bluuebunny/crossref_metadata_2025 huggingface dataset:
A Propensity Score–Matched Comparison Between Knotless Layer-by-Layer and En Masse Suture Bridge Techniques for Delaminated Rotator Cuff Tears
Authors: Kim Hyungsuk , Park Soo Bin , Song Hyun Seok
Published: May 2022

Background:

Because the articular layer is more prone to retraction than the bursal layer of the supraspinatus tendon, it is important to restore each layer anatomically while repairing delaminated rotator cuff tears (RCTs).

Purpose:

To compare clinical outcomes and tendon integrity between knotless layer–by–layer and conventional en masse repair techniques for delaminated RCTs.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively reviewed data from 174 consecutive patients with delaminated RCTs treated by arthroscopic suture bridge repair. Only 115 patients with medium to large supraspinatus tears with delamination were included. The 33 patients treated using the knotless layer–by–layer technique (group 2) were matched 1:1 with patients treated using en masse repair with the suture bridge technique (group 1) based on propensity scores. Tendon thickness was measured on magnetic resonance imaging (MRI). Signal changes in the bursal, articular, and intratendinous layers were assessed using T2-weighted MRI.

Results:

Postoperatively, statistically significant improvements were seen in both groups compared with preoperatively functional scores. At the final follow–up, there was a statistically significant difference in the Constant score, which was higher in group 2 than in group 1 (91.4 ± 6.0 and 84.3 ± 16.4, respectively; P = .005). There was 1 case of a retear in each group, representing a 3% retear rate. Group 2 had thicker tendons than group 1 (6.9 ± 1.1 and 6.0 ± 1.2 mm, respectively; P = .017). On T2-weighted MRI, a low signal intensity in the articular layer was more common in group 2 ( P = .046).

Conclusion:

En masse repair using the suture bridge technique and the knotless layer–by–layer technique were both effective. Regarding tendon healing, no significant differences were seen in retear rates. However, superior results in terms of the Constant score, tendon thickness, and signal intensity in the articular layer were observed using the knotless layer–by–layer technique.
Adolescent Baseball Pitchers With Ulnar Collateral Ligament Tears Exhibit a High Proportion of Partial Tears
Authors: Goodrich Eric , Cox Benjamin , Plummer Hillary A. , Cohen Achraf , Andrews James R. , Saper Michael
Published: May 2022

Background:

Ulnar collateral ligament (UCL) tears in the throwing elbow are classified according to grade and location using magnetic resonance arthrography (MRA). However, the frequency of each tear type and the association to age, competition level, and radiographic findings in adolescent baseball pitchers are unknown.

Purposes:

The primary purpose of this study was to use MRA to characterize the severity, location, and UCL tear type in adolescent pitchers. The second aim was to describe the relationship between the UCL tear type and age, competition level, and plain radiographic findings.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Records of adolescent pitchers with a UCL tear treated by the senior author between 2007 and 2016 were retrospectively reviewed. MRA scans were reviewed and tears were classified according to the Joyner-Andrews classification. Low-grade partial tears are classified as type I, high-grade partial tears as type II, complete full-thickness tears as type III, and tear pathology in >1 region in the UCL as type IV. Each type of tear also has a location designated at the midsubstance, ulna (U), or humerus (H). Patient characteristics, competition level, and associated plain radiographic abnormalities were recorded. Univariate analyses were performed to examine the relationships between tear types and age, competition level, and plain radiographic findings.

Results:

A total of 200 adolescent pitchers (mean ± SD age, 17.2 ± 1.5 years) with MRA scans were reviewed. Type II-H (n = 62), type II-U (n = 51), and type III-U (n = 28) were the most common tear types observed. Type II tears comprised 64.5% of adolescent UCL tears, with type II-H being the most common. Plain radiographs were abnormal in 32% of patients, with calcifications (10.5%) and olecranon osteophytes (12.5%) being the most common findings. There were no significant relationships between tear type and age ( P = .25), competition level ( P = .23), or radiographic abnormalities ( P = .75).

Conclusion:

Humeral-sided high-grade partial tears were the most common tear type in adolescent pitchers. There was no relationship between UCL tear type and age competition level, and plain radiographic abnormalities.
Shrinking Greens: Travellers’ Account of the Heritage Gardens of Ahmedabad—1400–2016
Authors: Sharma Mahesh
Published: May 2022

The sultans of Gujarat tried to transform the landscape by planting native and exotic trees and introducing gardens on the perceived Central-Asian Khorasan style to underpin their control over the acquired or conquered territory and its nature-landscape. After the founding of Ahmedabad, gardens within the religious and secular architecture came up all over the city. The foliage and gardens were hugely admired by the travellers passing by the city. Perusing their travelogues, we navigate the changing landscape and the green spaces of Ahmedabad over a period of time. While constructing the history of gardens in Ahmedabad, this article reflects on the future sustainability of the city if the culture of nature and environment-sensitive values are not inculcated and promoted.
“Mental Readiness” and Gatekeeping in Trans Healthcare
Authors: Verbeek Wesley , Baici Wayne , MacKinnon Kinnon R. , Zaheer Juveria , Lam June Sing Hong
Published: May 2022

Gatekeeping refers to clinicians’ strict application of eligibility criteria to determine a trans patient's “fitness” to engage in medical transition, resulting in significant barriers to gender-affirming care. Gatekeeping often uses “mental readiness” as a prerequisite to medical transition, which contributes to patient distress and systemic discrimination. Changing international trans health guidelines (the new World Professional Association for Transgender Health Standards of Care version 8) recommends clinicians shift from a gatekeeping model towards an informed consent model, which improves access to care. This commentary offers recommendations on how clinicians can reconsider existing “mental readiness” frameworks around medical transition to facilitate improved access to care.
A numerical model for analysis of layer thicknesses on ballistic resistance of a multilayer armor
Authors: Ozdil Kacan Yelda , Elaldi Faruk
Published: May 2022

The interest in composite materials, which are lighter and have better mechanical properties (strength, fatigue resistance, corrosion resistance, etc.) than traditional engineering materials, is increasing day by day. In particular, their responses to low or high-velocity impact loads have been among the important research topics of recent years. In this study, unlike the traditional ceramic-based composite armor structures used in the defense industry, the effect of total carbon fibers specifically parallel oriented into impact direction on penetration resistance has been investigated, and penetration resistance of a multilayer hybrid composite armor which is composed of carbon fiber composite blocks sandwiched by two armor steel plates exposed to high-velocity impact has been analyzed numerically. Carbon fibers are normally very brittle to the transverse loading direction, contrarily, to their axial tension or compression direction. This is the reason why it is claimed that this high compression strength property of carbon fibers could be used as a layer in order to replace ceramics in add-on multilayer composite armor. The numerical model created in the ANSYS LS-DYNA program was verified by using the experimental data obtained in an earlier study. The verified numerical model was used to analyze high-velocity impact simulations of multilayer hybrid composite armor for different thicknesses of armor steel to reduce the areal density. By these simulations, minimum areal density compared to Rolled Homogeneous Armor steel for equivalent protection was finally achieved, and thus the hypothesis saying that carbon fibers parallel oriented to impact direction can give high penetration resistance was proved by showing that developed multilayer carbon fiber reinforced epoxy composite–armor steel hybrid panels have indicated a better protection level than STANAG 4569 Level-4 with a lower areal density.
Systematic Review Revisited, 2010–2020: The Effect on Surrogates of Making Treatment Decisions for Others
Authors: Rogers Anita Hendrix , Lopez Ruth Palan
Published: May 2022

Objectives: This study mapped research evidence spanning the last 10 years to identify the effect of being a surrogate decision maker for an incapacitated adult. Methods: A scoping review strategy was employed to allow for a focus on the breadth of the effect of surrogate decision making and to identify gaps in the existing research literature. Results: Surrogate decision making created emotional distress and burden for the majority of the SDMs. We found the negative effects on SDMs were linked to variety of stressors: fear of not knowing what the patient would want or being unable to fulfill the patient's actual or perceived wishes, feeling unprepared to assume the role of a SDM, and watching a loved one's health deteriorate over time. Discussion: Additional research is needed to elucidate the emotional burden of culturally diverse SDMs to determine their differences when compared to various groups.
Components, Models of Integration, and Outcomes Associated with Palliative/ end-of-Life Care Interventions in the Burn Unit: A Scoping Review
Authors: Bayuo Jonathan , Abu-Odah Hammoda , Koduah Adwoa Owusuaa
Published: May 2022

Objective: To scope the literature to ascertain the components of palliative care (PC) interventions for burn patients, models of integration, and outcomes. Methods: Arksey and O’Malley scoping review design with narrative synthesis was employed and reported following the PRISMA-ScR guidelines. Primary studies reporting PC interventions in the burn unit were considered for inclusion. CINAHL via EBSCO, PubMed, EMBASE via OVID, Web of Science, and gray literature sources were searched from inception to June 2021. Results: Fifteen studies emerging from high-income settings were retained. Data were organized around three concepts: components of palliative/ end of life care in the burn unit; models of integration; and outcomes. The components of interventions based on the Robert Wood Johnson Foundation Critical Care End-of Life Group domains include decision-making, communication, symptom management and comfort care, spiritual support, and emotional and practical support for families. Consultative and integrative models were noted to be the strategies for integrating PC in the burn unit. The outcomes were varied with only few studies reporting healthcare staff related outcomes. Conclusion: PC may have the potential of improving end-of-life care in the burn unit albeit the limited studies and lack of standardized outcomes makes it difficult to draw stronger conclusions regarding what is likely to work best in the burn unit.
Genipin-crosslinked decellularized scaffold induces regeneration of defective rat kidneys
Authors: Du Aoling , Liu Dan , Zhang Wenhui , Wang Xinwang , Chen Shenghua
Published: May 2022

Objective: The purpose of this study was to improve the performance of decellularized renal scaffolds by the genipin crosslinking method to facilitate the regeneration of tissues and cells and provide better conditions for the regeneration and repair of defective kidneys. Methods: SD rats were randomly divided into three groups: normal group, uncrosslinked scaffold group and genipin-crosslinked scaffold group. Hematoxylin eosin, Masson and immunofluorescence staining was used to observe the histomorphological characteristics of the kidneys in each group. The preservation of the renal vascular structure in the three groups was observed by vascular casting. A collagenase degradation assay was used to detect the antidegradation ability of the kidney in the three groups. CCK8 assays were used to test the in vitro biocompatibility of the scaffolds. The lower 1/3 of the rat left kidney was excised, and the defect was filled with decellularized renal scaffolds to observe the effect of scaffold implantation on the regenerative ability of the defective kidney. Results: Histological images showed that the genipin-crosslinked scaffold did not destroy the structure of the scaffold, and the collagen fibers in the scaffold was more regular, and the outline of the glomerulus was clearer than uncrosslinked scaffold. The results of casting showed that the vascular structure of genipin-crosslinked scaffold was still intact. The anti-degradation ability test showed that the anti-degradation ability of genipin-crosslinked scaffold was significantly higher than that of the uncrosslinked scaffold. Cell culture experiments showed that the genipin-crosslinked scaffold had no cytotoxicity and promoted cell proliferation to some extent. In vivo scaffold transplantation experiments further demonstrated that the genipin-crosslinked scaffold had better anti-degradation and anti-inflammatory ability. Conclusion: Genipin-crosslinked rat kidney scaffold complemented kidney defects in rats can enhance scaffold-induced kidney regeneration and repair.
Racial and Ethnic Disparities in Violent Penetrating Injuries and Long-Term Adverse Outcomes
Authors: Nistler Conor M. , James Thea L. , Dugan Elizabeth , Pino Elizabeth C.
Published: May 2022

Violent injury is known to be a chronic, recurrent issue, with high rates of recidivism following initial injury. While the burden of violence is disproportionately felt among young Black men and in communities of color, examination of distinct risk factors and long-term outcomes for other racial and ethnic groups could lead to improved violence intervention strategies. In this study, we examined the risk of violent penetrating injury and long-term adverse outcomes by race and ethnicity. This retrospective study was performed using a cohort of patients presenting to the Boston Medical Center emergency department for a violent penetrating injury between 2006 and 2016. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) for the risk of all-cause mortality and violent re-injury at one and 3 years after surviving a penetrating injury.

Of the 4191 victims of violent injury, 12% were White, 18% were Hispanic, and the remaining 70% self-identified as Black. Within 3 years after initial injury, Black patients were at the greatest risk of all-cause violent re-injury (vs. Hispanic: HR = 1.46, 95%CI[1.15,1.85], p = 0.002; vs. White: HR = 1.89, 95%CI[1.40,2.57], p < 0.0001), particularly by gunshot wound (vs. Hispanic: HR = 2.04, 95%CI[1.29,3.22] p = 0.002; vs. White: HR = 2.34, 95%CI[1.19,4.60], p = 0.01). At 3-years following initial injury, White patients were at 2.03 times the risk for all-cause mortality, likely due to a 4.96 times greater risk of death by drug or alcohol overdose for White patients compared to Black patients (HR = 4.96, 95%CI[2.25,10.96], p < 0.0001). In conclusion, Black survivors of violent injury have a significantly higher risk of violent re-injury, particularly by gun violence, while White patients are at the highest risk for mortality due to the incidence of drug and alcohol overdose. Violence intervention programs with similar patient populations should explore options to collaborate with drug treatment programs to reach this vulnerable population.
Does Bystander Intervention Training Work? When Employee Intentions and Organisational Barriers Collide
Authors: Kuntz Joana C. , Searle Freya
Published: May 2022

Scholars have recently begun to consider the role of bystander intervention training in countering workplace incivility and bullying. Given the scarce empirical evidence of bystander training outcomes in occupational settings, this study set out to evaluate the effectiveness of a bystander intervention training in a large healthcare organisation, by assessing changes to levels of psychological safety, bystander efficacy, intent and behaviours over time. One hundred and forty employees in a large healthcare organisation in New Zealand attended the training and were asked to complete three surveys, one conducted at baseline, one carried out 2 weeks following the training and the last survey conducted 2 months later. The qualitative and qualitative findings of this study show that the bystander intervention training resulted in significant improvements to bystander attitudes and beliefs, which were ascribed to the quality of training materials, the facilitator and opportunities to role-play bystander intervention strategies. However, the positive bystander beliefs, attitudes and intent to intervene declined in the months following the training. The qualitative findings shed a light on these results and suggest that the participants required support for training transfer in the form of updated and accessible information about negative acts and bystander intervention strategies, leadership support and role modelling of bystander behaviours and civility, and the implementation of accountability systems that ensure the ongoing development of a civility culture.
Soret and Dufour effects on thresholds of stability in a horizontal Brinkman porous layer submitted to vertical temperature and species gradients using linear and non-linear analysis
Authors: Filahi Ismail , Amahmid Abdelkhalek , Bourich Mohamed , Hasnaoui Mohammed
Published: May 2022

The present study deals with Soret and Dufour effects on the onset of double-diffusive natural convection in a horizontal Brinkman porous layer with a free-stress upper boundary. The thresholds of stationary, oscillatory, and subcritical bifurcations are derived on the basis of linear and non-linear analysis, as functions of the governing parameters. The effect of Dufour ([Formula: see text]) and Soret [Formula: see text] parameters on the thresholds of instabilities is illustrated and discussed. There are critical combinations [Formula: see text] for which the thresholds of supercritical bifurcations are independent of the buoyancy ratio. Particularly, for [Formula: see text] and [Formula: see text], the stationary convection starts at the threshold of the pure thermal convection whatever the value of the buoyancy ratio.
Experimental analysis of steering wheel vibrations of an agriculture tractor for reduction of hand-arm vibrations
Authors: Naygaonkar Sumit Someshwar , Desai Sandeep Rangrao
Published: May 2022

Steering wheel vibration is one of the most important factors in determining the operator comfort in agricultural tractors. It is important to investigate steering wheel vibrations in an agricultural tractor in order to improve the operator’s comfort and decrease the negative health impacts on the operator’s hand. The Mahindra 575 DI tractor was selected for further investigation and development as the maximum vibration acceleration was found in the Mahindra 575 DI tractor while measuring the amplitude of vibration on various tractors. The experimental test setup was designed with a solution to reduce steering wheel vibrations. The experimental analysis of steering wheel vibration of an agriculture tractor for the reduction of Hand-Arm Vibration Syndrome (HAVS) is presented in this research article. The vibration level was decreased effectively after establishing a tuned mass damper between the steering gearbox and the vibration exciter.
Entrepreneurial Ecosystem: A Systematic Literature Review
Authors: Wadichar Rahul Krushnaji , Manusmare Prashant , Burghate Mukul Abasaheb
Published: May 2022

Entrepreneurial ecosystems (EEs) is a relatively new concept that has piqued the curiosity of legislators, researchers and professionals. Despite the fact that research on EES is growing, their inputs are still dispersed. No studies have attempted to combine the available research on EES because the literature is fragmented. As a result, the goal of this study is to perform a systematic literature review on EES. This assessment of the literature looks at research included in the Scopus and web of science indexed journals publication like Emerald, Science Direct (Elsevier), JSTOR, SAGE and Google Scholar. The purpose of this research is to uncover research gaps and flaws in the field of entrepreneurial ecosystem (EE). The results reveal that the emergence of EEs is poorly understood, with conceptual research dominating in recent years. By recognizing research gaps in the current literature, we provide a road map for future entrepreneurial environment research. Cooperation, knowledge exchange and innovation at the higher levels are more likely to produce favourable entrepreneurship environments. It identifies present gaps in theories and empirical studies as well as potential research directions in EEs.
Prevalence and Risk Factors Associated With Elevated Thyroid Stimulating Hormone in Late Preterm Newborns With Low Birthweight: A Cross-Sectional Study
Authors: Sardana Gitika , Malwade Sudhir , Agarkhedkar Sharad
Published: May 2022

Introduction:

Congenital hypothyroidism (CH) is seen more often in preterm and low birthweight infants. However, very few studies exist that explore the epidemiology and risk factors associated with CH, especially from the Indian subcontinent.

Methods:

A cross-sectional screening study was carried out on 240 low birthweight (<2.5 kg) and late preterm (34-36.6 weeks) newborns not requiring ventilator support over a period of 18 months. A total of 0.5 mL of venous sample was obtained on day 4 of life for analyzing thyroid stimulating hormone (TSH), tetraiodothyronine (T4), as well as tetraiodothyronine (T3) levels by an architect plus Chemiluminescence microparticle immunosorbent assay. Neonates with TSH values of more than 20 mIU/L were categorized as having elevated TSH.

Results:

Elevated TSH was seen in 10 (4.2%) neonates. The presence of maternal anemia ( P = .011), gestational diabetes mellitus (GDM) ( P < .001), and maternal hypothyroidism ( P < .01) was found to be significantly linked to elevated TSH levels. Other maternal comorbidities, gestational age, birthweight, as well as the nature of birth bore no significant relation with CH.

Discussion:

Elevated TSH was found to be common in late preterm and low birthweight newborns. Neonates of mothers suffering from hypothyroidism, advanced maternal age, GDM, and maternal anemia should be serially evaluated for thyroid abnormalities as they possess a significantly higher risk of having elevated TSH levels.
Governing Olympic education: Technologies of policy announcements and outsourcing
Authors: Zhang Honglu , Powell Darren
Published: May 2022

The Chinese government views the Olympic Games as a critical platform to present national pride on a global scale. Olympic education also has an important role to play for China, as it is a requirement for any Olympic host country. In the context or preparations for the 2022 Beijing Winter Olympics, this original ethnographic research examines the governance of Olympic education, with a focus on how relationships between China's government and a range of stakeholders (e.g. private sectors, academics, and individual teachers) ‘worked’ to shape the implementation of Olympic education in two Beijing primary schools. Utilising Foucault's notion of governmentality, we demonstrate that Olympic education was a significant tactic for Chinese government to realise their ambition of the great rejuvenation of China. Here, the state employed two technologies of government: policy announcements and outsourcing. In tension with common assumptions about China – and Chinese education – being purely authoritarian, our research illuminates how hybrid socialist-neoliberal rationalities worked to shape Olympic education in schools.
Connecting with the subject of our science: Course-of-experience research supports valid theory building in cognitive science
Authors: McGann Marek
Published: May 2022

This commentary addresses the course-of-experience method in the context of calls for improved theorising in psychological science, and in particular the prospect of applying distinctive means of analysis to examine patterns and variance both between people and across contexts. Psychology can benefit by the development of both theories of principle (formal accounts of the structure of phenomena) and constructive theories (formal accounts of the mechanics of phenomena). The course-of-experience method can provide a useful step toward the development of both. Resonances with other work grounded in naturalistic observation identify potential questions that remain as to how the course-of-experience method can address questions about the relationship between individual and collective aspects of experience, but the technique represents a significant boon to the future development of valid cognitive science.
Safety Assessment of Plant-Derived Proteins and Peptides as Used in Cosmetics
Authors: Burnett Christina L. , Boyer Ivan J. , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Heldreth Bart
Published: May 2022

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of 19 plant-derived proteins and peptides, which function mainly as skin and/or hair conditioning agents in personal care products. The Panel concluded that 18 plant-derived proteins and peptides are safe as used in the present practices of use and concentration as described in this safety assessment, while the data on Hydrolyzed Maple Sycamore Protein are insufficient to determine safety.
Psychological factors of Canadian and Mexican tourists and the US tourism sector
Authors: Istiak Khandokar
Published: May 2022

This paper investigates the impact of psychological factors of Canadian and Mexican tourists on the US tourism sector. Using the data of 1996–2019, the study uses vector autoregression models and the spillover analysis to perform the investigation. The paper discovers that high insecurity of tourists significantly reduces tourist arrivals, passenger fare receipts, and expenditure of tourists in the US. Also, tourist inflows are highly influenced by insecurity during terrorist attacks, natural disasters, and the financial crisis of the US. It is found that high sentiment of Canadian and Mexican tourists increases their outbound travel to the US, but the impact of sentiment is relatively stronger for the Canadian tourists. Results show that the tourist inflows from Canada and Mexico are influenced by low sentiment during recessionary periods of Canada and Mexico, respectively. The paper finds no robust evidence of mood and nationalism-based retaliation of tourists for traveling to the US.
Toward a Global Definition and Understanding of Child Sexual Exploitation: The Development of a Conceptual Model
Authors: Laird Jessica J. , Klettke Bianca , Hall Kate , Hallford David
Published: May 2022

Child sexual exploitation (CSE) is a serious and persistent global issue affecting up to 5% of the child and youth population worldwide; yet there is no universally accepted definition. To develop a theoretically robust definition of CSE, this review systematically synthesized literature examining CSE definitions aiming to develop a conceptual model and typology. Electronic databases were searched to February 2021, yielding 384 nonduplicative records. Inclusion criteria were peer-reviewed and grey literature investigations of sexual exploitation, with a mean sample age of 18 years or younger, available in the English language. Literature review and data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Sixty-six studies met final inclusion criteria. Two independent reviewers extracted relevant data and used an epistemological approach to thematically analyse meaning and patterns across CSE definitions. Key findings demonstrate that CSE nomenclature is widely inconsistent, and despite growing awareness of this severe form of abuse, language continues to perpetuate stigma and criminalisation, utilising terms such as ‘adolescent or child prostitute’. Our findings propose a scientifically and trauma-informed definition and conceptualisation of CSE, based on the following four-dimensional components: (1) A child/young person; (2) sexual acts; (3) abuse; and (4) exploitation (abuse + exchange). In this systematic review, a unified definition and conceptual model aims to advance knowledge and understanding of CSE, contributing to the progression of social norms which embrace nuances of trauma-informed practice and support for the identification and recovery of children, young people and families affected by sexual exploitation.
Cardio-Respiratory Fitness and Cardiovascular Disease Risk Factors Among South African Medical Students
Authors: Torres Georgia , Gordon Neil F , Constantinou Demitri
Published: May 2022

Cardiovascular disease (CVD) risk factors have been associated with CVD mortality, and physicians use CVD risk factor profiles (smoking, dyslipidemia, hypertension, etc.) to address patient health. Furthermore, cardio-respiratory fitness (CRF) has been shown to be an independent risk factor for CVD and all-cause mortality. Cardio-respiratory fitness is also the risk factor that contributes the highest percentage to all-cause deaths when compared to other traditional risk factors. In addition, studies have reported that adding CRF to established CVD risk factors improves the precision of prediction for CVD morbidity and mortality. Medical students tend to adopt sedentary and unhealthy lifestyles during the course of their education that negatively affect CVD risk factors and CRF. The majority of research on CVD risk, health status and lifestyle factors of medical students has used self-reported data and questionnaires for CVD risk factors and not included CRF in the health status measurements. In addition, studies have found that future medical doctors’ own health and lifestyle practices influence their counselling activities. Allowing future medical doctors to assess their personal CVD risk factors and CRF may thus be important in their use of physical activity counselling with patients’ lifestyle management for health benefits and improvement. A descriptive, cross-sectional cohort study design was used with the aim to determine CVD risk factors using CRF measures and physical activity levels in a cohort of South African medical students. The most significant finding was that they were not meeting the PA levels recommended to maintain health and lower CVD risk.
Physician Nutrition Advice and Referrals to Registered Dietitians
Authors: Pojednic Rachele , Phillips Edward , Shehadeh Amal , Muller Alexandria , Metallinos-Katsaras Elizabeth
Published: May 2022

Purpose. This study aims to examine the frequency and content of healthcare providers’ nutrition recommendations and referrals Registered Dietitian Nutritionists (RDN). Methods. Physicians, physician assistants, nurses, and other providers (> 18 years of age) currently practicing primarily in the United States received an email survey that assessed dietary recommendations for diabetes, hypertension, dyslipidemia, overweight/obesity, and general wellbeing, frequency and comfort level of providing nutrition advice, and RDN referrals. Chi-square and Student’s t-tests were used for analysis. Results. 154 physicians (61%), registered nurses/nurse practitioners/physician assistants (19.5%), and other providers (19.5%) were included. Those with nutrition education gave nutrition advice more than those without for some, but not all, conditions ( P = .01). The Mediterranean diet was most frequently recommended, except for hypertension. The DASH diet was recommended to 47.7% of patients with hypertension. More providers gave dietary advice than referred to RDNs. Dietary advice was associated with RDN referrals for diabetes ( P = .01) and wellbeing ( P = .05). Providers with an RDN in their practice provided advice for diabetes more than those without ( P = .01). Conclusion. Healthcare providers gave nutrition recommendations consistent with evidence-based guidance. RDN referrals occur in conjunction with dietary recommendations, not as replacement.
Effect of miR-663 on atherosclerosis by regulating the proliferation of vascular smooth muscle cells in lipid plaques
Authors: Deng Zhisheng , Li Lihua
Published: May 2022

Objectives

Atherosclerosis (AS) is the main cause of coronary heart disease, cerebral infarction, and peripheral vascular disease. microRNAs (miRNAs) are widely distributed in the human body and closely related to the pathological progress of AS. This study probed into the function of miR-663 in AS.

Methods

The atherosclerotic plaques, cholesterol (CHOL), low-density lipoprotein (LDL), inflammatory factors, and miR-663 expression in ApoE−/− mice on high-fat diet were evaluated. The overexpressing miR-663 adenovirus was injected into ApoE−/− mice, followed by measurement of type III collagen (Col III), matrix metalloproteinase (MMP)-2, α-SMA, osteopontin, and CD31. miR-663 mimic or inhibitor was introduced into vascular smooth muscle cells (VSMCs) stimulated by oxidized LDL (Ox-LDL), and cell proliferation and IL-6 and IL-18 secretion were evaluated. The binding relationship between miR-663 and HMGA2 was verified, followed by the determination of HMGA2 role in VSMC proliferation.

Results

Atherosclerotic plaques appeared in ApoE−/− mice on high-fat diet, with increased CHOL, LDL, osteopontin, MMP-2 and Col III and decreased miR-663, α-SMA and CD31. miR-663 overexpression downregulated osteopontin, MMP-2 and Col III and upregulated α-SMA and CD31 in ApoE−/− mice on high-fat diet. With Ox-LDL concentration increase, VSMC proliferation was promoted and miR-663 was downregulated. miR-663 overexpression inhibited proliferation of Ox-LDL-stimulated VSMCs and reduced levels of inflammatory factor levels, whereas silencing miR-663 did the opposite. miR-663 targeted HMGA2. HMGA2 overexpression partially reversed the inhibitory effect of miR-663 overexpression on VSMC proliferation.

Conclusion

miR-663 targeted HMGA2 to inhibit VSMC proliferation and AS development, which may offer insights into AS treatment.
Sjögren syndrome: looking forward to the future
Authors: Zandonella Callegher Sara , Giovannini Ivan , Zenz Sabine , Manfrè Valeria , Stradner Martin H. , Hocevar Alojzija , Gutierrez Marwin , Quartuccio Luca , De Vita Salvatore , Zabotti Alen
Published: May 2022

Primary Sjögren’s syndrome (pSS) is a heterogeneous disease characterised by a wide spectrum of manifestations that vary according to the different stages of the disease and among different subsets of patients. The aim of this qualitative literature review is to summarise the recent advances that have been reported in pSS, ranging from the early phases to the established disease and its complications. We analysed the diagnostic, prognostic, and management aspects of pSS, with a look into future clinical and research developments. The early phases of pSS, usually antedating diagnosis, allow us to investigate the pathophysiology and risk factors of the overt disease, thus allowing better and timely patient stratification. Salivary gland ultrasound (SGUS) is emerging as a valid complementary, or even alternative, tool for histopathology in the diagnosis of pSS, due to a standardised scoring system with good agreement and performance. Other promising innovations include the application of artificial intelligence to SGUS, ultrasound-guided core needle biopsy, and a wide array of novel diagnostic and prognostic biomarkers. Stratifying pSS patients through the integration of clinical, laboratory, imaging, and histopathological data; differentiating between activity-related and damage-related manifestations; and identifying patients at higher risk of lymphoma development are essential steps for an optimal management and individualised treatment approach. As new treatment options are emerging for both glandular and systemic manifestations, there is a need for a more reliable treatment response evaluation. pSS is a complex and heterogeneous disease, and many distinct aspects should be considered in the different stages of the disease and subsets of patients. In recent years, efforts have been made to improve our understanding of the disease, and certainly in the coming years, some of these novelties will become part of our routine clinical practice, thus improving the management of pSS patients.
The comparative effectiveness of antidepressants for youths with major depressive disorder: a nationwide population-based study in Taiwan
Authors: Lee Sheng-Yu , Wang Liang-Jen , Yang Yao-Hsu , Hsu Chih-Wei
Published: May 2022

Background:

Guidelines recommend fluoxetine as a first-line medication for youths diagnosed with major depressive disorder (MDD). However, little is known about the long-term effectiveness of different antidepressants in juveniles in the real world. This study aimed to compare the effectiveness of antidepressants in youths with MDD.

Methods:

Youths (<20 years old) with a diagnosis of MDD who were new users of antidepressants were selected from a nationwide population-based cohort in Taiwan between 1997 and 2013. We divided a total of 16,981 users (39.9% male; mean age: 16.6 years) into 10 different antidepressant groups (fluoxetine, sertraline, paroxetine, venlafaxine, citalopram, escitalopram, bupropion, fluvoxamine, mirtazapine and moclobemide). Regarding treatment outcomes (hospitalisation and medication discontinuation), Cox proportional hazards regression models were applied to estimate the hazards of such outcomes.

Results:

Compared with the youths treated with fluoxetine, the bupropion-treated group demonstrated lower rates of hospitalisation and discontinuation. Mirtazapine-treated group demonstrated a higher hospitalisation risk mainly when administered for single depressive episodes. Furthermore, patients treated with sertraline and fluvoxamine had higher discontinuation rates. Among the younger teenage subgroups (< 16 years), significantly higher rates of discontinuation were observed in those treated with sertraline, escitalopram and fluvoxamine. Among the older teenage subgroups (⩾ 16 years), bupropion was superior to fluoxetine in preventing hospitalisation and discontinuation.

Conclusion:

We concluded that bupropion might surpass fluoxetine with regard to hospitalisation prevention and drug therapy maintenance among youths with MDD, while mirtazapine users demonstrated a higher hospitalisation risk. Our findings might serve as a reference for clinicians in future studies.
The problem of the urban–rural binary in geography and political ecology
Authors: Baird Ian G.
Published: May 2022

Geographers have been challenging problematic spatial concepts for decades. Gillen et al. usefully add to this work by disrupting the urban–rural binary in human geography, suggesting that we take people in the Global South more seriously, especially those ‘whose perspectives on urbanization are entangled with ongoing rural dynamics’. They advocate for advancing the concept of relational ruralization. In this commentary, I express my general support for Gillen et al.'s efforts to expose the limitations associated with the urban–rural divide. However, I go somewhat beyond their work to suggest that human geographers should consciously reduce the primacy of the urban–rural binary when conceptualizing space, especially when looking at activities that transcend the urban–rural. There are more productive ways to consider connections.
From Roots to Contemporary Nursing in Ex-Yugoslavian Countries: A Synthetic Review
Authors: Vošner Helena Blažun , Kokol Peter , Železnik Danica , Završnik Jernej
Published: May 2022

To analyze the development of contemporary nursing in Ex-Yugoslavia countries. A performance and spatial bibliometric analysis combined with synthetic knowledge synthesis were completed to profile the development of the nursing literature production, volume, and thematic content. The corpus was harvested from the Web of Science, limiting the search to the period 1991 to 2020. The search resulted in 1,380 papers. Slovenia was the most productive country, followed by Croatia and Serbia. The synthetic knowledge synthesis revealed that nursing literature production is growing both in scope and number of publications, even though thematic content differs between individual countries. Each country is focused on their local health problems. A substantial part of the research is published in national journals in national languages. However, it is noteworthy that some ex-Yugoslavian authors have succeeded in publishing their research in top English language nursing journals. The study also revealed substantial international cooperation between ex-Yugoslavian countries and individual countries in the European Union. Performance and production of individual countries in nursing research broadly correspond to their overall scientific production, economic and health determinants/indices. The countries which established nursing schools early in the 20th century were considerably more scientifically productive.
What Predicts Academic Achievement in EMI Courses? Focus on Vocabulary Knowledge and Self-Perceptions of L2 Skills
Authors: Masrai Ahmed , El-Dakhs Dina Abdel Salam , Yahya Noorchaya
Published: May 2022

This study examines the relationship between L2 vocabulary knowledge, self-rating of word knowledge, self-perceptions of four language skills (listening, reading, speaking, and writing), and students’ academic achievement. An objective measure of lexical knowledge and questionnaire on self-perception and self-rating of vocabulary knowledge were administered to 106 undergraduate students in an English as a medium of instruction (EMI) program. The students’ academic achievement was measured through their EMI course grades. Results showed positive significant correlations between learners’ vocabulary knowledge, whether measured objectively or subjectively, and self-perceptions of the four skills. Results also showed that vocabulary knowledge was the strongest correlate with academic achievement, followed by self-perception. Interestingly, vocabulary knowledge explained the largest unique variance in the learners’ academic achievement. The contribution of students’ self-perceptions of L2 use, although predicted as an additive value to the model of academic achievement, was minimal compared to that explained by vocabulary knowledge. Findings of the study address implications directed to teaching and assessing lexical knowledge in the EMI context.
A Computed Tomography Scan Near Miss of an Intraorbital Wooden Foreign Body
Authors: Farahvash Armin , Wang Annie M.Q. , Cardemil Felipe , Chew Hall F. , Gill Harmeet S. , Antonyshyn Oleh M.
Published: May 2022

When intraorbital wooden foreign bodies are missed, the consequences can be devastating. While the gold standard diagnostic imaging is computed tomography (CT), it has low sensitivity. We present a 61-year-old man with a bamboo injury to his right eye. He underwent two CT scans that failed to raise the possibility of intraorbital foreign bodies. Upon additional review, a rectangular-shaped pocket of air was identified in the orbit which was most consistent with wooden foreign bodies based on the clinical history. A combined mid-lid approach followed by a transconjunctival and transcaruncular extension were employed to remove several wooden splinters. Postoperatively, due to recurrent orbital compartment syndrome, he required a second decompression with an inferior rim osteotomy. He had good recovery at 3 months follow-up. Overall, intraorbital wooden foreign bodies are challenging to diagnose due to imaging limitations. Providing a clear history and suspected diagnosis to radiology is critical for diagnosis.
Conditions Influencing Effective Nurse Nonverbal Communication With Hospitalized Older Adults in Cameroon
Authors: Wanko Keutchafo Esther L. , Kerr Jane , Baloyi Olivia B. , Duma Sinegugu E.
Published: May 2022

Effective communication between nurses and patients is an important factor to quality nursing care but ineffective nonverbal communication could take a toll on health care. Therefore, understanding the factors that influence nonverbal communication between nurses and hospitalized older adults could help solve communication problems, thus improve nursing care. A sample of 13 nurses and 4 student nurses from two hospitals in Cameroon participated in the study. Data were collected using participant observations and semi-structured interviews, and analyzed using open coding and constant comparative analysis. Three categories were identified as influencing factors: nurse views of hospitalized older adults, hospitalized older adult-related factors, and nurse intrinsic factors. Effective nurses’ nonverbal communication with hospitalized older adults relies mostly on nurses’ intrinsic factors. Identification and nurturing of the positive nurse intrinsic factors are important to develop effective nonverbal communication skills among nurses.
The Importance and Impact of Participation and Network Building in Care Leaving: The Use and Significance of the Care Leaver Declaration from the International Care Leavers Convention 2020
Authors: Landerer Fabienne
Published: May 2022

Widely across the globe, regardless of their country or continent, young people in alternative care and child protection systems as well as care leavers do face similar problems. In 2020, various child care institutions who form the International Care Leavers’ Community organised the International Care Leavers Convention which should originally have taken place in India but was, due to the COVID-19 pandemic, moved to an online platform, which created the opportunity for care involved people across the world to participate. During the convention, following a participatory approach, over 140 care leavers from about 25 countries came together for several webinars and discussed the challenges young people with care experience face globally and how the pandemic has enforced these vulnerable situations even more, as well as given suggestions and recommendations to improve this situation. This knowledge about the situation care leavers face amid COVID-19 and beyond was identified, collected and summarised into a transnational declaration, now which constitutes 11 universal gaps: financial security, housing, education, career support and employability, psychosocial support, physical health which includes health, nutrition and hygiene; legislative and policy reforms as well as awareness and identity, participation, the social network and finally, inclusion and social protection. These gaps can be found in a certain amount in all countries around the globe, as different as their care policies may be, and could therefore be seen as universal. By identifying them, this project tried to create a kind of toolkit, which can be used by institutions as well as care leaver communities on a national as well as on international level to reclaim change in these sectors, affirming that these gaps are the same and real for thousands of young people worldwide. This article aims to synthesise the 11 gaps and develop an analysis on how participation and network building can use the declaration to help and support care leaver communities and also care leavers as individual change maker as well as caregivers to better understand the systematic and institutional problems young adults face after leaving care and when starting their independent life as well as the recommendations in response to these universally defined problems.