bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptation and evaluation of psychometric properties of HELAM using the Rasch model in the Indonesian context
Authors: Handayani Trikinasih , Sukarelawan Moh Irma , Matore Mohd Effendi Ewan Mohd , Saifuddin Much Fuad
Published: October 2023

Many schools have shifted their learning mode from face to face to fully online in order to reduce virus transmission and avoid learning loss, resulting in accelerated use of the learning management system (LMS). The implementation of online learning over the last 3 years in Indonesia needs to be evaluated. However, the available evaluation scales are in different cultural contexts. Therefore, the existing scales should be adapted. This study aims to adapt and report the psychometric properties of the Hexagonal E-Learning Assessment Model (HELAM) scale in the context of Indonesian culture. The adaptation followed the procedure suggested by Beaton. To achieve a measurement accuracy of up to 0.5 logit at a 99% confidence level, 326 teachers taking the Teacher Professional Education (TPE) program in position program were involved. The psychometric properties of the HELAM scale were analyzed using the Rasch model to improve accuracy and observe the quality of the HELAM scale. The results of the analysis show that the HELAM scale has good psychometric properties in the context of Indonesian culture at the instrument and item level. The elements of reliability and validity have met the good criteria. Thus, the adapted HELAM scale can be applied to the Indonesian context.
Gerenciamento de lock-in em soluções de tecnologia: cada escolha uma renúncia
Authors: Queiroz Fabio Wilson Barreto de , Faccin Kadígia , Francisco Rosemary
Published: October 2023

This text describes a technology management case to be used as teaching material in postgraduate courses in administration and related areas. The manuscript design followed the appropriate methodology for case studies. The central characters in the case are João, technology manager at Tradição Ltda., an accounting firm, and Afonso, representative of a technology solution used by Tradição Ltda. The case addressed a difficult moment in the relationship between the customer and the technology provider when the customer became dependent on the technology solution, and the licensing costs began to rise: deciding whether to keep the solution or to substitute for another one. The text details the solution of a traditional company to remain competitive with new technologies and the decision regarding the implementation of a transformation plan first phase. The data presented aims to clarify the scenario related to costs and the scenario related to the qualitative aspects of the technology market. It is noteworthy that the established scenario lacks a multi-criteria analysis for decision making.
Irrupção e reação (raça, gênero, sexualidade e classe na teoria literária brasileira contemporânea)
Authors: Saldanha Fabio Pomponio , Santos Ariadne Catarine dos , Natali Marcos
Published: October 2023

Editorial do dossiê 36.
Cenas de um discurso monstruoso
Authors: Nakagome Patricia Trindade
Published: October 2023

Na tentativa de responder a uma chamada para pensar irrupção e reação no meio acadêmico, busquei captar não elementos antagônicos, mas uma imbricada ligação de monstruosidade e amor, inclusive em mim mesma. Para tanto, centrei a discussão em dois textos literários voltados às relações familiares, apostando que, ao olhar para esse meio em que afeto e dor se combinam na formação de pessoas, consiga levantar pontos para refletir sobre a universidade, essa alma mater. Mesclando a leitura das obras com episódios autobiográficos, atento-me especialmente ao caráter movente da filiação, em que filhos e estudantes logo podem ocupar o lugar de pais e professores. Essa dinâmica talvez possa gerar um olhar mais amoroso para o outro e também um reconhecimento da herança monstruosa em si.
Assessing “Cause and Effect”: Objective Based Measurement for Public Relations
Authors: Michaelson David , Stacks Don , Wright Donald
Published: October 2023

Despite numerous proposed approaches, the public relations profession has failed to develop a widely adopted method for the measurement of public relations activities. In this paper, the authors propose an objective-based approach to measurement that assesses the impact of public relations by applying a “cause and effect” model based on message delivery. This approach is based on an actual measurement protocol used by a leading global industrial manufacturing company and is consistent with well-established communication theories. In this model, the authors propose a five-stage approach to measurement that includes message development and testing, message distribution, message delivery, message delivery and message impact.
Obesity Modifies Clinical Outcomes of Right Ventricular Dysfunction
Authors: Ma Janet I. , Zern Emily K. , Parekh Juhi K. , Owunna Ndidi , Jiang Nona , Wang Dongyu , Rambarat Paula K. , Pomerantsev Eugene , Picard Michael H. , Ho Jennifer E.
Published: October 2023

BACKGROUND:

Right ventricular (RV) dysfunction is associated with increased mortality across a spectrum of cardiovascular diseases. The role of obesity in RV dysfunction and adverse outcomes is unclear.

METHODS:

We examined patients undergoing right heart catheterization between 2005 and 2016 in a hospital-based cohort. Linear regression was used to examine the association of obesity with hemodynamic indices of RV dysfunction (pulmonary artery pulsatility index, right atrial pressure:pulmonary capillary wedge pressure ratio, RV stroke work index). Cox models were used to examine the association of RV function measures with clinical outcomes.

RESULTS:

Among 8285 patients (mean age, 63 years; 40% women), higher body mass index was associated with worse indices of RV dysfunction, including lower pulmonary artery pulsatility index (β, −0.23; SE, 0.01;
P
<0.001), higher right atrium:pulmonary capillary wedge pressure ratio (β, 0.25; SE, 0.01;
P
<0.001), and lower RV stroke work index (β, −0.05; SE, 0.01;
P
<0.001). Over median of 7.3 years of follow-up, we observed 3006 mortality and 2004 heart failure hospitalization events. RV dysfunction was associated with a greater risk of mortality (eg, pulmonary artery pulsatility index:hazard ratio, 1.11 per 1-SD increase [95% CI, 1.04–1.18]), with similar associations with risk of heart failure hospitalization. Body mass index modified the effect of RV dysfunction on all-cause mortality (
P
interaction
≤0.005 for PAPi and RA:PCWP ratio), such that the effect of RV dysfunction was more pronounced at higher body mass index.

CONCLUSIONS:

Patients with obesity had worse hemodynamic measured indices of RV function across a broad hospital-based sample. While RV dysfunction was associated with worse clinical outcomes including mortality and heart failure hospitalization, this association was especially pronounced among individuals with higher body mass index.
Preeclampsia Prediction Using Machine Learning and Polygenic Risk Scores From Clinical and Genetic Risk Factors in Early and Late Pregnancies
Authors: Kovacheva Vesela P. , Eberhard Braden W. , Cohen Raphael Y. , Maher Matthew , Saxena Richa , Gray Kathryn J.
Published: October 2023

BACKGROUND:

Preeclampsia, a pregnancy-specific condition associated with new-onset hypertension after 20-weeks gestation, is a leading cause of maternal and neonatal morbidity and mortality. Predictive tools to understand which individuals are most at risk are needed.

METHODS:

We identified a cohort of N=1125 pregnant individuals who delivered between May 2015 and May 2022 at Mass General Brigham Hospitals with available electronic health record data and linked genetic data. Using clinical electronic health record data and systolic blood pressure polygenic risk scores derived from a large genome-wide association study, we developed machine learning (XGBoost) and logistic regression models to predict preeclampsia risk.

RESULTS:

Pregnant individuals with a systolic blood pressure polygenic risk score in the top quartile had higher blood pressures throughout pregnancy compared with patients within the lowest quartile systolic blood pressure polygenic risk score. In the first trimester, the most predictive model was XGBoost, with an area under the curve of 0.74. In late pregnancy, with data obtained up to the delivery admission, the best-performing model was XGBoost using clinical variables, which achieved an area under the curve of 0.91. Adding the systolic blood pressure polygenic risk score to the models did not improve the performance significantly based on De Long test comparing the area under the curve of models with and without the polygenic score.

CONCLUSIONS:

Integrating clinical factors into predictive models can inform personalized preeclampsia risk and achieve higher predictive power than the current practice. In the future, personalized tools can be implemented to identify high-risk patients for preventative therapies and timely intervention to improve adverse maternal and neonatal outcomes.
Hourly Air Pollution Exposure and Emergency Hospital Admissions for Stroke: A Multicenter Case-Crossover Study
Authors: Lv Xin , Shi Wanying , Yuan Kun , Zhang Yangchang , Cao Wangnan , Li Chunrong , Xu Lufei , Wu Lizhi , Sun Shengzhi , Hong Feng
Published: October 2023

BACKGROUND:

Daily exposure to ambient air pollution is associated with stroke morbidity and mortality; however, the association between hourly exposure to air pollutants and risk of emergency hospital admissions for stroke and its subtypes remains relatively unexplored.

METHODS:

We obtained hourly concentrations of fine particulate matter (PM
2.5
), respirable particulate matter (PM
10
), nitrogen dioxide (NO
2
), sulfur dioxide (SO
2
), ozone (O
3
), and carbon monoxide (CO) from the China National Environmental Monitoring Center. We conducted a time-stratified case-crossover study among 86 635 emergency hospital admissions for stroke across 10 hospitals in 3 cities (Jinhua, Hangzhou, and Zhoushan) in Zhejiang province, China, between January 1, 2016 and December 31, 2021. Using a conditional logistic regression combined with a distributed lag linear model, we estimated the association between hourly exposure to multiple air pollutants and risk of emergency hospital admissions for total stroke, ischemic stroke, hemorrhagic stroke, and undetermined type.

RESULTS:

Hourly exposure to PM
2.5
, PM
10
, NO
2
, and SO
2
was associated with an increased risk of hospital admissions for total stroke and ischemic stroke. The associations were most pronounced during the concurrent hour of exposure and lasted for ≈2 hours. We found that the risk was more pronounced among male patients or those aged <65 years old.

CONCLUSIONS:

Our findings suggest that exposure to PM
2.5
, PM
10
, NO
2
, and SO
2
, but not CO and O
3
, is associated with emergency hospital admissions for total stroke or ischemic stroke shortly after exposure. Implementing targeted pollution emission reduction measures may have significant public health implications in controlling and reducing the burden of stroke.
Most Promising Approaches to Improve Stroke Outcomes: The Stroke Treatment Academic Industry Roundtable XII Workshop
Authors: Wechsler Lawrence R. , Adeoye Opeolu , Alemseged Fana , Bahr-Hosseini Mersedeh , Deljkich Emir , Favilla Christopher , Fisher Marc , Grotta James , Hill Michael D. , Kamel Hooman , Khatri Pooja , Lyden Patrick , Mirza Mahmood , Nguyen Thanh N. , Samaniego Edgar , Schwamm Lee , Selim Magdy , Silva Gisele , Yavagal Dileep R. , Yenari Midori A. , Zachrison Kori S. , Boltze Johannes , Yaghi Shadi ,   on behalf of the XIIth Stroke Treatment Academic Industry Roundtable
Published: October 2023

The Stroke Treatment Academic Industry Roundtable XII included a workshop to discuss the most promising approaches to improve outcome from acute stroke. The workshop brought together representatives from academia, industry, and government representatives. The discussion examined approaches in 4 epochs: pre-reperfusion, reperfusion, post-reperfusion, and access to acute stroke interventions. The participants identified areas of priority for developing new and existing treatments and approaches to improve stroke outcomes. Although many advances in acute stroke therapy have been achieved, more work is necessary for reperfusion therapies to benefit the most possible patients. Prioritization of promising approaches should help guide the use of resources and investigator efforts.
Propofol-mediated Unconsciousness Disrupts Progression of Sensory Signals through the Cortical Hierarchy
Authors: Tauber John M. , Brincat Scott L. , Stephen Emily P. , Donoghue Jacob A. , Kozachkov Leo , Brown Emery N. , Miller Earl K.
Published: October 2023

A critical component of anesthesia is the loss of sensory perception. Propofol is the most widely used drug for general anesthesia, but the neural mechanisms of how and when it disrupts sensory processing are not fully understood. We analyzed local field potential and spiking recorded from Utah arrays in auditory cortex, associative cortex, and cognitive cortex of nonhuman primates before and during propofol-mediated unconsciousness. Sensory stimuli elicited robust and decodable stimulus responses and triggered periods of stimulus-related synchronization between brain areas in the local field potential of Awake animals. By contrast, propofol-mediated unconsciousness eliminated stimulus-related synchrony and drastically weakened stimulus responses and information in all brain areas except for auditory cortex, where responses and information persisted. However, we found stimuli occurring during spiking Up states triggered weaker spiking responses than in Awake animals in auditory cortex, and little or no spiking responses in higher order areas. These results suggest that propofol's effect on sensory processing is not just because of asynchronous Down states. Rather, both Down states and Up states reflect disrupted dynamics.
Is It Fitting to Divide Value? A Review of The Value Gap
Authors: Perrine Timothy
Published: October 2023

Rønnow-Rasmussen’s The Value Gap is an extended argument for Value Dualism, the view that both goodness and goodness for are coherent value concepts that are not fully understandable in terms of each other. In the first part of the book, he criticizes attempts to fully understand one type of value in terms of the other. In the second part of the book, he argues that both concepts are value concepts by appealing to a “Fitting Attitude” analysis of value concepts. This book review exposits Rønnow-Rasmussen’s argument for Dualism, and his proposed analysis of both goodness and goodness for. More critically, it briefly defends a strategy for understanding goodness for in terms of goodness and criticizes Rønnow-Rasmussen’s proposed analysis of goodness for.
To Follow Bousaadiya
Authors: Tayeb Leila
Published: October 2023

This article takes the figure of Bousaadiya, once performed in varying iterations throughout central North Africa, as an entry point to approach the problematics of mobility and memory in Libya. Bousaadiya performance, a multidimensional set of practices that I read critically as dance, produces an embodied social ground upon which Libyans have enacted and contested racialized practices of belonging and a mobile gravesite where it is possible to interrogate regional histories of enslavement and their material and symbolic legacies. While reading Bousaadiya performance enables an excavation of the trans-Saharan slave trade and its ghostly e/affects, performing Bousaadiya enabled the incomplete burial of these through surrogation, easing particular losses. In this article, I explore both of these aspects of the performativity of Bousaadiya’s dance, which is underscored by the forms of remembering it that continue to proliferate. To follow Bousaadiya is to grapple with the ongoing unresolvedness in Libyan cultural politics of the country’s histories of slave economies and the hierarchies left in their wake and to gesture toward the prospect of repair.
A new species of the genus Pseudohomonyx Arrow, 1908 (Coleoptera: Scarabaeidae: Dynastinae) from Malaysia and Thailand, with first description of P. apoensis Miyake & Yamaya, 1997 male and a catalogue of the genus
Authors: GESHEV) QIAO-ZHI YANG (GEORGI , PATHOMWATTANANURAK WUTTIPON
Published: October 2023

Pseudohomonyx continentalis Yang & Pathomwattananurak, new species from Malaysia and Thailand, is described and illustrated herein. Male of P. apoensis Miyake & Yamaya, 1997 is described and illustrated for the first time. Pseudohomonyx javanus (Burmeister, 1847) is newly recorded from Malaysia and Thailand. An annotated catalogue and a distribution map for the genus are also provided.
Observations of Tidally Driven Turbulence over Steep, Small-Scale Topography Embedded in the Tasman Slope
Authors: Marques Olavo B. , Alford Matthew H. , Pinkel Robert , MacKinnon Jennifer A. , Voet Gunnar , Klymak Jody M. , Nash Jonathan D.
Published: October 2023

Enhanced diapycnal mixing induced by the near-bottom breaking of internal waves is an essential component of the lower meridional overturning circulation. Despite its crucial role in the ocean circulation, tidally driven internal wave breaking is challenging to observe due to its inherently short spatial and temporal scales. We present detailed moored and shipboard observations that resolve the spatiotemporal variability of the tidal response over a small-scale bump embedded in the continental slope of Tasmania. Cross-shore tidal currents drive a nonlinear trapped response over the steep bottom around the bump. The observations are roughly consistent with two-dimensional high-mode tidal lee-wave theory. However, the alongshore tidal velocities are large, suggesting that the alongshore bathymetric variability modulates the tidal response driven by the cross-shore tidal flow. The semidiurnal tide and energy dissipation rate are correlated at subtidal time scales, but with complex temporal variability. Energy dissipation from a simple scattering model shows that the elevated near-bottom turbulence can be sustained by the impinging mode-1 internal tide, where the dissipation over the bump is O(1%) of the incident depth-integrated energy flux. Despite this small fraction, tidal dissipation is enhanced over the bump due to steep topography at a horizontal scale of O(1) km and may locally drive significant diapycnal mixing.

Significance Statement

Near-bottom turbulent mixing is a key element of the global abyssal circulation. We present observations of the spatiotemporal variability of tidally driven turbulent processes over a small-scale topographic bump off Tasmania. The semidiurnal tide generates large-amplitude transient lee waves and hydraulic jumps that are unstable and dissipate the tidal energy. These processes are consistent with the scattering of the incident low-mode internal tide on the continental slope of Tasmania. Despite elevated turbulence over the bump, near-bottom energy dissipation is small relative to the incident wave energy flux.
Postoperative Urinary Complications in Head and Neck Free Flap Reconstructive Surgery
Authors: Chan Kimberly , Keane Allison , Pradhan Sandeep , King Tonya , Moroco Annie , Goyal Neerav , Choi Karen Y.
Published: October 2023

Objective:

The purpose of this study is to evaluate the postoperative urinary complications and the optimal timing of foley catheter removal in patients who underwent free flap reconstructive surgery for head and neck pathology.

Methods:

A retrospective case-control study of head and neck patients who underwent free flap reconstructive surgery at a single institution between January 2009 and December 2021 was conducted. Patient risk factors for postoperative urinary retention (POUR) were analyzed. Fisher Exact and Wilcoxon Rank Sum tests were used to evaluate rates of foley replacement, straight catheterization, and catheter-associated urinary tract infection (CAUTI) and associated risk factors.

Results:

Two hundred and eleven patients were included in this study. Older age, lower BMI, lower intraoperative fluid volumes, and need for straight catheterization were statistically significant for POUR requiring foley replacement. Shorter total ( P = .04) and postoperative ( P = .01) foley duration showed statistical significance for POUR requiring straight catheterization. About 60% of patients who had straight catheterization required a foley replacement ( P < .001). Only one patient (0.5%) developed a urinary tract infection (UTI).

Conclusion:

Foley catheter duration impacts the risk of POUR requiring straight catheterization and subsequently, foley replacement. Optimal timing for foley catheter removal in the postoperative period remains to be elucidated. Removal of catheters between 21 and 48 hours after surgery may decrease the risk of POUR without increasing the rate of CAUTI in patients with head and neck pathology undergoing free flap reconstructive surgery.
Formulary Drug Review: Rezafungin
Authors: Kessel Brittney , Baker Danial E.
Published: October 2023

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers. Monographs can be customized to meet the needs of a facility. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, contact Wolters Kluwer customer service at 866-397-3433.
Antibiotic-Induced Hiccups: A Case Report and Brief Literature Review
Authors: Barka Malek , Abdesslem Mohamed Zied , Jarrar Mohamed Saleh , Ben Salem Chaker
Published: October 2023

Hiccups, also called hiccoughs, are sudden, involuntary and rapid expulsion of air from the lungs with synchronous closure of the glottis causing blockade of the air flow. Hiccups may be induced by a multitude of etiologies such as central nervous disorders, gastrointestinal disorders, cardiovascular disorders, psychogenic factors, and metabolic disorders. Hiccups induced by medications are rare. The diagnosis of drug-induced hiccup is difficult. The exact mechanism responsible for this adverse drug reaction is still unknown. Herein, we report the first case of cefotaxime-induced hiccups and briefly review the literature on antibiotic-induced hiccups.
Secondary infections in critically ill patients with COVID-19 receiving steroid therapy
Authors: Pearce Alex K , Zawaydeh Qais , McGuire W Cameron , Husain Abdurrahman , Ayoub Claudia G , Sweeney Daniel A , Cotton Shannon A , Malhotra Atul
Published: October 2023

Secondary infections can occur during or after the treatment of an initial infection. Glucocorticoids may decrease mortality in patients with severe COVID-19; however, risk of secondary infection is not well described. Our primary objective was to investigate the risk of secondary infection among critically ill patients with COVID-19 treated with glucocorticoids. We examined patients with COVID-19 being treated in the intensive care unit at two academic medical centers from 1 to 7/2020. One hundred-seven patients were included. Of these, 31 received steroids and 76 patients did not. Analysis of the larger cohort was performed followed by a matched pairs analysis of 22 steroid and 22 non-steroid patients. Secondary infection was seen in 14 patients (45.2%) receiving steroids compared to 35(46.1%) not receiving steroids (p = 0.968). Secondary infections were most frequently encountered in the respiratory tract. Escherichia coli and Staphylococcus aureus were the most frequently identified organisms. Mortality was 16.1% in the steroid-treated group compared to 23.7% in the control group (p = 0.388). After performing matched pairs analysis and multivariable logistic regression there was no significant difference between secondary infection or mortality and steroid receipt. Secondary infections were common among critically ill patients with COVID-19, but the incidence of secondary infection was not significantly impacted by steroid treatment.
Theorising the causal impacts of social frontiers: The social and psychological implications of discontinuities in the geography of residential mix
Authors: Iyer Aarti , Pryce Gwilym
Published: October 2023

Until very recently, the question of how residents might be affected by the gradient of neighbourhood boundaries – whether these boundaries are abrupt or gradual – has remained largely absent from mainstream segregation research. Yet, theoretical and empirical findings emerging from recent studies suggest the impacts could be profound and far-reaching. This article seeks to provide a conceptual foundation for understanding such effects. We focus on the concept of ‘social frontiers’: spatial discontinuities in the geography of residential mix which occur when community boundaries are abrupt. Drawing on insights from cognate disciplines, we develop a theory of social frontier impacts that articulates their potential importance in limiting and shaping contact between neighbouring communities, exacerbating territorial conflict and ultimately affecting the psychological wellbeing and life course outcomes of those living at the frontier. We present our thesis as a series of propositions and corollaries, and reflect on the implications for empirical research.
Cough elixir overdose causing toxic leuco-encephalopathy and serotonin syndrome
Authors: Asranna Ajay , Kulanthaivelu Karthik , Ramakrishnan Subasree , Raghavendra Kenchiah
Published: October 2023

Acute toxic leukoencephalopathy and serotonin syndrome are rare neurological complications associated with various drugs and toxins, some of which overlap. However, the co-occurrence of these conditions is poorly documented. We present the case of a 14-year-old boy who suddenly developed altered consciousness and autonomic dysfunction after consuming excessive quantities of cough remedies containing dextromethorphan, chlorphenamine, dichlorobenzyl alcohol, and amylmetacreson. Magnetic resonance imaging of the brain revealed distinct white matter lesions. With supportive care, the patient rapidly improved, and the magnetic resonance imaging abnormalities disappeared. The swift resolution, typical magnetic resonance imaging findings, and a history of exposure to drugs affecting the central nervous system's serotonergic system suggested concurrent acute toxic leukoencephalopathy and serotonin syndrome. The components of cough medications can be hazardous in overdose due to their potential to enhance serotonin toxicity and cause direct or indirect central nervous system white matter damage. Early recognition and appropriate treatment are essential for recovery.
Atmospheric negations: Weaponising breathing, attuning irreducible bodies
Authors: Joronen Mikko
Published: October 2023

This paper elaborates various ways in which atmospheric negations operate by weaponising bodily vulnerability to air. It shows, firstly, how bodies remain exposed to colonial proximities of respiratory, olfactory, and sonic violence with ways that are constituted through negating site- and body-spheres. It highlights these spheric materialities by discussing the use of tear gas and skunk water, bombing of chemical warehouses, and the sonic settler aggression in Palestine, further arguing that we need to pay more attention to the irreducibility of the body to such violent orchestrations of atmospheric. Here the irreducibility of the body and the incapacity of the spheric become key matters related to what is called, secondly, the reciprocal sphereological vulnerability between the corporeal and the spheric. By paying particular attention to difference between breathing and attunement, the paper shows how a negative limit condition resides at the heart of what constitutes sphere-dwelling. Here an ontological shift in thinking atmospheric is suggested, one that starts, not from current framings aligned around the notions of vitality, affirmation, and relationality, but from the weaponisation of the fundamental incapacity of the body to overcome its own vulnerability to the air it breathes.
Implementation of a Decision Aid for Hip and Knee Osteoarthritis in Orthopedics: A Mixed-Methods Process Evaluation
Authors: Bossen Jeroen Klaas Jacobus , Wesselink Julia Aline , Heyligers Ide Christiaan , Jansen Jesse
Published: October 2023

Background

In orthopedics, the use of patient decision aids (ptDAs) is limited. With a mixed-method process evaluation, we investigated patient factors associated with accepting versus declining the use of the ptDA, patients’ reasons for declining the ptDA, and clinicians’ perceived barriers and facilitators for its use.

Methods

Patients with an indication for joint replacement surgery ( N = 153) completed questionnaires measuring demographics, physical functioning, quality of life (EQ-5D-3L), and a visual analog scale (VAS) pain score at 1 time point. Subsequently, their clinician offered them the relevant ptDA. Using a retrospective design, we compared patients who used the ptDA (59%) with patients who declined (41%) on all these measures as well as the chosen treatment. If the use of the ptDA was declined, patients’ reasons were recorded by their clinician and analysed ( n = 46). To evaluate the experiences of clinicians ( n = 5), semistructured interviews were conducted and thematically analyzed. Clinicians who did not use the ptDA substantially (<10 times) were also interviewed ( n = 3).

Results

Compared with patients who used the ptDA, patients who declined use had higher VAS pain scores (7.2 v. 6.2, P < .001), reported significantly worse quality of life (on 4 of 6 EQ-5D-3L subscales), and were less likely to receive nonsurgical treatment (4% v. 28%, P < .001). Of the patients who declined to use the ptDA, 46% said they had enough information and felt ready to make a decision without the ptDA. The interviews revealed that clinicians considered the ptDAs most useful for newly diagnosed patients who had not received previous treatment.

Conclusion

These results suggest that the uptake of a ptDA may be improved if it is introduced in the early disease stages of hip and knee osteoarthritis.

Highlights

Patients who declined the use of a patient decision aid (ptDA) for hip and knee osteoarthritis reported more pain and worse quality of life. Most patients who declined to use a ptDA felt sufficiently well informed to make a treatment decision. Patients who declined the ptDA were more likely to have received prior treatment in primary care. Clinicians found the ptDA to be a helpful addition to the consultation, particularly for newly diagnosed patients.
The first Marxist reflection of Georg Lukács
Authors: Qin Jiayang
Published: October 2023

The article ‘Aesthetic culture’ was written in 1908. Although it is in the same period as Soul and Form, in essence, the ideas expressed in this article go beyond the pure philosophy of life and the theory of form, which is different from the idealistic tendency of Lukács in this period. Moreover, ‘Aesthetic culture’ and History and Class Consciousness have ontological and epistemological consistency in subject–object relation and class consciousness. This was the first Marxist reflection of Lukács, and also a reliable sign that he was to join the Hungarian Communist Party 10 years later and turned to Marxism. By criticizing the paradox of aesthetic culture itself, Lukács tried to construct a culture as a whole as a category, and tried to solve the deep contradiction between the freedom of consciousness and the passive form of the subject in modern society. This kind of culture as a whole would be based on the class consciousness of the proletariat itself and take life as the main category, so as to provide the proletariat with practical theoretical conception to expand their space for living in bourgeois culture.
Comparison of Sepsis-1, 2 and 3 for Predicting Mortality in Septic Patients of a Middle-Income Country: A Retrospective Observational Cohort Study
Authors: Machado Lessa Carem Luana , Branchini Gisele , Moreira Delfino Isabela , Ramos Voos Matheus Henrique , Teixeira Cassiano , Hoher Jorge Amilton , Nunes Fernanda Bordignon
Published: October 2023

Introduction

The diagnosis of sepsis is based on expert consensus and does not yet have a “gold standard.” With the aim of improving and standardizing diagnostic methods, there have already been three major consensuses on the subject. However, there are still few studies in middle-income countries comparing the methods. This study describes the characteristics of patients diagnosed with sepsis and evaluates and compares the performance of Sepsis-1, 2, and 3 criteria in predicting 28 days, and in-hospital mortality.

Patients and Methods

A retrospective observational cohort study was conducted in the intensive care unit of a tertiary hospital. All admissions between January 1, 2018, and December 31, 2019, were reviewed. Patients diagnosed with sepsis were included.

Results

During the study period, 653 patients diagnosed with sepsis (by any of the studied criteria) were included in the study. The 28 days mortality rate was 45.8%, and the in-hospital mortality rate was 59.7%. We observed that 72.1% of patients met the minimum criteria for diagnosing sepsis according to the three protocols, and this group also had the highest mortality rate. Age and comorbidities such as cancer and liver cirrhosis were significantly associated with in-hospital mortality. The most common microorganisms were Escherichia coli, Klebsiella spp., and Staphylococcus spp.

Conclusions

The study found that most patients met the diagnostic criteria for sepsis using the three methods. Sepsis-2 showed greater sensitivity to predict mortality, while Sequential Organ Failure Assessment showed low accuracy, but was the only significant one. Furthermore, quick Sequential Organ Failure Assessment (qSOFA) had the highest specificity for mortality. Overall, these findings suggest that, although all three methods contribute to the diagnosis and prognosis of sepsis, Sepsis-2 is particularly sensitive in predicting mortality. Sepsis-3 shows some accuracy but requires improvement, and qSOFA exhibits the highest specificity. More research is needed to improve predictive capabilities and patient outcomes.
Self-Compassion, Health, and Empowerment: A Pilot Randomized Controlled Trial for Chinese Immigrant Women Experiencing Intimate Partner Violence
Authors: Li Yang , Rhee Hyekyun , Bullock Linda F. C. , McCaw Brigid , Bloom Tina
Published: October 2023

Chinese immigrant survivors of men’s violence experience both significant mental health impacts from abuse and barriers to formal services. Therefore, we examined the preliminary efficacy of an innovative mobile-based empowerment-based intervention (self-compassion, health, and empowerment; SHE) that specifically focuses on abused Chinese immigrant women in the US. This pilot study used a two-arm randomized controlled design with repeated measures. A convenience sample ( N = 50) of Chinese immigrant women who experienced past year intimate partner violence (IPV) were recruited online and randomly assigned to the intervention or control group (25 per group). We assessed IPV exposure, safety behaviors, depressive symptoms, anxiety symptoms, post-traumatic stress disorder (PTSD) symptoms, and self-compassion at baseline, post-intervention, and 8-week follow-up. Of 95 eligible participants, 50 (52.6%) agreed to participate and completed baseline data collection; intervention completion rate was 64%. We found a significant group and time interaction for self-judgment (a self-compassion component), with a significant reduction seen in the intervention group compared to the control group. Despite no other significant group differences observed over time, the intervention group showed consistent trends toward improvements in most outcome measures, including specific types of IPV (i.e., negotiation, psychological aggression, and sexual coercion), depressive and PTSD symptoms, self-compassion, and certain components of self-compassion (i.e., isolation and over-identification) when compared to the control group. Our findings suggest that the SHE intervention shows promise in improving the mental health well-being of Chinese immigrant survivors. However, a fully powered randomized controlled trial is warranted to determine its efficacy. Our intervention has the potential to be translated in the Chinese immigrant populations with the necessary organizational support.
Development and Application of a Weighted Gingivitis and Periodontitis (W-G/P) Score System in Cats
Authors: Harvey Colin E.
Published: October 2023

The adaptation for use in cats of a weighted periodontal scoring system developed in dogs is described. The system uses standardized methods to score the extent of gingivitis and periodontitis of buccal tooth surfaces, weighted by size of teeth and adjusted for missing teeth and size of the cat.
Climate change versus winter sports; can athlete climate activism change the score?
Authors: Knowles Natalie LB , Scott Daniel , Rutty Michelle
Published: October 2023

Outdoor winter sports sit on the frontlines of climate change, with athletes subject to increasingly unsafe, unfair and non-ideal competition and training conditions as a result. With athletes’ livelihoods and the future of winter sports on the line, this research investigates if and how winter athletes use their position as public figures, celebrities and role models to challenge the hegemonic structures in sports and society driving climate change. Framed through the broad athlete-activism literature, this study used a qualitative survey of 390 elite winter-sport athletes and coaches combined with eight key stakeholder interviews to understand athlete climate activism. Results demonstrate that winter athletes’ climate action is generally low risk constituting advocacy rather than activism. Athletes express fear of being called out as hypocritical for their high-carbon sport and lifestyle, insecurity over their level of climate education and frustration with the lack of climate action from international- and national-level winter-sport organizations. Scholarly, grassroots and sport-based activism may help athletes engage more effectively in climate activism within and beyond sport.
ADDing up?
Authors: Parker Gordon
Published: October 2023

Objective

To hypothesise that a possible increased prevalence of adult-onset attention-deficit disorder (ADD) and attention-deficit hyperactivity disorder (ADHD) may reflect mobile technology and digital media use being an aetiological factor.

Conclusions

Data and clinical observations support but do not prove the hypothesis.
Practical psychiatry: On therapeutic equipoise – Principles of a balanced approach to psychiatric treatments
Authors: Looi Jeffrey CL , Allison Stephen , Woon Luke , Bastiampillai Tarun
Published: October 2023

Objective

There are many burgeoning treatments, and a large range of therapeutic options for 21st century psychiatry. This paper briefly comments upon considerations for balancing treatment to suit the patient, their illness, and their milieu.

Conclusions

Therapeutic equipoise, for psychiatric care, is an aspiration rather than a position easily achieved. In day-to-day clinical practice, there will be unexpected demands and barriers that cannot always be accommodated or surmounted. Psychiatrists can work collaboratively with patients, carers, and colleagues in conceptualising and care-planning to avoid extremes of therapeutic hubris and despair, and to adapt evidence-based care more effectively so that it is suited to the patient and their circumstances.
Dignity and the Importance of Acknowledgement of Personhood for People With Disability
Authors: Chapman Kelsey , Dixon Angel , Ehrlich Carolyn , Kendall Elizabeth
Published: October 2023

Exploring the intricate relationship between individual and collective experiences, this study explores dignity from the perspectives of people with disability. Using an extreme citizen science approach, we engaged people with disability as active partners in gathering data through qualitative surveys and focus groups. Framework Analysis was employed to ensure the validity of findings while privileging the voices of people with lived experience of disability. Dignity was contingent on the acknowledgement of personhood and the delivery of human rights. Our research identified five key aspects to maintain and protect dignity: (1) acknowledging personhood; (2) recognising people with disability as decision-makers of their lives; (3) realising the right to access information; (4) maintaining the right to privacy; and (5) eliminating or minimising barriers to accessibility and inclusion. Undignified experiences that resulted from a lack of acknowledgement negatively affected participants’ wellbeing, and healthcare settings were identified as particularly challenging environments for dignity. These findings have significant implications for healthcare systems and services within an international and interdisciplinary context. They emphasise the need for adaptable, flexible services, co-designed with people with lived experience of disability. Addressing organisational constraints, resource limitations, and expectations is paramount to ensuring dignity is maintained through the acknowledgement of personhood and safeguarding of human rights.
Histology Shift in Esophageal Cancer Between Biopsies and Resections After Neoadjuvant Therapy: A Pilot Study
Authors: Hou Tieying , Yang Zhaohai , Zhang Qingzhao , Zhang Xuchen , Liao Xiaoyan , Lin Jingmei
Published: October 2023

Preoperative neoadjuvant therapy followed by resection is the mainstay treatment for locally advanced esophageal adenocarcinoma. We recently observed the histology shift from predominant esophageal adenocarcinoma in the biopsy to neuroendocrine neoplasm with or without adenocarcinoma in the post-treatment resection. The underlying mechanism of this finding is uncertain, and there is limited information in the literature. A total of 11 patients were identified: 10 patients received presurgical chemoradiation and 1 with chemotherapy. All biopsies were diagnosed with adenocarcinoma. When neuroendocrine immunomarkers were retrospectively performed on 5 biopsies, 2 showed focal positivity, although the classic neuroendocrine morphology was not readily appreciated. All resections contained neuroendocrine neoplasm, including 8 of well-differentiated type and 3 of neuroendocrine carcinomas. Two post-treatment esophagectomies consisted of neuroendocrine neoplasm only without residual adenocarcinoma. Upon follow-up, 8 patients died of the disease (median survival = 26 months), and 3 patients were alive after a median follow-up of 14 months. The overall median survival time was better than the reported esophageal neuroendocrine carcinoma (15 months). The 5-year observed survival rate was 11.3%, which was lower than the Surveillance, Epidemiology, and End Results 5-year survival rate of adenocarcinoma (21.8%). We reported a small series of esophageal adenocarcinoma that showed histology shift between biopsy and esophagectomy after neoadjuvant therapy. Our limited data suggest that prognosis of this group is different than the conventional adenocarcinoma. Awareness of this morphological change reminds pathologists to examine the biopsy specimens thoroughly, because recognition of neuroendocrine neoplasm, especially high-grade neuroendocrine component, might potentially affect pre- and post-surgical regimens.
Who Is Worthy of a Name? Identity, Naming, and Social Difference in News Images’ Captions
Authors: Scott Alex , Peña Vincent
Published: October 2023

This study examined news images and captions published by The Associated Press ( N = 7,455) between 2018 and 2022 to ascertain whether names were more frequently included for certain groups of people. The analysis found that people depicted in the Global North are named far more frequently than in the Global South, and that sports, entertainment, and political images include names more often than news and feature images. These pervasive patterns suggest naming has a discursive function that constructs an Other by excluding familial and cultural connotations inherent in names, forming a hierarchy through opposition, and extending social prominence for certain groups.
Development of oral oncolytic nonadherence estimator (ORACLE): A pretreatment nonadherence risk assessment for oral oncolytics
Authors: Signorelli Jessie , Tran Thuy , Sirek Marie E , Díaz-Rohena Yarelis , Taraba Jodi L , Muluneh Benyam , Basu Nayanika , Lilly Jennifer , Darling Julianne
Published: October 2023

Introduction

To date, there is no adherence estimator to identify risk of nonadherence prior to initiating oral oncolytics.

Methods

A workgroup was assembled through the National Community Oncology Dispensing Association and tasked with creating a tool to meet this need. Tool constructs were defined after a review of the literature identifying top barriers to adherence. A second literature search was conducted to identify questions targeting specific barriers from validated adherence questionnaires. Once a finalized draft was complete, the risk assessment tool was built into an electronic survey where a risk category can be automatically calculated for the patient.

Results

The six most impactful factors affecting compliance to oral oncolytics were identified as patient's confidence, health literacy, perception of treatment, quality of life, social support, and complexity of chemotherapy regimen. A six-item questionnaire was created with five patient-directed questions and one clinician-directed question. Examples and descriptions were provided for clinicians to consider when categorizing complexity of a regimen. The tool was designed for responses to each question to be indexed into categories through a 10-point system. Results will be stratified into low, moderate, or high risk for nonadherence.

Conclusion

The creation of a tool to predict nonadherence prior to starting therapy is an unmet need for patients initiating oral oncolytics. The aim of this tool is to meet those needs and better guide clinicians to provide patients with strategies to better manage nonadherence. Next steps include tool validation and piloting in clinical practice.