bluuebunny/crossref_metadata_2025 huggingface dataset:
Nationalism and Siberian archeology of the 19th century
Authors: Ternov Nikolay , Mikhailov Dmitry
Published: December 2021

The article provides a comparative characteristic of the nationally motivated ethnocultural concepts of the 19th century, based on the interpretation of Siberian peoples` history. Finnish nationalism was looking for the ancestral home of the Finns in Altai and tried to connect them with the Turkic-Mongol states of antiquity and the Middle Ages. Under the influence of the cultural and historical theories of regional experts, the Siberian national discourse itself began to form, which was especially clearly manifested in the example of the genesis of Altai nationalism. Russian great-power nationalism sought to make Slavic history more ancient and connected it with the prestigious Scythian culture.

If we rely on the well-known periodization of the development of the national movement of M. Khrokh, then in the theory of the Finns` Altai origin, we can distinguish features characteristic of phase “B,” when the cultural capital of nationalism gradually turns into political. In turn, the historical research of the regional specialists illustrates the earliest stage in the emergence of the national movement, the period of nationalism not only without a nation but also without national intellectuals. The oblasts are forming the very national environment, which does not yet have the means for its own expression, but it obviously contains separatist potential. At the same time, both the Finnish and Siberian patriots, with their scientific research, solved the same ideological task—to include the objects of their research in the world cultural and historical context, to achieve recognition of their right to a place among European nations. However, Florinsky’s theory, performing the function of the official propaganda, is an example of the manifestation of state unifying nationalism, with imperial connotations characteristics of Russia.
Establishing Early Foundations to Promote Emotional Competence in Preschool Children
Authors: Kaur Jasleen , Sharma Anupam
Published: December 2021

The primary objective of this paper is to design the framework for enhancing the emotional competence of preschool children by examining the perspective of parents’ involvement with children staying at home. The paper also discusses (1) the concept of social-emotional competence and its importance for preschool children; (2) the concept of emotional competence, happiness, home learning, and sharing among children; and (3) the role of parents in promoting emotional competence in preschool children. The paper examined the impact of home learning, happiness, and sharing habits on the emotional competence of preschool children by using Partial Least Squares-Structural Equation Modeling (PLS-SEM) 2.0. The respondents included 358 randomly selected parents in two districts of Punjab state of India who have children aged 3 to 6 years. The results showed that happiness and home learning had a significant positive impact on the emotional competence of preschool children. However, sharing habits did not impact emotional competence to a significant extent in the current study.
Form and Function in Information for Visual Perception
Authors: Lappin Joseph S. , Bell Herbert H.
Published: December 2021

Visual perception involves spatially and temporally coordinated variations in diverse physical systems: environmental surfaces and symbols, optical images, electro-chemical activity in neural networks, muscles, and bodily movements—each with a distinctly different material structure and energy. The fundamental problem in the theory of perception is to characterize the information that enables both perceptual awareness and real-time dynamic coordination of these diverse physical systems. Gibson's psychophysical and ecological conception of this problem differed from that of mainstream science both then and now. The present article aims to incorporate Gibson's ideas within a general conception of information for visual perception. We emphasize the essential role of spatiotemporal form, in contrast with symbolic information. We consider contemporary understanding of surface structure, optical images, and optic flow. Finally, we consider recent evidence about capacity limitations on the rate of visual perception and implications for the ecology of vision.
Implementing a project-based collaborative learning approach using PowerPoint to improve students’ 21st- century skills
Authors: Aifan Hanan
Published: December 2021

In this industrial age, skills required in most jobs are 21st-century skills. The current study aimed to investigate whether there is a relationship between implementing project-based collaborative learning using PowerPoint and improving students’ 21st-century skills from the students’ perspectives. It also examines whether there is a significant relationship between students’ attitudes toward learning collaboratively using PowerPoint to improve their 21st-century skills and their major. The participants of the study were 75 female students enrolled in an Educational Technology and Means course at Najran University. The findings revealed that there is a significant and positive relationship between implementing a project-based collaborative learning approach using PowerPoint and improving the students’ 21st-century skills, r (74) = 0.74 and p < 0.05. Additionally, the findings demonstrated that 21st-century skills improved the most through “actively collaborating with others” (M = 4.6, SD = 0.56). Additionally, there was no significant difference in students’ attitudes toward learning collaboratively using PowerPoint to improve their 21st-century skills in terms of human studies or scientific studies majors, t (37) = 1.97 and p > 0.05. The findings demonstrate that more research is required on the role of higher education in developing meaningful technology-based strategies to improve students’ 21st-century skills in learning environments.
Determinants of short birth interval among ever married reproductive age women living in Jigjiga, Eastern Ethiopia 2020 (unmatched case–control study)
Authors: Roble Abdurahman Kedir , Osman Mohamed Omar , Ibrahim Ahmed Mohamed , Wedajo Girma Tadesse , Abdi Usman Seid
Published: December 2021

Objectives:

A short birth interval is a universal public health problem resulting in adverse maternal, neonatal, and child outcomes. Therefore, the aim of this study was to identify determinants of short birth interval among ever married reproductive age mothers who live in Jigjiga city administration, Eastern Ethiopia, 2020.

Methods:

A community-based unmatched case–control study was used among 194 cases and 194 controls in Jigjiga city administration from September to December 2020. Cases were women with short birth interval (less than 3 years) and controls were women with optimum birth interval (3–5 years). Simple random sampling technique was employed to select cases and controls. Data were entered into Epi data version 4.2 and analysis with SPSS version 22. Binary logistic regression with 95% confidence interval at p < 0.05 is used to declare significantly associated predictors of short birth interval.

Result:

This study reported that women who have not attended formal education (adjusted odds ratio = 5.28, 95% confidence interval: (2.25–12.36)), attended primary education (adjusted odds ratio = 2.79, 95% confidence interval: (1.46–5.34)), women who married to a polygamous husband (adjusted odds ratio = 3.69, 95% confidence interval: (1.80–7.58)), having a history of neonatal death (adjusted odds ratio = 2.15, 95% confidence interval: (1.07–4.32)), preceding child being female (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)), and never used contraceptive methods (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)) were identified as determinants of the short birth interval.

Conclusion:

Short birth intervals were associated with educational level of the women, sex of the baby, husband marriage types, history of neonatal death, and contraceptive utilization. Strategy should be engaged to enhance women education, contraceptive uses, and to decrease neonatal death.
Parathyroid cyst: A rare entity
Authors: Chaabouni Mohamed Amine , Achour Imen , Thabet Wadii , Sellami Moncef , Charfi Slim , Kallel Souha , Charfeddine Ilhem
Published: December 2021

Parathyroid cysts are an uncommon entity. They are classified as functioning and nonfunctioning cysts. Cyst aspiration with detection of parathyroid hormone is a useful tool to confirm the diagnosis. Here, we report four cases of parathyroid cysts. One patient had a functioning cyst. Ultrasonography of the neck revealed a cystic lesion behind the left lobe of the thyroid gland in two cases and a right cystic thyroid nodule in two cases. The cysts exerted a mass effect on the adjacent structures in two cases without clinical compressive symptoms. Fine-needle aspiration with detection of parathyroid hormone in the cyst fluid was performed in one case (nonfunctioning cyst): intracystic parathyroid hormone level was high. Recurrence was noted 1 month after the cyst aspiration. All patients underwent surgical treatment. Our series is characterized by two cases of nonfunctioning intrathyroidal parathyroid cysts which are very uncommon. They are mistaken for thyroid cysts. After surgery, no recurrence was noted. We aim to describe the epidemiological, clinical, and paraclinical features of this condition as well as its therapeutic modalities.
The Datafication of #MeToo: Whiteness, Racial Capitalism, and Anti-Violence Technologies
Authors: Henne Kathryn , Shelby Renee , Harb Jenna
Published: December 2021

This article illustrates how racial capitalism can enhance understandings of data, capital, and inequality through an in-depth study of digital platforms used for intervening in gender-based violence. Specifically, we examine an emergent sociotechnical strategy that uses software platforms and artificial intelligence (AI) chatbots to offer users emergency assistance, education, and a means to report and build evidence against perpetrators. Our analysis details how two reporting apps construct data to support institutionally legible narratives of violence, highlighting overlooked racialised dimensions of the data capital generated through their use. We draw attention to how they reinforce property relations built on extraction and ownership, capital accumulation that reinforces benefits derived through data property relations and ownership, and the commodification of diversity and inclusion. Recognising these patterns are not unique to anti-violence apps, we reflect on how this example aids in understanding how racial capitalism becomes a constitutive element of digital platforms, which more generally extract information from users, rely on complex financial partnerships, and often sustain problematic relationships with the criminal legal system. We conclude with a discussion of how racial capitalism can advance scholarship at the intersections of data and power.
Forced Empowerment and the Paradox of Mobile Dating Apps
Authors: Sobieraj Sabrina , Humphreys Lee
Published: December 2021

New women-focused mobile dating apps purport to empower women by having them “make the first move” and disrupt traditional male-dominated dating norms. Drawing on feminist approaches and technological affordances, we examine how heterosexual cisgender women and men experience this “empowerment” and contrast it to other mobile dating app use. We used a multimethod approach to conducting app walkthroughs, focus groups, and interviews to contrast the mobile dating apps, Tinder and Bumble. The findings reveal that perceptions of free choice and action determine empowerment experiences. Our study reveals that the “forced empowerment” on Bumble was still strongly shaped by heterosexual gender norms that encouraged “good” girls and guys to use the app to look for long-term relationships but continue to use Tinder to hook up, despite the popular misogyny on Tinder identified by both men and women in our study. We conclude by discussing the empowerment paradox of dating apps through popular feminism and misogyny.
Autistic Traits, STEM, and Medicine: Autism Spectrum Quotient Scores Predict Medical Students’ Career Specialty Preferences
Authors: Turner Emma , Aitken Emma , Richards Gareth
Published: December 2021

There is a higher than chance representation of autistic people and people with elevated autistic traits in Science, Technology, Engineering and Mathematics (STEM) industries. Medical students, despite studying a STEM subject, have lower autistic traits than other STEM students. Medicine is heterogenous, covering technique-oriented specialties (e.g., surgery) with little patient interaction, person-oriented specialties (e.g., pediatrics), and general practice. We present an online survey in which 502 UK university students (medicine, n = 344; STEM, n = 94; non-STEM, n = 64) reported their study area and career aspirations and completed the Autism Spectrum Quotient (AQ), a quantitative self-report measure of autistic traits. Our main findings were that medical students had significantly lower AQ scores than other STEM ( p < .001, d = 0.614) and non-STEM students ( p < .001, d = 0.874), and that medical students aiming to pursue technique-focused career paths had significantly higher AQ scores than medical students aiming to pursue person-oriented career paths ( p = .009, d = 0.318). Each of these effects remained statistically significant after adjusting for alpha inflation. The findings of this study corroborate those of previous research reporting a link between autism and STEM; they also provide evidence that autistic traits are a predictor of medical students’ career ambitions, with those students with high AQ scores being more likely to pursue technique-focused (as opposed to person-focused) roles. This may be informative for developing and optimizing the strengths of individuals with differing levels of autistic traits.
Key Factors Influencing Talent Retention and Turnover in Convenience Stores: A Comparison of Managers’ and Employees’ Perspectives
Authors: Tsai Pei-Hsuan , Chen Chih-Jou , Tang Jia-Wei
Published: December 2021

This study identifies the main factors influencing turnover among convenience store employees from a managerial perspective and infers the changes necessary to reduce such high turnover rates. Employing the decision-making trial and evaluation laboratory (DEMATEL) methodology, it investigates the degree of mutual influence between evaluation indicators and constructs a network relation map for evaluation dimensions and criteria. This study also uses the DEMATEL-based analytic network process method to compute the influential weights of each dimension and criteria. According to the empirical results of the causality model, convenience store employees must first improve the relatedness dimension, and managers must first improve the existence dimension. These findings can help convenience store managers address talent retention and turnover problems, develop effective strategies to lower the high turnover rates at convenience stores, and offer solutions to new industry entrants to avoid potential problems that might lead to early exit.
A Comparative Review of Mobile and Non-Mobile Games for Language Learning
Authors: Su Fan , Zou Di , Xie Haoran , Wang Fu Lee
Published: December 2021

Recent studies have increasingly investigated the effectiveness of both mobile and non-mobile digital game-based language learning. To gain an in-depth understanding of the differences in the effectiveness of mobile and non-mobile games, we compared studies from January 2000 to August 2020 investigating mobile game-based language learning (MGBLL) and non-mobile game-based language learning (NMGBLL). Sixty-four articles were analyzed from four aspects: game types, game elements, target languages, and learning outcomes. The results showed that (a) gamification, simulation games, and immersive games were applied most; (b) all games possessed the game elements of goals or rules; (c) the most investigated target languages were English and Chinese; and (d) the most discussed learning outcomes were language acquisition and psychological/affective state. The similarities and differences between MGBLL and NMGBLL were also identified. The current review provides an overview and in-depth analysis of mobile and non-mobile games for language learning, guiding practitioners to select appropriate digital games to cater to specific language teaching goals. Future directions of research are also discussed.
Refugees and the Mission of the Church
Authors: Wu Cindy M.
Published: December 2021

The world has changed and shifted. Regional demographics on both large and small scales look drastically different and are constantly changing from just one lifetime ago, as the World Christian Encyclopedia, third edition, has shown us. Forced migration is an integral part of the shifting landscape. One might wonder what God is doing in the midst of this. This article focuses on forced migration and the response of the church to the global refugee crisis.
The Poverty Captivity of Mission in the Churches—and Strategies for Its Liberation
Authors: Presler Titus
Published: December 2021

Western world mission initiatives since World War II have become captive to a dominant emphasis on socioeconomic amelioration. The Poverty Captivity of Mission departs from the economically multivalent mission patterns of Jesus, early Christian communities, and the medieval church. It typically recapitulates assumptions of Western and white superiority embedded in colonial emphases on “civilizing” mission. Strategies for its liberation include learning from the Majority World, reaching middle and elite classes as well as the poor, developing relationships of companionship and friendship, and employing asset-based community development.
Seeing no net loss: Making nature offset-able
Authors: Carver Louise
Published: December 2021

Policies for biodiversity no net loss and net gain underwrite narratives for green growth through advancing reparative logics to ongoing habitat impacts. By enabling offsetting practices that risk accommodating rather than averting land change developments, net principles are said to resemble modes of ‘accumulation by environmental restoration’. Biodiversity net principles are frequently depicted visually as a diagram of the mitigation hierarchy for communicational ease and have proliferated over recent decades despite little evidence for their ecological effectiveness. This paper combines economic sociology, visual media analysis of the net diagram and political ecology to account for the stabilisation of net principles in policy frameworks. It highlights the upstream imaginative work that this visual tool and its wider assemblages perform to support offsetting and habitat banking practices on the ground. The paper positions the NNL diagram as a conceptual and ideational technology. It traces the practices through which biodiversity is rationalised by the Cartesian coordinates of an XY schematic, and en-framed as a measure of numerical value on a vertical scale. The effect is to engender coherence to the idea of netting out differences in aggregate sums of biodiversity unit value, making nature conceptually offset-able.

I develop this account through a history of the diagram as well as the broader processes that have shaped the policy and its arrival in English planning frameworks. Observers increasingly question how biodiversity offsetting and no net loss/ net gain have become so popular when their empirical foundations are so weak. This paper proposes that within the wider assemblages of actors, one answer is located in the potency and mobility of conceptual technologies such as diagrams of no net loss or net gain of biodiversity and the logic of balance-sheet accounting that is imbricated within the visual design.
Prospective predictors of sustainment of multiple EBPs in a system-driven implementation context: Examining sustained delivery based on administrative claims
Authors: Lau Anna S. , Lind Teresa , Motamedi Mojdeh , Lui Joyce H. L. , Kuckertz Mary , Innes-Gomberg Debbie , Pesanti Keri , Brookman-Frazee Lauren
Published: December 2021

Background

System-driven scale-up of multiple evidence-based practices (EBPs) is an increasingly common method used in public mental health to improve care. However, there are little data on the long-term sustained delivery of EBPs within these efforts, and previous studies have relied on retrospective self-report within cross-sectional studies. This study identified prospective predictors of sustained EBP delivery at the EBP-, therapist-, and organizational-levels using survey and administrative claims data within a large-scale system-driven implementation effort.

Methods

777 therapists and 162 program leaders delivering at least one of six EBPs of interest completed surveys assessing perceptions of EBPs and organizational context. These surveys were linked to administrative data to examine prospective predictors of therapists’ EBP delivery over 33 months.

Results

Five of the six EBPs implemented showed sustained delivery in the system, with volume varying by EBP. Although total EBP claim volume per therapist decreased over time, the volume ratio (ratio of EBP-specific claims to total EBP and non-EBP claims) stayed relatively stable. Multilevel models revealed that EBPs that required consultation, had unstructured content, higher therapist self-efficacy with the EBP, and more positive program leader perceptions of the EBP were associated with greater sustained volume and volume ratio of the EBP. Therapists who were trained in fewer EBPs, who were unlicensed, and who worked in agencies rated by program leaders as lower on organizational staff autonomy and stress showed greater sustained EBP volume and volume ratio. Finally, more direct service hours per week provided by therapist predicted greater sustained EBP volume, but lower volume ratio.

Conclusions

The results point to the importance of EBP, therapist, and organizational factors that may be targeted in implementation strategies to promote the sustainment of EBPs.
Endoscopic Removal of an Eroded LINX® Device Using a Mechanical Biliary Lithotriptor
Authors: Parker Brett C. , Dinary Fazel , Kumbhari Vivek , Louie Brian E.
Published: December 2021

Background:

Magnetic sphincter augmentation (MSA) via the surgical placement of a LINX® device (LINX® Reflux Management System, Torax Medical, Shoreview, MN, USA) is an increasingly performed minimally invasive outpatient anti-reflux procedure with a low erosion rate. The most common initial approach to eroded LINX® devices is endoscopic removal. Often endoscopy centers do not have specialized devices to cut through the newer, more durable LINX® systems. In this paper we describe a unique approach for removal of a LINX® with intraluminal erosion using a commonly stocked mechanical biliary lithotripsy device.

Case description:

A 63-year-old male with a history of GERD and symptomatic type III paraesophageal hernia (PEH) underwent a robotic PEH repair with magnetic sphincter augmentation (1.5T, 17 bead) at an outside hospital. He developed an acute recurrence of his PEH, and subsequent upper endoscopy and contrast esophagram four weeks postoperatively revealed a gastric erosion of the LINX device, which had migrated 6 cm onto the stomach. Attempted endoscopic LINX® removal using the OVESCO remove DC Cutter device was unsuccessful. Using principles of prior endoscopic bariatric lap band foreign body removal, the entire LINX® device was successfully removed with the described biliary lithotriptor technique.

Conclusion:

Using a common biliary mechanical lithotriptor device and a guidewire to transect the newer 1.5T LINX® Reflux Management System is a safe, effective and familiar technique for endoscopic removal of an eroded MSA device.
Sodium stibogluconate and CD47-SIRPα blockade overcome resistance of anti-CD20–opsonized B cells to neutrophil killing
Authors: van Rees Dieke J. , Brinkhaus Maximilian , Klein Bart , Verkuijlen Paul , Tool Anton T.J. , Schornagel Karin , Treffers Louise W. , van Houdt Michel , Kater Arnon P. , Vidarsson Gestur , Gennery Andrew R. , Kuijpers Taco W. , van Bruggen Robin , Matlung Hanke L. , van den Berg Timo K.
Published: December 2021

Anti-CD20 antibodies such as rituximab are broadly used to treat B-cell malignancies. These antibodies can induce various effector functions, including immune cell-mediated antibody-dependent cellular cytotoxicity (ADCC). Neutrophils can induce ADCC toward solid cancer cells by trogoptosis, a cytotoxic mechanism known to be dependent on trogocytosis. However, neutrophils seem to be incapable of killing rituximab-opsonized B-cell lymphoma cells. Nevertheless, neutrophils do trogocytose rituximab-opsonized B-cell lymphoma cells, but this only reduces CD20 surface expression and is thought to render tumor cells therapeutically resistant to further rituximab-dependent destruction. Here, we demonstrate that resistance of B-cell lymphoma cells toward neutrophil killing can be overcome by a combination of CD47-SIRPα checkpoint blockade and sodium stibogluconate (SSG), an anti-leishmaniasis drug and documented inhibitor of the tyrosine phosphatase SHP-1. SSG enhanced neutrophil-mediated ADCC of solid tumor cells but enabled trogoptotic killing of B-cell lymphoma cells by turning trogocytosis from a mechanism that contributes to resistance into a cytotoxic anti-cancer mechanism. Tumor cell killing in the presence of SSG required both antibody opsonization of the target cells and disruption of CD47-SIRPα interactions. These results provide a more detailed understanding of the role of neutrophil trogocytosis in antibody-mediated destruction of B cells and clues on how to further optimize antibody therapy of B-cell malignancies.
Sleep apnoea and heart failure
Authors: Lévy Patrick , Naughton Matthew T. , Tamisier Renaud , Cowie Martin R. , Bradley T. Douglas
Published: December 2021

Heart failure and sleep disordered breathing (SDB) are two common conditions that frequently overlap and have been studied extensively in the past three decades. Obstructive sleep apnoea (OSA) may result in myocardial damage due to intermittent hypoxia that leads to increased sympathetic activity and transmural pressures, low-grade vascular inflammation, and oxidative stress. On the other hand, central sleep apnoea and Cheyne–Stokes respiration (CSA-CSR) occurs in heart failure, irrespective of ejection fraction, either reduced (HFrEF), preserved (HFpEF) or mildly reduced (HFmrEF). The pathophysiology of CSA-CSR relies on several mechanisms leading to hyperventilation, breathing cessation and periodic breathing. Pharyngeal collapse may result at least in part from fluid accumulation in the neck, owing to daytime fluid retention and overnight rostral fluid shift from the legs. Although both OSA and CSA-CSR occur in heart failure, the symptoms are less suggestive than in typical (non-heart failure-related) OSA. Overnight monitoring is mandatory for a proper diagnosis, with accurate measurement and scoring of central and obstructive events, since the management will be different depending on whether the sleep apnoea in heart failure is predominantly OSA or CSA-CSR. SDB in heart failure is associated with worse prognosis, including higher mortality, than in patients with heart failure but without SDB. However, there is currently no evidence that treating SDB improves clinically important outcomes in patients with heart failure, such as cardiovascular morbidity and mortality.
Chronic lung allograft dysfunction phenotype and prognosis by machine learning CT analysis
Authors: McInnis Micheal C. , Ma Jin , Karur Gauri Rani , Houbois Christian , Levy Liran , Havlin Jan , Fuchs Eyal , Tikkanen Jussi , Chow Chung-Wai , Huszti Ella , Martinu Tereza
Published: December 2021

Background

Chronic lung allograft dysfunction (CLAD) is the principal cause of graft failure in lung transplant recipients and prognosis depends on CLAD phenotype. We used a machine learning computed tomography (CT) lung texture analysis tool at CLAD diagnosis for phenotyping and prognostication compared with radiologist scoring.

Methods

This retrospective study included all adult first double lung transplant patients (January 2010–December 2015) with CLAD (censored December 2019) and inspiratory CT near CLAD diagnosis. The machine learning tool quantified ground-glass opacity, reticulation, hyperlucent lung and pulmonary vessel volume (PVV). Two radiologists scored for ground-glass opacity, reticulation, consolidation, pleural effusion, air trapping and bronchiectasis. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance of machine learning and radiologist for CLAD phenotype. Multivariable Cox proportional hazards regression analysis for allograft survival controlled for age, sex, native lung disease, cytomegalovirus serostatus and CLAD phenotype.

Results

88 patients were included (57 bronchiolitis obliterans syndrome (BOS), 20 restrictive allograft syndrome (RAS)/mixed and 11 unclassified/undefined) with CT a median 9.5 days from CLAD onset. Radiologist and machine learning parameters phenotyped RAS/mixed with PVV as the strongest indicator (area under the curve (AUC) 0.85). Machine learning hyperlucent lung phenotyped BOS using only inspiratory CT (AUC 0.76). Radiologist and machine learning parameters predicted graft failure in the multivariable analysis, best with PVV (hazard ratio 1.23, 95% CI 1.05–1.44; p=0.01).

Conclusions

Machine learning discriminated between CLAD phenotypes on CT. Both radiologist and machine learning scoring were associated with graft failure, independent of CLAD phenotype. PVV, unique to machine learning, was the strongest in phenotyping and prognostication.
Impact of hepatopulmonary syndrome in liver transplantation candidates and the role of angiogenesis
Authors: Kawut Steven M. , Krowka Michael J. , Forde Kimberly A. , Al-Naamani Nadine , Krok Karen L. , Patel Mamta , Bartoli Carlo R. , Doyle Margaret , Moutchia Jude , Lin Grace , Oh Jae K. , Mottram Carl D. , Scanlon Paul D. , Fallon Michael B.
Published: December 2021

Background

Hepatopulmonary syndrome affects 10–30% of patients with cirrhosis and portal hypertension. We evaluated the serum angiogenic profile of hepatopulmonary syndrome and assessed the clinical impact of hepatopulmonary syndrome in patients evaluated for liver transplantation.

Methods

The Pulmonary Vascular Complications of Liver Disease 2 study was a multicentre, prospective cohort study of adults undergoing their first liver transplantation evaluation. Hepatopulmonary syndrome was defined as an alveolar–arterial oxygen gradient ≥15 mmHg (≥20 mmHg if age >64 years), positive contrast-enhanced transthoracic echocardiography and absence of lung disease.

Results

We included 85 patients with hepatopulmonary syndrome and 146 patients without hepatopulmonary syndrome. Patients with hepatopulmonary syndrome had more complications of portal hypertension and slightly higher Model for End-Stage Liver Disease-Na score compared to those without hepatopulmonary syndrome (median (interquartile range) 15 (12–19)versus14 (10–17), p=0.006). Hepatopulmonary syndrome patients had significantly lower 6-min walk distance and worse functional class. Hepatopulmonary syndrome patients had higher circulating angiopoietin 2, Tie2, tenascin C, tyrosine protein kinase Kit (c-Kit), vascular cell adhesion molecule 1 and von Willebrand factor levels, and lower E-selectin levels. Patients with hepatopulmonary syndrome had an increased risk of death (hazard ratio 1.80, 95% CI 1.03–3.16, p=0.04), which persisted despite adjustment for covariates (hazard ratio 1.79, 95% CI 1.02–3.15, p=0.04). This association did not vary based on levels of oxygenation, reflecting the severity of hepatopulmonary syndrome.

Conclusion

Hepatopulmonary syndrome was associated with a profile of abnormal systemic angiogenesis, worse exercise and functional capacity, and an overall increased risk of death.
Characterisation of hemidiaphragm dysfunction using dynamic chest radiography: a pilot study
Authors: FitzMaurice Thomas Simon , McCann Caroline , Nazareth Dilip S. , Walshaw Martin J.
Published: December 2021

Objectives

Dynamic chest radiography (DCR) is a novel real-time digital fluoroscopic imaging system that produces clear, wide field-of-view diagnostic images of the thorax and diaphragm in motion, alongside novel metrics on moving structures within the thoracic cavity. We describe the use of DCR in the measurement of diaphragm motion in a pilot series of cases of suspected diaphragm dysfunction.

Methods

We studied 21 patients referred for assessment of diaphragm function due to suspicious clinical symptoms or imaging (breathlessness, orthopnoea, reduced exercise tolerance and/or an elevated hemidiaphragm on plain chest radiograph). All underwent DCR with voluntary sniff manoeuvres.

Results

Paradoxical motion on sniffing was observed in 14 patients, and confirmed in six who also underwent fluoroscopy or ultrasound. In four patients, DCR showed reduced hemidiaphragm excursion, but no paradoxical motion; in three, normal bilateral diaphragm motion was demonstrated. DCR was quick to perform, and well tolerated in all cases and with no adverse events reported. DCR was achieved in ∼5 min per patient, with images available to view by the clinician immediately within the clinical setting.

Conclusion

DCR is a rapid, well-tolerated and straightforward chest radiography technique that warrants further investigation in the assessment of diaphragm dysfunction.
Vitamin D supplementation in childhood asthma: a systematic review and meta-analysis of randomised controlled trials
Authors: Kumar Jogender , Kumar Prawin , Goyal Jagdish Prasad , Thakur Chirag , Choudhary Puja , Meena Jitendra , Charan Jaykaran , Singh Kuldeep , Gupta Atul
Published: December 2021

Background

There is conflicting evidence for vitamin D supplementation in childhood asthma. We aimed to systematically synthesise the evidence on the efficacy and safety of vitamin D supplementation in childhood asthma.

Methods

We searched electronic databases (Medline, Embase and Web of Science) and a register (CENTRAL) for randomised controlled trials (RCTs) published until 30 September 2021. RCTs enrolling asthmatic children (1–18 years old) and comparing vitamin D against placebo/routine care were included if they met at least one of the endpoints of interest (asthma attacks, emergency visits or hospitalisation). We used the Risk of Bias 2 tool for risk of bias assessment. Random-effects meta-analysis with RevMan 5.3 software was performed. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the level of certainty of the evidence.

Results

18 RCTs (1579 participants) were included. The pooled meta-analysis did not find a significant effect of vitamin D supplementation on asthma attacks requiring rescue systemic corticosteroids (six studies with 445 participants; risk ratio (RR) 1.13, 95% CI 0.86–1.48; I2=0%) (moderate-certainty evidence). In addition, there was no significant difference in the proportion of children with asthma attacks of any severity (11 trials with 1132 participants; RR 0.84, 95% CI 0.65–1.09; I2=58%) (very low-certainty evidence). Vitamin D does not reduce the need for emergency visits (three studies with 361 participants; RR 0.97, 95% CI 0.89–1.07; I2=0%) and hospitalisation (RR: 1.38, 95% CI 0.52–3.66; I2=0%) (low-certainty evidence).

Conclusion

Very low- to moderate-certainty evidence suggests that vitamin D supplementation might not have any protective effect in childhood asthma.
Low muscle mass and Charlson comorbidity index are risk factors for short-term postoperative prognosis of elderly patients with gastrointestinal tumor: a cross-sectional study
Authors: Wang Jiaqiu , Xu Liqian , Huang Shunmei , Hui Quan , Shi Xuexue , Zhang Qin
Published: December 2021

Background

Sarcopenia is one of the most frequent syndromes in older adults and one of its main characteristics is low muscle mass. Gastrointestinal tumor is a malignant disease with high incidence. This study aimed to investigate the risk factors of low muscle mass in older adults with gastrointestinal tumor, the prognostic indicators of and short-term outcomes after resection for gastrointestinal tumor, and to explore the relationship between low muscle mass and short-term postoperative prognosis.

Method

A total of 247 older patients with gastrointestinal tumors who underwent radical resection in 2019 were included in this study. Relevant indexes were calculated using L3 slice image of computed tomography (CT) to evaluate low muscle mass. Short-term postoperative complications and length of stay were considered as short-term outcomes of this study.

Results

Advanced age, lower higher body mass index (BMI), lower hemoglobin, having history of abdominal surgery and higher visceral fat index (VFI) were risk factors of low muscle mass, while higher BMI and lower subcutaneous fat index (SFI) were protective factors of low muscle mass. Further multivariate logistic regression analysis showed that having history of abdominal surgery, advanced age and lower BMI were independent risk factors. Low muscle mass and higher Charlson comorbidity index were independent risk factors of short-term postoperative complications in older adults with gastrointestinal tumor. Higher Charlson comorbidity index gave rise to longer length of stay.

Conclusions

Low muscle mass and higher Charlson comorbidity index predict poor short-term prognosis of older patients undergoing gastrointestinal tumor resection.
Determinants of stakeholders’ attitudes and intentions toward supporting the use of Wolbachia-infected Aedes mosquitoes for dengue control
Authors: Arham Ahmad Firdhaus , Amin Latifah , Mustapa Muhammad Adzran Che , Mahadi Zurina , Yaacob Mashitoh , Ibrahim Maznah
Published: December 2021

Background

A recent approach in controlling dengue is by using theWolbachia-infected Aedes mosquito (WiAM). The approach has been reported to be more effective than traditional methods, such as fogging. Therefore, it is imperative to assess the factors predicting its acceptance among stakeholders before implementing this technology more widely in Malaysia.

Methods

The survey data were collected from two primary stakeholder groups using a stratified random sampling technique. The two primary stakeholder groups were scientists (n = 202) and the public (n = 197) in the Klang Valley region of Malaysia, a hot spot area known for the high rate of dengue cases. The respondents answered questions on a seven-point Likert scale survey regarding trust in key players, attitudes toward nature versus materialism, religiosity, perceived benefits, perceived risks, attitudes, and intentions. The data were analyzed using Smart Partial Least Square (SmartPLS) software (version 3.2.6) to determine the predictors influencing attitudes and intentions to support the use of WiAM technology.

Results

The results indicated a strong positive relationship between attitudes and intentions to support the use of WiAM (β = 0.676,p < 0.001). The most important significant predictor for attitudes was perceived benefits (β = 0.493,p < 0.001), followed by perceived risks (β = − 0.080,p = 0.048). Trust in key players, attitudes toward nature versus material, and religiosity had indirect relationships with attitudes through the perceived benefits and risks.

Conclusions

The identified predictors can serve as indicators for the decision-making process regarding WiAM implementation in Malaysia and other developing countries with similar demographics and cultures.
Reducing behavioral health symptoms by addressing minority stressors in LGBTQ adolescents: a randomized controlled trial of Proud & Empowered
Authors: Goldbach Jeremy T. , Rhoades Harmony , Mamey Mary Rose , Senese John , Karys Peter , Marsiglia Flavio F.
Published: December 2021

Background

Minority stress may lead to poorer mental health for sexual and gender minority adolescents, yet no interventions have been tested through an RCT to address these concerns.

Methods

We report on an RCT of an intervention—Proud & Empowered—with four high schools. Measures assess the intervention’s impact on mental health symptoms.

Results

Compared to the control, participants in the treatment condition reported significant differences in minority stress, anxiety, and depressive symptoms. Moderation analyses showed that the intervention significantly moderated the relationship between minority stress and PTSD (b = -1.28, p = .032), depression (b = -0.79, p = .023), and suicidality (b = 0.14, p = .012) symptoms; those in the intervention condition had mitigated relationships between measures of stress and health outcomes compared to those in the control condition.

Conclusions

Results suggest that Proud & Empowered help reduce mental health symptoms and exposure to minority stressors and build coping strategies.

Trial Registration

The intervention was registered on clinicaltrials.gov on August 1, 2019 under Trial #NCT04041414.
Factors affecting utilization of sexual and reproductive health services among women with disabilities- a mixed-method cross-sectional study from Ilam district, Nepal
Authors: Shiwakoti Rupa , Gurung Yogendra Bahadur , Poudel Ram Chandra , Neupane Sandesh , Thapa Ram Krishna , Deuja Sailendra , Pathak Ram Sharan
Published: December 2021

Background

Persons with disabilities can have physical, mental, intellectual, or sensory impairments which can hinder their social participation. Despite Sustainable Development Goals call for “universal access to sexual and reproductive health (SRH)”, women with disabilities (WwDs) continue to experience barriers to access SRH services in Nepal. This study evaluated factors affecting the utilization of SRH services among WwDs in Ilam district, Nepal.

Methods

A mixed-method study with 384 WwDs of reproductive age was conducted in Ilam district, eastern Nepal. Quantitative data were collected using a structured questionnaire. Relationships between utilization of SRH services and associated factors were explored using multivariate logistic regression analysis. Qualitative data were collected from focus groups with female community health volunteers and interviews with WwDs, health workers and local political leaders. They were audio-recorded, translated and transcribed into English and were thematically analyzed.

Results

Among 384 respondents (31% physical; 7% vision,16% hearing, 7% voice&speech,12% mental/psychosocial, 9% intellectual, 18% multiple disabilities), only 15% of them had ever utilized any SRH services. No requirement (57%) and unaware of SRH services (24%) were the major reasons for not utilizing SRH services. A majority (81%) of them reported that the nearest health facility was not disability-inclusive (73%), specifically referring to the inaccessible road (48%). Multivariate analysis showed that being married (AOR = 121.7, 95% CI: 12.206–1214.338), having perceived need for SRH services (AOR = 5.5; 95% CI: 1.419–21.357) and perceived susceptibility to SRH related disease/condition (AOR = 6.0; 95% CI:1.978–18.370) were positively associated with the utilization of SRH services. Qualitative findings revealed that illiteracy, poor socioeconomic status, and lack of information hindered the utilization of SRH services. WwDs faced socioeconomic (lack of empowerment, lack of family support), structural (distant health facility, inaccessible-infrastructure), and attitudinal (stigmatization, bad behaviour of health care providers, perception that SRH is needed only for married) barriers to access SRH services.

Conclusions

Utilization of SRH services among WwDs was very low in Ilam district, Nepal. The findings of this study warrant a need to promote awareness-raising programs to WwDs and their family members, sensitization programs to health service providers, and ensure the provision of disability-inclusive SRH services in all health facilities.
Design and implementation of a Pacific intervention to increase uptake of urate-lowering therapy for gout: a study protocol
Authors: Ofanoa Malakai , Ofanoa Samuela Malakai , Heather Maryann , Tu’akoi Siobhan , Lutui Hinamaha , Dalbeth Nicola , Grey Corina , van der Werf Bert , Goodyear-Smith Felicity
Published: December 2021

Background

Gout is a painful chronic disease which disrupts work and family life and can lead to chronic joint damage. Pacific people in Aotearoa/New Zealand experience significant inequities, with over three times the gout prevalence of the non-Pacific non-Māori populations. Pacific people receive less regular urate-lowering drugs to prevent gout flare-ups, and have nine times the hospitalisation from gout compared with non-Pacific non-Māori people. Rates for Indigenous Māori lie between Pacific and non-Pacific non-Māori. A long-established Collective comprising community members from the Pacific People’s Health Advisory Group, clinical staff from the Pacific Practice-Based Research Network, and University of Auckland researchers have identified that improving Pacific urate-lowering therapy use as the research question of prime importance for improved health outcomes of Pacific people in South Auckland. Building on the existing knowledge, this study aims to develop, implement and evaluate a novel innovative intervention to improve the uptake of urate-lowering therapy by Pacific patients with gout.

Methods

Three-phase mixed methods co-design study using the Fa’afaletui research framework following the STROBE statement. Phase1 is observational times series of prevalence of patients with gout, proportion with urate blood-level monitoring and use of urate-lowering medication over past 5 years. In Phase 2 the Collective will workshop new interventions to address previous uptake barriers, using culturally-appropriate Talanga communications with results synthesised in line with Kakala principles. The designed intervention will be implemented and process and outcome evaluations conducted. Finally, an implementation framework will be produced to facilitate further roll-out.

Discussion

The study aims to enhance health and reduce inequities for Pacific people, contribute to creation of Pacific health knowledge and translation of research findings into Pacific health gains. Potential longer-term impact is a gout-management pathway for use throughout Aotearoa/New Zealand. Māori have similar issues with high gout prevalence and low urate-lowering therapy use hence the intervention is likely to translate to Māori healthcare. The project will contribute to Pacific research capacity and capability-building as well as general upskilling of community and practice members involved in the co-design processes.

Trial registration

The Australian New Zealand Clinical Trial Registry is in process, request number 38206, 1-09-2021.