bluuebunny/crossref_metadata_2025 huggingface dataset:
Value of Interprofessional Education: The VA Quality Scholars Program
Authors: Godwin Kyler M. , Narayanan Anand , Arredondo Kelley , Miltner Rebecca (Suzie) , Bowen Michael E. , Gilman Stuart , Shirks Allan , Eng Jessica A. , Naik Aanand D. , Hysong Sylvia J.
Published: May 2021

Interprofessional collaboration (IPC) has been shown to improve healthcare quality and patient safety; however, formal interprofessional education (IPE) training is insufficient. The VA Quality Scholars (VAQS) program exists to develop interprofessional leaders and scholars in healthcare improvement. The purpose of this study was to examine the impact of integrating interprofessional healthcare learners and designing an interprofessional curriculum for the national VAQS program. VAQS alumni (graduates from 2001 to 2017) across eight national sites (n = 102 [53.1%]) completed a web-based survey to assess alumni perceptions of IPC skill development during the program and IPC skill utilization in their careers. Alumni from 2009 and earlier were physicians; alumni after 2009 came from diverse health professional backgrounds. Overall, IPC and teamwork was identified as the most used skill (n = 82, 70%) during their career. When comparing the pre-IPE period and the post-IPE period, post-IPE alumni identified IPC and teamwork as the area of greatest skill development (n = 38). Integrating interprofessional trainees and robust IPE curricula enhanced an established and successful quality improvement (QI) training program. VAQS alumni endorsed the importance of IPC skills during their careers. The VAQS program is an example of how health professionals can successfully learn IPC skills in healthcare QI.
Scaling Up CareKit: Lessons Learned from Expansion of a Centralized Home HIV and Sexually Transmitted Infection Testing Program
Authors: Norelli Jenna , Zlotorzynska Maria , Sanchez Travis , Sullivan Patrick S.
Published: May 2021

Background

Despite advances in implementing human immunodeficiency virus (HIV)/sexually transmitted infection (STI) services for men who have sex with men (MSM), many remain underserved because of barriers like stigma, low facility coverage, and provider competency. This article describes the implementation of centralized nationwide mailed HIV/STI home testing (CareKit).

Methods

The Emory Center for AIDS Research developed CareKit for research study participants to request HIV self-test kits, STI specimen collection kits, and condom/lubricant packs to be shipped to any mailing address in the United States. Sexually transmitted infection kits were customized according to study needs and could include materials to collect whole blood, dried blood spots, urine sample, and rectal and pharyngeal swab samples for syphilis, gonorrhea, and chlamydia testing. Specimens were mailed back to a central Clinical Laboratory Improvement Amendments–approved laboratory for testing, and results were returned to participants.

Results

CareKit was used by 12 MSM studies and mailed 1132 STI kits to 775 participants between January 2018 and March 2020. Participants returned 507 (45%) STI kits, which included 1594 individual specimens. Eighty-one kits (16%) had at least one positive STI test result: pharyngeal chlamydia (n = 7), pharyngeal gonorrhea (n = 11), rectal chlamydia (n = 15), rectal gonorrhea (n = 12), genital chlamydia (n = 6), genital gonorrhea (n = 1), and syphilis (n = 54). In this same 2-year period, 741 HIV self-test kits were mailed to 643 MSM.

Conclusions

CareKit successfully met studies' needs for home HIV/STI testing and diagnosed many STIs. These processes continue to be adapted for research and programs. The ability to mail home test kits has become increasingly important to reach those who may have limited access to health care services, particularly during the COVID-19 pandemic.
Human Immunodeficiency Virus and Hepatitis C Linkage-to-Care Initiative for New Orleans Residents Experiencing Homelessness During the COVID-19 Pandemic
Authors: Cironi Katherine A. , Jones Austin T. , Hauser Elizabeth M. , Olsen Joseph W. , Kissinger Patricia J.
Published: May 2021

Background

People experiencing homelessness are disproportionately infected with human immunodeficiency virus (HIV) and hepatitis C virus (HCV). In response to COVID-19, cities nationwide temporarily housed people experiencing homelessness in unused hotels. One such initiative in New Orleans also enacted a screening, counseling, and linkage-to-care model for HIV and HCV treatment for this temporarily housed population between May and July 2020.

Methods

A nonconcurrent cohort study was performed assessing follow up in the treatment of HIV and HCV for this population. Outcome data were collected on seropositive patients' electronic medical record to assess patient progression through the treatment cascade.

Results

Of 102 unhoused residents, 25 (24.5%) tested HCV seropositive. Of the HCV positive 21/25 (84%) were connected to the associated clinic for follow up care and 10 (40%) obtained HCV treatment medication. Furthermore, all 3 patients who tested seropositive for HIV either started or re-initiated antiviral treatment. The greatest barrier to providing medication for the HCV seropositive patients, once care was initiated, was loss-to-follow-up.

Conclusions

Targeting homeless persons living in temporary residences for HCV and HIV screening can be effective at promoting access to care for those infected due to this population's high HCV seropositivity especially significant if the patient has a history of intravenous drug use or is older than 40 years. However, continued outreach strategies are needed to assist patients in retention of care.
Prostate Cancer With Neuroendocrine Differentiation Recurring After Treatment With 177Lu-PSMA
Authors: Nesari Javan Farnaz , Aryana Kamran , Askari Emran
Published: May 2021

Prostate cancer with NED (neuroendocrine differentiation) may occur in various stages of the disease, which is associated with a poor prognosis and treatment resistance. We present a case of a patient with metastatic castration-resistant prostatic cancer, who was treated with 7 cycles of 177Lu-PSMA and a very good response. Although only few foci with PSMA uptake were remained in the last posttreatment images, PSA levels dramatically began to rise. This raised suspicion for NED, and 68Ga-DOTATATE was done showing sufficient uptake to consider a trial of 177Lu-DOTATATE. The patient reported pain response, and PSA levels dropped after 1 cycle of the treatment.
Ectopic Parathyroid Adenoma on Pectoralis Major After Endoscopic Parathyroidectomy Revealed by 99mTc-MIBI SPECT/CT
Authors: Wu Meiqi , Chen Libo , Huo Li , Jing Hongli
Published: May 2021

A 45-year-old woman, who had endoscopic parathyroidectomy 5 years ago for a right inferior parathyroid adenoma, underwent 99mTc-MIBI scan for the evaluation of recurrent parathyroidism. The images did not identify any abnormal uptake in the neck. Instead, an abnormal activity in the right upper chest wall was noted, which was located in a soft tissue nodule inseparable from the right pectoralis major muscle on SPECT/CT images. Pathology confirmed parathyroid tissue.
Procedural Trends in Medicare Reimbursement and Utilization for Breast Reconstruction
Authors: Gupta Nikita , Thornburg Danielle A. , Chow Nathan A. , Haglin Jack , Kruger Erwin , Rebecca Alanna M. , Casey William J. , Teven Chad M.
Published: May 2021

Purpose

Development of appropriate reimbursement models for breast reconstruction in the United States requires an understanding of relevant economic trends. The purpose of this study is to evaluate longitudinal patterns in Medicare reimbursement for frequently performed breast reconstruction procedures between 2000 and 2019.

Methods

Reimbursement data for 15 commonly performed breast reconstruction procedures were analyzed using the Centers for Medicare & Medicaid Services Physician Fee Schedule Look-Up Tool for each Current Procedural Terminology code. By utilizing changes to the US consumer price index, monetary data were adjusted for inflation to 2019 US dollars. Inflation-adjusted trends were used to calculate average annual and total percentage changes in reimbursement over time.

Results

From 2000 to 2019, average adjusted reimbursement for all procedures fell by 13.32%. All procedures demonstrated a negative adjusted reimbursement rate other than immediate insertion of breast prosthesis, which increased by 55.37%. The largest mean decrease was observed in breast reconstruction with other technique (−28.63%), followed by single pedicle transverse rectus abdominis myocutaneous flap (−26.02%), single pedicle transverse rectus abdominis myocutaneous flap with microvascular anastomosis (−23.33%), latissimus dorsi flap (−19.65%), and free flap reconstruction (−19.36%).

Conclusions

There has been a steady yet substantial decline in Medicare reimbursement for the majority of breast reconstruction procedures over the last 20 years. Given increasing medical costs and the financial uncertainty of the US health care system, an understanding of Medicare reimbursement trends is vital for policymakers, administrators, and physicians to develop agreeable reimbursement models that facilitate growth and economic vitality of breast reconstruction in the United States.
Efficacy of Microsurgical Treatment of Primary Lymphedema
Authors: Fallahian Fedra , Tadisina Kashyap Komarraju , Xu Kyle Y.
Published: May 2021

Introduction

Treatment of lymphedema remains a challenging clinical problem. Lymphatic surgery has recently gained momentum as an effective method to treat both early- and late-stage disease. In particular, “physiologic” microsurgical techniques including vascularized lymph node transplant and lymphovenous bypass/anastomosis have been shown to be effective in treating even advanced lymphedema. Most published reports describe techniques and success in secondary lymphedema. Traditionally, physiologic surgery was not believed to be useful in the treatment of primary lymphedema where baseline lymphatic function is abnormal. However, recent studies have shown a benefit in these cases. The objective of this study is to evaluate outcomes and complications of physiologic microsurgical treatment for primary lymphedema.

Methods

The electronic databases of PubMed, Scopus, and MEDLINE were searched using key words “primary lymphedema” and “surgery” (also vascularized lymph node transplant, lymphovenous bypass, microsurgery). Only human studies published between 2000 and 2021 were included. Studies that only included ablative or resection surgeries were excluded.

Results

A total of 10 studies comprising 254 patients with primary lymphedema who underwent 357 physiologic microsurgical operations were included. Lymphovenous bypass comprised 88% of cases, and in the patients who underwent vascularized lymph node transplant, all but 1 flap survived. Regardless of type of operative intervention, all studies showed a statistically significant improvement in lymphedema, through either reduction in limb circumference or edema volume or improvement in quality of life.

Discussion

Physiologic lymphatic surgery has shown success and improvement for patients with primary lymphedema. Based on current literature, physiologic surgical treatment of primary lymphedema should be considered when treating this patient population.
Abdominal Plication for Better Cosmetic Outcomes During Deep Inferior Epigastric Perforator Flap Breast Reconstruction
Authors: Van Vliet Austin , Girardot Alexandra , Bouchez Jonathan , Kumar Ambuj , Dayicioglu Deniz
Published: May 2021

Background

Deep inferior epigastric perforator flap (DIEP) for breast reconstruction is a widely accepted technique for breast reconstruction. Secondary benefit of this technique is abdominal contour improvement. Because of direct access, abdominal plication can be performed at the time of abdominal closure. Our goal was to investigate if this addition affected the complications.

Methods

A retrospective chart review was performed on all DIEP flap reconstructions performed by a single surgeon at a cancer center, from March 2011 through February 2020. Presence of abdominal plication, age, and body mass index were compared with reoperation due to abdominal wound or hernia, procedure length in minutes, and length of stay. The association between the dependent and independent variables for the unadjusted and adjusted analysis was performed using the binary logistic regression analysis.

Results

Three hundred fifty-eight DIEP flaps performed on 233 patients for breast reconstruction were analyzed. Flap loss was 1.7%. Abdominal plication was performed in 178 flaps (49.7%) and not performed in 180 flaps (50.3%). Thirty-nine percent were immediate; 61% were delayed. The results did not show a statistically significant association between abdominal plication and the need to reoperate (P = 0.3). Results from the adjusted analysis (age, body mass index) also did not show a significant association between the plication, need to reoperate, procedure duration, or hospital stay (P = 0.4).

Conclusions

Abdominal plication can improve cosmetic outcomes without increasing the duration of surgery, hospital stay, or reoperation rates due to abdominal complications. Therefore, it can be a valuable addition in DIEP flap breast reconstructions.
Phrenic Nerve Reconstruction for Effective Surgical Treatment of Diaphragmatic Paralysis
Authors: Kaufman Matthew R. , Chang Eric I. , Bauer Thomas , Rossi Kristie , Elkwood Andrew I. , Paulin Ethan , Jarrahy Reza
Published: May 2021

Diaphragmatic paralysis due to phrenic nerve injury may cause orthopnea, exertional dyspnea, and sleep-disordered breathing. Phrenic nerve reconstruction may relieve symptoms and improve respiratory function. A retrospective review of 400 consecutive patients undergoing phrenic nerve reconstruction for diaphragmatic paralysis at 2 tertiary treatment centers was performed between 2007 and 2019. Symptomatic patients were identified, and the diagnosis was confirmed on radiographic evaluations. Assessment parameters included pulmonary spirometry (forced expiratory volume in 1 second and FVC), maximal inspiratory pressure, compound muscle action potentials, diaphragm thickness, chest fluoroscopy, and Short Form 36 Health Survey Questionnaire (SF-36) survey. There were 81 females and 319 males with an average age of 54 years (range, 19–79 years). The mean duration from diagnosis to surgery was 29 months (range, 1–320 months). The most common etiologies were acute or chronic injury (29%), interscalene nerve block (17%), and cardiothoracic surgery (15%). The mean improvements in forced expiratory volume in 1 second and FVC at 1 year were 10% (P < 0.01) and 8% (P < 0.05), respectively. At 2-year follow-up, the corresponding values were 22% (P < 0.05) and 18% (P < 0.05), respectively. Improvement on chest fluoroscopy was demonstrated in 63% and 71% of patients at 1 and 2-year follow-up, respectively. There was a 20% (P < 0.01) improvement in maximal inspiratory pressure, and compound muscle action potentials increased by 82% (P < 0.001). Diaphragm thickness demonstrated a 27% (P < 0.01) increase, and SF-36 revealed a 59% (P < 0.001) improvement in physical functioning. Symptomatic diaphragmatic paralysis should be considered for surgical treatment. Phrenic nerve reconstruction can achieve symptomatic relief and improve respiratory function. Increasing spirometry and improvements on Sniff from 1 to 2 years support incremental recovery with longer follow-up.
Navigating the Gray of Academic Publication
Authors: Soteropulos Carol E. , Poore Samuel O.
Published: May 2021

Academic publishing has undergone a transition from print-based, subscription access journals targeted toward physicians and scientists to the widely accessible, open access (OA) format made possible by the Internet. The objectives of OA broadly include audience expansion and improved public access to publicly funded research, reduction of limitations on content reuse and alteration, and prompt turnaround from submission to publication. Despite well-intended founding principles, unexpected disadvantages of the OA model have arisen including the emergence of predatory journals, which exploit the author-pays publishing model with the deceptive promise of reputable publishing platforms. Predatory journals can be difficult to discern from the legitimate yet unsophisticated novice journal, which represents a destructive influence on the credibility of surgeons and scientists within many specialties. As an author, when the highly reputable, “whitelisted” journals in our field are not available or interested in the scope of our work, how can we ensure authenticity of those journals that exist in the gray area between legitimate and illegitimate? Given these questions, the goal of this article is to demystify the history and selected issues that surround academic publication including content access, licensing, indexing, and journal metrics. With this background, we then evaluate highly visible OA journals in plastic and reconstructive surgery and build a basic framework, which authors can use to evaluate a journal for legitimacy and visibility.
Standardization of the Rat Dorsal Random Pattern (McFarlane) Flap Model and Evaluation of the Pharmacological Agents Aiming to Salvage Partial Flap Necrosis
Authors: Üstün Galip Gencay , Öztürk Semih , Koçer Uğur
Published: May 2021

Introduction

Partial flap necrosis is a common complication after surgery. McFarlane flap model has been used for assessment of various agents' effects on random flap survival. The aim of this study was to review the methodology of studies using this flap model and reveal the most successful agents.

Materials and Methods

PubMed, Scopus, and Web of Science databases were screened for words “McFarlane flap,” “flap survival,” and (“flap” and “rat”) by using time limits between 1965 and 2019. A total of 71 original articles were reviewed. Dimensions and base (cranial/caudal) of the flap, treatment protocol, follow-up period, and survival rates were extracted. Modified survival rates were calculated. Coefficients of variation of cranial/caudally based control group flaps and most commonly used flap models were calculated to assess interstudy variability.

Results

A total of 165 different treatment regimens were studied. One-hundred twelve regimens (67.9%) were found to increase flap survival. Most common flap dimensions were 9 cm × 3 cm, followed by 10 cm × 3 cm, 8 cm × 2 cm and 6 cm × 2 cm. Studies using caudally based flaps showed less interstudy variability, but survival rates were similar. Pentoxifylline, sildenafil, chlorpromazine, phenoxybenzamine, and phentolamine were reported to be successful in multiple studies.

Conclusions

There are numerous agents found to be effective for treatment of partial flap necrosis, but further clinical research is needed. To overcome standardization problems, use of commonly used flap dimensions with a caudal base and interpretation of results after 7 days of follow-up seems appropriate.
Laparoscopic Sutureless Rectopexy Using a Fixation Device for Complete Rectal Prolapse
Authors: Tomochika Shinobu , Suzuki Nobuaki , Yoshida Shin , Fujii Toshiyuki , Tokumitsu Yukio , Shindo Yoshitaro , Iida Michihisa , Takeda Shigeru , Hazama Shoichi , Nagano Hiroaki
Published: May 2021

Background:

Complete rectal prolapse (CRP) commonly affects the daily life of older people and has no established operative treatment approach. We describe our simple method of laparoscopic, sutureless rectopexy, involving rectal mobilization (along with its peritoneum bilaterally) and fixation to the sacral promontory using a fixation device. We also present an analysis of short-term outcomes in patients treated using this procedure.

Materials and Methods:

We retrospectively evaluated 62 patients with CRP, who underwent a laparoscopic rectopexy via tack fixation, between 2004 and 2017. The peritoneum was widely attached near the site of peritoneal reflection, as in rectal cancer surgery. The hypogastric nerve was carefully detached from the front of the sacrum. Keeping the nerve intact, we lifted and mobilized the dissected rectum cranially towards the promontory, and the rectal peritoneum was affixed to the sacrum by applying 2 to 3 fixed tacks bilaterally, using a fixation device.

Results:

The median age of the study group was 80 (10 to 91) years. All procedures were successful without serious intraoperative complications; only 1 patient required conversion to open surgery. Median values for operative duration, intraoperative blood loss, and postoperative period of hospitalization were 177 (125 to 441) minutes, 5 (0 to 275) mL, and 7 (3 to 17) days, respectively. Only 6 (9.7%) patients experienced recurrence during the follow-up period.

Conclusion:

Laparoscopic tacking rectopexy performed using a fixation device for repairing CRP is a simple, safe, and sutureless procedure with no severe complications or mortality.
Urinary Retention Following Inguinal Herniorrhaphy: Role of Neuromuscular Blockade Reversal
Authors: Valencia Morales Diana J. , Stewart Brody R. , Heller Stephanie F. , Sprung Juraj , Schroeder Darrel R. , Ghanem Omar M. , Weingarten Toby N.
Published: May 2021

Background:

Nondepolarizing neuromuscular blockade is reversed with neostigmine/glycopyrrolate or sugammadex. Anticholinergic glycopyrrolate decreases bladder detrusor muscle contractility, potentially leading to postoperative urinary retention (POUR). POUR commonly complicates inguinal herniorrhaphy. In this study we assess association between reversal technique and POUR.

Methods:

Records of adult patients undergoing unilateral inguinal herniorrhaphy with neuromuscular blockade from January 2013 to September 2020 were reviewed for POUR (unplanned postoperative insertion of urinary catheter). A propensity-adjusted analysis was performed to assess POUR in neostigmine/glycopyrrolate versus sugammadex using inverse probability of treatment weighting (IPTW) to adjust for potential confounding.

Results:

We identified 181 patients who underwent herniorrhaphy with amnio-steroidal neuromuscular blockers, 75 (41.4%) who received sugammadex and 106 (58.6%) neostigmine/glycopyrrolate. Compared with sugammadex, neostigmine/glycopyrrolate group had longer surgical course [unweighted standardized difference (USTD)=0.38, P=0.004], received more intraoperative opioids (USTD=0.704, P<0.001), more often performed via laparoscopic approach (USTD=0.407, P=0.012), and less often with periprocedural urinary catheter insertion (USTD=0.452, P=0.003). POUR was observed in 2 (3%) of patients in the sugammadex group, and 16 (15%) in neostigmine/glycopyrrolate [unadjusted odds ratio (OR)=0.15; 95% confidence interval (CI): 0.03-0.69; P=0.015, and IPTW OR=0.13; 95% CI: 0.03-0.64; P=0.012]. Results remained similar with further analysis adjusted for opioid administration in the postanesthesia care unit (adjusted IPTW OR=0.18; 95% CI: 0.04-0.88; P=0.034). Of the POUR patients, 9 required unplanned overnight admission and 4 emergency room visit.

Conclusion:

These results suggest that neuromuscular blockade reversal with sugammadex is associated with lower rates of POUR following unilateral inguinal herniorrhaphy. Our results need to be reconfirmed in a randomized prospective study.
Ninjin’yoeito, a traditional Japanese Kampo medicine, suppresses the onset of anhedonia induced by dysfunction in the striatal dopamine receptor type 2-expressing medium spiny neurons
Authors: Oizumi Hiroaki , Imai Ryota , Suzuki Toru , Omiya Yuji , Tanaka Kenji F , Mimura Masaru , Mizoguchi Kazushige
Published: May 2021

Objective

Recent studies have suggested that ninjin’yoeito (NYT), a traditional Japanese Kampo medicine, improves diminished motivation in humans and animals, rendering it a novel therapeutic option for impaired motivation. To better characterize the effect of NYT on motivation, we examined its effect on motivated behaviors in mice.

Methods

Mouse models of neurodegeneration-related apathy, in which striatal dopamine receptor type 2-expressing medium spiny neurons (D2-MSNs) were progressively damaged by diphtheria toxin expression, were chosen.

Results

The decrease in effort-based operant responding for rewards (sucrose pellets), indicative of the mouse’s motivated behavior, in the affected mice was not suppressed by chronic treatment with NYT suspended in drinking water at 1% (w/v). Mice were then subjected to a sucrose preference test, wherein they freely chose to ingest tap water and a sucrose solution without being required to exert effort. The affected mice showed a decline in preference for sucrose over tap water, relative to nonaffected controls, indicating anhedonia-like traits. In contrast to the diminished operant behavior, the anhedonic behavior in the affected mice was prevented by the NYT administration. Furthermore, NYT did not affect the size of Drd2 mRNA disappearance in the striatum of affected mice, suggesting that the NYT effect was unrelated to DTA-mediated neurodegeneration.

Conclusion

These results demonstrate that the beneficial effect of NYT on motivation is mediated, at least in part, through the potentiation of hedonic capacity by certain neuromodulatory pathways.
Modulation of prefrontal cortex function by basal forebrain cholinergic and GABAergic neurons at the behavioral and molecular level
Authors: Beselia Gela V. , Chkhikvishvili Nino C. , Burjanadze Maia A. , Solomonia Revaz O. , Meparishvili Maia , Nozadze Barbare , Asanidze Sulkhan , Nemsitsveridze Aleksandre , Dashniani Manana G.
Published: May 2021

The present research aimed to study the effects of selective immunolesions of cholinergic or gamma-aminobutyric acid (GABA)ergic neurons in the nucleus basalis magnocellularis (NBM) on memory function as well as cholinergic activity and the level of expression of glutamatergic [NR2B subunit of N-methyl-D-aspartate(NMDA)] receptors in the medial prefrontal cortex (mPFC) and hippocampus of behaviorally characterized rats. In behavioral experiments, working memory was assessed by a spatial alternation testing procedure in a plus-maze, and acquisition and retention of spatial memory was evaluated in a Morris water maze. The rats were divided into three groups: the NBM cholinergic, GABAergic immunolesioned groups and the normal control group. Cholin acetyltransferase or parvalbumin staining of the NBM and acetylcholinesterase staining of the mPFC and hippocampal sections were performed to visualize the effects of immunotoxins. The electrophoresis and immunoblotting were run to evaluate the effect of NBM lesions on the amount of the NR2B subunit of NMDA receptors. The results indicate that the immunolesion of cholinergic NBM neurons impair spatial working memory, as well as long-term spatial memory which is accompanied by significant changes in glutamatergic (the NR2B subunit of NMDA receptor) and cholinergic markers in the mPFC, whereas immunolesion of GABAergic NBM neurons does not affect long-term spatial memory, it does though cause the impairment of working memory with a reduction of the NMDA NR2B receptor signaling in the mPFC. The present results demonstrate that the cholinergic and GABAergic NBM cell groups play diverse and complementary roles and are integrated in distinct NBM-mPFC networks that may play different roles in mPFC memory function.
Effect of repetitive peripheral magnetic stimulation combined with motor imagery on the corticospinal excitability of antagonist muscles
Authors: Asao Akihiko , Hoshino Yuma , Nomura Tomonori , Shibuya Kenichi
Published: May 2021

Objective

Repetitive peripheral magnetic stimulation (rPMS) combined with motor imagery facilitates the corticospinal excitability of the agonist muscles. However, the effects of rPMS combined with motor imagery on the corticospinal excitability of the antagonist muscles are unclear. This is an important aspect for applying rPMS in neurorehabilitation for sensorimotor dysfunction. Therefore, we investigated the real-time changes of corticospinal excitability of antagonist muscles during rPMS combined with motor imagery.

Methods

Fourteen healthy volunteers underwent four different experimental conditions: rest, rPMS, motor imagery, and rPMS combined with motor imagery (rPMS + motor imagery). In the rPMS and rPMS + motor imagery conditions, rPMS (25 Hz, 1600 ms/train, 1.5× of the motor threshold) was delivered to the dorsal side of the forearm. In motor imagery and rPMS + motor imagery, the participant imagined wrist extension movements. Transcranial magnetic stimulation was delivered to record motor-evoked potentials of the antagonist muscle during experimental interventions.

Results

The motor-evoked potential (normalized by rest condition) values indicated no difference between rPMS, motor imagery, and rPMS + motor imagery.

Conclusion

These results suggest that rPMS combined with motor imagery has no effect on the corticospinal excitability of the antagonist muscles and highlight the importance of investigating the effects of rPMS combined with motor imagery at the spinal level.
Differences in the neuronal correlation between the central and peripheral vision in the cat early visual cortex
Authors: Okamura Jun-ya , Wang Ridey Hsiao , Kawano Kousuke , Wang Gang
Published: May 2021

Significant surround modulation was reported in the cortical areas corresponding to the periphery of the visual field, whereas no clear surround modulation was reported in the center. To understand the neural bases underlying the differences of the functions between the cortical areas corresponding to the center and periphery of the visual field, responses of the cells in the cat early visual cortex with their receptive fields in the center and periphery of the visual field were recorded by using multichannel electrodes, and cross-correlations of the spikes in the responses to the full-field stimuli, and the center-surround stimuli, which contained a grating in a central patch and a surround grating, were analyzed. Percentages of the cell pairs showing significant cross-correlation were larger in the cortical areas corresponding to the periphery than the center. In the center of the visual field, the percentages of the cell pairs showing significant cross-correlation significantly decreased as the separation of the recording points increased, and the time lags of the peaks of the cross-correlogram distributed around zero. In the periphery of the visual field, the time lags of the peaks of the cross-correlogram distributed more widely and increased as the separation of the recording points increased. In the responses to the center-surround stimuli in the preferred orientation of each cell, percentages of the cell pairs showing significant cross-correlation were larger in the periphery than the center. These results suggest that more lateral interactions occur in the cortical areas corresponding to the periphery than the center of the visual field.
Dose-dependent effect of nuts on blood pressure: a systematic review and meta-analysis of randomized controlled trials
Authors: Jayedi Ahmad , Khan Tauseef Ahmad , Mirrafiei Amin , Jabbarzadeh Bahareh , Hosseini Yasaman , Motlagh Sheida , Jibril Aliyu Tijani , Shahinfar Hossein , Shab-Bidar Sakineh
Published: May 2021

Objective

Traditional pairwise meta-analyses indicated that nuts consumption can improve blood pressure. We iamed to determine the dose-dependent effect of nuts on systolic (SBP) and diastolic blood pressure (DBP) in adults.

Methods

A systematic search was undertaken in PubMed, Scopus, and ISI Web of Science till March 2021. Randomized controlled trials (RCT) evaluating the effects of nuts on SBP and DBP in adults were included. We estimated change in blood pressure for each 20 g/d increment in nut consumption in each trial and then, calculated mean difference (MD) and 95%CI using a random-effects model. We estimated dose-dependent effect using a dose-response meta-analysis of differences in means. The certainty of evidence was rated using the GRADE instrument, with the minimal clinically important difference being considered 2 mmHg.

Results

A total of 31 RCTs with 2784 participants were included. Each 20 g/d increase in nut consumption reduced SBP (MD: -0.50 mmHg, 95%CI: -0.79, -0.21; I2= 12%, n = 31; GRADE = moderate certainty) and DBP (MD: -0.23 mmHg, 95%CI: -0.38, -0.08; I2= 0%, n = 31; GRADE = moderate certainty). The effect of nuts on SBP was more evident in patients with type 2 diabetes (MD: -1.31, 95%CI: -2.55, -0.05; I2= 31%, n = 6). The results were robust in the subgroup of trials with low risk of bias. Levels of SBP decreased proportionally with the increase in nuts consumption up to 40 g/d (MD40g/d: -1.60, 95%CI: -2.63, -0.58), and then appeared to plateau with a slight upward curve. A linear dose-dependent reduction was seen for DBP, with the greatest reduction at 80 g/d (MD80g/d: -0.80, 95%CI: -1.55, -0.04).

Conclusions

The available evidence provides a good indication that nut consumption can result in a small improvement in blood pressure in adults. Well-designed trials are needed to confirm the findings in long term follow-up.
Measurement of multiple SARS-CoV-2 antibody titer after vaccination represents individual vaccine response and contributes to individually appropriate vaccination schedules
Authors: Ota Kenji , Murakami Satoshi , Mukae Hiroshi , Kohno Shigeru , Yanagihara Katsunori
Published: May 2021

The SARS-CoV-2 mRNA vaccine BNT162b2 (Pfizer-BioNTech) has become a game-changer in the COVID-19 crisis. Faster and wider coverage of vaccine supply is urgently needed, although vaccine supply is far from abundant in many countries and regions. There is no denying that Japan is vaccinating at a slower pace than in many other countries. At the end of April 2021, it had administered less than 2% of the population, according to the statistics website Our World in Data.1 Single-dose vaccination may be considered to induce an adequate antibody response in individuals with prior infection,2–5 which can lead to more effective vaccine distribution to people in serious need. However, multiple antibody responses in populations with various backgrounds, including prior COVID-19 infection, underlying diseases, and age, have not been investigated sufficiently. Due to the lack of antibody measurement data, antibody follow-up measurement recommendations have yet to be suggested. Accumulation of available data regarding quantitative antibody titer will lead to the establishment of personally customized schedules, including antibody follow-up, and will balance both faster delivery of vaccines and confirmation of effective vaccination.
Sex matters: effects of sex and mating in the presence and absence of a protective microbe
Authors: Kloock Anke , Peters Lena , Rafaluk-Mohr Charlotte
Published: May 2021

In most animals, female investment in offspring production is greater than for males. Lifetime reproductive success (LRS) is predicted to be optimised in females through extended lifespans to maximise reproductive events. Extended lifespan can be achieved through increased investment in immunity. Males, however, maximise lifetime reproductive success by obtaining as many matings as possible. Microbe-mediated protection (MMP) is known to affect both immunity and reproduction, but whether the two sexes respond differently to the provision of MMP remains to be explored. Here, we investigated the sex-specific differences in host life history traits between female and male Caenorhabditis elegans following pathogenic infection with Staphylococcus aureus with or without MMP by Enterococcus faecalis. Overall, female survival decreased with increased mating. With MMP, females increased investment into offspring production, while males displayed higher behavioural activity. These results highlight the different strategies employed by the two sexes under pathogen infection with and without MMP.
Ready to learn in an uncertain future: ways to support student engagement
Authors: Sum Carmen , Chan Ivy , Wong Helen
Published: May 2021

Purpose

The purpose of this paper is to examine student engagement in learning amid COVID-19 and compare it with the previous cohort under face-to-face learning and propose a series of learning activities to engage students for any uncertain situations in the future.

Design/methodology/approach

Two online surveys were conducted at the end of the academic years of 2018/2019 and 2019/2020 to measure student engagement under face-to-face tradition learning and emergency remote learning respectively.

Findings

Student behavioural engagement was found no statistical difference between the two learning situations, whereas students having face-to-face learning demonstrated greater emotional and cognitive engagement. Social interaction is essential to drive student engagement in emergency remote learning.

Practical implications

The authors intended to highlight some teaching approaches and learning activities for social interaction to engage students.

Originality/value

Engaging students in remote or online learning is an educational challenge for the new reality. This paper proposed the teaching approach and learning activities to engage students in their learning in the future.
Modeling barriers of digital manufacturing in a circular economy for enhancing sustainability
Authors: Bag Surajit , Sahu Atul Kumar , Kilbourn Peter , Pisa Noleen , Dhamija Pavitra , Sahu Anoop Kumar
Published: May 2021

Purpose

Circular economy denotes future sustainability that allows optimum utilization of resources. In the present era of technology, plenty of innovations are happening across the world, and digital manufacturing is one of such innovations. However, there are several barriers which are impeding adoption of digital manufacturing in circular economy environment. The study explores the barriers of digital manufacturing initiatives in a circular economy and develops a methodological model to prioritize the identified challenges for automotive parts manufacturing industry.

Design/methodology/approach

Seven categories of challenges namely process, human resources, financial, collaboration, technological, security and leadership challenges were identified from literature and further validated with subsequent discussions with experts from the industry. The study is conducted in two phases, where in the first phase, the Decision-Making Trial and Evaluation Laboratory (DEMATEL) technique is used to define the priority and importance of seven categories of challenges. In second phase, the barriers are ranked using a Fuzzy Performance Important Index (FPII), taking into account contextual factors associated with the challenges and linked barriers, to determine the extent to which they impede the adoption of digital manufacturing in the sample automotive parts manufacturing company.

Findings

The “risk of data security and information privacy in connection with use of external data and protecting customer data” appeared as the most significant barrier to digital manufacturing in circular economy. Furthermore, technological challenges emerged as the most significant category of challenges followed by financial challenges in adoption of digital manufacturing in circular economy.

Practical implications

Identification of the identified barriers and understanding the interrelationships will lead to easier adoption of digital manufacturing in circular economy.

Originality/value

Despite all the potential benefits of implementing Industry 4.0 technologies in manufacturing industries, the adoption thereof is still in nascent phase with significant challenges yet to be overcome to accelerate the pace of adoption. Hence, this study explores the barriers preventing companies from adopting and benefiting from digital manufacturing initiatives and further develops a methodological model.
Reflections on the utility of school-based surveys for gang research
Authors: Thomas Kyle J. , Taylor Terrance J.
Published: May 2021

Purpose

The purpose of this paper is to consider the utility of school-based research for studying gangs and gang members. Police–researcher collaborations have led to considerable advancements in the understanding of gang involvement and its consequences. But the current social environment should encourage scholars to take stock of alternative methodologies to examine gang-related questions.

Design/methodology/approach

In this paper, the authors reflect on the advantages of school-based research designs for studying gang affiliated youth, primarily contrasting the data derived from school-based designs to official data from police.

Findings

xSpecifically, the authors discuss the key advantages of school-based survey research, identify concerns that can arise from such designs and offer recommendations as to how to mitigate such concerns.

Originality/value

This paper provides a discussion on the utility of gang-related research and guidance on addressing potential limitations.
From Industry 4.0 to Education 4.0: acceptance and use of videoconferencing applications in higher education of Oman
Authors: Jain Vishal , Jain Parul
Published: May 2021

Purpose

The present paper is an attempt to study Education 4.0 supported by Industry 4.0 tools and techniques. The main purpose of the study is to examine the acceptance and use of one of the internet of things (IoT)-based learning management systems, i.e. videoconferencing application (Google Meet, Microsoft Teams, Zoom, GoToMeeting, WebEx), by academicians of higher education using the unified theory of acceptance and use of technology (UTAUT) model.

Design/methodology/approach

The study comprises 218 responses of academicians associated with higher education in the Sultanate of Oman. Descriptive and factor analysis of the collected data are employed using SPSS-26. Further, using Amos-21, the fit and validity indices of the measurement model are computed. Various relationships of the UTAUT structural model along with moderation effects of gender and nationality are tested.

Findings

The results suggest that performance expectancy, effort expectancy and social influence significantly predict behavioral intention. In turn, behavioral intention and facilitating conditions also significantly predict the use behavior of academicians for videoconferencing in higher education. Finally, gender moderates two out of four UTAUT relations, but nationality does not moderate any of these relations.

Originality/value

A lot of prior studies investigate several models to use technology-enabled pedagogy from educators' or students' perspectives. There are very limited studies that examine IoT-based learning tools within the UTAUT environment. Additionally, no study is available that considers UTAUT relations for the use of videoconferencing in higher education. Also, in the present study, one more moderator, i.e. nationality, is tested.
Developing a university learning, teaching and research framework through practice conversations
Authors: Harris Brigitte , Childs Elizabeth Anne , Axe Jo , Gorley Charlotte
Published: May 2021

Purpose

This project engaged faculty, students, alumni and staff in re-visioning their university's learning, teaching and research framework. An extensive consultation process allowed participants to explore, discuss and critically reflect on effective practice.

Design/methodology/approach

This action research project provided a process for university community members to engage in practice conversations. In phase 1, focus groups and campus community discussions elicited the diverse perspectives of the community. The design-thinking process of discovery, ideation and prototyping aligned with the action research cycles to help a working group create a learning and teaching framework prototype based on the findings. In the second phase, surveys were used to elicit community members' responses to the prototype, which was then refined.

Findings

The prototype was organized into three overarching categories, each containing several attributes. The attributes of the “Applied and Authentic” category were: interdisciplinary and transdisciplinary; experiential and participatory; flexible and individualized; outcomes based; and openly practiced. The attributes of the “Caring and Community-Based” category were: inclusive and diverse; community-based; supportive; team-based; co-creative; and place and virtual space-based. The attributes of the “Transformational” category were socially innovative; respectful of Indigenous peoples and traditions; impactful; and reflective.

Originality/value

This article should interest higher education institutions seeking to engage faculty, staff, students and others in practice conversations to develop a learning, teaching and research strategy. This research demonstrated that fostering practice conversations among diverse community members can be a powerful process for creating a common and integrated vision of excellent learning, teaching and research practice.
Value co-creation activities in retail ecosystems: well-being consequences
Authors: Gardiazabal Pilar , Bianchi Constanza
Published: May 2021

Purpose

This paper aims to analyze the well-being consequences of value co-creation activities at an ecosystem level, focusing specifically on the micro and meso levels. This study is performed in a retail ecosystem, a highly relevant context where individuals spend a considerable amount of time and resources, but where well-being is usually not deemed as a relevant outcome.

Design/methodology/approach

The investigation analyzes qualitative data from micro and meso level actors of a retail ecosystem. At the micro-level, in-depth interviews performed with customers, employees and suppliers were assessed. The meso level analysis included most of the actors embedded in the retail ecosystem: employees’ headquarters, suppliers’ headquarters, nearby competitors, family, other retail outlets and external employees.

Findings

This study is one of the first in the transformative service research area to analyze well-being from a retail ecosystem perspective. Hence, this analysis broadens the literature on transformative service by considering supermarket retailing, an everyday service context that is not assumed to generate well-being outcomes. Results reveal that actors who spend more time or have fewer options available for them in the retail ecosystem see their well-being deeply affected. It also extends the conceptualization of value co-creation to a retail ecosystem, a specific ecosystem, which differs from previous studies that focus mostly on health-care ecosystems.

Research limitations/implications

Although useful to understand new insights, a limitation of this investigation is that it is based upon a single qualitative study.

Practical implications

The study portrays how activities happening within a business context have consequences beyond traditional measures such as loyalty or turn-over. It proposes specific value co-creation actions to be performed by employees, suppliers and customers to promote positive well-being consequences for the micro and meso level retail ecosystem.

Social implications

Retail ecosystems are usually not deemed as relevant when trying to understand societal well-being outcomes. This study empirically depicts that all services, even the ones without transformative goals, need to be aware of the impact they have on societal well-being.

Originality/value

This paper provides a novel conceptualization of well-being effects in a retail ecosystem. Specifically, this is the first study in the transformative service research literature to identify the micro and meso level well-being consequences of value co-creation activities within a retail ecosystem.