bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting ureteral status below the ureteral calculi in patients undergoing ureteroscopic lithotomy
Authors: Qin Caipeng , Yin Huaqi , Du Yiqing , Li Qing , Liu Hijun , Xu Tao
Published: January 2021

Background

During ureteroscopy, severe ureter straightness or contortion may occur before the stone is passed.

Purpose

To identify clinical factors associated with distal ureteral status below the ureteral calculi in patients before surgery.

Material and Methods

From October 2016 to March 2017, 101 patients with ureteral calculi who underwent ureteroscopic lithotripsy were reviewed. Patients who lacked clinical data and underwent preoperative indwelling ureteral stent placement were excluded. Univariate and multivariate analyses were performed to determine the clinical factors associated with intraoperative findings.

Results

A total of 101 patients were enrolled in the study (mean age  =  54 years; mean stone size  =  7.9 ± 4.5 mm). Overall, 25 of the 101 patients (24.7%) were diagnosed with poor distal ureteral status defined as intraoperative ureterostenosis or contortion resulting in a ureteroscope being unable to pass during the initial attempt. Univariate analysis showed significant differences in renal parenchyma thickness, ureteral wall thickening on imaging, and stone location (all, P < 0.05) with and without poor distal ureteral status. On multivariable analysis, renal parenchyma thickness (adjusted odds ratio [aOR] 0.288; 95% confidence interval [CI] 0.099–0.838; P = 0.022) and ureteral wall thickening on imaging (aOR 6.114; 95% CI 2.015–18.548; P = 0.001) independently predicted poor distal ureteral status. However, only renal parenchyma thickness was associated with severe ureter straightness or tortuosity that resulted in conversion.

Conclusion

In conclusion, renal parenchyma thickness and ureteral wall thickening on imaging were associated with poor distal ureteral status. Therefore, patients with these predictive factors should undergo more intensive preparation before surgery.
Efficiency of diffusion-weighted MRI for differentiating radiologically similar simple and type I hydatid cysts of the liver
Authors: Dundar Ilyas , Ozgokce Mesut , Durmaz Fatma , Ozkacmaz Sercan , Turkoglu Saim , Goya Cemil
Published: January 2021

Background

Determining the nature of purely cystic hepatic lesions is essential because different kinds have different follow-ups, treatment options, and complications.

Purpose

To explore the potential of apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) for the differentiation of type I hydatid cysts (HC) and simple liver cysts (SLC), which have similar radiological appearances.

Material and Methods

This single-center prospective study was conducted during 2016–2019. Round, homogenous, anechoic liver cysts >1 cm were classified according to at least two years of imaging follow-up, radiological features, serology, as well as puncture aspiration injection reaspiration procedure and pathology results. ADC values of 95 cysts (50 type I HCs and 45 SLCs) were calculated on DWI. The differences in ADC values were analyzed by independent t-test.

Results

Of 51 patients, 28 were female, 23 were male (mean age 32.07 ± 22.95 years; age range 5–82 years). Mean diameter of 45 SLCs was 2.59 ± 1.23 cm (range 1.2–7.6 cm) and ADCmean value was 3.03 ± 0.47 (range 2.64–5.85) while mean diameter of 50 type I HCs was 7.49 ± 2.95 cm (range 2.8–14 cm) and ADCmean value was 2.99 ± 0.29 (range 2.36–3.83). There was no statistically significant difference in ADC values between type I HCs and SLCs

Conclusion

Some studies report that ADC values of type I HCs are statistically significantly lower than those of SLCs. Others suggest no significant difference. In our study with a higher number of cases, using ADC parameters similar to those in previous studies, we did not find any statistically significant difference.
Evaluation of main functional dyspepsia symptoms after probiotic administration in patients receiving conventional pharmacological therapies
Authors: Drago Lorenzo , Meroni Gabriele , Pistone Dario , Pasquale Luigi , Milazzo Giuseppe , Monica Fabio , Aragona Salvatore , Ficano Leonardo , Vassallo Roberto ,   Gastrobiota Group
Published: January 2021

Objective

Postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS) are the two main forms of functional dyspepsia (FD). Probiotics are a promising therapy for FD, but current data remains heterogeneous. This work aims to evaluate a probiotic combination of Lacticaseibacillus rhamnosus LR04 (DSM 16605), Lactiplantibacillus pentosus LPS01 (DSM 21980), Lactiplantibacillus plantarum LP01 (LMG P-21021), and Lactobacillus delbrueckii subsp. delbruekii LDD01 (DMS 22106), alone or together with other pharmacological therapies, for clinical improvement of symptoms associated with FD.

Methods

Patients with FD were enrolled and divided into two groups: PDS and EPS. Probiotic alone or combined with prokinetics, antacids, or proton-pump-inhibitors were administered for 30 days. A progressive-score scale was used to evaluate symptoms in all patients at the beginning of the trial and at 15 days after the end of treatment.

Results

A cohort of 2676 patients were enrolled (1 357 with PDS; 1 319 with EPS). All patients showed significant improvements in dyspeptic symptoms following treatment. In patients with PDS, probiotic alone resulted in the lowest prevalence of symptoms following treatment, while patients with EPS showed no clear between-treatment differences.

Conclusions

Dyspeptic symptoms were reduced following treatment in all patients.
Pathogenicity and transmissibility assessment of two strains of human influenza virus isolated in China in 2018
Authors: Zhang Cheng , Cui Huan , Wang Zhongyi , Dong Shishan , Zhang Chunmao , Li Jiaming , Meng Keyin , Sun Yucheng , Liu Juxiang , Guo Zhendong , Chen Ligong
Published: January 2021

Objective

Influenza season occurs every year in China, but its presentation was unusual in the period from December 2017 to early 2018. During this period, influenza activity was increasing across the country and was much greater than during the same period in previous years, with great harm to people’s health.

Methods

In this study, we isolated two human influenza virus strains—A/Hebei/F076/2018(H1N1) and B/Hebei/16275B/2018—from patients with severe influenza in Hebei, China, during the flu season in January 2018, and explored their genetic characteristics, pathogenicity, and transmissibility.

Results

A/Hebei/F076/2018(H1N1) belongs to the human-like H1N1 influenza virus lineage, whereas B/Hebei/16275B/2018 belongs to the Victoria lineage and is closely related to the World Health Organization reference strain B/Brisbane/60/2008. Pathogenicity tests revealed that A/Hebei/F076/2018(H1N1) replicated much more strongly in mice, with mice exhibiting 40% mortality, whereas B/Hebei/16275B/2018 was not lethal. Both viruses could be transmitted through direct contact and by the aerosol route between guinea pigs, but the H1N1 strain exhibited higher airborne transmissibility.

Conclusions

These results may contribute to the monitoring of influenza mutation and the prevention of an influenza outbreak.
Application of a treatment planning system-assisted large-aperture computed tomography simulator to percutaneous biopsy: initial experience of a radiation therapist
Authors: Lin Xiaoyi , Ma Liqin , Du Kaixin , Hong Junqiang , Luo Shuiying , Lai Youqun , Dai Yongliang , Kong Xiangquan
Published: January 2021

Objective

To evaluate the application of treatment planning system (TPS)-assisted large-aperture computed tomography (CT) simulator to percutaneous biopsy.

Methods

This retrospective study enrolled patients that underwent TPS-assisted large-aperture CT simulator-guided percutaneous biopsy from November 2018 to December 2019. Retrospective analyses of puncture accuracy were compared using paired t-test and a Wilcoxon rank sum test. The risk factors for puncture accuracy and complications were identified.

Results

A total of 38 patients were included in this study. There were no significant differences between the planned and actual puncture depth and angle. Pulmonary puncture was significantly associated with the accuracy of the puncture angle. The diagnostic rate of malignancy was 76% (29 of 38), of which 20 of 25 patients were in the group initially diagnosed with unconfirmed lesions and nine of 13 patients were in the group of treated patients that needed additional pathological analyses. For patients that underwent a pulmonary biopsy, 12 had minor pneumothorax and three suffered needle track bleeding. No other complications were observed. Regression analyses indicated a significant correlation between puncture angle and the incidence of pneumothorax.

Conclusion

TPS-assisted large-aperture CT simulator may improve the percutaneous biopsy procedure by combining the advantages of radiotherapy specialties with computer targeting.
Treatment of multiple physiological and psychological disorders in one patient with stellate ganglion block: a case report
Authors: Xu Yunyao , Zhang Yuenong
Published: January 2021

Patients with several concurrent illnesses often present with complex manifestations and therefore receive a variety of treatments. The purpose of this report was to describe a patient diagnosed with hypothyroidism, Hashimoto’s encephalopathy, cerebral infarction, and ventricular arrhythmia. The patient also had multiple physiological and psychological disorders, including dizziness, frequent ventricular premature beats, hypotension, anxiety, and insomnia. Among other treatments, the patient received a stellate ganglion block and most symptoms were substantially alleviated. Therefore, stellate ganglion block appears to be a useful approach for treating perplexing clinical conditions in patients with autonomic dysfunction.
Dyspnoea and diffuse pulmonary nodules in a patient with pulmonary veno-occlusive disease: a case report and literature review
Authors: He Yuanzhou , Xie Min , Liu Xiansheng
Published: January 2021

Pulmonary veno-occlusive disease (PVOD) is a rare type of pulmonary hypertension characterized by capillary damage or arterial pulmonary hypertension. Early lung transplantation is the only effective treatment for PVOD because of the lack of specificity in its clinical manifestations and its rapid progression and poor prognosis. A 28-year-old woman presented with exertional dyspnoea. A chest computed tomography scan revealed diffuse centrilobular ground glass opacities in both lungs, a ratio of the transverse diameter of the main pulmonary trunk to the ascending aorta of >1, and enlargement of the right ventricle and right atrium. A right atrial floating catheter test showed right ventricular pressure of 82/0/4 mmHg, mean pulmonary artery pressure of 83/34/53 mmHg, and pulmonary artery wedge pressure of 15/8/12 mmHg. A mutation was found in the eukaryotic translation initiation factor 2 alpha kinase 4 ( EIF2AK4) gene. Thus, the patient was diagnosed with PVOD and subsequently given standard bosentan treatment (62.5 mg twice a day). However, after 6 months of follow-up, there was no significant improvement in the pulmonary artery pressure or activity tolerance (6-minute walking test). Therefore, cardiopulmonary transplantation was performed. Early diagnosis and timely treatment of PVOD may improve the patient’s prognosis.
Prevalence of neuropathic pain in terminally ill patients with cancer admitted to a general ward: a prospective observational study
Authors: Yanaizumi Ryota , Nagamine Yusuke , Harada Shinsuke , Kojima Keiko , Tazawa Toshiharu , Goto Takahisa
Published: January 2021

Objectives

To determine the prevalence of neuropathic pain among terminally ill patients with cancer admitted to a general ward, using the International Association for the Study of Pain algorithm.

Methods

This prospective observational study was conducted at a tertiary care center. We enrolled terminally ill patients with cancer admitted to the general ward between September 2018 and September 2019. On the day of consultation with our palliative care team, pain management clinicians examined and diagnosed neuropathic pain using the International Association for the Study of Pain diagnostic criteria.

Results

A total of 108 patients were enrolled during the study period. The median age was 69 years (interquartile range [IQR] 58.3–76.8 years), 72 patients (66.7%) were men, and the median survival time was 33 days (IQR 14.3–62 days). Of the 108 patients, 33 (30.6%) had neuropathic pain. Patients with neuropathic pain had more severe pain than those without neuropathic pain.

Conclusions

The prevalence of neuropathic pain in terminally ill patients with cancer admitted to a Japanese general ward was 30.6%. Further studies are warranted to elucidate whether the accurate diagnosis of neuropathic pain can improve pain control and/or patient conditions.
The Importance of Context: An ESM Study in Forensic Psychiatry
Authors: Habets P. , Delespaul Ph. , Jeandarme I.
Published: January 2021

Experience Sampling Method (ESM) is a structured diary technique assessing variations in thoughts, mood, and psychiatric symptoms in everyday life. Research has provided ample evidence for the efficacy of the use of ESM in general psychiatry but its use in forensic psychiatry has been limited. Twenty forensic psychiatric patients participated. The PsyMate™ Device emitted a signal 10 times a day on six consecutive days, at unpredictable moments. After each “beep,” the patients completed ESM forms assessing current context, thoughts, positive and negative affect, and psychotic experiences. Stress was measured using the average scores of the stress related items. Compliance rate was high (85% beeps responded). Activity stress was related to more negative affect, lower positive affect, and more psychotic symptoms. This finding was restricted to moments when a team member was present; not when patients were alone or with other patients. ESM can be useful in forensic psychiatry and give insights into the relationships between symptoms and mood in different contexts. In this study activity-related stress was contextualized. These findings can be used to personalize interventions.
Participant-perceived occupational outcomes after two years of yoga for chronic pain
Authors: Rose Caroline M , Atler Karen E , Dickman Portz Jennifer , Andrews Alexandra P , Schmid Arlene A
Published: January 2021

Introduction

The study aim was to investigate the perceived impact and experience of long-term involvement in community-based group yoga for people with chronic pain.

Methods

Eleven participants, who previously completed an 8-week yoga intervention and continued attending yoga at a community pain clinic for 2 years, participated in the study. A mixed-methods approach was employed. Canadian Occupational Performance Measure data were collected during the 8-week yoga study (baseline) and after 2 years of yoga (follow-up). Baseline and follow-up Canadian Occupational Performance Measure data were compared to measure change in perceived occupational performance and satisfaction. Individual qualitative interviews were conducted to explore participants’ perceived impact and experience of long-term yoga involvement. Canadian Occupational Performance Measure data were analyzed using Wilcoxon signed-rank tests, and qualitative interviews were analyzed using an inductive approach.

Findings

Canadian Occupational Performance Measure scores significantly improved between baseline and follow-up. Three main themes emerged from qualitative interviews: (a) Occupational shift from “existing” to “living,” (b) The change process is “progressive,” and (c) Yoga is “a positive thing I do in my life.”

Conclusion

Long-term involvement in community-based group yoga may improve and sustain occupational performance and satisfaction. Occupational therapists may consider yoga as a tool to promote occupational gains in people with chronic pain.
Making sense of sustainability work: A narrative approach
Authors: Williams Tim , Edwards Melissa , Angus-Leppan Tamsin , Benn Suzanne
Published: January 2021

Corporate sustainability is a priority for organisations, but the nature of the enabling intra-organisational activities, processes and managerial agency is not well understood. In this study, we examine the activity and agency of corporate sustainability managers through a narrative approach and the novel theoretical lens of ‘sustainability work’: purposeful and strategic activities to shape the social-symbolic context such that social and environmental outcomes are prioritised. Analysing how individuals across a range of diverse organisations and industries frame their activity, we identify three overlapping and co-occurring broad subsets of sustainability work: goal-directed, other-directed and self-directed. Through our notion of sustainability work, we contribute by recasting managerial agency in the enabling of sustainability as occurring in the social-symbolic realm and highlighting the implications in both theory and practice for the professionalisation of sustainability.

JEL Classification: M10, M14
Aragonite-Based Scaffold for the Treatment of Joint Surface Lesions in Mild to Moderate Osteoarthritic Knees: Results of a 2-Year Multicenter Prospective Study
Authors: Kon Elizaveta , Di Matteo Berardo , Verdonk Peter , Drobnic Matej , Dulic Oliver , Gavrilovic Gordan , Patrascu Jenel M. , Zaslav Ken , Kwiatkowski Grzegorz , Altschuler Nir , Robinson Dror
Published: January 2021

Background:

Osteoarthritis (OA) is considered a contraindication to most cartilage repair techniques. Several regenerative approaches have been attempted with the aim of delaying or preventing joint replacement, with controversial results. Currently, there is a paucity of data on the use of single-step techniques, such as cell-free biomimetic scaffolds, for the treatment of joint surface lesions (JSLs) in OA knees.

Purpose:

To present the 2-year follow-up clinical and radiological outcomes after implantation of a novel, cell-free aragonite-based scaffold for the treatment of JSLs in patients with mild to moderate knee OA in a multicenter prospective study.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 86 patients, 60 male and 26 female, with a mean age of 37.4 ± 10.0 years, mild to moderate knee OA, and a mean defect size of 3.0 ± 1.7 cm2, were recruited at 8 medical centers according to the following criteria: radiographic mild to moderate knee OA (Kellgren-Lawrence grade 2 or 3); up to 3 treatable chondral/osteochondral defects (International Cartilage Repair Society grades 3 and 4) on the femoral condyles or trochlea; a total defect size ≤7 cm2; and no concurrent knee instability, severe axial malalignment, or systemic arthropathy. All patients were evaluated at baseline and at 6, 12, 18, and 24 months after implantation using the Knee injury and Osteoarthritis Outcome Score (KOOS) and International Knee Documentation Committee (IKDC) subjective score. Additionally, magnetic resonance imaging (MRI) was performed to assess the amount of cartilage defect filling at the repaired site.

Results:

Significant improvement on all KOOS subscales was recorded from baseline (Pain: 49.6 ± 13.1; Activities of Daily Living [ADL]: 56.1 ± 18.4; Sport: 22.8 ± 18.8; Quality of Life [QoL]: 23.5 ± 16.5; Symptoms: 55.4 ± 19.9) to the 24 months’ follow-up (Pain: 79.5 ± 21.1 [ P < .001]; ADL: 84.1 ± 21.4 [ P < .001]; Sport: 60.8 ± 31.9 [ P < .001]; QoL: 54.9 ± 30.4 [ P < .001]; Symptoms: 77.7 ± 21.2 [ P < .001]). The IKDC subjective score showed a similar trend and improved from 37.8 ± 14.7 at baseline to 65.8 ± 23.5 at 24 months ( P < .001). MRI showed a significant increase in defect filling over time: up to 78.7% ± 25.3% of surface coverage after 24 months. Treatment failure requiring revision surgery occurred in 8 patients (9.3%).

Conclusion:

The use of an aragonite-based osteochondral scaffold in patients with JSLs and mild to moderate knee OA provided significant clinical improvement at the 24-month follow-up, as reported by the patients. These findings were associated with good cartilage defect filling, as observed on MRI.
Clocks, Viruses, and Immunity: Lessons for the COVID-19 Pandemic
Authors: Sengupta Shaon , Ince Louise , Sartor Francesca , Borrmann Helene , Zhuang Xiaodong , Naik Amruta , Curtis Annie , McKeating Jane A.
Published: January 2021

Circadian rhythms are evolutionarily conserved anticipatory systems that allow the host to prepare and respond to threats in its environment. This article summarizes a European Biological Rhythms Society (EBRS) workshop held in July 2020 to review current knowledge of the interplay between the circadian clock and viral infections to inform therapeutic strategies against SARS-CoV-2 and COVID-19. A large body of work supports the role of the circadian clock in regulating various aspects of viral replication, host responses, and associated pathogenesis. We review the evidence describing the multifaceted role of the circadian clock, spanning host susceptibility, antiviral mechanisms, and host resilience. Finally, we define the most pressing research questions and how our knowledge of chronobiology can inform key translational research priorities.
Crosslinking porcine aortic valve by radical polymerization for the preparation of BHVs with improved cytocompatibility, mild immune response, and reduced calcification
Authors: Xu Liangpeng , Yang Fan , Ge Yao , Guo Gaoyang , Wang Yunbing
Published: January 2021

Over one million artificial heart valve transplantations are performed each year due to valvular stenosis or regurgitation. Among them, bioprosthetic heart valves (BHVs) are increasingly being used because of the absence of the need for lifelong anticoagulation. Almost all of the commercial BHVs are treated with Glutaraldehyde (GLUT). As GLUT-treated BHVs are prone to calcification and structural degradation, their durability is greatly reduced with a service life of only 12–15 years. The physiological structure and mechanical properties of the porcine aortic valve (PAV) are closer to that of a human heart valve, so in this study, PAV is used as the model to explore the comprehensive properties of the prepared BHVs by radical polymerization crosslinking method. We found that PAV treated by radical polymerization crosslinking method showed similar ECM stability and biaxial mechanical properties with GLUT-treated PAV. However, radical polymerization crosslinked PAV exhibited better cytocompatibility and endothelialization potential in vitro cell experiment as better anticalcification potential and reduced immune response than GLUT-treated PAV through subcutaneous animal experiments in rats. To conclude, a novel crosslinking method of non-glutaraldehyde fixation of xenogeneic tissues for the preparation of BHVs is expected.
We’ve Come a Long Way, Guys! Rhetorics of Resistance to the Feminist Critique of Sexist Language
Authors: Kleinman Sherryl , Copp Martha , Wilson Kalah B.
Published: January 2021

We provide a qualitative analysis of resistance to calls for gender-neutral language. We analyzed more than 900 comments responding to two essays—one on AlterNet and another on Vox posted to the Vox editor’s Facebook page—that critiqued a pervasive male-based generic, “you guys.” Five rhetorics of resistance are discussed: appeals to origins, appeals to linguistic authority, appeals to aesthetics, appeals to intentionality and inclusivity, and appeals to women and feminist authorities. These rhetorics justified “you guys” as a nonsexist term, thereby allowing commenters to continue using it without compromising their moral identities as liberals or feminists. In addition to resisting an analysis that linked their use of “you guys” to social harms, commenters positioned the authors who called for true generics as unreasonable, divisive, and authoritarian. We conclude with suggestions for how feminists can challenge the status quo and promote social change.
The Long-Term Impact of Different Offline Population Inclusion Strategies in Probability-Based Online Panels: Evidence From the German Internet Panel and the GESIS Panel
Authors: Cornesse Carina , Schaurer Ines
Published: January 2021

While online panels offer numerous advantages, they are often criticized for excluding the offline population. Therefore, some probability-based online panels have developed offline population inclusion strategies. Two dominant approaches prevail: providing internet equipment and offering an alternative survey participation mode. We investigate the impact of these approaches on two probability-based online panels in Germany: the German Internet Panel, which provides members of the offline population with internet equipment, and the GESIS Panel, which offers members of the offline population to participate via postal mail surveys. In addition, we explore the impact of offering an alternative mode only to non-internet users versus also offering the alternative mode to internet users who are unwilling to provide survey data online. Albeit lower recruitment and/or panel wave participation probabilities among offliners than onliners, we find that including the offline population has a positive long-term impact on sample accuracy in both panels. In the GESIS Panel, the positive impact is particularly strong when offering the alternative participation mode to non-internet users and internet users who are unwilling to provide survey data online.
Optimization of squeeze casting parameters of hybrid aluminium matrix composite using Taguchi approach
Authors: Arulraj M , Palani PK , Sowrirajan M
Published: January 2021

Squeeze casting is one of the simplest processes of manufacturing of composite materials and it attains higher advantages of low material processing cost, easy handling of material, size, design and good stability of matrix structure. LM24 aluminium alloy reinforced with silicon carbide (SiC) and coconut shell ash (CSA) were used to prepare the composite. LM24 alloy had wide engineering applications, wherein the addition of SiC enhances the wear resistance and CSA particles offer significant technical and economic benefits. In the present study, the composite samples were prepared based on Taguchi experimental conditions L16 (4-levels and 5- parameters) through squeeze casting method. From the experimental results, percentage of reinforcement and squeeze pressure were most influential parameters on impact strength. The optimum casting condition was obtained by using Taguchi optimization. From microstructural study, applying high level of squeeze pressure improved the uniform dispersion, good bonding between the matrix and reinforcement. Also, 25% of impact strength was improved the composite using Taguchi optimum conditions compared than conventional alloys. Higher squeeze pressure seen to have refined dendritic structure with uniform distribution of reinforcement materials in the aluminium matrix.
Mapping Emoji Usage Among Youth
Authors: Shah Reena , Tewari Ruchi
Published: January 2021

Emoji is now a popular inclusion in technology-mediated communication and a part of everyday expression of users. Yet, there is a dearth of scientifically designed research studies focussing on the human implications of the use of emojis. Limited systematic inquiry in this area is restricted to technical studies focussing on algorithm analysis of humongous quantitative data ignoring the people who are posting these emojis. Therefore, in the present study, an attempt is made to study the use of emojis from an individual’s behavioural perspective borrowing from the classic ‘contagion theory’ and the ‘information-signal theory’. A mixed research approach was adopted to study young university student’s emoji usage behaviour. Focus group discussion (FGD) was conducted on 11 participants with an average age of 22.5 years. The discussion was transcribed and thematic analysis was then conducted from which a survey instrument was developed which was administered to 250 university students. These survey data were then analysed using exploratory factor analysis. Results show that social media platforms, linguistic pattern, social relationships, emotional connect and level of formality and gender emerged as important factors that drive emoji usage.

The findings of the study indicate the psychological implications and socio-behavioural impact of emoji usage which can be used for creating regulations and norms. What appears to be casual pictorial supplement of textual messages holds the power to be developed as a stand-alone language which could impact the usage of language-dependent communication.
The Effects of Ownership Structure on Borrowing Rate: The Case of Listed Iranian Companies
Authors: Ebrahimi Sajad
Published: January 2021

The Iranian banking system engages in financial repression, and there are legal restrictions on interest rate. However, micro-evidence shows that the interest rates paid by Iranian firms in this condition are different across firms. This article aims to investigate the roots of the difference in borrowing rates by exploring the effects of the borrowers’ ownership structure and bank–firm relationship features. Using data collected from companies listed in the Tehran Stock Exchange (TSE) for the period 2007–2016, empirical models are estimated through applying the dynamic panel data regression method. According to the estimation results, the presence of an institutional stockholder, and particularly banks, among a firm’s shareholders can generally reduce its borrowing rate. Moreover, the results show that the financing rate is significantly lower in the firms with more than 20 per cent of their shares owned by the government. In addition, the findings suggest that borrowers of unhealthy banks, in terms of non-performing loans (NPL), bear a higher finance rate.
Anemia Management in Rural Haitian Children: A Mixed Methods Study
Authors: Martial Marc-Aurel , Sward Katherine A. , Morse Janice M. , Wilson Andrew R. , Martial Cempaka , Penney Debra S. , Nicolas Elie
Published: January 2021

Introduction

We examined factors influencing anemia outcomes in rural children following implementation of a prevention program.

Method

Mixed methods study of children, parents, and clinicians utilized statistical modeling and content/ethnographic analysis. Retrospective chart abstraction evaluated treatments administered and measured hemoglobin in children aged 6 to 59 months ( n = 161). Prospective interviews/questionnaires examined parent ( n = 51) and clinician ( n = 19) perceptions.

Results

Anemia prevalence decreased by 21.2%. Predictors of increased hemoglobin were clinic visit number and age at first visit. Once anemia improved, children were likely to remain improved ( P = .65). Despite favorable program perceptions, stakeholders emphasized ecological barriers, including social disadvantage and local practices.

Discussion

Socioeconomic factors prevented guideline concordant behaviors. Persistent attention to intrapersonal, interpersonal, and community social determinants is a sine qua non for successfully managing the epidemic. The first step to provide culturally congruent care is to explicitly acknowledge that guideline-concordant behaviors are often complex.
Experiences of Asian Women Who Live in Urban Environments and Are Breast Cancer Survivors
Authors: Polek Carolee , Hardie Thomas , Deatrick Janet A.
Published: January 2021

Introduction

Despite expanding interest in cancer survivorship, little is known about urban Asian breast cancer survivors whose experience may differ from those in suburban and rural locations. This study explores survivors’ challenges to maximize outcomes and identify common and unique themes among urban Asian survivors. Information was obtained from the survivors and outreach workers from their community.

Methodology

Descriptive qualitative methods including semistructured interview guides were used to plan, conduct, and analyze both individual interviews of Asian women ( n = 6) and a focus group ( n = 7) composed of community outreach workers.

Results

The interview and focus group findings, endorsed themes of communication/language, trust, and privacy, with generational differences. Poor health literacy in both survivors and providers was identified.

Discussion

Nurses are in a unique position to use the themes identified to both assist survivors expand their health literacy and lobby for resources for providers to promote culturally congruent care.
Development of the Adherence to Healthy Behaviors Scale
Authors: Huang Chen-Hui , Natashia Dhea , Lin Tzu-Chia , Yen Miaofen
Published: January 2021

Adherence to healthy behaviors is a protective factor in the disease progression of chronic kidney disease (CKD). Measuring adherence can lead to the recognition of unhealthy behaviors and the suggestion of programs to prevent poor health outcomes. An assessment measurement for patients with CKD not requiring dialysis was developed and psychometrically tested. A convenience sample ( n = 330) of patients with CKD attending a nephrology clinic in southern Taiwan completed the 13-item Adherence to Healthy Behaviors Scale (AHBS). A principal axis factor analysis and a parallel analysis demonstrated a three-factor structure accounting for 47.16% of the total variance. Confirmatory factor analysis indicated a good model fit. The criterion-related validity was adequate ( r = .51; p < .000), with a Cronbach’s alpha of .70; the test-retest reliability demonstrated good stability ( r = .70; p < .000). The AHBS is a valid, reliable instrument to assess adherence to healthy behaviors among patients with CKD.
College and Career Ready and Critically Conscious: Asset-Building With Latinx Immigrant Youth
Authors: McWhirter Ellen Hawley , Cendejas Christina , Fleming Maureen , Martínez Samantha , Mather Nathan , Garcia Yahaira , Romero Lindsey , Ortega Robert I. , Rojas-Araúz Bryan Ovidio
Published: January 2021

A growing body of evidence supports critical consciousness as a developmental asset for young people, including its benefits for educational and vocational outcomes. National dynamics and policies in the U.S., such as restricting immigration and asylum, have raised the salience of critical consciousness as a protective factor for the career development of Latinx immigrant youth. In this manuscript, we first review the nature and benefits of critical consciousness for Latinx immigrant youth. We then highlight how college and career readiness (CCR) and the components of critical consciousness (CC) can be simultaneously fostered among Latinx immigrant high school students, drawing upon our own work in the context of an afterschool program. We introduce a framework to illustrate this integration, and describe a series of intervention activities and processes designed to simultaneously build CC and CCR. Finally, we provide recommendations and describe caveats and challenges to developing classroom-based career education curricula that integrate CCR and CC.
Recognition, Treatment, and Outcome of Calcaneal Fracture-Dislocation
Authors: Rammelt Stefan , Marx Christine , Swords Grace , Swords Michael
Published: January 2021

Background:

Calcaneal fracture-dislocations are rare but potentially disabling injuries that are regularly overlooked at first presentation. To date, only about 50 cases have been reported in the literature.

Methods:

Over a period of 8 years, 10 patients (average age 61.7 years) with acute fracture-dislocations of the calcaneus were treated at 2 level 1 trauma centers. The calcaneocuboid joint was involved in 9 patients. There was a concomitant fracture of the lateral talar process and of the tip of the distal fibula in 7 patients each. Open reduction and internal fixation was performed in 9 of 10 patients via an oblique lateral dislocation approach. One patient underwent primary subtalar fusion. All patients were seen for clinical and radiographic follow-up at an average of 3 years using patient-reported outcome scores.

Results:

Anatomic fixation was achieved in all patients as judged by postoperative computed tomographic imaging. In the 9 patients treated with internal fixation, the Foot Function Index averaged 12.8, the EuroQol 5D score averaged 0.89 and the visual analog scale score for patient satisfaction averaged 79.3 at final follow-up. Signs of mild subtalar arthritis were seen in 6 patients. No secondary subtalar fusions were needed.

Conclusion:

When recognized and treated early, prognosis of calcaneal fracture-dislocation was favorable. A dislocation approach starting over the distal fibula, continuing over the sinus tarsi, and extending toward the calcaneocuboid joint allowed for adequate visualization of the subtalar joint and treatment of all components of the injury.

Level of Evidence:

Level IV, retrospective case series.
Management and Outcome of Hindfoot Trauma With Concomitant Talar Head Injury
Authors: Engelmann Esmee Wilhelmina Maria , Wijers Olivier , Posthuma Jelle , Schepers Tim
Published: January 2021

Background:

Talar head fractures account for 2.6% to 10% of all talar fractures and are often associated with concomitant musculoskeletal injuries. The current literature only describes a total of 14 patients with talar head fractures and, with that, guidelines for management are lacking. The aim of the current study was to evaluate the management and long-term outcome of patients who have hindfoot trauma with concomitant talar head fractures.

Methods:

This study includes a retrospective cohort of patients with talar head fractures. Patient characteristics, trauma mechanism, fracture characteristics, treatment, follow-up, and complications were reported. Functional outcome was assessed using the Foot Function Index (FFI) and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. Quality of life was measured by the EuroQol-5D (EQ-5D). Twenty-one patients with acute fractures of the talar head were identified. The mean follow-up time was 4.9 years.

Results:

All patients sustained additional ipsilateral foot and/or ankle injuries. Fifteen patients had operative management of their talar head fracture. There were no postoperative wound infections and no cases of avascular necrosis. All fractures united, and 29% of patients developed posttraumatic osteoarthritis. The overall mean FFI score index was 34.2, and the mean AOFAS score was 70.7. The mean EQ-5D index score was 0.74.

Conclusion:

Talar head fractures always coincided with other (foot) fractures. Management and long-term functional outcome were affected by the extent of associated injuries. Due to the low incidence and high complexity of talar head fractures, early referral to dedicated foot surgeons and centralization of complex foot surgery is recommended.

Level of Evidence:

Level IV, retrospective case series.
Comparison of Functional and Radiographic Outcomes of Talar Osteochondral Lesions Repaired With Micronized Allogenic Cartilage Extracellular Matrix and Bone Marrow Aspirate Concentrate vs Microfracture
Authors: Drakos Mark C. , Eble Stephanie K. , Cabe Taylor N. , Patel Karan , Hansen Oliver B. , Sofka Carolyn , Fabricant Peter D. , Deland Jonathan T.
Published: January 2021

Background:

Microfracture (MF) has been used historically to treat osteochondral lesions of the talus (OLTs), with favorable outcomes reported in approximately 80% to 85% of cases. However, MF repairs have been shown to degrade over time at long-term follow-up, suggesting that further study into optimal OLT treatment is warranted. The use of adjuvant extracellular matrix with bone marrow aspirate concentrate (ECM-BMAC) has not been extensively evaluated in the literature. We present a comparison of patient-reported and radiographic outcomes following ECM-BMAC repair vs traditional MF.

Methods:

Patients who underwent MF (n = 67) or ECM-BMAC (n = 62) treatment for an OLT were identified and their charts were retrospectively reviewed. Postoperative magnetic resonance imaging (MRI) was evaluated and patient-reported outcome scores, either Foot and Ankle Outcome Scores (FAOS) or Patient-Reported Measurement Information System (PROMIS) scores, were collected. MRIs were scored by a radiologist, fellowship trained in musculoskeletal radiology, using the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) system. Radiographic and clinical outcomes were compared between groups.

Results:

On average, patients treated with ECM-BMAC demonstrated a higher total MOCART score compared to the MF group (73 ± SD 11.5 vs 54.0 ± 24.1; P = .0015). ECM-BMAC patients also had significantly better scores for the Infill, Integration, and Signal MOCART subcategories. Last, patients treated with ECM-BMAC had a lower rate of revision compared to those treated with MF (4.8% vs 20.9%; P = .007). FAOS scores were compared between groups, with no significant differences observed.

Conclusion:

When comparing outcomes between patients treated for an OLT with ECM-BMAC vs traditional MF, we observed superior MRI results for ECM-BMAC patients. The rate of revision surgery was higher for MF patients, although patient-reported outcomes were similar between groups. The use of ECM-BMAC as an adjuvant therapy in the treatment of OLTs may result in improved reparative tissue when compared to MF.

Level of Evidence:

Level III, comparative series.
Efficacy of Group Cognitive Behavior Therapy Targeting Time Management for Adults with Attention Deficit/Hyperactivity Disorder in Japan: A Randomized Control Pilot Trial
Authors: Nakashima Misuzu , Inada Naoko , Tanigawa Yoshie , Yamashita Masako , Maeda Emi , Kouguchi Megumi , Sarad Yoko , Yano Hiroyuki , Ikari Keisuke , Kuga Hironori , Oribe Naoya , Kaname Hitoshi , Harada Tsuyoshi , Ueno Takefumi , Kuroki Toshihide
Published: January 2021

Objective:

Time-processing disorders in adults is a priority area for intervention. Time management program, which has been demonstrated to be effective in children with ADHD, has not been examined in adults. We anticipate the need for the development of specialized programs for adults. This is because it has been reported that time processing disorders have different patterns in childhood and adulthood. This study aimed to evaluate the therapeutic effect of a gCBT program focusing on time management for adults with ADHD.

Method:

Adults with ADHD were randomly assigned to gCBT ( n = 24) or a treatment as usual group ( n = 24). Outcome measures were masked clinically rated, self-reported, and family-reported ADHD symptoms.

Results:

The gCBT group significantly reduced ADHD symptoms on all measures.

Conclusion:

Interventions focused on time management have been shown to be effective not only in children with ADHD but also in adult patients.
The Effects of Intragroup Guanxi Interaction on Customers’ Intentions to Complain
Authors: Xu Xing’an , Chi Christina Geng-Qing , Cai Ruiying , Pan Li
Published: January 2021

This study examined the impacts of intragroup guanxi interaction on customers’ complaint behavior following service failure on a group tour. Based on the guanxi literature and social support theory, two dimensions of intragroup guanxi interaction were identified, and their effects on customers’ intentions to complain were examined. The moderating effects of group size and relational distance were also assessed. Three experimental studies were conducted to test the proposed hypotheses. Findings revealed that instrumental guanxi interaction and emotional guanxi interaction among tour group members both positively influenced travelers’ intentions to complain, and the impact of emotional guanxi interaction was greater than that of instrumental guanxi interaction. Moreover, the effects of intragroup guanxi interaction on group customers’ intentions to complain were stronger for larger groups and for groups with closer relational distance. This study contributes to the literature on group service failure and customers’ complaint behavior from an Eastern cultural perspective.
Pilot assessment of an on-demand telehealth ‘left without being seen’ follow-up programme
Authors: Sheridan Matthew D , Adams Katharine T , Booker Ethan , Krevat Seth A , Calabrese Mary , Gomes Kylie , Ratwani Raj M
Published: January 2021

Introduction

On-demand telehealth can have a high rate of patients requesting visits and dropping off without being seen by a provider, especially during the COVID-19 pandemic.

Methods

On-demand telehealth requests made to a large healthcare system in the USA between 15 March 2020 and 31 May 2020 were included for analysis with a focus on patients who were defined as left without being seen (LWBS). As part of a pilot program a registered nurse attempted to call LWBS patients within 24 hours of their telehealth request and asked if they were ok, if they sought care for their original visit reason, what that care was, or if they still needed guidance. This information and patient demographics were analyzed.

Results

During the study period there were 21,610 completed on-demand telehealth visits and 1852 patients for whom there were LWBS attempted follow-ups. Most patients LWBS for a reason that originated from the patient and not associated with the provider or telehealth platform. The mean wait time for LWBS patients was 12.4 min compared to patients waiting 15.1 min before engaging with a provider to complete a visit. Of the 1852 total LWBS patients in the follow-up programme, 819 (44.2%) were successfully contacted with a follow-up phone call. Most of these patients (63.2%) already completed or planned to complete a telehealth visit, 13.6% indicated they no longer needed to see a provider, and 12.8% planned or already completed an in-person visit. Only 2.2% went to an emergency department.

Discussion

Results suggest patients can effectively self-manage their care needs.
Becoming a sexademic: Reflections on a ‘dirty’ research project
Authors: Keene Samantha
Published: January 2021

Sex and sexuality research can be understood as a form of ‘dirty work’, as despite its public need, it continues to be marginalised and demeaned within the academy and beyond. Through association, sex and sexuality researchers come to be labelled ‘dirty workers’ and are vulnerable to experiencing a range of stigmatised responses and negative repercussions. This article contributes to knowledge about the challenges involved in doing dirty work, through reflexively examining my experiences as a doctoral researcher investigating pornography’s gendered influence. It explores the various institutional, professional and personal hurdles that I encountered during my dirty work journey and illustrates how these experiences may have been affected by my identity as a young, female researcher.
National temporal variation in major trauma in England, Wales and Northern Ireland
Authors: Kieffer Will , Michalik Daniel , Bernard Jason , Bouamra Omar , Rogers Benedict
Published: January 2021

Introduction

Trauma is one of the leading causes of mortality worldwide, but little is known of the temporal variation in major trauma across England, Wales and Northern Ireland. Proper workforce and infrastructure planning requires identification of the caseload burden and its temporal variation.

Materials and Methods

The Trauma Audit Research Network (TARN) database for admissions attending Major Trauma Centres (MTCs) between 1st April 2011 and 31st March 2018 was analysed. TARN records data on all trauma patients admitted to hospital who are alive at the time of admission to hospital. Major trauma was classified as an Injury Severity Score (ISS) >15.

Results

A total of 158,440 cases were analysed. Case ascertainment was over 95% for 2013 onwards. There was a statistically significant variation in caseload by year (p < 0.0001), times of admissions (p < 0.0001), caseload admitted during weekends vs weekdays, 53% vs 47% (p < 0.0001), caseload by season with most patients admitted during summer (p < 0.0001). The ISS varied by time of admission with most patients admitted between 1800 and 0559 (p < 0.0001), weekend vs weekday with more severely injured patients admitted during the weekend (p < 0.0001) and by season p < 0.0001). Discussion and Conclusion: There is a significant national temporal variation in major trauma workload. The reasons are complex and there are multiple theories and confounding factors to explain it. This is the largest dataset for hospitals submitting to TARN which can help guide workforce and resource allocation to further improve trauma outcomes.