bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation, relationship and reflection: Lessons for international medical electives
Authors: Stone Stephanie L , Moore Jolene N , Tweed Sam , Poobalan Amudha S
Published: June 2022

Background:

International medical electives (IMEs) provide opportunities for global health education within undergraduate medical curricula; however, ethical and practical preparations vary.

Methods:

Single-centre, prospective, mixed-methods study, utilising online questionnaires with students and host supervisors, contemporaneous reflective diaries and focus groups, to explore the preparedness and experiences of final-year UK medical students undertaking IMEs.

Results:

Students experienced communication challenges and felt underprepared prior to IME. Students undervalued cultural preparation, whereas host supervisors primarily desired humility and cultural sensitivity. Visitors to high-income countries underpredicted cultural differences with reflective practice supporting understanding of global health inequalities. Burden on hosts and ethical dilemmas related to acting beyond competence remained significant concerns.

Conclusion:

International medical electives provide experiential learning, and with authentic reflection facilitate professional development. Enhanced culturally competent preparation and debriefing is however essential for collaborative and responsible student learning. Acting beyond competency persists, requiring concerted reform during the pandemic-mandated hiatus of IMEs.
A probable case of vaccine-induced immune thrombotic thrombocytopenia secondary to Pfizer Comirnaty COVID-19 vaccine
Authors: Goh CY Carol , Teng Keat Chew , Su Kien Chiang , Ai Sim Goh
Published: June 2022

The accelerated development of various vaccines against COVID-19 was a global effort to curb the COVID-19 pandemic. As a result, several unique vaccine-related adverse events were observed. Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been recognised as a clinically distinct entity with a predisposition for thrombosis at unusual sites with laboratory features of consumptive coagulopathy in addition to anti-PF4 assay seropositivity. The majority of cases reported were associated with adenoviral-based vectors such as ChAdOx1 nCoV-19 (Oxford-AstraZeneca) and Janssen Ad26.COV2.S (Johnson & Johnson). In our online search, we have not found any reports to date of VITT associated with Pfizer–BioNTech Comirnaty mRNA vaccine. We report a case of a previously healthy 76-year-old man who received his first-dose Pfizer Comirnaty vaccine on 11 October 2021 who developed left upper limb swelling on day 2 post-vaccination, which progressively worsened on day 4 post-vaccination. He was confirmed to have left axillary vein thrombosis on computer tomography arteriography/computed tomography venography of left upper limb on day 5 post-vaccination with new onset aphasia with unilateral limb weakness on day 8 post-vaccination. Magnetic resonance imaging/magnetic resonance angiography of the brain confirmed acute left middle cerebral artery thrombosis with infarction. Blood investigations showed thrombocytopenia, elevated D-dimer, hypofibrinogenemia in addition to his unusual sites of thrombosis involving both arterial and venous circulation. His IgG ELISA assay for anti-PF4 antibody was positive.
Too much of a good thing: A case series of rare yet pertinent causes of hypercalcaemia and acute kidney injury
Authors: Munir Mohsin , Kejeh Kwerinuchi T , Richardson Michelle L , Ande Praveen C
Published: June 2022

Calcium compounds and vitamin D supplements are readily available as over-the-counter preparations. Whilst integral in maintaining calcium homeostasis in certain patients, excess exogenous intake of these preparations can have deleterious effects, particularly in terms of renal function. We look at the cases of two patients, aged 52 and 34, who were referred into hospital with hypercalcaemia and acute kidney injury (AKI). Both individuals reported regular and prolonged self-medication with unregulated over-the-counter supplements containing calcium carbonate and vitamin D, respectively. Prompt investigation and treatment enabled an element of reversibility of the AKI in both the cases, with further improvement in renal function over time. We emphasise the importance of recognising the overuse of exogenous vitamin D supplements and calcium compounds as rare yet treatable causes of AKI associated with hypercalcaemia and discuss how raising public awareness into the risks posed by self-medication of over-the-counter medicines is paramount.
Dr Robert Knox and his book on fishing in Scotland: A window into his mind
Authors: Donaldson Ken , Henry Christopher
Published: June 2022

Robert Knox was publicly vilified for his suspected complicity in the 16 murders committed by Burke and Hare, although he had no involvement in them. Along with several books on anatomy Knox also wrote a book on angling in Lowland Scotland. In ‘Fish and Fishing in the Lone Glens of Scotland’ Knox’s deep love for nature and for fishing emerges. Most interesting however is that although generally focussed on fish and fishing, the book abounds with asides on Knox’s other preoccupations and passions. These provide rare insights into the character of the great anatomist, whose personality has otherwise retained its opacity over the years. In the book, Knox writes in passing and in a relatively unguarded fashion, about such topics as transcendental anatomy, Scottish Independence, empiricism, race and Edinburgh medical figures. In so-doing, we contend that he affords the reader some insight into the mind of the real Dr Robert Knox.
Improving muscle strength and physical function in older people living with sarcopenia and physical frailty: Not all exercise is created equal
Authors: Hurst Christopher , Sayer Avan A
Published: June 2022

Exercise is an increasingly widely used treatment for older people across a range of clinical conditions including sarcopenia and physical frailty. Whilst exercise can have many benefits for older people, adaptations to exercise are specific to the exercise mode that is performed and not all exercise is created equal. The correct type of exercise, at the correct dose, needs to be prescribed to maximise effectiveness in treating sarcopenia and physical frailty where maintaining or improving muscle strength and physical function represent key aims. Resistance exercise (RE) is the most potent approach to improving muscle strength and physical function and should be prioritised within exercise programmes delivered to this group. Resistance exercise programme design should be underpinned by the fundamental principles of exercise prescription in order to deliver an appropriate and individualised exercise dose to maximise the potential of RE as a treatment for older people living with sarcopenia and physical frailty.
Direct[Message]: Exploring Access and Engagement With the Arts Through Digital Technology in COVID Times
Authors: La Rose Tara , Rice Carla M. , Alfaro-Laganse Carmela , Maxwell Colina , El Kadi Rana , Luzius-Vanin Christina , Fisher Michele , Lebrun Simon , Ruxton Jim , Bobier David , Paton Cathy , Badri Suad , O’Reily Sheila , Perquin Maggie , Smith Kathy , Bhatta Kusum , Katz Becky
Published: June 2022

Direct[Message], a community-based research (CBR) project developing a digital platform supporting older adults engagement with the arts through digital technologies, faced the challenge of redesigning the research protocol after the COVID-19 pandemic was declared in March 2020. The redesign, which brought challenges and opportunities, allowed the research team to embed the project with process goals considering older adults’ experiences of social isolation, and exploring how these experiences might be mitigated by greater access to the arts through technology. This article explores the redesign process undertaken by the Direct[Message] team and presents preliminary findings from this multiyear study.
Dosimetric Impacts of Source Migration, Radioisotope Type, and Decay with Permanent Implantable Collagen Tile Brachytherapy for Brain Tumors
Authors: Pinnaduwage Dilini S. , Srivastava Shiv P. , Yan Xiangsheng , Jani Shyam , Brachman David G. , Sorensen Stephen P.
Published: June 2022

Introduction: Brachytherapy using permanently implantable collagen tiles containing cesium-131 (Cs-131) is indicated for treatment of malignant intracranial neoplasms. We quantified Cs-131 source migration and modeled the resulting dosimetric impact for Cs-131, iodine-125 (I-125), and palladium-103 (Pd-103). Methods and Materials: This was a retrospective analysis of a subgroup of patients enrolled in a prospective, single-center, nonrandomized, clinical trial (NCT03088579) of Cs-131 collagen tile brachytherapy. Postimplant Cs-131 plans and hypothetical I-125 and Pd-103 calculations were compared for 20 glioblastoma patients for a set seed geometry. Dosimetric impact of decay and seed migration was calculated for 2 hypothetical scenarios: Scenario 1, assuming seed positions on a given image set were unchanged until acquisition of the subsequent set; Scenario 2, assuming any change in seed positions occurred the day following acquisition of the prior images. Seed migration over time was quantified for a subset of 7 patients who underwent subsequent image-guided radiotherapy. Results: Mean seed migration was 1.7 mm (range: 0.7-3.1); maximum seed migration was 4.3 mm. Mean dose to the 60 Gy volume differed by 0.4 Gy (0.6%, range 0.1-1.0) and 0.9 Gy (1.5%, range 0.2-1.7) for Cs-131, 1.2 Gy (2.0%, range 0.1-2.1) and 1.6 Gy (2.6%, range 1.2-2.6) for I-125, and 0.8 Gy (1.3%, range 0.2-1.5) and 1.4 Gy (2.3%, range 0.3-1.9) for Pd-103, for Scenarios 1 and 2, respectively, compared with the postimplant plan. For a set seed geometry mean implant dose was higher for Pd-103 (1.3 times) and I-125 (1.1 times) versus Cs-131. Dose fall-off was steepest for Pd-103: gradient index 1.88 versus 2.23 (I-125) and 2.40 (Cs-131). Conclusions: Dose differences due to source migration were relatively small, suggesting robust prevention of seed migration from Cs-131-containing collagen tiles. Intratarget heterogeneity was greater with Pd-103 and I-125 than Cs-131. Dose fall-off was fastest with Pd-103 followed by I-125 and then Cs-131.
The Effect of Foot Care Education for Patients with Diabetes on Knowledge, Self-Efficacy and Behavior: Systematic Review and Meta-Analysis
Authors: Yıldırım Ayaz Elif , Dincer Berna , Oğuz Aytekin
Published: June 2022

This systematic review and meta-analysis aimed to synthesize randomized controlled trials on the impact of foot care education on knowledge, self-efficacy and behavior in patients with diabetes. A search was made using PubMed, Web of Science, Science Direct, Google Scholar, YOK National Thesis Center and Google Scholar electronic databases for studies published between March 2003-January 2022. The search medical subject headings (MeSH) terms were diabetic foot, knowledge, self-efficacy, and behavior. Studies suitable for the systematic review and the meta-analysis met the following criteria (PICOS): target participants would be diagnosed with diabetes (population), diabetic foot education (intervention), comparison of the group receiving diabetic foot care education and routine care education, and the control group receiving only routine care education (comparison), studies evaluating the levels of knowledge, self-efficacy and behavior (outcome), randomized controlled trials (study design). Twenty-six studies were included in systematic review. Three studies for knowledge, 5 studies for behavior, 8 studies for self-efficacy were included in the meta-analysis (total sample: 2534, experiment: 1464, control: 1071). All of the studies had low reporting bias. The mean duration of educations for knowledge was 5.2 months. This duration was 4.8 months for behavior and 4.5 months for self-efficacy. In the random effect (since the homogeneity test: P < .001, this model was used), there were significantly difference in terms of knowledge (standardized mean difference (SMD): 1.656, 95% [CI]: 1.014-2.299, P < .001), and behavior (SMD: 1.045, 95% CI: 0.849-1.242, P < .001). But no difference was observed in terms of self-efficacy (SMD: 0.557, 95%CI: −0.402-1.517, P > .05). The results of a systematic review of twenty-six studies and a meta-analysis of 9 studies showed that diabetic foot education improved the level of knowledge and behavior of patients with diabetes, while not affecting their self-efficacy. Educational interventions with long-term follow-up are needed to address the growing health care needs of patients with diabetes.
Towards the Transformative Role of Global Citizenship Education Experiences in Higher Education: Crossing Students’ and Teachers’ Views
Authors: Coelho Dalila P. , Caramelo João , Amorim José Pedro , Menezes Isabel
Published: June 2022

This work analyzes the transformative learning potential of global citizenship education (GCE) in academia. This is done by examining learning conditions, processes, and outcomes and is then followed by a reflection on the opportunity to link transformative learning (TL) and GCE. Students’ views were collected through focus groups with 72 students and interviews with seven teachers. Data was analyzed using thematic analysis informed by TL theory and critical GCE. We suggest that the experiences studied offer important opportunities for potentially transformative learning; however, there is a need for more emphasis on linking GCE and TL, and on the narratives and conditions for “transformation.”
Combined CSF-venous Fistula and middle meningeal artery embolization for treatment of spontaneous intracranial hypotension
Authors: Madhavan Ajay A. , Cutsforth-Gregory Jeremy K. , Oushy Soliman H. , Borg Nicholas , Brinjikji Waleed
Published: June 2022

Transvenous Onyx embolization was recently described as an effective treatment of spontaneous intracranial hypotension caused by CSF-venous fistulas. Patients with CSF-venous fistulas can present with a wide spectrum of clinical and imaging findings, sometimes including spontaneous subdural hematomas, subdural hygromas, or a combination of both. Here, we describe four patients with spontaneous intracranial hypotension complicated by subdural fluid collections caused by CSF-venous fistulas. The patients were treated with transvenous Onyx embolization of their CSF-venous fistulas and transarterial particle embolization of the bilateral middle meningeal arteries, with both procedures performed in a single treatment session. All four patients had clinical improvement and decreased size or resolution of their subdural fluid collections. Based on our findings, we believe that middle meningeal embolization could be a useful adjunct to CSF-venous fistula embolization. A case-control study comparing patients who did or did not undergo middle meningeal embolization will be necessary to validate this supposition.
Increased prevalence of colorectal neoplasia in patients with intraductal papillary mucinous neoplasms
Authors: Zelnik Yovel Dana , Bear Lior , Scapa Erez , Shnell Mati , Bar Yishay Iddo , Bar Nir , ZIv Baran Tomer , Younis Fadi , Phillips Adam , Lubezky Nir , Shibolet Oren , Ben-Ami Shor Dana
Published: June 2022

Background:

The association between intraductal papillary mucinous neoplasms (IPMNs) and colorectal cancer (CRC) and polyps is controversial.

Objectives:

To compare the prevalence of CRC and colorectal polyps among patients with IPMN and matched average risk individuals.

Methods:

A match cross-sectional historical study comparing colonoscopy findings of 310 patients with IPMN cysts who underwent at least one colonoscopy examination from 2004 through 2019, with 310 age- and gender-matched average risk participants who underwent a screening colonoscopy. CRC and polyps were assessed in both groups. The prevalence and odds ratio were calculated.

Results:

CRC was diagnosed in 16 of 310 patients with IPMN (5.2%), and at least one polyp was detected in 96 patients (31%). The prevalence of CRC was greater among patients with IPMN than in matched individuals [5.2% versus 1.3%, p = 0.012, prevalence odds ratio (POR) 4, confidence interval (CI) 1.29–16.44]. The overall prevalence of polyps was not higher among patients with IPMN than in matched individuals (31% versus 26.8%, p = 0.291, POR 1.22, CI 0.85–1.76). However, the prevalence of colorectal adenomas with high-grade dysplasia was higher in patients with IPMN than in matched individuals (4.2% versus 1%, p = 0.02, POR 4.33, CI, 1.19–23.7). The prevalence of large polyps (i.e. more than 20 mm in size) was also greater in patients with IPMN than in matched individuals (6.1% versus 1.9%, p = 0.011, POR 3.6, CI, 1.29–12.40).

Conclusion:

Patients with IPMN have a significantly higher prevalence of CRC and advanced polyps than the average risk population. In view of our findings, we suggest that once the diagnosis of IPMN is made, special consideration of CRC should be undertaken.
COVID-19 contact tracing in the hospitals located in the North Denmark region: A retrospective review
Authors: Fromberg Dorte , Ank Nina , Nielsen Hans L
Published: June 2022

Background

The Department of Infection Control, at our University Hospital conducted contact tracing of COVID-19 positive patients and staff members at all hospitals in the North Denmark Region.

Aim

To describe the contact tracing performed during the COVID-19 pandemic in the Region and its outcomes.

Methods

Data from each contact tracing were collected prospectively during 14 May 2020–26 May 2021. Data included information about the index case (patient or hospital staff member), presentation (asymptomatic vs symptomatic), probable source of transmission (community-acquired or hospital-acquired), number of close contacts and if any of these were SARS-CoV-2 PCR-test positive.

Findings

362 contact tracing were performed. A total of 573 COVID-19 positive cases were identified among 171 (30%) patients and 402 (70%) staff members. 192 (34%) of all cases were tested due to symptoms of COVID-19, whereas two-third were tested for other reasons including outbreak and systematic screening tests. A total of 1575 close contacts were identified, including 225 (14%) patients and 1350 (86%) staff members. 100 (6%) close contacts, including 24 patients and 76 staff members, were infected with SARS-CoV-2, of which 33 (43%) staff members was positive at day 0 i.e. the same day as being identified as close contacts.

Discussion

We found a three to one of close contacts to each index case, but only 6% became SARS-CoV-2 positive, with a surprisingly high number of those identified at day 0. Our data confirm that regular testing of patients and staff will identify asymptomatic carriers and thereby prevent new cases.
The Impact of Tourist–Robot Interaction on Tourist Engagement in the Hospitality Industry: A Mixed-Method Study
Authors: Fang Shujie , Han Xiaoyun , Chen Shuping
Published: June 2022

Service robots have become a topic of interest for tourism and hospitality researchers and practitioners. The success of service robot adoption lies in the effectiveness of tourist–robot interaction. There has been less interest in the performance of tourist–robot interaction, with research related to tourist engagement being particularly scarce. Drawing on the theoretical perspective of relationships, this article examines the impact of tourist–robot interaction on tourist engagement in the hospitality context. A mixed-methods approach is adopted, utilizing grounded theory and structural equation modeling. The findings reveal two types of tourist–robot interaction, emotional (fun and playfulness) and instrumental (convenience and ease of use). Tourist–robot emotional interactions influence tourist engagement by enhancing tourists’ needs satisfaction, tourist emotion, and social bonds with robots. It was found that tourist–robot instrumental interaction positively affects tourist engagement through needs satisfaction and tourist emotion but not social bonds. The findings extend our understanding of human–robot interaction and customer engagement.
Congenital internal carotid artery hypoplasia: A systematic review
Authors: Whitley Helen , Zazay Awista , Skalický Petr , Malík Jozef , Charvát František , Beneš Vladimír , Bradáč Ondřej
Published: June 2022

This review evaluates the current evidence for the clinical management of congenital internal carotid artery hypoplasia (CICAH). We summarise clinical presentations diagnostic standards, imaging recommendations, treatment and follow-up. The review was prompted by a case of CICAH in a 50-year-old female who presented to our neurosurgery clinic with an acute episode of vertigo. The patient underwent CT angiogram, which showed an unusually low right carotid bifurcation. The right internal carotid artery (ICA) was hypoplastic, and the A1 segment of the anterior cerebral artery (ACA) was absent. Skull base CT showed an ipsilateral hypoplastic carotid canal. To summarise current evidence for clinical management of CICAH we followed PRISMA guidelines to identify papers meeting our predefined inclusion criteria. We searched three databases using the terms ‘ICA’ and ‘Hypoplasia’. We reviewed 41 papers meeting our criteria. 34 were clinical reports. We performed a data extraction and quality appraisal on these reports. We found that CICAH may be less rare than previously described. Blood pressure control in CICAH is crucial due to the increased risk of stroke and aneurysm formation. Follow-up imaging is strongly recommended. Carotid doppler sonography is a powerful and underutilised diagnostic tool, and carotid canal hypoplasia is not a pathognomic sign. In conclusion, clinicians should be alert to anatomic variations such as CICAH because these produce haemodynamic changes that may have serious clinical consequences. We recommend a central registry of patients with CICAH in order to understand the longer-term natural history of the condition.
Miscibility effect of biodegradable aliphatic poly(butylene succinate)/aromatic polycarbonate blends
Authors: Gumede Thandi P , Shingange Katekani , Mbule Pontsho , Motloung Bennie
Published: June 2022

Biodegradable polymers are gaining attention for applications in drug delivery, tissue engineering, and wound management. Methods for enhancing their potential in these applications include blending biodegradable aliphatic polyester with other biodegradable aliphatic polyester and/or blending aliphatic polyesters with aromatic polyesters to form blends with unique properties. Herein, we report on the effect of a non-biodegradable aromatic polycarbonate (PC) on the physical, mechanical, and thermal properties of biodegradable aliphatic polybutylene succinate (PBS). The PBS/PC blends contained 3, 13, and 27 wt% PC and were prepared by melt extrusion. The FTIR results revealed apparent compatibility between the two polymers. Even though the blends are compatible, the extent of miscibility depends on thermodynamics terms such as enthalpy, entropy, and Gibbs free energy. According to the SEM micrographs, adding 3 wt% PC resulted in a miscible polymer blend. Above this content, phase dispersion was observed. XRD results revealed peak shifts to higher angles and new peaks forming between 25 and 30°. This is related to the interaction between the components in the blends. The crystallinity was also improved at 3 wt% PC and this is consistent with the DSC results. TGA analysis indicated no improvement in the thermal stability of the blends. DMA revealed that at low PC content (3 wt%), there is a marked improvement in the elastic modulus. This study will benefit the field of Polymer Science because if one wants to prepare PBS/PC they will know that they perform optimally at low PC content.
Design and Development of a Digital Counseling Program for Chronic Kidney Disease
Authors: Ong Stephanie W. , Wong Julia V. , Auguste Bourne L. , Logan Alexander G. , Nolan Robert P. , Chan Christopher T.
Published: June 2022

Background:

Self-management has shown to improve the quality of life in patients with chronic kidney disease (CKD). Readily accessible self-management tools are essential in promoting adherence to self-care behaviors. In recognizing that digital health facilitates efficient access to self-management programs, we developed a digital counseling program, ODYSSEE Kidney Health, to promote self-care behaviors while supporting health-related quality of life.

Objective:

To present the design and development of ODYSSEE Kidney Health for digital counseling for patients with CKD.

Design:

The study involved an iterative design process based on user-centered design principles to develop the digital counseling program, ODYSSEE Kidney Health.

Setting:

A sample of 10 to 15 participants were purposively sampled from nephrology clinics at the University Health Network, Toronto, Canada.

Methods:

Participants underwent 2 phases in the development process. In each phase, participants were presented with a component of the program, asked to perform goal-oriented tasks, and participate in the “think-aloud” process. Semi-structured interviews followed the first phase to identify feedback about the overall program. Thematic analysis of the interviews identified themes from the usability testing. Descriptive statistics were used to summarize patient demographic data.

Results:

We enrolled 11 participants (n = 7 males, n = 4 females, ages 30-82). The main themes generated anchored on (1) impact on nephrology care, (2) technical features, and (3) CKD content. Overall, participants reported positive satisfaction toward the navigation, layout, and content of the program. They cited the value of the program in their daily CKD care.

Limitations:

Study limitations included using a single center to recruit participants, most of the participants having prior technology use, and using one module as a representative of the entire digital platform.

Conclusion:

The acceptability of a digital counseling program for patients with CKD relies on taking the patients’ perspective using a user-centered design process. It is vital in ensuring adoption and adherence to self-management interventions aimed at sustaining behavioral change.
Cognitive behavioral therapy with and without biofeedback in fibromyalgia: Assessment of functional and clinical change
Authors: Govillard Leila , Gorbeña Susana , Iraurgi Ioseba
Published: June 2022

The study compared the effectiveness of Cognitive Behavioral Therapy (CBT) with biofeedback or with emotional expression in individuals with fibromyalgia, and a waiting list control group. 88 women participated in a naturalistic study with random assignment. The Fibromyalgia Impact Questionnaire, SCL-90R, and a visual analog quality of life scale were used. Both intervention groups improved, but differed in physical and emotional control response. Using the reliable change index procedure, clinical improvement occurred in 18.8% of participants, and 4.8% achieved scores comparable with clinical recovery. Greater specificity on therapeutic objectives is warranted.
Cyber-attacks are a permanent and substantial threat to health systems: Education must reflect that
Authors: Niki O’Brien , Saira Ghafur , Arvind Sivaramakrishnan , Mike Durkin
Published: June 2022

Cyber-attacks on healthcare institutions have increased in recent years and have made headlines through the COVID-19 pandemic. With the fallout of attacks increasingly reported in academic research and in the media, there is a real urgency to address cyber-threats that must be augmented across and within health systems. Until now, clinical healthcare professionals have considered cyber-attacks on healthcare organisations a predominantly information and communication technology issue, but this perception is no longer fit-for-purpose. This commentary provides insights into the scale of cyber-attacks and their impact on staff wellbeing, arguing that cybersecurity education for all staff in healthcare organisations must be improved through online resources, simulation, and gaming. The role of national educators, policymakers, and multilateral organisations in achieving this is outlined alongside implications for future policy and practice.
Sexual harassment experiences and their consequences for the private lives of Chinese women
Authors: Xu Jiashu , Zhang Chunni
Published: June 2022

Sexual harassment is a global issue threatening individuals’ safety and rights, especially for women. Previous studies mainly focused on the negative impact of sexual harassment on women's health, work, and education. Using data from the Chinese Private Life Survey, this article examines the effect of sexual harassment in both physical and non-physical forms and probes the effect of the perpetrator's relationship to the victim on women's sexual behaviors, sexual and marital well-being, and desires for marriage and childbearing. The results indicate that both physical and non-physical sexual harassment lowered married or cohabitating women's sexual satisfaction and functioning. Sexual harassment by a family member/relative, an intimate partner or an acquaintance produced a larger negative effect on women's sexual well-being than that by others. Married women's marital satisfaction and stability were also undermined if they experienced sexual harassment. A family member/relative, an intimate partner and a stranger as the perpetrator had a larger effect on women's marital well-being than other perpetrators. For unmarried women, sexual harassment was not associated with the desire for marriage. However, those who were physically harassed by an acquaintance were unlikely to have a desire for childbearing. Comparing with non-physical sexual harassment, physical sexual harassment was found to have a larger negative impact on women's private lives.
Regional political paradigm shift: Challenges and opportunities for Pakistan
Authors: Zaidi Syed Muhammad Saad , Nirmal
Published: June 2022

With the dawn of the 21st century, a global political paradigmatic shift was witnessed; no longer was Europe considered to be the focal point of geopolitics. Now, all eyes were on the Asian continent; with the brewing Afghan conflict, the arguably rising global hegemony contender China, the convoluted Iranian crisis, rapidly rising economic powers in South-East Asia, the key strategic power of the Indian Ocean and India and, amidst all, the dramatically increasing footprint of the United States. Consequently, as states with opposing interests were ferociously competing for regional dominance, a great degree of political polarization was induced in the regional geopolitical structure, which in turn forced political realignments. Old foes became friends (India and the United States), whereas decades old alliances broke (Pakistan and the United States). This dramatic regional political paradigm shift has forced Pakistan to completely transform its foreign policy, from a pro-western to an eastern/regional approach. This article explores how the changing regional geopolitical dynamics is affecting Pakistan’s foreign policy. It does so by critically analysing the geopolitical realignments in the region and the myriad regional conflicts/crises, while predominantly highlighting their implications for Pakistan. A mix-approach based on descriptive and critical analytical qualitative research methods has been adopted to conduct this study.
Iterative reconstruction with multifrequency signal recognition technology to improve low-contrast detectability: A phantom study
Authors: Funama Yoshinori , Shirasaka Takashi , Goto Taiga , Aoki Yuko , Tanaka Kana , Yoshida Ryo
Published: June 2022

Background

Brain CT needs more attention to improve the extremely low image contrast and image texture.

Purpose

To evaluate the performance of iterative progressive reconstruction with visual modeling (IPV) for the improvement of low-contrast detectability (IPV-LCD) compared with filtered backprojection (FBP) and conventional IPV.

Materials and methods

Low-contrast and water phantoms were used. Helical scans were conducted with the use of a CT scanner with 64 detectors. The tube voltage was set at 120 kVp; the tube current was adjusted from 60 to 300 mA with a slice thickness of 0.625 mm and from 20 to 150 mA with a slice thickness of 5.0 mm. Images were reconstructed with the FBP, conventional IPV, and IPV-LCD algorithms. The channelized Hotelling observer (CHO) model was applied in conjunction with the use of low-contrast modules in the low-contrast phantom. The noise power spectrum (NPS) and normalized NPS were calculated.

Results

At the same standard and strong levels, the IPV-LCD method improved low-contrast detectability compared with the conventional IPV, regardless of contrast-rod diameters. The mean CHO values at a slice thickness of 0.625 mm were 1.83, 3.28, 4.40, 4.53, and 5.27 for FBP, IPV STD, IPV-LCD STD, IPV STR, and IPV-LCD STR, respectively. The normalized NPS for the IPV-LCD STD and STR images were slightly shifted to the higher frequency compared with that for the FBP image.

Conclusion

IPV-LCD images further improve the low-contrast detectability compared with FBP and conventional IPV images while maintaining similar FBP image appearances.
STEM Education as a Concept Borrowing Issue: Perspectives of School Administrators in Turkey
Authors: Kulakoglu Busra , Kondakci Yasar
Published: June 2022

Purpose

As a borrowed concept, science, technology, engineering, and mathematics (STEM) education holds limited relevance in many country contexts. This study investigates how school administrators in Turkey view STEM education from three dimensions: (a) their understanding of STEM education, (b) their experiences of STEM implementations, and (c) their perception of their roles in STEM implementation.

Design/Approach/Methods

This phenomenological study analyzes the perceptions of school principals working in prominent high schools in Turkey.

Findings

The findings indicate that there are gaps in STEM implementation at both the conceptual level and the school level, including epistemological issues, infrastructural gaps, mismatch with overall organizational culture, and knowledge and skill gaps. Despite efforts to integrate STEM education into educational practices, significant deficiencies are making it an unrealistic practice in Turkey.

Originality/Value

While the literature on STEM education is expanding, a few empirical studies focus on school management in relation to STEM education. Arguably, despite promising to transform science and mathematics teaching, STEM education appears to have limited relevance to science and mathematics teaching in Turkey—rendering it yet another example of concept and policy borrowing in education.
How Sports Event Volunteer Management Affects Volunteers’ Satisfaction and Engagement: The Mediating Role of Social Capital
Authors: Zhigang Wang , Yingfei Liu , Jinyao Zhang , Xintao Liu , Hongyan Duan , Lei Zhang
Published: June 2022

This study investigated the role of social capital in the relationship between sports event volunteer management and volunteers’ attitude and behavior. Social capital was discovered to mediate the relationships of sports event volunteer management with volunteers’ satisfaction and work engagement. These relationships were empirically examined by conducting a survey of 303 volunteers from the 2016 Wuhan Open and 2016 Wuhan Marathon. The results revealed that sports event management practices, namely training and working conditions, significantly affected the volunteers’ social capital. The social capital of the sports event volunteers significantly affected their satisfaction and work engagement. The volunteers’ social capital promoted their satisfaction and engagement only if sports event volunteer management practices effectively enhanced their social capital. This study provides recommendations to help sports event organizers motivate volunteers.
Association Between Preoperative Neuropathic Pain and Patient Reported Outcome Measures After Cervical Spinal Cord Decompression Surgery
Authors: Nagata Kosei , Tozawa Keiichiro , Miyahara Junya , Ito Yusuke , Nakamoto Hideki , Nakajima Koji , Kato So , Doi Toru , Taniguchi Yuki , Matsubayashi Yoshitaka , Tanaka Sakae , Oshima Yasushi
Published: June 2022

Study design

A prospective observational study.

Objective

To evaluate the impact on surgical outcomes of preoperative neuropathic pain (NeP) assessed by the painDETECT questionnaire (PDQ) administered to participants undergoing cervical decompression surgery for degenerative cervical myelopathy (DCM).

Methods

Participating patients were separated into the Non-NeP group (preoperative PDQ score ≤ 12), and NeP group (score ≥ 13). They were asked to complete a booklet questionnaire, including NRS for pain, the Short Form-12 for PCS and MCS, EQ-5D, NDI, and COMI-Neck, at baseline and 1 year after surgery. The JOA score for DCM and radiological changes were also evaluated. Propensity scores were used for the generalized linear model to adjust the patients’ backgrounds.

Results

Of the 116 patients recruited, 105 completed the one-year follow-up. In this study, 31 (29.5%) and 74 (70.5%) patients in the NeP and non-NeP groups, respectively, were compared. Except for the higher female ratio in the NeP group (64.6% vs 33.2%, P = .009), preoperative demographic data and surgical factors were not significantly different between both groups. The NeP group showed greater neck/arm/hand NRS scores and worse pre- and postoperative NDI/EQ-5D/COMI-Neck scores at baseline and 1 year after surgery, but this was not significant in the MCS/PCS and JOA scores. Change scores of neck/arm/hand NRS scores and MCS/PCS/NDI/EQ-5D/COMI-Neck scores were not significant between both groups.

Conclusions

The preoperative NeP, assessed by PDQ, was observed in approximately 30% of patients with DCM who underwent decompression surgery. The presence of NeP was associated with worse pre- and postoperative NDI/EQ-5D/COMI-Neck scores.
Influence of Pedicle Screw Insertion Depth on Posterior Lumbar Interbody Fusion: Radiological Significance of Deeper Screw Placement
Authors: Matsukawa Keitaro , Konomi Tsunehiko , Matsubayashi Kohei , Yamane Junichi , Yato Yoshiyuki
Published: June 2022

Study Design

Retrospective case series.

Objectives

To investigate the influence of screw size on achieving bone fusion in posterior lumbar interbody fusion (PLIF).

Methods

In total, 137 consecutive patients with L4 degenerative spondylolisthesis who underwent single-level PLIF at L4-L5 were evaluated. Factors investigated for their contribution to bone fusion included: 1) age, 2) sex, 3) body mass index, 4) bone mineral density, 5) intervertebral mobility, 6) screw diameter, 7) screw length, 8) screw fitness in the pedicle (%fill), 9) screw depth in the vertebra (%depth), 10) screw angle, 11) facetectomy, 12) crosslink connector, and 13) cage material.

Results

Bone fusion was confirmed in 88.2% of patients. The comparison between fusion (+) and fusion (-) groups showed no significant differences in screw size. The %fill and %length were significantly greater in the fusion (+) group than in the fusion (-) group (%fill: 58.5% ± 7.5% vs 52.3% ± 7.3%, respectively, P = .005; %depth: 59.8% ± 9.7% vs 50.3% ± 13.8%, respectively, P = .025). Multivariate logistic regression analysis revealed that %fill (odds ratio [OR]= 1.11, P = .025) and %depth (OR = 1.09, P = .003) were significant independent factors affecting bone fusion. Receiver operating characteristic curve analyses identified a %fill of 60.0% and a %depth of 54.2% as optimal cutoff values for achieving bone fusion

Conclusions

Screw size should be determined based on the screw fitness in the pedicle (%fill > 60%) and screw insertion depth in the vertebral body (%depth > 54.2%) according to individual vertebral anatomy in L4-L5 PLIF.
Managing the Crisis: Learnings from ‘Zero Risque’
Authors: Malya Sapna U.
Published: June 2022

This case study aims to identify the leadership qualities required to manage the business during a pandemic-like crisis. Kamadgiri Fashion Limited (KFL) a small company incorporated in India in the year 1987, was into the manufacturing of fabric and ready-made apparels. Slowly and steadily, it had established its foothold in the B2B market and also had strategic partnerships with large FMCG companies in the country. During COVID-19 lockdown, the company had to completely stop its manufacturing process. Demand suddenly dropped and the management knew that if this continued, they would not be able to sustain the business. They wanted to convert this adversity into an opportunity. With the help of technological innovation, they started manufacturing bacteria- and virus-resistant masks under the brand name Zero Risque. The company always wanted to be a part of the solution to the pandemic problem, and they could do it with Zero Risque. Decisions were taken quickly to buy the technology, manufacture the product according to the customer needs and market it. They became the first company headquartered in India, to sell these masks in the country. With daily sales almost doubling after few months, the company gradually could overcome the crisis.
Low-Dose Oral Contraceptives and Spontaneous Coronary Artery Dissection With Heavy Clot Burden in a Nonpregnant Woman
Authors: Del Rio-Pertuz Gaspar , Benjanuwattra Juthipong , Nawaa Saif El , Lahoti Ankush , Shurmur Scott
Published: June 2022

Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS) caused by a nontraumatic tear in the coronary artery wall. The true incidence is thought to be underestimated owing to its diagnostic difficulty as coronary angiography is insensitive in assessing the arterial wall structure, thereby warranting additional diagnostic modalities such as intravascular ultrasound. We report a case of a young woman who had been taking oral contraceptives, and presented with acute non-ST segment elevation myocardial infarction due to SCAD with superimposed thrombosis.
Social Marginality, Adversity and Adolescent Thriving in India: A Narrative Review
Authors: Jose Justin P. , Ravindranath Sreehari , Talreja Vishal , Bhat Suchetha
Published: June 2022

All human beings are inherently motivated for self-improvement and growth. People tend to respond diversely in the face of adversity, from succumbing and recovering to remaining resilient and thrive. The present narrative review is not an exhaustive review of the existing literature on thriving but is an informed effort to add to the adolescent thriving discourse within the conceptual background of social marginality in the Indian context. This review thus defines and summarizes perspectives, determinants and assessment of thriving. It also discusses the interaction between social marginality, adversity and adolescences. Finally, this review discusses the opportunities opened by the new National Education Policy 2020 for thriving interventions and research.
Governing Their Way: Traditional Self-governing Institutions Among the Tai Khamtis of Arunachal Pradesh
Authors: Gogoi Chuchengfa
Published: June 2022

Democracy has the quality of governance as it encourages people’s participation in decision-making and provides ample space for a transparent and egalitarian society based on equality, freedom and justice. Many democratic institutions have the qualities of internal governance, which broadens the idea of transparency, accountability, equal participation, responsiveness etc. The traditional self-governing institutions also have similar internal and external qualities to a democratic institution. Notably, many tribal communities in the north-eastern part of India have several such institutions working enormously in establishing democratic temperament and quasi-judicial activities, which are otherwise the prime functions of a modern democratic institution. The Khamtis are also not an exception. Khamtis are the prime ethnic dwellers of the eastern part of Arunachal Pradesh under the district of Namsai. They have their self-governing traditional institutions, which still have been actively performing their role in the administration of the village and the tribe. Many of the village-level decisions have been taken by the self-governing institutions along with the modern democratic institutions based on customary laws. Hence, it is interesting to study how the traditional institutions are rooted in the community life of the Khamtis and the present status of those institutions with the deepening of modern democracy. This study applied a case study method for the collection of information.
Preparation of a miR-155-activating nucleic acid nanoflower to study the molecular mechanism of miR-155 in inflammation
Authors: Wang Wenxin , Geng Jie , Wu Xiaohan , Zhang Jianguang , Zheng Chenna , Rao Huachun , Li Tianyu , Diao Yong , Yang Huiyong
Published: June 2022

At present, the molecular mechanisms underlying inflammation remain unclear. In recent years, research on inflammation has focused on stimulating cell inflammation by using exogenous pro-inflammatory substances such as lipopolysaccharide (LPS) or inflammatory factors. To investigate the molecular mechanism of inflammation from a new perspective, we designed a nucleic acid nanoflowers (NFs) complex to directly activate inflammatory genes to study the inflammatory response without the need for external microbial factors to trigger an inflammatory response. An RNAa-type target gene-activated NFs was designed. Human umbilical vein endothelial cells (HUVECs) were transfected with NFs carrying small activating RNA (saRNAs) to directly co-activate microRNA (miR)-155 and SHIP1 genes. After RNA activation (RNAa)-type NFs were transferred into HUVECs, the expression of miR-155 and pro-inflammatory and cancer-related factors increased, anti-inflammatory factors were reduced, cell proliferation increased, and cell migration was promoted. IL-1β protein levels were decreased and SHIP1 expression was downregulated. When miR-155 and its target SHIP1 were both activated, the expression of both was unaltered, maintaining cell homeostasis. This points towards miR-155 overexpression can trigger inflammation, and that miR-155 and its target genes act as a molecular switch role in the development of inflammation.
Retraction Note: Efficacy of dexmedetomidine as an adjunct to ropivacaine in bilateral dual-transversus abdominis plane blocks in patients with ovarian cancer who underwent cytoreductive surgery
Authors: Zhang Jian-ping , Zhang Na , Chen Xu , Zhou Yin , Jiang Zhen , Gao Chen , Xie Yan-Hu , Wang Sheng , Zhang Wei
Published: June 2022

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12871-022-01731-4.