social distancing measures to reduce [Formula: see text] below 1. [Box: see text]
Association between joint effusions and concomitant structural injuries (tendinitis and structural injury) on MRI in ankle trauma without fracture
Authors: Choi Yeon Gyu , Park Hee Jin , Kim Ji Na , Kim Myung Sub , Park Se Jin , Hong Seok Woo , Kim Young Hwan
Published: May 2021

Background

The evaluation of correlations among joint effusion, ligament injuries, tenosynovitis and osteochondral lesion of talus (OLT) in the ankle joint is important for developing a treatment plan and predicting prognosis.

Purpose

To evaluate correlations among tibiotalar (anterior) and talocalcaneal (posterior) joint effusion, tenosynovitis of major flexor tendons, ligaments, and OLT in a group of patients with ankle trauma.

Material and Methods

This retrospective study included 101 patients with ankle trauma who underwent magnetic resonance imaging. Two radiologists assessed the presence and amount of effusion in the tibiotalar and talocalcaneal joints from grade 0 to 2, according to the amount of capsular distension. Concomitant structural injuries were assessed in the tibialis posterior (TP), flexor digitorum longus, flexor hallucis longus, and peroneus tendons, and the anterior talofibular ligament, calcaneofibular ligament, anteroinferior tibiofibular ligament, posteroinferior tibiofibular ligament, and OLT.

Results

The proportion of anterior and posterior joint effusion according to grade was 67.3% for anterior joint effusion grade 0, 22.8% for grade 1, and 9.9% for grade 2; for posterior joint effusion, grade 0 was 74.2%, grade 1 was 22.8%, and grade 2 was 3.0%. We found statistically significant correlations between posterior joint effusion and tenosynovitis of TP ( P < 0.05) and between posterior joint effusion and OLT ( P < 0.05).

Conclusion

Posterior joint effusion is correlated with TP injury and OLT; however, tendon injuries have no correlation with other structural injuries of the ankle joint in a general population with ankle trauma.
Granulomatous orchitis: case report and review of the literature
Authors: Liang Liu , Jiajia Wang , Shoubin Li , Yufeng Qi , Gang Wang , Junjiang Liu
Published: May 2021

We report the disease characteristics, diagnosis, and treatment of granulomatous orchitis. A 38-year-old man presented with a history of intermittent swelling, pain, and discomfort in the right testicle of 3 days’ duration. Unenhanced magnetic resonance imaging (MRI) of the testis and scrotum revealed an oval mass in the right testis measuring approximately 17 mm in diameter, with clear borders and a target ring-like appearance from periphery to center. T1-weighted imaging (T1WI) showed uniform low-intensity signals, and T2WI showed mixed high- and low-intensity signals. Diffusion-weighted imaging (DWI) signals were iso-intense, and the outer ring on enhanced scans showed progressive enhancement. We performed radical resection of the right testis under combined spinal–epidural anesthesia. The pathological diagnosis was granulomatous right orchitis. Two months postoperatively, ultrasonography showed no testis and epididymal echo signals in the right scrotum, and no obvious abnormalities; color Doppler blood flow imaging (CDFI) findings were normal. Granulomatous orchitis is rare in clinical practice, and the cause is unknown. The disease involves non-specific inflammation; however, it is currently believed that antibiotics and steroids are ineffective for conservative treatment, and orchiectomy should be actively performed.
Effects of alpha-lipoic acid treatment on serum progranulin levels and inflammatory markers in diabetic neuropathy
Authors: Nádró Bíborka , Lőrincz Hajnalka , Molnár Ágnes , Szentpéteri Anita , Zöld Eszter , Seres Ildikó , Páll Dénes , Paragh György , Kempler Péter , Harangi Mariann , Sztanek Ferenc
Published: May 2021

Objectives

Progranulin (PGRN) is a secreted growth factor that helps to regulate neuronal survival by blocking tumor necrosis factor-alpha (TNFα) receptors. The antioxidant alpha-lipoic acid (ALA) is used in diabetic neuropathy to improve nerve conduction and relieve neuropathic pain, but its effects on PGRN levels have not yet been elucidated.

Methods

In this prospective study, 54 patients with type 2 diabetes and peripheral neuropathy received 600 mg of ALA daily for 6 months. Twenty-four patients with diabetes without neuropathy were also included in the study. Serum PGRN and TNFα levels were determined using enzyme-linked immunosorbent assays. In addition, current perception threshold (CPT) testing was used to assess sensory neuropathy.

Results

After ALA treatment, serum PGRN levels were significantly increased and CPT values were significantly improved. Furthermore, there were significant positive correlations among TNFα, ICAM-1, and PGRN levels both before and after ALA treatment. A significant negative correlation was observed between the improvements in CPT and the PGRN levels. Furthermore, ICAM-1 levels were an independent predictor of PGRN levels.

Conclusions

Changes in serum PGRN levels indicate that ALA treatment may have beneficial effects on endothelial function and neuronal inflammation.
Evaluation of the construct reliability and validity of the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Chinese version in maintenance hemodialysis patients
Authors: Ma Shao-Jun , Wang Wen-Ji , Tang Min , Chen Han , Ding Feng
Published: May 2021

Objective

The study aim was to assess the construct reliability and validity of the internal structure of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Self-Rated Level 1 Cross-Cutting Symptom Measure (CCSM)-Chinese version in maintenance hemodialysis (MHD) patients, and to clarify whether the CCSM is suitable for patients with psychological issues.

Methods

Participants were 190 MHD patients. Structural equation modelling was used to establish a measurement model to confirm the reliability and validity of the internal structure of the CCSM-Chinese version, and to compare it with the Chinese version of the Symptom Checklist-90 (SCL-90).

Results

Of the 13 CCSM domains, 8 showed stability and validity in the initial screening of psychological symptoms. Although the Chinese version of the SCL-90 is widely used, the measurement model of the 8-domain CCSM was a better fit than the SCL-90 (CCSM: chi-square = 35.668, chi-square/degrees of freedom [CMIN/df] = 1.877; root mean square error of approximation [RMSEA]  = 0.061; adjusted goodness of fit index [AGFI] = 0.931 vs. SCL-90: chi-square = 89.159, CMIN/df = 2.972; RMSEA = 0.084; AGFI = 0.879).

Conclusion

The Chinese version of the CCSM is a useful rapid screening tool to detect psychological symptom risk in MHD patients.
Pancreatic pseudocyst, pancreatitis, and incomplete pancreas divisum in a child treated with endotherapy: a case report
Authors: Yan Jingxin , Zhang Zheheng , Wang Zhixin , Yu Wenhao , Xu Xiaolei , Wang Yaxuan , Fan Haining
Published: May 2021

Pancreatic divisum (PD) is caused by the lack of fusion of the pancreatic duct during the embryonic period. Considering the incidence rate of PD, clinicians lack an understanding of the disease, which is usually asymptomatic. Some patients with PD may experience recurrent pancreatitis and progress to chronic pancreatitis. Recently, a 13-year-old boy presented with pancreatic pseudocyst, recurrent pancreatitis, and incomplete PD, and we report this patient’s clinical data regarding the diagnosis, medical imagining, and treatment. The patient had a history of recurrent pancreatitis and abdominal pain. Magnetic resonance cholangiopancreatography was chosen for diagnosis of PD, pancreatitis, and pancreatic pseudocyst, followed by endoscopic retrograde cholangiopancreatography, minor papillotomy, pancreatic pseudocyst drainage, and stent implantation. In the follow-up, the pseudocyst lesions were completely resolved, and no recurrent pancreatitis has been observed.
Predictors of early postoperative hypocalcemia in patients with secondary hyperparathyroidism undergoing total parathyroidectomy
Authors: Gong Wei , Lin Yaqi , Xie Yu , Meng Zilu , Wang Yudong
Published: May 2021

Objective

To summarize the clinical features of secondary hyperparathyroidism (SHPT) in patients with chronic renal failure and to explore the predictive factors of postoperative hypocalcemia after total parathyroidectomy in these patients.

Methods

The clinical data of 87 patients admitted to Guangdong Electric Power Hospital from May 2013 to February 2020 were reviewed. All patients underwent total parathyroid resection and sternocleidomastoid microtransplantation. Age, sex, and the serum calcium, phosphorus, alkaline phosphatase (ALP), and intact parathyroid hormone (iPTH) concentrations were analyzed as predictive factors of postoperative hypocalcemia.

Results

Bone pain was the most common clinical manifestation in this study population, and all 87 patients experienced relief from their clinical symptoms after the surgical procedure. Age and the preoperative serum calcium, ALP, and iPTH concentrations were determined to be early predictive factors of postoperative hypocalcemia.

Conclusions

Age and the preoperative calcium, ALP, and iPTH concentrations are independent risk factors for postoperative hypocalcemia in patients with SHPT and renal disease who undergo total parathyroidectomy with sternocleidomastoid microtransplantation. These factors can help identify high-risk patients who can be managed by a multidisciplinary team to improve graft survival and quality of life.
Diagnostic value of pulse oximetry combined with cardiac auscultation in screening congenital heart disease in neonates
Authors: Song Jiajia , Huang Xianping , Zhao Shenzhi , Chen Jiajia , Chen Ruiheng , Wu Guowei , Xu Zhangye
Published: May 2021

Objective

This study aimed to investigate the feasibility and reliability of pulse oximetry combined with cardiac auscultation in screening neonatal congenital heart disease (CHD).

Methods

This was a retrospective, observational, screening study. All newborns included in the study were at the Second Affiliated Hospital of Wenzhou Medical University from July 2019 to January 2020. Primary screening of CHD was conducted by pulse oximetry combined with cardiac auscultation assays. Indices, including sensitivity, specificity, the positive/negative predictive value, the positive/negative likelihood ratio, and the diagnostic odds ratio, were calculated. The area under the relative operating characteristic curve of the subjects was measured.

Results

A total of 3327 neonates were enrolled, among whom 139 were diagnosed with CHD and the incidence of CHD was 4.2%. The sensitivity, specificity, diagnostic odds ratio, and area under the relative operating characteristic curve of pulse oximetry combined with cardiac auscultation were 89.9%, 94.7%, 169.0, and 0.923, respectively.

Conclusions

Pulse oximetry combined with cardiac auscultation is a novel screening method with acceptable accuracy and feasibility for neonatal CHD. This combination method is worth promoting widely.
Rheumatologists’ understanding of refractory gout: a questionnaire survey in China
Authors: Han Xinxin , Yin Yue , Cao Yu , Chu Xiaotian , Han Yingdong , Di Hong , Xu Na , Zhang Yun , Zeng Xuejun
Published: May 2021

Objective

To explore the understanding of refractory gout in Chinese rheumatologists.

Methods

We conducted an anonymous survey of rheumatologists attending an annual national academic conference on rheumatism.

Results

Of the 910 rheumatologists who completed the questionnaire, 751 (82.5%) had received relevant continuing medical education (CME). Of these, 140 (18.6%) rheumatologists did not select xanthine oxidase inhibitors as the first treatment for patients with chronic tophaceous gout. Of all respondents, 113 (12.4%), 251 (27.6%) and 324 (35.6%) prescribed incorrect maximum doses of allopurinol, febuxostat and benzbromarone, respectively; this tendency was more pronounced in the non-CME group. Most rheumatologists agreed that complications and comorbidities increased the difficulty of gout management and considered the term refractory gout to describe those cases with uncontrolled symptoms, unmet treatment targets or non-shrinkage of tophi after standardized drug treatment. Moreover, 62.8% (472/751) of specialists considered that a diagnosis of refractory gout was appropriate for patients whose lifestyle and compliance failed to improve despite adequate education and regular urate-lowering therapy.

Conclusions

Incorrect and inadequate drug therapy may contribute to some cases of refractory gout, especially in physicians without CME. An emphasis on non-drug therapy and the management of comorbidities and complications may reduce cases of refractory gout.
Addition of low-dose sufentanil to ropivacaine for reducing shivering and visceral traction pain during cesarean section
Authors: Chen Xiao-Rong , Gao Tao , Zhang Yin , Peng Ming-Qing
Published: May 2021

Objective

To investigate the efficacy of low-dose sufentanil for preventing shivering and visceral traction pain during cesarean section under spinal anesthesia.

Methods

This was a prospective, randomized, controlled study. A total of 112 full-term parturients who underwent elective caesarean delivery were randomly divided into two groups. Group R received 0.75% isobaric ropivacaine intrathecally and group RS received 0.75% isobaric ropivacaine plus 5 µg sufentanil intrathecally.

Results

There were no significant differences in the maximum sensory block time, motor block time, duration of the surgery, and heart rate, mean arterial pressure, and blood oxygen saturation before and 1, 5, and 10 minutes after spinal anesthesia, and at the end of the surgery between the two groups. Shivering was significantly more common in group R (n = 30) than in group RS (n = 8). The incidence of visceral traction pain in group R (46.43%) was significantly higher than that in group RS (14.29%). There was no significant difference in the newborns’ Apgar scores between the groups.

Conclusion

Adding low-dose sufentanil to ropivacaine can significantly reduce the incidence of shivering and visceral traction pain after spinal anesthesia.
Gastric cancer with repeated metastasis in the colonic lumen: a case report and multi-surgical experience
Authors: Wang Yi , Ma Peiqing , Liu Kan , Xu Dongkui , Liu Qian
Published: May 2021

Poorly differentiated gastric adenocarcinoma is commonly associated with lymph node metastasis, peritoneal spread, and liver metastasis but rarely with intraintestinal metastasis. Most patients with metastatic gastric carcinoma are unable to undergo surgical treatment and have a poor prognosis. A 42-year-old man with hunger-related abdominal pain was diagnosed as having gastric cancer. After the first surgery (distal partial gastrectomy) and the second surgery (gastric stump carcinoma (GSC) resection), the patient suffered repeated multiple intracolonic metastases and underwent three additional resection operations. The patient survived for 154 months after the first operation. In patients with gastric carcinoma that metastasizes to the colonic lumen, radical resection, if possible, can extend survival. Once patients develop extensive extraintestinal metastasis, radical resection cannot be performed, and patients often exhibit a poor prognosis.
Association of serum irisin concentration with thyroid autoantibody positivity and subclinical hypothyroidism
Authors: Chen Zhengyi , Zhang Qiao , Peng Nianchun , Hu Ying , Li Hong , He Xi , Liu Ruoyi , Xu Shujing , Zhang Miao , Shi Lixin
Published: May 2021

Objective

This study evaluated the association of serum irisin level with thyroid autoantibody (TAA) positivity and subclinical hypothyroidism (SH).

Methods

In this cross-sectional study, 334 participants were assigned to one of the following four age- and sex-matched groups: TAA plus SH (84 patients), isolated TAA (83 patients), isolated SH (83 patients), or healthy controls (84 individuals). Irisin and creatine kinase (CK) were measured in serum samples.

Results

Patients with TAA plus SH, isolated TAA, and isolated SH had higher irisin levels compared with the controls. There was a significant increase in the irisin level in the TAA plus SH group compared with the control group. Among all participants, the irisin levels were positively associated with thyroglobulin and thyroid peroxidase antibody titers and high-density lipoprotein cholesterol levels, but negatively associated with waist circumference, glycated hemoglobin levels, and fasting plasma glucose levels. The irisin level was not associated with the thyroid-stimulating hormone, free thyroxine, or CK levels. Irisin levels were independently associated with TAA, with or without SH, but they were not associated with SH alone.

Conclusions

Irisin level may help to predict the risk of developing TAA with or without SH.
Necrotizing soft tissue infection: clinical characteristics, diagnosis, and management of 32 cases in Beijing
Authors: Cui Zhen , Lu Shuai , Bai Ying , Sun Xu , Tian Peng , Liu Ying , Mao Lu , Jiang Xieyuan
Published: May 2021

Objective

Necrotizing soft tissue infection (NSTI) is a rare but life-threatening bacterial infection. This study was performed to analyze the clinical characteristics of patients with NSTI admitted to the intensive care unit of a trauma and burn center in Beijing and to summarize the treatment experience.

Methods

This retrospective study involved patients with NSTI admitted to the intensive care unit from January 2010 to January 2020. The clinical manifestations, pathogens, laboratory test results, and prognosis were compared between survivors and nonsurvivors.

Results

Thirty-two patients were enrolled (28 men, 4 women), including 25 (78.1%) survivors and 7 (21.9%) nonsurvivors. The patients’ median age was 41.5 years (range, 30.0–52.5 years). Mortality was significantly higher in patients with a blood urea nitrogen concentration of ≥11.5 mg/dL, creatinine concentration of <3.4 mg/dL, prothrombin time of ≥15.9 s, and international normalized ratio of ≥1.3. Streptococcus pyogenes and Clostridium perfringens infections were associated with higher mortality.

Conclusions

More attention should be given to elderly patients and those with hyponatremia, coagulation disorder, and higher blood urea nitrogen or creatinine concentrations. The finding of large gram-positive rods or large numbers of gram-positive cocci in wound secretion smears is a helpful early warning sign of highly lethal NSTI.