bluuebunny/crossref_metadata_2025 huggingface dataset:
The Family as a Locus of Illness: Secrecy, Suffering, and Institutional Practices
Authors: Meier Marie , Vallgårda Karen
Published: March 2022

The family has long played a key role in the perception, interpretation, and treatment of mental illness across Europe and North America. Yet, historical studies of psychiatry tend to neglect the complex relationship between psychiatric institutions, patients, and their families. Using a Danish nerve sanatorium as a case, this article traces the shifting meanings attached to the family and the home as a potential cause and cure of mental illnesses from the mid-1950s to the late 1980s. While the family figured prominently in conceptions of mental illness throughout these decades, the specific interpretations and treatment practices, as well as the degrees of secrecy, altered significantly. From offering discretion and seclusion and focusing on outer, objectively verifiable circumstances regarding family relationships, doctors increasingly emphasized internal psychodynamics between family members and encouraged openness as a path to healing. The findings call for greater scholarly attention to the complicated intertwinements of psychiatric practices, family history, and changing knowledge practices in the shifting historical configurations of experiences of mental illness.
Pathologic Findings on Hip Arthroscopy in High-Level Athletes Competing in Flexibility Sports
Authors: Saks Benjamin R. , Monahan Peter F. , Maldonado David R. , Jimenez Andrew E. , Ankem Hari K. , Sabetian Payam W. , Lall Ajay C. , Domb Benjamin G.
Published: March 2022

Background:

Athletes who compete in flexibility sports (FS) place unique demands on their hip joints because of the supraphysiologic range of motion required.

Purpose:

To compare the pathologic features, outcomes, and return-to-sports (RTS) rates of high-level athletes participating in FS who underwent hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and labral tear against a propensity score–matched cohort of high-level athletes participating in non–flexibility sports (NFS).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data were prospectively collected and retrospectively reviewed for high-level athletes who underwent primary hip arthroscopy for FAIS from April 2008 to December 2018. Patients who participated in FS such as dancing, gymnastics, martial arts, figure skating, and cheerleading were propensity score matched by body mass index, age at time of surgery, sex, sports competition level, and labral treatment to a cohort of high-level athletes participating in all other sports, such as distance running, soccer, volleyball, and softball. Baseline patient characteristics, intraoperative findings, and surgical procedures were compared. Minimum 2-year patient-reported outcome measures were compared for the modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Sport Specific Subscale, and visual analog scale for pain and satisfaction. Rates of secondary surgery and RTS were compared.

Results:

A total of 47 patients (50 hips) who participated in FS were included and propensity score matched to 130 patients (150 hips) who participated in NFS. Follow-up time was 37.5 ± 10.4 months (mean ± SD). Most patients (96.0%) were female with a mean age of 19.5 ± 7.3 years. FS athletes had significantly higher rates of femoral head cartilage lesions (Outerbridge ≥2; 12.0% vs 2.0%; P = .008) and ligamentum teres tears (48% vs 26%; P = .003). FS and NFS athletes demonstrated significant clinical improvements after surgery for all patient-reported outcome measures. Of the patients who attempted, 34 (75.6%) participating in FS were able to RTS while 11 (24.4%) were not because of ongoing hip issues. This was not significantly different than the NFS group ( P = .073).

Conclusion:

High-level athletes who participated in FS and were treated for FAIS with hip arthroscopy exhibited higher rates of femoral head cartilage lesions and ligamentum teres tears requiring debridement when compared with a benchmark group of athletes who participated in other sports. Despite this, both groups demonstrated similar improvements in outcome scores and comparable rates of RTS at minimum 2-year follow-up.
Patient & Caregiver Experiences: Qualitative Study Comparison Before and After Implementation of Early Palliative Care for Advanced Colorectal Cancer
Authors: Ahmed Sadia , Naqvi Syeda Farwa , Sinnarajah Aynharan , McGhan Gwen , Simon Jessica , Santana Maria J.
Published: March 2022

Background

The Palliative Care Early and Systematic (PaCES) program implemented an early palliative care pathway for advanced colorectal cancer patients in January 2019, to increase specialist palliative care consultation and palliative homecare referrals more than three months before death. This study aimed to understand the experience of patients with advanced colorectal cancer and family caregivers who received early palliative care supports from a specialist palliative care nurse and compared those experiences with participants who experienced standard oncology care prior to implementation of early palliative care.

Methods

This was a qualitative and patient-oriented study. We conducted semi-structured telephone interviews with two cohorts of patients with advanced colorectal cancer before and after implementation of an early palliative care pathway. We conducted a thematic analysis of the transcripts guided by a Person-Centred Care Framework.

Results

Seven patients living with advanced colorectal cancer and five family caregivers who received early palliative care supports expressed that visits from their early palliative care nurse was helpful, improved their understanding of palliative care, and improved their care. Four main themes shaped their experience of early palliative care: care coordination, perception of palliative care & advance care planning, coping with advanced cancer, and patient and family engagement. These findings were compared with experiences of 15 patients and seven caregivers prior to pathway implementation.

Conclusion

An early palliative care pathway can improve advanced cancer care, and improve understanding and acceptance of early palliative care. This work was conducted in the context of colorectal cancer but may have relevance for the care of other advanced cancers.
Pediatric Petrous Apex Lesions: A Radiological Classification and Diagnostic Algorithm
Authors: Gupta Neetika , Hiremath Shivaprakash , Martinez-Rios Claudia , Chakraborty Santanu , Miller Elka
Published: March 2022

The petrous apex (PA) is involved in a myriad of pathological conditions, some of which are exclusive in children. Diagnosis may be difficult due to vague clinical presentation, and local examination is challenging owing to its inaccessible location. This is further complicated by multiple unfused sutures and ongoing PA pneumatization in children. Cross-sectional imaging is vital for the evaluation of the PA lesions, due to their precarious location and proximity to the major neurovascular structures. Several classification systems have been proposed for these lesions based on their site of origin, solid or cystic appearance, surgical or non-surgical (no touch lesions) management, and benign or malignant nature. In this article, we emphasize the distinctive role of different cross-sectional imaging modalities in the diagnosis of pediatric PA lesions, with special attention to normal variants that should not be mistaken for pathology. We also propose a radiological classification and algorithmic approach to aid in the precise diagnosis and facilitate appropriate management of the various PA lesions in children.
Status Dystonicus in Children: A Cross-Sectional Study and Review of Literature
Authors: Saini Arushi Gahlot , Hassan Ijas , Sharma Kanika , Muralidharan Jayashree , Dhawan Sumeet , Saini Lokesh , Suthar Renu , Sahu Jitendra , Sankhyan Naveen , Singhi Pratibha
Published: March 2022

Background: Status dystonicus is a life-threatening, underrecognized movement disorder emergency. We aimed to ascertain the etiology, clinical presentation, complications, and outcomes of status dystonicus in children and reviewed the literature for similar studies. Methods: Records of all children aged <14 years admitted to a single center with status dystonicus between 2014 and 2018 were reviewed. Results: Twenty-four children (75% male) were identified with status dystonicus. The annual incidence rate was 0.05 per 1000 new admissions <12 years of age. The mean age at presentation was 6.3 ± 3.6 years. Median duration of hospital stay was 10.5 days (interquartile range 5-21.7). The severity of dystonia at presentation was grade 3 (n = 9; 37.5%) and 4 (n = 9; 37.5%). The most common triggering factor was intercurrent illness/infection (n = 18; 75%). The most common underlying etiologies were cerebral palsy (n = 8; 33.3%), complicated tubercular meningitis (n = 3; 12.5%), and mitochondrial disorders (n = 3; 12.5%). Basal ganglia involvement was seen in 15 cases (62.5%). Respiratory and/or bulbar compromise (n = 20; 83.3%) and rhabdomyolysis (n = 15; 62.5%) were most commonly seen. Oral trihexyphenidyl (96%) followed by oral or intravenous diazepam (71%), oral baclofen (67%), and midazolam infusion (54%) were the most common drugs used. Clonidine was used in 33% cases, without any significant side effects. Three children died owing to refractory status dystonicus and its complications; the mortality rate was 12.5%. Conclusion Status dystonicus is a neurologic emergency in children with severe dystonia, with significant complications and a high mortality rate. Static and acquired disorders are more common than heredo-familial causes. Identification and treatment of infection in children is important as the majority of cases are triggered by an intercurrent infection.
Valproic Acid Serum Concentration and Incidence of Toxicity in Pediatric Patients
Authors: Young McKenzie R. , Bisaccia Elizabeth K. , Romantseva Lubov , Hovey Sara W.
Published: March 2022

In certain pediatric patients on valproic acid, therapeutic range (50-100 μg/mL) is maximized or exceeded to achieve better seizure control. This study compared incidence of common valproic acid adverse effects (thrombocytopenia, hepatotoxicity, and hyperammonemia) across maintenance concentration and age group. One hundred twenty-four children on maintenance valproic acid between January 2013 and January 2021 were eligible for inclusion. Fifty-six patients were maintained in concentration range 50 to 80 μg/mL, an additional 44 between 80 and 100 μg/mL and 24 between 100 and 120 μg/mL. Forty-one patients were prepubescent, 57 pubescent, and 26 postpubescent. There were no statistically significant differences observed in the primary endpoint of thrombocytopenia across serum concentration range ( P = .093) or age group ( P = .628). No significant differences in hepatic dysfunction ( P = .099) or hyperammonemia ( P = .548) were observed in serum concentration groups. Similarly, age group analysis observed no difference in hepatic dysfunction ( P = .615) or hyperammonemia ( P = .369). Serum valproic acid levels >100 μg/mL can be considered in select pediatric patients based on this study.
Engaging Native American Youth and Their Caregivers in Sexual Violence Research: A Case Study Documenting Challenges, Opportunities, and Lessons Learned
Authors: Edwards Katie M. , Herrington Ramona , Charge Leon Leader , Charge Damon Leader , Hopfauf Skyler , Camp Emily E. , Simon Briana , Waterman Emily A. , Banyard Victoria L.
Published: March 2022

Native Americans (the preferred term of our partners/co-authors) experience high rates of sexual violence, which is rooted in colonization and multiple historical traumas. Sexual violence leads to numerous deleterious outcomes, underscoring the critical need for prevention early in life. Yet, most research to date on sexual violence has not focused on Native American populations, and we know little about the most effective strategies to recruit and retain Native American individuals in sexual violence prevention research. The purpose of the current study, grounded in principles of participatory action research, is to describe strategies that were used to recruit (e.g., traditional feeds, door knocking) and retain (e.g., monetary incentives, ongoing community engagement) Native American youth for a study that sought to assess, via surveys and qualitative interviews, the impacts of a youth-led sexual violence prevention initiative in a small city in the Great Plains. We also collected qualitative data from Native American caregivers regarding their perceptions of research. Overall, 67.9% ( n = 545) of eligible Native American youth completed the survey, and school and door knocking were most effective methods of recruitment/enrollment followed by community and school events and texting. Over the course of 3 years of data collection, there were higher rates of attrition among Native American youth compared to white youth, and several factors (e.g., older age, sexual assault victimization) predicted attrition among Native American youth. Native American caregivers’ responses reflected on reasons it is hard to engage youth and caregivers in research (e.g., lack of time, distrust) as well as strategies to enhance engagement (e.g., personal connection, providing community resources). Throughout the paper, Native American co-authors and project partners reflect on these findings. Implications for future sexual violence prevention research with Native American youth and their caregivers that uses decolonized, participatory action research methodologies are discussed.
Design, modeling, and research on vertical performance of a drive system with in-wheel motor as dynamic vibration absorber
Authors: Zhao Pingping , Fan Zhimin
Published: March 2022

There are many advantages to an in-wheel motor drive (IWMD) vehicle. However, installing the motor in the wheel will increase the unsprung mass and deteriorate the vehicle ride comfort. In this paper, this conclusion is verified by a comparative simulation test of ride comfort. To solve the above problems, this paper puts forward a new in-wheel motor drive (NIWMD) model and comprehensively evaluates the vertical performance of the vehicle from two aspects: vehicle ride comfort and motor vibration. The vertical performance evaluation indexes include body acceleration, wheel dynamic load, suspension dynamic deflection, motor acceleration, and motor relative displacement. The vertical performance of the NIWMD model, CMD model, and IWMD model is compared. The results show that, especially in the high-frequency resonance region, the NIWMD model can effectively suppress the peak vibration response and improve the vehicle vertical performance. The influence of system parameters of the NIWMD model is studied, and the sensitivity of system parameters is calculated. The research results show the parameters that have a great influence on the vehicle vertical performance, which points out the direction for the optimization of the vertical performance of the NIWMD model.
Effect of electrode negativity ratio and heat input on bead and arc characteristics in submerged arc welding
Authors: Naik Ajit Kumar , Roshan Rakesh , Arora Kanwer Singh , Shajan Nikhil , Mishra Subash Chandra
Published: March 2022

The effect of electrode negativity (EN) ratio, current and welding speed on bead profile and arc stability in case of constant current square wave power source were investigated by conducting bead on plate (BOP) welding experiments on API X80 steel. In addition to this, effects of heat input on prior austenite grain (PAG) size, microstructure and hardness of coarse grain heat affected zone (CGHAZ) were also studied. Deleterious hump angle created due to EN ratio variation, decreased with increase in EN ratio and welding current. Average PAG size and spacing between bainite laths increased from 17.09 µm to 62.66 µm and 0.67 µm to 50 µm respectively with increase in heat input from 0.69 kJ/mm to 3.6 kJ/mm, which altered CGHAZ hardness. Arc stability and metal transfer mode for different EN ratios and currents were analyzed by means of probability density distribution (PDD) graphs of current and voltage transients recorded using a digital storage oscilloscope. PDD graph show better arc stability at higher currents and during the electrode positive (EP) part of current waveform.
Asymmetric effect of financial globalization on carbon emissions in G7 countries: Fresh insight from quantile-on-quantile regression
Authors: Adebayo Tomiwa Sunday , Akadiri Seyi Saint , Akpan Usenobong , Aladenika Bisola
Published: March 2022

Being among the highest emitters of greenhouse gases globally, the G7 countries have pledged to halve their carbon emissions by 2030, relative to 2010. This is in clear recognition of the need to transit from carbon energy to more sustainable solutions that are climate-friendly. In view of this, understanding how financial globalization contributes to the realization of those pledges becomes necessary. In this paper, we introduce two major innovations to the literature on financial globalization and environmental degradation. First, in terms of methodology, we apply the quantile-on-quantile regression (QQR) approach with a nonparametric technique over the period 1970Q1–2018Q4. The combination of these techniques has so far received limited attention in the literature. Second, we test for an asymmetric nexus between financial globalization and carbon emission in the G7 economies—Canada, France, Germany, Italy, Japan, the United Kingdom and the United States—as they present an interesting area of research focus. Empirical results from the QQ regression show an emission-increasing effect of financial globalization on environmental degradation in the G7 nations. Furthermore, in order to assess the causal effect of financial globalization on environmental degradation, we apply the nonparametric causality technique. Overall, results from the nonparametric estimations show that financial globalization significantly predicts variation in environmental degradation across quantiles. From a policy standpoint, economic and political frameworks in these nations should be directed towards enhancing higher financial inflows that are in line with the stated economic and environmental policies, among other policy suggestions.
Adaptive neural networks force/position control of uncertain manipulators subject to input saturation and output constraints
Authors: Wu Yuxiang , Fang Haoran , Xu Tian , Wan Fuxi
Published: March 2022

In this work, considering the influence of input saturation and time-varying output constraints, an adaptive neural networks force/position control method is proposed for a class of uncertain robotic manipulators in contact with the external environment. Radial basis function neural networks are introduced to approximate the system uncertainty and only one parameter needs to be updated online. The output constraints are satisfied by converting the constrained system to an unconstrained one. Moreover, an auxiliary dynamic system is applied in the transformed unconstrained system to handle the input saturation nonlinearity and the Moore–Penrose pseudo-inverse term is introduced for controller design. All signals in the closed-loop system are proved to be bounded by using the Lyapunov method. To show the good performance of the given scheme, comparative simulation is conducted on a two-joint manipulator, which is controlled by the proposed adaptive neural networks force/position tracking controller and a conventional force/position controller without considering input saturation and output constraints. Simulation results show that the adaptive neural network force/position controller has better control performance than the traditional method.
Disturbance-observer-based tracking controller for a flexible-joint robotic manipulator with full-state constraints
Authors: Tian Linran , Gao Yang , Zhang Zhongcai
Published: March 2022

In this study, a nonlinear tracking controller is designed for a flexible-joint (FJ) robotic manipulator system subject to full-state constraints and external disturbances. First, a nonlinear disturbance observer (NDO) is introduced to guarantee that the respective disturbance can be estimated asymptotically. Then, state-dependent function (SDF) transformations are used to convert the original state-constrained system into a new unconstrained system. Subsequently, a NDO-based tracking controller is proposed to enable the output tracking error to converge to a predefined compact set that can be adjusted to be arbitrarily small. The boundedness of all the closed-loop system signals is rigorously proved. Finally, simulation results are presented that show the effectiveness of the proposed control algorithm.
The relation of CD4+CD25+Foxp3+ regulatory T cells concentration with disease activity and damage index in systemic lupus erythematosus
Authors: Kamal Mostafa , Gabr Hala , Anwar Somaya , Bastawy Samah , Salah Lamiaa
Published: March 2022

Introduction

Regulatory T cells (Treg) deficits, both quantitative and qualitative, are known to be possible triggers for the development of autoimmune disorders by causing T and B cells dysfunction. The contribution of Treg deficiency in the etiology of systemic lupus erythematosus (SLE) is still being debated. The aim of the present study is to evaluate the percentage of circulating CD4+CD25+Foxp3+ Treg cells in a cohort of Egyptian SLE patients and to correlate this value with the activity and damage index of these patients.

Methods

50 female patients with SLE together with an equal number of age- and sex-matched healthy controls were enrolled in the study. Flow cytometric determination of peripheral Treg cells was carried out for all participants by detecting the percentage of CD4+CD25+Foxp3+ cells to compare cases with the control group. Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), while disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR DI). Both indices were correlated with the percentage of CD4+CD25+Foxp3 T regulatory cells.

Results

CD4+CD25+Foxp3+ Treg cells percentage was significantly decreased in patients with SLE as compared to healthy controls. On correlating CD4+CD25+Foxp3+ Treg percentage with SLEDAI-2K, a significantly negative correlation was found. Also, there was a negative significant correlation between CD4+CD25+Foxp3+ Treg cells percentage and SLICC/ACR DI. On correlating SLEDAI-2K with damage index (SLICC/ACR DI), we found highly significant positive correlation.

Conclusion

Our study showed impaired production of CD4+CD25+Foxp3+ Tregs in SLE patients, which can play a reciprocal role with some cytokines to affect the activity of the disease and organ damage. CD4+CD25+Foxp3+ Tregs cells should be the target to determine the clinical effectiveness of new therapy to modulate Tregs besides the traditional treatments.
A pharmacoeconomic study comparing the use of mycophenolate mofetil or cyclophosphamide as induction therapy in lupus nephritis patients in Egypt
Authors: Khattab Nada M , Abbassi Maggie , A Raafat Hala , Farid Samar
Published: March 2022

Introduction/objectives

Lupus nephritis (LN) is a major and serious complication of systemic lupus erythematosus (SLE) and is associated with morbidity and mortality. The difference in drug cost between mycophenolate mofetil (MMF) and cyclophosphamide (CYC) inducing regimens becomes a relevant and realistic issue, especially in developing countries. Thus, this study aims to estimate and compare the costs and outcomes of CYC and MMF for better allocation of resources to reduce the burden on the Egyptian healthcare system.

Methods

A prospective, parallel observational study was conducted at Kasr Al-Aini Hospital between 2018 and 2020. One hundred and twenty-two LN patients were followed up monthly during the study period. Remission and maintenance of renal remission were assessed at 6 and 12 months from the start of therapy. Total direct medical costs associated with both regimens were examined. We applied the cost-minimization analysis method from governmental perspective. Besides, a prospective evaluation of reported changes in health-related quality of life using SF-36 was included in our study.

Results

There was no statistically significant difference in treatment response at 6 and 12 months (RR 0.6 [0.26;1.43] and 0.8 [0.27;2.33]), respectively, as well as the incidence of infection episodes between MMF and CYC group (71.4% versus 70.45%, p > 0.05). The average direct medical expenditures per patient in the MMF group were approximately one and half times more than the CYC group (2339.69 $ versus 1329.03 $, p <0.001).

Conclusion

The CYC arm was associated with lower costs than the MMF arm, with equally effective outcomes indicating that CYC is an attractive treatment option.
Malpractice litigation following orthopaedic surgery of the hip: Frequency, reasons for lawsuit, and outcomes
Authors: Fano Adam N , Fields Michael W , Levidy Michael F , Ippolito Joseph , Luis Justin , Dobitsch Andrew , Beebe Kathleen
Published: March 2022

Medical malpractice litigation in the United States has resulted in the widespread adoption of defensive medicine practices. Orthopaedic surgery is among the specialties most likely to face a malpractice lawsuit, and hip-related surgeries are commonly involved. This study aimed to analyse malpractice litigation as it relates to hip surgery in the United States. The purpose of this study was to seek answers to the following questions: Has there been an increase or a decrease in the number of hip surgery malpractice cases in recent years? What are the most common reasons for a patient to pursue litigation? Which surgical complications are most likely to result in a lawsuit? What trends do we see in terms of outcomes? The Westlaw legal database was queried for all relevant cases from 2008 to 2018. A retrospective review of cases was conducted and descriptive analyses were performed in order to identify factors associated with hip surgery malpractice litigation. A total of 82 cases were analysed. There was a downtrend in the number of cases per year. Total hip arthroplasty (47 cases, 57.3%) was the procedure most often involved. Procedural error was noted as a reason for litigation in 71 (86.6%) cases. Neurological injury (22 cases, 26.8%), malpositioned hardware (15 cases, 18.3%) and leg length discrepancy (8 cases, 9.8%) were the most common complications listed. The majority of cases resulted in a verdict in favour of the defendant orthopaedic surgeon (48 cases, 58.5%). The mean payout for a plaintiff verdict (20 cases, 24.4%) was $1,647,981 (range, $1,852–$7,000,000) and the mean payout for a settlement (13 cases, 15.9%) was $657,823 (range, $49,000–$3,000,000) (p = 0.063). The study concluded that, within the 10-year period, there was a significant downtrend in hip surgery malpractice cases filed per year. Orthopaedic surgeons were found liable in the minority of cases. As expected, verdicts in favour of plaintiffs resulted in seemingly higher payouts than settlements.
How does Context Influence Implementation Mechanism of Publicly Funded Health Insurance Schemes in Indian States
Authors: Rout Sarit Kumar , Boyanagari Vamsi Krishna , Pani Saumya Ranjan , Mokashi Tushar , Chokshi Maulik , Kadam Shridhar M.
Published: March 2022

Introduction:

The success of any insurance scheme is contingent upon well-defined processes related to payment, referral, grievances and quality control mechanisms. Any deviation observed may result in unsatisfactory performance. This study attempts to examine various processes related to the implementation of Pradhan Mantri Jan Arogya Yojana (PMJAY) and a state-specific insurance scheme across three states of India.

Objective:

To describe the policies and process adapted by selected states in implementing a government-sponsored health insurance scheme. To examine the strategies that work effectively, how they operate and what contextual factors enable or disable the desired implementation mechanisms.

Methodology:

The three states of Karnataka, Chhattisgarh, and Odisha were selected to understand various processes related to the implementation of Publicly Funded Health Insurance Schemes (PFHIS) schemes in diverse settings. A realist evaluation framework was used to study the contexts and mechanisms and how this influences outcomes.

Results:

The three schemes differ in implementation modes and follow different strategies owing to the local contexts. Some mechanisms worked well in specific contexts, whereas similar things have hindered the process in other contexts.

Conclusion:

The evidence generated is helpful to strengthen implementation processes under PMJAY and allows learning from each other to increase uptake of the scheme.
Determining the Role of Community Engagement in the Design of Primary Care Models Addressing Non-communicable Diseases
Authors: Sharma Atul , Joshi Arun Dhananjay , Purohit Nidhi , Sharma Shruti , Bhat Meenal , Chokshi Maulik , Mokashi Tushar , Nair Arun
Published: March 2022

Non-communicable diseases (NCDs) are a major health concern in India and were estimated to account for 63% of all deaths in 2016, and if left unaddressed, they could cost India approximately US$3.55 trillion in economic losses by 2030. The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS) has identified community engagement to enable behaviour change as a top intervention to manage various NCDs. Community engagement initiatives in India are plagued with multiple issues such as a lack of long-term focus, non-clarity on budgets, ineffective programme planning and the absence of visionary leadership and governance. This article attempts to understand the role of community engagement in providing access to NCD awareness and to support action on prevention, screening, diagnosis, treatment and compliance, so that the community is empowered to proactively behave in a way to prevent and manage NCDs effectively and hence reduce the incidence of NCDs. The article is based on research study using a mixed-method approach in a five-step manner, which included secondary and primary research. After scanning 200 initiatives across the spectrum of community engagement globally, 20 were shortlisted and detailed case studies of the initiatives were analysed and presented. In addition, primary research was pursued to propose recommendations for community engagement across the areas of visioning and planning, leadership and governance, and community involvement. Some guiding principles were recommended to create an environment of shared leadership and collaboration for community engagement, consequently creating greater positive influence on NCD management within the community.
Exchange Rate Volatility and Financial Stress: Evidence from Developing Asia
Authors: Tiwary Daitri , Das Khanindra Ch. , Shettigar Jagdish , Misra Pooja
Published: March 2022

The study investigates the role of financial stress in triggering exchange rate volatility in developing Asia, where instability in financial markets contributes to the extent of exogenous shocks. We investigate volatility clustering in nominal exchange rate (NER) of dollar-denominated domestic currencies of developing Asia. Using country-level monthly time series data from 2006 to 2019 of NER and financial stress for seven representative economies of developing Asia, namely, Philippines, Indonesia, Malaysia, India, Republic of Korea, Singapore, and Thailand, we construct conditional volatility of returns. With volatility clustering in dollar-denominated exchange rates, we find significant bi-directional and predictive causality in exchange rate volatility and financial stress using vector autoregressive model and test for Granger’s causality. Our findings corroborate with the third-generation model of currency crises in the context of emerging economies. For developing Asian nations, our study implicates the strength of the financial system impacting the level and spread of stress, inducing exchange rate volatility. Our empirical model propounds that though stress is driven by multiple factors, management of exchange rate volatility in emerging economies will need to address problems not only in the foreign exchange market, but also in other financial sectors.

JEL Codes: G01, F31, C58
Kinesiophobia and Its Association With Fatigue in CHF Patients
Authors: Qin Jingwen , Xiong Juanjuan , Wang Xue , Gao Ya , Gong Kaizheng
Published: March 2022

Kinesiophobia is related with adverse outcomes in various diseases, but it has not been studied in chronic heart failure (CHF). Fatigue often causes movement avoidance in CHF patients, and thereby, leads to a worsening of condition and increasing severity of symptom burden. The purpose of this study was to explore kinesiophobia and its related factors and the relationship between the kinesiophobia and fatigue in CHF patients. We recruited (n = 236) inpatients with CHF from October 2020 to March 2021 and administered a self-designed demographic questionnaire, the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart-C), and the Multidimensional Fatigue Inventory (MFI-20), and collected related electronic medical record data. Findings revealed that 63% of participants had kinesiophobia. was a moderate correlation between fatigue and kinesiophobia ( r = .49, p < .01). Educational background, monthly family income, disease course, and fatigue explained 41% of the variance in kinesiophobia, of which fatigue independently accounted for 9%.
The Impact of Fan-Type Rapid Palatal Expanders on Speech in Patients With Unilateral Cleft Lip and Palate
Authors: Bertucci Virginia , Stevens Kyle , Sidhu Nicole , Suri Sunjay , Bressmann Tim
Published: March 2022

Rapid palatal expanders (RPEs) are commonly used in patients with cleft lip and palate (CLP) prior to secondary alveolar bone grafting (SABG). Their position and size can impede tongue movement and affect speech. This study assessed changes in perception and production of speech over the course of RPE treatment.

Prospective longitudinal.

Tertiary university-affiliated hospital.

Twenty-five patients with unilateral CLP treated with Fan-type RPEs, and their parents.

Patient and parent speech questionnaires and patient speech recordings were collected at baseline before RPE insertion (T1), directly after RPE insertion (T2), during RPE expansion (T3), during RPE retention (T4), directly after RPE removal but before SABG (T5), and at short-term follow-up after RPE removal and SABG (T6).

Ratings for patient and parent questionnaires, first (F1) and second (F2) formants for vowels /a/, /i/, and /u/, and nasalance scores for non-nasal and nasal sentences, were obtained and analyzed using mixed model analyses of variance.

Ratings worsened at T2. For the vowel /a/, F1 and F2 were unchanged at T2. For the vowel /i/, F1 increased and F2 decreased at T2. For the vowel /u/, F1 was unchanged and F2 decreased at T2. Nasalance was unchanged at T2. All outcome measures returned to T1 levels by T4.

RPE insertion resulted in initial adverse effects on speech perception and production, which decreased to baseline prior to removal. Information regarding transient speech dysfunction and distress may help prepare patients for treatment.
Exploring the Process of Policy Overreaction: The COVID-19 Lockdown Decisions
Authors: Hafsi Taieb , Baba Sofiane
Published: March 2022

Policy overreaction is a common phenomenon, especially in complex and emergency situations where politicians are led to make decisions fast. In these emergency decisions, emotions run generally high and cognitive processes are often impaired. The conditions of policy overreaction are in place as emotions overwhelm decision makers’ rational processes. Drawing on the response patterns of three countries to the COVID-19 pandemic, we develop a process model of policy overreaction which describes the effects of negative emotions and institutional isomorphism on policy decision-making. Our model highlights four critical stages: negative emotions buildup, propagation of fear, isomorphic decision-making, and leading to an intractable crisis. This article shows precisely how the cascading effect of negative emotions, particularly fear, is contagious and spreads to generate crowd effects, which bend considerably policy makers’ ability to make rational decisions. Our theory provides a better understanding of the process by which policy overreaction takes place.
Metastatic Clear Cell Renal Cell Carcinoma Involving the Thyroid Gland: A Clinicopathologic Study of 17 Patients
Authors: Velez Torres Jaylou M. , Briski Laurence M. , Martinez Duarte Ernesto , Sadow Peter M. , Kerr Darcy A. , Kryvenko Oleksandr N.
Published: March 2022

Background. Metastatic clear cell renal cell carcinoma (RCC) is one of the most common secondary thyroid malignancies. Diagnosis can be challenging, particularly if presenting many years after initial diagnosis. We reviewed clinicopathologic features and immunoprofile of metastatic clear cell RCC in thyroid. Design. We identified 17 patients from 2003-2021. Clinical data were obtained from medical records, and slides were retrieved and reviewed. Results. Seventeen patients (12 male and 5 female) included 12 thyroidectomies, 3 core biopsies, 1 excisional biopsy, and 1 fine-needle aspiration. The average patient age was 68.7 years (range, 45-88 years). Sixteen patients had history of clear cell RCC, and in 1 patient, the clear cell RCC was discovered after the thyroid metastasis was found. Thyroid gland metastases were on average diagnosed 90.7 months after the diagnosis of the renal primary (range, 24-240 months). Patients presented with a new palpable mass (n = 11) or dyspnea/stridor (n = 1). Five tumors were incidentally found via surveillance imaging. In 2 patients, metastases occurred within follicular thyroid neoplasms. All metastases showed conspicuous sinusoidal vasculature between the tumor nests and areas of myxoid degeneration. A prominent thick fibromuscular pseudocapsule was evident in 10 resections. Immunohistochemistry (n = 5) showed that the metastases were positive for PAX8, CA9, and CD10, while negative for keratin 7, thyroglobulin, and TTF1. Conclusions. Metastatic clear cell RCC involving the thyroid gland is infrequent and typically occurs remotely after the initial diagnosis. Cytologic and histologic features may show significant overlap with primary thyroid lesions. Immunohistochemistry can help reliably distinguish metastases from primary thyroid neoplasms.
Transformed Mycosis Fungoides with a Cytotoxic T-Cell Phenotype
Authors: Hiraiwa Shinichiro , Hashimoto Norisato , Ueda Tomoki , Sugiyama Tomoko , Yokoyama Kenji , Matsuyama Takashi , Tajiri Takuma , Nakamura Naoya
Published: March 2022

Mycosis fungoides (MF) is a cutaneous T-cell lymphoma and occasionally undergo large cell transformation (transformed MF, TMF), resulting in a poorer clinical outcome. We describe a case of TMF with an immunophenotypic shift. MF showed the CD4 + CD8- T-cell phenotype, while TMF exhibited the CD4-CD8 + T-cell phenotype. Moreover, TMF expressed cytotoxic markers of TIA1 and Granzyme B. A PCR analysis of T-cell receptor genes revealed peak sizes that were the same in both biopsies, indicating that these two lymphomas were derived from the same clone.
Theoretical, numerical, and experimental study on synchronization of three motors coupled with a tensile spring in a nonlinear vibrating system
Authors: Du Mingjun , Xiong Guang , Hou Duyu , Du Lei , Yang Rong , Hou Yongjun
Published: March 2022

A synchronization mechanism for three motors coupled with a tensile spring in a nonlinear vibrating system is proposed to apply in drilling fluid shaker. The purpose of this paper is to investigate the synchronization mechanism of the system. Firstly, the dynamic equations of the system are established by using the Lagrange’s equation, and the steady-state solutions of the system are solved. Then, synchronous conditions and stability criteria of the system in a steady state are obtained. Next, the influences of various structure parameters on the synchronous state of the system are numerically discussed. Additionally, we use the Runge–Kutta algorithm to build an electromagnetic coupling model, and the synchronous behavior of the system is explored. Finally, an experimental strategy including the synchronous tests of the system is implemented to verify the correctness of theoretical analysis, numerical discussion, and simulation. It is concluded that the steady synchronous motion of three motors can be achieved by selecting an appropriate stiffness of the tensile spring. All these study results will provide a strong support for developing the design of large-scale vibration machinery with high efficiency and energy-saving in engineering.
High fiber content snack bars made with maize biomass flour, rice flakes and oat flakes: Physicochemical properties and sensory acceptance
Authors: Ribeiro Alline Emannuele Chaves , Oliveira Aryane Ribeiro , Silva Ana Caroline Mendes da , Garcia Marina Costa , Ribeiro Keyla de Oliveira , Caliari Márcio , Soares Júnior Manoel Soares
Published: March 2022

The aim of this study was to assess physicochemical properties and sensory acceptance of snack bars (SBs) made with different levels of maize biomass flour (MBF), rice flakes (RF) and oat flakes (OF). A simplex design was used, with 6 mixtures and 2 repetitions. The different levels of MBF, RF and OF used in the SBs influenced all physicochemical properties evaluated (moisture, water activity, specific volume, hardness and instrumental color). SB4 (containing 14.85:5:10.85% of MBF:RF:OF, respectively) and SB6 (containing 14:8:8% of MBF:RF:OF, respectively) were the closest to the desirable formulation according to the desirability diagram for the physicochemical properties of the SBs. SB1 (containing 20:5:5% of MBF:RF:OF, respectively) was also selected for sensory analysis as it showed the highest MBF content among all formulations. None SBs presented a microbiological risk. The SB6 presented the highest sensory acceptance and purchase intent, highlighting its rich content of dietary fiber (16.45 ± 0.1 g/100 g) and protein (7.04 ± 0.02 g/100 g) besides its low-calorie characteristic (1421.22 kJ/100 g/339.68 kcal/100 g). The development of SBs using MBF is feasible in relation to their physicochemical and sensory properties, which can stimulate the sustainable production of new goods from this by-product.
Which Measures From a Sustained Attention Task Best Predict ADHD Group Membership?
Authors: Machida Keitaro , Barry Edwina , Mulligan Aisling , Gill Michael , Robertson Ian H. , Lewis Frances C. , Green Benita , Kelly Simon P , Bellgrove Mark A. , Johnson Katherine A.
Published: March 2022

Difficulty with sustaining attention to a task is a hallmark of ADHD. It would be useful to know which measures of sustained attention best predict a diagnosis of ADHD. Participants were 129 children with a diagnosis of ADHD and 129 matched controls who completed the fixed Sustained Attention to Response Task (SART). The number of commission and omission errors, standard deviation of response time (SDRT), tau, fast and slow frequency variability, d-prime, and mu were able to successfully classify children with and without ADHD. The mean response time, criterion, and sigma were not able to classify participants. The best classifiers were d-prime (0.75 Area Under the Receiver Operated Characteristic), tau (.74), SDRT (0.74), omission errors (0.72), commission errors (0.71), and SFAUS (0.70). This list of the best classifier measures derived from the SART may prove useful for the planning of future studies.
Analysis of feline humeral fracture morphology and a comparison of fracture repair stabilisation methods: 101 cases (2009–2020)
Authors: Gall Nick , Parsons Kevin , Radke Heidi , Comerford Eithne , Mielke Ben , Grierson James , Ryan John , Addison Elena , Logethelou Vasileia , Blaszyk Agnieszka , Langley-Hobbs Sorrel J
Published: March 2022

Objectives

The aims of this study were to describe the type, presentation and prognostic factors of feline humeral fractures over a 10-year period and to compare three stabilisation systems for feline humeral diaphyseal fractures.

Methods

In total, 101 cats with humeral fractures presenting to seven UK referral centres between 2009 and 2020 were reviewed. Data collected included signalment, weight at the time of surgery, fracture aetiology, preoperative presentation, fixation method, surgical details, perioperative management and follow-up examinations. Of these cases, 57 cats with humeral diaphyseal fractures stabilised using three different fixation methods were compared, with outcome parameters including the time to radiographic healing, time to function and complication rate.

Results

The majority of the fractures were diaphyseal (71%), with only 10% condylar. Of the known causes of fracture, road traffic accidents (RTAs) were the most common. Neutered males were over-represented in having a fracture caused by an RTA ( P = 0.001) and diaphyseal fractures were significantly more likely to result from an RTA ( P = 0.01). Body weight had a positive correlation ( r = 0.398) with time to radiographic healing and time to acceptable function ( r = 0.315), and was significant ( P = 0.014 and P = 0.037, respectively). Of the 57 humeral diaphyseal fractures; 16 (28%) were stabilised using a plate–rod construct, 31 (54%) using external skeletal fixation and 10 (18%) using bone plating and screws only. Open diaphyseal fractures were associated with more minor complications ( P = 0.048). There was a significant difference between fixation groups in terms of overall complication rate between groups ( P = 0.012). There was no significant difference between fixation groups in time to radiographic union ( P = 0.145) or time to acceptable function ( P = 0.306).

Conclusions and relevance

All three fixation systems were successful in healing a wide variety of humeral diaphyseal fractures. There was a significantly higher overall complication rate with external skeletal fixators compared with bone plating; however, the clinical impact of these is likely low.
Functionally significant polymorphisms of the MMP9 gene are associated with primary open-angle glaucoma in the population of Russia
Authors: Ponomarenko Irina , Reshetnikov Evgeny , Dvornyk Volodymyr , Churnosov Mikhail
Published: March 2022

Purpose

The aim of this study was to investigate the role of functionally significant loci of the matrix metalloproteinases genes 1, 3, 9 ( MMP1, MMP3, and MMP9) in the development of primary open-angle glaucoma (POAG) in Caucasians of the Central region of Russia.

Methods

In total 604 participants were recruited for the study, including 208 patients with POAG and 396 healthy controls. They were genotyped at eight single nucleotide polymorphisms (SNPs) of the three MMP genes. The association was analyzed using logistic and log-linear regression. POAG-associated loci and their proxies were in silico assessed for their functional prediction.

Results

Variant allele G*rs2250889 of MMP9 was significantly associated with higher risk of POAG (ORcov = 1.57–1.71). Haplotype CCA [rs3918242-rs3918249-rs17576] of the MMP9 gene was associated with lower risk of POAG (ORcov = 0.33). Allele А*rs3787268 of MMP9 was associated with the low intraocular pressure in the POAG patients (βcov = −0.176 - −0.272), and so were haplotypes AA [rs17576-rs3787268] (βcov = −0.577) and AAC [rs17576-rs3787268- rs2250889] (βcov = −0.742) of the same gene, whereas allele 2G*rs1799750 of MMP1 was associated with the earlier onset of the disease (βcov = −0.112 - −0.218). In silico analysis of the polymorphisms suggested the functionality of POAG-associated SNPs and their proxies (epigenetic potential, expression and alternative splicing effects for several genes).

Conclusions

The MMP9 gene polymorphisms are associated with POAG and intraocular pressure in POAG patients; rs1799750 of MMP1 was associated with the earlier age of manifestation of the disease symptoms.