bluuebunny/crossref_metadata_2025 huggingface dataset:
Stunting and Associated Factors among Under-Five-Age Children in West Guji Zone, Oromia, Ethiopia
Authors: Afework Eyob , Mengesha Selamawit , Wachamo Demelash
Published: February 2021

Background. Stunting is one of the most important public health problems in Ethiopia. It remains a problem of greater magnitude particularly in rural and low-income areas. It reflects chronic nutritional deficiencies and illness that occur during the most critical periods for growth and development in early life. It needs proper intervention to save the future, unless it resulted in diminished cognitive and physical development for the rest of their lives. Therefore, this study aimed to assess the prevalence of stunting and associated factors among under-five children in West Guji Zone, Oromia, Ethiopia. Method. A community-based cross-sectional study was conducted among 767 under-five children who were included in this study by using a multistage sampling technique in 12 kebeles from 3 selected districts. Data were collected from a mother/caregiver of the child by using a structured pretested questionnaire. Standardized anthropometric measurements were used to measure length, weight, and height of a child. Data were entered into Epi Info software version 3.5.1 and exported to SPSS version 23 for analysis for descriptive and logistic regression models. Result. The prevalence of stunting was 244 (31.8%) with 95% CI (28.6–35.2) among under-five-age children. The under-five children whose fathers had a polygamous marriage (AOR = 4.92, 95% CI: 3.46, 7.00), being female sex (AOR = 1.74, 95% CI: 1.23, 2.47), having below 4 meal frequencies (AOR = 2.95, 95% CI: 1.56, 5.58), not vaccinated (AOR = 1.75, 95% CI: 1.15, 2.67), and from poor households’ wealth status (AOR = 3.03, 95% CI: 1.63, 5.63) and also from severely food insecure household (AOR = 2.92, 95% CI: 1.36, 6.24) were short for their age compared with their counterparts. Conclusion. Nearly one-third of the under-five children were stunted in the study area which needs intervention on child-feeding practice to avoid sex discrimination in the community. In addition to this health officials in collaboration with other sectors, it is needed to act together to improve enforcement of the law for polygamous marriage, the household’s wealth status, and food security for the better health of a child and future.
Esophageal Cancer in Tanzania: A Welcome Stimulus in Primary Prevention Research
Authors: McCormack Valerie , Kaimila Bongani , Mmbaga Blandina T. , Schüz Joachim
Published: February 2021

In this issue, Mmbaga and colleagues present results of a case–control study to investigate environmental and lifestyle risk factors for esophageal cancer in Tanzania, East Africa. The results contribute to the early stage of a growing evidence base aimed to inform primary prevention of a major poor prognosis cancer in East Africa. In this commentary, we first discuss considerations needed to evaluate causality of associations, a feature needed for primary prevention. There is a need for further studies across the African esophageal cancer corridor, for more refined exposure assessment and a careful consideration of potential epidemiologic biases within study designs for real-life situations in the setting. This study also forms a prime example of the broader research needs for cancer in low- and middle-income countries and in Sub-Saharan Africa, a setting with distinct and underresearched cancers and exposure patterns. While this etiologic research is challenging, it is an essential component of the ground-shot approach to global health research needed to inform primary prevention.

See related article by Mmbaga et al., p. 305
Alterations in BAP1 Are Associated with Cisplatin Resistance through Inhibition of Apoptosis in Malignant Pleural Mesothelioma
Authors: Oehl Kathrin , Vrugt Bart , Wagner Ulrich , Kirschner Michaela B. , Meerang Mayura , Weder Walter , Felley-Bosco Emanuela , Wollscheid Bernd , Bankov Katrin , Demes Melanie C. , Opitz Isabelle , Wild Peter J.
Published: February 2021

Purpose:

The clinical standard treatment for patients with malignant pleural mesothelioma (MPM) includes a cisplatin-based chemotherapy, leading to reduction of tumor size in only a minority of patients. Predicting response to chemotherapy in patients with MPM by using a genetic marker would, therefore, enable patient stratification.

Experimental Design:

In this retrospective biomarker study, eligible patients had resectable MPM, measurable disease, and available primary MPM tissue. All patients underwent first-line treatment with cisplatin and pemetrexed, followed by surgery. Thorough molecular analysis was performed (whole-exome and targeted deep sequencing, and copy-number analyses), and also mechanistic in vitro data (viability assays, Western blots, and immunoprecipitation) using mesothelioma cell lines with and without siRNA-mediated BRCA1-associated protein 1 (BAP1) knockdown were provided.

Results:

In a training cohort of patients with MPM (n = 28), mutations or deletions of BAP1 each predicted resistance to chemotherapy in patients with primary MPM. The negative predictive value of BAP1 loss in patients with MPM was confirmed by amplicon sequencing and copy-number array technology in an independent test cohort (n = 39). Preliminary mechanistic studies using siRNA-based knockdown of BAP1 in MPM cell culture models along with immunoprecipitation assays confirmed chemoresistance in vitro, possibly through inhibition of apoptosis and transcriptional regulation of the BAP1/HCF1/E2F1 axis.

Conclusions:

Alterations in BAP1 in MPM were a negative predictor for response to chemotherapy and could possibly be used as a companion biomarker for treatment decision.
Therapeutic Approaches for the No-Option Refractory Angina Patient
Authors: Povsic Thomas J. , Henry Timothy D. , Ohman E. Magnus
Published: February 2021

The combination of an aging population and improved survival rates among patients with coronary artery disease has resulted in an increase in the number of patients with refractory angina or anginal equivalent symptoms despite maximal medical therapy. Patients with refractory angina are often referred to the cardiac catheterization laboratory; however, they have often exhausted conventional revascularization options; thus, this population is often deemed as having “no options.” We review the definition, prevalence, outcomes, therapeutic options, and treatment considerations for no-option refractory angina patients and focus on novel therapies for this complex and challenging population. We propose a multidisciplinary team approach for the evaluation and management of patients with refractory angina, ideally in a designated clinic. The severe limitations and symptomatology experienced by these patients highlight the need for additional research into the development of innovative treatments.
Relative Impact of Clinical Risk Versus Procedural Risk on Clinical Outcomes After Percutaneous Coronary Intervention
Authors: Kang Jeehoon , Park Kyung Woo , Lee Hak Seung , Zheng Chengbin , Rhee Tae-Min , Ki You-Jeong , Chang Mineok , Han Jung-Kyu , Yang Han-Mo , Kang Hyun-Jae , Koo Bon-Kwon , Kim Hyo-Soo
Published: February 2021

Background:

The clinical outcome after percutaneous coronary intervention (PCI) is affected by various clinical and procedural risk factors. We investigated the relative impact of clinical and procedural risks on clinical outcomes after PCI.

Methods:

A total of 13 172 patients were enrolled from the Grand-DES registry. The population was grouped into tertiles (high-, intermediate-, low-risk) according to the number of prespecified clinical and procedural risk factors, respectively. The primary end point was major adverse cardiac and cerebrovascular events (MACCE) at 3 years post-PCI.

Results:

MACCE occurred in 1109 (8.4%) patients during the follow-up period (median duration: 1126 days). Compared with procedural risk, clinical risk showed superior predictive power (area under the curve: 0.678 versus 0.570,
P
<0.001, for clinical and procedural risks, respectively) and greater magnitude of effect in the multivariate analysis for MACCE (Clinical risk: hazard ratio, 1.953 [95% CI, 1.809–2.109],
P
<0.001; procedural risk: hazard ratio, 1.240 [95% CI, 1.154–1.331],
P
<0.001). In subgroup analyses within each clinical risk tertile, procedural risk had no significant impact on MACCE in the lowest clinical risk tertile. An annual landmark analysis revealed that clinical and procedural risks were both significant predictors of MACCE, which occurred within the first and second year post-PCI. However, for MACCE occurring in the third year post-PCI, only clinical risk but not procedural risk was a significant predictor of events.

Conclusions:

Clinical and procedural risks were both significant predictors for ischemic clinical events in patients undergoing PCI. However, clinical risk had a greater and more prolonged effect on outcomes than procedural risk.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT03507205.
An evaluation of the Cactaceae of Barbados, Grenada, Saint Vincent, and The Grenadines
Authors: HOXEY PAUL , GDANIEC ANDREW
Published: February 2021

Three species of Cactaceae are considered native to Barbados and eight species to Grenada and Saint Vincent and The Grenadines. Melocactus intortus is reported for the first time from The Grenadines and the identity of Selenicereus innesii, a Saint Vincent endemic, is clarified. Lectotypes for Melocactus broadwayi, Cereus margaritensis, and Cereus grenadensis are proposed. Cereus plumieri, which was described on the basis of a Plumier’s illustration published 300 years ago, is finally observed in habitat and a new combination made in the genus Selenicereus. Morphological descriptions and distributions of the recognized species are provided.
Characterizing Regimes of Atmospheric Circulation in Terms of Their Global Superrotation
Authors: Lewis Neil T. , Colyer Greg J. , Read Peter L.
Published: February 2021

The global superrotation index S compares the integrated axial angular momentum of the atmosphere to that of a state of solid-body corotation with the underlying planet. The index S is similar to a zonal Rossby number, which suggests it may be a useful indicator of the circulation regime occupied by a planetary atmosphere. We investigate the utility of S for characterizing regimes of atmospheric circulation by running idealized Earthlike general circulation model experiments over a wide range of rotation rates Ω, 8ΩE to ΩE/512, where ΩE is Earth’s rotation rate, in both an axisymmetric and three-dimensional configuration. We compute S for each simulated circulation, and study the dependence of S on Ω. For all rotation rates considered, S is on the same order of magnitude in the 3D and axisymmetric experiments. For high rotation rates, S ≪ 1 and S ∝ Ω−2, while at low rotation rates S ≈ 1/2 = constant. By considering the limiting behavior of theoretical models for S, we show how the value of S and its local dependence on Ω can be related to the circulation regime occupied by a planetary atmosphere. Indices of S ≪ 1 and S ∝ Ω−2 define a regime dominated by geostrophic thermal wind balance, and S ≈ 1/2 = constant defines a regime where the dynamics are characterized by conservation of angular momentum within a planetary-scale Hadley circulation. Indices of S ≫ 1 and S ∝ Ω−2 define an additional regime dominated by cyclostrophic balance and strong equatorial superrotation that is not realized in our simulations.
Observed Statistical Connections Overestimate the Causal Effects of Arctic Sea Ice Changes on Midlatitude Winter Climate
Authors: Blackport Russell , Screen James A.
Published: February 2021

Disentangling the contribution of changing Arctic sea ice to midlatitude winter climate variability remains challenging because of the large internal climate variability in midlatitudes, difficulties separating cause from effect, methodological differences, and uncertainty around whether models adequately simulate connections between Arctic sea ice and midlatitude climate. We use regression analysis to quantify the links between Arctic sea ice and midlatitude winter climate in observations and large initial-condition ensembles of multiple climate models, in both coupled configurations and so-called Atmospheric Model Intercomparison Project (AMIP) configurations, where observed sea ice and/or sea surface temperatures are prescribed. The coupled models capture the observed links in interannual variability between winter Barents–Kara sea ice and Eurasian surface temperature, and between winter Chukchi–Bering sea ice and North American surface temperature. The coupled models also capture the delayed connection between reduced November–December Barents–Kara sea ice, a weakened winter stratospheric polar vortex, and a shift toward the negative phase of the North Atlantic Oscillation in late winter, although this downward impact is weaker than observed. The strength and sign of the connections both vary considerably between individual 35-yr-long ensemble members, highlighting the need for large ensembles to separate robust connections from internal variability. All the aforementioned links are either absent or are substantially weaker in the AMIP experiments prescribed with only observed sea ice variability. We conclude that the causal effects of sea ice variability on midlatitude winter climate are much weaker than suggested by statistical associations, evident in observations and coupled models, because the statistics are inflated by the effects of atmospheric circulation variability on sea ice.
COVID-19 Communication Ecology: Visualizing Communication Resource Connections During a Public Health Emergency Using Network Analysis
Authors: Brian Houston J. , Thorson Esther , Kim Eunjin (Anna) , Mantrala Murali K.
Published: February 2021

The COVID-19 outbreak began in December 2019 and soon became a global pandemic, resulting in major public health consequences for countries across the world. As the COVID-19 outbreak evolved, individuals were challenged to understand the risk of COVID-19 and to identify ways to stay safe. This understanding was accomplished through COVID-19 communication ecologies that consist of interpersonal, organizational, and mediated communication resources. In the current study, we examine the U.S. COVID-19 communication ecology in September 2021. We introduce the communication ecology network (CEN) model, which posits that similar useful communication resources will cluster in a communication ecology, and we use network analysis for visualization of the ecology. Our results indicate a robust COVID-19 communication ecology. The most important communication resources in the ecology were partisan and organizational communication resources. We identify and discuss five clusters within the COVID-19 communication ecology and examine how use of each of these clusters is associated with belief in COVID-19 misinformation. Our use of network analysis illustrates benefits of this analytical approach to studying communication ecologies.
Journalists on COVID-19 Journalism: Communication Ecology of Pandemic Reporting
Authors: Perreault Mildred F. , Perreault Gregory P.
Published: February 2021

In the midst of the COVID-19 pandemic, journalists have the challenging task of gathering and distributing accurate information. Journalists exist as a part of an ecology in which their work influences and is influenced by the environment that surrounds it. Using the framework of disaster communication ecology, this study explores the discursive construction of journalism during the COVID-19 crisis. To understand this process in the field of journalism, we unpacked discourses concerning the coronavirus pandemic collected from interviews with journalists during the pandemic and from the U.S. journalism trade press using the Discourses of Journalism Database. Through discourse analysis, we discovered that during COVID-19 journalists discursively placed themselves in a responsible but vulnerable position within the communication ecology—not solely as a result of the pandemic but also from environmental conditions that long preceded it. Journalists found their reporting difficult during the pandemic and sought to mitigate the forces challenging their work as they sought to reverse the flow of misinformation.
What Does the Debt Burden Index of Eighteen Major States of India Reveal? 2005–2006 to 2018–2019
Authors: Barik Anirudha , Mohanty Asit Ranjan
Published: February 2021

This study attempts to measure the relative debt burden of 18 major states of India by grouping them into high-, middle- and low-income states for the post– Fiscal Responsibility and Budget Management (FRBM) Act, 2003 period (from 2005–2006 to 2018–2019) through developing a new debt burden index (DBI) using the relative-distance method. Data are sourced from ‘Handbook of Statistics on Indian States’ published by the Reserve Bank of India (RBI). Using DBI, the study shows the interstate variations in debt burden and thereby compares debt management across the states. The analysis reveals that the debt burden has been consistently declining in the case of low-income states, whereas it has been increasing for both middle- and high-income states. DBI may be used as an important input for the credit rating for State Development Loans (SDLs).

JEL Classification: H63, H74, C43
Autonomy, Meaning, and the Mediating Role of Symbolic Immortality
Authors: Horner Dylan E. , Sielaff Alex R. , Greenberg Jeff
Published: February 2021

The present work built on self-determination theory, terror management theory, and related existential and humanistic perspectives to test the mediating role of symbolic immortality in the association between autonomy and meaning in life. In two samples (Sample 1, n = 1,414; Sample 2, n = 882), autonomy was significantly associated with symbolic immortality, which in turn was significantly associated with meaning in life. Moreover, in both samples, multiple regression analyses supported the view that autonomy is a unique and significant predictor of symbolic immortality, and the proposed indirect effect remained significant after controlling for self-esteem. These results extend prior work addressing autonomy and meaning in life and point to interesting empirical directions for further understanding the existential role of autonomy in managing death-related concerns.
Thematic expansion: A new strategy for theory development
Authors: Kelly Katherine P. , Knafl Kathleen A. , Keller Susan , Hinds Pamela S.
Published: February 2021

We developed and applied metasynthesis methods to expand previously reported thematic descriptions of parents’ internal definition of “being a good parent to my seriously ill child” as part of a larger study to examine parenting of children with serious illness. Our systematic approach included: literature search, purposeful selection of grounded theories regarding parenting a seriously ill child, study summaries, mapping evidence of good parent themes onto structural elements of grounded theory, cross-study comparisons, and theoretical memoing to summarize analytic insights. Twenty-five grounded theory studies from 32 reviewed reports reflected multiple conditions (n=5), countries (n=10) and family members (n=386 families). We report a worked example of the processes used to extend the original good parent themes and detail our processes through one good parent theme. The methods we describe are a promising approach to extend thematic analysis findings and advance thematic expansions toward development of more formal theoretical syntheses.
Depressive Symptoms in Comorbid Obstructive Sleep Apnea and Insomnia: An Integrative Review
Authors: Jeon Bomin , Luyster Faith S. , Callan Judith A. , Chasens Eileen R.
Published: February 2021

The purpose of this integrative review was to synthesize evidence concerning the relationship between comorbid obstructive sleep apnea and insomnia (OSA+I), and depressive symptoms. OSA and insomnia are common sleep disorders, recently comorbid OSA+I has been recognized as prevalent in adults. Although each sleep disorder increases the risk and severity of depressive symptoms, the effect of comorbid OSA+I on depressive symptoms remains unclear. A systematic search of PubMed, CINAHL, and PsycINFO identified 15 data-based studies. All the studies were observational with either a cross-sectional (n = 14) or a case-control design (n = 1). Study quality was assessed. Most of the studies (n = 14) indicated that comorbid OSA+I had an additive role on depressive symptoms. Insomnia appeared to have a more important role than OSA in increasing the severity of depressive symptoms in persons with comorbid OSA+I.
Robot-assisted laparoscopic resection of a pelvic solitary fibrous tumor
Authors: Qin Jie , Zhu Yi , Kong Mei , Wang Ping , Xia Dan , Wang Shuo
Published: February 2021

Solitary fibrous tumor (SFT) is a rare soft tissue neoplasm of mesenchymal origin. SFT is most commonly located in the thoracic cavity (in approximately 80% of cases), but can also develop rarely in the pelvis. A 47-year-old man presented to our hospital with a pelvic tumor that was discovered during a health checkup. We performed transperitoneal robotic resection of the pelvic tumor. Intraoperative blood loss and the console time were 100 mL and 2 hours 42 minutes, respectively, and no intraoperative or postoperative complications were recorded. Histologic analysis revealed a pelvic SFT with negative surgical margins. The patient was followed-up for 13 months with no evidence of tumor recurrence. To our knowledge, this is the first report of robot-assisted laparoscopic resection of a pelvic SFT.
Ureteritis associated with systemic lupus erythematosus: a case report
Authors: Li Chunyan , Huang Fei , Wang Yu , Tian Mei
Published: February 2021

We report herein an unusual case of systemic lupus erythematosus in a 35-year-old woman who developed acute abdominal pain while hospitalized. Abdominal computed tomography (CT) scan with enhancement indicated long-segment inflammatory lesions in the right ureter. The patient received spasmolytic and analgesic drugs with poor effect and continued to have persistent severe abdominal pain and signs of peritonitis. We suspected that the patient had acute abdominal disease, but no abnormality was detected during laparoscopic surgery. Therefore, we considered the possibility of right upper urinary tract hydronephrosis; the patient’s abdominal pain was relieved after double-J tube implantation. The patient’s clinical symptoms improved after hormone and mycophenolate mofetil therapy for 1 year, and all laboratory indicators returned to normal. Reexamination by abdominal CT showed that the long-segment inflammatory lesions of the right ureter had resolved. Early identification and diagnosis are important for ureteritis associated with systemic lupus erythematosus.
The Role of Uncertainty in the Experiences of Nurses During the Covid-19 Pandemic: A Phenomenological Study
Authors: Nelson Heather , Hubbard Murdoch Natasha , Norman Kasandra
Published: February 2021

Background

The novel coronavirus (Covid-19) has spread quickly to all corners of the globe and caused high rates of morbidity and mortality. Nurses have been at the centre of this experience managing the outbreak through direct bedside care, managing hospital units, providing Covid-19 testing, and contact tracing.

Purpose

The aim of this article is to examine the role that nurses played in the early stages of the Covid-19 pandemic through the voices of the participants.

Methods

Using a phenomenological methodology thirty-one interviews were completed via phone and thematic analysis was completed.

Results

The major themes that emerged from this phenomenological study were: emotional challenges, uncertainty, and protective factors. Emotional challenges included, stress, anxiety, exhaustion, frustration, guilt, and loneliness. These challenges were magnified by uncertainty through leadership and communication challenges, needs of the pandemic versus needs of the patient, and Covid-19 and best practice. In this study, emotional challenges were mitigated by the protective factors of: education, ability to contribute, team cohesiveness, and community support.

Conclusions

Nurses are challenged during this time but by limiting uncertainty and providing protective factors, nurses can be less affected by emotional challenges and able to provide nursing care and manage the outbreak effectively.
Do Spiritual Health Connections Protect Adolescents When They Are Bullied: A National Study of 12,593 Young Canadians
Authors: Shaver Nicole , Michaelson Valerie , Pickett William
Published: February 2021

It has long been established that bullying has many negative impacts on the mental health of adolescents. Young people who are victimized by bullying may cope by drawing on available assets to protect themselves from harm. One such asset with ancient roots but with the potential for contemporary application is the concept of spiritual health—the idea that the connections in our lives (whether to ourselves, others, nature, or something transcendent) affect our well-being. In this study, we examined 12,593 Canadians aged 11–15 years to determine the effects of being victimized by bullying on their mental health, as measured by frequent subjective health complaints. We then explored whether strong spiritual health connections were effect modifiers that buffer such negative pathways, thereby acting as protective health assets. Data were obtained from the 2017/18 Canadian Health Behaviour in School-aged Children study. Generalized linear regression models were used to estimate associations and evaluate effect modification in different age and gender groups. Approximately 21% of participants reported being victimized by bullying. Strength of “connections to self” (i.e., a sense of meaning/purpose or joy and happiness in one’s life) was found to act as an effect modifier, but in girls alone. Contrary to expectations of a buffering effect, the strongest associations between victimization and frequent health complaints were identified for girls with high connections to self. Relative risks for poor mental health among these highly self-connected girls were 1.63 [95% CI: 1.26–2.12] and 1.25 [1.06–1.47] for younger and older girls, respectively. We interpreted this unexpected finding in light of cognitive theories of trauma, which suggest that adverse events may lead to worse health outcomes among those who place particular value on their world being meaningful, controllable or benevolent. Implications for clinical intervention and health promotion are considered.
Assessment of atherosclerotic cardiovascular disease risks between people living with HIV receiving first-line and second-line antiretroviral therapy in a resource-limited setting
Authors: Tiarukkitsagul Jaruwan , Sungkanuparph Somnuek
Published: February 2021

Cardiovascular disease has become an important health problem in people living with HIV (PLHIV) who receive antiretroviral therapy (ART). Atherosclerotic cardiovascular disease (ASCVD) risk score is a non-invasive tool to estimate the 10-year risk for ASCVD. A cross-sectional study was conducted among PLHIV receiving ART in a resource-limited setting, in order to assess the 10-year ASCVD risk between PLHIV receiving first-line and second-line ART. Of 460 participants with a mean age of 51.2 years, 262 (57.0%) were men. The mean duration of HIV infection was 14.7 years and the mean CD4 cell count was 509 cells/μL. Of all, 345 participants were receiving first-line ART and 115 were receiving second-line ART. The median 10-year ASCVD risk was 3.0% and 5.1% in the first-line and second-line ART groups, respectively ( p = 0.029). The prevalence of a high 10-year ASCVD risk (≥20%) was significantly higher in the second-line ART group (3.5% vs 0.9%, p = 0.048). In multivariate analysis, receiving second-line ART was significantly associated with intermediate to high 10-year ASCVD risk (OR = 2.952; 95% CI, 1.656–6.997; p = 0.015). Atherosclerotic cardiovascular disease risk should be assessed in PLHIV, particularly those who receive second-line ART.
Primary nasal Kaposi Sarcoma in well-controlled HIV-positive patient with normal CD4 count associated with long-term nasal steroid use
Authors: Htet Kyaw Zin , Waul Michael , Edelstein Howard , Mui Stanley , Cherny Sarah , Leslie Kieron
Published: February 2021

Kaposi sarcoma (KS) is an angioproliferative disease that is caused by human herpesvirus 8. The epidemic form of KS is associated with acquired immunodeficiency syndrome (AIDS) and is common in HIV-positive patients with CD4 counts less than 200 cells/mm. We present the case of a 63-year-old man with well-controlled HIV and normal CD4 count developing atypical nasal KS associated with intranasal steroid use.
Surgical Repair of Internal Carotid Artery Aneurysm: Case Report
Authors: Kankılıç Nazım , Aydın Mehmet Salih , Göz Mustafa
Published: February 2021

Extracranial carotid artery aneurysms are extremely rare aneurysms. Treatment options are conventional open surgery, endovascular surgery, and conservative treatment. Surgical treatment of such aneurysms is challenging and it is important to determine the treatment strategies wisely. There is still no definite association for treatment modalities. In this case report, we present open surgical treatment of a 58-year-old female patient with internal carotid artery aneurysm. The patient was admitted to our clinic with spontaneous pulsatile mass in the right jugular region. Computed tomography angiography shown right internal carotid artery aneurysm. Aneurysm cranial distance was enough to perform end to end anastomosis. Aneurysm was excised by preserving cranial nerves. No complications developed during the postoperative period.
The impact of major trauma centre designation on routine orthopaedic trauma care
Authors: Archer James , Odeh Abdulrahman , Piper Danielle , Moore Ellen , Butt Annisa , Fawdington Ross , Fenton Paul
Published: February 2021

Introduction

Major Trauma networks were introduced in 2012 to improve care for patients with major traumatic injuries. Current evidence suggests that this has been successfully achieved, however, there are implications for ‘routine trauma care’ of patients who attend a major trauma centre.

Methods

We assessed time from injury to surgery in August to October in 2011 and 2019. We also assessed the National Hip Fracture Database outcomes for time to surgery for hip fracture patients.

Results

Average wait times for ankle surgery increased from 4.9 days (18 patients) in 2011 to 7.0 in days (26 patients) in 2019, whilst for distal radius fracture surgery increased from 3.9 days (36 patients) to 6.5 days (23 patients); the percentage of patients who received their hip fracture surgery within the recommended 36 hours was 53.7% in 2011 (322 patients) compared to 66.7% in 2019 (375 patients).

Conclusion

The wait times for ‘routine trauma care’ have increased since the introduction of the major trauma network. This is probably due to the large demand on major trauma centres presented by complex trauma patients. However, the number of patients undergoing hip fracture surgery within 36 hours has improved, probably driven by the NHS tariff for hip fracture care. Changes to the current major trauma system or an increase in resources are required to help reverse this trend.
He’s frequency formula to fractal undamped Duffing equation
Authors: Feng Guang-Qing
Published: February 2021

Nonlinear oscillation is an increasingly important and extremely interesting topic in engineering. This article completely reviews a simple method proposed by Ji-Huan He and successfully establishes a fractal undamped Duffing equation through the two-scale fractal derivative in a fractal space. Its variational principle is established, and the two-scale transform method and the fractal frequency formula are adopted to find the approximate frequency of the fractal oscillator. The numerical result shows that He’s frequency formula is a unique tool for the fractal equations.
Comparing Payments Between Sociobehavioral and Biomedical Studies in a Large Research University in Southern California
Authors: Brown Brandon , Marg Logan , Michels Emily , Zhang Zhiwei , Kuzmanović Dario , Dubé Karine , Galea Jerome T
Published: February 2021

Given the dearth of regulatory guidance and empirical research on practices of providing payments to research participants, our study aimed to examine whether there were significant differences in payment amounts between sociobehavioral and biomedical studies and to examine study factors that may explain payment differences. This study reviewed 100 sociobehavioral and 31 biomedical protocols. Results showed that both biomedical studies and sociobehavioral studies had a wide variation of payments and, on average, the biomedical studies paid significantly more. Additionally, more biomedical studies offered payment than sociobehavioral studies. The primary factors that explained differences in payment amounts between sociobehavioral and biomedical studies were the number of study visits, study time, participation type, risk level, and research method. These findings provide pilot data to help inform future ethical decision-making and guidance regarding payment practices.
Injury Prevention Programs for Throwing Injuries in Softball Players: A Systematic Review
Authors: Paul Jonathan , Brown Symone M. , Mulcahey Mary K.
Published: February 2021

Context:

Throwing-related injuries occur commonly in softball players. Preventative programs can be implemented to assist in identifying and correcting risk factors that could potentially lead to injury and therefore time missed from both practice and games.

Objective:

The purpose of this study was to determine if position-specific injury prevention programs have been developed to decrease the risk of throwing-related injuries in softball players.

Data Sources:

A systematic review was performed using the PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) guidelines. PubMed, PMC, and EBSCO were searched for articles on injury prevention programs using the following key terms: softball, injury prevention, throwing injuries, pitcher, and shoulder.

Study Selection:

Studies that involved fast-pitch softball and included female participants as well as rehabilitation programs were included. Articles that highlighted slow-pitch softball or did not include female participants were excluded.

Level of Evidence:

Level 1.

Data Extraction:

The initial search identified 1605 articles. After implementing a filter, 131 articles remained. Thirteen articles were screened out as duplicates. After screening for inclusion criteria, 7 articles remained and were included in the systematic review.

Results:

Decreased range of motion (ROM) in both the upper and the lower extremities, unbalanced muscular strength, and fatigue were identified as risk factors for throwing injuries in softball players. Within the upper extremity, strength and ROM of the rotator cuff muscles, biceps, and extensors of the forearm were emphasized. The main focus of the lower extremity was the strength of the gluteal muscles and ROM of the lumbopelvic-hip complex. Only 1 study detailed an injury prevention program for softball players. The prevention program outlined was generalized for all softball players and was not position specific.

Conclusion:

There is a paucity of information about injury prevention programs for softball players. Of the evidence analyzed, balanced strengthening of the upper and lower extremities while maintaining dynamic range of motion was frequently utilized in developing an injury prevention program.
Excellent Outcome of Acute Necrotizing Encephalopathy in an Adult With Bacterial Infections, Case Report
Authors: Wang Yan , Younce John R. , Perlmutter Joel S. , Mar Soe S.
Published: February 2021

Acute necrotizing encephalopathy (ANE) is a rare para-infectious encephalopathy that classically occurs in children. However, ANE should be considered in the differential diagnosis of adults with symmetric brain lesions after a prodromal illness given recent reports of coronavirus disease of 2019 (COVID-19) to presumably cause ANE in adults. We report a case of a 29-year-old male presenting with fever, malaise, and rapid deterioration into coma. Brain magnetic resonance imaging revealed multifocal symmetric areas of diffusion restriction and surrounding vasogenic edema involving bilateral thalami, pons and cerebellar hemispheres with a core of susceptibility artifact, and minimal thalamic contrast enhancement, most consistent with ANE. Extensive infectious workup revealed isolated Escherichia coli and Neisseria gonorrhoeae in his urine. Despite the severe encephalopathy on initial presentation, the patient improved with intravenous antibiotics and supportive management with minimal residual deficits at 9 months follow-up. We aim to provide an overview of the radiological features, differential diagnosis, treatment and prognosis of ANE. Becoming familiarized with this rare but devastating disease will improve detection, treatment, and ultimately prognosis, especially in the era of a new pandemic.
COVID-19: The Oral and Maxillofacial Surgery Experience, Oxford, UK
Authors: Visholm Toby M. , Sandhu Neha , Dhariwal Daljit K.
Published: February 2021

Study Design:

In response to the COVID-19 pandemic the Oxford Oral and Maxillofacial Surgery Department, that operates as a Hub and Spoke model underwent several changes to its structure to respond to the change in service. This study is an audit of all emergency patients seen during a 10-week period and compared these patients to the same time period 1-year previous.

Objective:

The objective was to observe the change in the service provision during the COVID-19 pandemic.

Methods:

This study prospectively recorded all the emergency referrals, inpatient admissions and emergency outpatient reviews during a 10-week period, this was compared to data from the same time period in 2019.

Results:

The unit saw a statistically significant decrease in the number of facial lacerations (p = 0.0007) and fractured mandibles (p = 0.0067) and received a statistically significant increase in patients presenting with dental abscesses (p = 0.0067). Average length of inpatient stay was reduced from 2.4 days to 1.7; of these patients significantly less were reviewed face to face (p = 0.026) in favor of telemedicine options.

Conclusions:

During this period, the hub and spoke model allowed the service to quickly adapt during the COVID pandemic aiding the dissemination of new guidelines and establishing hub and spoke local consultant led daily emergency and follow up clinics. The Specialist Training Registrars were located in the central hub which allowed the service to have 24-hour resident senior decision makers and enabled the redeployment of junior doctors. The authors believe that the Hub and Spoke model allowed their workforce and resources to best serve their patient population.
Notes from the Field: Results from the Parent Acceptance of Pediatric Integrated Care Survey
Authors: Bruni Teryn , Birnbaum Richard , Turnier Luke , Caserta Abigail , Maragakis Alexandros , Tennant Katherine , Lancaster Blake
Published: February 2021

Objective:

To collect data and gain an understanding of parental satisfaction with and attitudes toward treatment in a pediatric integrated primary care (IPC) model.

Data Sources:

Primary data were collected across the United States over the course of a few months.

Study Design:

The 35-item, Parent Acceptance of Pediatric Integrated Care Survey (PAPICS) was developed by a panel of IPC experts. The survey was then distributed through the Qualtrics Panels Service with recruited participants (i.e., parents with children under 18-years-old) receiving a $4.00 incentive for their involvement.

Data Collection/Extraction Methods:

A single exploratory factor analysis was performed along with four factor retention tests and clinical judgment to guide factor selection. A 5-factor structure was selected.

Principal Findings:

Parents reported a high level of comfort with an IPC model and a favorable attitude toward child therapy, with some concerns regarding psychological stigma and privacy. Notable variation in parents’ beliefs regarding one-on-one psychological service delivery were observed.

Conclusions:

Results provided evidence for parental openness to an IPC model. Findings also highlighted potential fundamental misunderstandings regarding evidence-based psychological treatment methods for children and adolescents.
Using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) in Supervision
Authors: Evans Alison , Griffith Gemma M , Crane Rebecca S , Sansom Sophie A
Published: February 2021

The Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) is a useful framework for supporting teacher development in the context of mindfulness-based supervision (MBS). It offers a framework that enhances clarity, develops reflexive practice, gives a structure for feedback, and supports learning. MBS is a key component of Mindfulness-Based Program (MBP) teacher training and ongoing good practice. Integrating the MBI:TAC within the MBS process adds value in a number of ways including: offering a shared language around MBP teaching skills and processes; framing the core pedagogical features of MBP teaching; enabling assessment of developmental stage; and empowering supervisees to be proactive in their own development. The paper lays out principles for integrating the MBI:TAC framework into MBS. The supervisor needs awareness of the ways in which the tool can add value, and the ways it can inadvertently interrupt learning. The tool enables skills clarification, but the learning process needs to remain open to spontaneous experiential discovery; it can enable structured feedback but space is also needed for open reflective feedback; and it can enable conceptual engagement with the teaching process but space is needed for the supervisee to experientially sense the teaching process. The tool needs to be introduced in a carefully staged way to create optimal conditions for learning at the various stages of the MBP teacher-training journey. Practical guidance is presented to consolidate and develop current practice. The principles and processes discussed can be generalized to other forms of reflective dialogue such as mentoring, tutoring and peer reflection groups.
The Case for Regulating Huawei
Authors: Alon Ilan , Zhang Wenxian , Lattemann Christoph
Published: February 2021

Huawei’s growth overseas has paralleled that of China Inc ( Li and Farrell, 2020 ). Through favorable policies such as the Belt and Road Initiative, China has paved the way for Chinese multinationals to capture global markets, acquire and exploit new technologies, and have privileged access to local resources. In turn, Huawei has played an important role in the development of China Inc., its technological capabilities and global diplomatic relations. But Huawei plays by a different set of rules: it has been accused of unfair and illegal practices, and for breaking international norms. This perspective explores the need for regulatory oversight of Huawei.
Sweet Syndrome precipitated by Mycobacterium abscessus in a Laotian Man with Autoantibodies to Interferon Gamma
Authors: Thapa Priyenka , Mohr Kayla , Campbell Katelynn K. , Saccente Michael
Published: February 2021

Autoantibodies to interferon γ, part of the first line of defense in the human immune response, constitutes a rare form of an acquired immunodeficiency in HIV-uninfected adults that can predispose to disseminated atypical mycobacterial infection. Particularly, this has been described in people of Southeast Asian origin. In this case report, we describe a previously healthy, Laotian man who presented with skin lesions consistent with Sweet syndrome that were later found to be precipitated by disseminated atypical mycobacterial disease. Extensive immunological workup revealed the patient to have autoantibodies to interferon γ, rendering him susceptible to this infection. Our report demonstrates a complex case with a multilayered diagnosis, while inviting perspective from multiple specialties. This enigmatic case emphasizes the importance of a broad differential with special attention to demographics while demonstrating the difficulty in treating certain atypical infections that are inherently multidrug resistant.
Resistance Training Reduces Age- and Geography-Related Physical Function Discrepancies in Older Adults
Authors: Baker Breanne S. , Miller Kristin , Weitzel Kelsey J. , Duren Dana L. , Gammon Robin , Mills-Gray Susan , Ball Stephen D.
Published: February 2021

Comorbidities affecting physical function increase with advanced-age and rural living. This study investigated the degree of benefit from resistance training (RT) in older adults based on age (50–89 years), location (urban vs. rural), and program duration (10 vs. 8-weeks). 260 participants completed pre- and post-program dynamic and static tasks and flexibility testing. Paired and independent t-tests and one-way and repeated measures ANOVAs were used to test group improvements. All ages improved performance (all p ≤ .002) but those in their 50’s improved flexibility the most and those in their 60’s improved 30STS more and tandem balance less than those in their 80’s. Both rural and urban participants improved in all areas (all p ≤ .002), but rural participants reported greater improvements in tandem balance. Both 10- and 8-week classes improved performance (all p ≤ .001), but 8-week participants improved dynamic tasks and tandem balance more. RT can reduce functional discrepancies in older adults and rural residents.
Motukoreaite, a new hydrated carbonate, sulphate, and hydroxide of Mg and Al from Auckland, New Zealand
Authors: Rodgers K. A. , Chisholm J. E. , Davis R. J. , Nelson C. S.
Published: February 2021

Motukoreaite occurs as relatively abundant, white, clay-like cement in both beach-rock and basaltic volcanic tuffs on the flanks of a small, extinct, late Pleistocene, basaltic cone at Brown's Island (Motukorea), within Waitemata Harbour, Auckland, New Zealand (36° 50′ S., 174° 35′ E.). The occurrence was originally recorded by Bartrum (1941) as ‘beach limestone’ found at two places of the island's shore. The beach-rock consists of a grain-supported fabric of poorly sorted, well-rounded, alkali-olivine basalt pebbles and granules, subangular to sub-rounded fresh olivine sand and abraded sand- and gravel-sized bioclasts in a colourless to pale yellow-green aphanocrystalline matrix of motukoreaite. Additional detritals include quartz, feldspar, and sedimentary rock fragments. Stereoscan examination of the surface of pieces of the cement prised from the beach-rock showed a box-work of plate-like crystals with a hexagonal form in which individuals measured about 3×3×0·02 microns (fig. 1).

Wet-chemical analysis of a separate of the cement containing some 5 % quartz and traces of calcite and goethite gives SiO2 5·55, Al2O3 17·87, Fe2O3 0·73, CaO 0·92, MgO 22·98, MnO 0·70, ZnO 0·56, Na2O 0·71, K2O 0·10, CO2 9·32, SO3 10·00, H2O+ 19·62, H2O- 10·35, sum 99·41 %. The unit-cell formula using obtained unit-cell constants and measured specific gravity 1·43) is (Na0·73K0·07)∑0·80(Mg18·13Mn0·32Zn0·21)∑18·66Al11·15(CO3)6·22(SO4)3·97 (OH)51·1927·20H2O. Of several idealized formulae that may be proposed NaMg19Al12(CO3)6.5 (SO4)4(OH)54·28H2O is preferred.