bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical utility of a regional precision medicine molecular tumor board and challenges to implementation
Authors: Peh Keng Hee , Przybylski Daniel J , Fallon Michael J , Bergsbaken Jason J , Hutson Paul R , Yu Menggang , Deming Dustin A , Burkard Mark E
Published: April 2022

Purpose

Molecular tumor boards provide precision treatment recommendations based on cancer genomic profile. However, practical barriers limit their benefits. We studied the clinical utility of the precision medicine molecular tumor board (PMMTB) and described challenges with PMMTB implementation.

Methods

An observational cohort study included patients reviewed by the PMMTB between September 2015 to December 2017. Patients who had consented to the registry study were included. The primary endpoint of this study was time on treatment (ToT) ratio. Clinical utility was established if the primary endpoint had least 15% of patients achieving a ToT ratio of ≥1.3.

Results

Overall, 278 patients were presented to the PMMTB and 113 cases were included in the final analysis. The PMMTB identified at least one nonstandard of care (SOC) clinically actionable mutation for 69.0% (78/113) of cases. In patients who received non-SOC treatment, 43.8% (7/16) achieved a ToT ratio of 1.3 or more (p < 0.001). Fifty-nine patients did not receive non-SOC recommendations. Reasons for not pursuing treatment included 35.6% having response to current treatment, 20.3% died prior to starting or considering PMMTB recommendations, 13.6% pursued other treatment options based on clinician discretion, another 10.2% pursued other treatment options because clinical trials recommended were not geographically accessible, 8.5% had rapid decline of performance status, 6.8% lacked of financial support for treatment, and 5.1% were excluded from clinical trials due to abnormal laboratory values.

Conclusion

The regional PMMTB non-SOC recommendations benefitted a majority of patients and additional processes were implemented to assist with non-SOC treatment accessibility.
Late renal toxicity in patient with radioiodine-refractory differentiated thyroid cancer treated with lenvatinib: A case report and literature review
Authors: Pham Bryan , Kwon Sue Min , Castillo Dan Ran , Majeed Yasamin , Ahmad Sarmad , Hou Jean , Ganesan Lakshmi , Mohammad Sharif , Cao Huynh
Published: April 2022

Introduction

Thyroid carcinoma is the most common endocrine neoplasm. Multimodal therapy including surgery, radioactive iodine (RAI) therapy, and indefinite suppression of thyroid-stimulating hormone has led to an 85% cure rate in differentiated thyroid tumors (DTT). Approximately 5–10% of patients will have recurrence or metastases that have the potential to become resistant to RAI treatment. 1 10-year overall survival rates are reported to be 10% in these patients versus 56% in patients with RAI avid disease. 2 Lenvatinib, a multi-tyrosine-kinase inhibitor (TKI), was shown to have a 65% overall response rate in addition to a significant improvement in progression-free survival (PFS), approved to treat RAI-resistant DTTs. 3 , 4

Case Report

We are reporting a very rare case of late renal toxicity in a 68-year-old woman with a history of type 2 diabetes and metastatic RAI-resistant follicular thyroid carcinoma (Hurthle cell variant) who developed thrombotic microangiopathy 21 months after initiation of treatment.

Management & Outcome

It was determined that LEN should be held, due to worsening renal function secondary to TKI-induced kidney injury. Although the patient's renal function eventually improved and returned to her baseline after discontinuation of LEN, there was marked disease progression after drug cessation.

Discussion

Renal toxicity is a rare adverse event (AE) that tends to occur typically within three weeks of initiation of treatment. The utilization of TKIs can lead to glomerulosclerosis, and careful considerations and precautions should be taken by clinicians who intend to initiate TKI therapy in patients with pre-existing diabetes to prevent renal toxicity.
Optimization of process conditions for effective ohmic heating of greater lizardfish (saurida tumbil) sausage via response surface methodology
Authors: Shabani S. , Hosseini E. , Asadi G. , Beheshti B. , Yousefi Sh.
Published: April 2022

In current research, the optimization of ohmic heating on greater lizardfish ( Saurida tumbil) sausage variables was carried out using response surface methodology-central composite design (RSM-CCD). The effect of process variables including voltage gradient (15–60 V/cm), time (1–15 min), and temperature (60–90°C) on the microbial properties, pH, peroxide value, water holding capacity (WHC), and cooking loss of the sausages was evaluated. The results showed that the characteristics of the sausages were dependent on the ohmic heating conditions and these properties can be modulated. As per the results, the voltage gradient and temperature has a significant effect on the total plate count (p < 0.05). The increase in voltage gradient was the most effective on pH (5.63–6.91). The interaction terms of all items had a significant effect (p < 0.05) on the peroxide value of the fish sausages. Higher amount of temperature and process time were resulted in the more cooking loss. Increasing the voltage gradient was more effective on WHC compared to the temperature. Finally, the process was optimized and the optimized condition was achieved by setting the voltage gradient at 30 V/cm, process time at 4 min, and temperature at 66 °C. Also, it was compared with conventional heating. The results were shown that the differences between the mean values of all responses were statistically significant (p < 0.05) except for pH. Therefore, ohmic method was carried out faster, with lower temperature and obtaining the highest WHC and lowest total plate count, peroxide value, cooking loss, and optimized pH. Generally, this study suggested that the ohmic heating can be used as a rapid and homogeneous cooking method for the preparation of sausages from greater lizardfish as a commercial low-valued fish.
ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics
Authors: Adamis Dimitrios , Flynn Caroline , Wrigley Margo , Gavin Blánaid , McNicholas Fiona
Published: April 2022

Objective:

Systematic review and meta-analysis to estimate the pooled prevalence of ADHD in adult attendees of outpatient mental health clinics and to investigate factors influencing prevalence rates.

Methods:

The following were extracted: demographics, design of the study (screening only or two-phase), scales/criteria for diagnosis of ADHD, number of ADHD, and non-ADHD participants.

Results:

The pooled prevalence of ADHD from screening studies ( n = 9) was 26.7%, (95% CI [17.2–37.4]), ADHD = 1727, No ADHD = 3,578. From studies employing a two-stage design ( n = 5), prevalence was 14.61%, CI [10.39–19.41], ADHD = 561, No ADHD = 3,578. Age and gender did not have any significant effect on the estimated prevalence. By contrast exclusion of psychotic disorders lowers prevalence. The screening scale used also influence prevalence rates.

Conclusion:

Meta-analysis shows high rates of adult ADHD among psychiatric outpatient clinics. Applying DSM-5 criteria increased prevalence rates. More methodologically robust studies, using two-stage design, need to be conducted to help assist in service planning.
Oculoplastic Surgeries in Patients Older than 90 Years of Age
Authors: Abumanhal Muhammad , Feldman Ilan , Leibovitch Igal , Cnaan Ran Ben
Published: April 2022

Purpose

To report the epidemiology, indications and surgical outcomes of oculoplastic surgeries in older adults (≥ 90 years old).

Methods

A retrospective study was conducted reviewing the medical charts of 114 patients aged 90 years old and older who underwent oculoplastic procedures from 2010 to 2020. Data retrieved from the medical records included: past medical and ocular history, indication for surgery, type of surgery, intra and post-operative complications, pathological analysis for removed tissues, and surgical outcome in the last follow-up.

Results

One hundred and twenty eight surgeries were performed on 114 patients (male: female = 1:1). The mean age was 92.95 years old (± 3.12 SD). Six patients (5.2%) were older than 100 years old. The most common indication for surgery was lower lid malpositioning (32%). Mass/lesion excision was performed in 34 procedures (25%). Forty-three biopsies were analyzed and basal cell carcinoma was found to be the most common pathological diagnosis (32%). Hypertension was the most common associated systemic comorbidity (79 patients, 69%). 80% of the surgeries were performed under local anesthesia. Surgical revision was required in seven patients (5.2%). One patient had suffered from a minor stroke one day after the surgical pocedure. The same patient had orbital-skin fistulas after orbital exenteration

Conclusion

In our experience, oculoplastic surgeries among the elderly population are safe without significant complications and can usually be performed under local anesthesia. Advanced age should not prevent surgery, especially if the procedure may improve vision and quality of life.
Discussing a methodology for researching the long-term impact of music education: Drawing on learners’ memories and self-accounts
Authors: Matsunobu Koji
Published: April 2022

In this article, based on a longitudinal study that the author conducted in a primary school in Japan, a methodology for assessing the long-term impact of music education is discussed. With the intention of understanding the meaning of primary music education from the perspectives of the learners, retrospective data were collected from former primary school students who became university students. Methodological possibilities are discussed in the light of nine themes, including the use of retrospective data and video recordings, focus group interviews, the involvement of teachers, subjectivity, and the view of narrative understanding. While most impact case studies pay little attention to how student learning actually takes place, the proposed methodology in this article emphasizes the importance of qualitative understanding in the initial stages as well as underscoring learners’ retrospective valuations of their own learning experiences.
Transforming the Doctoral Defence: Remote-Access Technologies and Social Space
Authors: Lehtiniemi Tuukka , Trifuljesko Sonja
Published: April 2022

Lockdowns and social distancing measures in the wake of the COVID-19 pandemic have made remote participation a necessity for a wide range of social situations. This article examines one example: the abrupt transformation of the Finnish doctoral defence into a remote-access experience facilitated by video-conferencing technologies. The event is regularly centred on a formal public academic debate, rife with local academic ritual and ceremonial formality and firmly tied to the assumption of physical co-presence in the material space. Following the tradition of spatial conceptualisations of the digital, we draw inspiration from Henri Lefebvre’s theory on the production of space, particularly the analytical framework of the spatial triad, which enables regarding the doctoral defence as a social space made up of relations between things. As remote-access tools are introduced, new actants enter the field; the relations they mediate are affected, as is the social space that the relations constitute. This facilitates the examination of the effects that remote-access technologies have on conceiving, perceiving and living the doctoral defence, and ultimately on the social space as holistically understood. Our analysis is based on observations of remote-access defences and interviews with doctoral candidates who defended their doctoral theses remotely. Our findings highlight how the social space of the defence is both curtailed and broadened by remote-access technologies; some relations that make up space are narrowed while others stretch sufficiently to be included. As a result, the remote-access defence conceptually counts as the real thing in our material, but it remains unsatisfactory as an experience. This finding suggests how to mediate social space without reducing it: focusing on the lived experience and ensuring that it is not inadvertently distorted.
Trust and collaboration between patients and staff in SUD treatment: A qualitative study of patients’ reflections on inpatient SUD treatment four years after discharge
Authors: Wangensteen Turid , Hystad Jacob
Published: April 2022

Background and aim: Substance use disorder (SUD) is multifactorial, complex, and involves the severe problematic use of alcohol, prescription drugs, and other substances. People with SUD have long histories of perceived stigma, marginalisation, exclusion, social isolation, and shame. Moreover, patients with SUD are often treated as untrustworthy and incapable of actively participating in their treatment planning, even by healthcare and social services workers. Methods: Through in-depth interviews with former patients who have undergone SUD treatment, we explored their reflections on the treatment content. Interpretative phenomenological analysis revealed that some informants experienced aspects of the treatment as valuable, whereas others considered the same treatment useless or harmful. Results: Essential aspects of treatment were developing self-esteem and optimism about the future, developing strategies for coping with stress and challenging emotions and situations, developing relationships with family and friends, and preparing for life after inpatient treatment. Relationships with staff were described as crucial in all parts of the treatment. Conclusion: In conclusion, we suggest that a transition to a more collaborative treatment philosophy would be ethically and professionally valuable for providing support and treatment and enhancing patients’ perceptions of empowerment, inclusion, participation, and well-being on their terms, in cooperation with supportive others.
Developing a pneumonia diagnosis ontology from multiple knowledge sources
Authors: Azzi Sabrina , Michalowski Wojtek , Iglewski Michal
Published: April 2022

Background: Pneumonia is difficult to differentiate from other pulmonary diseases because it shares many symptoms with these diseases. Diagnosing pneumonia in clinical practice would benefit from having access to a codified representation of clinical knowledge. An ontology represents a well-established paradigm for such codification. Objectives: The goal of this research is to create Pneumonia Diagnosis Ontology (PNADO) that brings together the medical knowledge dispersed among multiple medical knowledge sources. Material and Methods: We used several clinical practice guidelines (CPGs) describing the pneumonia diagnostic process as a starting point in developing PNADO. Preliminary version of PNADO was subsequently expanded to cover a broader range of the concepts by reusing ontologies from Open Biological and Biomedical Ontology (OBO) Foundry and BioPortal. PNADO was evaluated by examining relevant concepts from the pneumonia-specific systematic reviews, using patient data from the MIMIC-III clinical dataset, and by clinical domain experts. Results: PNADO is a comprehensive ontology and has a rich set of classes and properties that cover different types of pneumonia, pathogens, symptoms, clinical signs, laboratory tests and imaging, clinical findings, complications, and diagnoses. Conclusion: PNADO unifies pneumonia diagnostic concepts from multiple knowledge sources. It is available in the BioPortal repository.
Separate modeling technique for deformation monitoring of concrete dams
Authors: Yin Chuan , Wu Zhenyu
Published: April 2022

Deformation monitoring is an important aspect of safety control for concrete dams. Deformation monitoring models (such as statistical models and hybrid models) are extensively applied to predict concrete dam deformation and derive confidence interval of normal deformation for anomaly detection. Deformation monitoring models for concrete dams mainly consist of hydrostatic component, temperature component, and aging component. The optimum parameters of individual components are simultaneously determined by least square method for monitoring data fitting. Thus, significant over-fitting of deformation monitoring models may be induced by mutual compensation among the parameters of model components. In this paper, the Separate Modeling Technique (SMT) is proposed for mitigating the over-fitting problem of deformation monitoring models for concrete dams. Firstly, the Empirical Mode Decomposition (EMD) is adopted to extract and visualize the aging component of displacement sequence. Proper mathematical formulation of the aging component can be established, and the problem of improperly presupposing the mathematical form of aging component in the process of constructing traditional deformation monitoring models is well addressed. In this study, the hydrostatic component is represented by the Hybrid Response Surface (HRS), which is formulated using numerical simulation with varying water levels and material parameters. The displacement variation caused by water level fluctuation is identified in terms of isothermal conditions and is used to calibrate the material parameters in the HRS. The temperature component is separated through subtracting the hydrostatic and aging components from displacement time series and then is expressed with proper mathematical formulations. Finally, hybrid models for displacement monitoring of concrete dams are established by combining the separately formulated components. The Separate modeling technique is applied to formulate crest displacement of the YL concrete gravity dam. The false alarm rate of displacement monitoring and a new model selection criterion (namely over-fitting coefficient) are adopted to compare various deformation monitoring models. It is shown that the over-fitting levels of deformation monitoring models can be effectively reduced using the SMT. The deformation monitoring models constructed with the SMT are of better accuracy in displacement prediction and present no false alarm of displacement monitoring for the tested period.
Management of cough in patients with idiopathic interstitial lung diseases in primary care
Authors: Sanchez-Ramirez Diana C. , Kosowan Leanne , Singer Alex
Published: April 2022

Importance: Cough is a common symptom in idiopathic interstitial lung diseases (ILDs), there is little information of its management in primary care. The objective of this study was to explore the frequency of cough-related consultations and the medications prescribed to patients with ILDs in primary care. Methods: This retrospective cohort study used electronic medical records (EMR) from Manitoba primary care providers participating in the Manitoba Primary Care Research Network repository (2014–2019). Cough-related consults and the subsequent medications prescribed to patients with ILDs were identified in the EMR. Results: 295 patients with ILDs were identified, 73 (25%) of them had 141 cough-related consultations (mean 1.9, SD 1.3) during the period studied. In 50 (35%) of the consultations, patients were prescribed one or more of the following: inhaled bronchodilators (34%), nasal corticoids (18%), codeine/opiates (18%), antibiotics (14%), inhaled corticoids (14%), proton pump inhibitors (8%), cough preparations (6%), antihistamines (4%), and oral corticoids (2%). 13 (26%) subsequent cough-related consultations were identified within 6 months, mainly among patients who were prescribed cough preparations, nasal corticoids, antihistamines, and antibiotics. Conclusion: One-quarter of patients with ILDs consulted primary care due to cough, and about a third of them received a prescription to address potentially underlying causes of cough. Although further studies are required to explore the effect of the medications prescribed, recurrent cough consultations suggested that cough preparations, nasal corticoids, and antihistamines are among the least effective treatments. More research is needed to understand the causes and optimal treatment of cough in patients with ILDs.
Humanistic Mindfulness: A Bridge Between Traditional and Modern Mindfulness in Schools
Authors: Malin Yael
Published: April 2022

Mindfulness, which originated in the Buddhist tradition, has become popular in the West and has been integrated into schools. During this migration from a particular-traditional-religious context into a universal-modern-secular one, mindfulness has shed key ethical values and became a “science of happiness.” In addition, in the West it has taken on diverse interpretations, such that the original concept has become unclear. Thus, it is important to understand mindfulness in its original form before its implementation in schools. The gap between West and East can be bridged by incorporating important elements from traditional Buddhism—meditation, wisdom, and moral virtues, into Western mindfulness. Humanistic education already has similar elements incorporated into it and Social-Emotional Learning (SEL) programs have the potential to be the practical tool through which this holistic concept of mindfulness may be applied. In this manner, mindfulness in schools will be even more compatible with educational goals.
A Randomized, Crossover Trial of a Nutritional Intervention for Rheumatoid Arthritis
Authors: Barnard Neal D. , Levin Susan , Crosby Lee , Flores Rosendo , Holubkov Richard , Kahleova Hana
Published: April 2022

To investigate the effects of a dietary intervention on arthritis pain and disease severity, 44 adults previously diagnosed with rheumatoid arthritis were randomly assigned to a Diet phase (vegan diet for 4 weeks, elimination of additional foods for 3 weeks, and then reintroduction of the eliminated foods individually over 9 weeks) or a Supplement (placebo) phase for 16 weeks. After a 4-week washout, they then switched to the opposite phase. The Disease Activity Score-28 (DAS28) decreased from 4.5 to 2.5 (P < .001) in the Diet phase and from 3.2 to 2.9 (P = .41) in the Supplement phase (between-group P = .01). The mean number of swollen joints decreased from 7.0 to 3.3 in the Diet phase (P = .03) and increased from 4.7 to 5 in the Supplement phase (P = .63; between-group P = .047).

In a subanalysis excluding individuals who increased medications during the study, DAS28 decreased 1.9 points in the Diet phase (P = .003) and .4 points in the Supplement phase (P = .27; between-group P = .04). In a further subanalysis limited to participants making no medication changes, DAS28 decreased 1.5 points in the Diet phase (P = .009) and .3 points in the Supplement phase (P = .40, between-group P = .11). We conclude that the dietary intervention was associated with symptomatic improvements. TRIAL REGISTRATION: Clinicaltrials.gov NCT01544101, NCT01700881, NCT03417648, and NCT03580681
Senior leaders’ theories of action for managing subject departments as a school improvement strategy
Authors: Montecinos Carmen , Cortez Mónica , Zoro Bárbara , Zett Isabel
Published: April 2022

The current study examines senior school leaders’ theories of action driving their decision-making around how they manage departments and distribute leadership to department heads. Based on a thematic analysis of transcripts of interviews with the principal, head of the curriculum unit, and two department heads from nine high schools, four approaches for managing departments were identified: (a) quasi self-managing units; (b) hierarchical managerial control; (c) participatory management; and (d) transitioning from hierarchical control to incipient participatory management. All approaches, to varying degrees, involved hierarchical managerial control and, to a greater or lesser extent, department heads participated in decision-making. At the centre of the distinct patterns for the distribution of leadership associated with each management model was a concern for aligning teachers’ improvement priorities. These approaches are examined through a distributed leadership lens in terms of their potential affordances and constraints for strengthening the contributions of departments to school improvement processes. The main conclusion is that variations in how senior leaders manage departments for the distribution of leadership need to be understood in the context of a school's history and culture.
Cerebrospinal fluid volume improves prediction of malignant edema after endovascular treatment of stroke
Authors: Kauw Frans , Bernsen Marie Louise E , Dankbaar Jan W , de Jong Hugo WAM , Kappelle L Jaap , Velthuis Birgitta K , van der Worp H Bart , van der Lugt Aad , Roos Yvo BWEM , Yo Lonneke SF , van Walderveen Marianne AA , Hofmeijer Jeannette , Bennink Edwin
Published: April 2022

Background:

The ratio of intracranial cerebrospinal fluid (CSF) volume to intracranial volume (ICV) has been identified as a potential predictor of malignant edema formation in patients with acute ischemic stroke.

Aims:

We aimed to evaluate the added value of the CSF/ICV ratio in a model to predict malignant edema formation in patients who underwent endovascular treatment.

Methods:

We included patients from the MR CLEAN Registry, a prospective national multicenter registry of patients who were treated with endovascular treatment between 2014 and 2017 because of acute ischemic stroke caused by large vessel occlusion. The CSF/ICV ratio was automatically measured on baseline thin-slice noncontrast CT. The primary outcome was the occurrence of malignant edema based on clinical and imaging features. The basic model included the following predictors: age, National Institutes of Health Stroke Scale, Alberta Stroke Program Early CT score, occlusion of the internal carotid artery, collateral score, time between symptom onset and groin puncture, and unsuccessful reperfusion. The extended model included the basic model and the CSF/ICV ratio. The performance of the basic and the extended model was compared with the likelihood ratio test.

Results:

Malignant edema occurred in 40 (6%) of 683 patients. In the extended model, a lower CSF/ICV ratio was associated with the occurrence of malignant edema (odds ratio (OR) per percentage point, 1.2; 95% confidence interval (CI) 1.1–1.3, p < 0.001). Age lost predictive value for malignant edema in the extended model (OR 1.1; 95% CI 0.9–1.5, p = 0.372). The performance of the extended model was higher than that of the basic model ( p < 0.001).

Conclusions:

Adding the CSF/ICV ratio improves a multimodal prediction model for the occurrence of malignant edema after endovascular treatment.
Anatomic greater tuberosity healing does not influence the functional outcomes of reverse shoulder arthroplasty for acute proximal humerus fractures
Authors: Cassart Masnou E , Pérez Andrés R , Mora Solé E , García Perdomo D , Ruiz Macarrilla L
Published: April 2022

Background

To investigate the functional outcomes of reverse shoulder arthroplasty (RSA) in acute complex proximal humerus fractures (PHF) in patients with an anatomic greater tuberosity union in comparison to patients with a displaced or resorbed tuberosity.

Method

It is a retrospective study with prospective data collection including 32 consecutive PHF with a minimum two-year follow-up treated with RSA. A radiological study and a CT scan were performed specifically for the study. Two shoulder surgeons and a musculoskeletal radiologist assessed the position and union of the greater tuberosity. The functional outcomes were assessed with the Constant-Murley, DASH, ASES and ADLER scores.

Results

The mean overall CS was 59.55. In 17 cases, the greater tuberosity healed in an anatomical position. In 15 cases, it was non-anatomical. In 53% of patients, greater tuberosity union was obtained. The CS was 62.76 in the anatomic union group and 55.9 in the non-anatomic union group. No significant differences were observed. No differences were observed in the ASES, DASH and ADLER scores.

Conclusion

After RSA for PHF, anatomic greater tuberosity healing was obtained in 53% of patients. The influence of the position and union of the greater tuberosity on the functional results could not be evidenced.
A Review of Traditional Uses, Phytochemistry and Pharmacological Properties of Some Vietnamese Wound-Healing Medicinal Plants
Authors: Hua Oanh Hoang , Tran Quynh Thi Thuy , Trinh Dieu-Thuong Thi , Nguyen Van-Dan , Duong Duc Phan Nguyen , Nguyen Triet Thanh
Published: April 2022

Wound healing is a sophisticated process that results in the repair of damaged tissues. Any impairment to this process can lead to non-healing (chronic) wounds. Since these can cause a massive burden on the healthcare system, alternative therapies that promote wound healing should be considered. Therapies of natural origins that are safe and with no adverse side effects are especially promising. Vietnam, a tropical-climate country, has many medicinal plants that possess the potential for healing wounds. This report explores the use of some common plants used in Traditional Vietnamese medicine and their molecular mechanisms.
Less is More: Perception as a fun way to Rich Minimalism
Authors: Carbon Claus-Christian , Utz Sandra , Hesslinger Vera M.
Published: April 2022

Perceptual science is important to understand how humans and other animals perceive and experience scenes, objects and events. So, it is the essential science to predict how we construct reality and our Umwelt. We learn from perceptual phenomena that we only need a minimal amount of information to create rich worlds of imagination and perception. As such, perception is the perfect analogue to what we would like to call “Rich Minimalism” – the way to save resources while having even more fun as our brains complete the missing parts in a creative way. Here, we briefly mention three little examples from basic research to demonstrate the power of perception for creating efficiency, effectiveness, and economy while having great fun with the resulting minimalism.
Deep vein thrombosis in an elderly patient with chronic limb-threatening ischaemia presented with limb swelling: The role of diagnostic tools and surgical dilemma
Authors: Omar Mohamed Ozaal AM , Fernando Thanoj
Published: April 2022

Leg and foot swelling is inherently found in 70% of patients with critical limb-threatening ischaemia due to ischaemia, which does not necessitate any specific intervention. Unilateral leg swelling is a vital sign for the clinical suspicion and diagnosis of deep vein thrombosis and phlegmasia. There is a significant surgical dilemma to delay the diagnosis of deep vein thrombosis or phlegmasia in patients with critical limb-threatening ischaemia when a methodical approach is not followed. We report a case of proximal deep vein thrombosis in an elderly patient with ipsilateral critical limb-threatening ischaemia and discuss the role of diagnostic tools. The role of antiplatelets along with vitamin K antagonists, duration of anticoagulation, iliocaval venous obstruction, compression therapy and inferior vena cava filter is discussed.
Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies
Authors: Musiimenta Angella , Tumuhimbise Wilson , Atukunda Esther C , Ayebaza Sandrah , Kobutungi Phionah , Mugaba Aaron T , Asasira Justus , Mugyenyi Godfrey R , Katusiime Jane , Zender Raphael , Pinkwart Niels , Haberer Jessica E
Published: April 2022

Background

The COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time.

Objectives

This study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis.

Methods

We administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants’ characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges.

Results

Among 50 women, the median age was 28 years (interquartile range 24–34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support.

Conclusion

SNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.
Innovative teaching in turbulent times: The benefits of faculty–student collaboration in a graduate healthcare management course
Authors: Bragadóttir Helga , Schram Ásta B.
Published: April 2022

In this article we share our experience of successfully changing our teaching and assignment methods by combining scientific research and student learning, with both students and faculty benefitting. Students applied their course material in a practical assignment collecting nursing faculty study data. In a survey following the course completion, students expressed their satisfaction and described how their knowledge base from the course material came to life when carrying out the course assignment. The core lesson we learned and share here with readers is that there are, without a doubt, underutilized opportunities for combining student course assignments with scientific research of faculty.
Validity and Reliability of a Brief Scale of Intention to Vaccinate Against COVID-19 in a Peruvian Sample
Authors: Morales-García Wilter C. , Huancahuire-Vega Salomón , Saintila JackSaint , Ruiz Mamani Percy G.
Published: April 2022

Objective:

This study aimed to analyze the psychometric properties of a brief scale measuring intention to vaccinate against COVID-19 in a Peruvian sample in the context of the current pandemic.

Methods:

A cross-sectional and instrumental study was carried out. A total of 547 Peruvian citizens selected through non-probability convenience sampling participated. Considering existing theories of vaccination hesitancy, 12 items were proposed that evaluate the intention to vaccinate against COVID-19 and the internal structure was evaluated through exploratory and confirmatory factor analysis. Reliability was analyzed with the ordinal alpha coefficient.

Results:

The exploratory factor analysis yielded a structure of 2 oblique factors that explain 69% of the total variance and the items saturated between 0.52 and 0.97. The confirmatory factor analysis showed that, of 4 models analyzed, the fourth model that was composed of 6 items presented optimal indices of goodness-of-fit ( X2 = 11.089, P = .197, CFI = 0.999, TLI = 0.999, RMSEA = 0.034 [IC 90%, 0.000-0.077], SRMR = 0.016). Reliability analysis through the ordinal alpha coefficient yielded that the brief scale of intention to vaccinate against COVID-19 has adequate internal consistency (α = .91).

Conclusions:

The brief scale of intention to vaccinate against COVID-19 presents adequate psychometric properties that demonstrate validity and reliability and can be used in future research and clinical practice.
Analysis of the Impact of Interprovincial Migration on the First Wave of COVID-19 Transmission in China
Authors: LingHu Yuwei , Ren Shanjing
Published: April 2022

In the first wave of the COVID-19 outbreak in China, the epidemic has spread rapidly due to interprovincial migration from Wuhan to Hubei province and to the rest of China. Based on Chinas interprovincial migration and outbreak data, this paper established panel models. The transmission of the first wave of COVID-19 of China can be divided into two stages: a phase of national outbreak caused by interprovincial migration and a phase of sustained development due to close contacts. Interprovincial migration triggered a nationwide outbreak that lasted until around 28 January 2020, about 5 days after the Wuhan lockdown. In this phase of transmission, the population inflow from Hubei province was more contagious than the inflow from other provinces. The results also show that the sum of the influence coefficients of interprovincial population inflow is less than 1, which means a state of convergence, indicating that “Wuhan lockdown” is an effective measure to cut off the spread of the epidemic by interprovincial migration.
Morphology of Glenoid Cartilage Defects in Anteroinferior Glenohumeral Instability
Authors: Kawakami Jun , Yamamoto Nobuyuki , Itoi Eiji , Henninger Heath , Tashjian Robert , Chalmers Peter N.
Published: April 2022

Background:

Glenoid cartilage defects may contribute to anterior shoulder instability recurrence and progression to osteoarthritis, but their morphology remains unknown.

Purpose/Hypothesis:

The purpose was to determine the shape, size, and location of glenoid cartilage defects and the prevalence and risk factors for cartilage defects in the setting of anterior glenohumeral instability. It was hypothesized that glenoid cartilage defects would be common, would be associated with recurrence of dislocation, and would share similar morphology with glenoid osseous defects.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

In this retrospective study, all patients who underwent arthroscopic surgical treatment for anterior glenohumeral instability between January 2012 and May 2019 were included; excluded were patients with documented posterior or multidirectional instability or previous glenohumeral surgery. For each patient, the operative report, arthroscopic images, and preoperative magnetic resonance imaging (MRI) scans were reviewed to determine the prevalence of cartilage injury. For those patients with an Outerbridge grade 3 or 4 defect, the cartilage surfaces on the MRI scans were segmented to make 3-dimensional (3-D) segmentations. From these 3-D segmentations, we measured length, width, and surface area of the glenoid and defect, and the orientation of the defect relative to the superior and inferior poles of the glenoid. A multivariable analysis was conducted to determine correlates with cartilage damage.

Results:

In 322 patients treated operatively for anterior glenohumeral instability, 38% had a concomitant cartilage defect. The mean cartilage defect was located directly anteriorly at the 3:07 clockface position (range, 2:10-4:05) and encompassed 6.5% ± 3.5% of the glenoid surface area. However, defects ranged up to >56% of glenoid length and up to 27% of glenoid width, and the largest defect encompassed 19.5% of the glenoid cartilage surface area. Patients with a cartilage defect were more likely to be male ( P = .031) and to have undergone a concomitant posterior labral repair ( P = .018).

Conclusion:

Cartilage defects were common in patients with operatively treated anterior glenohumeral instability, occurring in 38% of patients. These defects were located directly anteriorly at 3:07, similar to osseous glenoid defects. Future prospective studies with cartilage-specific MRI sequences should be conducted.
Use of “Finding Cards” to Improve Relative Experience on Arrival at an Emergency Department
Authors: Rowlinson J S
Published: April 2022

This report describes introducing “Finding Cards” as a solution to improve relatives’ experience. Arriving at an emergency department (ED) can feel daunting for relatives. The simple bespoke Finding Card is handed to the relative on arrival. The card can help relatives feel less overwhelmed when attempting to find their family member who is a patient within one of many subsections of the ED. The card helps the relative remember the patient location, it reassures and gives confidence that help will be available if they become lost, it empowers relatives to approach any staff member for help, it supports relatives to feel at ease. The Finding Card enables clinical staff to immediately know the location any lost relative is trying to find, minimizes the length of interruptions to health professionals, improving patient safety. This simple, cost-effective tool to improve relatives’ experience and limit interruptions, could easily be replicated in large EDs.
The Swedish HealthPhys Study: Study Description and Prevalence of Clinical Burnout and Major Depression among Physicians
Authors: Hagqvist Emma , Ekberg Kerstin , Lidwall Ulrik , Nyberg Anna , Landstad Bodil J. , Wilczek Alexander , Bååthe Fredrik , Sjöström Malin
Published: April 2022

Objectives

The study purpose was to describe the Swedish HealthPhys cohort. Using data from the HealthPhys study, we aimed to describe the prevalence of clinical burnout and major depression in a representative sample of Swedish physicians across gender, age, worksite, hierarchical position, and speciality in spring of 2021, during the third wave of the Covid-19 pandemic.

Method

The HealthPhys questionnaire was sent to a representative sample of practising physicians (n = 6699) in Sweden in February to May of 2021 with a 41.3% response rate. The questionnaire included validated instruments measuring psychosocial work environment and health including measurements for major depression and clinical burnout.

Results

Data from the HealthPhys study showed that among practising physicians in Sweden the prevalence of major depression was 4.8% and clinical burnout was 4.7%. However, the variations across sub-groups of physicians regarding major depression ranged from 0% to 10.1%. For clinical burnout estimates ranged from 1.3% to 14.5%. Emergency physicians had the highest levels of clinical burnout while they had 0% prevalence of major depression. Prevalence of exhaustion was high across all groups of physicians with physicians working in emergency departments, at the highest (28.6%) and anaesthesiologist at the lowest (5.6%). Junior physicians had high levels across all measurements.

Conclusions

In conclusion, the first data collection from the HealthPhys study showed that the prevalence of major depression and clinical burnout varies across genders, age, hierarchical position, worksite, and specialty. Moreover, many practising physicians in Sweden experienced exhaustion and were at high risk of burnout.
The Effect of Orientation Degree of Electrospun Polystyrene Fiber on Filtration Performance of Fiber Membrane
Authors: Zheng Yuansheng , Gao Jingyuan , Liu Kai , Ge Cheng
Published: April 2022

In this study, ultrafine polystyrene fiber membranes with different fiber orientation degrees were prepared by and electrospinning method, and two methods were used to characterize the fiber orientation degree. In addition, the effects of fiber orientation degree on the surface wettability and smoke filtration performance of fiber membrane were studied. The results showed that the water repellency and smoke absorption capacity of the polystyrene fiber membrane decrease with the increasing fiber orientation degree and the porosity. The orientation degree of the fiber has a significant influence on the smoke filtration performance of fiber membrane.
Structural and chemical complexity of minerals: an update
Authors: Krivovichev Sergey V. , Krivovichev Vladimir G. , Hazen Robert M. , Aksenov Sergey M. , Avdontceva Margarita S. , Banaru Alexander M. , Gorelova Liudmila A. , Ismagilova Rezeda M. , Kornyakov Ilya V. , Kuporev Ivan V. , Morrison Shaunna M. , Panikorovskii Taras L. , Starova Galina L.
Published: April 2022

The complexities of chemical composition and crystal structure are fundamental characteristics of minerals that have high relevance to the understanding of their stability, occurrence and evolution. This review summarises recent developments in the field of mineral complexity and outlines possible directions for its future elaboration. The database of structural and chemical complexity parameters of minerals is updated by H-correction of structures with unknown H positions and the inclusion of new data. The revised average complexity values (arithmetic means) for all minerals are 3.54(2) bits/atom and 345(10) bits/cell (based upon 4443 structure reports). The distributions of atomic information amounts,chemIGandstrIG, versus the number of mineral species fit the normal modes, whereas the distributions of total complexities,chemIG,totalandstrIG,total, along with numbers of atoms per formula and per unit cell are log normal. The three most complex mineral species known today are ewingite, morrisonite and ilmajokite, all either discovered or structurally characterised within the last five years. The most important complexity-generating mechanisms in minerals are: (1) the presence of isolated large clusters; (2) the presence of large clusters linked together to form three-dimensional frameworks; (3) formation of complex three-dimensional modular frameworks; (4) formation of complex modular layers; (5) high hydration state in salts with complex heteropolyhedral units; and (6) formation of ordered superstructures of relatively simple structure types. The relations between symmetry and complexity are considered. The analysis of temporal dynamics of mineralogical discoveries since 1875 with the step of 25 years show the increasing chemical and structural complexities of human knowledge of the mineral kingdom in the history of mineralogy. In the Earth's history, both diversity and complexity of minerals experience dramatic increases associated with the formation of Earth's continental crust, initiation of plate tectonics and the Great Oxidation event.
Choroidal involvement in systemic vasculitis: a systematic review
Authors: Özdal Pınar Çakar , Tugal-Tutkun Ilknur
Published: April 2022

Systemic vasculitides are a large group of heterogeneous diseases characterized by inflammatory destruction of blood vessels targeting diverse organs and tissues including the eye. As the most vascularized layer of the eye, the choroid is expected to be affected in multiple systemic rheumatologic diseases with vascular involvement. While there are plenty of studies investigating retinal vascular involvement, choroidal vascular involvement in systemic vasculitides has not been investigated in isolation. However, choroidal manifestations including thickness changes, choroidal vasculitis and ischemia may be the earliest diagnostic features of systemic vasculitic diseases. Thus, multimodal imaging of the choroid may help early detection of choroidal involvement which may also have prognostic implications in these life-threatening diseases. This article aimed to review involvement of the choroid in systemic vasculitic diseases.