bluuebunny/crossref_metadata_2025 huggingface dataset:
Representation of Tropical Mesoscale Convective Systems in a General Circulation Model: Climatology and Response to Global Warming
Authors: Dong Wenhao , Zhao Ming , Ming Yi , Ramaswamy V.
Published: April 2021

The characteristics of tropical mesoscale convective systems (MCSs) simulated with a finer-resolution (~50-km) version of the Geophysical Fluid Dynamics Laboratory (GFDL) AM4 model are evaluated by comparing with a comprehensive long-term observational dataset. It is shown that the model can capture the various aspects of MCSs reasonably well. The simulated spatial distribution of MCSs is broadly in agreement with the observations. This is also true for seasonality and interannual variability over different land and oceanic regions. The simulated MCSs are generally longer-lived, weaker and larger than observed. Despite these biases, an event-scale analysis suggests that their duration, intensity and size are strongly correlated. Specifically, longer-lived and stronger events tend to be bigger, which is consistent with the observations. The same model is used to investigate the response of tropical MCSs to global warming using time-slice simulations forced by prescribed sea surface temperatures (SST) and sea-ice. There is an overall decrease in occurrence frequency, and the reduction over land is more prominent than over ocean.
Above the Clavicle: A Simplified Screening Method for Asymptomatic Blunt Cerebral Vascular Injury
Authors: McCullough Mary A. , Cairns Ashley L. , Shin Jaewook , Appelbaum Rachel D. , Couture Daniel E. , Nunn Andrew M. , Miller Preston R. , Martin Robert S. , Carmichael Samuel P.
Published: April 2021

Introduction

Blunt cerebrovascular injury (BCVI) is an increasingly detected pattern in trauma with significant morbidity, putting patients at risk for subsequent stoke. Complex screening protocols exist to determine who should undergo CT angiography of the neck (CTAN) to evaluate for BCVI. Once identified, stroke incidence may be reduced with appropriate treatment across grades. We hypothesize that an expanded and simplified method for identifying patients with clinical suspicion for BCVI based upon injury above the clavicle (ATC) will illustrate a previously undiagnosed cohort of patients.

Methods

A single-institution retrospective review of adult (age ≥18 years) blunt trauma patients with BCVI from January 1, 2010 to December 31, 2019 was conducted at a tertiary academic medical center. Patients undergoing CTAN were divided into 2 groups based upon qualification by either the expanded Denver criteria or clinical evidence of any injury ATC.

Results

A total of 219 patients were diagnosed with BCVI (25 566 blunt trauma admissions, .9% incidence). Seventeen patients (8%) who did not satisfy expanded Denver were diagnosed with BCVI by ATC, most commonly undergoing CTAN due to facial trauma (n = 8). There were no differences in distribution of carotid artery injuries (CAI) and vertebral artery injuries (VAI) in the expanded Denver criteria group compared to the ATC group.

Conclusions

CTAN for blunt trauma with any injury ATC is an easy-to-use screening tool and may be seamlessly included with initial whole-body imaging.
The Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ): Estimating Individual Susceptibility to Motion Sickness-Like Symptoms When Using Visual Devices
Authors: Keshavarz Behrang , Murovec Brandy , Mohanathas Niroshica , Golding John F.
Published: April 2021

Objective

Two studies were conducted to develop and validate a questionnaire to estimate individual susceptibility to visually induced motion sickness (VIMS).

Background

VIMS is a common side-effect when watching dynamic visual content from various sources, such as virtual reality, movie theaters, or smartphones. A reliable questionnaire predicting individual susceptibility to VIMS is currently missing. The aim was to fill this gap by introducing the Visually Induced Motion Sickness Susceptibility Questionnaire (VIMSSQ).

Methods

A survey and an experimental study were conducted. Survey: The VIMSSQ investigated the frequency of nausea, headache, dizziness, fatigue, and eyestrain when using different visual devices. Data were collected from a survey of 322 participants for the VIMSSQ and other related phenomena such as migraine. Experimental study: 23 participants were exposed to a VIMS-inducing visual stimulus. Participants filled out the VIMSSQ together with other questionnaires and rated their level of VIMS using the Simulator Sickness Questionnaire (SSQ).

Results

Survey: The most prominent symptom when using visual devices was eyestrain, and females reported more VIMS than males. A one-factor solution with good scale reliability was found for the VIMSSQ. Experimental study: Regression analyses suggested that the VIMSSQ can be useful in predicting VIMS ( R2 = .34) as measured by the SSQ, particularly when combined with questions pertaining to the tendency to avoid visual displays and experience syncope ( R2 = .59).

Conclusion

We generated normative data for the VIMSSQ and demonstrated its validity.

Application

The VIMSSQ can become a valuable tool to estimate one’s susceptibility to VIMS based on self-reports.
Psychotic symptoms associate inversely with social support, social autonomy and psychosocial functioning: A community-based study
Authors: Guerrero-Jiménez Margarita , Gutiérrez Blanca , Cervilla Jorge A
Published: April 2021

Background:

Population-based studies exploring psychotic symptoms (PS) show that their prevalence in the community is higher than previously thought. Psychosocial functioning and social support are poorer among people presenting clinical and subclinical PS.

Aims:

We aimed to estimate the prevalence rate of PS in Andalusia and to explore the association between PS and psychosocial functioning, social support and social autonomy in a Southern European population.

Material and methods:

This is a cross-sectional study. We undertook multi-stage sampling using different standard stratification techniques. Out of 5496 households approached, we interviewed 4507 (83.7%) randomly selected participants living in the autonomous region of Andalusia (Southern Spain). The Spanish version of the MINI International Neuropsychiatric Interview was used to elicit PS. We also gathered information on socio-demographic factors, suicidality risk, psychosocial functioning, social support and social autonomy.

Results:

The overall prevalence of PS was 6.7% (95% CI: 5.99–6.45). PS were associated with lower age (OR 0.975; 95% CI (0.967–0.983); p < .0001), female gender (OR = 1.346; 95% CI (1.05–1.07) p = .018), not living in a rural area (OR = 0.677; 95% CI (0.50–0.90) p = 0.009), lower social support (OR = 0.898; 95% CI (0.85–0.94) p < .0001), lower scores on social autonomy (OR = 0.889; 95% CI (0.79–1.00) p = .050), having an increased suicidality risk score (OR = 1.038; 95% CI (1.005–1.07); p = .023) and having lower scores on psychosocial functioning (OR = 0.956; 95% CI (0.95–0.96); p < 0.0001).

Conclusions:

Social outcomes seem to be strongly inversely associated with PS in spite of presumed higher levels of social support among Southern European cultures.
Situational Risk Factors for Inmate-on-Staff Assaults
Authors: McNeeley Susan
Published: April 2021

This study examines whether situational characteristics of incidents involving inmates and correctional staff are related to the occurrence of inmate-on-staff assaults. The analyses compare assaultive and non-assaultive incidents at an all-male, maximum security prison. The results of logistic regression models show that several situational characteristics (time, location, behavior of inmates, and actions taken by staff) differentiate between inmate-on-staff assaults and non-assaultive incidents. The results suggest that inmate-on-staff assaults can be reduced through the use of situational crime prevention, as well as training on signs indicating an assault is likely, the effective use of protective strategies, and de-escalation techniques.
Re-Imagining Literacy and Language Education for Girls of Color
Authors: Player Grace D. , González Ybarra Mónica
Published: April 2021

This introduction to a special issue on Girl of Color literacies explores the editors’ purpose for creating the issue. Utilizing sociocultural definitions of literacy nuanced and bolstered by Women of Color theories of language and literacy, they establish an urgency to pursue research that is conducted with and for Girls of Color within the field of literacy. The editors articulate the goals of the special issue as well as provide proposed lines of inquiry the field must address to create research, pedagogies, and practices that are more loving toward Girls of Color and that honor their beautifully complex meaning-making practices.
Event-triggered integral sliding mode fixed time control for trajectory tracking of autonomous underwater vehicle
Authors: Su Bo , Wang Hongbin , Li Ning
Published: April 2021

In this paper, an event-triggered integral sliding mode fixed-time control method for trajectory tracking problem of autonomous underwater vehicle (AUV) with disturbance is investigated. Initially, the global fixed time stability is ensured with conventional periodic sampling method for reference trajectory tracking. By introducing fixed time integral sliding mode manifold, fixed time control strategy is expressed for the AUV, which can effectively eliminate the singularity. Correspondingly, in order to reduce the damage caused by chattering phenomenon, an adaptive fixed-time method is proposed based on the designed continuous integral terminal sliding mode (ITSM) to ensure that the trajectory tracking for AUV is achieved in fixed-time with external disturbance. In order to reduce resource consumption in the process of transmission network, the event-triggered sliding mode control strategy is designed which condition is triggered by an event. Also, Zeno behavior is avoided by proof of theoretical. It is shown that the upper bounds of settling time are only dependent on the parameters of controller. Theoretical analysis and simulation experiment results show that the presented methods can realize the control object.
Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection
Authors: Dunlap Quinn , Gardner James Reed , Ederle Amanda , King Deanne , Merriweather Maya , Vural Emre , Moreno Mauricio Alejandro
Published: April 2021

Objective

Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND).

Study Design

Retrospective chart review.

Setting

Academic tertiary care center.

Methods

Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05.

Results

Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P <. 001) and endocrine pathology (34% vs 2.6%, P <. 001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis.

Conclusion

While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.
Effect of good meeting practices and interactional justice on online workplace informal learning in Korea
Authors: Kim Minjung , Park Min Jae
Published: April 2021

The purpose of this study is to investigate the contextual factors that facilitate informal workplace learning during the meeting process or after the meeting in the online context. This research utilized structural equation modeling technique and the target sample of this study was fulltime workers employed at various levels within a wide range of organizations. The results show that good meeting practice has a positive impact on external scanning among the three types of informal learning. Specifically, good meeting practice is not significantly related to learning with others and self-experimentation but is positively associated with external scanning. Interactional justice, which is comprised of interactional and informational justice, has a significant effect on learning with others and the self-experimentation learning type Neither interactional nor informational justice is significantly related to external scanning. Furthermore, the moderating effects of the relationship among good meeting practices, interactional justice and informal learning are based on demographic profiles, especially gender. The findings are distinctively different in terms of several hypotheses depending on gender.
Toward a socio-spiritual approach? A mixed-methods systematic review on the social and spiritual needs of patients in the palliative phase of their illness
Authors: Lormans Tom , de Graaf Everlien , van de Geer Joep , van der Baan Frederieke , Leget Carlo , Teunissen Saskia
Published: April 2021

Background:

Patients express a variety of needs, some of which are labeled social and spiritual. Without an in-depth exploration of patients’ expressions of these needs, it is difficult to differentiate between them and allocate appropriate healthcare interventions.

Aim:

To gain insight into the social and spiritual needs of patients with a life-limiting illness and the distinction between these needs, as found in the research literature.

Design:

A mixed-methods systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) approach to qualitative synthesis and the PALETTE framework and were reported according to the PRISMA statement. This review was registered in PROSPERO (CRD42019133571).

Data sources:

The search was conducted in PubMed, EMBASE, CINAHL, Scopus, and PsycInfo. Eligible studies reported social and spiritual needs from the patients’ perspective and were published between January 1st 2008 and October 2020. The quality of evidence was assessed using JBI Critical Appraisal Tools.

Results:

Thirty-four studies (19 qualitative, 1 mixed-methods, and 14 quantitative) were included. The five synthesized findings encompassing social and spiritual needs were: being autonomous, being connected, finding and having meaning, having a positive outlook, and dealing with dying and death.

Conclusion:

What literature labels as social and spiritual needs shows great similarities and overlap. Instead of distinguishing social from spiritual needs based on patients’ linguistic expressions, needs should always be explored in-depth. We propose a socio-spiritual approach that honors and preserves the multidimensionality of patients’ needs and enables interdisciplinary teamwork to allocate patient-tailored care.
School-Based Speech-Language Services Using Telepractice
Authors: Walters Sharon M. , Bernis Shelley A. , Delvin-Brown M. Angela , Hirsch Shanna E.
Published: April 2021

Students diagnosed with specific learning disabilities, autism, or emotional disturbance may also receive speech-language services as part of their individual education program. This article focuses on the use of telepractice for providing speech-language services in schools. The benefits of telepractice are described, including the accessibility, efficiency, and preference of telepractice in delivering effective speech-language services. In addition, the implementation of telepractice services is outlined, strategies for troubleshooting are described, and two implementation checklists are provided.
The Neurobiology of Modern Viral Scourges: ZIKV and COVID-19
Authors: Mittal Swapnil , Federman Hannah G. , Sievert David , Gleeson Joseph G.
Published: April 2021

The interactions of viruses with the nervous system were thought to be well understood until the recent outbreaks of Zika and SARS-CoV-2. In this review, we consider these emerging pathogens, the range and mechanisms of the neurological disease in humans, and how the biomedical research enterprise has pivoted to answer questions about viral pathogenesis, immune response, and the special vulnerability of the nervous system. ZIKV stands out as the only new virus in a generation, associating with congenital brain defects, neurological manifestations of microcephaly in newborns, and radiculopathy in adults. COVID-19, the disease caused by SARS-CoV-2, has swept the planet in an unprecedented manner and is feared worldwide for its effect on the respiratory system, but recent evidence points to important neurological sequelae. These can include anosmia, vasculopathy, paresthesias, and stroke. Evidence of ZIKV and SARS-CoV-2 genetic material from neural tissue, and evidence of infection of neural cells, raises questions about how these emerging viruses produce disease, and where new therapies might emerge.
Tribological behaviour of AZ91D/ultra-high-temperature ceramic composites at room and elevated temperatures
Authors: Sunu Surendran KT , Gnanavelbabu A
Published: April 2021

In this research work, the tribological behaviour of an AZ91D alloy and its composites reinforced with different titanium-based ultra-high-temperature ceramic particulates was investigated. Titanium-based ultra-high-temperature ceramic materials (5 wt%) such as titanium carbide, titanium boride and titanium nitride was used for the fabrication of three different composites, namely ATC, ATB and ATN, respectively. The proposed composites were prepared using a novel ultrasonic treatment-assisted stir-squeeze casting technique. Material characterization was performed using scanning electron microscopy and X-ray diffraction techniques. The porosity and hardness of the composites were determined prior to the wear test. In the pin-on-disc tribometer, the wear test was carried out at room temperature by varying the normal load (12.5–50 N) and the sliding speed (0.25–1 m/s). In addition, at a temperature of up to 200 °C, the tribological behaviour of the composites was assessed. The homogeneous distribution of ultra-high-temperature ceramic particles in the matrix was confirmed by the analysis of the microstructure using scanning electron microscopy images. The X-ray diffraction results showed that the reinforcement materials in the matrix were thermally stable. The hardness of the ATC, ATB and ATN was improved by approximately 31%, 33.8% and 29.6%, respectively. In comparison, at all wear testing conditions, ATB demonstrated superior tribological performance, while the performance of ATN was poor and ATC was moderate. Abrasion, oxidation and delamination were the wear mechanisms at room temperature. At elevated temperatures, oxidation, delamination, thermal softening and plastic deformation wear mechanisms were significant..
Modelling and response analysis of multibody large-scale displacement of boom-type roadheader
Authors: Zong Kai , Fu Shichen , Li Xu , Wu Miao , Chu Fulei
Published: April 2021

Boom-type roadheader is the most widely used equipment in the fully mechanized excavation face of coal mine. Under complicated operation conditions of underground coal mine, multibody large-scale displacement phenomenon of roadheader will occur during cutting process. Specifically, the position and attitude of the body are changing continuously, and radial runout phenomenon of the cutting arm will take place, which will seriously reduce the overall stability of roadheader and drivage efficiency of the roadway. Focused on the vertical cutting condition, the coupling dynamical model of position and attitude of the body is established based on Lagrange equation. Combined with the calculated cutting load, the dynamical model is solved through Simulink simulation method, and the solving results are analysed under different influence factors. Consequently, the response regularities of position and attitude of the body under influence of different factors are obtained. In the similar way, the dynamical model of radial runout quantity of the cutting arm is established, and the dynamic response of radial runout of the cutting arm during vertical cutting process is obtained as well. Finally, the simulation analysis results are validated through field experiments. The research work of this paper provides useful theoretical basis for deviation rectification control of the multibody structures of roadheader, fills the vacancy of theoretical study in this aspect, and contributes to improving the dynamics theory of mining machinery.
Twenty-five books a day: Literacy events in subsidized childcare
Authors: Cheyney-Collante Kristi
Published: April 2021

The purpose of this case study was to investigate a segment of a data set collected as part of a larger ethnographic study exploring the early language and literacy practices of one unique preschool programme, selected for its unusually high outcomes for children in typically underserved populations. The original study explored administrators’ literacy leadership within the context of system-level funding and oversight inequities and inadequate local, state, and federal support. Analysis from the original study showed that their lofty commitment to a ‘twenty-five books a day’ mindset guided them in supporting teachers as they made books, stories, and language play a universal occurrence throughout the school day. This article, reporting on an extension of this original study, explores how school administrators operationalized this ‘twenty-five books a day’ mindset: prioritizing ample and consistent (1) access to high quality, diverse books, (2) both structured and impromptu, responsive literacy interactions, and (3) professional support for teachers.
Mouvement de passage: Creating connections through movement among persons with dementia
Authors: Motta-Ochoa Rossio , Incio-Serra Natalia , Boulet Ariane , Fu Dannie , Frantz Allison , William Meghan , Blain-Moraes Stefanie
Published: April 2021

One of the challenging consequences of dementia is the change in relationships that can co-occur with the progression of this condition. Despite this well-documented change, few arts-based interventions target the relational dimension of dementia. This study aims to explore the effects of one arts-based relational intervention: a movement program designed to foster connections within a group of persons with dementia. We used ethnographic methods—including participant observations and informal interviews—to understand the relational effects of this program conducted by two dancers and a musician. The movement sessions were video recorded, and participant movement trajectories were analyzed for different ways in which they created connections. We identified two types of connections—nonreciprocal and reciprocal—and four subtypes of connections—connection to exercise/music, connection to participant, interpersonal connection, and group connection—that participants engaged in during the movement program. Despite most participants not remembering the previous movement sessions, they experienced increasing numbers of connections over the course of the program, particularly reciprocal interpersonal connections. Participants explored new forms of moving and creatively transformed the movement structures proposed by the dancers. The results demonstrate the effectiveness of this program in augmenting connections and fostering exploration and creativity in individuals with dementia, providing a template for further developments of interventions targeting the relational dimensions of dementia. This study also highlights the potential of combining ethnographic methods and video analysis to include the perspectives of persons with dementia in research.
What difference does literacy make among adult learners? Impact of adult basic education programme in a rural community in Botswana
Authors: Kolawole Oluwatoyin D , Pusoetsile Tshegofatso
Published: April 2021

Functional education and human development are not mutually exclusive. To achieve an all-round development, the fourth Sustainable Development Goal partly emphasizes the need to ‘… promote lifelong learning opportunities for all’ by year 2030. This article, therefore, uses a case study approach to analyse the impact of a government funded adult basic education programme in improving literacy level of Sehithwa community in rural, northwestern Botswana. Using a snowball technique and questionnaire/interview schedule survey to sample and interview 30 adult basic education programme participants and 30 non-participants, respectively, and holding other factors constant, the article’s main thrust was to determine the difference in literacy attainment between the two groups. Results from the T-test analysis performed showed that there was a significant difference in participants’ and non-participants’ age, association membership, and household size at p ≤ 0.00 level. Nonetheless, there was no significant difference in literacy attainment between the two groups, perhaps as a result of lack of effectiveness and other challenges associated with the implementation of the literacy programme in the study area.
Conceptualizing the Experiential Affordances of Watching Online TV
Authors: Lüders Marika , Sundet Vilde Schanke
Published: April 2021

This article investigates the experiential affordances of watching online TV as outcomes of the material underpinnings of online TV and the actions taken by viewers. Potential experiential changes derive from how online TV services can be considered libraries of content affording self-scheduling action possibilities. Such changes need to be situated in the slow-to-change conditions of television viewing. We draw on a qualitative study of how viewers respond to the action possibilities and constraints of online TV services. We argue that potentials for individualized viewing are counterbalanced by television viewing as a social activity. Next, self-scheduling ties in with viewing as a deliberate action, appropriated to create experiences where attentiveness is tailored to what is narratively required. Finally, flow schedules are replaced with programed paths constraining the agency of viewers.
Recent update on craniofacial tissue engineering
Authors: Emara Aala’a , Shah Rishma
Published: April 2021

The craniofacial region consists of several different tissue types. These tissues are quite commonly affected by traumatic/pathologic tissue loss which has so far been traditionally treated by grafting procedures. With the complications and drawbacks of grafting procedures, the emerging field of regenerative medicine has proved potential. Tissue engineering advancements and the application in the craniofacial region is quickly gaining momentum although most research is still at early in vitro/in vivo stages. We aim to provide an overview on where research stands now in tissue engineering of craniofacial tissue; namely bone, cartilage muscle, skin, periodontal ligament, and mucosa. Abstracts and full-text English articles discussing techniques used for tissue engineering/regeneration of these tissue types were summarized in this article. The future perspectives and how current technological advancements and different material applications are enhancing tissue engineering procedures are also highlighted. Clinically, patients with craniofacial defects need hybrid reconstruction techniques to overcome the complexity of these defects. Cost-effectiveness and cost-efficiency are also required in such defects. The results of the studies covered in this review confirm the potential of craniofacial tissue engineering strategies as an alternative to avoid the problems of currently employed techniques. Furthermore, 3D printing advances may allow for fabrication of patient-specific tissue engineered constructs which should improve post-operative esthetic results of reconstruction. There are on the other hand still many challenges that clearly require further research in order to catch up with engineering of other parts of the human body.
Decision-making in complex health care situations: Shared understanding, experimenting, reflecting and learning
Authors: Reerink Antoinette T , Bussemaker Jet , Leerink C Bastiaan , Kremer Jan AM
Published: April 2021

People who have complex problems affecting multiple areas of their lives need a different approach than people who have singular health conditions. They benefit more from an effectively cooperating support network that explores appropriate ways of providing assistance, rather than a strong focus on outcome-based care.
From Language Brokering to Digital Brokering: Refugee Settlement in a Smartphone Age
Authors: Worrell Shane
Published: April 2021

Many young people in migrant families perform language-brokering tasks for their parents to help them overcome their everyday challenges of communicating in a new language. Such informal brokering is typically the result of younger people being more exposed to, and becoming more familiar with, the dominant language of their new country. This article argues that such brokering has a digital equivalent in a migrant setting, in which transnational family communication increasingly relies on a grasp of the dominant “language” of smartphones and social media. Using data drawn from a study of Karen humanitarian migrants who have settled in Australia, younger migrants are shown to have had a greater exposure to, and familiarity with, digital technology than their parents, leading to significant communicative differences between two generations. Such differences, I explain, have created conditions conducive to the performance of a new type of intergenerational support in a migrant context: “digital” brokering. This is demonstrated through young people helping their parents use smartphones, social media, and video-calling apps to maintain transnational relationships after settlement.
Design and Retrospective Application of a Spine Trauma DVT Prophylaxis Protocol on Level 1 Trauma Center Patient Database
Authors: Nimmons Scott , Rizkalla James , Solis Jaicus , Dawkins Jonathan , Syed Ishaq
Published: April 2021

Study Design:

Systematic literature review.

Objectives:

The impact of thromboembolic disease on the morbidity and mortality of patients with acute spinal cord injury is well documented, with rates as high as 67%-100% among untreated patients. The efficacy of mechanical prophylaxis as a stand-alone measure has been questioned, so we sought to determine a safe perioperative window for chemical anticoagulation use after spine surgery. Many surgeons have concerns anticoagulants may cause post-operative hematoma.

Methods:

A systematic literature review was performed, ultimately yielding 13 articles. Based on the existing literature and input from our multidisciplinary institutional trauma committee, a Spine Trauma DVT Prophylaxis Protocol was developed.

Results:

Effort was placed to identify cases within our institution in which patients suffered vertebral column fractures and/or spinal cord injuries. Of these 466 vertebral column fractures and/or spinal cord injuries, 4 patients were identified and diagnosed with DVTs while admitted.

Conclusions:

Of these patients, there is a clear dilemma with regard to safety of chemoprophylaxis use versus risk of developing a DVT. Though none of the patients developed a PE, utilizing the protocol would have led to earlier IVC filter placement or initiation of a VTE surveillance protocol in 2 of the patients. Initiation of enoxaparin before surgery in one patient (despite delay of surgical timing) may have avoided his subsequent LUE DVT. Though not appropriate for all clinical scenarios, we are confident that our treatment algorithm will prove beneficial for patient care in avoiding DVTs and helping trauma surgeons with evidence-based clinical decision making.
Building institutional capacity for student competencies: An organizational perspective
Authors: Stensaker Bjørn
Published: April 2021

One of the key ambitions of universities around the world is to improve the educational design and delivery to the benefit of their students. Many universities acknowledge that they need to educate students for a future characterised by high levels of uncertainty in which individuals need to possess substantial confidence and competencies to navigate. While much attention has been given to the need for innovation in educational design, this paper focuses more on the organizational conditions needed to realize the necessary changes. Based on a review of current organizational developments and characteristics of universities, it is argued that a number of tasks, areas and practices need to be better integrated if higher education is to fulfil their ambition to equip students with the competencies needed for the future.
The Psychological Impact of Coronavirus Disease 2019 on Nurses in Saudi Arabia and Their Coping Strategies
Authors: Al Muharraq Essa H.
Published: April 2021

Aims and Objectives

To explore the psychological impact of coronavirus disease 2019 on frontline nurses working in Jazan, Saudi Arabia, and their coping strategies.

Background

As the coronavirus disease 2019 pandemic continues to expand globally, healthcare systems have become more overwhelmed than ever before, placing a great psychological strain on frontline nurses.

Design

A cross-sectional, observational, quantitative study.

Methods

In total, 215 frontline nurses working at 12 hospitals across Jazan, Saudi Arabia, were recruited. Data were collected during August 2020 using a modified version of the severe acute respiratory syndrome team questionnaire.

Results

Roughly two-thirds (62.3%) of the participants reported moderate to high levels of nervousness and fear at work. Ethical and moral responsibility has been determined as the main motivator for frontline nurses to practice their profession, with 88% of them expressing a willingness to work even if the situation deteriorated further. However, 87% of the participants were extremely concerned about transmitting the disease to their family members. The most common coping strategy adopted by the nurses appeared to be adherence to strict protective measures (93.5%), followed by the acquisition of more knowledge about the disease (82.3%).

Conclusion

Frontline nurses experience severe psychological stress, which is mainly caused by their fear of contracting the infection or passing it on to their family members. Thus, proper education, adherence to infection control protocols, effective social support system, and access to sufficient personal protective equipment will help nurses enhance their coping abilities.
Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem's Self-Care Deficit Nursing Theory
Authors: Yip Jeffrey Yuk Chiu
Published: April 2021

Introduction

Many researchers have commended the self-care deficit nursing theory (SCDNT) developed by Orem as a means of improving patients' health outcomes through nurses' contributions. However, experimental research has investigated specific aspects of SCDNT, such as self-care agency and self-care requisites, rather than how the construct is practiced and understood as a whole. The current research presents a case study in which an advanced practice nurse (APN) used SCDNT-led practice within a primary healthcare setting that illustrates how the theory is applied to case management.

Methods

A case study was conducted by observing an APN during her work in the asthma clinic of a public hospital in Hong Kong. A comparison was made between the case management of the APN under observation with the nursing processes stipulated by the SCDNT across four key operations: diagnostic, prescriptive, treatment or regulatory, and case management.

Conclusion

During the observed consultation, the APN applied the four key operations. In SCDNT, the role of the APN is to apply practical nursing knowledge by determining how a patient can best undertake self-care within the circumstances of their living arrangements and support facilities. The case study also demonstrated that SCDNT-based nursing practice has strengths and limitations in a primary healthcare setting. The study concluded that Orem's SCDNT serves as an appropriate theoretical framework for nursing practice within primary healthcare settings. One practical consequence of using SCDNT is that it enables APNs to use nurse-sensitive indicators when evaluating their clinical practice. This study offers a practice update to increase the accountability of nursing practice for nurse-led healthcare services.
Correction to: Effects of continuous cropping of sweet potatoes on the bacterial community structure in rhizospheric soil
Authors: Gao Zhiyuan , Hu Yaya , Han Meikun , Xu Junjie , Wang Xue , Liu Lanfu , Tang Zhonghou , Jiao Weijing , Jin Rong , Liu Ming , Guan Zhengjun , Ma Zhimin
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Retrograde inferior vena caval perfusion for total aortic arch replacement surgery: a randomized pilot study
Authors: Lin Jing , Qin Zhen , Liu Xinhao , Xiong Jiyue , Wu Zhong , Guo Yingqiang , Kang Deying , Du Lei
Published: April 2021

Objectives

Antegrade cerebral perfusion (ACP) under moderate hypothermic circulatory arrest is used during total aortic arch replacement surgery (TARS) in patients with acute type A aortic dissection, but it is associated with high mortality and morbidity. We hypothesized that combining ACP with retrograde inferior vena caval perfusion (RIVP) improves outcomes.

Methods

This pilot study was prospective, randomized, controlled and assessor-blinded. Patients scheduled for TARS were randomly treated with either ACP or RIVP + ACP. The primary outcome was a composite of mortality and major complications including paraplegia, postoperative renal failure, severe liver dysfunction, and gastrointestinal complications. Secondary outcomes included neurological complications, length of intubation and requirement of blood products.

Results

A total of 76 patients were recruited (n = 38 per group). Primary outcome occurred in 23 patients (61%) in the ACP group and 16 (42%) in the RIVP + ACP group (OR: 0.60, 95% CI: 0.21–1.62;p = 0.31). There was a lower incidence of transient neurological deficits in the RIVP + ACP group (26% vs. 58%, OR: 0.26; 95% CI: 0.10–0.67,p = 0.006;). The RIVP + ACP group underwent shorter intubation (25 vs 47 h,p = 0.022) and required fewer blood products (red cells, 3.8 units vs 6.5 units,p = 0.047; platelet: 2.0 units vs 2.0 units, p = 0.023) compared with the ACP group.

Conclusions

RIVP + ACP may be associated with lower incidence of transient neurological deficits, shorter intubation and less blood transfusion requirement than ACP alone during TARS. Multi-center, randomized trials with larger samples are required to determine whether RIVP + ACP is associated with lower rates of mortality and major complications.

Trial registration: Pilot study of a RCT registered in clinicaltrials.gov (NCT03607786), Registered 30 July, 2018—Retrospectively registered,https://clinicaltrials.gov/ct2/show/NCT03607786.
Case report of portal hepatic schwannoma: presentation of multimodality images
Authors: Amano Maki , Amano Yasuo , Takagi Ryo , Tang Xiaoyan , Omori Yuko , Okada Masahiro
Published: April 2021

Background

Portal hepatic schwannoma is a rare benign tumor and difficult to diagnose preoperatively because of its rarity and imaging manifestations that mimic malignancy. We present a case of portal hepatic schwannoma that showed moderate contrast enhancement on computed tomography (CT), extension along the bile duct on T2-weighted imaging and magnetic resonance cholangiopancreatography (MRCP), and uptake of 18F-fluorodeoxyglucose (FDG) on positron emission tomography.

Case presentation

Ultrasonography at an annual health checkup identified a hepatic mass in a 38-year-old woman. CT showed a well-defined portal hepatic tumor with mild contrast enhancement. T2-weighted imaging and MRCP showed a clavate tumor extending along the intrahepatic bile ducts but no dilatation of the ducts. The tumor exhibited increased FDG uptake, such as maximum standardized uptake values of 5.0 and 6.5 in the early and late phases, respectively. Neither dilatation of intrahepatic bile ducts nor lymphadenopathy was identified, and the multimodality imaging suggested hepatic portal lymphoma, gastrointestinal tumor, or IgG4-related disease rather than cholangiocarcinoma. A needle biopsy via endoscopic ultrasonography was performed, and immunohistology confirmed the tumor as a schwannoma.

Conclusions

The diagnosis of a portal hepatic schwannoma requires immunohistological examinations in addition to multimodality imaging studies to reflect fully the pathohistological characteristics of the tumor.
High levels of anti-Leishmania IgG3 and low CD4+ T cells count were associated with relapses in visceral leishmaniasis
Authors: Kuschnir Renata Caetano , Pereira Leonardo Soares , Dutra Maria Rita Teixeira , de Paula Ludmila , Silva-Freitas Maria Luciana , Corrêa-Castro Gabriela , da Costa Cruz Silva Simone , Cota Glaucia , Santos-Oliveira Joanna Reis , Da-Cruz Alda Maria
Published: April 2021

Background

Visceral leishmaniasis (VL) is severe and potentially fatal. Brazil is one of the countries with the greatest endemicity for the disease in the world. The reduction of CD4+T lymphocytes, B cells activation and high levels of inflammatory cytokines (IL-6/IL-8/TNF/IL-1β), plasma LPS, soluble CD14, anti-LeishmaniaIgG3 and low leptin levels are involved in the immunopathogenesis of VL, most associated with severe VL. Despite relapses occurring in about 4–5% of patients with VL not associated with HIV infection, the factors underlying relapses are little known. Our aim was to identify clinical, laboratory and immunological parameters that may be associated with recurrences in VL.

Methods

Fifteen VL patients recruited from Hospital Eduardo de Menezes (BH-MG) were grouped into relapsing (R-VL,n = 5) and non-relapsing (NR-VL,n = 10) and evaluated during active disease, immediately after treatment (post-treatment) and 6 months post-treatment (6mpt). Clinical and laboratory data obtained from medical records were correlated with CD4+and CD8+T cell counts and anti-LeishmaniaIgs and IL-6 plasma levels and compared to those parameters of ten healthy controls.

Results

During the active phase of VL, despite similarity in the clinical symptoms, the rates of thrombocytopenia, elevated transaminases (AST and ALT) and hyperbilirubinemia were higher in the NR-VL group compared to R-VL (p < 0.05), a profile reversed during the post-treatment phase. All patients had low CD4+T counts in active phase, however, NR-VL patients had a higher gain of this cell type than R-VL in the post-treatment (p < 0.05). There was a significant reduction in IgG3 levels during the follow-up in the NR-VL group compared to the R-VL, especially at 6mpt (p < 0.05). In addition, IgG3 levels were negatively correlated with CD4+T counts in the R-VL group (r = − 0.52). Elevated levels of IL-6 were observed in active VL and correlated with clinical markers of severity.

Conclusions

During active phase of VL, the NR-VL patients presented more severe laboratorial abnormalities compared to R-VL, probably because the latter had already received previous treatment. On the other hand, R-VL exhibited greater impairment of immune reconstitution and a high degree of B lymphocyte activation, which must be a factor that favored relapses.
Delayed bowel perforation after instilling over warmed peritoneal dialysate
Authors: Lai Xueli , Nie Mingming , Xu Xiaodong , Chen Yuanjie , Guo Zhiyong
Published: April 2021

Background

Peritoneal dialysis (PD) is a safe and home-based treatment for end-stage renal disease (ESRD) patients. The direct thermal damage of abdominal organs is very rare.

Case presentation

We report a peritoneal dialysis patient presented abdominal pain and feculent effluent 3 weeks after he instilled hot dialysis solution. In spite of emergency exploratory laparotomy and active treatment, the patient died of septic shock. Biopsy revealed necrosis and perforation of the intestines.

Conclusions

Delayed bowel perforation by hot fluid is very rare. Standardized performance is of the first importance for peritoneal dialysis patients.
RB1 and TP53 co-mutations correlate strongly with genomic biomarkers of response to immunity checkpoint inhibitors in urothelial bladder cancer
Authors: Manzano Ramon Gonzalez , Catalan-Latorre Ana , Brugarolas Antonio
Published: April 2021

Background

Muscle invasive urothelial bladder carcinoma (MIBC) present RB1 and TP53 somatic alterations in a variable percentage of tumors throughout all molecular subtypes. MIBCs with neuroendocrine features have a high response rate to immunity checkpoint inhibitors (ICIs). Whether the presence of somatic co-alterations in these 2 genes in MIBCs is relevant to their responsiveness to ICIs is not known.

Methods

The potential correlation of different genomic biomarkers of response to ICIs like tumor mutational burden (TMB), single nucleotide variants (SNV) predicted neoantigens, DNA damage response (DDR) genes, DNA somatic signatures and TILs infiltrate was explored in patients with somatic co-alterations in RB1 and TP53 (RB1&TP53) as compared with patients with no alterations in any (double wild type, DWT) or with alterations in just one of the 2 genes. The Cancer Genome Atlas (TCGA) pancancer BLCA dataset of cystectomy specimens (n = 407) with mutation, copy number alterations and transcriptomic (RNA sequencing) data as well as the IMVigor 210 study (n = 348) of metastatic urothelial bladder cancers treated with atezolizumab (PD-L1 inhibitor) with clinical response data containing transcriptomic (RNA sequencing), along with a subset (n = 274) with mutation and copy number data were used for this purpose. A novel tumor microenvironment metascore (TMM) was developed based in a LASSO regularized Cox model with predictive and prognostic ability.

Results

Samples with co-altered RB1&TP53: a) were enriched in immunity effectors (CD8 cytotoxic lymphocytes, NK cells) and display higher scores of a T cell inflamed signature; b) have a higher TMB, higher number of SNV predicted neoantigens and higher TILs fractions; c) have a higher number of DDR mutated and deep deleted DDR genes; d) have DNA somatic signatures 2 and 13 related to APOBEC mutagenesis. Using the IMVigor 210 dataset, RB1&TP53 samples had the highest response rate to atezolizumab and a strong correlation with TMB and TMM. The consensus molecular subtype classification in the IMVigor 210 dataset showed a significant correlation with both the response to treatment (p = 0.001, Chisquare) and the presence of RB1 and TP53 genomic alterations (p < 0.001, Chisquare).

Conclusions

RB1&TP53 co-alterations are strongly associated with genomic biomarkers of response to ICIs in MIBCs.