bluuebunny/crossref_metadata_2025 huggingface dataset:
Whistleblowing advocacy: Solidarity and fascinance
Authors: Van Portfliet Meghan , Kenny Kate
Published: October 2021

What role does difference play in relationships between partners in solidarity? In this article we add to debates on difference-in-solidarity by proposing fascinance as a critical aspect of intersubjective relations in solidarity networks. We build upon extant feminist and affect theory scholarship in doing so. Our novel approach is informed by our analysis of in-depth empirical data from a special case of solidarity – whistleblowing advocacy groups – and by Bracha Ettinger’s concept of the matrixial borderspace. Whistleblower support is a critical factor in enabling disclosures about organisational wrongdoing to come to light. Examining the experiences of workers in advocacy groups, we find that difference-in-solidarity is multi-faceted, compelling compassion while simultaneously generating ambivalence and tendencies towards exclusion. Where such contrary affects are enabled to co-exist, and where boundaries between self and other begin to be troubled, the impetus for people to work towards a common cause is enhanced. Our specific contribution is to add a matrixial perspective to debates on difference-in-solidarity: the concept of fascinance represents a powerful aspect of connection between self and other that is at once elusive, affectively felt, and invokes earlier experiences of interdependency between infant and mother. Our study also provides a unique examination of the difficulties and affordances that can accompany whistleblowing advocacy work.
Motivation, basic psychological needs and intention to be physically active after a gamified intervention programme
Authors: Fernandez-Rio Javier , Zumajo-Flores Marc , Flores-Aguilar Gonzalo
Published: October 2021

The aim of the present study was to compare the possible effects of a gamified programme and a traditional instructional approach in secondary physical education at the level of intrinsic motivation, autonomy satisfaction, competence satisfaction, relatedness satisfaction, and intention to be physically active. A total of 54 year-nine students (14 ± 0.1 years) enrolled in two classes in the same high school participated. The school administration (totally anonymous to the study) distributed all the students among the two classes and the research team randomly considered one the experimental group ( n = 27, 13 boys, 14 girls), which experienced a gamified learning unit, and the other the comparison group ( n = 27, 15 boys, 12 girls), which followed a traditional instructional approach. Both study groups had the same physical education teacher with training and experience on several pedagogical approaches, including gamification. The study followed a pre-test, post-test quasi-experimental research design (the time lag between pre-test and post-test was nine weeks). The results showed significant differences at post-tests favouring the experimental group in all the variables assessed. In conclusion, the results from the present study provided support for the use of gamification in physical education since it was associated with increased levels of students’ intrinsic motivation, basic psychological needs and intention to be physically active more than a traditional approach. Therefore, gamification could be considered a positive pedagogical framework for secondary physical education. Nevertheless, more studies with larger variability in contexts, participants and content are needed.
Exploring commensality, household and solidarity. Evidence of a medium-scale community gathering place in Neolithic Kleitos 1, north-western Greece
Authors: Kalogiropoulou Evita , Ziota Christina
Published: October 2021

This paper describes the cooking installations found inside a specific building, Building C, in the Late Neolithic site of Kleitos 1, their morphological and functional diversification, how they changed and evolved throughout time, and their spatial arrangements. Building C provided the stratigraphic information required by the authors to discern two distinct chronological phases, during which a significant change took place in the characteristics and organisation of the cooking facilities in the building. Building C underwent a transformation from a household unit during phase A to a medium-scale gathering place, capable of hosting a certain number of people, in Phase B. The identification of Building C as a medium-scale gathering place is based on the quantity and quality of its cooking facilities in comparison both to findings in other buildings on the site and to two well-explored Neolithic contexts of large-scale gatherings in Northern Greece, Makriyialos and Promachon-Topolniča. This is the first time a medium-scale gathering place has been recorded in Neolithic Greece. The aim of this paper is to highlight the importance of multi-scalar gatherings and the broader variability witnessed in social dynamics and site organisation in the Late Neolithic period of Northern Greece (late 6th to early 5th millennium cal BC).
Evaluation of doravirine-based regimen population target in a large Italian clinical center
Authors: Farinacci Damiano , Ciccullo Arturo , Lombardi Francesca , Moschese Davide , D’Angelillo Anna , Iannone Valentina , Lamanna Francesco , Passerotto Rosa Anna , Giambenedetto Simona Di
Published: October 2021

Background

Doravirine (DOR) is a non-nucleoside reverse transcriptase inhibitor (NNRTI) approved for HIV-1 infection treatment. Because of its genetic barrier, DOR appears to be a good alternative in switch strategies compared to other NNRTI. Our aim was to evaluate the percentage of people living with HIV (PLWHIV) followed in our center who could be eligible to a DOR-based regimen.

Methods

We collected data from all treatment-experienced PLWHIV, never exposed to DOR and with a demonstrated virological suppression. We analyzed previous genotypic analyses, clinical history, and previous exposure to NNRTIs.

Results

We analyzed data from 653 patients, whose characteristics are shown in Table 1. 59% of them presented no resistance mutation (RAM) at genotypic analysis. The most common DOR-related RAM were V106A, Y181V, and Y188L. We also analyzed RAM that can possibly interfere with combination therapy (mostly K65R and M184V). In the end, 81.8% of our patients results to be eligible for a DOR-based therapy regimen.

Conclusions

DOR represents a good option for switch strategies in virological suppressed PLWHIV. It seems to have a higher genetic barrier and a lower risk for resistance mutation development compared to other NNRTI. In our cohort, we found 81.8% of patients who could be eligible for a regimen containing DOR and almost 2/3 of patients who can be treated with the fixed-dose combination DOR/3TC/TDF.
Challenging traditional gender roles in the Arab classroom through transaction with literature
Authors: Hayik Rawia
Published: October 2021

This study is situated within a male-dominated Palestinian-Israeli reality rife with issues of gender privilege. With a purpose to disrupt the status quo in my language classroom and positively affect students’ beliefs towards gender injustices, I, as a teacher researcher, designed a unit on gender issues including a book set that would challenge such reality. Framed by transactional theory, the study offered an array of literacy engagements that encouraged students to critically transact with the texts and question the context. This article describes students’ transaction with the third book in the unit, Piggybook (Browne, 1986). Using students’ oral and written reader responses, it attempts to explore whether students’ transaction with the text reflected any emerging transformation or manifested unchanged views towards traditional gender roles.
‘Let emotion ring’: An autoethnographic self-study of an EFL instructor in Wuhan during COVID-19
Authors: Liu Shuwen , Yuan Rui , Wang Chuang
Published: October 2021

Teaching has always been an emotionally demanding profession, which involves tremendous emotional labour on the part of language teachers. This is particularly true for instructors of English as a foreign language (EFL) suddenly obliged to teach online during the COVID-19 pandemic. Drawing on the approach of autoethnographic self-study, this article reveals the first author’s understanding and negotiation of complex emotions during her online teaching from February to May 2020 in Wuhan, the centre of the COVID-19 pandemic during that period. This study sheds light on a language teacher’s complex emotional experiences in relation to technology, students and colleagues under the sudden shifts of teaching environment. It also explores how emotional regulation strategies are employed through undertaking emotional labour and observing/renegotiating emotional rules. The study exemplifies the importance of emotionally managed classrooms, and language teachers are advised to make deliberate and strategic efforts in channelling positive emotions into online teaching. The authors call for more attention to self-study as a viable and instrumental approach to facilitating language teachers’ continuing development and enhancing their emotional reflexivity and well-being.
The use of Multi-Sensory Environments with autistic children: Exploring the effect of having control of sensory changes
Authors: Unwin Katy L , Powell Georgina , Jones Catherine RG
Published: October 2021

Multi-Sensory Environments (also called sensory or Snoezelen® rooms) are specialised spaces that contain equipment to modify the environment. They are commonly used in special-needs schools with autistic children, but empirical investigation into how to best use Multi-Sensory Environments with autistic children has been limited. Based on converging evidence that autistic children may benefit from having control, we tested 41 autistic children (8 female) aged 4–12 years (mean = 8 years, standard deviation = 2.05 years) who used the Multi-Sensory Environment both with and without control over the sensory changes. Behavioural coding of video data showed that having control was associated with increased attention and reduced repetitive motor behaviours, sensory behaviours, activity levels, stereotyped speech and vocalisations. Social behaviour, anxiety, positive affect and arousal were not significantly affected by condition. Our findings demonstrate that how a Multi-Sensory Environment is used can affect autistic children’s behaviours. They also suggest that providing control of sensory changes to autistic children may help create better conditions for learning.

Lay abstract

Multi-Sensory Environments (also called sensory or Snoezelen® rooms) are rooms that contain equipment which can create light, sound and touch experiences. Multi-Sensory Environments are often used with autistic children, particularly in schools, but there is no evidence for how best to use them. We investigated whether having control over the sensory equipment in the Multi-Sensory Environment affected how a group of 41 (8 female) autistic children aged 4–12 years behaved. We found that when autistic children could control the sensory equipment, they paid more attention and performed fewer repetitive and sensory behaviours. They also used less stereotyped speech, produced fewer vocalisations and showed lower levels of activity. Other behaviours were not affected. Our findings demonstrate that how a Multi-Sensory Environment is used can impact behaviour and that providing control of sensory changes to autistic children may help create better conditions for learning.
What is needed to promote gender equality in the cultural sector? Responses from cultural professionals in Catalonia
Authors: Barrios Maite , Villarroya Anna
Published: October 2021

Despite the growing evidence of inequalities related to the presence, promotion and labor conditions of women in the cultural sector, as well as the factors that cause these inequalities, there is still a lack of research and consensus on the key measures that should be applied to reduce the effect of these inequalities. The aim of this study was to identify intervention measures, from both the public and private sectors, that will help promote gender equality in the Catalan context. In a three-round survey using the Delphi technique, cultural professionals were asked about the most appropriate measures to achieve gender equality in cultural employment. In this regard, this article presents an innovative data-gathering methodology for cultural studies, involving diverse stakeholders from the public, private and civil society sectors and contributing to informed decision-making processes. The highest priority measure identified in both the public and private sectors was related to compliance with legal provisions regarding the recognition of equal pay for work of equal value between women and men. The adoption of and compliance with laws and regulations aimed at advancing gender equality and the establishment of measures related to the reconciliation of work with family and social life was also prioritized highly by most professionals. The full set of measures proposed by cultural experts and affected groups can help to effectively address gender inequalities in the Catalan context and provide ideas for other local and national settings.
Research on innovative one-dimensional mathematical model applied to the on-line measurement for transient discharge coefficient of diesel injector nozzle
Authors: Yang Xiyu , Zhou Tanqing , Dong Quan , Lu Changhao , Ni Zuo
Published: October 2021

This paper presents an innovative one-dimensional mathematical model applied to the on-line measurement for transient discharge coefficient of diesel injector nozzle. The state change in the fuel system is abstracted into the transfer and evolution process of the Riemann wave, and a direct mathematical relationship between the pressure and the transient discharge coefficient in a single Riemann wave environment is established. The on-line calibration method of fuel sound velocity is proposed, which avoids the complicated off-line calibration of fuel physical property. The time-domain characteristics recognition method of input signal is put forward and the model is segmented according to time characteristics to improve the applicability. The decoupling algorithm of reflected wave and the correction method of interference wave are proposed to improve the model robustness. The experimental results show that this mathematical model has good accuracy. It is found that the variation of the average discharge coefficient with injection pressure and pulse width is nonlinear due to the cavitation and needle valve average opening.
Knock and knock intensity models for boosted SI conditions with gasoline-ethanol blends
Authors: Lavoie George , Middleton Robert , Martz Jason , Blumberg Paul
Published: October 2021

In this work, a previously developed, two-stage table-lookup kinetic method for surrogate Toluene Reference Fuels (TRF) was extended to gasoline-ethanol blends and exercised in a GT-POWER model of knock in several engines. Experimentally, the knock limit is normally determined by the magnitude of pressure oscillations, known as the knock intensity (KI), rather than the crank angle of initial pressure oscillations or the crank angle of auto-ignition, which is difficult to identify. A number of empirical expressions of knock intensity have been developed for modeling purposes which relate the knock intensity to the crank angle and conditions at auto-ignition, and are available in the literature. These models were implemented into a GT-POWER model and tested against experimental knock-limited data for gasoline and gasoline-ethanol blends. The KI models are phenomenological in nature and are based on varying conceptual views of the knock event. With calibration all methods gave satisfactory results at mid-speed conditions when compared with the experimental data. Some deviations were seen at low and high speeds. Low speeds are potentially important because both RON and MON testing occurs under such conditions. Implications of the results and their relationship to recent knock experimental work are discussed and suggestions offered for improved knock models.
‘What works’ and for whom? Bold Beginnings and the construction of the school ready child
Authors: Kay Louise
Published: October 2021

School readiness is a dominant discourse in current policy agendas in UK and international contexts, fulfilling a range of goals such as providing children with the ‘best start in life’ by breaking the cycle of poverty, and preparing children for formal learning in compulsory education. Focussing on the school readiness agenda in England, this paper interrogates how the local touchdown of international policy formulations influences policy at country-level. It is argued that the emphasis on teaching Mathematics, Reading and Writing as a way of readying children for school raises concerns over the formalisation of pedagogy and curriculum in the Reception year (aged 4–5), in preparation for the transition to Year One of the National Curriculum. Using Hyatt’s Critical Discourse Policy Analysis Frame (CPDAF) this paper examines how the Office for Standards in Education (OfSTED) report ‘Bold Beginnings’ further strengthens the policy discourse that establishes Reception as a site for school readiness through a discursively constructed narrative of ‘what works’. Based on the analysis, the paper then questions whether the ‘what works’ OfSTED agenda works for teachers and children.
Political Posters Reveal a Tension in WhatsApp Platform Design: An Analysis of Digital Images From India’s 2019 Elections
Authors: Sahoo Sananda
Published: October 2021

This article examines the effects of WhatsApp as a mode of dissemination of political posters. It found that platform affordances that control the crafting and dissemination of political messages open up the possibility of vague political messaging by conforming to the social media’s visual culture and limit the spread of these messages, restricting the ability to organically gather support for a political cause. Despite the growing appeal of social media in political campaigns, social media messages when used by individuals and small, independent social media groups, who are not a part of a larger, organized political party or movement, have little influence on electoral decisions of voters about a political cause that faces weak public support. This was discussed in the context of electoral results of the Leftist political party in India in 2019 national elections. The paper then contributes to our understanding of the extent of the influence of social media platforms on political media messages.
Hemoglobin assisted carbon nanofiber preparation for selective detection of miRNA molecules
Authors: Sahtani Karima , Aykut Yakup , Aladag Tanik Nilay
Published: October 2021

A selective miRNA detection is an important factor for the early-stage diagnosis of the diseases and determination of an appropriate treatment method. In this regard, hemoglobin assisted carbon nanofibers (CNFs) were prepared via electrospinning of the precursor polyacrylonitrile/hemoglobin (PAN/Hb) hybrid nanofibers and the following heat treatment process. Addition of low ratio Hb in the precursor PAN nanofibers caused a catalytic effect on the reaction taken place during the stabilization process that helps the formation of more graphitic structure during the carbonization process. But, increasing Hb ratio in the PAN/Hb nanofibers caused an inhibiting effect on the related reactions. Guanine oxidation signals of miRNA molecules were determined via differential pulse voltammetry (DPV) measurement. In this regard, the attachment of anti-miRNA molecules on the CNFs immobilized screen-printed electrodes (SPEs) and a following hybridization of the attached anti-miRNA with miRNA molecules were carried out. Three different miRNA molecules including the target (miRNA), single-base mismatched (SM.miRNA), and non-complementary (NC.miRNA) were hybridized with the previously attached anti-miRNA molecules on the Hb-CNFs immobilized SPEs. The enhancement of the guanine oxidation signal level was observed by using Hb-CNFs instead of using CNFs. That could be attributed to the increase of the graphitic level with low Hb addition to the precursor PAN/Hb nanofibers that causes a catalytic effect on carbonization process. The prepared biosensory system could be used for the selective detection of miRNA molecules.
Participatory Action Research on School Culture and Student Mental Health: A Study Protocol
Authors: Kaluzeviciute Greta , Jessiman Tricia , Burn Anne–Marie , Ford Tamsin , Geijer–Simpson Emma , Kidger Judi , Limmer Mark , Ramsay Sheena E. , Spencer Liam
Published: October 2021

Background: Young people spend a large proportion of their time in school, which presents both risk and protective factors for their mental health. A supportive school culture can promote and protect good mental health by creating experiences of safety and belonging amongst staff and students. In this qualitative study, we seek to explore whether a participatory action research (PAR) approach is an effective way to promote and improve student mental health. Methods: Participatory action research is an approach in which people collaboratively research their own experience: the researched communities become co-researchers of their own experiences in a specific context. We will work with four secondary schools in the UK to develop PAR projects. In each school, a group of 2–4 staff and 6–8 students will work together to develop a shared understanding of their school culture and to introduce activities or changes to make the culture more supportive of student mental health. We will evaluate the effectiveness of the PAR approach through i) a review of school documents pertaining to mental health (e.g., policies and Ofsted reports), ii) interviews with staff members ( n = 40), parents ( n = 8) and students ( n = 24–40) before and after the PAR intervention, iii) observations and reports of the PAR group meetings and iv) interviews with members of the PAR groups after the PAR intervention. Discussion: We anticipate that our research findings will advance knowledge on effective methods to develop a positive school culture that will contribute to the improvement of young people’s mental health and well-being. We will seek to identify the mechanisms through which school culture can have a positive impact on mental health and develop a logic model and a school culture toolkit that can be utilised as a resource to inform public health interventions to promote mental health in a range of educational settings.
Circulating sex steroids and bladder pain sensitivity in dysmenorrhea
Authors: Hellman Kevin M , Oladosu Folabomi A , Garrison Ellen F , Roth Genevieve E , Dillane Katlyn E , Tu Frank F
Published: October 2021

Although elevated estradiol levels facilitate chronic pelvic pain in animal models, it remains to be determined whether sex steroid levels are altered in a cross-section of women with chronic pelvic pain (CPP) and those at-risk for developing CPP. We sought to determine if sex steroid levels are increased in women with menstrual pain and whether those changes were more extreme in two groups of women with worsened pelvic pain profiles: a) dysmenorrhea plus evidence of bladder pain sensitivity and b) bladder pain syndrome. Serum samples were collected during the mid-luteal phase to measure estradiol, progesterone, testosterone, and sex hormone-binding globulin. We also compared quantitative sensory testing profiles to evaluate how sex steroid differences influence proposed pain sensitivity mechanisms. Women with combined dysmenorrhea and bladder sensitivity had higher estradiol concentrations than controls (487 [IQR 390 – 641] vs 404 [336 – 467] pmol/L, p = 0.042). Bladder pain syndrome participants had greater sex hormone-binding globulin than controls (83 [71 – 108] vs 55 [42 – 76 nmol/L; p = 0.027). Levels of pain sensitivity and mood were different across the groups, but the only significant relationship to sex steroids was that sex hormone-binding globulin was correlated to somatic symptoms ( r = 0.26, p = 0.03). These findings show women potentially at-risk for CPP and women with diagnosed CPP exhibit altered circulating levels of sex steroids. Because these hormonal differences appear to be independent of mood or pain sensitivity, the role of sex steroids in the emergence of CPP may be via sensitization of visceral afferents.
Mechanisms and management of prothrombotic state in COVID-19 disease
Authors: Acherjee Trishna , Behara Aparna , Saad Muhammad , Vittorio Timothy J.
Published: October 2021

The novel severe acute respiratory syndrome viral disease outbreak due to SARS-CoV-2 is a rapidly evolving disease and represents one of the greatest medical challenges in recent times. It is believed that SARS-CoV-2 has migrated from bats to an intermediate host and then to humans. This article aims at the mechanism and management of prothrombotic state in COVID-19 positive patients. We tried to present how the SARS-CoV-2 virus can induce thromboembolic events and the incidence of these thromboembolic events. We also tried to depict anticoagulation management in these patients as well as postdischarge plan and follow-up. Invasion of type 2 pneumocytes by the SARS-CoV-2 virus is critical in the course of illness because it results in activation of immune cells leading to elevation of cytokines. The subsequent activation of T cells and macrophages infiltrates the infected myocardial cells causing direct myocardiocyte toxicity and development of arrhythmia. Hypoxia or hypotension during the clinical course causes a mismatch between myocyte oxygen supply and workload demand resulting in cardiac distress. SARS-CoV-2 affects endothelial cells and pericytes that lead to severe micro and macrovascular dysfunction, and together with oxygen supply-demand mismatch, immune hyperresponsivity can potentially cause destabilization and plaque rupture causing acute coronary syndromes. Other mechanisms of injury include myocarditis, pericarditis, stress cardiomyopathy, vasculitis, and DIC (Disseminated intravascular coagulation)/microthrombi. SARS-CoV-2 enters the cells by the Spike protein S whose surface unit, S1, binds to the ACE2 receptor on the host cell. The type II transmembrane serine proteases TMPRSS2 and histone acetyltransferases (HAT) are host cell proteases that are recruited by the virus to cleave ACE2 surface protein S which facilitates the viral entry. Therefore, TMPRSS2 and HAT could be targeted for potential drugs against SARS-CoV-2. SARS-CoV-2 uses an RNA-dependent RNA polymerase for proliferation, which is targeted by remdesivir that is currently approved for emergency use by Food and Drug Administration (FDA). We need to adopt a multifaceted approach when combating SARS-CoV-2 because it presents several challenges including medical, psychological, socioeconomic, and ethical. COVID-19 is the biggest calamity during the 21st century, we need to have a keen understanding of its pathophysiology and clinical implications for the development of preventive measures and therapeutic modalities.
Health promotion research has come of age! Structuring the field based on the practices of health promotion researchers
Authors: Potvin Louise , Jourdan Didier
Published: October 2021

Health promotion is mostly framed as a discourse and practices based on a set of values and principles that promote changes at various levels (individual, community and global). There is no well-defined knowledge base and no widely agreed knowledge development methods. During the past decades, health promotion knowledge has developed following a potluck model. Researchers from various disciplinary backgrounds attracted to the values and transformative vision of health promotion have used their disciplinary-based research methods and theories to conduct studies about the various practices that are associated with health promotion. Although health promotion research has acquired many attributes of a distinct field, researching practices from various disciplinary perspectives is not sufficient to create a coherent knowledge base for health promotion. We propose three dimensions to further structure health promotion research. The first relates to the object for which knowledge is produced. For health promotion research this relates to health social practices. The second dimension relates to the purpose and ethics of research. In the case of health promotion research it pursues the dual purpose of producing knowledge (epistemic aim) and contributing to social changes (transformative aim). The third dimension concerns the knowledge produced and the conditions for valid knowledge. In the case of health promotion research, the condition of knowledge production should include a recognition of the complexity of social practice and the necessary dialogue between scientific. True to health promotion principles, we propose a bottom-up process for structuring the field through the creation of a ‘Global Handbook of Health Promotion Research’ that would draw on the research practices of those involved in health promotion research.
Open Reduction and Screw Fixation of a Diastatic Bipartite Hallux Sesamoid in Turf Toe Injury: A Case Report
Authors: Müller Max , Genelin Konstantin , Riecke Johannes , Deml Christian
Published: October 2021

We present a case of a 25-year-old male professional soccer player who complained of severe pain over the first metatarsal head after opponent contact during a soccer game. Clinical findings showed swelling and tenderness. Initial radiographs showed a diastasis of a bipartite medial sesamoid between the fragments as compared to radiographs taken 4 years earlier of the same foot. A computed tomography scan was performed objectifying the widened interval and also showing an angulation of the proximal fragment. Open reduction and screw fixation were performed, leading to adequate positioning of the 2 bipartite fragments. The patient showed good clinical recovery and returned to the same performance level. Turf toe injury with diastasis of a medial bipartite sesamoid can be treated successfully with this operative technique.

Levels of Evidence: Level V: Case report
COVID-19 Stress and the Health of Black Americans in the Rural South
Authors: Adesogan Olutosin , Lavner Justin A. , Carter Sierra E. , Beach Steven R. H.
Published: October 2021

Black Americans have been disproportionately affected by the COVID-19 pandemic. To better understand changes in and predictors of their mental and physical health, in the current study, we used three waves of data (two prepandemic and a third during summer 2020) from 329 Black men and women in the rural South. Results indicated that health worsened after the onset of the pandemic, including increased depressive symptoms and sleep problems and decreased self-reported general health. Greater exposure to COVID-19-related stressors was significantly associated with poorer health. Prepandemic stressors (financial strain, racial discrimination, chronic stress) and prepandemic resources (marital quality, general support from family and friends) were significantly associated with exposure to COVID-19-related stressors and with health during the pandemic. Findings underscore how the pandemic posed the greatest threats to Black Americans with more prepandemic psychosocial risks and highlight the need for multifaceted interventions that address current and historical stressors among this population.
The Progression of Celiac Disease, Diagnostic Modalities, and Treatment Options
Authors: Tarar Zahid Ijaz , Zafar Muhammad Usman , Farooq Umer , Basar Omer , Tahan Veysel , Daglilar Ebubekir
Published: October 2021

Celiac disease (CD) is an autoimmune disorder that affects genetically predisposed individuals who are sensitive to gluten and related proteins. It affects children and adults with increasing prevalence in the older age groups. Both adaptive and innate immune responses play role in CD pathogenesis which results in damage of lamina propria and deposition of intraepithelial lymphocytes. There are other proposed mechanisms of CD pathogenesis like gastrointestinal infections, intestinal microbiota, and early introduction of gluten. The diagnosis of CD is based on clinical symptoms and serological testing, though a majority of cases are asymptomatic, and small intestinal biopsies are required to confirm the diagnosis. Celiac disease is generally associated with other autoimmune diseases, and it is advisable to test these patients for diseases like type 1 diabetes mellitus, Addison’s disease, thyroid diseases, inflammatory bowel disease, and autoimmune hepatitis. The patient with a new diagnosis of CD requires close follow-up after starting treatment to see symptom improvement and check dietary compliance. A newly diagnosed patient is advised to follow with a dietitian to better understand the dietary restrictions as about 20% of patients stay symptomatic even after starting treatment due to noncompliance or poor understanding of diet restrictions. The most effective treatment for CD is a gluten-free diet, but work on non-dietary therapy is in process and few medications are in the clinical trial phase.
Safety of Intra-articular Hip Corticosteroid Injections: A Matched-Pair Cohort Study
Authors: Abraham Paul F. , Varady Nathan H. , Small Kirstin M. , Shah Nehal , Beltran Luis S. , Kucharik Michael P. , Martin Scott D.
Published: October 2021

Background:

Recent studies have suggested there is an increased risk of avascular necrosis (AVN), subchondral insufficiency fracture (SIF), femoral head collapse, and osteoarthritis (OA) progression in the 12-month period after hip corticosteroid/anesthetic injection (CSI); however, these studies have failed to account for preinjection OA severity or preexisting AVN/SIF.

Purpose:

To compare these complication rates in patients treated with versus without hip CSI, while minimizing the aforementioned forms of selection bias present in previous investigations.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

For all patients who had undergone a single hip CSI and hip magnetic resonance imaging (MRI) within the preceding 12 months at a single institution (CSI cohort), 2 musculoskeletal radiologists retrospectively graded OA severity (modified Kellgren-Lawrence classification) and femoral head collapse on hip radiographs taken within 12 months before, and 1 to 12 months after, CSI. Using identical methodology, radiographs from a control cohort (composed of hips that had never undergone CSI and had undergone hip MRI with hip radiographs taken within 12 months before, and 1-12 months after, MRI) were also graded. The cohorts were matched for age, sex, body mass index, and OA severity. Readers were blinded to cohort and time point. OA progression was defined as an increase in modified Kellgren-Lawrence grade ≥1 between radiographs.

Results:

Included were 141 matched pairs. After exclusion of 48 matched pairs with at least 1 incidence of preexisting AVN or SIF on index MRI, CSI (n = 93; mean time between CSI and final hip radiograph, 5.43 months) and control (n = 93; mean time between MRI and final hip radiograph, 4.87 months), groups did not significantly differ in rates of OA progression (3.2% vs 3.2%) or new femoral head collapse (3.2% vs 2.2%).

Conclusion:

In contrast to the findings of recent retrospective investigations, we did not find that patients treated with hip CSI had significantly higher rates of short-term OA progression or femoral head articular surface collapse after controlling for baseline OA severity and preexisting AVN or SIF. Future randomized trials investigating safety of hip CSI are needed to determine its exact short-term risk profile.
Effect of Concomitant Meniscal Lesions and Meniscal Surgery in ACL Reconstruction With 5-Year Follow-Up: A Nationwide Prospective Cohort Study From Norway and Sweden of 8408 Patients
Authors: Ulstein Svend , Årøen Asbjørn , Engebretsen Lars , Forssblad Magnus , Røtterud Jan Harald
Published: October 2021

Background:

Increased knowledge of the factors predicting outcome after anterior cruciate ligament reconstruction (ACLR) is needed.

Purpose:

To determine the effect of concomitant meniscal lesions, and the surgical management thereof, on patient-reported outcomes 5 years after ACLR.

Study Design:

Prospective cohort study; Level of evidence, 2.

Methods:

A total of 15,706 patients who underwent primary unilateral ACLR between 2005 and 2008 were enrolled prospectively and evaluated longitudinally. All patients were part of the Norwegian and Swedish national knee ligament registries. Outcomes at 5-year follow-up were evaluated with the Knee injury and Osteoarthritis Outcome Score (KOOS). A multivariable linear regression model was used to assess possible effects on prognosis, as measured by KOOS, of a concomitant meniscal lesion and its associated surgical treatment.

Results:

At a mean follow-up of 5.1 ± 0.2 years, KOOS data were available from 8408 patients: 4774 (57%) patients with no and 3634 (43%) patients with concomitant meniscal lesions (mean patient age, 33.8 ± 10.7 years). Patients with concomitant meniscal lesions reported equal crude mean scores compared with patients without meniscal lesions in all KOOS subscales 5 years after ACLR. The mean improvement in scores from preoperative to the 5-year follow-up was greater for patients with a concomitant meniscal lesion for the KOOS Pain, Activities of Daily Living (ADL), and Sport and Recreation subscales. In the adjusted regression analyses, using patients without concomitant meniscal lesions as the reference, neither no treatment nor resection or repair of medial meniscal lesions were significantly associated with KOOS scores 5 years after ACLR. Except for the ADL subscale, in which a repaired lateral meniscal lesion was associated with better outcome, no significant associations between any of the lateral meniscal lesion treatment categories and KOOS outcome at 5-year follow-up were identified.

Conclusion:

Concomitant meniscal lesions at the time of ACLR conferred no negative effects on patient-reported outcomes 5 years after ACLR. The improvement in selected KOOS subscales from preoperative to the 5-year follow-up was significantly greater for patients with concomitant meniscal lesions than for patients without such lesions.
Male Teacher Assignment and Teacher Turnover in Elementary Schools
Authors: Hwang NaYoung , Fitzpatrick Brian
Published: October 2021

Parents and educators commonly assume that male teachers serve as more effective disciplinarians for boys than female teachers. Do schools tend to assign male teachers to teach boys with perceived behavioral issues? Our study uses administrative data in Indiana to investigate male teacher assignment in elementary school. We find that boys with at least one suspension record in the previous year are 12% more likely to be assigned to a male teacher than boys without suspensions, whereas girls’ suspension histories do not predict assignments to male teachers. In addition, teachers who have 10% or more of students with suspension histories are 19.5% more likely to migrate to another school and 16.2% more likely to leave the state’s teacher workforce. Our study suggests that male teachers have an elevated risk of being assigned to teach male students with suspension histories, which may contribute to teacher turnover.
COVID-19 convalescent plasma
Authors: Tobian Aaron A. R. , Cohn Claudia S. , Shaz Beth H.
Published: October 2021

As the coronavirus disease (COVID-19) pandemic led to a global health crisis, there were limited treatment options and no prophylactic therapies for those exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Convalescent plasma is quick to implement, potentially provides benefits, and has a good safety profile. The therapeutic potential of COVID-19 convalescent plasma (CCP) is likely mediated by antibodies through direct viral neutralization and Fc-dependent functions such as a phagocytosis, complement activation, and antibody-dependent cellular cytotoxicity. In the United States, CCP became one of the most common treatments with more than a half million units transfused despite limited efficacy data. More than a dozen randomized trials now demonstrate that CCP does not provide benefit for those hospitalized with moderate to severe disease. However, similar to other passive antibody therapies, CCP is beneficial for early disease when provided to elderly outpatients within 72 hours after symptom onset. Only high-titer CCP should be transfused. CCP should also be considered for immunosuppressed patients with COVID-19. CCP collected in proximity, by time and location, to the patient may be more beneficial because of SARS-CoV-2 variants. Additional randomized trial data are still accruing and should be incorporated with other trial data to optimize CCP indications.
PLCG1 is required for AML1-ETO leukemia stem cell self-renewal
Authors: Schnoeder Tina M. , Schwarzer Adrian , Jayavelu Ashok Kumar , Hsu Chen-Jen , Kirkpatrick Joanna , Döhner Konstanze , Perner Florian , Eifert Theresa , Huber Nicolas , Arreba-Tutusaus Patricia , Dolnik Anna , Assi Salam A. , Nafria Monica , Jiang Lu , Dai Yu-Ting , Chen Zhu , Chen Sai-Juan , Kellaway Sophie G. , Ptasinska Anetta , Ng Elizabeth S. , Stanley Edouard G. , Elefanty Andrew G. , Buschbeck Marcus , Bierhoff Holger , Brodt Steffen , Matziolis Georg , Fischer Klaus-Dieter , Hochhaus Andreas , Chen Chun-Wei , Heidenreich Olaf , Mann Matthias , Lane Steven W. , Bullinger Lars , Ori Alessandro , von Eyss Björn , Bonifer Constanze , Heidel Florian H.
Published: October 2021

In an effort to identify novel drugs targeting fusion-oncogene–induced acute myeloid leukemia (AML), we performed high-resolution proteomic analysis. In AML1-ETO (AE)-driven AML, we uncovered a deregulation of phospholipase C (PLC) signaling. We identified PLCgamma 1 (PLCG1) as a specific target of the AE fusion protein that is induced after AE binding to intergenic regulatory DNA elements. Genetic inactivation of PLCG1 in murine and human AML inhibited AML1-ETO dependent self-renewal programs, leukemic proliferation, and leukemia maintenance in vivo. In contrast, PLCG1 was dispensable for normal hematopoietic stem and progenitor cell function. These findings are extended to and confirmed by pharmacologic perturbation of Ca++-signaling in AML1-ETO AML cells, indicating that the PLCG1 pathway poses an important therapeutic target for AML1-ETO+ leukemic stem cells.
Xanthomonas bacteriophages: a review of their biology and biocontrol applications in agriculture
Authors: Nakayinga Ritah , Makumi Angela , Tumuhaise Venansio , Tinzaara William
Published: October 2021

Phytopathogenic bacteria are economically important because they affect crop yields and threaten the livelihoods of farmers worldwide. The genus Xanthomonas is particularly significant because it is associated with some plant diseases that cause tremendous loss in yields of globally essential crops. Current management practices are ineffective, unsustainable and harmful to natural ecosystems. Bacteriophage (phage) biocontrol for plant disease management has been of particular interest from the early nineteenth century to date. Xanthomonas phage research for plant disease management continues to demonstrate promising results under laboratory and field conditions. AgriPhage has developed phage products for the control of Xanthomonas campestris pv. vesicatoria and Xanthomonas citri subsp. citri. These are causative agents for tomato, pepper spot and speck disease as well as citrus canker disease.

Phage-mediated biocontrol is becoming a viable option because phages occur naturally and are safe for disease control and management. Thorough knowledge of biological characteristics of Xanthomonas phages is vital for developing effective biocontrol products. This review covers Xanthomonas phage research highlighting aspects of their ecology, biology and biocontrol applications.
Evaluating complex interventions in context: systematic, meta-narrative review of case study approaches
Authors: Paparini Sara , Papoutsi Chrysanthi , Murdoch Jamie , Green Judith , Petticrew Mark , Greenhalgh Trisha , Shaw Sara E.
Published: October 2021

Background

There is a growing need for methods that acknowledge and successfully capture the dynamic interaction between context and implementation of complex interventions. Case study research has the potential to provide such understanding, enabling in-depth investigation of the particularities of phenomena. However, there is limited guidance on how and when to best use different case study research approaches when evaluating complex interventions. This study aimed to review and synthesise the literature on case study research across relevant disciplines, and determine relevance to the study of contextual influences on complex interventions in health systems and public health research.

Methods

Systematic meta-narrative review of the literature comprising (i) a scoping review of seminal texts (n = 60) on case study methodology and on context, complexity and interventions, (ii) detailed review of empirical literature on case study, context and complex interventions (n = 71), and (iii) identifying and reviewing ‘hybrid papers’ (n = 8) focused on the merits and challenges of case study in the evaluation of complex interventions.

Results

We identified four broad (and to some extent overlapping) research traditions, all using case study in a slightly different way and with different goals: 1) developing and testing complex interventions in healthcare; 2) analysing change in organisations; 3) undertaking realist evaluations; 4) studying complex change naturalistically. Each tradition conceptualised context differently—respectively as the backdrop to, or factors impacting on, the intervention; sets of interacting conditions and relationships; circumstances triggering intervention mechanisms; and socially structured practices. Overall, these traditions drew on a small number of case study methodologists and disciplines. Few studies problematised the nature and boundaries of ‘the case’ and ‘context’ or considered the implications of such conceptualisations for methods and knowledge production.

Conclusions

Case study research on complex interventions in healthcare draws on a number of different research traditions, each with different epistemological and methodological preferences. The approach used and consequences for knowledge produced often remains implicit. This has implications for how researchers, practitioners and decision makers understand, implement and evaluate complex interventions in different settings. Deeper engagement with case study research as a methodology is strongly recommended.