bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Lobe Parotid Tumors: A Systematic Review and Meta‐analysis
Authors: Aasen Margaret H. , Hutz Michael J. , Yuhan Brian T. , Britt Christopher J.
Published: April 2021

Objective

We performed a systematic review and meta‐analysis of deep lobe parotid tumors to evaluate their unique characteristics.

Data Sources

PubMed/Medline, Embase, Web of Sciences, and Cochrane Library databases were queried for relevant literature.

Review Methods

Studies were individually assessed by 2 independent reviewers. Risk of bias was assessed with the Cochrane bias tool, GRADE criteria, and MINORS criteria. Results were reported according to the PRISMA guidelines. Statistical analysis was performed by comparing rates of malignancy between deep and superficial lobe tumors.

Results

In total, 8 studies including 379 deep lobe parotid tumors met inclusion criteria. Mean age at diagnosis was 44.9 years. Computed tomography scan was the most common imaging modality. Preoperative diagnostic fine‐needle aspiration was utilized in 39.4% of patients and demonstrated high sensitivity for malignant disease. The most common approach was subtotal parotidectomy with facial nerve preservation (58.9%). The rate of malignancy was 26.6%, which was significantly higher than that of the superficial lobe tumors in this study (risk ratio, 1.25; 95% CI, 1.01‐1.56). The rate of temporary postoperative facial nerve weakness between deep and superficial lobe tumors was 32.5% and 11.7%, respectively.

Conclusion

Deep lobe parotid tumors had a 26.6% rate of malignancy. On meta‐analysis, deep lobe tumors appeared to have higher rates of malignancy than superficial lobe tumors. Surgical excision of deep lobe tumors showed increased rates of temporary facial nerve paresis as compared with superficial lobe tumors. Computed tomography scan was the most common imaging modality. There were limited data regarding the utility of fine‐needle aspiration.
Sustainability of integrated anaemia prevention activities implemented through non-government organizations and schools, and its effect on haemoglobin status of adolescent girls in urban slums of Pune, in Maharashtra, India
Authors: Jeyakumar Angeline , Chalwadi Shraddha , Madhu Pooja , Ghugre Padmini
Published: April 2021

Background:

Programmes for the prevention of iron deficiency anaemia among adolescent girls need sustainable inputs for maximum benefits.

Aim:

To assess the interventions sustained for anaemia prevention implemented through NGOs and schools.

Methods:

An intervention study followed longitudinally in three phases. Phase I comprised (a) needs assessment of the community and (b) capacity assessment of service providers through a cross-sectional survey in nine slums, through six NGOs and three schools. Based on needs assessment, an integrated intervention for anaemia prevention was provided for adolescent girls ( n = 384) in the community. To ensure sustainability the capacity of stakeholders ( n = 67) was built by providing training in the components of the integrated intervention and establishing linkages with the public health system. Refresher training was conducted during phase II ( n = 69) for reinforcing and strengthening of activities introduced in phase I. In phase II and III continuations of activities by the NGOs and schools that were initiated in phase I were monitored. Sustainability of activities was measured using an index that comprised technical, programmatic, social, and financial indicators. The impact of sustained interventions was assessed by comparing the mean rank haemoglobin concentrations of centres with varying levels of coverage.

Results:

Scores of sustainability indicators decreased from phase II to phase III. Organizations that showed > 50% coverage showed significantly higher mean rank haemoglobin ( p = < 0.05) during phases II and III.

Conclusion:

There is a need to identify and address barriers that prevent sustainable interventions for anaemia control.
Application and outcomes of extracorporeal life support in emergency general surgery and trauma
Authors: Brewer Jennifer M , Tran Anthony , Yu Jielin , Ali M Irfan , Poulos C M , Gates Jonathan , Underhill David , Gluck Jason
Published: April 2021

Background:

We analyzed the use of Extracorporeal Membranous Oxygenation (ECMO) in acute care surgery patients at our Level-1 trauma center. We hypothesized that this patient population has improved ECMO outcomes.

Methods:

This was a retrospective analysis of emergency general surgery and trauma patients placed on ECMO between the periods of October 2013 and February 2020. There were 10 surgical and 12 trauma patients studied, who eventually required ECMO support. ECMO support and ECMO type/modality were analyzed with injury and survival prognostic scores examined.

Main results:

Overall, 16 of the 22 patients survived to hospital discharge, for a survival rate of 73%. Mean age was 34.18 years. Mean hospital length of stay was 23.4 days with mean days on ECMO equal to 7.5. The net negative fluid balance was 5.36 L.

Conclusions:

The survival of our ECMO cohort is notably higher than previously cited studies. Our group demonstrated decreased length of time on ECMO, decreased length of stay in the hospital, and similar rates of complications compared to prior reports. ECMO is a useful modality in acute care surgical patients and should be considered in these patient populations. Our focus on net negative fluid balance for ECMO patients demonstrates improved survival. ECMO should be considered early in surgical patients and early in advanced trauma life support.
Migration: Diversifying transnational flows under neoliberal transformation
Authors: Koido Akihiro
Published: April 2021

Transnational migration to Japan has been developing since the 1980s, despite the fact that the Japanese government has officially denied accepting ‘immigrants’ and maintained a rigid immigration control policy over the years. This contradiction produced multiple gates of entry for migrants and led to the fragmentation of transnational networks of human movement. The neoliberal transformation of Japanese labor markets began in the mid-1990s, and migrant labor played a pivotal role in its restructuring. Sociologists have been dedicated to the analysis of the unique structures of the transnational supply chains and the surrounding constellations of interests in each labor market. Researchers have also identified the emergence of diverse ethnic entrepreneurs beyond their ethnic enclaves and across national borders, while other researchers have examined the structural constraints facing highly skilled workers in Japan. Recently, this transnational structure has been extended to include reproductive spheres of labor allowing the incorporation of nurses, care workers, and domestic workers as migrant workers. Beneath the diversity of types of transnational networks, Japanese sociologists have documented the increasing influence of the migration industry in the commercialization of transnational mobilities.
Institutional Variation, Professionalization, and State Implementation Choices: An Examination of Investment in Water Quality Across the 50 States
Authors: Williamson Ryan D. , Morris John C. , Fisk Jonathan M.
Published: April 2021

The question of the effect of administrative arrangements on program administration and program outcomes is a central question for those interested in policy implementation. In the implementation of federal programs, the specific state-level administrative arrangements can have a significant impact not only on resource distribution patterns, but also on the ability of involved agencies to secure adequate state resources for the program. This paper addresses this question through the lens of the Clean Water State Revolving Loan Fund program designed to fund water quality infrastructure. Employing a dataset covering nearly thirty years of state-level data, we find that measures of administrative structure and state capability are more powerful explanators of state resource decisions than are more standard explanations of politics, needs, and ideology.
Association between cardiovascular risk factors and degenerative disc disease of the thoracolumbar spine in the general population: results from the KORA MRI Study
Authors: Maurer Elke , Klinger Christian , Lorbeer Roberto , Hefferman Gerald , Schlett Christopher L , Peters Annette , Nikolaou Konstantin , Bamberg Fabian , Notohamiprodjo Mike , Walter Sven S
Published: April 2021

Background

Little is known about the associations between cardiovascular risk factors (CRF) and disc degeneration (DD).

Purpose

To evaluate the potential association between CRFs and intervertebral DD in a population-based sample.

Methods

A total of 400 participants from the community-based KORA-study were assessed in terms of CRFs, specifically obesity, hypertension, diabetes, elevated LDL-c, low HDL-c, elevated triglycerides, smoking status, and alcohol consumption. The patients additionally underwent whole-body magnetic resonance imaging (MRI) using T2-weighted single-shot fast-spin-echo and T1 dual-echo gradient-echo Dixon pulse sequences. Thoracic and lumbar DD were assessed using the Pfirrmann score and for the presence of disc bulging/protrusion. Cross-sectional associations between CRFs and MR-based Pfirrmann score were then analyzed.

Results

A total of 385 individuals (58.2% men; mean age 56.3 ± 9.2 years) were included. Prevalence of DD was 76.4%. Older age (β = 0.18; 95% CI 0.12–0.25; P < 0.001) and higher body mass index (BMI) (β = 0.19; 95% CI 0.06–0.30; P = 0.003) were significantly associated with DD of the thoracolumbar spine. Diabetes was significantly associated with DD at T7/8 ( P = 0.029) and L3/4 ( P = 0.017). Hypertension correlated significantly with DD in univariate analysis, but the association did not persist using multivariate analysis (β = 0.53; 95% CI –0.74 to 1.81; P = 0.41). None of the other CRFs ( P ≥ 0.11) were associated with advanced DD. Disc bulging was independently associated with hypertension (β = 0.47; 95% CI 0.27–0.81; P = 0.01).

Conclusion

A significant independent association exists between age, BMI, and intervertebral DD. In contrast, there is no significant association between cardiovascular risk factors and DD. Providing strong evidence that the pathologic process undergirding DD is mechanical, rather than microvascular, in nature.
A unified analytical parametric method for kinematic analysis of planar mechanisms
Authors: Abhary Kazem
Published: April 2021

This paper describes a method for unified parametric kinematic analysis of those planar mechanisms whose geometry can be defined with a set of independent vectorial loops, i.e. solvable independently; this covers a wide range of planar mechanisms. The method is developed by employing the well-known vectorial illustration, and vectorial-loop equations solved with the aid of complex polar algebra leading to a total of only nine unified/generic one-unknown parametric equations consisting of five equations for position analysis and two equations for velocity and acceleration analysis each. Then, the kinematics of joints and mass centers are manifested as resultants of a few known vectors. This method is needless of relative-velocities, relative-accelerations, instantaneous centers of rotation and Kennedy’s Theorem dominantly used in the literature, especially textbooks. The efficiency of the method is demonstrated by its application to a complex mechanism through only eight unified equations, and simultaneously compared to the solution using the textbook common (Raven’s) method which required the derivation of 67 extra equations to get the same results. This reveals the fact that the method is not only a powerful tool for mechanical designers but a most powerful and efficient method for teaching and learning the kinematics of planar mechanisms.
They’re Comparing Me to Her: Social Comparison Perceptions Reduce Belonging and STEM Engagement Among Women With Token Status
Authors: Derricks Veronica , Sekaquaptewa Denise
Published: April 2021

Belonging and academic engagement are important predictors of women’s retention in STEM. To better understand the processes influencing these outcomes, we investigate how numerical underrepresentation (i.e., token status) triggers social comparison perceptions—concerns that others are comparing oneself to another person—that can undermine women’s STEM outcomes. Across four experiments, female college students recruited via subject pool (Study 1a) and MTurk (Studies 1b–3) read a hypothetical scenario in which another female (Studies 1a–3) or male (Study 2) student performed well or poorly in an engineering course. Findings showed that having token (vs. non-token) status in the course increased social comparison perceptions (i.e., perceptions about being compared to an ingroup peer), which subsequently reduced course belonging (Studies 1a and 1b). Study 2 found that (a) token status increased social comparison perceptions in response to the ingroup (vs. outgroup) peer and (b) social comparison perceptions decreased belonging through stereotype threat concerns, particularly when the peer performed poorly. Study 3 directly manipulated social comparison perceptions to further establish their causal role on negative outcomes and demonstrated that these perceived direct comparisons predicted additional consequences signaling STEM disengagement. Collectively, findings identify a novel process that can diminish belonging and academic engagement for women in STEM. Additional online materials for this article are available on PWQ ’s website at http://journals.sagepub.com/doi/suppl/10.1177/03616843211005447
Maternal Mental Health Mediates the Relationship Between Household Food Insecurity and Early Child Development in Brazil
Authors: Pedroso Jéssica , Herkrath Fernando José , Buccini Gabriela , Venancio Sonia Isoyama , Pérez-Escamilla Rafael , Gubert Muriel Bauermann
Published: April 2021

Background:

Optimal early child development (ECD) is fundamental for every child to achieve their developmental potential and thrive. Household food insecurity (HFI) is a risk factor for suboptimal development, but there is still a need to better understand the pathways that explain this relationship.

Objective:

To evaluate whether maternal mental health and infant’s diet mediate the association between HFI and ECD using structural equation modeling.

Methods:

Cross-sectional study with 474 mother–infant dyads. Mothers answered a questionnaire that evaluated variables through validated instruments. Structural equation modeling analyses were conducted to obtain standardized effects (β) and bias-corrected 95% CI, enabling comparisons between the magnitude of the effects. The following observed variables were included: HFI, ECD, consumption of a healthy and diverse diet, the presence of a partner in the household, wanted pregnancy, and current breastfeeding. Latent variables were included to evaluate mental health, poverty, and neonatal health.

Results:

Poor maternal mental health mediated the relationship between HFI and ECD (β = −.05), but a healthy and diverse diet was not a mediator in this relationship. Poverty was related to lower development scores directly (β = .21) and indirectly (β = .02). Not having a partner (β = .05) and having an unwanted pregnancy (β = .02) predicted indirectly lower development scores.

Conclusions:

Poor maternal mental health mediates the relationship between HFI and ECD, and ECD is influenced by poverty, single motherhood, and unwanted pregnancy through different pathways. Therefore, public policies and interventions that aim to promote an optimal ECD should also approach these aspects.
Neuroimaging Findings of Hospitalized Covid-19 Patients: A Canadian Retrospective Observational Study
Authors: Jegatheeswaran Vibeeshan , Chan Michael W. K. , Chakrabarti Sumon , Fawcett Adrian , Chen Yingming Amy
Published: April 2021

Purpose:

Coronavirus disease (COVID-19) has been associated with neurologic sequelae and neuroimaging abnormalities in several case series previously. In this study, the neuroimaging findings and clinical course of adult patients admitted with COVID-19 to a tertiary care hospital network in Canada were characterized.

Methods:

This is a retrospective observational study conducted at a tertiary hospital network in Ontario, Canada. All adult patients with PCR-confirmed COVID-19 admitted from February 1, 2020 to July 22, 2020 who received neuroimaging related to their COVID-19 admission were included. CT and MR images were reviewed and categorized by fellowship-trained neuroradiologists. Demographic and clinical data were collected and correlated with imaging findings.

Results:

We identified 422 patients admitted with COVID-19 during the study period. 103 (24.4%) met the inclusion criteria and were included: 30 ICU patients (29.1%) and 73 non-ICU patients (70.9%). A total of 198 neuroimaging studies were performed: 177 CTs and 21 MRIs. 17 out of 103 imaged patients (16.8%) had acute abnormalities on neuroimaging: 10 had macrohemorrhages (58.8%), 9 had acute ischemia (52.9%), 4 had SWI abnormalities (23.5%), and 1 had asymmetric sulcal effacement suggesting possible focal encephalitis (5.8%). ICU patients were more likely to have positive neuroimaging findings, more specifically acute ischemia and macrohemorrhages ( P < 0.05). Macrohemorrhages were associated with increased mortality ( P < 0.05).

Conclusion:

Macrohemorrhages, acute ischemia and SWI abnormalities were the main neuroimaging abnormalities in our cohort of hospitalized COVID-19 patients. Acute ischemia and hemorrhage were associated with worse clinical status.
A Confessional Representation of Ethnographic Fieldwork in an Academy Sport Setting
Authors: Bowles H.C.R. , Fleming S. , Parker A.
Published: April 2021

Methodological “confessions” are an established genre of ethnographic writing and have contributed to the development of reflexivity in the practice of qualitative research. Yet despite their prevalence, methodological reflections on the specific challenges of conducting ethnography in institutional sport settings have not been developed. The aim of this article, therefore, is to provide a confessional representation of ethnographic fieldwork in a male academy sport environment in the United Kingdom which exhibited several institutional characteristics. Five images are used as stimuli for further methodological reflection in order to illustrate and analyze some practical, ethical, and relational qualities of ethnographic fieldwork. The interpretation and analysis draw attention to strategic ways ethnographers adapt their ethnographic presence in response to specific contextual challenges and constraints. The article concludes with a series of recommendations to guide ethnographic fieldworkers (especially novice ethnographers) in settings of a similar nature.
Association of Multimorbidity on Healthcare Expenditures Among Older United States Adults With Pain
Authors: Marupuru Srujitha , Axon David R
Published: April 2021

Objectives: This cross-sectional study compared the healthcare expenditures associated with multimorbidity (having ≥2 chronic conditions) versus no multimorbidity among older United States (US) adults (aged ≥ 50 years) with self-reported pain in the past 4 weeks. Methods: This research used data from the 2018 Medical Expenditure Panel Survey. Adjusted linear regression models evaluated group differences in various annual healthcare expenditures. Results: Descriptive statistics indicated multimorbidity was associated with all personal characteristics ( p < 0.05) except gender and smoking status ( p > 0.05). Multimorbidity had 75.8% greater annual total health expenditures ( p = 0.0083), 40.6% greater office-based expenditures ( p = 0.0224), 100.6% greater prescription medication costs, ( p = 0.0268), yet 47.3% lower inpatient expenditures ( p = 0.0158), and 56.6% lower home healthcare expenditures ( p < 0.0001) than no multimorbidity. Discussion: This study found greater healthcare expenditures among older US adults with pain and multimorbidity, which captures the financial burden of comorbidity in this population.
Negotiating Gendered Ageing: Intersectional Reflexivity and Experiences of Incongruity of Self-Employed Older Women
Authors: Meliou Elina , Mallett Oliver
Published: April 2021

This article analyses the experiences of self-employed older women. Developing an intersectional reflexivity approach, our analysis shows how older women negotiate their concerns in relation to gendered ageing and realize self-employment. Our study reveals three practices: ‘Expressing the self’, ‘Exploring learning’ and ‘Embracing solidarity’. We contribute to the neglected intersection of gender and age in studies of work, and to an appreciation of the transformational potential of self-employment for older women.
Adaptive Repulsion of Long-Term Memory Representations Is Triggered by Event Similarity
Authors: Chanales Avi J. H. , Tremblay-McGaw Alexandra G. , Drascher Maxwell L. , Kuhl Brice A.
Published: April 2021

We tested whether similarity between events triggers adaptive biases in how those events are remembered. We generated pairs of competing objects that were identical except in color and varied the degree of color similarity for the competing objects. Subjects ( N = 123 across four experiments) repeatedly studied and were tested on associations between each of these objects and corresponding faces. As expected, high color similarity between competing objects created memory interference for object–face associations. Strikingly, high color similarity also resulted in a systematic bias in how the objects themselves were remembered: Competing objects with highly similar colors were remembered as being further apart (in color space) than they actually were. This repulsion of color memories increased with learning and served a clear adaptive purpose: Greater repulsion was associated with lower associative-memory interference. These findings reveal that similarity between events triggers adaptive-memory distortions that minimize interference.
La « femme musulmane opprimée » : genèse d’un nouveau genre littéraire à succès (1988–2003)
Authors: Hajjat Abdellali
Published: April 2021

Depuis la fin des années 1980, le genre littéraire de la « femme musulmane opprimée » connaît un succès phénoménal dans le monde occidental. L’objectif de cet article est de faire la sociologie de sa genèse à partir du cas français, qui est sûrement le pays qui publient le plus de livres de ce genre. Il s’agit ainsi d’analyser les conditions de production et de diffusion de ces livres, en laissant de côté leur contenu textuel et sa réception par les lectrices. Dans un premier temps, l’enjeu est d’inscrire ce nouveau genre littérature dans l’histoire du champ de l’édition française marqué par un phénomène de concentration médiatique, de financiarisation et de changement du métier d’éditeur. Le « témoignage » devient ainsi un genre littéraire particulièrement rentable, comme l’illustre le cas du club de lecture France Loisirs, véritable « machine » à best-sellers à destination d’un public essentiellement féminin. Dans un second temps, il s’agit d’étudier le contenu des catalogues de France Loisirs depuis 1976 en se focalisant sur le type de témoignages promus. Cette analyse révèle le passage, dans les années 1980, de la figure du « repenti communiste » à celle de la « repentie musulmane ». Dans un dernier temps, l’attention se porte sur Jamais sans ma fille de Betty Mahmoody, véritable modèle à suivre pour de nombreuses maisons d’édition françaises. Il se met alors en place un véritable système de découverte de nouvelles histoires de femmes musulmanes, de traduction/réécriture de la part de prête-plume (ghostwriters) expérimentés, et de campagne publicitaire massive dans la presse, la radio et la télévision, qui font de ce genre littéraire un produit de consommation. Ce genre littéraire est révélateur de l’imbrication de la logique de marché et du processus de racialisation des musulmans, débouchant sur la diffusion massive de representations islamophobes.
Neuroprotective effect of miR-204-5p downregulation against isoflurane-induced learning and memory impairment via targeting EphB2 and inhibiting neuroinflammation
Authors: Liu H , Wang M , Xu L , Li M , Zhao M
Published: April 2021

Background:

Isoflurane, one of the most commonly used inhalational anesthetics, is usually used in surgery patients and often causes long-term learning and memory impairment. The aim of this study was to explore the role of microRNA-204-5p (miR-204-5p) in isoflurane-induced learning and memory impairment in rats.

Methods:

The Morris Water Maze (MWM) test was used to estimate the spatial learning and memory abilities of laboratory rats. Enzyme-linked immunosorbent assay (ELISA) was used to determine interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) concentrations in the hippocampal tissues. The expression level of miR-204-5p was determined by using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The potential target genes of miR-204-5p were predicted and verified by the TargetScan and dual-luciferase reporter assay, respectively.

Results:

Isoflurane-induced rats showed significantly higher neurological function scores, higher escape latency and shorter time spent in the original quadrant. Isoflurane could significantly induce neuroinflammation, and the expression of miR-204-5p was increased in the hippocampal tissue of rats exposed to isoflurane. Moreover, downregulation of miR-204-5p attenuated the effect of isoflurane treatment on the escape latency and the time in the original quadrant, and inflammatory cytokines level was downregulated by inhibiting the expression of miR-204-5p. EphB2 was verified as a direct target gene of miR-204-5p.

Conclusion:

Downregulated miR-204-5p exerts protective effects against isoflurane-induced learning and memory impairment via targeting EphB2 and inhibiting neuroinflammation. MiR-204-5p could serve as a potential therapeutic target for the lightening of cognitive dysfunction induced by isoflurane.
AI-driven multiscale simulations illuminate mechanisms of SARS-CoV-2 spike dynamics
Authors: Casalino Lorenzo , Dommer Abigail C , Gaieb Zied , Barros Emilia P , Sztain Terra , Ahn Surl-Hee , Trifan Anda , Brace Alexander , Bogetti Anthony T , Clyde Austin , Ma Heng , Lee Hyungro , Turilli Matteo , Khalid Syma , Chong Lillian T , Simmerling Carlos , Hardy David J , Maia Julio DC , Phillips James C , Kurth Thorsten , Stern Abraham C , Huang Lei , McCalpin John D , Tatineni Mahidhar , Gibbs Tom , Stone John E , Jha Shantenu , Ramanathan Arvind , Amaro Rommie E
Published: April 2021

We develop a generalizable AI-driven workflow that leverages heterogeneous HPC resources to explore the time-dependent dynamics of molecular systems. We use this workflow to investigate the mechanisms of infectivity of the SARS-CoV-2 spike protein, the main viral infection machinery. Our workflow enables more efficient investigation of spike dynamics in a variety of complex environments, including within a complete SARS-CoV-2 viral envelope simulation, which contains 305 million atoms and shows strong scaling on ORNL Summit using NAMD. We present several novel scientific discoveries, including the elucidation of the spike’s full glycan shield, the role of spike glycans in modulating the infectivity of the virus, and the characterization of the flexible interactions between the spike and the human ACE2 receptor. We also demonstrate how AI can accelerate conformational sampling across different systems and pave the way for the future application of such methods to additional studies in SARS-CoV-2 and other molecular systems.
Clinical Case of Surreptitious Hypoglycemia Due to Deliberate Insulin Analog Administration
Authors: Yukina Marina , Nuralieva Nurana , Troshina Ekaterina , Malysheva Natalya , Zuraeva Zamira , Bratchikova Alina
Published: April 2021

Hypoglycemic syndrome is a life-threatening condition that can lead to hypoglycemic coma and death. Surreptitious hypoglycemic syndrome is the deliberate use of insulin preparations or oral hypoglycemic drugs aimed to reduce blood glucose level. If human insulin is injected, high level of immunoreactive insulin (IRI) and low level of C-peptide at the moment of hypoglycemia are always detected. However, the fact of deliberate administration of insulin analogs is difficult to prove. In these cases if insulin kit test with low cross-reactivity with insulin analogs is used, the low levels of IRI and C-peptide will be suspected. Some experts suggest the presence of cross reactivity with analogs of insulin in a number of commercial kits, which makes it possible to detect cases of surreptitious hypoglycemia. We present a clinical case of a patient with surreptitious hypoglycemia due to the administration of insulin analogs and discuss the problems of its laboratory diagnosis.
Patient and Caregiver Perspectives on an eHealth Tool: A Qualitative Investigation of Preferred Formats, Features and Characteristics of a Presurgical eHealth Education Module
Authors: Reid Holly , Mohammadi Somayyeh , Watson Wendy , Robillard Julie M , Crocker Morag , Westby Marie D , Miller William C
Published: April 2021

Introduction:

Total hip and total knee replacement (THR and TKR) are suggested for reducing joint pain resulting from hip and knee osteoarthritis (OA), especially when other interventions have not resulted in desired outcomes. Providing prehabilitation education can improve patients’ psychological and physical well-being before and after surgery. The use of electronic health (eHealth) tools can be considered an effective method to increase patients’ access to prehabilitation, particularly for those facing barriers to attending diagnosis-specific in-person education sessions. However, limited attention is paid to both caregiver and patient perspectives regarding the delivery formats, features, and characteristics of eHealth tools.

Method:

Patients with hip (n = 46) and knee OA (n = 14) and their family caregivers (n = 16) participated in in-person focus groups or phone interviews. Participants were shown a mock-up of an eHealth module, and asked to share their preferences regarding the formats, features, and characteristics of the eHealth prehabilitation tool. Data was transcribed verbatim and coded using primary thematic and secondary content analyses.

Result:

Analyses revealed 3 main themes: 1. “easier to understand” emphasizes patients’ preferences on delivery formats and features; 2. “what does that mean?” highlights requests for clear and simple information; and 3. “Preparation, right?” shows patients’ perspectives on the best time to have access to the eHealth tool.

Discussion:

Participants’ preferences for prehabilitation tools included offering eHealth tools in multiple mediums of delivery (eg, written materials, pictures, videos). Participants preferred simplified information that emphasized the key points and rationale for the knowledge. There were differences in preferred timeline for having access to prehabilitation education, such as some participants wanting to receive prehabilitation well in advance, while others stated just before surgery was adequate. Our findings provide novel and actionable information about patient and caregiver perspectives on features and characteristics of prehabilitation education for patients with hip and knee OA.
Effect of process parameters on sliding wear performance of red brick dust-filled glass–epoxy composites
Authors: Pati Pravat Ranjan , Satpathy Mantra Prasad
Published: April 2021

This research is focused on the study of the tribological properties of epoxy composites reinforced with red brick dust and glass fiber. Wear tests are conducted on a pin-on-disk apparatus. The wear rate and coefficient of friction are measured after tribological tests. The relative effect of process parameters such as sliding velocity, normal load, filler content on specific wear rate, and coefficient of friction is also examined using the Taguchi model and analysis of variance technique. Furthermore, an innovative optimization approach is adopted by combining grey relational analysis with the metaheuristic firefly algorithm to obtain the desired response values. A nonlinear regression model is generated to cater to the relationship between the grey relational grade and the process parameters. This model is further employed in the firefly algorithm to move the firefly to the neighboring brighter and attractive firefly. The most influencing factors for wear rate and friction coefficient are sliding velocity and normal load, respectively. This work not only opens up an opportunity for value-added utilization of waste material such as red brick dust but also the proposed metaheuristic approach can be customized and applied for any multi-response optimization problem.
Bioinformational diplomacy: Global health emergencies, data sharing and sequential life
Authors: Elbe Stefan
Published: April 2021

Global health emergencies – like COVID-19 – pose major and recurring threats in the 21st century. Now societies can be better protected against such harrowing outbreaks by analysing the detailed genetic sequence data of new pathogens. Why, then, is this valuable epistemic resource frequently withheld by stakeholders – hamstringing the international response and potentially putting lives at risk? This article initiates the social scientific study of bioinformational diplomacy, that is, the emerging field of tensions, sensitivities, practices and enabling instruments surrounding the timely international exchange of bioinformation about global health emergencies. The article genealogically locates this nascent field at the intersection of molecularised life, informationalised biology and securitised health. It investigates the deeper political, economic and scientific problematisations that are engendering this burgeoning field. It finally analyses the emergent international instruments developed by governments, scientists and industry to facilitate more rapid global sharing of bioinformation through novel practices of data passporting. Overall, the in-depth study of bioinformational diplomacy reveals just how deeply, and even constitutively, international relations are entangled with the life sciences – by carefully tracing how laboratory practices of sequencing life at molecular scale also end up recontouring the play of sovereignty, power and security in international relations.
Data and optimisation requirements for Kidney Exchange Programs
Authors: Smeulders Bart , Pettersson William , Viana Ana , Andersson Tommy , Bolotinha Catarina , Chromy Pavel , Gentile Margherita , Hadaya Karine , Hemke Aline , Klimentova Xenia , Kuypers Dirk , Manlove David , Robb Matthew , Slavcev Antonij , Tubertini Paolo , Valentin María O. , van de Klundert Joris , Ferrari Paolo
Published: April 2021

Kidney Exchange Programs (KEP) are valuable tools to increase the options of living donor kidney transplantation for patients with end-stage kidney disease with an immunologically incompatible live donor. Maximising the benefits of a KEP requires an information system to manage data and to optimise transplants. The data input specifications of the systems that relate to key information on blood group and Human Leukocyte Antigen (HLA) types and HLA antibodies are crucial in order to maximise the number of identified matched pairs while minimising the risk of match failures due to unanticipated positive crossmatches. Based on a survey of eight national and one transnational kidney exchange program, we discuss data requirements for running a KEP. We note large variations in the data recorded by different KEPs, reflecting varying medical practices. Furthermore, we describe how the information system supports decision making throughout these kidney exchange programs.
Using computational tools to support journalists’ creativity
Authors: Franks Suzanne , Wells Rebecca , Maiden Neil , Zachos Konstantinos
Published: April 2021

This paper presents work surrounding INJECT, a newsroom innovation offering digital tools to support journalists. Research showing increasing time and resource pressure on journalists has led to concerns about the demise of investigative reporting and the ability of today’s journalists to interrogate information adequately. Some digital innovations (e.g. tools facilitating robot journalism) have been viewed with suspicion by newsrooms. This paper reports on a research project that seeks to create an innovative tool to support the creative capabilities of time and resource poor journalists. The INJECT project used the advanced information discovery capabilities of digitisation to help journalists find new angles on stories and this paper analyses the extent to which such initiatives might harness digital innovation to benefit both the quality and range of reporting and thereby enhance creativity. It examines the potential of an information processing model of creativity derived from the INJECT tool to assist and support journalists, exploring the theoretical impact as well as the practical implications reported from the newsroom.
Modified Combined Physiological and Debulking Procedure for Lower Limb Lymphedema to Achieve Both Immediate and Sustained Results in Lymphedema
Authors: Mir Mohd Altaf , Mahakalkar Sameer S. , Rashim Muhammed
Published: April 2021

A 17-year-old girl presented with bilateral lower limb lymphedema since 3 years. Lymphedema in the right leg was Grade III, not pitting and not reducing in size after limb elevation. She hailed from a tribal community. Considering her young age, a single-stage operative procedure for her lymphedematous leg was followed, as she was not prepared for a multistaged operation. However, this operative procedure needed to be a combination of both, debulking and physiological procedures, so as to give her immediate limb girth reduction as well as reduction in recurrence, as seen with debulking procedures. We report a newer technique that could achieve both goals.
A Review of Network and Computer Analysis of Epileptiform Discharge Free EEG to Characterize and Detect Epilepsy
Authors: West Caitlin , Woldman Wessel , Oak Katy , McLean Brendan , Shankar Rohit
Published: April 2021

Objectives. There is emerging evidence that network/computer analysis of epileptiform discharge free electroencephalograms (EEGs) can be used to detect epilepsy, improve diagnosis and resource use. Such methods are automated and can be performed on shorter recordings of EEG. We assess the evidence and its strength in the area of seizure detection from network/computer analysis of epileptiform discharge free EEG. Methods. A scoping review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance was conducted with a literature search of Embase, Medline and PsychINFO. Predesigned inclusion/exclusion criteria were applied to selected articles. Results. The initial search found 3398 articles. After duplicate removal and screening, 591 abstracts were reviewed, 64 articles were selected and read leading to 20 articles meeting the requisite inclusion/exclusion criteria. These were 9 reports and 2 cross-sectional studies using network analysis to compare and/or classify EEG. One review of 17 reports and 10 cross-sectional studies only aimed to classify the EEGs. One cross-sectional study discussed EEG abnormalities associated with autism. Conclusions. Epileptiform discharge free EEG features derived from network/computer analysis differ significantly between people with and without epilepsy. Diagnostic algorithms report high accuracies and could be clinically useful. There is a lack of such research within the intellectual disability (ID) and/or autism populations, where epilepsy is more prevalent and there are additional diagnostic challenges.
The Role of Vertebral Body Tethering in Treating Skeletally Immature Scoliosis
Authors: Meza Blake C. , Samuel Andre M. , Albert Todd J.
Published: April 2021

This is a critical analysis of a study by Hoernschemeyer et al, “Anterior Vertebral Body Tethering for Adolescent Scoliosis with Growth Remaining: A Retrospective Review of 2 to 5-Year Postoperative Results” ( J Bone Joint Surg Am, 2020;102[13]:1169–1176), that assessed the clinical and radiographic outcomes of vertebral body tethering (VBT) in the treatment of adolescent scoliosis. The authors demonstrated successful treatment in 74% of patients, based on radiographic outcomes and avoidance of subsequent posterior spinal fusion. Nearly a quarter of patients required revision surgery. Almost half suffered a broken tether, although the effects of such complications are not fully understood. The study provided valuable information for determining which patients are reasonable candidates for VBT and emphasizes several questions surrounding this novel technology that remain unanswered. This analysis discusses the study’s strengths and weaknesses, suggests potential directions of future research, and examines the potential indications for VBT.
“This Is the Result of Something Else”: Experiences of Men That Abused Drugs and Had Experienced Childhood Trauma
Authors: Georgsdottir Margret Torshamar , Sigurdardottir Sigrun , Gunnthorsdottir Hrafnhildur
Published: April 2021

Drug abuse is a serious public health issue that may have irreversible consequences. Research has revealed that childhood psychological trauma can promote addictive behaviors in adulthood and that drugs are often used as a coping mechanism. Men are less likely to report trauma and seek help than women. The purpose of this qualitative study was to explore the experience of men in Iceland who have abused drugs and experienced childhood psychological trauma, to increase knowledge and deepen the understanding of trauma and addiction. Participants were seven men who had both experienced childhood trauma and had a history of drug abuse. Two interviews were conducted with each participant. The main findings suggest that participants abused drugs as a coping mechanism due to the trauma experienced in childhood. For some participants, seeking companionship was a key component of their drug use. Participants were mostly dissatisfied with treatment resources in Iceland; waiting lists were long and too much focus was on religion. Five main themes were identified: emotional impact, self-medication for pain, gender expectations, impermanence of thoughts, and loss of a sense of wholeness. Increased societal and professional awareness of the linkage between trauma and drug abuse is needed, as are additional resources specific to men who have experienced childhood trauma and drug abuse. It is important to integrate trauma focused services into health-care settings to educate health-care professionals on trauma and the consequences thereof, in addition to utilizing screening tools such as the Adverse Childhood Experience Questionnaire for those seeking assistance.
Safety and Duration of Low-Dose Adjuvant Dexamethasone in Regional Anesthesia for Upper Extremity Surgery: A Prospective, Randomized, Controlled Blinded Study
Authors: Gouda Nura , Zangrilli Julian , Voskerijian Armen , Wang Mark L. , Beredjiklian Pedro K. , Rivlin Michael
Published: April 2021

Background

Orthopedic procedures concerning the upper extremity commonly use a brachial plexus nerve block to achieve postoperative analgesia. The addition of dexamethasone to peripheral nerve blocks has been shown to significantly prolong its effect. We hypothesize that 1 mg doses of dexamethasone will prolong brachial plexus nerve block with similar efficacy to 4 mg and better than ropivacaine alone.

Methods

Seventy-nine patients who received a brachial plexus nerve block prior to undergoing upper extremity surgery were randomized to 1 of 4 treatment groups: group 1 received only 30 mL of 0.5% ropivacaine without dexamethasone (control); groups 2, 3, and 4 received 4, 2, and 1 mg of dexamethasone, respectively, added to 30 mL of 0.5% ropivacaine.

Results

Comparison of block duration, specifically “first signs of the block wearing off” to the 0-mg group, referencing the 1-, 2-, and 4-mg groups ( P = .02, .04, and .01, respectively) that received steroid adjuvant therapy demonstrated a significant increase in time until the block began to wear off. All study groups receiving steroids also demonstrated a significant increase in duration of the block prior to its effects being completely gone when compared with the control group ( P < .01 for all groups).

Conclusions

Our findings demonstrate that adjuvant dexamethasone can prolong brachial plexus nerve blocks effectively at low doses compared with high doses, in addition to prolonging analgesia compared with local anesthetic alone.
The triple aim of clinical research
Authors: Dorsey E Ray , Kieburtz Karl
Published: April 2021

The proposed triple aim of health care—enhanced patient experience, improved population health, and reduced per capita costs—can be applied to clinical research. A triple aim for clinical research would (1) improve the individual research participant’s experience; (2) promote the health of populations; and (3) reduce per capita costs of clinical research. Such an approach is possible by designing trials around the needs of participants rather than sites, embracing digital measures of health, and advancing decentralized studies. Recent studies, including those evaluating therapies for COVID-19, have demonstrated the value of such an approach. Accelerating the adoption of these methods can help fulfill this new triple aim of clinical research.
Participation in the Swedish national principal training programme: How does it intertwine with principals’ practice?
Authors: Jerdborg Stina
Published: April 2021

Blending principal education programmes and leadership practice has become a common feature in the education of school principals. However, the need for further research in how programme participants experience learning within an overall structure of a programme has been highlighted since the same programmes are experienced differently. This empirical study used a practice-based approach to explore how participation in the Swedish National Principal Training Programme intertwines with principals’ work in practice. A situated perspective was used, interviewing and observing principals in both their educational and their workplace practice. In addition, teachers were interviewed at their school. This study revealed processes of continuous learning, which connects practice to what was learned in the Principal Programme. These processes mend and bridge old practices with new practices and therefore facilitate change. The principal also becomes a broker, rendering legitimacy in practice. The analyses, however, also reveal processes of interrupted learning, which disconnects working in practice from the participation in the Principals’ Programme, leading to discontinuous processes and exits. Increasing consciousness of the value of working with bridging and brokering would support principals’ professional learning and function as a foundation for leadership development.