bluuebunny/crossref_metadata_2025 huggingface dataset:
Engels, humanism and revolutionary praxis: The centrality of the dynamic analysis of historical materialism and its inherent relation to overcoming capitalist alienation
Authors: Jiménez Contreras Baruc
Published: May 2021

At the end of the 19th century, a debate emerged among academics of historical materialism on the apparent divergence between Engels’ and Marx’s theoretical developments. During the 20th century, those who wanted to argue that there was a dichotomy between the two authors identified Engels as responsible for historical materialism’s crises. This paper aims to demonstrate that Engels, far from distancing himself from Marx’s central positions, contributed to the formation of historical materialism as a revolutionary praxis that seeks a more rational regulation of the human metabolism with nature through overcoming the alienating conditions of the capitalist system. For this reason, the paper analyses Ludwig Feuerbach and the End of Classical German Philosophy, one of Engels’ most controversial texts, and exposes the correlation with the historical development of the revolutionary praxis in the Engels’ and Marx’s work. The article will be drawing on Adolfo Sánchez Vázquez’s Philosophy of Praxis, understood as a ‘revolutionary’ activity, and his analysis of Marx’s and Engels’ work. It is argued that one of Engels’ primary purposes, in Ludwig Feuerbach, was to show the demystification process of the Hegelian dialectical method, resulting in the formation of historical materialism as a dynamic epistemic model, that seeks to transform social reality through revolutionary praxis. The Feuerbachian ontological categories and Feuerbach’s perception of nature were the objects of the same process of demystification and critique, resulting in the characterisation of the human being in Marxism as a generic, social and historical being. Finally, it is shown that Engels demonstrates the possibilities for transformation of the human subject; for that reason, Engels’ argument is associated with the revolutionary praxis.
Complications of the Transmasseteric Anteroparotid Approach for Subcondylar Fractures: A Retrospective Study
Authors: Gilliland Jared , Ritto Fabio , Tiwana Paul
Published: May 2021

Study Design:

A retrospective analysis of patients with subcondylar fractures treated via a transmasseteric anteroparotid approach by the Oral and Maxillofacial Department at the University of Oklahoma.

Objective:

The goal of this study was to evaluate complications, morbidity, and safety with the transmasseteric anteroparotid approach for treatment of subcondylar fractures, and compare it to other findings previously reported in the literature.

Methods:

A retrospective study was conducted that consisted of 23 surgically treated patients in the past 2 years for subcondylar fractures. Only patients with pre-operative malocclusion and who underwent open reduction with internal fixation with the transmasseteric anteroparotid (TMAP) approach were included. Exclusion criteria included 1) patients treated with closed reduction 2) patients who failed the minimum of 1, 3, and 6-week post-operative visits. The examined parameters were the degree of mouth opening, occlusal relationship, facial nerve function, incidence of salivary fistula and results of imaging studies.

Results:

20 of the surgically treated patients met the inclusion criteria. Two patients were excluded due to poor post-operative follow up and 1 was a revision of an attempted closed reduction by an outside surgeon that presented with pre-existing complications. There were no cases of temporary or permanent facial nerve paralysis reported. There were 3 salivary fistulas and 2 sialoceles, which were managed conservatively and resolved within 2 weeks, and 2 cases of inadequate post-surgical maximal incisal opening (<40 mm) were observed.

Conclusion:

The transmasseteric anteroparotid approach is a safe approach for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.
Incidental T2 hyperintensities in the medial part of the bilateral globus pallidus are possibly an age-related physiological finding
Authors: Oyama Jun , Yokoyama Kota , Fujioka Tomoyuki , Nariai Tadashi , Karakama Jun , Maehara Taketoshi , Tateishi Ukihide
Published: May 2021

Background and purpose

Bilateral T2 hyperintensities in the medial part of the globus pallidus (GP) are sometimes incidentally observed in patients without a known history of diseases that present with such lesions. The purpose of this study was to evaluate the frequency of this finding and the association between this finding and age, lifestyle diseases and GP calcification.

Methods

We retrospectively investigated the brain magnetic resonance imaging (MRI) of 742 patients, which included between 104 and 108 consecutive patients from each decade of life between the 20s and 80s. The signal intensity ratio of the medial part to the lateral part of the GP in T2-weighted images (T2 medial/lateral ratio) was evaluated. For cases in which brain computed tomography images were available ( N=437), GP calcifications were also evaluated. The associations between the T2 medial/lateral ratio and age, sex, history of lifestyle diseases and GP calcification were investigated.

Results

Bilateral T2 medial/lateral ratios >1.10, 1.30 and 1.50 were observed in 29.8%, 7.1% and 1.8% of all cases, respectively. A high bilateral T2 medial/lateral ratio was observed less frequently in young patients ( p<0.01), more frequently in elderly patients and those with hypertension or dyslipidaemia ( p<0.05) and more frequently in patients with a calcified GP ( p<0.01).

Conclusion

Incidental bilateral T2 hyperintensities in the medial part of the GP on brain MRI are most likely an age-related physiological finding.
Improving before-noon discharges in the acute medical ward
Authors: Zainuddin Siti Khadijah Binte , Balakrishnan Tharmmambal
Published: May 2021

Background:

Mismatch in admission and discharge rates with poor coordination of bed availability to prepare for peak admission time do not favor patient flow in any healthcare situation. In order to meet the admissions demand from the emergency department, early discharge is advocated.

Aim:

The purpose of this study was to increase the 11:30 discharge rate in the acute medical ward to 20% within 5 months in order to facilitate patient transfers from the emergency department.

Method and intervention:

A nurse-led multidisciplinary team discussion at 10:00 was formed empowering nurses and aims to prioritize early discharges or transfer patients who require a longer stay in the hospital. The indication of expected discharge date was determined by team doctors on either day 1 or 2 of admission, to facilitate and prioritize allied health intervention or even prescription processing. Physical transfer to the discharge lounge was to occur earlier, awaiting preparation of prescription and documentation. Dedicated nursing staff who manage the discharge lounge processes, were to ensure the transfers and care arrangements to be smooth and coordinated with enhanced communication to next of kin.

Results:

The overall median rate for discharges before 11:30 in the acute medical ward was at 17%, compared to baseline median discharge rate of 12% ( p=0.05) and evening discharges that remained. With the implementation of a framework for multidisciplinary team discussion, the mean time spent on multidisciplinary team reduced to 40 min from the pre-intervention stage, ranging approximately 57–68 min.

Conclusion:

The discharge process is complex and requires multidisciplinary team collaboration and coordination. This project also created an opportunity for more relevant project targeting evening discharges that addresses another emergency department peak admission time.
Busulfan plus melphalan versus melphalan alone conditioning regimen after bortezomib based triplet induction chemotherapy for patients with newly diagnosed multiple myeloma
Authors: Park Songyi , Shin Dong-Yeop , Hong Junshik , Kim Inho , Koh Youngil , Byun Ja Min , Yoon Sung-Soo
Published: May 2021

Background:

High dose melphalan (HDMEL) is considered the standard conditioning regimen for autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients. Recent studies showed superiority of busulfan plus melphalan (BUMEL) compared to HDMEL as a conditioning regimen. We compared the efficacy of HDMEL and BUMEL in newly diagnosed Asian MM patients, who are often underrepresented.

Methods:

This is a single-center, retrospective study including MM patients who underwent ASCT after bortezomib-thalidomide-dexamethasone (VTD) triplet induction chemotherapy between January 2015 and August 2019.

Result:

In the end, 79 patients in the HDMEL group were compared to 31 patients in the BUMEL group. There were no differences between the two groups with regards to sex, age at ASCT, risk group, and stage. The HDMEL group showed better response to pre-transplant VTD compared to BUMEL, but after ASCT the BUMEL group showed better overall response. In terms of progression-free survival (PFS), although BUMEL showed trends towards better PFS regardless of pre-transplant status and age, the difference did not reach statistical significance. The BUMEL group more often experienced mucositis related to chemotherapy, but there was no difference between the two groups with regards to hospitalization days, cell engraftment, and infection rates.

Conclusion:

BUMEL conditioning deserves attention as the alternative option to HDMEL for newly diagnosed MM patients, even in the era of triplet induction chemotherapy. Specifically, patients achieving very good partial response (VGPR) or better response with triplet induction chemotherapy might benefit the most from BUMEL conditioning. Tailored conditioning regimen, based on patient’s response to induction chemotherapy and co-morbidities, can lead to better treatment outcomes.
‘Unmentionable’ condoms vs. ‘glamorous’ pills: How the London Rubber Company tackled an image problem in 1960s Britain
Authors: Borge Jessica
Published: May 2021

This article responds to a special call for papers on the subject of ‘Taboos in Health Communication: Stigma, Silence and Voice’ and presents the historic case study of the London Rubber Company, manufacturers of Durex condoms, who used PR techniques to undermine confidence in the oral contraceptive pill over 1961–1965. It is argued that continuities between the public discussion of birth control products between the 1960s and today can help practitioners to better understand the nature and uses of ‘fake news’, secrecy and transparency and the productive possibilities of rumour. It is written from the perspective of an empirical research historian with an interest in historical cases of PR relating to contraception, using a qualitative, chronological approach based on original archival research.
Global, regional, and national consumption of controlled opioids: a cross-sectional study of 214 countries and non-metropolitan territories
Authors: Richards Georgia C , Aronson Jeffrey K , Mahtani Kamal R , Heneghan Carl
Published: May 2021

Introduction:

The consumption of opioids has increased globally since the 1990s. Previous studies of global opioid consumption have concentrated on morphine alone or a subset of opioids, with a focus on cancer pain and palliative care. In this study, we have determined the global, regional, and national consumption of all controlled opioids, including anaesthetics, analgesics, antidiarrheals, opioid substitution therapies, and cough suppressants.

Methods:

We conducted a cross-sectional study using data from the International Narcotics Control Board (INCB). We calculated mean opioid consumption (mg/person) globally, regionally, and nationally for 2015–2017, where consumption refers to the total amount of controlled opioids distributed for medical purposes and excludes recreational use. We ranked countries by total consumption and quantified the types of opioids consumed globally.

Results:

Between 2015 and 2017, 90% of the world’s population consumed only 11% of controlled opioids. An average of 32 mg/person was consumed annually, but this was not equally distributed across the world. Consumption was the highest in Germany (480 mg/person), followed by Iceland (428 mg/person), the United States (398 mg/person) and Canada (333 mg/person). Oxycodone (35%) was the most heavily consumed controlled opioid globally, followed by morphine (15.9%), methadone (15.8%) and tilidine (14%).

Conclusion:

Large disparities persist in most of the world in accessing essential opioid medicines. Consumption patterns should continue to be monitored, and collaborative strategies should be developed to promote access and the appropriate prescribing of opioids in all countries and non-metropolitan territories.
Antimicrobial stewardship and antibiograms: importance of moving beyond traditional antibiograms
Authors: Klinker Kenneth P. , Hidayat Levita K. , DeRyke C. Andrew , DePestel Daryl D. , Motyl Mary , Bauer Karri A.
Published: May 2021

The rapid evolution of resistance, particularly among Gram-negative bacteria, requires appropriate identification of patients at risk followed by administration of appropriate empiric antibiotic therapy. A primary tenet of antimicrobial stewardship programs (ASPs) is the establishment of empiric antibiotic recommendations for commonly encountered infections. An important tool in providing empiric antibiotic therapy recommendations is the use of an antibiogram. While the majority of institutions use a traditional antibiogram, ASPs have an opportunity to enhance antibiogram data. The authors provide the rationale for why ASPs should implement alternative antibiograms, and the importance of incorporating an antibiogram into clinical decision support systems with the goal of providing effective empiric antibiotic therapy.
A review on recipients of hematopoietic stem cell transplantation patients with COVID-19 infection
Authors: Sahu Kamal Kant , Siddiqui Ahmad Daniyal
Published: May 2021

For the last few months, various geographical regions and health sectors have been facing challenges posed by the current COVID-19 pandemic. COVID-19 has led to significant disruption in the normal functioning of potentially life-saving therapies of hematopoietic cell transplant and chimeric antigen receptor therapy. As transplant physicians are gaining more information and experience regarding the undertaking of these complex procedures during the ongoing COVID-19 pandemic, we believe it is important to discuss the challenges faced, prognostic risk factors, and outcomes of COVID-19 in post-hematopoietic stem cell transplantation patients based on the available real-world data.
Enlightening religion: Light and darkness in religious knowledge and knowledge about religion
Authors: Stolow Jeremy , Meyer Birgit
Published: May 2021

This introduction elaborates how the relationship between religion and light can and should be addressed as a key theme for the critical study of religion. It synthesizes the principal arguments of the six articles collected in this special journal issue and locates them in a broader theoretical framework, focussing especially on the politics of knowledge production.
Messianic Illusions: Taubes, Bloch, Benjamin and the Necessity of Interiority
Authors: Steele-Fisher Benjamin
Published: May 2021

This article addresses rabbi and philosopher of religion Jacob Taubes’s claim that he had “presented the apocalypse of the revolution, although free from the illusions of messianic Marxists like Ernst Bloch and Walter Benjamin.” Detailing the shape of Taubes’s thought in relation to Bloch and Benjamin, it explores the manner in which Taubes embraces their respective messianisms while also charting an interiorized departure predicated upon a history of messianic crisis in Sabbateanism and early Christianity. Further, it frames this in terms of their respective historical contexts. Contrary to the Weimar-era messianism of Bloch and Benjamin inflected by an open futurity despite catastrophe, Taubes's messianism takes shape in response to a foreclosed future brought on by the events of the postwar era.
Speaking “religion” through a gender code: The discursive power and gendered-racial implications of the religious label
Authors: Khan Rabea M
Published: May 2021

Drawing on the scholarship of Critical Religion, this article shows how the modern category “religion” operates through a gender code which upholds its discursive power and enables the production of religious—and therefore racial—hierarchies. Specifically, it argues that mentioning religion automatically makes gender present in discourse. Acknowledging religion as an inherently gendered category in this way gives further insight into the discursive power and functioning of the religious label. With the example of the Westphalian production of the “myth of religious violence” and the employment of “religion” in colonial contexts, I demonstrate how a gender code upholds and enables the discursive power of religion. Religion is both gendered (as part of the Western public/private binary) and gendering (in colonial contexts vis-à-vis non-Christian, non-White religions). Acknowledging the multiple ways in which religion is gendered and gendering, then, has important bearings on the analysis of religion’s racializing function which is upheld and aided by the gender code through which religion is spoken.
Descriptive cross-sectional study on knowledge, awareness and adherence to medication among hypertensive patients in a tertiary care center, Eastern Sri Lanka
Authors: Pirasath Selladurai , Sundaresan Thadchanamoorthy
Published: May 2021

Introduction:

Hypertension is one of the common non-communicable diseases and public health problem among developed and developing countries. The lack of knowledge and awareness on hypertension and poor adherence of medication are a major challenge to control hypertension and prevent its complications. Our study aimed to assess the knowledge, awareness of hypertension and adherence to medication among hypertensive patients attending the medical clinics of a tertiary care center, Eastern Province of Sri Lanka.

Methods:

A descriptive cross-sectional study was conducted among hypertensive patients to assess knowledge, awareness of hypertension and adherence to medication in medical clinics in a tertiary care for 6 months duration. Data were collected by using pretested and validated Hypertension Facts Questionnaire. Their medication adherence and the reasons for nonadherence were studied using Medication Adherence Scale. Data were analyzed using SPSS (version 18) analytical package and the chi-square test was performed. The scoring system was used to categorize the level of knowledge and awareness of hypertension among patients.

Results:

The majority of patients had moderate-to-high knowledge (101, 65.8%) about hypertension and had moderate-to-high awareness (111, 73.2%) on hypertension. Even though, 134 (87.6%) patients knew that they have hypertension, and 108 (70.6%) patients did not know their blood pressure value at the time of diagnosis. Most of the patients (90, 58.8%) had good drug adherence, and most of them (141, 92.1%) thought that taking medicine plays a key role to control their blood pressure. The main reasons for nonadherence of medication were forgetfulness (39, 32%) and expenses (46, 35.4%). The knowledge and awareness about hypertension among respondents were significantly associated with educational level (p < 0.05)

Conclusion:

Most of the patients had adequate knowledge on the risk factors and complications of hypertension. But they were unaware about their disease status, and their diagnosis, target organ damage and recent blood pressure values. The drug adherence was reasonably adequate. The main reasons for nonadherence of medication were forgetfulness and expenses.
Evaluation of circulating β2-microglobulin as a prognostic factor for biochemical recurrence after radical prostatectomy
Authors: Nikoobakht Mohammad R , Khalili Masoud , Dialameh Hossein , A Pishkuhi Mahin , Karimi Arash , Ramezani-Binabaj Mahdi , Jelveh-Moghaddam Erfan
Published: May 2021

Objectives:

One of the most challenging issues after radical prostatectomy (RP) is biochemical recurrence (BCR). The prediction of BCR can determine the selection of modality and its continuation. Currently, preoperative PSA level, Gleason score, and stage of tumor are used for prediction of BCR. The association of β2-microglobulin (B2MG) with hematologic and solid tumors, such as prostate cancer, was suggested in previous studies. The circulating B2MG, as a risk factor for BCR, has been applied for the first time in the current study. Circulating B2MG likely provides a good environment for the growth of cancer cells due to its angiogenesis and tumorigenesis properties.

Methods and materials:

A cohort study of 59 patients who underwent RP from 2012 to 2013 was carried out. B2MG was measured in the stored serum samples taken from the patients who underwent biopsy. Patients were monitored for BCR and metastasis caused by prostate cancer over a five-year period. The association of B2MG level with the PSA rising were investigated using multivariate models by adjustment for age, PSA, and Gleason's score effects.

Results:

Mean concentration of B2MG varied significantly according to patient age, PSA, and Gleason's score. One unit increase in the B2MG may significantly increase the hazard of PSA rising (HR=2.528; 95% CI 1.101–5.319; p-value=0.015). Hazard of PSA rising in high-risk groups was a 2.543-fold increase with a unit increase in B2MG.

Conclusion:

B2MG could help identify those who would derive the greatest benefit from additional systemic or local treatment.

Level of evidence:

Not applicable for this multicentre audit.
Prognostic and predictive role of intra-tumoral CXCR1 expression in patients receiving tyrosine kinase inhibitors for metastatic clear-cell renal cell carcinoma
Authors: Panaiyadiyan Sridhar , Nayak Brusabhanu , Singh Prabhjot , Kaushal Seema , Karmakar Subhradip , Seth Amlesh
Published: May 2021

Objective:

We aimed to evaluate the role of intra-tumoral CXCR1 expression in predicting prognosis and treatment response in metastatic clear-cell renal cell carcinoma patients receiving tyrosine kinase inhibitors.

Materials and methods:

Patients with metastatic clear-cell renal cell carcinoma presented between February 2018–December 2019 were studied for the CXCR1 expression in tumor tissues before starting tyrosine kinase inhibitors. Primary outcome measure was progression-free survival. Secondary outcome measures included overall survival and prediction of treatment response.

Results:

The study included 35 patients with a mean age of 53.6±9.6 years. At a mean follow-up of 12.2±4.1 months, 17 (48.6%) patients had disease progression including eight (22.9%) deaths. Patients with high CXCR1 expression, compared to those with low CXCR1 expression, had a significantly shorter 12-month progression-free survival (35.4% vs 77.9%, p=0.01) and an insignificant impact on 12-month overall survival. The CXCR1 expression scores significantly differed between patients with progressive and nonprogressive disease (20.1 vs 15.1, p=0.01) and patients with high CXCR1 expression had a reduced benefit from tyrosine kinase inhibitors. The multivariate Cox regression analysis showed CXCR1 expression as a significant predictor of progression-free survival.

Conclusion:

High intra-tumoral CXCR1 expression before tyrosine kinase inhibitors can be an independent prognostic factor for progression-free survival and predictor of reduced benefit in patients with metastatic clear-cell renal cell carcinoma.

Level of evidence:

Level 2b.
Assessing biases, relaxing moralism: On ground-truthing practices in machine learning design and application
Authors: Jaton Florian
Published: May 2021

This theoretical paper considers the morality of machine learning algorithms and systems in the light of the biases that ground their correctness. It begins by presenting biases not as a priori negative entities but as contingent external referents—often gathered in benchmarked repositories called ground-truth datasets—that define what needs to be learned and allow for performance measures. I then argue that ground-truth datasets and their concomitant practices—that fundamentally involve establishing biases to enable learning procedures—can be described by their respective morality, here defined as the more or less accounted experience of hesitation when faced with what pragmatist philosopher William James called “genuine options”—that is, choices to be made in the heat of the moment that engage different possible futures. I then stress three constitutive dimensions of this pragmatist morality, as far as ground-truthing practices are concerned: (I) the definition of the problem to be solved (problematization), (II) the identification of the data to be collected and set up (databasing), and (III) the qualification of the targets to be learned (labeling). I finally suggest that this three-dimensional conceptual space can be used to map machine learning algorithmic projects in terms of the morality of their respective and constitutive ground-truthing practices. Such techno-moral graphs may, in turn, serve as equipment for greater governance of machine learning algorithms and systems.
The COVID-19 Infodemic: Twitter versus Facebook
Authors: Yang Kai-Cheng , Pierri Francesco , Hui Pik-Mai , Axelrod David , Torres-Lugo Christopher , Bryden John , Menczer Filippo
Published: May 2021

The global spread of the novel coronavirus is affected by the spread of related misinformation—the so-called COVID-19 Infodemic—that makes populations more vulnerable to the disease through resistance to mitigation efforts. Here, we analyze the prevalence and diffusion of links to low-credibility content about the pandemic across two major social media platforms, Twitter and Facebook. We characterize cross-platform similarities and differences in popular sources, diffusion patterns, influencers, coordination, and automation. Comparing the two platforms, we find divergence among the prevalence of popular low-credibility sources and suspicious videos. A minority of accounts and pages exert a strong influence on each platform. These misinformation “superspreaders” are often associated with the low-credibility sources and tend to be verified by the platforms. On both platforms, there is evidence of coordinated sharing of Infodemic content. The overt nature of this manipulation points to the need for societal-level solutions in addition to mitigation strategies within the platforms. However, we highlight limits imposed by inconsistent data-access policies on our capability to study harmful manipulations of information ecosystems.
“It was an unexpected bond”: How an emerging participant-driven online social network may be enhancing an eLearning nutrition education & supplemental produce intervention
Authors: Stotz Sarah A , Lee Jung Sun , Thompson Jennifer Jo
Published: May 2021

Objective

The purpose of this paper is to describe a participant-driven, online text message-based social support network that emerged from an eLearning nutrition education and supplemental produce intervention.

Methods

Adults (n = 20) who utilized a safety-net clinic for their healthcare participated in a 12-week smartphone-based nutrition education eLearning program using loaned smartphones. Participants also received a box of fresh produce weekly. Participants received weekly text message reminders to collect their produce, and from this researcher-initiated reminder text, a supportive, participant-led, all-group text message thread commenced. Researchers collected all 471 text messages in this all-group thread and included them in the qualitative content analysis of pre and post intervention focus groups.

Results

The original design of the eLearning nutrition education program was to asynchronously engage learners with nutrition education resources. However, participants themselves initiated a robust group text message support system through which they shared encouragement, recipes, grocery shopping tips, and images of food they prepared with the produce box amongst themselves for the duration of the 12-week intervention.

Conclusion

The novel nature by which these participants voluntarily engaged in this peer-to-peer nutrition education-focused text message conversation exemplifies participants becoming agents in their own learning experience and will be used to enhance future eLearning nutrition education experiences developed by our team.
AQP4-IgG autoimmunity in Japan and Germany: Differences in clinical profiles and prognosis in seropositive neuromyelitis optica spectrum disorders
Authors: Asseyer Susanna , Masuda Hiroki , Mori Masahiro , Bellmann-Strobl Judith , Ruprecht Klemens , Siebert Nadja , Cooper Graham , Chien Claudia , Duchow Ankelien , Schließeit Jana , Liu Jia , Sugimoto Kazuo , Uzawa Akiyuki , Ohtani Ryohei , Paul Friedemann , Brandt Alexander U , Kuwabara *Satoshi , Zimmermann *Hanna G
Published: May 2021

Background

Clinical outcomes in neuromyelitis optica spectrum disorders (NMOSD) vary across different regions.

Objective

To describe clinical profiles in Japanese and German NMOSD patients.

Methods

Medical records of aquaporin-4-immunoglobulin G (AQP4-IgG) positive NMOSD patients from Japan (n = 54) and Germany (n = 38) were retrospectively analyzed.

Results

The disability status was similar between both cohorts, although Japanese patients had a longer disease duration (13.3 ± 11.1 vs. 8.1 ± 6.9 years, p = 0.018) but similar relapse rates. Optic neuritis and myelitis were the most frequent attacks in both cohorts. Brain attacks occurred more frequently in Japanese patients (40.7% vs. 15.8%, p = 0.020). The time from disease onset (median [interquartile range] 2.3 [0.3-10.1] vs. 0.6 [0.2-1.9] years, p = 0.009) and the number of attacks (2.5 [1-7] vs. 2 [1-3], p = 0.047) until start of the first immunotherapy were higher in the Japanese cohort. Rituximab was the most common drug in the German cohort (52.6%) and not given in the Japanese cohort (p < 0.001), where oral prednisolone was the most common drug (92.6% vs. 15.8%, p < 0.001). The frequency of autoimmune comorbidities was higher in the German cohort (39.5% vs. 18.5%, p = 0.047).

Conclusion

Compared with Japanese NMOSD patients, German patients presented with similar disability despite shorter disease duration and earlier and more frequent immunosuppressive therapy.
The character of Controlled schools in Northern Ireland: A complementary perspective to that of Gracie and Brown
Authors: Barnes L Philip
Published: May 2021

The aim of this article is to interact with Anita Gracie and Andrew W Brown’s recent account of the historical development and nature of Controlled schools and of religious education in Northern Ireland in this journal. A complementary perspective is used to illustrate how the relationship between the Protestant churches and Controlled schools has evolved, and the bearing this has on how best to describe them. This is followed by a consideration of their claim that the type of education and of religious education practised in Anglican schools in England provide a model for Controlled schools to emulate.
Hope and anxiety: The study of female embodied experience with assisted reproductive technology
Authors: Yu Chengpu , Li Wanlin , Deng Mingfen
Published: May 2021

Assisted reproductive technology (ART) is hailed as “the holy grail” for infertile patients in the mainstream narrative. The existing studies have clearly demonstrated how external social factors shape how ART is to be used, but they ignore the recipients of the technologies, and especially the experiences of women. Based on an investigation conducted in Z hospital’s reproductive center, this article regards embodiment as the methodological orientation for integrating socio-cultural context with female embodied experience in order to show their bio-social entanglement. As fieldwork evidence indicates, ART in practice is far from simple “hope technology”; instead, it throws women into a paradoxical world in which hope and anxiety coexist. Embodied experience, hope, and anxiety are transmitted through the bodies of women, which reveals the inscription of social-cultural context and technical uncertainty on the female body and, meanwhile, women actively learn strategies by which to cope with the technical uncertainty and moral pressures from local culture (including healing the body, folk religion, etc.), so as to hold onto infertility treatment with hope.
The serum C-reactive protein to prealbumin ratio and fibrinogen to prealbumin ratio are two relevant indicators for evaluating the disease activity of ankylosing spondylitis
Authors: Zhang Kai , Wang Junhao , Chen Jinhong , Li Zhi , Lou Zhaohui
Published: May 2021

The C-reactive protein to prealbumin ratio (CPR) and fibrinogen to prealbumin ratio (FPR) in serum are two emerging biomarkers. The purpose of this study is to explore the relationship between these two markers and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Scores (ASDAS). A total of 163 patients with AS and 120 healthy examinees were included in this study. The t-test and Mann-Whitney U ranking test were used to analyze the differences between groups. The spearman-test was used to analyze the correlation between erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), fibrinogen (Fib), prealbumin (PAlb), CPR, FPR, and AS disease activity in the test group. We generated the receiver operating characteristic curves (ROC) of CPR and FPR and determined the discriminating ability by calculating the area under the curve (AUC). Compared with the healthy group, ESR ( p < 0.001), CRP ( p < 0.001), Fib ( p < 0.001), CPR ( p < 0.001), and FPR ( p < 0.001) of AS patients were significantly increased, while PAlb was significantly reduced. CPR and FPR were more correlated to ASDAS-CRP. CPR was positively correlated with CRP, ESR, BASDAI, and ASDAS-CRP in AS patients ( r = 0.959, p < 0.001, r = 0.717, p < 0.001, r = 0.704, p < 0.001, r = 0.763, p < 0.001). FPR was positively correlated with CRP, ESR BASDAI, and ASDAS-CRP in AS patients ( r = 0.779, p < 0.001, r = 0709, p < 0.001, r = 0.551, p < 0.001, r = 0.763, p < 0.001). ROC showed that the AUC levels of CPR and FPR were high (AUC = 0.952 and AUC = 0.893). CPR and FPR are two promising new biological indicators for assessing disease activity in AS patients.
Prolonged concussion effects: Constellations of cognitive deficits detected up to year after injury
Authors: Leeds Daniel D , Nguyen Annie , D’Lauro Christopher , Jackson Jonathan C , Johnson Brian R
Published: May 2021

Concussions are associated with an array of physical, emotional, cognitive, and sleep symptoms at multiple timescales. Cognitive recovery occurs relatively quickly – five-to-seven days on average. Yet, recent evidence suggests that some neurophysiological changes can be identified one year after a concussion. To that end, we examine more nuanced patterns in cognitive tests to determine whether cognitive abilities could identify a concussion within one-year post injury. A radial-basis (non-linear boundary) support vector machine classifier was trained to use cognitive performance measures to distinguish participants with no prior concussion from participants with prior concussion in the past year. After incorporating only 10 cognitive measures, or all 5 composite measures from the neurocognitive assessment (Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)), over 90% accuracy was achieved in identifying both participants without prior concussions and participants with concussions in the past year, particularly when relying on non-linear patterns. Notably, classification accuracy stayed relatively constant between participants who had a concussion early or late in the one-year window. Thus, with substantial accuracy, a prior concussion can be identified using a non-linear combination of cognitive measures. Cognitive effects from concussion linger one-year post-injury, indicating the importance of continuing to follow concussion patients for many months after recovery and to take special note of constellations of cognitive abilities.
Knowledge, Attitudes, Behaviors of Women Related to Pregnancy, and Early Childhood Caries Prevention: A Cross-Sectional Pilot Study
Authors: Shimpi Neel , Glurich Ingrid , Maybury Catherine , Wang Min Qi , Hashimoto Kazumasa , Acharya Amit , Horowitz Alice M.
Published: May 2021

Objective

Health education interventions during pregnancy can influence maternal oral health (OH), maternal OH-behaviors and children’s OH. Interventions that can be delivered at anytime and anywhere, for example mobile-health (mHealth) provides an opportunity to address challenges of health education and support activation of women in underserved and rural communities to modify their health behavior. This pilot study was undertaken as a part of a mHealth initiative to determine knowledge, attitudes, and behaviors related to pregnancy and ECC prevention among women attending obstetrics/gynecology (OB/GYN) practices at a large rurally-based clinic.

Methods

A cross-sectional survey study was voluntarily engaged by women (n = 191) aged 18 to 59 years attending OB/GYN visits, over a 3-week period from 12/2019 to 1/2020. Survey results were analyzed applying descriptive statistics, X2 and Fisher’s Exact tests. The significance level was set at P < .0001 for all analyses.

Results

Approximately half of respondents were between 18 and 29 years (53%), had a college degree (55%), and 100% reported cell phone use. Whereas 53% and 31%, respectively, indicated that they were “somewhat” or “very” sure of how to prevent ECC in their children, only 9% recognized evidence of early decay and 30% did not know the purpose of fluoride. Overall, only 27% of participants correctly answered the knowledge-based questions. Further, only 57% reported their provider explained things in a way that was easy to understand. Only 24% reported seeing a dentist during their current pregnancy.

Conclusions

Study results suggested potential gaps in knowledge and behaviors related to ECC prevention and provided baseline data to inform future interventions to improve ECC prevention practices. Notably, majority of participants used their cell phones for making medical/dental appointments and reported using their phones to look up health-related information. This demographic represents a potentially receptive target for mHealth approaches to improve understanding of oral health maintenance during pregnancy and ECC prevention.
Revelations from the Clinic: Protective Behaviors and Perceptions among People at High Risk for Severe Illness from COVID-19
Authors: Greathouse Frances R. , Nagia Sally T. , Rayyan Morsi S. , Bailey Beth A.
Published: May 2021

Objectives

The CDC has warned of increased risk for severe COVID-19 illness among those with certain preexisting conditions. Protective behaviors such as social distancing and mask-wearing have been shown effective at curbing infection rates. These practices are subject to individual perceptions of risk and responsibility. This study aimed to characterize the risk perceptions and protective behaviors of residents in a rural central Michigan region. Specifically, we examined whether individual risk status predicted protective behaviors and concern about the pandemic.

Methods

Participants were identified via medical records at participating clinics. The high-risk group was those with conditions that put them at increased risk of severe illness from COVID-19, and was compared to healthy controls. Data were collected via phone survey. Participants were asked about their protective behaviors and level of concern about the ongoing pandemic.

Results

A total of 150 patients participated in the survey; 73 were high-risk acknowledgers, 29 were high-risk deniers, and 48 were healthy controls. There was no significant difference between the groups on level of concern regarding the pandemic or protective behaviors ( P > .05). Compared to other comorbidities, obese people were significantly more likely to deny their risk ( P < .05).

Conclusions

In this study, high risk, whether acknowledged or denied, did not appear to significantly impact behaviors or concern. The high percentage of those at high risk who did not acknowledge this suggests many factors including a potential lack of patient education regarding their comorbidities, specifically, how their illness increases their risk of severe illness from COVID-19.
Unicommissural Unicuspid Aortic Valve, Ascending Aortic Aneurysm, and Bovine Arch: A Rare Case Report
Authors: Wilson Zachary T. , Stockdale Graham , Reichert William B. , Colon Modesto , Morris Michael , Moe Tabitha G.
Published: May 2021

A 24-year-old man presented with rapidly progressive dyspnea due to mixed aortic stenosis and insufficiency. Unicommissural unicuspid aortic valve, ascending aortic aneurysm, and a bovine arch were identified on computed tomography angiography. Uncomplicated surgical mechanical valve replacement and ascending aortic graft placement improved his symptoms. Aortopathy is common in unicuspid valve patients.
Ectopia Cordis Sternal Cleft Repair With Mandibular Distractors: A Follow-Up Case Report
Authors: Bharadwaj Sandeep , Vicari Frank A. , Backer Carl L. , Eltayeb Osama
Published: May 2021

A neonate with thoracic ectopia cordis presented following an uncomplicated delivery. A mandibular distractor was placed to bridge the sternal cleft and retracted (reverse distractor activation) over 24 days to facilitate sternal closure. Follow-up at five years postoperatively demonstrated a well-healed sternum. This novel approach to ectopia cordis repair facilitates slow, steady physiologic accommodation of the heart without hemodynamic instability or long-term complications.
Native Pulmonary Valve Restoration Late Following Transannular Patch Repair of Tetralogy of Fallot
Authors: Fedevych Oleg , Dhannapuneni Ramana , Guerrero Rafael , Lotto Attilio
Published: May 2021

We present a surgical case of native pulmonary valve (PV) restoration in a 16-year-old boy with a previous history of transannular patch repair of tetralogy of Fallot in infancy. The PV was restored by approximation of split anterior commissure in the presence of developed and pliable leaflets well preserved after initial surgery. Postoperative echocardiogram showed a competent valve with peak velocity of 2.8 m/s. At six-week follow-up, the patient remained well, and echocardiogram demonstrated a competent PV with decreased velocity of 2.1 m/s across it. We encourage a mindful preservation of PV leaflets whenever it is possible at time of initial repair to implement this relatively easy operation to restore PV function later in life.
Repair of Anomalous Left Anterior Descending Coronary Artery Arising From the Pulmonary Artery Using a Dacron Interposition Bypass Graft
Authors: Tan Corinne , Holland Margaret , Quinonez Luis
Published: May 2021

An anomalous left anterior descending artery arising from the pulmonary artery (ALADAPA) is exceedingly rare. We present an adult case of ALADAPA that was repaired using a Dacron interposition graft.
Acyanotic Truncus Arteriosus: Not a Misnomer But a True Rarity
Authors: Chellappan Subramanian , Manohar Krishna , Sathe Yogesh , Pandey Rakesh , Joshi Radha , Deshpande Akshay
Published: May 2021

Truncus arteriosus, also referred to as common arterial trunk (CAT), is generally classified as a cyanotic congenital heart disease characterized by a single arterial trunk arising from the heart and supplying both pulmonary and systemic circulations. Cyanosis exists by virtue of it being an admixture lesion. We report a 13-year-old boy diagnosed to have type 1 CAT who was acyanotic at presentation and had all features of an operable lesion even at this age. He underwent a successful repair with closure of the subtruncal VSD and insertion of a hand-sewn valved right ventricle-to-pulmonary artery conduit made of bovine pericardium and Gore-Tex membrane.
Educator–Counselor: A Nondual Identity for School Counselors
Authors: Levy Ian P. , Lemberger-Truelove Matthew E.
Published: May 2021

In this special issue, the editors and each team of contributing authors offer examples of how a combined identity as educator–counselor can affect the various roles and responsibilities associated with school counseling. The suggestion that school counselor identity is always both educator and counselor is neither trivial nor a semantic distinction. Reshaping the narrative to suggest that school counselors are situated as educators who are oriented by counseling has the potential to mitigate much of the role ambiguity that has persisted in the profession for decades and, more important, has the potential to sharpen practice and contribute to greater student and schoolwide outcomes.
Growth in Middle School Students’ Curiosity, Executive Functioning, and Academic Achievement: Results From a Theory-Informed SEL and MBI School Counseling Intervention
Authors: Lemberger-Truelove Matthew E. , Ceballos Peggy L. , Molina Citlali E. , Carbonneau Kira J.
Published: May 2021

The authors investigated a combined social and emotional learning and mindfulness-based intervention as delivered by school counselors to students in classrooms and their teachers using consultation practices. The study used a cluster-randomized design at the classroom level, with an ethnically diverse sample of 109 middle school students divided between treatment and delayed treatment groups. Analyses found significant intervention effects for the treatment group in students’ changes in stress tolerance, social curiosity, executive functioning (i.e., shift, plan and organize, and task monitoring), and academic achievement (i.e., mathematics, science, English, and social studies). Implications of these findings evince how theory-informed school counseling can contribute to important outcomes in educational settings.
Reducing Inequality in High School Students’ College Knowledge: The Role of School Counselors
Authors: Poynton Timothy A. , Lapan Richard T. , Schuyler Sophie W.
Published: May 2021

This study examined inequalities in college knowledge across the high school years. Twelfth graders had significantly more college knowledge than ninth and 10th graders. Although college knowledge increased during high school among both first- and continuing-generation college-going students, we found significant between-group differences. Continuing-generation students had significantly more college knowledge than first-generation students, and the gap between groups widened across the high school years. School counselors are uniquely positioned within the K–12 education system to address inequalities such as the college knowledge gap through their roles as educators and leaders.
School Counselor and Teacher Collaboration to Enhance Students’ Career Development Using Project-Based Learning
Authors: Limberg Dodie , Starrett Angie , Ohrt Jonathan H. , Irvin Matthew J. , Lotter Christine , Roy George J.
Published: May 2021

We utilized a mixed-methods design to examine the experiences of 15 school counselors and 26 teachers who participated in a professional development program focused on collaboration to enhance students’ career development using project-based learning (PBL). PBL is a teaching method through which students engage in active learning by responding to a real-world challenge, problem, or question. We identified the following four themes: collaboration facilitators, collaboration challenges, classroom collaboration, and place-based collaboration. After participating in the program, teachers and school counselors reported being likely to engage with each other to incorporate career development in the classroom.