bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics of breast ductal carcinoma in situ with microinvasion: a narrative review
Authors: Zheng Jie , Yu Jingjing , Zhou Tao
Published: November 2020

Ductal carcinoma in situ (DCIS) with microinvasion (DCIS-MI) is defined as the extension of cancer cells beyond the basement membrane into adjacent tissue with no focus larger than 1 mm or a maximum diameter of less than 1 mm for multiple invasive foci. DCIS-MI constitutes approximately 1% of all breast cancer cases and 5% to 10% of cases of DCIS. The current literature is controversial concerning the clinical prognostic features and management of DCIS-MI. This narrative review described recently reported literature regarding the characteristics, diagnosis, treatment, and prognosis of DCIS-MI.
Methodologies and Techniques for Determining the Value of an Aircraft
Authors: Vasigh Bijan , Azadian Farshid , Moghaddam Kamran
Published: November 2020

Aircraft valuation and the estimation of an accurate aircraft price is undoubtedly a challenging task that has significant consequences for airlines. This paper presents an asset valuation model to show how a series of endogenous as well as exogenous factors can influence the value of an aircraft. Specifically, a discounted cash flow methodology is used to forecast the valuation of an old or new generation aircraft. Both total operating revenue and aircraft operating costs are taken into account to devise a reliable pre-tax profit measurement that is used as the basis of the discounted cash flow analysis. A sensitivity analysis based on Monte Carlo simulation is utilized to identify which factors have a more significant influence on the suggested aircraft value. Therefore, it addresses how value fluctuates in response to economic fluctuations. Indeed, the calculated value of an aircraft highly depends on the underlying assumptions used. The calculated value is compared with available data in a case study for verification.
Interphase approach for modeling the DC conductivity of diverse allotropic types of carbon-reinforced polymer composites
Authors: Nioua Y , Aribou N , Boukheir S , Achour ME , Costa LC
Published: November 2020

This work is based on a generalized effective medium-modified model for predicting the DC electrical conductivity of polymer composites, taken into account the interactions between the components using an interphase approach. Generalized effective medium-modified model is a simple extension of the Generalized Effective Medium Theory proposed by McLachlan. We studied the modeling of the DC electrical conductivity using the proposed model for diverse allotropic types of carbon-reinforced polymer composites. Three series of composite materials obtained by mixing an insulating matrix DGEBA with (i) carbon nanotubes which are one-dimensional materials (1 D), (ii) reduced graphene oxide, which is a two-dimensional material (2 D) and (iii) carbon black, which is a three-dimensional material (3 D) have been studied. Predictions from the model are in good agreement with the experimental data of the electrical conductivity of composite materials, where the classical models have not been able to explain them. Moreover, in this paper, the effects of the filler dimension on the interphase properties of the composite materials, in particular the interphase volume fraction and the interphase conductivity, have been investigated.
Facile preparation of uniform polydopamine particles and its application as an environmentally friendly flame retardant for biodegradable polylactic acid
Authors: Tawiah Benjamin , Yu Bin , Yuen Anthony Chun Yin , Fei Bin
Published: November 2020

The demand for environmentally benign flame retardants for biodegradable polymers has become particularly necessary due to their inherently “green” nature. This work reports intrinsically non-toxic polydopamine (PDA) particles as an efficient and environmentally friendly flame retardant for polylactic acid (PLA). 5 wt% PDA loading resulted in a 22% reduction in the peak heat release rate, 34.7% increase in the fire performance index, and lower CO2 production compared to neat PLA. A limiting oxygen index (LOI) value of 27.5% and a V-2 rating was achieved in the UL-94 vertical burning test. Highly aggregated amorphous particulate char was formed with the increasing content of PDA, and a significant reduction in evolved pyrolysis gaseous products was achieved for the PLA/PDA composites as compared with control PLA. This work provides important insight into the potential commercial application of PDA alone as an efficiently green, environmentally benign flame retardant for bioplastic PLA.
Latinos in Kansas City: The Political Economy of Placemaking
Authors: Garay-Huamán Alejandro N. , Irazábal-Zurita Clara
Published: November 2020

This article critically reviews the literature on the relationship between global capitalist accumulation and placemaking and community building of Latinos in Kansas City. We use the social structure of accumulation (SSA) framework to analyze connections between these bodies of scholarship to provide a socio-spatial history of Latinos in Kansas City. We identify three SSAs: a monopolistic SSA (1870s–1930s), a Keynesian SSA (1940s–1970s), and a neoliberal SSA (1980s–present). Our findings show the impacts of each SSA on Latino communities in Kansas City. They also show the agency, flexibility, and resilience of these communities as they faced daunting challenges.
How to make a difference as a middle leader
Authors: Pavlopoulos Eleni
Published: November 2020

This practitioner reflection examines the challenges inherent in middle leadership and explores how to overcome them. It posits that schools and middle leaders benefit from clearly defining roles and reporting lines and communicating effectively. The investment by schools in ensuring that middle leaders have sufficient time to perform their roles and providing support for their development will enable them to make a bigger difference.
Don’t Work for Free: Online Discursive Resistance to Precarity in Commercial Photography
Authors: Patrick-Thomson Holly , Kranert Michael
Published: November 2020

While increasing academic attention has been paid to the precariousness of contemporary work, less research has examined how workers organise in response. This article examines how a group of precarious workers – commercial photographers – use an online forum to resist changes to their working conditions. Our findings illustrate how the forum enables photographers to share knowledge, debate rules and organise collectively. We discuss two implications: firstly that the forum performs many of the functions of a professional association, and so gives us a new insight into how traditional forms of worker organisation may be translated in the digital realm; and secondly, that the form of collective resistance produced by the group may constitute a move beyond existing understandings of online resistance as relatively ineffectual. Our work contributes a new perspective on how precarity is reshaping workers’ collective organisation and resistance mechanisms.
The Persistence of Residential Segregation by Race, 1940 to 2010: The Role of Federal Housing Policy
Authors: Abramovitz Mimi , Smith Richard J.
Published: November 2020

Has public policy shaped the persistence of residential segregation by race over time? Social Structures of Accumulation (SSA) theory, which explains major shifts in policy paradigms as a response to an economic crisis informs our analysis. We compare federal housing policy across two SSAs: the Keynesian period (1940–1970) characterized by welfare state expansion and the neoliberal period (1970–2010) marked by its contraction. Using the isolation index (a segregation measure), we track changes in the 20 Great Migration cities with the highest Southern-born Black population. Segregation rose steadily from 1940 to 1970s, plateaued at high levels from 1970 to 2010, but remained higher in 2010 than in 1940. Historical policy analysis reveals that regardless of the period, federal housing policy actively promoted residential segregation and underscores the urgency for social workers to mobilize for policy change.
Oral Habits in Children With Orofacial Clefts: A Comparative Study
Authors: Isiekwe Ikenna Gerald , Ligali Taofeek Olalekan , Abdullahi Mohammed Adam Sheikh , Adeyemo Wasiu Lanre
Published: November 2020

Background and Aim:

Children with cleft lip and palate present with a wide range of dental and occlusal anomalies as a result of the cleft defect. These patients also present with oral habits which may affect their quality of life. The aim of this study was to compare the prevalence of oral habits in these children, with children without orofacial clefts.

Methodology:

This was a cross-sectional comparative study comparing children with repaired cleft lip and/or palate aged 3 to 12 years, with children without orofacial clefts. Ethical approval for the study was obtained from the institutional review boards of both centers. Data collection was via interviewer administered questionnaires given to the parents/guardians of the children in each group. Data analysis was carried out using SPSS version 23. The level of significance was set at P < .05.

Results:

A total of 107 respondents participated in the study, comprising 53 children with repaired cleft lip and/or palate 54 children without orofacial clefts. The mean age for the children with Cleft lip and/or palate/ was 6.81 (standard deviation [SD] 1.898) years, while that for the control group was 7.78 (SD 1.68) years. Two oral habits recorded a significantly higher prevalence ( P < .05) in the children with repaired clefts as compared to controls and these were lip sucking and bruxism. No significant difference in prevalence was recorded for all the other oral habits surveyed.

Conclusion:

A significantly higher prevalence ( P < .05) was observed in lip sucking and bruxism among children with cleft lip and palate, as compared to the children without orofacial clefts.
Implementation of a pharmacy consult service for evaluation of immune checkpoint inhibitor related adverse events at a large community hospital
Authors: Kamta Jeff , Magruder Bren , Hymel Lisa
Published: November 2020

Introduction

Immune checkpoint inhibitors (ICI) are novel oncolytic therapies associated with various immune related adverse events (irAEs) affecting multiple organ systems, which may have a delayed presentation. Identification of irAEs and prompt initiation of appropriate treatment represents a challenge to clinicians. The purpose of this study was to evaluate the effectiveness of a pharmacy consult service in identification and management of irAEs. Methodology: This was a single center, retrospective study. Patients included were: ≥18 years old, admitted as inpatients, and reported a history of cancer treatment within the last year. A pharmacy consult was developed and implemented for patients who reported a history of ICI therapy within the last year. Education regarding the consult service was provided to select physicians, nurses, and all pharmacists. Primary outcome: percent of admitted patients reporting ICI therapy within the last year, who required pharmacist intervention for an irAE. Secondary outcomes: types of interventions performed, percentage of recommendation acceptance, pharmacist time spent.

Results

Fifty-one patients received a pharmacy immunotherapy consult. Seventeen patients (33%) met the primary outcome. Thirty-three separate recommendations were made by pharmacists for these 17 patients. The secondary outcomes of interventions made and percentage accepted (n; % accepted): Initiation/adjustment of steroid therapy (20; 40%), placement of a consult for oncology or other specialist (10; 70%), other therapeutic interventions (3; 67%). Average time spent by pharmacist on initial consultations (SD): 29 minutes (15).

Conclusion

A pharmacy consult service may help to increase identification of patients receiving immune checkpoint inhibitors and initiate timely interventions.
Lagrangian descriptions of dissipative systems: a review
Authors: Bersani Alberto Maria , Caressa Paolo
Published: November 2020

In this paper, we review classical and recent results on the Lagrangian description of dissipative systems. After having recalled Rayleigh extension of Lagrangian formalism to equations of motion with dissipative forces, we describe Helmholtz conditions, which represent necessary and sufficient conditions for the existence of a Lagrangian function for a system of differential equations. These conditions are presented in different formalisms, some of them published in the last decades. In particular, we state the necessary and sufficient conditions in terms of multiplier factors, discussing the conditions for the existence of equivalent Lagrangians for the same system of differential equations. Some examples are discussed, to show the application of the techniques described in the theorems stated in this paper.
Clinical reasoning in feline vestibular syndrome: which presenting features are the most important?
Authors: Grapes Nicholas J , Taylor-Brown Frances E , Volk Holger A , De Decker Steven
Published: November 2020

Objectives

The aim of this study was to evaluate whether clinical variables from the history, clinical presentation, and physical and neurological examinations of cats with vestibular syndrome were statistically predictive of the underlying diagnosis.

Methods

In total, 174 cats presenting with vestibular syndrome between January 2010 and May 2019 were investigated. Univariate statistical analysis of clinical variables was performed and those statistically associated with a diagnosis were retained for multivariable binary logistic regression modelling.

Results

The seven most prevalent diagnoses represented 95% of vestibular presentations, which included: otitis media/interna (n = 48), idiopathic vestibular syndrome (n = 39), intracranial neoplasia (n = 24), middle ear polyp (n = 17), feline infectious peritonitis (n = 13), thiamine deficiency (n = 13) and intracranial empyema (n = 11). Idiopathic vestibular syndrome was commonly associated with non-purebred cats and had 17.8 times the odds of an improving clinical progression (95% confidence interval [CI] 1.3–250.0; P = 0.03). Intracranial neoplasia was associated with older age and chronic onset of clinical signs, and was significantly more likely to have a central vestibular neuroanatomical localisation (95% CI 8.5–344,349,142.0; P = 0.015) with postural deficits on neurological examination. Thiamine deficiency was more common in female cats, with 52.6 times the odds of a waxing and waning clinical progression (95% CI 1.2–1000; P = 0.038) and 6.8 times the odds of presenting with bilateral vestibular signs (95% CI 1.0–45.7; P = 0.047) and wide excursions of the head (95% CI 1.0–45.7; P = 0.047). Middle ear polyps were associated with 8.8 times the odds of presenting with Horner syndrome (95% CI 1.5–50.0; P = 0.015).

Conclusions and relevance

Although it may be difficult to identify the underlying diagnosis in cats with vestibular syndrome from the presenting features alone, there are instances in which discrete clinical features may help to guide clinical reasoning when evaluating cats with vestibular presentations.
Playing the past: Historical video games as participatory public history in China
Authors: Li Na
Published: November 2020

Historical video games, as one genre of historical reenactment in the digital environment, have rapidly evolved in China during the past two decades. Probing the affective, imaginative, and playful nature of historical video games, this article argues that the power of historical video games lies first in the methodological value and pedagogical virtue of the counterfactual thinking, and second in the potential to digitally and collectively shape the historical consciousness of players. With a potential for a shared authority, historical video games have emerged as participatory public history in China.
Preliminary evaluation of an inter-professional e-consultation on vaccines
Authors: Fernández-Prada María , Cano-García Paula , Alonso-Penanes Paula , Zapico-Baragaño María J , Giménez-Gómez Pia , Lana Alberto
Published: November 2020

The aim of this study was to assess the preliminary effectiveness and acceptability of an inter-professional e-consultation on vaccines. We used a quasi-experimental design to introduce an application in electronic health records that allowed primary health providers to launch e-consults to the hospital vaccines unit. A total of 135 e-consults were received during 10 months. E-consults were more frequently about subjects with chronic diseases (82.2%). Most of the e-consults were global (60.7%), that is, to revise a patient’s complete vaccination schedule, whereas 39.3% were specific, that is, to request information regarding a concrete vaccine or serology, with hepatitis vaccines leading the ranking (42.9%). The e-consultation avoided hospital referral in 85.4% of the global e-consults and in 100% of the specific e-consults. Indicators of acceptability were all above nine points (10 points indicated the maximum). The best-rated aspect was the level of recommendation (9.7 ± 0.68 points). In summary, linking primary health-care providers with specialists in vaccines through an e-consultation tool is effective and well-accepted by users.
Protecting women from violence through legislation in Nigeria: Need to enforce anti-discrimination laws
Authors: Arowolo Grace Ayodele
Published: November 2020

Violence against women is a commonplace and widespread phenomenon in Nigeria. It results from multifarious factors the major ones being gender discrimination/male chauvinism, despite the ratification of major international anti-discrimination laws and the enactment of national laws that prohibit violence. Preliminary investigations reveal among others, that these ratified international anti-discrimination instruments are not yet domesticated into law, while some of the national laws condone violence against women, as encouraged by the patriarchal nature of the Nigerian society which is influenced by culture and religion as enshrined within the plural Nigerian legal system. The article highlights the major Nigerian Federal legislation and their failure to adequately combat violence against women. It argues that the domestication and enforcement of CEDAW and other relevant international anti-discrimination instruments, a review of extant Nigerian laws, and the abolition of Nigerian societal practices and other obnoxious beliefs can lead to adequate protection of women from violence.
Are Spanish Students Customers? Paradoxical Perceptions of the Impact of Marketisation on Higher Education in Spain
Authors: Jayadeva Sazana , Brooks Rachel , Gupta Achala , Abrahams Jessie , Lažetič Predrag , Lainio Anu
Published: November 2020

This article examines how higher education (HE) students are conceptualised in Spain, drawing on an analysis of policy and institutional narratives about such students, as well as on the perspectives of university staff and students themselves. More specifically, it will explore an interesting paradox that we encountered in our data: on one hand, marketisation is less firmly established in the HE system of Spain than in many other European countries, and policy and institutional narratives in Spain present the HE system as being relatively unmarketised. On the other hand, the staff and students we interviewed presented the Spanish HE system and the student experience as having been dramatically transformed by marketisation. In analysing this paradox, the article highlights the importance of not viewing countries as coherent educational entities. In addition – while broadly supporting scholarship that has pointed to a growing market orientation of national HE systems across Europe – the article draws attention to how the manner in which the marketisation of HE is experienced on the ground can be very different in different national contexts, and may be mediated by a number of factors, including perceptions about the quality of educational provision and the labour market rewards of a degree; the manner in which the private cost of education (if any) is borne by students and their families; and the extent to which marketisation may have become entrenched and normalised in the HE system of a country.
Carceral lock-in: How organizational conditions stymie the development of justice alternatives in a rape crisis center
Authors: Weiss Benjamin R
Published: November 2020

Many perpetrators of sexual violence are themselves victims of similar crimes. Such “complex victims” do not fit neatly into the dichotomous categories of victim and perpetrator essential to the functioning of the adversarial criminal-legal system. How anti-rape activists attempt to incorporate complex victims into their work illustrates challenges they experience when wrestling with the carceral state more broadly. In this article, I draw on 32 months of participant observation and 40 in-depth interviews to show how organizational conditions—departmental silos and physical infrastructure—prevent activists’ treatment of complex victims. Building on the concept of path dependence from organization theory, I argue that carceral understandings of harm become “locked-in” despite activists’ anti-carceral attitudes. This article identifies barriers to the treatment of complex victims, further explains feminist activists’ simultaneously contentious and coalitional relationship with the carceral state, and introduces the concept of carceral lock-in to help understand impediments to justice alternatives.
Designing compelling accommodationscapes: Testing a framework in a rural context
Authors: Agapito Dora , Pinto Patrícia , Ascenção Mário Passos , Tuominen Pasi
Published: November 2020

Well-designed experiencescapes are deemed a key factor in the marketing of tourist experiences aiming at positive tourists’ responses. However, this aspect has been underrepresented in empirical research focused on accommodation businesses. This study proposes the construct compelling accommodationscape and empirically tests a theoretical framework in a rural context through the lens of experiential marketing. The proposed construct is presented as the external stimuli that underlie an engaging context of the guest experience in lodging units, based on the idea that a holistic approach to stimuli can evoke interest and attention; and, subsequently, act as a driver to positive action. Apart from physical stimuli and staff performance, which have been the factors more commonly examined in services marketing, the construct compelling accommodationscape extends the servicescape approach by also addressing product-related factors, the existence of a theme and social interactions. Structural equation modelling applied to data from a survey administered in rural lodgings in Southwest Portugal supports that the five external factors underlie the proposed construct. In turn, compelling accommodationscape is positively related to tourists’ satisfaction and positive behavioural intentions. Theoretical and practical implications are provided for scholars and rural accommodation managers.
Implications for social work teaching and learning in Universiti Sains Malaysia, Penang, due to the COVID-19 pandemic: A reflection
Authors: Azman Azlinda , Singh Paramjit Singh Jamir , Isahaque Ali
Published: November 2020

The global lockdown due to COVID-19 is a major concern as all higher educational institutions face disruption in teaching, learning and assessment. Social work educators in Malaysia’s higher educational institutions are not spared of this disruption. Conventional teaching methods are now being replaced by non-conventional modes of teaching, which include online teaching and assessment using various platforms such as Zoom, WebEx and others. In embarking on online methods of teaching, social work educators will have to undergo many changes. It is particularly so as social work has a practice component that involves field training, which will be a different challenge to educators and students in this new and unexpected environment. This paper aims to discuss the implications of COVID-19 on the changes that have taken place in social work teaching and learning in Malaysia and potential responses.
Online Quizzes with Closed Questions in Formal Assessment: How Elaborate Feedback can Promote Learning
Authors: Enders Natalie , Gaschler Robert , Kubik Veit
Published: November 2020

Online-quizzes are an economic and objective method for formative assessment in universities. However, closed questions have been criticized for promoting shallow learning and resulting often in poor learning outcomes. These disadvantages can be overcome by embedding closed questions in effective instructional designs involving feedback. In the present field study, a final sample of N = 496 students completed the same online quiz, consisting of 60 true–false statements on the biological bases of psychology in two sessions. In order to enhance the benefit of formative testing on students’ test achievement in Session 2, students received elaborate feedback (i.e., by providing explanations for the in-/correctness) for half of their answers in Session 1, and corrective feedback (i.e., just indicating the in-/correctness) for the other half. The results showed that students scored higher in Session 2 if elaborate feedback had been provided in Session 1, compared with when corrective feedback was provided. More specifically, students profited more from elaborate feedback on incorrect answers in Session 1 than from feedback on correct answers. As a practical recommendation, self-administered formative tests with closed-question format should at least provide explanations why students’ answers are incorrect.
Developmental Post-Conflict Reconstruction in Postindependence Nigeria: Lessons From Asian Developmental States
Authors: Ikpe Eka
Published: November 2020

Post-conflict reconstruction (PCR) has come away from a dynamic reading of the role of the state within contemporary reflections on peacebuilding. This article introduces the framework of developmental PCR that draws on the developmental state paradigm to offer a lens for understanding the role of the state and its complex interlinkages with other milieus such as the market in PCR. Developmental PCR is premised on three tenets: interdependence between economic development and security; the importance of state–market interdependencies within industrial development, as reconstruction; and how characterisations of statehood interact with reconstruction. The deployment of developmental PCR in the case study of the Nigerian Civil War illuminates certain realities such as the significance of economic nationalism to security, complex interdependencies across the state and market that underpinned key elements of industrial policy during reconstruction, and the nuances in the characterisation of the Nigerian state as strong on account of military regimes.
The influence of the number of part-set cues on order retention
Authors: Kelley Matthew R , Strejc Madison , Walts Zoe L , Uribe Yesenia , Gonzales Leslie , Tcaturian Estella , Keller Anne E , Bronswick Julia K , Stephany Sophia E
Published: November 2020

Across seven experiments, the present article examined the influence of the number of part-set cues on order retention, as assessed by both reconstruction of order and serial recall tests. Historically, part-set cueing facilitation occurs when half of the items are provided as valid part-set cues on tests of order memory. Using a variety of list lengths (10 or 16), numbers of cues (0–14), and types of cues (full or partial), the present experiments showed disparate effects of the number of part-set cues on reconstruction and serial recall tasks. On reconstruction tests, a minimum number of full cues was required before part-set cueing facilitation was produced and the magnitude of facilitation increased as the number of cues increased. Generally, partial cues did not influence order retention until almost the entire list was provided as partial cues. On serial recall tests, part-set cueing facilitation was only evident with a few full cues. In contrast, part-set cueing impairment was the norm when many partial cues were provided. These results were largely consistent with predictions of the retrieval strategy disruption hypothesis, as well as with an anchoring account of part-set cueing for order.
ICU outcomes in Covid-19 patients with obesity
Authors: Parikh Raj , Garcia Michael A. , Rajendran Iniya , Johnson Shelsey , Mesfin Nathan , Weinberg Janice , Reardon Christine C.
Published: November 2020

The reviews of this paper are available via the supplemental material section.
Empirical or susceptibility-guided treatment for Helicobacter pylori infection? A comprehensive review
Authors: Gisbert Javier P.
Published: November 2020

Although susceptibility-guided therapy is frequently recommended for Helicobacter pylori infection, the evidence available to date supporting this strategy is limited. The aim of the present article is to review the advantages and limitations of the susceptibility-guided and the empirical strategies to treat this infection. We performed a bibliographic search to identify studies investigating H. pylori susceptibility-guided therapy. Culture is not the only way to assess antibiotic resistance, as different polymerase chain reaction-based approaches have been developed as alternative methods. For detecting H. pylori antimicrobial resistance, a molecular approach based on a stool sample might enable more convenient, time-saving methods. Unfortunately, the antimicrobial susceptibility cannot be obtained in all cases. Furthermore, antibiotic susceptibility testing in clinical practice yields useful information only for a few antibiotics: clarithromycin, metronidazole, and quinolones. In addition, susceptibility towards clarithromycin and metronidazole in vitro does not necessarily lead to eradication in vivo. In the case of H. pylori therapy failure, we should not re-administer any of the antibiotics against which H. pylori has probably become resistant. Our updated meta-analysis showed that susceptibility-guided treatment is not better than empirical treatment of H. pylori infection in first-line therapy if the most updated quadruple regimens are empirically prescribed, and similar efficacy results were also demonstrated with the two strategies for second-line therapy. Cumulative H. pylori eradication rate with several successive rescue therapies empirically prescribed reaches almost 100%. Finally, the studies that have evaluated the cost-effectiveness of the susceptibility-guided treatment have achieved contradictory results. In summary, we can conclude that the evidence is too limited to support the generalized use of susceptibility-guided therapy for H. pylori treatment in routine clinical practice, either as first-line or as rescue treatment. Nevertheless, it would be recommended that susceptibility tests are performed routinely, even before prescribing first-line treatment, in specialized centers with an interest in H. pylori management.
Biomarkers are associated with clinical and endoscopic outcomes with vedolizumab treatment in Crohn’s disease
Authors: Holmer Ariela K. , Battat Robert , Dulai Parambir S. , Vande Casteele Niels , Nguyen Nghia , Jain Anjali , Miralles Ara , Neill Jennifer , Le Helen , Singh Siddharth , Rivera-Nieves Jesus , Sandborn William J. , Boland Brigid S.
Published: November 2020

Background:

Vedolizumab, an α4β7 integrin antagonist, is an effective therapy for Crohn’s disease (CD). Biomarkers are needed to guide therapy and predict outcomes. This study evaluated biomarker concentrations and outcomes in patients with CD undergoing vedolizumab treatment.

Methods:

Sera at weeks 0, 2, 6, 14, and ⩾26 were collected from vedolizumab-treated, refractory CD patients. Concentrations of soluble (s)-Vascular Cell Adhesion Molecule (VCAM)-1, s-Intercellular Cell Adhesion Molecule (ICAM)-1, s-Mucosal Addressin Cell Adhesion Molecule (MAdCAM)-1, and s-α4β7 integrin were evaluated for associations with achieving endoscopic remission.

Results:

A total of 22 patients with CD were included. In all patients, s-MAdCAM-1 decreased significantly and s-α4β7 increased compared with baseline. s-VCAM-1 and s-ICAM-1 changed differentially in patients who achieved remission. At week 6, median s-VCAM-1 (859.6 ng/ml versus 460.3 ng/ml, p = 0.03) and s-ICAM-1 (545.7 ng/ml versus 286.2 ng/ml, p = 0.03) concentrations were higher in patients who achieved endoscopic remission compared with those who did not, and similar differences were observed for s-ICAM-1 concentrations in patients who achieved clinical remission, compared with those who did not (669.1 ng/ml versus 291.0 ng/ml, p = 0.04). Week 14 s-α4β7 concentrations were lower in patients who achieved endoscopic remission, compared with those who did not (7.5 ng/ml versus 17.6 ng/ml, p = 0.020).

Conclusion:

In all vedolizumab-treated CD patients, s-MAdCAM-1 decreased significantly and s-α4β7 increased. However, higher concentrations of s-ICAM-1 and s-VCAM-1 at week 6 and lower concentrations of s-α4β7 at week 14 differentiated patients who achieved endoscopic remission. These findings may help identify early predictors of response to vedolizumab treatment in patients with CD. Further validation in less refractory CD patients is needed.
From Fable to Reality at Parkland Hospital: The Impact of Evidence-Based Design Strategies on Patient Safety, Healing, and Satisfaction in an Adult Inpatient Environment
Authors: Rich Renae K. , Jimenez Francesqca E. , Puumala Susan E. , DePaola Sheila , Harper Kathy , Roy Lonnie , Brittin Jeri
Published: November 2020

Objective:

This research aimed to evaluate the quantitative effects of new hospital design on adult inpatient outcomes.

Background:

Tenets of evidence-based healthcare design, notably single-patient acuity-adaptable and same-handed rooms, decentralized nursing stations, onstage offstage layout, and access to nature were expected to promote patient healing and increase patient satisfaction, while decreasing adverse events.

Methods:

Patient healing was operationalized through length of stay (LOS) and patient safety through three adverse events: falls, hospital-acquired infections (HAI), and medication-related events. Standard patient surveys captured patient satisfaction. Patient records from 2013 through 2017 allowed for equivalent time periods surrounding the move to the new hospital in August 2015. Stratified by hospital division where significant, pre/post comparisons utilized proportional hazards or logistic regression models as appropriate; interrupted time series analyses afforded longitudinal interpretations.

Results:

Observed higher postmove LOS was due to previously increasing trends, not increases after the move. In surgical and trauma units, a constant increase in falls was unaffected by the move. Medication events decreased consistently over time; medication events with harm dropped significantly after the move. No change in HAI was found. Significant improvement on most relevant patient satisfaction items occurred after the move. Call button response decreased immediately after the move but subsequently improved.

Conclusion:

Results did not clearly indicate a net change in adult inpatient outcomes of healing and safety due to the hospital design. There was evidence that the new hospital improved patient satisfaction outcomes related to the environment, including comfort, noise, temperature, and aesthetics.
Election Night Broadcasts and the Hybrid Media System: A Case Study of Australia
Authors: Beratis Daniel , Wright Scott
Published: November 2020

This article presents an analysis of broadcast election night coverage, contemporaneous social media data, and semi-structured interviews focused on the 2018 Victorian state election to assess the extent and nature of media hybridity that occurred. This work contributes to the field by providing the first analysis of the hybrid media system using a case study event in Australia, the first study of a second-order election, and by focusing in detail on how journalistic processes and decisions shape hybridity and how these are, themselves, shaped by hybrid logics. It finds some evidence of hybrid norms and actions, but in other ways coverage followed traditional media logics.
Talking about my generation: How values shape luxury consumption
Authors: Pueschel Julia , Parguel Béatrice , Chamaret Cécile
Published: November 2020

Literature suggests that when shopping for luxury goods, consumers arbitrate between genuine and fake luxury goods, with younger consumers being more likely to arbitrate in favor of luxury fakes because of their lower income and different values. We challenge this alleged influence in the United Arab Emirates (UAE), a country where access to luxury can be controlled for, and generations differ in values following 1990s’ meteoric takeoff. Drawing on the functional theories of attitudes, a qualitative study shows that luxury consumption does not serve the same psychological functions for the pre-boom (born before 1990) and the post-boom generational cohorts in the UAE. As such, it demonstrates the power of values when explaining the trade-off between genuine and fake luxury goods, as values can explain both a current negative influence of age on counterfeit consumption in Western countries and a positive one in the Middle East. The findings are interesting for public policy makers and managers operating in the Gulf Cooperation Council countries.
A comparative study of motion detection with FMG and sEMG methods for assistive applications
Authors: Islam Muhammad Raza Ul , Waris Asim , Kamavuako Ernest Nlandu , Bai Shaoping
Published: November 2020

Introduction

While surface-electromyography (sEMG) has been widely used in limb motion detection for the control of exoskeleton, there is an increasing interest to use forcemyography (FMG) method to detect motion. In this paper, we review the applications of two types of motion detection methods. Their performances were experimentally compared in day-to-day classification of forearm motions. The objective is to select a detection method suitable for motion assistance on a daily basis.

Methods

Comparisons of motion detection with FMG and sEMG were carried out considering classification accuracy (CA), repeatability and training scheme. For both methods, classification of motions was achieved through feed-forward neural network. Repeatability was evaluated on the basis of change in CA between days and also training schemes.

Results

The experiments shows that day-to-day CA with FMG can reach 84.9%, compared with a CA of 77.8% with sEMG, when the classifiers were trained only on the first day. Moreover, the CA with FMG can reach to 86.5%, comparable to CA of 84.1% with sEMG, if classifiers were trained daily.

Conclusions

Results suggest that data recorded from FMG is more repeatable in day-to-day testing and therefore FMG-based methods can be more useful than sEMG-based methods for motion detection in applications where exoskeletons are used as needed on a daily basis.
Mental Health Literacy of Healthcare Providers in Arab Gulf Countries: A Systematic Review
Authors: Elyamani Rowaida , Hammoud Hamed
Published: November 2020

Background:

The concept of Mental Health Literacy (MHL) relies on our capacity to understand and recognize mental illnesses and the ability to maintain and promote a positive mentality for ourselves and others. In our review, we aim to examine the level of MHL among healthcare providers in the Arab Gulf States.

Methods:

PubMed, PsycINFO, Medline were searched till August 2019. Studies were included if at least one of the main components of mental health literacy was reported, including (a) knowledge of mental illnesses, (b) stigma toward mental illnesses, (c) confidence in helping patients, and (d) behavior of helping patients, regardless of study design. The risk of bias was rated according to the modified Newcastle-Ottawa Quality Assessment Scale for cross-sectional studies.

Results:

Seven studies were included in the review; all of them were cross-sectional, with a total of 3516 participants from the healthcare system. Overall most of the studies claimed limited knowledge, negative attitudes, behavior and/or confidence among nurses, pharmacists, and physicians, especially juniors. However, the overall quality of all outcomes was relatively very low.

Conclusion:

More high-quality evidence and in-depth qualitative studies are required to bridge the gap between mental health needs and services delivered by healthcare providers in the Gulf Arab region.
The Development of Instrument to Assess Physician’s Practice in the Management of Patients With Terminal Diseases
Authors: Arisanti Nita , Sasongko Elsa Pudji Setiawati , Pandia Veranita , Hilmanto Dany
Published: November 2020

Background

The need for improving knowledge and practice of palliative care delivered by health workers become an agenda in several countries. In order to measure the practice, an instrument is needed. The study analyzed the validity and reliability of the instrument to assess the physician’s practice in the management of patients with terminal diseases.

Methods

This was a cross-sectional study involving 89 physicians practicing in primary health care. The instrument of practice has been developed and resulted 5 domains consist of 20 items. An overview of reliability, construct validity, uni-dimensionality, and hierarchy of the person-items of the instrument were analyzed using Rasch Model.

Results

The reliability of the instrument is excellent with a person measure reliability of 0.85 and the item measure reliability of 0.96. Construct validity is confirmed with the MNSQ outfit values in the range of 0.54 to 1.59 and Pt Measure Corr. values in the range of 0.31 to 0.8. This instrument has a value of more than 20% unidimensionality which indicates the level of independence for items is good.

Conclusion

The instrument has good validity and reliability to assess physician’s practice in the management of patients with terminal disease.
Using a Wearable Activity Monitor to Accurately Measure Mobility After Surgery for Hip Fractures (MASH)—A Feasibility Study Protocol
Authors: Berwin James T. , Macdonald Hamish , Fleming Tom , Kempshall Peter , Engelke Daniel
Published: November 2020

Introduction:

Hip fractures are the most common reason for acute orthopaedic admission in the United Kingdom (UK) and pose a substantial cost to the National Health Service (NHS). A significant proportion of this expenditure is accounted for by hospital bed days, with additional contributions from health and social aftercare. Early ambulation following hip fracture surgery improves outcomes by accelerating functional recovery and reducing the need for ongoing care. The ability to track a patient’s rehabilitation is important in assessing their care needs. While this is challenging to assess accurately, doing so may help to further improve outcomes. The aim of this feasibility study is to determine whether it is possible to accurately measure Mobility After Surgery for Hip fractures (MASH) in the immediate post-operative period by tracking the frequency of mobilization, distance walked and overall activity in the first week following surgery using a wearable activity monitor, the activPAL device.

Methods and Materials:

A total of 50 patients will be recruited to participate in the study. Ethical approval was given to recruit patients with and without capacity to consent. Immediately after undergoing hip fracture surgery, a activPAL monitor weighing 9 grams and measuring 23.5 mm x 43 x 5 mm in size will be applied to the anterior aspect of the participants thigh with a standard adhesive dressing. We will be assessing the feasibility of using the activPALto measure mobility in this patient group.

Discussion:

The MASH study will contribute to the design and execution of the MASH trial, which will seek to assess the accuracy by which mobility can be measured following hip fracture surgery and how this information can best be used to improve rehabilitation and care.
The Epidemiology of Fractures and Muskulo-Skeletal Traumas During COVID-19 Lockdown: A Detailed Survey of 17.591 Patients in a Wide Italian Metropolitan Area
Authors: Dolci Andrea , Marongiu Giuseppe , Leinardi Lorenzo , Lombardo Massimo , Dessì Giuseppe , Capone Antonio
Published: November 2020

Introduction:

On 9 March 2020 the Italian Government declared a national lockdown to curb the spread of Covid-19. The aim of our study was to analyze the effects of such intervention on the traumatological emergency service, with particular emphasis on variations in trauma incidence and patients’ characteristics.

Materials and Methods:

An observational analysis was performed. Medical records were collected from 3 different trauma centers within a wide metropolitan area, and compared between 2 time periods: the full Italian lockdown period and the same period from the past year. The study population included all patients who were admitted to the Emergency Department (ED). For those who accessed for orthopedic reasons, the analyzed variables included the date of ED admission, age, gender, after visit discharge or hospitalization, place where the injury occurred, traumatic mechanism, diagnosis, relationship with sport activity, and time from injury/symptoms debut to ED access.

Results:

A total of 17591 ED accesses and 3163 ED trauma visits were identified. During the lockdown, ED trauma visits decreased by -59.8%, but required patient’s hospitalization significantly more frequently. The rate of ED trauma admissions in the elderlies significantly increased, together with the proportion of fragility fractures such as hip fractures. Road accident traumas (-79.6%) and sport-related injuries (-96.2%) significantly dropped. Admissions for less-severe reasons such as atraumatic musculoskeletal pain significantly decreased (-81.6%).

Conclusions:

The lockdown reduced the pressure on the Health System in at least 2 ways: directly, by curbing viral transmission and indirectly, by more than halving the ED trauma visits. Nonetheless, we observed an increased proportion of traumas in older patients, requiring hospitalizations, while the rate of less-severe cases decreased. This analysis may raise awareness of the effects of a lockdown on trauma services and may be helpful for those ones around the world who are now facing the emergency.
What You Should Know About Osteoarthritis Rehabilitation: A Bibliometric Analysis of the 50 Most-Cited Articles
Authors: Wang Shi-Qi , Wang Jian-Xiong , Zhang Chi , Sun Fu-Hua , Xie Yu-Jie , Jiang Wei , Ou Xia , Miyamoto Akira , Wang Li
Published: November 2020

Background:

Osteoarthritis is a degenerative disease that commonly occurs in middle-aged and elderly people. High-quality articles in the field of osteoarthritis rehabilitation have not been studied in detail.

Objective:

To identify and conduct a qualitative and quantitative analysis of the 50 most-cited articles on osteoarthritis rehabilitation and provide valuable scientific information for researchers.

Methods:

Fifty articles related to the rehabilitation of individuals with osteoarthritis were retrieved from the Web of Science Core Collection. Basic information, such as the authors, title, number of citations, year of publication, journal, country/territory, and research type, was extracted. CiteSpace was used to visualize the keywords.

Results:

The average number of citations per article was 244.54. The top 50 articles were published in 27 journals and published by 262 authors. Most of the top 50 articles were published in the United States. The top 50 articles included 23 randomized controlled trials, 21 cohort studies, 2 case series, and 4 expert opinion articles. The most commonly studied topics in osteoarthritis rehabilitation included rehabilitation for pain, gait abnormalities, muscle strength deficiencies, and other functional impairments caused by osteoarthritis in elderly people.

Conclusions:

The top articles in the field of osteoarthritis rehabilitation have a high level of evidence. Collaboration between authors was high for highly-cited articles. Moreover, the eminent articles can provide important information for the education of doctors and therapists specializing in osteoarthritis rehabilitation.