bluuebunny/crossref_metadata_2025 huggingface dataset:
The Spread of Integration in Major League Baseball
Authors: Holmes Paul M. , Kane Robert F.
Published: September 2022

After the initial integration of Major League Baseball (MLB), teams introduced black players at different rates. We examine whether, and to what extent, team performance affected the rate of spread of integration. Our theoretical model predicts that teams of moderate talent will integrate fastest. We confirm this prediction using data from the first twenty years of MLB integration. However we show that relatively little of the spread of integration can be explained by differences in talent/performance, suggesting that competitive rivalry (as we measure it) was not the primary driver of the pace of integration in MLB.
A Realistic Breast Phantom Proposal for 3D Image Reconstruction in Digital Breast Tomosynthesis
Authors: Polat Adem , Kumrular Raziye Kubra
Published: September 2022

Objectives: Iterative (eg, simultaneous algebraic reconstruction technique [SART]) and analytical (eg, filtered back projection [FBP]) image reconstruction techniques have been suggested to provide adequate three-dimensional (3D) images of the breast for capturing microcalcifications in digital breast tomosynthesis (DBT). To decide on the reconstruction method in clinical DBT, it must first be tested in a simulation resembling the real clinical environment. The purpose of this study is to introduce a 3D realistic breast phantom for determining the reconstruction method in clinical applications. Methods: We designed a 3D realistic breast phantom with varying dimensions (643-5123) mimicking some structures of a real breast such as milk ducts, lobules, and ribs using TomoPhantom software. We generated microcalcifications, which mimic cancerous cells, with a separate MATLAB code and embedded them into the phantom for testing and benchmark studies in DBT. To validate the characterization of the phantom, we tested the distinguishability of microcalcifications by performing 3D image reconstruction methods (SART and FBP) using Laboratory of Computer Vision (LAVI) open-source reconstruction toolbox. Results: The creation times of the proposed realistic breast phantom were seconds of 2.5916, 8.4626, 57.6858, and 472.1734 for 643, 1283, 2563, and 5123, respectively. We presented reconstructed images and quantitative results of the phantom for SART (1-2-4-8 iterations) and FBP, with 11 to 23 projections. We determined qualitatively and quantitatively that SART (2-4 iter.) yields better results than FBP. For example, for 23 projections, the contrast-to-noise ratio (CNR) values of SART (2 iter.) and FBP were 2.871 and 0.497, respectively. Conclusions: We created a computationally efficient realistic breast phantom that is eligible for reconstruction and includes anatomical structures and microcalcifications, successfully. By proposing this breast phantom, we provided the opportunity to test which reconstruction methods can be used in clinical applications vary according to various parameters such as the No. of iterations and projections in DBT.
Community Social Capital, Racial Diversity, and Philanthropic Resource Mobilization in the Time of a Pandemic
Authors: Hwang Hyunseok , Lee Young-joo
Published: September 2022

Using the county-level data of the 2009 H1N1 pandemic in the United States, we test the relationship between communities’ social capital and philanthropic resource mobilization during a pandemic and how this relationship is moderated by the racial diversity and the severity of the pandemic in the community. The analysis suggests that the collective monetary contributions to frontline nonprofits responding to pandemics are closely related to the level of social capital in the community. The results also reveal that the positive relationship between social capital and resource mobilization is reinforced in racially diverse communities and when communities are affected by pandemics more severely. Our findings suggest that building inclusive communities by embracing diverse racial groups and individuals will contribute to communities’ resilience to pandemics and other disasters.
Ethics challenges in sharing data from pragmatic clinical trials
Authors: Morain Stephanie R , Bollinger Juli , Weinfurt Kevin , Sugarman Jeremy
Published: September 2022

Numerous arguments have been advanced for broadly sharing de-identified, participant-level clinical trials data, and trial sponsors and journals are increasingly requiring it. However, data sharing in pragmatic clinical trials presents ethical challenges related to the use of waivers or alterations of informed consent for some pragmatic clinical trials and corresponding limitations of informed consent to guide sharing decisions; the potential for data sharing in pragmatic clinical trials to present risks not only for individual patient-subjects, but also for health systems and the clinicians within them; sharing of data from electronic health records instead of data newly collected for research purposes; and researchers’ limited capacity to control sensitive data within an electronic health record and potential implications of such limits for meeting obligations inherent to Certificates of Confidentiality. These challenges raise questions about the extent to which traditional research ethics governance structures are capable of guiding decisions about pragmatic clinical trial data sharing. This article identifies and examines these ethical challenges for pragmatic clinical trial data sharing. We suggest several areas for future empirical scholarship, including the need to identify patient and public attitudes regarding pragmatic clinical trial data sharing as well as to assess the demand for pragmatic clinical trial data and the correspondingly likely benefit of such sharing. Further conceptual work is also needed to explore how requirements to respect patient-subjects about whom data are shared in the context of pragmatic clinical trials should be understood, particularly in the absence of informed consent for initial research activities, and the appropriate balance between promoting the generation of socially valuable knowledge and respecting autonomy.
Long-term results of distal oblique bundle reinforcement for treatment of chronic bidirectional instability of the distal radioulnar joint
Authors: Verbeek Diederik O. , Wilssens Nicholas O. J. , ten Bosch Jan A. , Hannemann Pascal F. W.
Published: September 2022

Distal oblique bundle (DOB) reinforcement for treatment of post-traumatic bidirectional instability of the distal radioulnar joint (DRUJ) has previously been reported. The objective of the current study was to assess the incidence of symptomatic graft failure and the need for secondary wrist procedures at a longer follow-up in an updated patient cohort of 27 patients with 28 DOB reinforcement procedures. Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and patient-rated wrist/hand evaluation (PRWHE) outcome measures were also evaluated. At median 82 months follow-up, pre- to postoperative QuickDASH score improved from a mean of 62 (SD 14) to 31 (SD 22) ( p < 0.01) and PRWHE score from a mean of 67 (SD 17) to 34 (SD 23) ( p < 0.01). Symptomatic graft failure with resultant painful DRUJ instability occurred in four out of 28 procedures, which was better than the published results of alternative surgical options for DRUJ instability. DOB reinforcement presents a relatively safe, effective and durable method for treatment of post-traumatic DRUJ instability.

Level of evidence: III
A process evaluation of Promotional Guides used by health visitors to support men’s transition to fatherhood: a qualitative study
Authors: Baldwin S , Malone M , Sandall J , Bick D
Published: September 2022

Background:

Health visitors play an important role in supporting new parents in their transition to parenthood. A programme known as the Promotional Guide system is used by many health visitors in England with mothers and fathers to support this transition, but there is little known about health visitors’ views of the Promotional Guides, how they are used in practice or barriers to effective implementation with fathers.

Aims:

The aim of this study was to explore the following: (1) health visitors’ use of Promotional Guides with fathers, (2) health visitors’ assessment of father’s mental health and wellbeing and (3) facilitators and barriers to using Promotional Guides in practice.

Methods:

A prospective observational cohort study and a process evaluation informed by the Medical Research Council guidance were conducted. A purposive sample of 11 health visitors was interviewed, and an additional seven were observed using the Promotional Guides in practice. Data were analysed using framework analysis.

Results:

Five main themes were identified from interview and observational data as follows: (1) Enquiry into fathers’ mental health, (2) Promotional Guides in practice, (3) health visitors’ perceptions of the Promotional Guides system, (4) barriers to using Promotional Guides with fathers and (5) facilitators and recommendations for using Promotional Guides with fathers. This study identified a number of barriers and facilitators to the use of Promotional Guides with fathers. Recommendations were made for improving services for first-time fathers, implementing the Promotional Guide system with fathers and highlighting areas for future research.

Conclusion:

This study considered the acceptability, feasibility and fidelity of using the Promotional Guide programme with fathers from the health visitor’s perspective. The findings provided an insight into health visitors’ experiences of working with fathers, inquiring about men’s mental health needs and their use of the Promotional Guides with men during the perinatal period.
Validation of Patras Immunotherapy Score model for prediction and prognosis of patients with advanced NSCLC treated with nivolumab or pembrolizumab: results from a European multicentre study
Authors: Dimitrakopoulos Foteinos-Ioannis , Mountzios Giannis , Christopoulos Petros , Papastergiou Thomas , Elshiaty Mariam , Daniello Lea , Zervas Elefterios , Agelaki Sofia , Samantas Epaminondas , Nikolaidi Adamantia , Athanasiadis Ilias , Baka Sofia , Syrigos Konstantinos , Christopoulou Athina , Lianos Evangelos , Samitas Konstantinos , Tsoukalas Nikolaos , Perdikouri Eleni-Isidora , Oikonomopoulos George , Kottorou Anastasia , Kalofonou Foteini , Makatsoris Thomas , Koutras Angelos , Megalooikonomou Vasileios , Kalofonos Haralabos
Published: September 2022

Background:

Recently, the Patras Immunotherapy Score (PIOS) has been developed to estimate the survival benefit of patients with advanced non-small-cell lung cancer (aNSCLC) treated with nivolumab or pembrolizumab. The aim of this study was to validate the clinical value of PIOS in an external cohort of aNSCLC patients.

Methods:

PIOS is a baseline formula produced by the combination of performance status, body mass index, age and line of treatment. In this multicentre study, 626 patients with confirmed NSCLC pathology, who had been treated with nivolumab or pembrolizumab, as well as 444 patients with aNSCLC, who had been managed with chemotherapy alone, were retrospectively enrolled. Predictive and prognostic values of PIOS were finally evaluated.

Results:

Patients treated with immunotherapy and higher PIOS score had an improved progression-free survival not only in univariate [hazard ratio (HR) = 0.621, p = 0.001], but also in multivariable analysis (HR = 0.651, p = 0.003). In addition, improved overall survival with increasing PIOS score was also observed (HR = 0.608, p < 0.001) with this association remaining statistically significant after adjusting for programmed-cell death ligand 1 (PD-L1) expression (HR = 0.620, p < 0.001). In addition, patients with disease progression (PD) had lower scores compared to those with stable disease (SD), partial response (PR) or complete response (CR) in a two-tier model ( p < 0.001) as well as in a four-tier model (PD, SD, PR and CR; p < 0.001). Prognostic significance of PIOS score also persisted using a binary logistic regression analysis, adjusted for disease stage and PD-L1 status ( p = 0.002, odds ratio: 0.578). Contrarily, PIOS had no prognostic significance in the chemotherapy group; however, upon combined analysis of the two cohorts, PIOS was found to have a significant interaction with the type of treatment (HR = 0.066 with p < 0.001), confirming its predictive value for immunotherapy.

Conclusions:

This study provides further validation of PIOS in aNSCLC patients treated with anti-PD-1 monotherapy.
Active Compounds Screening and Hepatoprotective Mechanism of Shuganning Injection Based on Network Pharmacology and Experimental Validation
Authors: Wang Qiyi , Duan Xiaotong , Li Shan , Lai Huaqing , Cheng Weina , Ao Jingwen , Zhang Jianyong , Duan Cancan
Published: September 2022

Objective: The study aimed to analyze the core active compounds and the potential mechanism of Shuganning injection (SGNI) through network pharmacology with biological experiments. Methods: Active compounds and targets of SGNI were screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and Targetnet database, whereas the liver disease-related targets were identified through the Genecards and Online Mendelian Inheritance in Man databases. The “compound-target” and “protein-protein interaction” networks construction, core target identification, and pathway enrichment were then performed. Finally, the exploration of the mechanism of action for SGNI against acetaminophen (APAP)-induced liver injury in the HepaRG cells and validation of three identified protein targets was also carried out through western blot assay, including tumor protein p53 (p53, TP53), transcription factor Jun (Jun), and Caspase 3 (CASP3). Results: The result showed that a total of 312 active compounds of SGNI and 408 liver disease-related targets, as well as 131 core targets were revealed through databases, such as prostaglandin G/H synthase 1, prostaglandin G/H synthase 2, and nuclear factor NF-kappa B (NF-kB) p65 subunit (RELA). The core targets of SGNI were involved in regulating hepatitis B signaling pathway, NF-kB signaling pathway, Toll-like receptor signaling pathway, and tumor necrosis factor (TNF) signaling pathway. Moreover, results of molecular docking in this study indicated that chlorogenic acid, geniposide, baicalin, indirubin, and ganoderic acid A could act on RELA, JUN, TP53, TNF, CASP3, Caspase 8 (CASP8) and nuclear factor NF-kB p105 subunit (NFKB1). Similarly, results of western blot revealed that SGNI reduced the expression of p53, Jun, and Caspase 3 proteins in HepaRG cells as compared with the APAP group ( P < 0.01 or P < 0.05). Conclusion: The present study verified the therapeutic effects and mechanism of SGNI on liver diseases and pointed out new directions for further research.
Establishment of a New Qualitative Evaluation Method for Articular Cartilage by Dynamic T2w MRI Using a Novel Contrast Medium as a Water Tracer
Authors: Hosokawa Yoshiaki , Onodera Tomohiro , Homan Kentaro , Yamaguchi Jun , Kudo Kohsuke , Kameda Hiroyuki , Sugimori Hiroyuki , Iwasaki Norimasa
Published: September 2022

Objective

In the early stages of cartilage damage, diagnostic methods focusing on the mechanism of maintaining the hydrostatic pressure of cartilage are thought to be useful. 17O-labeled water, which is a stable isotope of oxygen, has the advantage of no radiation exposure or allergic reactions and can be detected by magnetic resonance imaging (MRI). This study aimed to evaluate MRI images using 17O-labeled water in a rabbit model.

Design

Contrast MRI with 17O-labeled water and macroscopic and histological evaluations were performed 4 and 8 weeks after anterior cruciate ligament transection surgery in rabbits. A total of 18 T2-weighted images were acquired, and 17O-labeled water was manually administered on the third scan. The 17O concentration in each phase was calculated from the signal intensity at the articular cartilage. Macroscopic and histological grades were evaluated and compared with the 17O concentration.

Results

An increase in 17O concentration in the macroscopic and histologically injured areas was observed by MRI. Macroscopic evaluation showed that the 17O concentration significantly increased in the damaged site group. Histological evaluations also showed that 17O concentrations significantly increased at 36 minutes 30 seconds after initiating MRI scanning in the Osteoarthritis Research Society International (OARSI) grade 3 (0.493 in grade 0, 0.659 in grade 1, 0.4651 in grade 2, and 0.9964 in grade 3, P < 0.05).

Conclusion

17O-labeled water could visualize earlier articular cartilage damage, which is difficult to detect by conventional methods.
Pediatric-type diffuse low-grade glioma with MYB/MYBL1 alteration: report of 2 cases
Authors: Kalelioglu Tuba , Rama Bharath , Cho Benjamin B , Lopes Beatriz M , Patel Sohil H
Published: September 2022

2016 World Health Organization (WHO) Classification of Tumors of the Central Nervous System (CNS) has shown how molecular features can impact the classification of brain tumors. The continued combination of molecular features with histopathology has led to distinguish tumors with similar histopathologic features but distinct clinical prognosis. The 2021 revised 5. edition of the WHO classification further includes molecular features for CNS tumor categorization including MYB/MYBL1 altered diffuse astrocytoma which is a newly recognized type of low-grade pediatric-type brain tumor. We discuss imaging features of two pediatric-type low-grade gliomas with MYB/MYBL1-mutation that encountered at our institution.
Central venous sampling and magnetic resonance imaging in the diagnosis of ACTH-dependent Cushing’s syndrome
Authors: Aydoğan Ünsal Yasemin , Öz Gül Özen , Ateş Coşkun , Aydemir Ensar , Cander Soner , Ersoy Canan , Özpar Rifat , Hakyemez Bahattin , Ertürk Erdinç
Published: September 2022

Objectives

Central venous sampling (CVS) with corticotropin-releasing hormone (CRH) stimulation is a crucial technique in evaluating adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (CS). We evaluated central venous sampling (CVS) and magnetic resonance imaging (MRI) findings in predicting the localization and lateralization of pituitary microadenomas.

Methods

We analyzed 29 patients with CS who underwent CVS with CRH stimulation and examined with MRI retrospectively. Catheterization to central sinuses was successfully performed in 26 patients. Three patients with variant anatomy or inability to cannulate were diagnosed with CD after examination of pathology.

Results

After CVS, among 26 patients, 23 patients were determined to have CD (88.4%) and 2 (7.7%) patients were diagnosed with ectopic ACTH syndrome. One patient was diagnosed with CD postoperatively. While the sensitivity of the CVS was 95.6%, sensitivity of the preoperative pituitary MRI was lower (69.5%). Also, the negative predictive value ratio was higher in CVS than in MRI (66% versus 22%). Diagnostic accuracy in the lateralization of the tumor was high as in CVS as in MRI (76.4% versus 73.9%).

Conclusion

Central venous sampling with higher sensitivity in the localization of pituitary microadenoma, also has approximately similar diagnostic accuracy in lateralizing the tumor with MRI.
The induced motion effect is a high-level visual phenomenon: Psychophysical evidence
Authors: Falconbridge Michael , Hewitt Kassandra , Haille Julia , Badcock David R. , Edwards Mark
Published: September 2022

Induced motion is the illusory motion of a target away from the direction of motion of the unattended background. If it is a result of assigning background motion to self-motion and judging target motion relative to the scene as suggested by the flow parsing hypothesis then the effect must be mediated in higher levels of the visual motion pathway where self-motion is assessed. We provide evidence for a high-level mechanism in two broad ways. Firstly, we show that the effect is insensitive to a set of low-level spatial aspects of the scene, namely, the spatial arrangement, the spatial frequency content and the orientation content of the background relative to the target. Secondly, we show that the effect is the same whether the target and background are composed of the same kind of local elements—one-dimensional (1D) or two-dimensional (2D)—or one is composed of one, and the other composed of the other. The latter finding is significant because 1D and 2D local elements are integrated by two different mechanisms so the induced motion effect is likely to be mediated in a visual motion processing area that follows the two separate integration mechanisms. Area medial superior temporal in monkeys and the equivalent in humans is suggested as a viable site. We present a simple flow-parsing-inspired model and demonstrate a good fit to our data and to data from a previous induced motion study.
Preventing wrong tooth extraction in primary care oral surgery: developing local safety standards for invasive procedures (LocSSIPs)
Authors: Tagar Harjit Kaur
Published: September 2022

Local Safety Standards for Invasive Procedures (LocSSIPs) offer a valuable way of mitigating wrong tooth extraction and other patient safety incidents during a patient’s dental care journey. This paper aims to guide primary care dental practitioners in creating tailored, co-produced LocSSIPs with guidance on analysis of work systems and consideration of the patient’s care journey, and provides the building blocks to create a detailed LocSSIP with a background of understanding of the importance of human factors and non-technical skills.
Making dental extractions predictable: A methodological approach
Authors: Patel Jashme , Shah Aneesha
Published: September 2022

Dental extractions are one of the most commonly undertaken procedures in dentistry. However, for some dentists it can be a stressful and daunting treatment to undertake. This paper explores the importance of planning and the salient aspects in the assessment that should be considered. A methodical approach to assessment will avoid important factors from being overlooked.
Oral surgery: Considerations for the medically complex patient
Authors: Bryant Cathy
Published: September 2022

As life expectancy and the number of people living with chronic illness increases, the medical complexity of patients requiring oral surgery will also increase. This and the continuously evolving range of medical treatments used to manage their conditions will increasingly challenge dentists in both primary and secondary care to avoid complications and treat this patient group safely.

This paper will describe the importance of careful treatment planning including consideration of the timing and location in which oral surgery is undertaken for medically complex patients. The risk of acute medical events, bleeding, infection, and impaired healing which may complicate oral surgical procedures in this group of patients is discussed and the role in their care played by general dental practitioners explored.
Temporomandibular disorder: A guide for general dental practitioners
Authors: Shah Aneesha , Naqvi Ambareen
Published: September 2022

The presentation of patients with symptoms associated with temporomandibular disorders (TMDs) is a common finding in general dental practice. The management of patients with TMDs is often complicated by its multifactorial aetiology. This paper aims to provide a guide for dental practitioners to the clinical examination, diagnosis, and recognition of red flags in relation to TMDs and inform the busy practitioner when to refer patients presenting with TMDs for specialist/secondary care management.
An evaluation of patient informed consent for dental extractions
Authors: Arya Richa , Jadun Sarah , Shah Aneesha
Published: September 2022

Dental practitioners are well versed in informing patients of the risks and benefits associated with dental extractions. The purpose of this service evaluation was to determine whether patients understood and recalled information relevant to their planned oral surgery procedure, prior to second stage consent.

A questionnaire was distributed to patients who were attending for their elective treatment appointment. This explored their ability to recall the planned intervention, the modality of treatment (local anaesthetic, intravenous sedation, or general anaesthetic), understanding of alternative treatment options and the risks associated with the procedure. Completed responses were received from 29 of the distributed questionnaires (response rate=58%). The majority of patients were not aware of the following risks with their procedure: pain, bleeding, bruising, swelling, infection, damage to adjacent structures.

Despite a well-documented consent form and comprehensive discussion, we identified that patients may not comprehend or recollect the risks associated with their dental extraction. As dental professionals we have a duty to seek ways to facilitate patient understanding and maximise their autonomy.
Anticoagulant but not antiplatelet use is associated with haematuria complications after bladder outflow surgery
Authors: Hilbert Rebecca , Bibby Lisa , Boxall Nicholas , Srinivasan Luxna , Aho Tev , Lamb Benjamin W
Published: September 2022

Objective:

The evidence on the safety of peri-procedural management of more novel antithrombotic medication in the context of a wider option of bladder outflow obstruction (BOO) procedures is limited. We aimed to assess the risk of delayed discharge or readmission (specifically due to haematuria) for all patients undergoing BOO surgery.

Patients and methods:

Prospective identification of all patients undergoing any type of BOO procedure at a single centre between April and December 2019 was performed. Clinical information was obtained from electronic patient records to scrutinise medications, procedure, delayed discharge and readmission within 30 days of surgery due to haematuria.

Results:

Two hundred forty patients were identified. In all, 78.6% (22/28) of patients on anticoagulants were on novel agents. The delayed discharge rate due to haematuria was 0.58% (1/171) in the no antithrombotic group and 7.14% (2/28) in the anticoagulant-only group. Increased age and perioperative anticoagulant therapy predicated delayed discharge. Readmissions due to haematuria were statistically significant with 1.16% (2/171) readmitted with no antithombotics, compared with 14.3% (4/28) of those on anticoagulants ( p ⩽ 0.01).

Conclusion:

Perioperative anticoagulant use is associated with an increased risk of readmission following BOO surgery. Further work is required to help stratify and lower risk, especially with evolving surgical and medical technologies.

Level of evidence:

3b
Advocating for global health locally: Swedish Red Cross nurses as nursing activists for COVID-19 vaccination
Authors: Borg Stéphanie Paillard , Kraft Mia
Published: September 2022

The COVID-19 vaccination has created turbulence in many communities. The dilemma has been particularly alive among health professionals such as nurses. As lecturers at the Swedish Red Cross University, whose academic profile is global nursing and global health, we promote the importance of the nursing profession as advocates for the COVID-19 vaccination. The main objective of this commentary is to reflect on the Red Cross Red Crescent (RCRC) fundamental tenet based on its principles in relation to nursing commitment beyond traditional responsibilities in times of pandemic when urgency, reactivity, and pedagogical health education become a priority. The notion of ‘globality’ and the contextualization and modernization of nursing responsibilities are associated with these professional reflections. We conclude that activism and advocacy, on issues crucial to planetary health and the advancement of social justice globally, are the responsibility of nurses. Furthermore, the liability of RCRC nurses is accentuated by the seven principles and the significance of humanity within the global perspective.
The Effects of Trade Governance on Sugar Trade and Its Landscape of Policy Practices in Tanzania
Authors: Kangile Joseph Rajabu , Mpenda Zena Theopist , Kadigi Reuben M. J. , Mgeni Charles Peter
Published: September 2022

Trade governance is important for the efficient implementation of trade policies that support and controls most of the global value chains (GVCs) trade in African countries. Poor trade governance leads to misalignment of trade policies and affects the sustainability of the agricultural commodities supply chains. This study used cross-sectional survey data of 375 randomly selected sugar supply chain actors in Tanzania to evaluate the level of trade governance in Tanzania and ascertain its effects on the sugar trade. Exploratory (factor analysis) and confirmatory (weighted least square regression) models were used for data analysis. The major findings are that governance affects the sugar trade with the magnitude of its effects being felt differently between farmers and traders. It shows further that abrupt trade policy change significantly ( p < .05) reduces sugar trade by almost half (47.7%) and lowers the overall level of efforts to invest within the sugar supply chain. Ensuring trade policies are stable and predictable will increase trade by allowing forward contracting and investments. It is also important to create awareness of institutions and organizations managing the sugar supply chain by encouraging transparency in trade policy administration and practices for improving trade governance.
Factors Affecting Attitude Toward Learning Mathematics: A Case of Higher Education Institutions in the Gulf Region
Authors: Moussa Nahla M. , Saali Tariq
Published: September 2022

Mathematics is an important subject that plays a crucial role in constructing mental discipline among students. There has been a great focus on investigating students’ attitudes toward mathematics in higher education settings. The current study is aiming to explore the factors that affect attitudes toward math among higher education students in the United Arab Emirates (UAE). The Math Attitude Questionnaire MAQ was adapted from Prokop et al. to fulfill the study objectives. Gender and math course levels were the proposed variables that could influence students’ attitudes toward learning mathematics in six different dimensions. Data analysis demonstrated that higher education students in the UAE show a positive attitude toward math in most MAQ dimensions. The T-test for Independent Sample revealed that gender does not affect students’ attitudes toward learning mathematics. Moreover, the ANOVA test revealed that mathematics course levels have a significant impact on students’ attitudes toward math in the six dimensions of MAQ. The math instructor and equipment dimensions were found to have a significant effect on students’ attitudes among the students taking advanced math courses. The findings of this study could benefit the higher education system in the context of enhancing mathematics teaching and assessment.
Reported Events Associated With Spine Robots: An Analysis of the Food and Drug Administration’s Manufacturer and User Facility Device Experience Database
Authors: Kirchner Gregory J. , Kim Andrew H. , Kwart Ariel H. , Weddle John B. , Bible Jesse E.
Published: September 2022

Study Design

Cross-Sectional Analysis

Objectives

To summarize medical device reports (MDRs) between August 1, 2017 and November 30, 2021 relating to robot-assisted spine systems within the Manufacturer and User Facility Device Experience (MAUDE) database maintained by The Food and Drug Administration (FDA).

Methods

The MAUDE database was abstract for all MDRs relating to each FDA-approved robot-assisted spine system. Event descriptions were reviewed and characterized into specific event types. Outcome measures include specific robot-assisted spine systems and reported events as detailed by the MDRs. All data is de-identified and in compliance with the Health Insurance Portability and Accountability Act (HIPAA)

Results

There were 263 MDRs consisting of 265 reported events. Misplaced screws represented 61.5% (n = 163) of reported events. Of the 163 reported events, 57.1% (n = 93) described greater than 1 misplaced screw, 15.3% (n = 25) required return to the operating room, 8.6% (n = 14) resulted in neurologic injury, 4.3% (n = 7) resulted in dural tear, and 1.2% (n = 2) resulted in hemorrhage or bleeding. Reported events other than misplaced screws included system imprecision detected prior to screw placement (58/265, 21.9%), mechanical failure (23/265, 8.7%), and software failure (18/265, 6.8%).

Conclusions

As more robot-assisted spine systems gain FDA approval and the adoption of these systems continues to grow, documenting and understanding the range of reported events associated with each “tool” is imperative to balancing patient safety with surgical innovation. This study of the MAUDE database provides a unique summary of reported events associated with robot-assisted spine systems that is not directly linked to a research setting.
Readability, Understandability, Usability, and Cultural Sensitivity of Online Patient Educational Materials (PEMs) for Lower Extremity Reconstruction: A Cross-Sectional Study
Authors: Veeramani Anamika , Johnson Anna Rose , Lee Bernard T. , Dowlatshahi Arriyan S.
Published: September 2022

Background: Lower extremity reconstructive surgery is an evolving field wherein patients rely on accessible online materials to engage with their perioperative care. This study furthers existing research in this area by evaluating the readability, understandability, actionability, and cultural sensitivity of online health materials for lower extremity reconstruction. Methods: We identified the 10 first-appearing, educational sites found by searching the phrases “leg saving surgery”, “limb salvage surgery,” and “leg reconstruction surgery”. Readability analysis was conducted with validated tools, including Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed with Patient Education and Materials Assessment Tool (PEMAT), while cultural sensitivity was measured with Cultural Sensitivity Assessment Tool (CSAT). A Cohen's κ value was calculated (PEMAT and CSAT analyses) for inter-rater agreement. Results: The mean SMOG reading level for websites was 13.12 (college-freshman reading level). The mean PEMAT understandability score was 61.8% and actionability score was 26.0% (κ = 0.8022), both below the 70% acceptability threshold. The mean CSAT score was 2.6 (κ = 0.73), exceeding the 2.5 threshold for cultural appropriateness. Conclusion: Online PEM for lower extremity reconstruction continue to fall below standards of readability, understandability, and actionability; however, they meet standards of cultural appropriateness. As patients rely on these materials, creators can use validated tools and positive examples from existing PEM for greater patient accessibility.
Permanent residency under temporary protection: Syrian refugees’ (steady) agglomeration pattern in Turkey
Authors: Oztürk Sevim P , Ayalp Emel K
Published: September 2022

Stateless persons and refugees from Syria have come to Turkey due to crisis in Syria starting at 2011. The Republic of Turkey identified a new “legal status” for Syrian asylum seekers. While the international status is “refugee,” Turkey identified “temporary protection” (TP) for Syrian asylum seekers. The geographical drawback that the government of Turkey indicated in Geneva Convention in 1951 has legitimated the “new legal status” for middle eastern asylum seekers. Recently, the status and the long-lasting residency of Syrians have been a critical agenda in Turkey.
Clinical Practice Update: Management of Infectious Endophthalmitis After Intravitreal Anti-VEGF Injection
Authors: Merani Rohan , Johnson Mark W. , McCannel Colin A. , Flynn Harry W. , Scott Ingrid U. , Hunyor Alex P.
Published: September 2022

Although infectious endophthalmitis after intravitreal antivascular endothelial growth factor injections is rare, it is the most feared and potentially devastating complication of this procedure. There is no high-level evidence to provide definitive guidance on the management of endophthalmitis occurring after intravitreal injection (IVI). This clinical practice update reviews the published literature regarding post-IVI endophthalmitis and highlights areas in which further research is needed to better guide its management.
Refractory Choroidal Neovascularization in a Patient With Pseudoxanthoma Elasticum and Cowden Syndrome
Authors: Wu Frances , Mukai Shizuo
Published: September 2022

Purpose:

To describe a patient with concurrent pseudoxanthoma elasticum (PXE) and Cowden syndrome who developed choroidal neovascularization (CNV) secondary to angioid streaks. The CNV presented at a young age and was relatively refractory to intravitreal antivascular endothelial growth factor (anti-VEGF) therapy.

Methods:

A retrospective chart review was performed.

Results:

A 32-year-old man was treated for bilateral sequential CNV over 11 years. Good visual acuity was maintained with 53 anti-VEGF injections in the right eye and 82 injections in the left eye. On average, 1 injection was administered every 1.7 months in each eye to control the exudation. A skin biopsy and genetic testing confirmed a diagnosis of PXE. He was also found to harbor a PTEN mutation consistent with Cowden syndrome.

Conclusions:

The concurrent PTEN mutation lends a possible explanation for the relative resistance of CNV to anti-VEGF therapy in this patient with PXE. Phosphatase and tensin homolog is a tumor suppressor that negatively regulates the VEGF pathway.
Hybrid Experimental Designs for Intervention Development: What, Why, and How
Authors: Nahum-Shani Inbal , Dziak John J. , Walton Maureen A. , Dempsey Walter
Published: September 2022

Advances in mobile and wireless technologies offer tremendous opportunities for extending the reach and impact of psychological interventions and for adapting interventions to the unique and changing needs of individuals. However, insufficient engagement remains a critical barrier to the effectiveness of digital interventions. Human delivery of interventions (e.g., by clinical staff) can be more engaging but potentially more expensive and burdensome. Hence, the integration of digital and human-delivered components is critical to building effective and scalable psychological interventions. Existing experimental designs can be used to answer questions either about human-delivered components that are typically sequenced and adapted at relatively slow timescales (e.g., monthly) or about digital components that are typically sequenced and adapted at much faster timescales (e.g., daily). However, these methodologies do not accommodate sequencing and adaptation of components at multiple timescales and hence cannot be used to empirically inform the joint sequencing and adaptation of human-delivered and digital components. Here, we introduce the hybrid experimental design (HED)—a new experimental approach that can be used to answer scientific questions about building psychological interventions in which human-delivered and digital components are integrated and adapted at multiple timescales. We describe the key characteristics of HEDs (i.e., what they are), explain their scientific rationale (i.e., why they are needed), and provide guidelines for their design and corresponding data analysis (i.e., how can data arising from HEDs be used to inform effective and scalable psychological interventions).
Māori elders’ perspectives of end-of-life family care: whānau carers as knowledge holders, weavers, and navigators
Authors: Simpson Mary Louisa , McAllum Kirstie , Oetzel John , Berryman Kay , Reddy Rangimahora
Published: September 2022

Background:

There is growing interest in palliative care within Indigenous communities, and within Aotearoa New Zealand, of the significant role that Māori (Indigenous people) families play in caring for older relatives. This study explored the centrality of culture in how Māori extended families ( whānau) in Aotearoa New Zealand interpret and enact family-based care roles within the Māori world ( Te Ao Māori).

Methods:

Applying Māori-centered and community-based participatory research principles, we examined 17 interviews with older Māori who shared experiences of palliative care for a partner or family member. The thematic analysis used a cultural-discursive framework incorporating Māori principles of wellbeing and values expressed within the care relationship.

Results:

The findings centered on three whānau roles in palliative care: whānau as (1) Holders and protectors of Māori knowledge; (2) Weavers of spiritual connection; and (3) Navigators in different worlds.

Conclusion:

The study problematizes the notion of a single ‘primary caregiver’, privileges whānau as an inter-woven relational, dynamic care network, and encourages health professionals to recognize the cultural embeddedness of dominant approaches to palliative care.
Columbite supergroup of minerals: nomenclature and classification
Authors: Chukanov Nikita V. , Pasero Marco , Aksenov Sergey M. , Britvin Sergey N. , Zubkova Natalia V. , Yike Li , Witzke Thomas
Published: September 2022

The columbite supergroup is established. It includes five mineral groups (ixiolite, wolframite, samarskite, columbite and wodginite) and one ungrouped species (lithiotantite). The criteria for a mineral to belong to the columbite supergroup are: the general stoichiometry MO2; the crystal structure based on the hexagonal close packing (hcp) of anions (or close to it); the six-fold coordination number of M-type cations (augmented to eight-fold in the case of slight distortion of hcp); and the presence of zig-zag chains of edge-sharing M-centred polyhedra. The ixiolite-type structure is considered as an aristotype with the space group Pbcn, the smallest unit cell volume, and the basic vectors a0, b0 and c0. Based on the multiplying of the ixiolite-type unit cell the following derivatives are distinguished: ixiolite type [ixiolite-group minerals; a = a0,b = b0 and c = c0; space group Pbcn; the members are ixiolite-(Mn2+), ixiolite-(Fe2+), scrutinyite, seifertite and srilankite]; wolframite type [wolframite-group minerals, ordered analogues of the ixiolite type with a = a0,b = b0 and c = c0; P2/c; the members are ferberite, hübnerite, huanzalaite, sanmartinite, heftetjernite, nioboheftetjernite, rossovskyite and riesite]; samarskite type [samarskite-group minerals; a = 2a0, b = b0 and c = c0; P2/c; the members are samarskite-(Y), ekebergite and shakhdaraite-(Y)]; columbite type [columbite-group minerals; a = 3a0,b = b0 and c = c0; Pbcn; the members are columbite-(Fe), columbite-(Mn), columbite-(Mg), tantalite-(Fe), tantalite-(Mn), tantalite-(Mg), fersmite, euxenite-(Y), tanteuxenite-(Y) and uranopolycrase]; and wodginite type [wodginite-group minerals; a = 2a0,b = 2b0 and c = c0; C2/c; the members are wodginite, ferrowodginite, titanowodginite, ferrotitanowodginite, tantalowodginite, lithiowodginite and achalaite]. Samarskite-(Yb), ishikawaite and calciosamarskite are insufficiently studied, tentatively considered as possible members of the samarskite supergroup. Qitianlingite, yttrocolumbite-(Y), yttrotantalite-(Y) and yttrocrasite-(Y) are questionable and need further studies. Polycrase-(Y) is discredited as identical to euxenite-(Y). Ixiolite has been renamed as ixiolite-(Mn2+), with the end-member formula (Ta2/3Mn2+1/3)O2. Ta- and Nb-dominant analogues of ixiolite with different schemes of charge balancing have the end-member formulae (M15+0.5M23+0.5)O2, M15+2/3M22+1/3)O2, M15+0.75M2+0.25)O2 or M15+0.8□0.2)O2 and the root name ‘ixiolite’ (for M1 = Ta) or ‘nioboixiolite’ (for M1 = Nb).
Prospective Hemophilia Inhibitor PUP Study reveals distinct antibody signatures during FVIII inhibitor eradication
Authors: Paul Helmut , Berg Verena , Gangadharan Bagirath , Bowen Joel , LeBeau Petra , Blatný Jan , Male Christoph , Radulescu Vlad C. , Diaz Rosa , Mancuso Maria Elisa , Brown Deborah L. , Reipert Birgit M.
Published: September 2022

Factor VIII (FVIII) inhibitor formation is a major clinical concern during replacement therapy in patients with hemophilia A. Immune tolerance induction (ITI) is the only therapeutic approach to attempt inhibitor eradication and establishment of long-term immune tolerance to FVIII. Hemophilia Inhibitor Previously Untreated Patient (PUP) Study (HIPS) was a prospective clinical trial to investigate changes in the immune system of PUPs with severe hemophilia A. Five patients who developed persistent FVIII inhibitors during HIPS entered an ITI extension arm (HIPS-ITI). During HIPS-ITI, inhibitor patients received ITI with the same FVIII product (a single source of recombinant, human full-length FVIII) used in HIPS until successful tolerance, declared failure, or a maximum of 2 years after HIPS-ITI enrollment, whichever came first. Blood samples and clinical data were collected monthly. Longitudinal FVIII-binding antibody signatures, associated binding specificities, and apparent affinities were determined for each patient at each sampling time point. ITI was successful or partially successful in 2 patients and failed in 3. Both groups presented with distinct FVIII-specific antibody signatures. ITI success required the disappearance of FVIII inhibitors, which was associated with the eradication or sustained titer minimization of high-affinity FVIII-specific antibodies, particularly of the immunoglobulin G1 (IgG1) and IgG4 subclasses. In contrast, ITI failure, as reflected by FVIII inhibitor persistence, was associated with persistent high-affinity FVIII-specific antibodies. Interestingly, 1 patient with partial ITI success and 1 patient with ITI failure developed apparent oligoreactive FVIII-binding antibodies during ITI. The explanation of the true nature of these antibodies requires more comprehensive follow-ups in future studies. This trial was registered at www.clinicaltrials.gov as #NCT01652027.
Proinflammatory microenvironment promotes lymphoma progression in mice with high megakaryocyte and TPO levels
Authors: Au Amanda E. , Corbin Jason , Lebois Marion , Gangatirkar Pradnya , Yassinson Fatme , Hyslop Stephanie R. , Cannon Ping , Mason Kylie D. , Li-Wai-Suen Connie S. N. , Garnham Alexandra L. , Moujalled Diane , Cimmino Luisa , Alexander Warren S. , Josefsson Emma C.
Published: September 2022

Platelets have been shown to enhance the survival of lymphoma cell lines. However, it remains unclear whether they play a role in lymphoma. Here, we investigated the potential role of platelets and/or megakaryocytes in the progression of Eμ-myc lymphoma. Eμ-myc tumor cells were transplanted into recipient wild-type (WT) control, Mpl−/−, or TpoTg mice, which exhibited normal, low, and high platelet and megakaryocyte counts, respectively. TpoTg mice that underwent transplantation exhibited enhanced lymphoma progression with increased white blood cell (WBC) counts, spleen and lymph node weights, and enhanced liver infiltration when compared with WT mice. Conversely, tumor-bearing Mpl−/− mice had reduced WBC counts, lymph node weights, and less liver infiltration than WT mice. Using an Mpl-deficient thrombocytopenic immunocompromised mouse model, our results were confirmed using the human non-Hodgkin lymphoma GRANTA cell line. Although we found that platelets and platelet-released molecules supported Eμ-myc tumor cell survival in vitro, pharmacological inhibition of platelet function or anticoagulation in WT mice transplanted with Eμ-myc did not improve disease outcome. Furthermore, transient platelet depletion or sustained Bcl-xL–dependent thrombocytopenia did not alter lymphoma progression. Cytokine analysis of the bone marrow fluid microenvironment revealed increased levels of the proinflammatory molecule interleukin 1 in TpoTg mice, whereas these levels were lower in Mpl−/− mice. Moreover, RNA sequencing of blood-resident Eμ-myc lymphoma cells from TpoTg and WT mice after tumor transplantation revealed the upregulation of hallmark gene sets associated with an inflammatory response in TpoTg mice. We propose that the proinflammatory microenvironment in TpoTg mice promotes lymphoma progression.