bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of two types of palliative home care in cancer and non-cancer patients: A retrospective population-based study using claims data
Authors: Krause Markus , Ditscheid Bianka , Lehmann Thomas , Jansky Maximiliane , Marschall Ursula , Meißner Winfried , Nauck Friedemann , Wedding Ulrich , Freytag Antje
Published: June 2021

Background:

Comparative effectiveness of different types of palliative homecare is sparsely researched internationally—despite its potential to inform necessary decisions in palliative care infrastructure development. In Germany, specialized palliative homecare delivered by multi-professional teams has increased in recent years and factors beyond medical need seem to drive its involvement and affect the application of primary palliative care, delivered by general practitioners who are supported by nursing services.

Aim:

To compare effectiveness of primary palliative care and specialized palliative homecare in reducing potentially aggressive interventions at the end-of-life in cancer and non-cancer.

Design:

Retrospective population-based study with claims data from 95,962 deceased adults in Germany in 2016 using multivariable regression analyses.

Settings/participants:

Patients having received primary palliative care or specialized palliative homecare (alone or in addition to primary palliative care), for at least 14 days before death, differentiating between cancer and non-cancer patients.

Results:

Rates of potentially aggressive interventions in most indicators were higher in primary palliative care than in specialized palliative homecare ( p < 0.01), in both cancer and non-cancer patients: death in hospital (odds ratio (OR) 4.541), hospital care (OR 2.720), intensive care treatment (OR 6.749), chemotherapy (OR 2.173), and application of a percutaneous endoscopic gastrostomy (OR 4.476), but not for parenteral nutrition (OR 0.477).

Conclusion:

Specialized palliative homecare is more strongly associated with reduction of potentially aggressive interventions than primary palliative care in the last days of life. Future research should identify elements of specialized palliative homecare applicable for more effective primary palliative care, too. German Clinical Trials Register (DRKS00014730).
Lived Experiences of Internalized Stigma Among HIV-Positive Adults in Delhi, India
Authors: Dhaor Sangeeta Sharma
Published: June 2021

The HIV infection is deeply associated with fear, stigma, discrimination, and internalization of the stigma. The ignorance around modes of transmission has led to many myths and misconceptions surrounding the infection. There is a stigma of contagion, along with the stigma of morality. Being ill and facing death is a situation that affects day to day living of the infected. It is not the virus but the stigmatizing environment around the infected that makes life with the virus a difficult journey. The infection leads to many behavioral issues and challenges for the infected as well as affected. In a mixed-method research, 105 HIV-positive consenting adults were recruited through the snowball method. They were interviewed using a semi-structured interview schedule in a confidential environment. Focus group discussions were conducted with infected males, females, men having sex with men (MSM), and uninfected partners of the infected respondents to understand the interpersonal issues and challenges. The current research explores and describes the impact of HIV and resultant internalized stigma upon the life of the infected in the background of moralistic values governing sexual behavior.
Big Data Insights into Container Vessel Dwell Times
Authors: Smith Daniel
Published: June 2021

Analysis of automatic identification system (AIS) vessel call records can greatly improve our understanding of container vessel dwell times when coupled with information on port volumes and vessel schedules. Port productivity discussions often use vessel time in port—referred to as dwell time, turnaround time, or berth time—as a primary metric. This emphasis implies a need to understand the factors that determine dwell time, especially in port comparisons. Previous dwell time analyses have been handicapped by limited data. This analysis differs in that it uses a multiyear, multiport database covering all relevant vessel calls at major continental U.S. container ports (Baltimore, Boston, Charleston, Houston, Jacksonville, Long Beach, Los Angeles, Miami, Mobile, New Orleans, Northwest Seaport Alliance, New York–New Jersey, Oakland, Palm Beach, Philadelphia, Port Everglades, Savannah, Virginia, and Wilmington, NC), and by including vessel schedules and seasonality. The analysis indicated a much stronger association of dwell time with expected cargo volume at each call than with vessel capacity, and expected cargo volumes helped explain port dwell time differences. The analysis also found that vessel schedules may be the primary determinants of dwell time, and that schedule adherence may thus be equally important as dwell time per se. Seasonality also affected container vessel dwell time, but that influence may be complex as both weather conditions and seasonal cargo peaks probably affect the outcomes. Promising avenues for future research lie in merging AIS vessel call records with other data sets that, unfortunately, may not yet exist or be accessible.
Occupying Paulista: Housing activism, the new right and the politics of public space during the Brazilian crisis
Authors: Albert Victor
Published: June 2021

Brazilian society has frequently been described as polarized during the country’s recent political and economic crisis. In 2018, a wave of opposition to the centre-left Workers’ Party culminated in the election of Jair Bolsonaro, a right-wing populist who portrays the political left as a malevolent force in Brazilian society. In this paper I explore this polarization through drawing on ethnographic research with the Homeless Workers’ Movement ( Movimento de Trablhadores Sem-Teto, MTST), a large urban social movement that develops settlements on underutilized land in the city, and a prominent civil society opponent of Bolsonaro. More specifically, I examine a key site of socio-spatial tension in São Paulo, Paulista Avenue, as a new political right came to predominate on the city’s main thoroughfare during the campaign to impeach the Workers’ Party President, Dilma Rousseff. I show how the perceived intolerance of the mobilized right helped to establish new normative codes that regulated the political symbolism which could be displayed in public spaces. Lastly, I consider how the vilification of the MTST in particular and the political left in general by the new right is embedded in broader structures of stigmatization.
“Micro Botulinum Toxin” for the Treatment of a Deep Dermal Burn After Single IPL and a Second Combined IPL/Nd: YAG Laser Treatment for Skin Rejuvenation and Discoloration
Authors: Soika Karen
Published: June 2021

Botulinum toxin (BTX) is a neurotoxin derived from the Clostridium botulinum bacterium that inhibits the release of acetylcholine at the neuromuscular junction. Botox is not new, and it has been used for many years to treat a variety of muscular/neuromuscular conditions and now more popularly for cosmetic use. Botulinum toxins use has been experimented in some dermatological conditions, which include Rosacea and facial flushing treatment with positive outcomes. The complex mechanism underlying those results is not completely understood but was proposed that a release inhibition of acetylcholine from peripheral autonomic nerves of the cutaneous vasodilatory system combined with the blockade of substance P and calcitonin gene-related peptide (CGRP), thus modulating vasodilatation of blood vessels as the likely mechanism of action. In cosmetic and aesthetic medicine, thermal burns from laser-type treatments are the number 1 lawsuit in this field. However, seldom are reports shared on management of these patient’s burns. This is a case report of such a patient who had a deep dermal burn after 2 consecutive treatments for the goal of correcting skin discoloration and sun damage.
Assessing the Relationships Between Past Victimization, Perceived Risk of Future Victimization, and Controversial Criminal Justice Policies Using Structural Equation Modeling
Authors: Dolliver Matthew J. , Kenney Jennifer L. , Williams Reid Lesley
Published: June 2021

Several decades of research show a strong relationship between past victimization and perceived risk of future victimization. Yet, few studies have explored the potential connection to individuals’ support for criminal justice policies. The purpose of this study is to better understand the relationships between past victimization, perception of risk for future victimization, and support for several criminal justice policies (e.g., stand your ground, open carry, three strikes, and the death penalty). Through structural equation modeling, the researchers examined relationships between these latent variables. Having both a history of victimization and a belief in the risk of future victimization increased one’s support for punitive and self-protective policies. Implications for future research and potential policies and services for victims/survivors are discussed.
Evaluation of Dexmedetomidine Dosing in Obese Critically Ill Patients
Authors: Atyia Sara A. , Smetana Keaton S. , Tong Minh C. , Thompson Molly J. , Cape Kari M. , May Casey C.
Published: June 2021

Background:

Dexmedetomidine is a highly selective α2-adrenoreceptor agonist that produces dose-dependent sedation, anxiolysis, and analgesia without respiratory depression. Due to these ideal sedative properties, there has been increased interest in utilizing dexmedetomidine as a first-line sedative for critically ill patients requiring light sedation.

Objective:

To evaluate the ability to achieve goal intensive care unit (ICU) sedation before and after an institutional change of dosing from actual (ABW) to adjusted (AdjBW) body weight in obese patients on dexmedetomidine.

Methods:

This study included patients ≥ 18 years old, admitted to a surgical or medical ICU, required dexmedetomidine for at least 8 hours as a single continuous infusion sedative, and weighed ≥ 120% of ideal body weight. Percentage of RASS measurements within goal range (−1 to +1) during the first 48 hours after initiation of dexmedetomidine as the sole sedative agent or until discontinuation dosed on ABW compared to AdjBW was evaluated.

Results:

100 patients were included in the ABW cohort and 100 in the AdjBW cohort. The median dosing weight was significantly higher in the ABW group (95.9 [78.9-119.5] vs 82.2 [72.1-89.8] kg; p = 0.001). There was no statistical difference in percent of RASS measurements in goal range (61.5% vs 69.6%, p = 0.267) in patients that received dexmedetomidine dosed based on ABW versus AdjBW.

Conclusion:

Dosing dexmedetomidine using AdjBW in obese critically ill patients for ongoing ICU sedation resulted in no statistical difference in the percent of RASS measurements within goal when compared to ABW dosing. Further studies are warranted.
Evaluation of a Treatment-Dose Enoxaparin Protocol for Patients With Obesity
Authors: Berger Olivia , Sebaaly Jamie , Crawford Rachel , Rector Katherine , Anderson William
Published: June 2021

Background:

Treatment-dose enoxaparin is not well studied in obese patients. Guidelines suggest that obese patients receiving enoxaparin therapy for acute venous thromboembolism (VTE) should receive a standard initial dose, 1 mg/kg, based on actual body weight. It is possible that this dosing strategy in obese patients may be overestimated, leading to a higher bleeding risk compared to non-obese patients.

Objective:

To gather data regarding enoxaparin treatment dosing and anti-Xa level monitoring in patients who are obese to guide dose adjustments.

Methods:

A single-center, retrospective chart review that included patients who were ordered treatment-dose enoxaparin and had a BMI ≥ 40 kg/m2, which resulted in an automatic pharmacy consult.The primary endpoint of this study was incidence of bleeding.

Results:

The analysis included 102 patients. Most patients (92.1%) had a BMI of ≥ 40-60 kg/m2 while 7.8% of patients had a BMI of > 60 kg/m2. The average initial and final doses were 1.0 ± 0.1 mg/kg and 0.9 ± 0.2 mg/kg, respectively. The incidence of bleeding was 4.9%. The average dose for those that bled was 0.7 ± 0.1 mg/kg. On average, patients who bled had higher BMIs than patients who did not bleed (51.6 kg/m2 vs. 48.0 kg/m2). Of the 71 patients with an initial anti-Xa level, 42 of the levels were considered supratherapeutic (59.2%).

Conclusion:

A 1 mg/kg starting dose of enoxaparin may be too high for patients who are obese as many patients required an adjustment to their dose after initial anti-Xa levels.
Perception of Internal Controls Helps Explain Whistleblowing
Authors: Scheetz Andrea M. , Smalls Tonya D. W. , Wall Joseph , Wilson Aaron B.
Published: June 2021

The nonprofit sector may suffer financially from inconsistency in regulations and polices surrounding internal control implementation. To address this issue, our study explores how perceived internal control strength differs between nonprofit and for-profit organizations. Furthermore, we examine three components of the Committee of Sponsoring Organization framework to determine which components might significantly influence whistleblowing for nonprofit organizations. As expected, all three components appear to significantly influence whistleblowing for those in for-profit organizations. For those in nonprofit organizations, the perception of control activities and monitoring activities significantly mediates the relationship between organization type and whistleblowing intentions. Finally, the data indicate that the use of an anonymous website for whistleblowing at a nonprofit organization may require added attention and resources if employees at nonprofits are to use this outlet to the same extent as it is used at a for-profit organization.
Recruiting students to an undergraduate supply chain management program
Authors: Welborn Cliff , Bullington Kimball , Abston Kristie
Published: June 2021

This study sought to utilize Six Sigma techniques to guide the design and selection of promotional materials and strategies to attract college students to an undergraduate Supply Chain Management major. Affinity Diagramming was used to collect and summarize students’ comments on what factors they considered when selecting a career. Pareto was used to prioritize their responses. Quality Function Deployment was used to align promotional materials and strategies to ensure that they addressed the factors identified by the students. Six unique promotional materials and strategies were identified as the most effective in attracting students to the Supply Chain Management major.
Rethinking ‘the personal is political:’ Enacting agency in the narrative of sexual harassment experiences in China
Authors: Rose Luqiu Luwei , Liao Sara Xueting
Published: June 2021

Through a close reading of 1904 individual stories of sexual harassment collected through an online survey, the study investigates how storytelling constitutes a feminist media practice that (re)defines sexual harassment, exposes the power relations at play in the situations described in the stories, and opens up space for discursive politics in everyday life. In focusing on the active production of identities through discourse, we demonstrate how women themselves make sense of their experience. Most of the storytellers struggled to define what sexual harassment meant to them in their first-person narrations of their experiences. Guided by feminist standpoint methodology and narrative analysis, the study recognizes the narratives as powerful sites of knowledge production from a marginalized group of people who rarely speak out about their sexual harassment experiences, and it reconsiders the importance of the personal in digital space, evaluating how varied narratives can be cooperative and participatory to enact agency in contentious politics.
Measuring returns on social investment beyond here-and-now redistribution: A commentary on Parolin and Van Lancker’s response article
Authors: Hemerijck Anton , Plavgo Ilze
Published: June 2021

Social policy research is truly interdisciplinary with academics from very different theoretical perspectives working together in fervent open-mindedness towards diverse methodological approaches. The exploration of social investment (SI) welfare provision is a clear example of this spirit of interdisciplinary engagement, having stirred up critical scholarly reception and debate over the past decade. On the one hand, some colleagues underscore the potential of SI policies to improve life chances. On the other hand, some researchers voice concerns about perverse unintended consequences of SI. The most worrying scholarly critique of SI is the conjecture that SI policies reinforce rather than alleviate inequality and poverty, because of the operation of so-called Matthew effects (MEs). Parolin and Van Lancker’s commentary on our article ‘The social investment litmus test: family formation, employment and poverty’ falls within the purview of the ME critique, with some extension to other shortcomings discussed in the literature. These criticisms certainly deserve engagement, and we are grateful to the editorial board of the Journal of European Social Policy for inviting us to do so fully. In our commentary, we commence with the multidimensionality of 21st-century welfare state provision. Subsequently, we turn to the welfare state’s carrying capacity, which we maintain needs to be taken into consideration for leveraging positive feedback mechanisms between the micro and the macro level of welfare provision. By so doing, we elaborate on the implications of our research approach for understanding MEs, with insights as to how they are exacerbated or mitigated through policy (in-)complementarities. We then discuss the importance of considering synergies between policies for an improved understanding of SI returns and possible source(s) of MEs. Finally, we turn to the misconception that capacitating SI policies and compensatory consumption-smoothing and poverty alleviation are somehow in competition with each other, and discuss the normative orientation underlying SI welfare provision.
Holocene evolution of a barrier-spit complex and the interaction of tidal and wave processes, Inskip Peninsula, SE Queensland, Australia
Authors: Köhler Martin , Shulmeister James , Patton Nicholas R , Rittenour Tammy M , McSweeney Sarah , Ellerton Daniel T , Stout Justin C , Hüneke Heiko
Published: June 2021

This paper presents a reconstruction of the Holocene evolution of the Inskip Peninsula in SE Queensland. The peninsula links two major dune fields, the Cooloola Sand Mass to the south and K’gari (Fraser Island) to the north. Geomorphic features of this peninsula include remnant parabolic dunes, numerous beach ridges with foredunes, and a series of spits. Together these features provide insight into Holocene coastal evolution and changing marine conditions. A remnant beach ridge/foredune complex at the northern portion of Inskip may have been connected to K’gari and a river/tidal channel near Rainbow Beach township which separated it from the Cooloola Sand Mass to the south. This channel avulsed northward in the early mid-Holocene (after 8.8 ka) with spit development from the south. This was followed by a phase of beach-ridge/foredune complex development that started by ~6.7 ka. Stratigraphic evidence from the highest and best developed parabolic dunes in the northern portion of Inskip Peninsula indicates dune development from the mid-Holocene beach complex by 4.8 ka. Beach ridges with foredunes continued to prograde but notably declined in size during the late-Holocene. In the latest Holocene (<4.8 ka) many of the late-Holocene beach ridges/foredune complexes have been truncated by a re-orientation of the shoreline and longshore sediment transport has promoted the growth of the modern spit at the northern end of the peninsula. Erosive and longshore processes continue to be highly active because of tidal interactions between Great Sandy Strait and the Coral Sea. This detailed study of Inskip Peninsula’s evolution aids significantly in future coastal management decisions, and provides evidence for World Heritage Area extension for the Cooloola Sand Mass, including the incorporation of Inskip Peninsula itself. It also contributes to the global understanding to coastal evolution in an area of strong wave and tidal interaction.
Nanocomposites based on biocompatible polymers and graphene oxide for antibacterial coatings
Authors: Fauzi Fika , Musawwa Muhammad Miqdam , Hidayat Habibi , Kusumaatmaja Ahmad , Dwandaru Wipsar Sunu Brams
Published: June 2021

Recently, antibacterial coatings based on graphene oxide (GO) nanocomposites have attracted many studies around the world. The use of polymers as the matrices of GO nanofillers in the nanocomposites has been explored to produce efficient coatings against bacteria. One of the most prospective applications is the incorporation of GO into biocompatible polymers, which can produce antibacterial coatings. Here, recent progresses on the antibacterial coatings of nanocomposites based on biocompatible polymers and GO are reviewed. The effect of GO filler concentrations, biocide materials, and biocompatibility are discussed to find the most efficient antibacterial activity and biocompatibility of nanocomposites. Among biocompatible polymers, chitosan (Cs), poly vinyl alcohol (PVA), and poly lactic acid (PLA) are the most popular matrices used for the nanocomposites. This review also elaborates challenges in the use of other biocompatible polymers. Future works on biocompatible antibacterial coatings should be conducted by considering the concentration of GO nanofillers or adding other materials such as essential oils to suppress the toxicity toward functional cells.
Feasibility of using tissue autolysis to estimate the postmortem interval in horses
Authors: Wenzlow Nanny , Neal Dan , Stern Adam W. , Prakoso Dhani , Liu Junjie J. , Delcambre Gretchen H. , Beachboard Sally , Long Maureen T.
Published: June 2021

Estimation of the postmortem interval (PMI) is a poorly studied field in veterinary pathology. The development of field-applicable methods is needed given that animal cruelty investigations are increasing continually. We evaluated various histologic criteria in equine brain, liver, and muscle tissue to aid the estimation of PMI in horses, which is central to forensic investigations of suspicious death. After death, autolysis proceeds predictably, depending on environmental conditions. Currently, no field-applied methods exist that accurately estimate the PMI using histology in animals or humans through quantification of autolysis. Brain, liver, and skeletal muscle from 12 freshly euthanized horses were held at 22°C and 8°C for 72 h. Tissues were sampled at T0h, T1h, T2h, T4h, T6h, T12h, T24h, T36h, T48h, T60h, and T72h. For each tissue, we quantified 5 to 7 criteria associated with autolysis, based on the percentage of microscopic field involved. Each criterion was modeled, with temperature and time as independent variables. Changes were most predictable in liver and muscle over the first 72 h postmortem. The criteria for autolysis that were present most extensively at both temperatures were hepatocyte individualization and the separation of bile duct epithelium from the basement membrane. The changes that were present next most extensively were disruption of myofiber continuity, hypereosinophilia, and loss of striation. Brain changes were highly variable. The high statistical correlation between the parameter “autolysis” and the variables “time/temperature”, indicates that autolysis is progressive and predictable. Further investigation of these criteria is needed to establish histologic algorithms for PMI.
Chalastospora gossypii in a Maine Coon cat: case report and literature review
Authors: Norris Samantha M. , Schaffer Paula A. , Bander Noah B.
Published: June 2021

A 15-y-old castrated male Maine Coon cat was evaluated for an ulcerated soft tissue mass on the right hindlimb that had been observed for 4 mo and had grown rapidly. A 3 × 3 cm soft, raised, amorphous, and ulcerated subcutaneous mass was observed on the lateral right metatarsus. In-house cytology via fine-needle aspiration was nondiagnostic. Incisional biopsy of the mass and further staging was declined, and amputation was elected. The amputated limb was submitted for histopathology, which revealed severe chronic nodular granulomatous dermatitis and multifocal granulomatous popliteal lymphadenitis with large numbers of intralesional fungal hyphae. Fungal PCR and sequencing on formalin-fixed, paraffin-embedded tissue identified Chalastospora gossypii. No adjunctive therapy was elected at the time. The patient has done well clinically 1 y post-operatively. C. gossypii is a rare microfungus found worldwide and is considered a minor pathogen of several plants. To our knowledge, infection by this fungus has not been reported previously in veterinary species. Features in our case are comparable to other mycotic infections. Nodular granulomatous mycotic dermatitis and cellulitis, although uncommon, should be a differential for soft tissue masses in veterinary species; C. gossypii is a novel isolate.
Streptococcus pluranimalium meningoencephalitis in a horse
Authors: Fu Dah-Jiun , Ramachandran Akhilesh , Miller Craig
Published: June 2021

A 3-y-old, female Quarter Horse with a history of acute neurologic signs was found dead and was submitted for postmortem examination. Areas of petechial and ecchymotic hemorrhage were present on cross-sections of the cerebrum, cerebellum, and brainstem. Histologic examination of the brain revealed severe, purulent meningoencephalitis and vasculitis with a myriad of intralesional gram-positive cocci. Streptococcus pluranimalium was identified from formalin-fixed, paraffin-embedded tissue obtained from sites with active lesions by PCR and nucleotide sequencing of bacterial 16S ribosomal RNA. S. pluranimalium should be considered as a cause of meningoencephalitis in a horse.
A Closer Look at Delayed Primary Cleft Surgery and Unrepaired Cleft Lip and/or Palate in 5 UK Cleft Centers
Authors: Butterworth Sophie , Rivers Clare , Fullarton Marnie , Murphy Colm , Beale Victoria , Neil-Dwyer Jason , Van Eeden Simon , Van Eeden Stephanie , Hodgkinson Peter D. , Smyth Alistair , Sainsbury David C
Published: June 2021

Background:

There may be many reasons for delays to primary cleft surgery. Our aim was to investigate the age of children undergoing primary cleft lip or primary cleft palate repair in 5 cleft centers within the United Kingdom. Identify the reasons for delayed primary cleft lip repair (beyond 6 months) and delayed primary palate repair (beyond 13 months). Identify children who had a cleft lip and/or palate (CL±P) that was intentionally unrepaired and the reasons for this.

Methods:

A retrospective, multicenter review of patients born with a CL±P between December 1, 2012, and December 31, 2016. Three regional cleft centers, comprising of 5 cleft administrative units in the United Kingdom participated.

Results:

In all, 1826 patients with CL±P were identified. Of them, 120 patients had delayed lip repair, outside the expected standard of 183 days. And, 178 patients in total had delayed palate repair, outside the expected standard of 396 days. Twenty (1%) patients had an unrepaired cleft palate.

Conclusions:

This large retrospective review highlights variations between centers regarding the timing of lip and palate surgery and details the reasons stated for delayed primary surgery. A small number of patients with an unrepaired cleft palate were identified. All had complex medical problems or comorbidities listed as a reason for the decision not to operate and 50% had a syndromic diagnosis. The number of patients receiving delayed surgery due to comorbidities, being underweight or prematurity, highlights the importance of the cleft specialist nurse and pediatrician within the cleft multidisciplinary team.
Radiographic Outcomes of Cotton Osteotomy in Treatment of Adult-Acquired Flatfoot Deformity
Authors: Abousayed Mostafa M. , Coleman Michelle M. , Wei Lawrence , de Cesar Netto Cesar , Schon Lew C. , Guyton Gregory P.
Published: June 2021

Background:

We investigated the long-term radiographic outcomes of the Cotton osteotomy performed at our institution by the 2 senior authors in conjunction with other reconstruction procedures to correct adult-acquired flatfoot deformity (AAFD).

Methods:

We retrospectively studied patients who underwent Cotton osteotomy between 2005 and 2010 with minimum 4-year follow-up. Radiographic assessment was made on weightbearing radiographs taken at 4 different time intervals: preoperative, early (first postoperative full weightbearing), intermediate (between 1 and 4 years postoperatively), and final (over 4 years postoperatively).

Results:

Nineteen patients were included. Final follow-up was 8.6 ± 2.6 years. The lateral talus–first metatarsal angle improved significantly from preoperative to early radiographs (n = 15; mean change: 30 degrees, 95% CI, 21.6-38.7; P < .0001). A significant loss of correction was observed between intermediate and final radiographs (n = 11; mean change: 17 degrees, 95% CI, 8.1-26.4; P < .0001). Of 14 patients with early radiographs, 8 lost >50% of the correction initially achieved. Medial column height decreased by 3.0 mm (95% CI, 1.80-7.90; P = .35) between early radiographs and final follow-up.

Discussion:

This is the longest reported radiographic follow-up of the Cotton osteotomy performed to address forefoot varus deformity as part of AAFD. The Cotton osteotomy achieved radiographic correction of the medial longitudinal arch at early follow-up, but approximately half of the patients had lost over 50% of that correction at final follow-up. The lengthened angular shape of the cuneiform did not collapse, implying that further collapse occurred through the medial column joints.

Level of Evidence:

Level IV, case series.
Outcomes of Joint Preservation Surgery in Valgus Ankle Arthritis Without Deltoid Ligament Insufficiency
Authors: Kim Jaeyoung , Kim Ji-Beom , Lee Woo-Chun
Published: June 2021

Background:

To date, information about the role of proximal alignment correction in treating nontraumatic valgus ankle arthritis is limited. This study aimed to report outcomes of realignment surgery, including supramalleolar correction in valgus arthritic ankles without evidence of deltoid ligament insufficiency.

Methods:

Thirteen patients (13 ankles) who underwent joint preservation surgery for valgus ankle arthritis without evidence of deltoid ligament insufficiency were reviewed. Medial opening wedge supramalleolar osteotomy ( n = 11) and varization supramalleolar dome osteotomy ( n = 2) were performed to realign the hip-knee-ankle-hindfoot axis. Concomitant hindfoot correction was accompanied with either medial displacement calcaneal osteotomy ( n = 8) or subtalar arthrodesis ( n = 5). Pain, functional outcome (Foot Function Index [FFI]), radiographic arthritis grade (grades 0-4), 9 plain radiographic parameters, and 2 weightbearing computed tomography parameters were evaluated pre- and postoperatively. All patients completed a minimum 2-year follow-up.

Results:

Preoperatively, 10 ankles (77%) demonstrated a varus tibial plafond, and 3 ankles (23%) demonstrated a valgus or neutral tibial plafond. Postoperatively, radiographic arthritis grade improved in all except 1 patient, and the mean talar tilt angle improved from 5.5 to 1.7 degrees. The mean pain score (visual analog scale) decreased significantly from 7.3 to 2.5 ( P < .05), and the mean FFI improved significantly from 57.7 to 18.6 ( P < .001). None of the patients underwent conversion to joint-sacrificing procedures at the latest follow-up.

Conclusion:

This study demonstrated a possible relationship between lower limb malalignment and valgus ankle arthritis. Realignment surgery, including supramalleolar osteotomies, which straightens the mechanical axis and decreases the slope of the tibial plafond, may be a reasonable approach in joint preservation of valgus ankle arthritis without deltoid ligament insufficiency.

Level of Evidence:

Level IV, case series.
Depression Following Operative Treatments for Achilles Ruptures and Ankle Fractures
Authors: Davison Reid , Daniel Jean-Philippe A. , Idarraga Alexander J. , Perticone Kathryn M. , Lin Johnny , Holmes George B. , Lee Simon , Hamid Kamran S. , Bohl Daniel D.
Published: June 2021

Background:

The sudden and debilitating nature of lower extremity injuries can trigger mood disturbances, including major depressive disorder.

Methods:

This prospective study enrolled patients undergoing operative repair of ankle fractures and Achilles ruptures and followed them for 1 year postoperatively. The validated Patient Health Questionnaire (PHQ-9) for depressive symptoms was administered at the preoperative visit and at postoperative weeks 1, 2, 4, 8, 16, 24, 32, 40, and 52. PHQ-9 is scored 0 to 27, with higher values indicating greater depression symptoms.

Results:

Fifty-eight patients completed 1 year of follow-up. The mean PHQ-9 score was 2.7 (range, 0-20) at the preoperative visit, peaked at postoperative week 1 (4.9; range, 0-16), and reached its low at postoperative week 52 (0.8; range, 0-7). Cumulative incidences of depressive symptoms during the first year following surgery were 51.7% for at least mild depression, 22.4% for at least moderate depression, and 6.9% for severe depression. A history of mental health disorder and the inability to work during the period of postoperative immobilization were independently associated with greater depressive symptoms.

Conclusion:

The majority of patients undergoing operative treatment of Achilles ruptures and ankle fractures develop postoperative symptoms of mild to moderate depression that normalize after several months. Patients with a history of mental health disorder or who cannot work while immobilized postoperatively are at greatest risk.

Level of Evidence:

Level II, prospective cohort study.
Long-term silicone oil tamponade in eyes with complicated retinal detachment
Authors: Vidne-Hay Orit , Platner Eva , Alhalel Amir , Moisseiev Joseph
Published: June 2021

Purpose:

To report the visual and anatomic outcomes of eyes with exceedingly long-term silicone oil tamponade.

Methods:

A retrospective chart review of 43 eyes of 41 patients with silicone oil tamponade for 5 years or more. Rates of retinal reattachment, visual acuity, and complications are presented. Further analysis was performed to identify if silicone oil complications are more common in eyes with lower vision. For this, cases were divided into group A-visual acuity of 20/400 or better and group B-visual acuity of less than 20/400.

Results:

Mean silicone oil duration was 12.6 ± 6.3 years. The etiology at presentation included: recurrent RRD (60.46%), RRD secondary to trauma (25.58%), and TRD (13.95%). Ninety-three percent of eyes underwent at least one ocular surgery before the vitrectomy with silicone oil tamponade. The retinal attachment rate was 55.8%. Mean visual acuity at presentation was 2.03 ± 0.6 logMAR, and at the final follow-up, 1.85 ± 0.78 logMAR ( p = 0.166). Emulsification developed in 33.3% of cases, glaucoma in 28.6%, band keratopathy in 21.4%, and corneal decompensation in 16.7%. In 26.2% of eyes, the final visual acuity was 20/400 or better (group A). In 73.8% of eyes, final visual acuity was worse than 20/400 (group B). The rates of silicone oil emulsification and glaucoma were not statistically significant between groups.

Conclusions:

Long-term silicone oil tamponade is a possible option in eyes with complicated retinal detachment following multiple intravitreal procedures, although the complication rates are relatively high. In 26.2% of eyes, visual acuity of 20/400 or better can be preserved for many years.
The Effect of Mayoral Gender on Gendered Budget: Evidence from South Korea
Authors: Jung Hoyong
Published: June 2021

Politicians’ individual traits can influence policy outcomes. A local mayor has authority over the budget process and can affect the municipal budget allocation. This study empirically examined whether the mayor’s gender affected the gendered budget in Korean cities between 2016 and 2020. Across various econometric designs, our results revealed little evidence that mayoral gender (women, in this case) affects the formulation and execution of the gendered budget. The results imply that the effects of female representation through a female leader are dependent on various socioeconomic contexts.
Staggered Dual Kidney Transplantation
Authors: Ismail Omar Mobeen , Saedon Mahmud , Sharma Videha , Asderakis Argiris , Augustine Titus
Published: June 2021

We describe a case where a patient received a successful dual kidney transplantation in a staggered fashion. Two kidneys from a deceased donor were accepted for 2 separate primary intended recipients, however, due to unforeseen circumstances, both kidneys were eventually transplanted in a staggered fashion into an alternate single recipient. The intention behind this method was to enhance the patient’s renal function and to prevent the wastage of a kidney. Despite the significantly prolonged cold ischemia times, the recipient has excellent dual graft function after 3 years. The positive outcome underpins the effectiveness of donor kidneys even with prolonged cold ischemia times outside established best practice guidelines. It also reinforces the effectiveness of dual kidney transplantation. Transplant professionals encounter complex situations occasionally where an established evidence-base or aids to decision-making are limited. This case reflects challenges in decision-making, patient counselling and consent, especially when the opportunity for the staggered dual kidney transplantation, with potential increased morbidity, came about as another recipient declined a usable kidney. It also highlights the widely differing risk appetites of different patients. Crucially, it optimised the donation process and procurement of 2 kidneys while preventing wastage. To our knowledge, this is the first report of a staggered dual kidney transplantation in a single recipient.
Knowledge, attitudes and practices of patients with chronic illnesses during the COVID-19 pandemic: A cross-sectional survey from Pakistan
Authors: Mahmood Muhammad Muzaffar , Rehman Junaid , Arif Bushra , Rehman Zahra , Aasim Muhammad , Saeed Muhammad Tahir
Published: June 2021

Objectives

We studied the impact of the Covid-19 pandemic on the physical and mental health of patients with chronic illnesses and their behavioural responses.

Methods

We conducted a cross-sectional knowledge, attitudes and practices (KAP) survey among outpatients with chronic illnesses in Lahore, Pakistan.

Results

Four hundred and one participants were surveyed (84% above 50 years of age). One or two chronic illnesses were present in 130 (32%), three or four in 211 (53%) and more than four in 60 (15%). The majority correctly identified the sources of Covid-19 infection and higher risk patients. Of the respondents, 127 (32%) described feeling more vulnerable. Respondents reported a lack of trust in the community response (199; 49.6%) and hospital measures (167; 41.6%) to slow the spread of Covid-19 and 369 (92%) practiced some degree of social distancing. Respondents described negative impacts of lockdown measures on their physical and mental health (235; 58.6% and 262; 65.3%, respectively). Many reported difficulty in getting medical help during the pandemic (302; 75.2%). Half of the respondents (200; 49.8%) felt that delays in receiving care had adversely affected their health.

Conclusions

Respondents with chronic illnesses frequently reported negative behavioural and health impacts during the Covid-19 pandemic.
COVID-19: Nutrition and functional outcomes for critical care survivors in a 400- bedded district general hospital in North London
Authors: Catlow Rachel , Cheeseman Charlotte , Newman Helen
Published: June 2021

Novel coronavirus disease (COVID-19) has resulted in huge numbers of critically ill patients. This study describes the inpatient recovery and rehabilitation needs of patients admitted with COVID-19 to the critical care unit of a 400 bedded general hospital in London, United Kingdom. The rehabilitation needs of our sample were considerable. It is recommended that the increase demand on allied health professionals capacity demonstrated is considered in future COVID-19-related workforce-planning.
How Did the COVID-19 Pandemic Affect Trends in Facial Trauma?
Authors: Stanisce Luke , Fisher Alec H. , Choi Bo Young , Newman Andrew , Wang Ju Lin , Koshkareva Yekaterina
Published: June 2021

Study Design:

Retrospective cohort analysis.

Objective:

To examine the impact the COVID-19 pandemic and its accompanying societal measures had on the incidence, characteristics, and management of maxillofacial traumatic injuries.

Methods:

This cohort analysis compared facial trauma injuries presenting to the highest-volume Level I Trauma Center in New Jersey, USA from January 1 to July 31 in 2020 and 2019. Differences in demographics, mechanisms, and interventions were compared between the pandemic period (March 16–July 31, 2020) and the equivalent pre-pandemic date period in 2019 using X2, Fishers Exact, and Mann–Whitney U testing.

Results:

In total, 616 subjects were included. The daily incidence of facial trauma consults during the 2020 pandemic (1.81 ± 1.1) decreased compared to 2019 (2.15 ± 1.3) ( p = 0.042). During the outbreak, there was an increase in the proportion of subjects with positive urine drug screens (21.5% vs. 12.2%; p = 0.011) and injuries related to domestic violence (10.2% vs. 4.5%; p = 0.023). Patients were 30% less likely to be transferred from local hospitals (RR, 0.70 [0.53–0.93]; p = 0.014). Although subjects had a 25% increased risk of presenting with injuries deemed procedural (RR, 1.25 [95% CI, 1.05–1.56]; p = 0.048), a greater proportion were discharged with operative procedures scheduled as outpatients (16.0% vs. 4.9%; p = 0.005).

Conclusions:

The COVID-19 pandemic has impacted both the epidemiology and management of maxillofacial traumatic injuries, perhaps secondary to modifications in personal and community behaviors or the effects on healthcare systems in our region.
The relationship of insight with psychopathological dimensions in patients with schizophrenia
Authors: Huang Si-Sheng , Chang Cheng-Chen
Published: June 2021

Impaired insight in patients with schizophrenia results in less satisfactory clinical outcomes. This study was conducted to investigate the relationship between insight and individual psychopathological dimensions in inpatients with schizophrenia using a self-report questionnaire. In this study, 90 patients with schizophrenia aged 18–75 years admitted in the acute psychiatric ward of a medical center in Taiwan were enrolled. Patient insight was measured using the Self-Appraisal of Illness Questionnaire (SAIQ), and psychopathological dimensions were measured using the Positive and Negative Syndrome Scale (PANSS) and its five-factor structure model. A higher SAIQ score indicates greater insight. In bivariate correlation analyses, statistically significant correlations were observed between age, single marital status, educational level, and positive, excited, and depressed symptom factor of the PANSS and SAIQ score. In regression analyses, age and excited and depressed symptom factors were significantly associated with SAIQ score. No significant association was observed between insight and neurocognitive functions. Considering demographic characteristics, psychopathology, and neurocognition, in the acute phase of schizophrenia, younger patients with less severe excited symptoms and more severe depressive symptoms had greater insight.
An emerging entity after pandemic: Post-coronavirus disease 2019 syndrome and associated medical complications
Authors: Hsieh Jenny Yi Chen , Chin Tan Tze
Published: June 2021

The coronavirus disease 2019 is a devastating illness that has infected millions of people since the beginning of year 2020, through its multi-systemic manifestations that range widely in severity. Because current knowledge on the types and severities of medical illnesses encountered by patients who recovered from coronavirus disease 2019 is limited, it remains unknown whether these illnesses are direct sequelae of coronavirus disease 2019 infection or unrelated coincidences. In this article, we summarize the evidence currently available on post-coronavirus disease 2019 medical complications and propose directions for studying the long-term complications of coronavirus disease 2019 in the future.
Intestinal perforation involving the Dacron cuff of nephrostomy tubes following subcutaneous ureteral bypass system implantation for ureteral obstructions in two cats
Authors: Johnston Sigrid K , Bennett Tristram , Miller Amanda J
Published: June 2021

Case summary

This case report describes two cats that had subcutaneous ureteral bypass (SUB) systems implanted and subsequently developed duodenal perforations and septic peritonitis associated with the Dacron cuff of the nephrostomy tube. One cat recovered following surgical explantation of the SUB system with intestinal resection and anastomosis of the perforated small intestine, and – at the time of writing – is still alive. The other cat was humanely euthanased intraoperatively at the owner’s request owing to its perceived prognosis.

Relevance and novel information

To our knowledge this is the first time this complication has been reported following SUB device placement.
Musical Preference: Role of Personality and Music-Related Acoustic Features
Authors: Flannery Maya B. , Woolhouse Matthew H.
Published: June 2021

Personality factors, typically determined by the Big Five Inventory (BFI), have been a primary method for investigating individual preferences in music. While these studies have yielded a number of insights into musical choices, weaknesses exist, owing to the methods by which music is characterized and categorized. For example, musical genre, music-preference dimensions (e.g., reflective and complex), and musical attributes (e.g., strong and mellow), reported within the literature, have arguably produced inconsistent and thus difficult to interpret results. We attempt to circumvent these inconsistencies by classifying music using objectively quantifiable acoustic features that are fundamental to Western music, such as tempo and register. Moreover, it is our contention that the link between musical preference and personality may operate primarily at the level of acoustic features and not at broader categorization levels, such as genre. This study attempts to address this issue. Ninety participants listened to and indicated preference for stimuli that were systematically manipulated by dynamics (attack rate), mode, register, and tempo. Personality was measured using the BFI, allowing for analysis of personality traits and preference for acoustic features. Results supported the link between personality and preference for certain acoustic features. Preference with respect to dynamics was related to openness and extraversion; mode to conscientiousness and extraversion; register to extraversion and neuroticism; and tempo to conscientiousness, extraversion, and neuroticism. Though significant, these associations were relatively weak; therefore, future research could expand the number of manipulated acoustic features. Specific attempts should also aim to disentangle the effects of genre versus acoustic features on musical preferences. Personality–preference relationships at the acoustic-feature level are discussed with respect to music recommender systems and other aspects of the literature.