bluuebunny/crossref_metadata_2025 huggingface dataset:
Congestive Heart Failure Patients’ Pulse Rate Progression and Time to Death at Debre Tabor Referral Hospital, Ethiopia
Authors: Belay Alebachew Taye , Belay Denekew Bitew , Gebremichael Shewayiref Geremew , Agegn Setegn Bayabil
Published: November 2021

Background. Heart failure is a progressive condition marked by worsening symptoms such as shortness of breath, coughing, exhaustion and lethargy, fluid retention with swelling of the legs and abdomen, and a reduced ability to exercise. As a result, this study aims to use a joint model application to determine the joint risk factors of longitudinal change in pulse rate and time to death of congestive heart failure patients and their association admitted to a hospital. Methods. A retrospective study was undertaken on congestive heart failure patients admitted to the Debre Tabor Referral Hospital from January 2016 to December 2019. A statistical joint modeling strategy was employed to match the repeated biomarker pulse rate and a survival outcome at the same time. A total of 271 patients with congestive heart failure were chosen. Data were analyzed with R statistical software via joineRML. Results. According to the findings, the association between longitudinal changes in pulse rate and time to death in heart failure patients is statistically significant. Sex, residence, left ventricular injection fraction, New York Heart Association class, and diabetes mellitus were all found to be significant risk factors for congestive heart failure patients’ short survival time to death. Age, sex, residence, hypertension, left ventricular injection fraction, congestive heart failure, diabetes mellitus, tuberculosis, and etiology were all significant contributors in pulse rate progression. Conclusion. The computed association parameters revealed subject-specific values. The subject-specific linear time slope of PR measurement was positively related to the hazard rate of time to death of CHF patients in the study area. To reduce the risk level of CHF, health professionals, governmental organizations, and nongovernmental organizations must promote and allocate a suitable amount of budget for the treatment of CHF patients.
Role of Vitamin D in Systemic Sclerosis: A Systematic Literature Review
Authors: Diaconu Alexandra-Diana , Ostafie Iustina , Ceasovschih Alexandr , Șorodoc Victorița , Lionte Cătălina , Ancuța Codrina , Șorodoc Laurențiu
Published: November 2021

Background. Systemic sclerosis (SSc) is a chronic multisystem autoimmune condition defined by a complex pathobiology, comprising excessive fibrosis of skin and internal organs, peripheral vasculopathy with endothelial cell dysfunction, inadequate vascular repair and neovascularization, and aberrant immunity. Vitamin D is a steroid hormone with pleiotropic effects beyond its traditional role in calcium and bone homeostasis. Since vitamin D has immunomodulatory, cardioprotective, and antifibrotic properties, it could potentially interfere with SSc pathogenesis. Suboptimal vitamin D levels are classically recognized in scleroderma, irrespective of clinical and serological phenotype. Aim. This systematic review is aimed at investigating and clarifying the role of vitamin D in SSc and emphasizing the association of vitamin D status with different clinical settings. Methods and Results. A systematic online search was performed, using PubMed databases to collect articles on the topic of vitamin D in SSc. The final analysis included 40 eligible articles. Conclusions. Hypovitaminosis D is common in SSc patients and could be associated with clinical and serologic patterns of the disease. Intervention for low serum vitamin D levels in SSc pathogenesis remains controversial, as well as the significance of vitamin D supplementation in such patients.
Spiral Computed Tomography in the Quantitative Measurement of the Adjacent Structure of the Left Atrial Appendage in Patients with Atrial Fibrillation
Authors: Zhang Zhen , Yan Wei
Published: November 2021

Cardiac arrhythmias are common clinical cardiovascular diseases. Arrhythmias are abnormalities in the frequency, rhythm, site of origin, conduction velocity, or sequence of excitation of the cardiac impulses. Arrhythmia mechanisms include foldback, altered autonomic rhythm, and triggering mechanisms. It can cause palpitations, dizziness, black dawn, syncope, and angina pectoris and can worsen a preexisting cardiac disease, reduce the quality of life, and increase mortality. Also, by making it one of the constant challenges for the clinical cardiovascular physician, we can get more information. The study included 94 patients with atrial fibers, including 56 men and 38 women aged 57, 46, 11, and 68 years. There are 80 patients with nonatrial fibers, including 44 men and 36 women aged 56, 10, and 83 years. Those who can perform a normal coronary angiography and exclude congenital heart disease, heart valve disease, and other cardiovascular diseases. In both groups, a 256-layer spiral CT examination was performed. A pulmonary vein scanning protocol was applied to the patients with atrial fibrillation, and this can perform normal coronary angiography and exclude those with cardiovascular diseases such as congenital heart disease and valvular heart disease. The purpose of this study is to investigate the anatomical changes of the left atrium and its adjacent structures by applying the 256 nm spiral CT imaging to visualize the left atrium and its adjacent structures and by applying the MPR technology, VR technology, and simulation endoscope techniques.
In Silico Epitope Prediction Analyses Highlight the Potential for Distracting Antigen Immunodominance with Allogeneic Cancer Vaccines
Authors: James C. Alston , Ronning Peter , Cullinan Darren , Cotto Kelsy C. , Barnell Erica K. , Campbell Katie M. , Skidmore Zachary L. , Sanford Dominic E. , Goedegebuure S. Peter , Gillanders William E. , Griffith Obi L. , Hawkins William G. , Griffith Malachi
Published: November 2021

Allogeneic cancer vaccines are designed to induce antitumor immune responses with the goal of impacting tumor growth. Typical allogeneic cancer vaccines are produced by expansion of established cancer cell lines, transfection with vectors encoding immunostimulatory cytokines, and lethal irradiation. More than 100 clinical trials have investigated the clinical benefit of allogeneic cancer vaccines in various cancer types. Results show limited therapeutic benefit in clinical trials and currently there are no FDA-approved allogeneic cancer vaccines. We used recently developed bioinformatics tools including the pVACseq suite of software tools to analyze DNA/RNA-sequencing data from the The Cancer Genome Atlas to examine the repertoire of antigens presented by a typical allogeneic cancer vaccine, and to simulate allogeneic cancer vaccine clinical trials. Specifically, for each simulated clinical trial, we modeled the repertoire of antigens presented by allogeneic cancer vaccines consisting of three hypothetical cancer cell lines to 30 patients with the same cancer type. Simulations were repeated ten times for each cancer type. Each tumor sample in the vaccine and the vaccine recipient was subjected to human leukocyte antigen (HLA) typing, differential expression analyses for tumor-associated antigens (TAA), germline variant calling, and neoantigen prediction. These analyses provided a robust, quantitative comparison between potentially beneficial TAAs and neoantigens versus distracting antigens present in the allogeneic cancer vaccines. We observe that distracting antigens greatly outnumber shared TAAs and neoantigens, providing one potential explanation for the lack of observed responses to allogeneic cancer vaccines. This analysis provides additional rationale for the redirection of efforts toward a personalized cancer vaccine approach.

Significance:

A comprehensive examination of allogeneic cancer vaccine antigen repertoire using large-scale genomics datasets highlights the large number of distracting antigens and argues for more personalized approaches to immunotherapy that leverage recent strategies in tumor antigen identification.
Pediatric Cranioplasty Using Hydroxyapatite Cement: A Retrospective Review and Preliminary Computational Model
Authors: Alshareef Mohammed , Alshareef Ahmed , Vasas Tyler , Shingala Aakash , Cutrone Jonathan , Eskandari Ramin
Published: November 2021

Introduction: Cranioplasty is a standard technique for skull defect repair. Restoration of cranial defects is imperative for brain protection and allowing for homeostasis of cerebral spinal fluid within the cranial vault. Calcium phosphate hydroxyapatite (HA) is a synthetic-organic material that is commonly used in cranioplasty. We evaluate a patient series undergoing HA cement cranioplasty with underlying bioresorbable mesh for various cranial defects and propose a preliminary computational model for understanding skull osteointegration. Methods: A retrospective review was performed at the institution for all pediatric patients who underwent HA cement cranioplasty. Seventeen patients were identified, and success of cranioplasty was determined based on clinical and radiographic follow-up. A preliminary computational model was developed using bone growth and scaffold decay equations from previously published literature. The model was dependent on defect size and shape. Patient data were used to optimize the computational model. Results: Seventeen patients were identified with an average age of 6 ± 5.6 years. Average defect size was 11.7 ± 16.8 cm2. Average time to last follow-up computer tomography scan was 10 ± 6 months. Three patients had failure of cranioplasty, all with a defect size above 15 cm2. The computational model developed shows a constant decay rate of the scaffold, regardless of size or shape. The bone growth rate was dependent on the shape and number of edges within the defect. Thus, a star-shaped defect obtained a higher rate of growth than a circular defect because of faster growth rates at the edges. The computational simulations suggest that shape and size of defects may alter success of osteointegration. Conclusion: Pediatric cranioplasty is a necessary procedure for cranial defects with a relatively higher rate of failure than adults. Here, we use HA cement to perform the procedure while creating a preliminary computational model to understand osteointegration. Based on the findings, cranioplasty shape may alter the rate of integration and lead to higher success rates.
Museus em retirada: até onde vai o pluralismo das instituições?
Authors: Mesquita Tiago
Published: November 2021

Em 21 de setembro de 2020, a exposição itinerante “Philip Guston Now” foi adiada nos Estados Unidos e na Inglaterra. O artigo tenta entender as razões da reação e a dificuldade das instituições de enfrentar as contradições apontadas pelos novos movimentos sociais.
Aneurysm and Artery Dissection Following the Use of Vascular Endothelial Growth Factor Inhibitor: A Real‐World Analysis Using a Spontaneous Reporting System
Authors: Wang Shuyue , Chen Mingzhu , Zhang Xinghui , Zhang Lingjian , Jia Min , Shen Zhiwen , Wang Junyan , Zhao Bin , Gong Yang , Gong Jian
Published: November 2021

Background

Pharmacological inhibition of angiogenesis via the vascular endothelial growth factor pathway is an important therapeutic target that prevents tumor growth and the formation of metastases. Although vascular endothelial growth factor inhibitor (VPI) is well understood as a well‐defined safety profile, few real‐world studies are comparing the incidence, clinical features, and prognosis of the aneurysm and artery dissection.

Methods and Results

To evaluate and compare the links between different VPIs and aneurysm and artery dissection, we identified 634 reports with VPIs in the US Food and Drug Administration Adverse Event Reporting System database ranging between January 2004 to March 2020. We used the reporting odds ratio for the association between the use of VPIs and aneurysm and artery dissection. The reporting odds ratio (3.68, 95%, 2.18‒6.23) shows that ramucirumab has a stronger correlation than other VPIs. The results show a significant difference in onset time (
P
<0.001). The median time to aneurysm and artery dissection was 79.5 (interquartile interval, 19.0–273.5) days after VPI administration. The results also show that VPI‐associated aneurysm and artery dissection was reported more often in men (n=336, 59.68% versus n=227, 40.32%), and there were more cases in patients aged between 45 to 74 years than those <45 years (n=312, 68.12% versus n=18, 3.93%); patients aged ≥75 years accounted for 27.95% (n=128). Finally, the suspected drugs generally led to 19.98% deaths and 29.81% hospitalizations.

Conclusions

We identified signals for aneurysm and artery dissection following various VPIs in real‐world practice via the Food and Drug Administration Adverse Event Reporting System, which represents the first step for continued pharmacovigilance investigation.
Relationship Between the Ratio of Acceleration Time/Ejection Time and Mortality in Patients With High‐Gradient Severe Aortic Stenosis
Authors: Altes Alexandre , Thellier Nicolas , Bohbot Yohann , Ringle Griguer Anne , Verdun Stéphane , Levy Franck , Castel Anne Laure , Delelis François , Mailliet Amandine , Tribouilloy Christophe , Maréchaux Sylvestre
Published: November 2021

Background

The ratio of acceleration time/ejection time (AT/ET) is a simple and reproducible echocardiographic parameter that integrates aortic stenosis severity and its consequences on the left ventricle. No study has specifically assessed the prognostic impact of AT/ET on outcome in patients with high‐gradient severe aortic stenosis (SAS) and no or mild symptoms. We sought to evaluate the relationship between AT/ET and mortality and determine the best predictive AT/ET cutoff value in these patients.

Methods and Results

A total of 353 patients (median age, 79 years; 46% women) with high‐gradient (mean pressure gradient ≥40 mm Hg and/or aortic peak jet velocity ≥4 m/s) SAS, left ventricular ejection fraction ≥50%, and no or mild symptoms were studied. The impact of AT/ET ≤0.35 or >0.35 on all‐cause mortality was retrospectively studied. During a median follow‐up of 39 (25th–75th percentile, 23–62) months, 70 patients died. AT/ET >0.35 was associated with a considerable increased mortality risk after adjustment for established prognostic factors in SAS under medical and/or surgical management (adjusted hazard ratio [HR], 2.54; 95% CI, 1.47–4.37;
P
<0.001) or conservative management (adjusted HR, 3.29; 95% CI, 1.70–6.39;
P
<0.001). Moreover, AT/ET >0.35 improved the predictive performance of models including established risk factors in SAS with better global model fit, reclassification, and discrimination. After propensity matching, increased mortality risk persisted when AT/ET >0.35 (adjusted HR, 2.10; 95% CI, 1.12–3.90;
P
<0.001).

Conclusions

AT/ET >0.35 is a strong predictor of outcome in patients with SAS and no or only mild symptoms and identifies a subgroup of patients at higher risk of death who may derive benefit from earlier aortic valve replacement.
Effects of Renin‐Angiotensin–Aldosterone System Inhibitors on Long‐Term Major Adverse Cardiovascular Events in Sepsis Survivors
Authors: Ou Shu‐Yu , Lee Yi‐Jung , Lo Yuan , Chen Chen‐Hsiu , Huang Yu‐Chi , Kuo Yu‐Ting , Chia Yuan‐Yi
Published: November 2021

Background

Sepsis is known to increase morbidity and duration of hospital stay and is a common cause of mortality worldwide. Renin‐angiotensin‐aldosterone system inhibitors (RAASis) are commonly used to treat hypertension but are usually discontinued during hospitalization for sepsis because of concerns about renal hypoperfusion. The aim of our study was to investigate whether RAASis should be continued after discharge in sepsis survivors and to identify the effects on the clinical outcomes.

Methods and Results

A total of 9188 sepsis survivors aged 20 years and older who were discharged from January 1, 2012 to December 31, 2019 were included in our analyses. We further divided sepsis survivors into RAASi users and nonusers. These groups were matched by propensity scores before the outcomes of interest, including all‐cause mortality and major adverse cardiac events (MACE), were examined. After propensity score matching, 3106 RAASi users and 3106 RAASi nonusers were included in our analyses. Compared with RAASi nonusers, RAASi users had lower risks of all‐cause mortality (hazard ratio [HR], 0.68; 95% CI, 0.62–0.75), MACEs (HR, 0.87; 95% CI, 0.81–0.94), ischemic stroke (HR, 0.85; 95% CI, 0.76–0.96), myocardial infarction (HR, 0.74; 95% CI, 0.61–0.90), and hospitalization for heart failure (HR, 0.84; 95% CI, 0.77–0.92). Subgroup analyses stratified by admission to the ICU and the use of inotropes showed similar results.

Conclusions

In our study, we found that RAASi users had reduced risks of all‐cause mortality and MACEs. These findings suggested a beneficial effect of RAASi use by sepsis survivors after discharge.
Phenomenology, Scientific Method and the Transformation Problem
Authors: Lopes Jesse , Byron Chris
Published: November 2021

We argue in this article that Marx’s scientific method coupled with his analysis of the phenomenological consciousness of agents trapped within the capitalist mode of production provides a sufficient solution to the transformation problem. That is, Marx needs no amending – mathematical, philosophical, or otherwise – and the tools he uses to demonstrate and resolve the problem – science and phenomenology – were already clearly spelled out in his texts. Critics of Marx either fail to understand his scientific method, or are themselves trapped within a non-scientific capitalist phenomenology. Similarly, Marxists that mathematically resolve the transformation problem fail to realise that Marx’s scientific analysis alone demonstrates that a mathematical solution to the transformation problem is a misapprehension of the relation between Marx’s abstract theory and concrete phenomena. Consequently, we also criticise the monetary theorists who try to dismiss the problem as pointless by claiming that Marx was not a pre-monetary theorist.
Reply to Comments (Contemporary Pragmatism, 2021)
Authors: Frega Roberto
Published: November 2021

These are the replies to critics on my book Pragmatism and the wide view of democracy.
Pushing Social Philosophy to Its Democratic Limits
Authors: Hogan Brendan
Published: November 2021

Roberto Frega’s Pragmatism and the Wide View of Democracy reformulates the question of democracy posed by our current historic conjuncture using the resources of a variety of pragmatic thinkers. He brings into the contemporary conversation regarding democracy’s fortunes both classical and somewhat neglected figures in the pragmatic tradition to deal with questions of power, ontology, and politics. In particular, Frega takes a social philosophical starting point and draws out the consequences of this fundamental shift in approach to questions of democratic and political theory. This turn to social philosophy as a theoretically more sufficient conceptual vocabulary, extended in detail by Frega, raises questions regarding the work that a social ontology does in clarifying the role of economic and political approaches to democracy that are worth further exploration. Likewise, the practical proposals for moving beyond methodological nationalism with respect to forming publics for the sake of problem-solving, while providing a clarifying and fresh starting point, are still too beholden to models of agency and expressions of coordinated action that themselves are the very fruit of those systems which undermine democratic power in the first instance.
Compensation for Wrongful Conviction/Miscarriage of Justice in Hong Kong in Light of A v Secretary for Justice and Another [2020] hkcfi 427; hcal 176/2018 (11 March 2020)
Authors: Mujuzi Jamil Ddamulira
Published: November 2021

Article 14(6) of the International Covenant on Civil and Political Rights (iccpr) provides for the right to compensation for wrongful conviction or miscarriage of justice. In Hong Kong, there are two compensation schemes for people who have been wrongfully convicted – the statutory scheme under Article 11(5) of the Bill of Rights Ordinance and the ex gratia scheme (also applicable to wrongful imprisonment). Although there are cases in which Hong Kong courts have dealt with the right to compensation under the ex gratia scheme, it was only in March 2020, in A v Secretary for Justice and Another, that the High Court, for the first time, dealt with a case on the right to compensation under Article 11(5). In this article, the author discusses the right to compensation for wrongful conviction in Hong Kong generally and in particular under Article 11(5) of the Bill of Rights Ordinance. The author deals with the case of A v Secretary for Justice and Another and illustrates how the High Court’s interpretation of Article 11(5) of the Bill of Rights Ordinance is likely to impact on the right to compensation for wrongful conviction in Hong Kong in the future.
Euphorbia motuogensis (Euphorbiaceae), a new species from Xizang, China
Authors: LI MAN-TING , LAN XIAO-ZHONG , ZUO YOU-WEI , DENG HONG-PING
Published: November 2021

Euphorbia motuogensis M. T. Li, X. Z. Lan, H. P. Deng & W. L. Zheng, sp. nov., a new species from Motuo, Tibet, China, is described and illustrated here. It is closely similar to Euphorbia sikkimensis in having terete root, alternate leaves, well-developed pseudoumbellate inflorescence, cyathium, smooth and glaborus capsule, but Euphorbia motuogensis is clealy distinguishable by its pilose stems, involucral leaves color, secondary involucral leaves absent, cyathophylls number and color, and five similar glands. Furthermore, molecular phylogenetic analyses of sequences from both nuclear ribosomal ITS confirm that this species is distinct from morphologically similar species in this subgenus.
A new species of the genus Proctogastrolaelaps McGraw & Farrier (Acari: Melicharidae) from the Far East of Russia, and contributions to knowledge of this genus
Authors: JOHARCHI OMID , MARCHENKO IRINA I. , DÖKER ISMAIL , KHAUSTOV VLADIMIR A.
Published: November 2021

We describe a new mite species from the Far East of Russia—Proctogastrolaelaps subsolanus Joharchi & Marchenko sp. nov. (Acari: Melicharidae). The new species was collected from soil-litter on the shores of the Tunaycha Lake and Sea of Okhotsk in Sakhalin Island. The important morphological characteristics of the genus Proctogastrolaelaps are revised.
The clinical and functional outcomes of a large naturalistic cohort of young people accessing national early psychosis services
Authors: Brown Ellie , Gao Caroline X. , Staveley Heather , Williams Georgia , Farrelly Simone , Rickwood Debra , Telford Nic , Papanastasiou Cerissa , McGorry Pat , Thompson Andrew
Published: November 2021

Aims:

Services for individuals with a first episode of psychosis or at ultra-high risk of psychosis have become a treatment model of choice in mental health care. The longitudinal changes in clinical and functional outcomes as a result of real-world treatment remain under-reported.

Methods:

We analysed data from first episode of psychosis and ultra-high risk services delivered across Australian primary youth mental health care services known as headspace between 19 June 2017 and 30 September 2019. Outcome measures were completed and entered into a minimum dataset every 90 days a participant was receiving treatment and included psychiatric symptomatology (Brief Psychiatric Rating Scale and psychological distress, K10) and psychosocial functioning (Social and Occupational Functioning Assessment Scale and My Life Tracker). Linear mixed-effects models were used to evaluate changes in outcome over time.

Results:

Outcome data from a total of 1252 young people were evaluated (643 first episode of psychosis, 609 ultra-high risk). Of those who entered ultra-high risk services, 11.8% transitioned to first episode of psychosis services. Overall, substantial improvement in clinical (Brief Psychiatric Rating Scale, K10) and functional (Social and Occupational Functioning Assessment Scale, My Life Tracker) outcomes were seen across groups and outcomes. Ultra-high risk patients showed a greater reduction in distress symptoms, while first episode of psychosis patients experienced a greater reduction in positive psychosis symptoms. Although clinical outcomes showed a plateau effect after approximately 3 months of care, improvement in functional outcomes (Social and Occupational Functioning Assessment Scale, My Life Tracker) continued later in treatment.

Conclusion:

These findings support the use of real-time, real-world and low-cost administrative data to rigorously evaluate symptomatic and functional outcomes in early psychosis treatment settings. Findings that functional outcomes improve past the remittance of clinical outcomes also support the functional recovery focus of early psychosis services and remaining high levels of distress suggest the need for ultra-high risk services to extend beyond 6 months of care.
Characterizing cassava farmer typologies and their seed sourcing practices to explore opportunities for economically sustainable seed business models in Rwanda
Authors: Kilwinger Fleur , Mugambi Samuel , Manners Rhys , Schut Marc , Tumwegamire Silver , Nduwumuremyi Athanase , Bambara Sylvie , Paauwe Marthe , Almekinders Conny
Published: November 2021

The overdependency on local cassava varieties and informal seed sources by farmers in Rwanda has contributed to the spread of cassava viral diseases. The use of improved planting materials made available through formal seed sources, that assure seed quality, is one way to prevent future disease outbreaks. In order to increase the availability of, and farmers access to, such materials there is increasing interest to develop seed business models. This study aims to understand seed sourcing practices of different farm typologies to inform the development of tailored seed business models. A total of 390 farmers were interviewed and the collected data was analyzed into clusters, resulting in seven farm typologies. Seed sourcing strategies, seed replacement dynamics and purchasing behavior of these typologies were explored via a seed tracing study. We find that more commercial oriented farmers have better access to formal seed sources. Nevertheless, the majority of farmers in all typologies accessed new varieties and quality cassava seed via informal channels. At both formal and informal sources, cash investments in seed were mainly made by the categories of better-off farmers, and were one-time investments to acquire a new variety. Based on farmers current seed sourcing practices, clarifications on the differences between farmers and their willingness-to-pay, the roles of seed degeneration, cost-benefit analysis, value propositions and profit formulas seem important requirements for the further development of viable cassava seed business models. We conclude that tailoring seed business models can have a high potential as it acknowledges differences among farmers, but that careful coordination is needed to ensure that one approach or intervention does not contrast with and/or undermine the others.
Why farmers use so many different maize varieties in West Kenya
Authors: Almekinders Conny J.M. , Hebinck Paul , Marinus Wytze , Kiaka Richard D. , Waswa Wycliffe W.
Published: November 2021

In this article we reflect on the discussions as to whether breeding and seed system development should proceed along its current well established route of developing varieties with a higher agricultural productivity or if the diversity of farmers, their contexts and rationales requires broader approaches. We make use of data from a recently held survey (2018) in West Kenya. The data show that some 80% of the households in the survey planted both local and hybrid maize varieties. The choices that people make about which variety to plant are many. Apart from rainfall, the availability of cash, the promise of a good yield, the presence of projects and programs and the culture of seed also influences these choices. We argue that an inclusive demand-oriented maize breeding and seed system needs to include a range of varieties and seed sources and to develop and support different delivery pathways to fit farmers’ diverse use of seeds and varieties. Our findings also indicate the need for more systematic study of the diversity of farmers’ rationales and the performance of crop varieties. This would provide useful information for all the actors involved.
Processual Validity in Qualitative Research in Healthcare
Authors: Hayashi Paulo , Abib Gustavo , Hoppen Norberto , Wolff Lillian Daisy Gonçalves
Published: November 2021

Knowledge development has been continuously challenging. Qualitative research seems to be promising; however, there are difficulties and complexities involved, one of which is validity. Qualitative research is based on different paradigms, ontologies, theories, and methods, and validity assessment may vary. We argue that processual validity can positively influence qualitative health care research. Processual validity is a methodological construction that involves all research steps, including those before and after data collection and analysis. We selected a processual validity model and two cases to illustrate its use and demonstrate processual validity’s importance and applicability. One case explores the gap between medical education and patients’ needs in primary health care. Other studies focus on health care improvements in hospitals. Our results highlight the benefits of processual validity to ensure the transparency and reliability of the research process and provide evidence of the findings to positively influence thinking and the execution of qualitative research in health care.
Family History of Psychiatric Disorders and Clinical Factors Associated With a Schizophrenia Diagnosis
Authors: Díaz-Castro Lina , Hoffman Kurt , Cabello-Rangel Héctor , Arredondo Armando , Herrera-Estrella Miguel Ángel
Published: November 2021

Background

Schizophrenia (SCH) and bipolar disorder (BD) have both shared and unique genetic risk factors and clinical characteristics. The aim of the present study was to identify potential risk factors significantly associated with SCH, relative to a BD reference group.

Methods

Data were obtained from medical records of patients that entered a major Mexico City hospital during 2009–2010 presenting psychotic symptoms (n = 1132; 830 cases of SCH, 302 cases of BD; 714 men and 418 women). SCH and BD diagnoses were compared with respect to a number of family and clinical characteristics. Logistic and linear regression analyses were used to respectively identify factors selectively associated with the SCH diagnosis relative to the BD diagnosis and explore the relationship between PANSS scores and parental age at time of birth to the age of SCH onset.

Results

Patients with SCH showed greater functional impairment than those with BD. Family history of mental illness, premorbid schizoid-like personality, and obstetric trauma were significantly associated with the SCH diagnosis. The association of obstetric trauma with SCH was greatest in male patients with a family history of mental illness. In women, increased paternal and decreased maternal age at time of the patient’s birth were associated with an earlier age of SCH onset.

Conclusion

Male gender, showing premorbid schizoid-like personality, familial SCH, and obstetric trauma are risk factors that distinguish SCH from BD. Additionally, our results suggest that risk for SCH relative to BD may be importantly influenced by interactions between familial risk, gender, and obstetric trauma.
Finite-time tracking control for nonstrict-feedback nonlinear systems with unknown time delays and input saturation
Authors: Qi Xiaojing , Liu Wenhui
Published: November 2021

In this article, the problem of adaptive finite-time control is studied for a category of nonstrict-feedback nonlinear time-delay systems with input saturation and full state constraints. The fuzzy logic systems are applied to model the unknown nonlinear terms in the systems. Then, a novel tan-type barrier Lyapunov function is adopted to overcome the problem of full state constraints. By utilizing the finite-time control theory and the backstepping technique, a finite-time fuzzy adaptive controller is designed. The controller can guarantee that the tracking error is adjusted around zero with a small neighborhood in a finite time and all the signals in the closed-loop system are bounded. Finally, two simulation examples are included to verify the validity and feasibility of the control scheme.
Revision Stapes Surgery: Hearing Symptoms and Associations With Intraoperative Findings and Outcomes
Authors: Luryi Alexander L. , Schettino Amy , Michaelides Elias M. , Babu Seilesh , Bojrab Dennis I. , Schutt Christopher A.
Published: November 2021

Objective

Stapes surgery for otosclerosis occasionally requires revision due to recurrent or persistent conductive hearing loss (CHL). This study examines outcomes after revision stapes surgery.

Study Design

Retrospective review.

Setting

Single tertiary neurotology center.

Methods

Patients undergoing revision stapes surgery for otosclerosis from 2008 to 2017 were reviewed. Postoperative air‐bone gaps (ABGs) were the primary outcome measure.

Results

During the study period, 150 patients underwent revision stapes surgery. One hundred patients (67%) had gradually progressive recurrent CHL; 16 (11%), sudden recurrent CHL; 13 (9%), persistent CHL; and 21 (14%), no CHL. For 129 patients with CHL, the mean ABG improved from 23.7 to 9.3 dB (P <. 0005). The most common intraoperative findings for these patients were prosthesis displacement with incus necrosis (38%) or without it (43%), normal anatomy with seemingly good prosthesis placement (6%), and abundant scar tissue (6%). Patients with recurrent hearing loss achieved lower mean ABGs than patients with persistent hearing loss (8.8 vs 13.2 dB, P =. 02). There were no associations between onset pattern of CHL or intraoperative findings and hearing outcomes (P >. 05). Four patients (2.7%) developed sensorineural hearing loss after revision, defined as an increase in bone conduction pure tone average ≥15 dB, all of whom had previous replacement of a malpositioned prosthesis.

Conclusions

Revision stapes surgery confers significant improvement in hearing for patients with persistent and recurrent CHL, although patients with persistent CHL after initial surgery see less improvement with revision.
Evaluation of radiological contribution to patient management: the orthopedist's point of view
Authors: Guney Betul , Uzun Erdal
Published: November 2021

Background

Orthopedists prefer imaging studies for the diagnosis, treatment, and follow-up of patients.

Purpose

To determine the effect of orthopedists’ characteristics, including subspecialty, age, education, and professional experience, in collaboration with radiologists and the usefulness of radiology reports for orthopedists in diagnosis and patient management.

Material and Methods

Questionnaires, consisting of 21 questions investigating the orthopedists’ characteristics, their behavior with radiology reports, their thoughts on communication, and collaboration with radiologists, were distributed to 205 orthopedists. Descriptive analysis was performed, and the effects of orthopedist characteristics on the outcomes was evaluated.

Results

In total, 161 out of 205 enrolled participants were included in the analysis. A total of 156 (96.9%) participants stated that they reviewed at least one official radiology report, with MRI receiving the highest rate (92.4%). The main reason provided for not reviewing the radiology reports and requests regarding changes to radiology report formats seemed to be mostly related to time pressure. Despite a significant portion of the participants stating that clinical and surgical findings were inconsistent with radiology reports, less than half were inclined to contact the radiologist most of the time or always. Increasing age ( P = 0.005), experience ( P = 0.016), and university hospital specialization ( P = 0.007) increased the tendency to form multidisciplinary team meetings. Communication with radiologists increased with age ( P < 0.001), while more experience reduced the impact of radiology reports on decision-making ( P = 0.035).

Conclusion

Increasing cooperation between orthopedists and radiologists will make a significant contribution to decision-making and treatment processes. Orthopedists’ characteristics are influential factors in establishing this communication.
Heart rate variability and subsequent psychological distress among family members of intensive care unit patients
Authors: Harris Benjamin RE , Beesley Sarah J , Hopkins Ramona O , Hirshberg Eliotte L , Wilson Emily , Butler Jorie , Oniki Thomas A , Kuttler Kathryn G , Orme James F , Brown Samuel M
Published: November 2021

Objective

To determine whether heart rate variability (HRV; a physiological measure of acute stress) is associated with persistent psychological distress among family members of adult intensive care unit (ICU) patients.

Methods

This prospective study investigated family members of patients admitted to a study ICU. Participants’ variability in heart rate tracings were measured by low frequency (LF)/high frequency (HF) ratio and detrended fluctuation analysis (DFA). Questionnaires were completed 3 months after enrollment to ascertain outcome rates of anxiety, depression, and post-traumatic stress disorder (PTSD).

Results

Ninety-nine participants were enrolled (median LF/HF ratio, 0.92 [interquartile range, 0.64–1.38]). Of 92 participants who completed the 3-month follow-up, 29 (32%) had persistent anxiety. Logistic regression showed that LF/HF ratio (odds ratio [OR] 0.85, 95% confidence interval [CI] 0.43, 1.53) was not associated with 3-month outcomes. In an exploratory analysis, DFA α (OR 0.93, 95% CI 0.87, 0.99), α1 (OR 0.97, 95% CI 0.94, 0.99), and α2 (OR 0.94, 95% CI 0.88, 0.99) scaling components were associated with PTSD development.

Conclusion

Almost one-third of family members experienced anxiety at three months after enrollment. HRV, measured by LF/HF ratio, was not a predictor of psychologic distress, however, exploratory analyses indicated that DFA may be associated with PTSD outcomes.
The depoliticization of health and safety committees and representation: The Ontario case
Authors: Hall Alan
Published: November 2021

Studies in several national jurisdictions have highlighted the limitations of joint health and safety committees and worker representatives in affecting change in working conditions. Using Canadian data, this article focuses on the argument that many health and safety committees and worker representatives have been captured or substantially controlled through the State’s promotion of an internal responsibility system framed around a technocratic partnership. The historical development of this framing is first understood within a political economic framework which highlights several major influences, followed by a field theory analysis which explains how these control relations are established by management within workplace settings.
Book review: Pandit Sunder Lal, British Rule in India
Authors: Tuteja K. L.
Published: November 2021

Pandit Sunder Lal, British Rule in India, New Delhi: SAGE Publications, 2018, ix + 536 pp., ₹395, ISBN: 9789352808021.
Book review: Rupendra Kumar Chattopadhyay, The Archaeology of Coastal Bengal
Authors: Sahu Bhairabi Prasad
Published: November 2021

Rupendra Kumar Chattopadhyay, The Archaeology of Coastal Bengal, New Delhi: Oxford University Press, 2018, xix + 338 pp., ₹1250, ISBN: 9780199481687 (Hardback).
Design guidelines for bump-type compliant conical foil bearing
Authors: Hu Hongyang , Feng Ming
Published: November 2021

The integral bump foil strip cannot optimize the performance for the compliant conical foil bearing (CFB) as the uneven distribution of structural stiffness. To maximize the bearing characteristics, this paper proposed different bump foil schemes. Firstly, the anisotropy of CFB was studied based on the nonlinear bump stiffness model, and the circumferentially separated foil structure was proposed. Moreover, an axially separated bump foil structure with the variable bump length was introduced to make the axial stiffness distribution more compliant with the gas pressure. In addition, the effect of foil thickness was also discussed. The results show that CFB with integral bump foil exhibits obvious anisotropy, and the suggested installation angle for largest load capacity and best dynamic stability are in the opposite position. Fortunately, a circumferential separated bump foil can improve this defect. The characteristics of CFB with axial separated foil structure can be improved significantly, especially for that with more strips and the variable bump half-length design. The suitable bump and top foil thickness should be set considering the improved supporting performance and proper flexibility. The results can give some guidelines for the design of CFB.
Where the Blame Lies: Unpacking Groups Into Their Constituent Subgroups Shifts Judgments of Blame in Intergroup Conflict
Authors: Halevy Nir , Maoz Ifat , Vani Preeti , Reit Emily S.
Published: November 2021

Whom do individuals blame for intergroup conflict? Do people attribute responsibility for intergroup conflict to the in-group or the out-group? Theoretically integrating the literatures on intergroup relations, moral psychology, and judgment and decision-making, we propose that unpacking a group by explicitly describing it in terms of its constituent subgroups increases perceived support for the view that the unpacked group shoulders more of the blame for intergroup conflict. Five preregistered experiments ( N = 3,335 adults) found support for this novel hypothesis across three distinct intergroup conflicts: the Israeli-Palestinian conflict, current racial tensions between White people and Black people in the United States, and the gender gap in wages in the United States. Our findings (a) highlight the independent roles that entrenched social identities and cognitive, presentation-based processes play in shaping blame judgments, (b) demonstrate that the effect of unpacking groups generalizes across partisans and nonpartisans, and (c) illustrate how constructing packed versus unpacked sets of potential perpetrators can critically shape where the blame lies.
The SLICC/ACR Damage Index (SDI) may predict adverse obstetric events in patients with systemic lupus erythematosus
Authors: Lacerda Marcela Ignacchiti , de Jesús Guilherme Ribeiro Ramires , dos Santos Flávia Cunha , de Jesús Nilson Ramires , Levy Roger Abramino , Klumb Evandro Mendes
Published: November 2021

Objective

The objective of this study was to evaluate the potential impact of irreversible damage accrual in women with systemic lupus erythematosus (SLE) and adverse maternal and/or fetal/neonatal outcomes.

Methods

Retrospective cohort study with SLE pregnant patients was carried out from January 2011 to January 2020 at the Hospital University Pedro Ernesto (HUPE) of the State University of Rio de Janeiro, Brazil. Irreversible damage was defined according to SLICC/ACR damage index (SDI). The association of SDI on pregnancy outcomes was established by univariate and multivariate regression models and included demographic and clinical variables.

Results

This study included data from 260 patients in their first pregnancies after SLE diagnosis, with a quarter of them (67/260) scoring one or more points on SDI at the beginning of prenatal care. These patients presented more frequently adverse maternal events, namely, disease activity during pregnancy ( p = 0.004) and puerperium ( p = 0.001), active lupus nephritis ( p = 0.04), and hospitalizations ( p = 0.004), than those with no SDI score. Similarly, the risks of adverse fetal and neonatal outcomes were also higher among the patients with SDI ≥ 1 (59.7% vs 38.3% p = 0.001) even after controlling data for disease activity (SLEPDAI > 4). Patients with SDI ≥ 1 presented more frequently preterm deliveries (46.3% vs 31.6%; p = 0.01), small for gestational age infants (28.3% vs 18.1%; p = 0.04), and neonatal intensive care unit admission (26.9% vs 1.5%; p < 0.001). The multivariate analyses showed that SDI ≥ 1 is an independent risk factor for hospitalization due to obstetric complications ( p = 0.0008) and preterm delivery ( p = 0.009).

Conclusion

Pregnant SLE patients who present irreversible damage accrual may have higher risk of maternal and fetal adverse outcomes, independently of disease activity. These results should be validated in further prospective studies.
Navigated micropulse laser for central serous chorioretinopathy: Efficacy, safety, and predictive factors of treatment response
Authors: Amoroso Francesca , Pedinielli Alexandre , Cohen Salomon Yves , Jung Camille , Chhablani Jay , Astroz Polina , Colantuono Donato , Semoun Oudy , Capuano Vittorio , Souied Eric H. , Miere Alexandra
Published: November 2021

Purpose

There is no widely accepted treatment for persistent/chronic central serous chorioretinopathy. The present study aimed to evaluate the efficacy, safety, and factors associated to treatment response to navigated micropulse laser in chorioretinopathy.

Methods

Retrospective observational case series including consecutive patients presenting with symptomatic persistent and chronic chorioretinopathy. All patients were treated with 5% navigated micropulse laser with the Navilas system (Navilas®, OD-OS GmBH, Teltwo, Germany), by overlying fluorescein angiography, indocyanine green angiography and/or spectral domain-optical coherence tomography images of visible leaking points and/or choroidal hyperpermeability/subretinal fluid to plan the laser treatment.

Results

Thirty-nine eyes of 36 consecutive patients (29 men and 7 women, with a mean age of 51.87 years) were included. Logarithm of the minimum angle of resolution (LogMar) best-corrected visual acuity increased from 0.39 ± 0.24 at baseline to 0.24 ± 0.22 at 3 months ( p < 0.0001) and to 0.20 ± 0.07 at 6 months ( p < 0.0001). Subretinal fluid decreased from 166.82 ± 111.11 micron at baseline to 52.33 ± 78.97 micron ( p < 0.0001) at 3 months and 34.12 ± 67.56 micron at 6 months ( p < 0.0001). The presence of a hot spot on fluorescein angiography and a focal choroidal hyperpermeability on indocyanine green angiography, but not the duration of symptoms correlated significantly with the resolution of subretinal fluid at month 3 ( p = 0.023 and p  = 0.001).

Conclusion

Navigated micropulse laser laser treatment was found to be effective and safe for the treatment of chorioretinopathy, with significant improvement in visual and anatomical outcomes, unaccompanied by any adverse event at 3 and 6 months follow-up. Factors associated to subretinal fluid resolution may allow a better selection of likely responders to navigated micropulse laser treatment.