bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric clinicians’ perspectives on assessing concerns about young children’s social-emotional wellbeing in primary care
Authors: Merle James L , Carroll Allison J , Mohanty Nivedita , Berkel Cady , Scherr Courtney , Davis Matthew M , Wakschlag Lauren S , Smith Justin D
Published: March 2023

We surveyed pediatric primary care clinicians working in Federally Qualified Health Centers about their perceptions of children’s social-emotional wellbeing. We identified clinician’s current methods for assessing social-emotional wellbeing in practices, perceived implementation barriers to providing behavioral health care, and interest in adopting a validated, low-burden developmentally sensitive parent-report instrument for screening for social-emotional wellbeing in young children. We surveyed 72 PCCs working in FQHCs from 9 US states. Analyses included examining central tendencies, correlations, analysis of variance, and group differences via t-tests. Average PCC perceptions of social-emotional wellbeing importance for overall health were statistically significantly higher than their confidence in providing care for common social-emotional wellbeing concerns (mean difference = 1.31, 95% CI = 1.13–1.49). PCCs expressed low satisfaction with currently available screening measures for identifying concerns in social-emotional wellbeing. Fewer than half of clinicians reported using any standardized parent-reported measure for identifying concerns in social-emotional wellbeing. Assessment methods and decision tools that improve clinician confidence concerning risk indications are needed, particularly at the critical early childhood period. Policymakers and payers ought to facilitate funding mechanisms that support pediatric PCCs in identifying early concerns in social-emotional wellbeing and providing referral guidance to evidence-based interventions to support parents and caregivers.
The different effects of collective narcissism and secure ingroup identity on collective action and life satisfaction among LGBTQ+ individuals
Authors: Górska Paulina , Stefaniak Anna , Matera Joanna , Marchlewska Marta
Published: March 2023

For LGBTQ+ community members, one way to cope with the discrimination they experience is through a stronger ingroup identity. However, not all types of ingroup identity may be equally beneficial to LGBTQ+ individuals. A longitudinal ( N = 1,044) and a cross-sectional ( N = 8,464) study among LGBTQ+ people in Poland demonstrated that collective narcissism was a positive predictor of group-based anger (Study 2) and had a positive reciprocal relationship with group relative deprivation (GRD; Study 1), however, it was negatively related to life satisfaction and exhibited a stronger positive link with nonnormative than normative collective action. Secure LGBTQ+ identification was not longitudinally predicted by GRD (Study 1) and showed a weaker positive association with group-based anger (Study 2). It had a reciprocal positive relationship with life satisfaction and was a stronger predictor of normative than nonnormative collective action. These results show that whereas secure ingroup identity is a clearly positive coping mechanism, the effects of collective narcissism are mixed.
The politics of regional integration: Domestic support for the enlargement of Mercosur in South America
Authors: Araujo André Leite
Published: March 2023

While there has been scholarly attention to the politics of the third wave of regionalism in South America, this typically focuses on the performance of the Executive Branch rather than the domestic constraints. This article innovatively compares the behaviour of Mercosurian parliaments to understand their role in regional integration. It contributes to Foreign Policy Analysis, by drawing on Qualitative Comparative Analysis to systematically identify the configurations of conditions for rapid approval of enlargement treaties and investigate the impact of national parliaments. Nine cases are analysed related to the episodes of enlargement of Mercosur to empirically test the political conditions to achieve fast approval of treaties. The key finding is that domestic support (channelled in national parliaments) is important to confirm and conduct international projects – and specifically regional integration. This has implications for understanding the possibilities for how future accessions to Mercosur and other regional organisations will take place.
Analysis of the explosion resistance of an I-shaped steel‒concrete composite structure under contact explosion
Authors: Liu Jianyu , Li Yuan
Published: March 2023

Reinforced concrete and steel structures are commonly used in bridge construction; thus, researchers have conducted relatively comprehensive analyses of their dynamic responses and damage mechanisms under blast loads. However, for a new type of I-shaped steel‒concrete composite structure with various structural performance advantages, there remains a lack of effective experiments and analyses of damage modes. In this paper, three I-shaped steel‒concrete composite specimens are designed and fabricated, and explosion experiments under different explosion scenarios are performed. The experimental results show that under the support of an I-shaped steel plate, the structure has a strong ability to withstand the blast load. The concrete damage area on the rear blast surface is small, and the I-shaped steel plate does not yield under a small explosive equivalent. Based on the experimental results, the dynamic response and failure behavior of the I-shaped steel‒concrete composite structure are numerically evaluated using Autodyn explicit dynamic analysis software. By considering different working conditions and by taking the deformation and damaged areas of the structure as the damage index, the key explosion resistance factors of the structure under contact explosion are studied. Some important structural parameters greatly influence the explosion resistance of the structure, including the thickness of the I-shaped steel plate; however, increasing the strength of concrete does not significantly improve the explosion resistance of the composite structure.
Verified play, precarious work: GamerGate and platformed authenticity in the cultural industries
Authors: Hewa Nelanthi , Tran Christine H.
Published: March 2023

This article argues that GamerGate, a critical hashtag event in the history of digital harassment, is key to understanding contemporary identity verification systems and digital labour. We build our argument from a comparative analysis of two case studies: (1) digital journalistic responses to GamerGate and (2) Twitter’s account verification ‘checkmark’ system from 2021 to 2022. These phenomena showcase the linkages between the gendered and raced policing of journalists and users during GamerGate and the rise of ‘authenticity’ as a key resource for journalists and other platformed creators in the present. We draw on digital games, journalism and critical media studies to analyse the work of ‘authenticity’. We argue that platform affordances such as identity verification badges are fundamentally implicated in the work of users to appear ‘real’, even as the visibility requisite for realness brings uneven risks for marginalised cultural workers.
Freedom From Symbolic Violence? Facilitators and Barriers to Participatory Practices in Youth Justice
Authors: Creaney Sean , Burns Samantha
Published: March 2023

The Child First Participation agenda in England marks a paradigm shift in youth justice. This solidifies a commitment to democratising decision-making processes with children. Drawing on interviews with children and professionals, this article explores the enablers and constraints to Child First participation in youth justice services, including how risk-oriented practices, managerialism and neo-liberal mechanisms constrain positive relationships with children. In this article, Bourdieu’s concept of ‘symbolic violence’ is used to explore systemic problems when engaging children in co-producing youth justice interventions. The article suggests how participatory practices can provide freedom from symbolic violence for both children and practitioners.
TimberSleuth: Visual anomaly detection with human feedback for mitigating the illegal timber trade
Authors: Datta Debanjan , Self Nathan , Simeone John , Meadows Amelia , Outhwaite Willow , Walker Linda , Elmqvist Niklas , Ramakrishnan Naren
Published: March 2023

Detecting illegal shipments in the global timber trade poses a massive challenge to enforcement agencies. The massive volume and complexity of timber shipments and obfuscations within international trade data, intentional or not, necessitates an automated system to aid in detecting specific shipments that potentially contain illegally harvested wood. To address these requirements we build a novel human-in-the-loop visual analytics system called TIMBERSLEUTH. TimberSleuth uses a novel scoring model reinforced through human feedback to improve upon the relevance of the results of the system while using an off-the-shelf anomaly detection model. Detailed evaluation is performed using real data with synthetic anomalies to test the machine intelligence that drives the system. We design interactive visualizations to enable analysis of pertinent details of anomalous trade records so that analysts can determine if a record is relevant and provide iterative feedback. This feedback is utilized by the machine learning model to improve the precision of the output.
Long-standing undiagnosed foreign body aspiration with concomitant pulmonary tuberculosis in an Immunocompetent man
Authors: Chaurasia Sheetal , Prabha Blessy B , Ray Shalina , Chowdhury Saurav
Published: March 2023

Foreign body aspiration is a rare clinical finding in adults, among which very few are reported, probably due to absence of classical clinical features in adults when compared to children and due to lack of awareness. We present a 57-year-old with chronic productive cough who was diagnosed to have pulmonary tuberculosis (TB), complicated by long-standing foreign body in the tracheobronchial tree. There are many cases reported in literature where there have been misdiagnosis with respect to pulmonary TB as foreign body or foreign bodies as pulmonary TB. However, this is the first case where retained foreign body and pulmonary TB coexisted in a patient.
Well, I’ll Be Damned: Living Differently in White Bodies
Authors: Sheridan Robyn Stout , McManimon Shannon K.
Published: March 2023

As two white women attempting to live differently in white bodies we are damned. Any choice we make is embedded in white supremacy. Damned if we do/speak/act, damned if we don’t. Recognizing this damnation, we began asking where else we could go and how else we could live. In this article, we conceptualize what emerges between “damned if I do, damned if I don’t” as the possibility of disordering whiteness and living differently. We conceptualize our method in this piece as relationship. In relationship, we trace the necessary but impossible, discursive, embodied, and geographic space that is damnation.
Early is Not Superior to Late Endoscopic Intervention for Acute Cholangitis
Authors: Lyu Yunxiao , Ye Shenjian , Wang Bin
Published: March 2023

Background

Acute cholangitis (AC) is a common emergency with a significant mortality risk. This study aimed to compare urgent, early, and late endoscopic retrograde cholangiopancreatography (ERCP) for AC.

Method

We retrospectively evaluated patients diagnosed with AC from June 2016 to May 2021. According to the time of ERCP, patients were divided into urgent (≤24 h), early (24-48 h), and late (≥48 h) groups. Primary outcomes were technical success, in-hospital mortality, and 30-day mortality. Secondary outcomes were the length of hospital stay (LOS), ERCP-related adverse events, and 30-day readmission.

Results

We divided 121 patients who underwent ERCP into urgent (N = 15), early (N = 19), and late groups (N = 87). There was no in-hospital mortality and no significant difference in technical success (93.3% (urgent) vs 89.5% (early) vs 96.6% (late); P = .41) and 30-day mortality ( P = .82). LOS in the urgent and early groups was shorter than that in the late group (13.93 days vs 8.82 days vs 14.20 days, respectively; P = .02). There was no difference between groups for ERCP-related adverse events and 30-day readmission rates.

Conclusions

Urgent or early ERCP was not superior to late ERCP for technical success and 30-day mortality. However, urgent or early ERCP was associated with shorter LOS than late ERCP.
Non-metric distance judgements are influenced by image projection geometry and field of view
Authors: Ruta Nicole , Ganczarek Joanna , Pietras Karolina , Burleigh Alistair , Pepperell Robert
Published: March 2023

Despite its mathematical simplicity and ubiquity in imaging technology, there has long been doubt about the ability of linear perspective to best represent human visual space, especially at wide-angle fields of view under natural viewing conditions. We investigated whether changes to image geometry had an impact on participants’ performance, specifically in terms of non-metric distance estimates. Our multidisciplinary research team developed a new open-source image database to study distance perception in images by systematically manipulating target distance, field of view, and image projection using non-linear natural perspective projections. The database consists of 12 outdoor scenes of a virtual three-dimensional urban environment in which a target ball is presented at increasing distance, visualised using both linear perspective and natural perspective images, rendered, respectively, with three different fields of view: 100°, 120°, and 140° horizontally. In the first experiment ( N = 52), we tested the effects of linear versus natural perspective on non-metric distance judgements. In the second experiment ( N = 195), we investigated the influence of contextual and previous familiarity with linear perspective, and individual differences in spatial skills on distance estimations. The results of both experiments showed that distance estimation accuracy improved in natural compared with linear perspective images, particularly at wide-angle fields of view. Moreover, undertaking a training session with only natural perspective images led to more accurate distance judgements overall. We argue that the efficacy of natural perspective may stem from its resemblance to the way objects appear under natural viewing conditions, and that this can provide insights into the phenomenological structure of visual space.
Update on the role of upadacitinib in the treatment of adults with moderately to severely active ulcerative colitis
Authors: Ernest-Suarez Kenneth , Panaccione Remo
Published: March 2023

With further knowledge of the pathogenesis of inflammatory bowel disease, small oral molecules have become available, including the Janus kinase (JAK) inhibitors. Upadacitinib (UPA) is a selective JAK1 inhibitor and has become the newest drug in this class, with recent approval for the management of moderate-to-severe ulcerative colitis. The large phase III program (including the U-ACHIEVE and U-ACCOMPLISH parallel induction trials and the U-ACHIEVE Maintenance trial) demonstrated superiority over placebo, for all primary and secondary endpoints including key clinical, endoscopic, and histological outcomes utilizing 45 mg orally (po) once daily (OD) during induction and either 30 mg or 15 mg po OD in maintenance. From a safety perspective, UPA has proven to be a safe and well-tolerated medication across immune-mediated diseases with manageable adverse risks such as an increase in herpes zoster. Proper discussion and patient profiling are essential when positioning UPA, considering efficacy and potential risks associated with this highly effective medication.
RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study
Authors: Gauhar Vineet , Chai Chu Ann , Chew Ben H , Singh Abhishek , Castellani Daniele , Tailly Thomas , Emiliani Esteban , Keat William Ong Lay , Ragoori Deepak , Lakmichi Mohamed Amine , Teoh Jeremy Yuen-Chun , Traxer Olivier , Somani Bhaskar Kumar
Published: March 2023

Introduction:

With several single-use ureteroscopes now available, our aim was to analyze and compare data obtained globally from high-volume centers using both disposable and reusable flexible ureteroscopes and see if indeed in real-world practice either scope has a distinct advantage.

Methods:

Retrospective analysis was performed on the FLEXOR registry, which was created as a TOWER group (Team of Worldwide Endourological Researchers, research wing of the Endourological Society) endeavor. Patients who underwent retrograde intrarenal surgery (RIRS) for renal stones from January 2018 to August 2021 were enrolled from 20 centers globally. A total of 6663 patients whose data were available for analysis were divided into Group 1 (Reusable scopes, 4808 patients) versus Group 2 (Disposable scopes, 1855 patients).

Results:

The age and gender distribution were similar in both groups. The mean stone size was 11.8 mm and 9.6 mm in Groups 2 and 1, respectively ( p < 0.001). Group 2 had more patients with >2 cm stones, lower pole stones and of higher Hounsfield unit. Thulium fiber laser (TFL) was used more in Group 2 ( p < 0.001). Patients in Group 2 had a slightly higher stone-free rate (SFR) (78.22%) and a lower number of residual fragments (RFs) compared with Group 1 ( p < 0.001). The need for further treatments for RF and overall complications was comparable between groups. On multivariate analysis, overall complications were more likely to occur in elderly patients, larger stone size, lower pole stones, and were also more when using disposable scopes with longer operative time. RFs were significantly higher ( p < 0.001) for lower pole, larger, harder, multiple stones and in elderly.

Conclusion:

Our real-world practice observations suggest that urologists choose disposable scopes for bigger, lower pole, and harder stones, and it does indeed help in improving the single-stage SFR if used correctly, with the appropriate lasers and lasing techniques in expert hands.
Enhancement and Repair of Degenerative Intervertebral Disc in Rats Using Platelet-Rich Plasma/Ferulic Acid Hydrogel
Authors: Chai Qiang , Zhang Baining , Da Yifeng , Wang Wenlei , Gao Yidan , Yao Mingyu , Zhu He , Yang Xuejun , Zhu Yong
Published: March 2023

Background

Intervertebral degenerative disc (IDD) disease is one of the most common clinical conditions causing low back pain. The main objective of this study was to investigate the repair effect of platelet-rich plasma (PRP) and ferulic acid (FA) hydrogel compound on degenerative discs in rats in combination with bioengineering technology, which may provide a strong theoretical basis for the future treatment of IDD.

Methods

Forty-five male Sprague-Dawley rats were randomly divided into groups A-F; MRI was performed in each group at 0, 4, and 8 weeks after injection; and disc tissues were obtained after executing the animals. The histomorphology, apoptosis, and protein synthesis of intervertebral discs in each group were observed by hematoxylin-eosin, Masson, terminal deoxynucleotidyl transferase dUTP nick end labeling staining, and Western blot.

Results

The release concentration of all groups reached the peak at 12 hours, and the highest concentration was found in the hydrogel/PRP/FA group at the same time. The MTT assay showed that hydrogel/PRP/FA is well-cytocompatible. The results of animal experiments show that hydrogel/PRP/FA has a good effect on degenerative intervertebral disc in rats.

Conclusion

PRP/FA-rich hydrogel compound plays an active role in promoting extracellular matrix synthesis, strengthening and repairing degenerated intervertebral discs in rats.
Dental drill noise reduction using a commercially-available earplug device
Authors: Jiang Pingfei , Atherton Mark , Millar Brian J.
Published: March 2023

Aim:

The dental handpiece noise in a dental surgery is concerning to both patients and staff as a major cause of dental phobia in patients and potential hearing loss in clinical staff. High-frequency noise generated by dental handpieces is considered to be the worst of the many noises in a dental clinic. Methods to reduce this noise have been proposed and either passive or active noise reduction headphones are often suggested. However, in a dental surgery environment, the need for good verbal communication with the patient needs to be maintained. As a result, this paper aims to evaluate one proprietary anti-noise device considered suitable for this specific purpose.

Methods:

Lab-based experiments were set up and carried out to evaluate QuietOn, using GRAS 43AG-1 Ear and Cheek Simulator to mimic a section of the human head and ear to represent the acoustic characteristics of an actual ear. Two types of dental drill noise recordings, one for electric motor-driven and another one for air turbine-driven, were played back through high-definition speakers. Sound data captured by the simulator are then visualised and plotted using MATLAB for analysis.

Main findings:

QuietOn is effective at low frequencies (< 1kHz). However, when dealing with high-frequency noise such as dental handpieces it is ineffective yet subdues verbal communication.

Conclusions:

Further development of passive or active noise cancellation earplugs is still needed to target dental handpiece noise while maintaining verbal communication.
The satisfaction of the undergraduate nursing classroom teaching quality based on the Kano model in China
Authors: Chen Jiu-Li , Zheng Li-Na
Published: March 2023

Objectives:

To investigate the satisfaction of the undergraduate nursing classroom teaching quality based on the Kano model and provide a reference for improving the overall quality of educational services.

Methods:

A total of 621 sophomores and juniors of nursing at Hubei University of Medicine were selected to conduct questionnaires based on the Kano model using convenient sampling.

Results:

The 16 items are all a one-dimensional factor. The satisfaction and importance are 0.77 to 0.86 and −0.58 to −0.80, respectively. In the quadrant analysis chart, there are four items in the dominant area, three items for improvement, three in the observation area, and six in the retention area.

Conclusion:

Analyzing the satisfaction of nursing undergraduates’ classroom teaching quality can help us effectively understand the intrinsic needs of students and improve the overall quality of nursing undergraduates’ curriculum teaching services.
A randomized clinical trial of Premaquick biomarkers versus transvaginal cervical length for pre-induction cervical assessment at term among pregnant women
Authors: Okafor Chigozie G , Eleje George U , Adinma Joseph I , Ikechebelu Joseph I , Umeh Eric O , Okafor Chisolum O , Ugwu Emmanuel O , Ugboaja Joseph O , Nwosu Betrand O , Ezeama Chukwuemeka O , Udigwe Gerald O , Okoro Chukwuemeka C , Egeonu Richard O , Ezema Evaristus C , Umeononihu Osita S , Okpala Boniface C , Okafor Chidinma C , Ofojebe Chukwuemeka J , Ilika Chito P , Oguejiofor Charlotte B , Ogabido Chukwudi A , Umeokafor Chijioke C , James John E , Obiagwu Hillary I , Okafor Lazarus U , Obidike Afam B , Okam Princeston C , Okeke Kenneth N , Inya Anselem O , Njoku Tobechi K , Eleje Lydia I
Published: March 2023

Objectives:

To compare Premaquick biomarkers (combined insulin-like growth-factor binding protein 1 and interleukin-6) and cervical length measurement via transvaginal ultrasound for pre-induction cervical evaluation at term among pregnant women.

Methods:

A randomized clinical trial of consenting pregnant women at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. The women were randomized equally into Premaquick group ( n = 36) and transvaginal ultrasound group ( n = 36). The cervix was adjudged ‘ripe’ if the Premaquick test was positive or if the trans-vaginal measured cervical length was less than 28 mm. The primary outcome measures were the proportions of women who needed prostaglandin analogue for cervical ripening and the proportion that achieved vaginal delivery after induction of labour. The trial was registered in Pan African clinical trial registry (PACTR) registry with approval number PACTR202001579275333.

Results:

The baseline characteristics were similar between the two groups ( p > 0.05). There was no statistically significant difference between the two groups in terms of proportion of women that required prostaglandins for pre-induction cervical ripening (41.7 versus 47.2%, p = 0.427), vaginal delivery (77.8 versus 80.6%, p = 0.783), mean induction to delivery interval (22.9 ± 2.81 h versus 24.04 ± 3.20 h, p = 0.211), caesarean delivery (22.2 versus 19.4%, p = 0.783), proportion of neonate with birth asphyxia (8.30 versus 8.30%, p = 1.00) and proportion of neonate admitted into special care baby unit (16.7 versus 13.9%, p = 0.872). Subgroup analysis of participants with ‘ripe’ cervix at initial pre-induction assessment showed that the mean induction to active phase of labour interval and mean induction to delivery interval were significantly shorter in Premaquick than transvaginal ultrasound group.

Conclusion:

Pre-induction cervical assessment at term with either Premaquick biomarkers or transvaginal ultrasound for cervical length is effective, objective and safe with similar and comparable outcome. However, when compared with women with positive transvaginal ultrasound at initial assessment, women with positive Premaquick test at initial assessment showed a significantly shorter duration of onset of active phase of labour and delivery of baby following induction of labour.
A rare case report of uterine didelphys, in which one uterus carried a pregnancy while the other prolapsed, with a successful pregnancy outcome resulting in an alive-term delivery
Authors: Yayna Amanuel Admasu , Ayza Adane , Dana Wokil Wolde , Desalegn Abinet , Kassaye Getu , Yemaneh Amdetsion , Geta Amanuel , Shote Belachewu , Gure Tadesse , Tesfaye Adise
Published: March 2023

Uterine didelphys is a rare congenital anomaly of the female reproductive organs, designated by the presence of the uterus as a pair of organs. This occurs as a result of the failure of the embryonic fusion of Müllerian ducts. Women with this abnormality have a paired uterus with two cervices and usually a double vagina. The chance of having a pregnancy in one of the pairs along with prolapse of the other is very low in a didelphic uterus. To the best of the author’s knowledge, only one case of such an event has been reported so far. In this case report, we are reporting on a 28-year-old gravida four para three (all are vaginal deliveries, 2 are alive, healthy, and term deliveries without any compilation; 1 is an early neonatal death delivered at 8 months) woman who presented to our hospital with a complaint of a protruding mass per vagina for 14 days in the presence of pregnancy. After she was evaluated and investigated, she was diagnosed with pelvic organ prolapse and late-preterm pregnancy. The prolapse reduced gradually as the gestational age advanced. Cesarean section was done at the gestational age of 38 weeks plus 2 days for the indication of infected pelvic organ prolapse in labor, with the outcome of a 3000 gram male alive neonate. Intraoperatively, there was uterine didelphys, one uterus holding the pregnancy while the other was prolapsing.
Can digital health apps provide patients with support to promote structured diabetes education and ongoing self-management? A real-world evaluation of myDiabetes usage
Authors: Blythin A.M. , Elkes J. , van Lindholm T. , Bhogal A. , Wilkinson T.M.A. , Saville C. , Kirk A.
Published: March 2023

Objective

Structured diabetes education has evidenced benefits yet reported uptake rates for those referred to traditional in-person programmes within 12 months of diagnosis were suboptimal. Digital health interventions provide a potential solution to improve diabetes education delivery at population scale, overcoming barriers identified with traditional approaches. myDiabetes is a cloud-based interactive digital health self-management app. This evaluation analysed usage data for people with type 2 diabetes focusing on digital structured diabetes education.

Methods

Descriptive quantitative analyses were conducted on existing anonymised user data over 12 months (November 2019–2020) to evaluate whether digital health can provide additional support to deliver diabetes education. Data was divided into two equal 6-month periods. As this overlapped the onset of COVID-19, analyses of its effect on usage were included as a secondary outcome. All data was reported via myDiabetes. Users were prescribed myDiabetes by National Health Service healthcare primary care teams. Those who registered for app use within the study period (n = 2783) were assessed for eligibility (n = 2512) and included if activated.

Results

Within the study period, n = 1245/2512 (49.6%) registered users activated myDiabetes. No statistically significant differences were observed between gender (p = 0.721), or age (p = 0.072) for those who activated (59.2 years, SD 12.93) and those who did not activate myDiabetes (57.6 years, SD 13.77). Activated users (n = 1119/1245 (89.8%)) viewed 11,572 education videos. No statistically significant differences were observed in education video views across age groups (p = 0.384), gender (p = 0.400), diabetes treatment type (p = 0.839) or smoking status (p = 0.655). Comparison of usage pre-COVID-19 and post-COVID-19 showed statistically significant increases in app activity (p ≤0.001).

Conclusion

Digital health is rapidly evolving in its role of supporting patients to self-manage. Since COVID-19 the benefits of digital technology have become increasingly recognised. There is potential for increasing diabetes education rates by offering patients a digital option in combination with traditional service delivery which should be substantiated through future research.
Effects of Virtual Care and Same-Day Access to Integrated Care on Specialty Mental Health Engagement in the Veterans Health Administration
Authors: Haderlein Taona P. , Dobalian Aram , Raja Pushpa V. , Der-Martirosian Claudia
Published: March 2023

Background:

In the Veterans Health Administration (VA), Primary Care-Mental Health Integration (PC-MHI) clinics offer mental health services embedded in primary care, a strategy shown to reduce overall specialty mental health clinic burden while facilitating prompt referrals when indicated. Among newly initiated patients, same-day access to PC-MHI from primary care increases subsequent specialty mental health engagement. However, the impact of virtual care on the association between same-day access to PC-MHI and subsequent mental health engagement remains unclear.

Objective:

To examine the effects of same-day access to PC-MHI and virtual care use on specialty mental health engagement.

Methods:

We used administrative data from 3066 veterans who initiated mental health care at a large, California VA PC-MHI clinic during 3/1/2018 to 2/28/2022 and had no previous mental health visits for at least 2 years prior to the index appointment. We conducted Poisson regression analyses to examine the effects of same-day access to PC-MHI, virtual access to PC-MHI and their combined effect on subsequent specialty mental health engagement.

Results:

Same-day access to PC-MHI from primary care was positively associated with specialty mental health engagement (IRR = 1.19; 95% CI 1.14-1.24). Virtual access to PC-MHI was negatively associated with specialty mental health engagement (IRR = 0.83; 95% CI 0.79-0.87). The positive effect of same-day access on specialty mental health engagement was smaller among patients who initiated PC-MHI in a virtual visit (IRR = 1.07) compared to in-person visits (IRR = 1.29; 95% CI 1.22-1.36).

Conclusions:

Although same-day access to PC-MHI increased overall specialty mental health engagement, the magnitude of this effect varied between in-person and virtual modalities. More research is needed to understand mechanisms of the association between virtual care use, same-day access to PC-MHI, and specialty mental health engagement.
Investigating Risk-Constraint Nexus of Construction Projects in Caribbean Small Island Developing States
Authors: Shih Hsu-Shih , Chen I-Fei , Munier Nolberto , Alcide Zena
Published: March 2023

This research identifies the critical risk factors in the management of construction projects and assesses their relationship on the project implementation constraints of cost, time, and quality, in order to gain a deeper understanding of those factors hindering project success in in Caribbean small island developing states experiencing the dilemma of transitioning to be sustainable in economy and environment. Through three-phase surveys, we identify 26 risk factors from five risk source categories that are more region-specific to influence construction project management, discover strongly positive relationships between a set of risk variables and a set of constraints, and estimate the relative importance of every dimension to the integrated risk-constraint canonical correlation. In risk categories, management has the dominant effect followed by design, contractual, and financial source. For implementation constraints, cost exhibits the most dominance, followed by time and quality. Overall, the directions and magnitudes of interactions gauged in the risk-constraint nexus provide a guideline for improving project planning, thus offering a reference value to other developing countries.
Inter- and Intraobserver Reliability of Three Different Methods Used for the Assessment of Carpal Collapse in Healthy Individuals
Authors: Yıldız Gürkan , Çilengir Atilla Hikmet , Bulut Tuğrul , Gürsoy Merve , Önder Yılmaz , Mete Berna Dirim
Published: March 2023

Introduction: Three different methods are described in the literature for the evaluation of carpal collapse. Measurements of carpal collapse by different people may affect the results. We aimed to investigate the inter and intraobserver reliability of three different methods used in carpal height measurement and to review the reference ranges for each method in healthy individuals. Methods: 179 wrist radiographs were evaluated by an orthopedist and a radiologist. Two observers made their evaluations independently of each other and unaware of each other's measurement results. They measured the carpal height ratio, the revised carpal height ratio, and the distance between the capitate-radius on each radiograph. One month later, all radiographs were reevaluated by two observers. Results: Results were analyzed by calculating the intraclass correlation coefficient. All methods had very high reproducibility. Interobserver reliability of the CH and RCH ratios were similar, and both had higher interobserver reliability scores than the CR index. In intraobserver reliability, the score of the CH ratio was higher in all measurements, and the lowest score was in the CR index. However, there was no statistical difference between the three methods in terms of inter- and intraobserver reliability. Conclusion: All three methods can be used in cases where the healthy extremity is desired to be used as a reference point in the evaluation of carpal height. Although the reliability scores of the CH ratio were found to be higher in this study, the practitioner can choose the desired method by evaluating the advantages and disadvantages of each method.
COVID-19 Associated Micro-Anastomotic Thrombosis After Abdominal Free Tissue Transfer: A Case Report and Literature Review
Authors: Vonu Peter , Safeek Rachel , Dadireddy Kalyan , Zumberg Marc , Spiguel Lisa , Sorice-Virk Sarah
Published: March 2023

The hypercoagulable state of COVID-19 infection presents a challenge to microsurgeons. While the American Society of Anesthesiologists recommends deferring surgery for 4–10 weeks for COVID-19-infected patients, little else is known regarding how to mitigate thrombotic complications for patients undergoing free tissue transfer. Here, we present a presumed COVID-19-induced hypercoagulable state in a patient undergoing abdominally based free tissue transfer for breast reconstruction as a brief review of the literature to guide clinical decision making.
Non-Small Cell Lung Cancer Presenting as Anterior Nasal Mass and Epistaxis
Authors: Ijaz Sardar H. , Aglan Amro , Nusrat Sanober , Shahnawaz Areeba , Drevets Douglas A.
Published: March 2023

Lung malignancy presentation with an uncommon metastatic site is a diagnostic challenge and often associated with poor prognosis. Nasal cavity is a rare metastatic site for any type of lung cancer. We report an unusual case of poorly differentiated adenosquamous carcinoma of the lung with widespread metastasis presenting as a right vestibular nasal mass with epistaxis. A 76-year-old male patient with chronic obstructive pulmonary disease and 80 pack-year smoking history presented with spontaneous epistaxis. He reported a new rapidly growing right-sided nasal vestibular mass first noticed 2 weeks prior. Physical examination showed fleshy mass with crusting in right nasal vestibule along with a left nasal domus mass. Imaging revealed an ovoid mass in the right anterior nostril and a large mass in the right upper lobe of the lung (RULL) along with thoracic vertebral sclerotic metastasis and large left frontal lobe hemorrhagic lesion with severe vasogenic edema. Positron emission tomography scan showed large right upper lobe mass and suspected to be the primary malignancy along with widespread metastasis. Biopsy of the nasal lesion revealed poorly differentiated non-small cell carcinoma with squamous and glandular features. The diagnosis of very poorly differentiated adenosquamous carcinoma of the lung with widespread metastasis was made. In conclusion, unusual metastatic sites with unknown primary lesions require a thorough diagnostic workup involving biopsy and extensive imaging. Lung cancer with unusual metastatic sites is inherently aggressive and associated with poor prognosis. Multidisciplinary treatment modalities should be employed keeping in view the functional status and comorbidities of the patient.
Buckling analysis of thick cylindrical shells using micropolar theory
Authors: Behzadi Parham , Salehi Manouchehr
Published: March 2023

Modeling complex materials with internal structure such as porous solids is challenging as in some cases the classical theory cannot provide precise responses. By considering the scale effects through additional kinematic descriptors and six constants for isotropic materials, the micropolar theory can accurately model complex materials like bone. This paper studies the buckling of a thick cylindrical shell using classical and non-classical theories. The cylinder’s material is considered bone and isotropic, and the critical load value for different geometries and boundary conditions has been obtained. Finally, the size-effect and importance of micropolar theory in micro dimensions are investigated. The micropolar equations are solved by a numerical solution using the 3D finite element method. The results show that decreasing the macroscopic length increases the stiffness of the cylinder more than that predicted by classical theory; In addition, by increasing the thickness of the cylinder and the importance of shear stresses, the micropolar theory predicts a more critical load than the classical one, and the result differences become more significant between micropolar and classical theories. Also, the characteristic length of the micropolar is investigated. The results show that the change of the critical load increased by moving toward the micro dimensions.
Community in Organizational Research: A Review and an Institutional Logics Perspective
Authors: Georgiou Andreas , Arenas Daniel
Published: March 2023

More than a decade ago, Thornton and colleagues added community to the inter-institutional system and argued that the community logic shapes individual and organizational behavior, determines organizing principles, and influences community–organization relationships. In justifying this addition and defining the ideal type, they drew mostly upon the literature on local communities and organizations. However, the increasing relevance of other types of communities to organization studies necessitates a re-examination and further specification of this framework. This article starts with a review of 172 papers from highly ranked organization and management journals over the last 30 years and summarizes insights on four types of communities for which discussion has flourished: communities of place, of practice, of users, and of firms. This is followed by pattern matching to explore whether these four types follow the initial description of the community logic. We find four variants of the community logic, one for each type of community. We show that all the reviewed types organize around a common boundary, which yields a new definition of the community logic. This commonality also offers scope for comparative research and reconceptualization of community–organization relationships. Furthermore, by specifying the organizing principles that vary, we extend previous research and explicate the main underpinnings of community organizing. The paper ends by suggesting avenues for future research that further embrace an institutional logics perspective on communities.
A novel case of homozygous PAX1 mutation associated with hypoparathyroidism
Authors: Hamel Benjamin L. , Kumar Seema , Heidenreich Leah , Joshi Avni , DaSilva Christiana , Asumda Faizal Z.
Published: March 2023

The PAX1 gene plays an important role in the development of the parathyroid glands and the thymus. Mouse knockout models of PAX1, PAX3, and PAX9 have been found to have hypoplastic or absent parathyroid glands. To our knowledge, there are no reported cases of PAX1-associated hypoparathyroidism in humans. We present a case of hypoparathyroidism in a 23-month-old boy with a homozygous pathogenic variant in the PAX1 gene ( PAX1 NM_006192.5 c.463_465del variant), predicted to cause an in-frame deletion of asparagine at position 155 (p.Asn155del) of the PAX1 protein. The hypoparathyroidism was unmasked after the patient developed significant hypocalcemia while receiving GoLYTELY (polyethylene glycol 3350, sodium sulfate anhydrous, sodium bicarbonate, sodium chloride, potassium chloride) for bowel cleanout. The patient had mild and asymptomatic hypocalcemia prior to hospitalization. The patient was noted to have inappropriately normal parathyroid hormone (PTH) level at the time of documented hypocalcemia thereby suggesting a diagnosis of hypoparathyroidism.

Plain language summary

The first human case of hypoparathyroidism associated with a rare genetic disorder: a case report of PAX1 gene mutation The paired box ( PAX) gene family is important for embryo development. One subfamily, PAX1, is necessary for development of the spinal column, thymus (important for the immune system development), and parathyroid (helps regulate the amount of calcium in the body). We present the case of a 23-month-old boy with known PAX1 gene mutation who came in with episodes of vomiting and poor growth. His presentation was thought to be most likely related to constipation. He was started on bowel cleanout medication and intravenous fluids. However, his calcium that had been mildly low subsequently dropped to very low levels. The level of parathyroid hormone (which helps regulate calcium levels) was inappropriately normal, meaning that his body was unable to make more, and was consistent with hypoparathyroidism. He was treated with calcium supplements and vitamin D and calcium levels normalized. He continues to be on calcium and vitamin D and calcium levels have remained stable. Doctors should keep this complication in mind when treating patients with PAX1 gene mutation.
How are secure attachment relationships fostered through talk between teachers and students who have been adopted? A conversation analysis
Authors: Phillips Rhiannon , Dallos Rudi , Minton Stephen , Keohane Peter
Published: March 2023

Despite the growing recognition of the importance of supportive teacher–student relationships to create safety for young people who have experienced early adversity and trauma, there is not a clear understanding of what factors make for positive school relationships and how these can be fostered. The aims of the study were to explore how children with challenging emotional backgrounds are supported by their key adult in school and how this occurs in the process of conversations between them. Three student–teacher pairs from a specialist school took part in a semi-structured interview about their relationship. Data was analysed using conversation analysis. Analysis found how teaching staff use several conversational markers in talk with children with attachment difficulties when emotional experiences are raised and when troubles occur in navigating difficult conversations. Recommendations for clinical practice and future research are made.
PLAST Classification of Mandibular Duplication and Associated Anomalies
Authors: Leberfinger Ashley N. , Murthy Ananth S.
Published: March 2023

Mandibular duplication is a rare subtype of craniofacial duplication. It is often associated with other anomalies including cleft palate, lingual duplication, and macrostomia. We present an 8-year-old female who had mandibular duplication presenting soon after birth with tongue-based airway obstruction. She was found to have cardiac abnormalities, split sternum, accessory tongue, cleft palate, and accessory submandibular gland. She underwent surgical correction including resection of the duplicated mandible, tongue, and submandibular gland as well as tongue lip adhesion at 12 days old. Post operatively, we were able to avoid tracheostomy and she was able to undergo successful correction of her cardiac anomaly. Literature review found 29 patients with mandibular duplication. Patients with w-shaped (type I) mandibular duplication are more likely to have airway compromise requiring intervention. Several associated anomalies were seen in patients with mandibular duplication. After analysis, we propose the PLAST classification to describe common findings: cleft Palate, Lip duplication, Airway obstruction, Salivary gland abnormalities, and Tongue duplication. Extra craniofacial anomalies such as cardiac and spinal anomalies were also noted in several patients.
Small cities and towns in global city-centred regionalism: Observations from Beijing-Tianjin-Hebei region, China
Authors: Li Yi , Jonas Andrew E.G.
Published: March 2023

This paper examines the historical and recent efforts towards constructing an integrated Beijing-Tianjin-Hebei global city-region, arguably the most politically privileged urban agglomeration in China. It considers how a progressive national policy discourse concerning city-regional integrated development is substantially focused on the central city (Beijing), thereby privileging the competitiveness and interests of the larger global city at the expense of those of the surrounding smaller cities and towns. The study argues that future research and policy informing city-regionalism should pay closer attention to the uneven power dynamics and distributional politics operating within, and often in tension with, the geopolitical orchestration of global city-regions by nation states.