bluuebunny/crossref_metadata_2025 huggingface dataset:
Gossip and Addiction Recovery in Rural Communities
Authors: Krentzman Amy R. , Glass Lauren K.
Published: September 2021

Features of rural life, such as low population density and greater distances from urban areas, could worsen the prospects of addiction recovery for rural residents. Gossip is a central feature of rural life, and studies have shown that being the target of it can worsen health and well-being. However, no previous study has focused on the impact of gossip on addiction in rural communities. The current study employed semi-structured interviews with individuals in recovery, as well as addiction providers, to create a conceptual model of the relationship between gossip and addiction recovery in a rural region of Minnesota. The conceptual model depicted a bi-directional relationship between the individual and the community and suggested that gossip transforms from negative to positive over the course of addiction, early recovery, and long-term recovery. These data demonstrate that education at both the community and individual levels could support the transition to long-term recovery.
Association Between Middle Facet Subluxation and Foot and Ankle Offset in Progressive Collapsing Foot Deformity
Authors: Barbachan Mansur Nacime Salomão , Lalevee Matthieu , Maly Connor , Dibbern Kevin , Lee Hee Young , Godoy-Santos Alexandre Leme , Lintz François , de Cesar Netto Cesar
Published: September 2021

Background:

Subtalar middle facet (MF) subluxation was recognized as a reliable marker for progressive collapsing foot deformity (PCFD) diagnosis. Foot and Ankle Offset (FAO) is an established measurement, predictive of malalignment severity. The objective of this study was to assess the potential association between MF subluxation and FAO in PCFD patients.

Methods:

56 individuals with flexible PCFD (74 feet) were assessed. Two blinded foot and ankle surgeons calculated MF uncoverage, MF incongruence, and FAO. Agreement was quantified using intraclass correlation coefficient (ICC). A multivariate regression analysis and partition prediction models were applied to assess relationship between values.

Results:

All ICCs were >0.80. MF subluxation and FAO were found to be correlated ( rs = 0.56; P < .0001). Changes in the MF subluxation were noticeably explained by FAO and BMI ( R2 = 0.33). MF incongruence was not correlated with the assessed variables ( P = .10). In this cohort, an MF subluxation of 27.5% was a threshold for increased FAO (FAO of 3.4%±2.4% when below; FAO of 8.0% ±3.5% when above).

Conclusion:

We found a correlation between MF subluxation and FAO. An MF subluxation of 27.5% was found to be a threshold for higher FAO, which corresponded to a greater malalignment. These data may help surgeons optimize treatment decisions in PCFD patients.

Level of Evidence:

Level III, retrospective comparative study.
Nonfatal Strangulation During Domestic Violence Events in New South Wales: Prevalence and Characteristics Using Text Mining Study of Police Narratives
Authors: Wilson Mandy , Spike Erin , Karystianis George , Butler Tony
Published: September 2021

Nonfatal strangulation (NFS) is a common form of domestic violence (DV) that frequently leaves no visible signs of injury and can be a portent for future fatality. A validated text mining approach was used to analyze a police dataset of 182,949 DV events for the presence of NFS. Results confirmed NFS within intimate partner relationships is a gendered form of violence. The presence of injury and/or other (non-NFS) forms of physical abuse, emotional/verbal/social abuse, and the perpetrator threatening to kill the victim, were associated with significantly higher odds of NFS perpetration. Police data contain rich information that can be accessed using automated methodologies such as text mining to add to our understanding of this pressing public health issue.
Heightened Sexual Misconduct Victimization Rates among Reserve Officers’ Training Corps Women: Results From a Campus Climate Survey
Authors: Gray Matt J. , Kilwein Tess M. , Amaya Stephanie , Binion Kendal C.
Published: September 2021

Sexual assault, harassment, and stalking are commonplace among college students, with identified subgroups being particularly at risk (e.g., Greek-life organizations and intercollegiate athletics). Despite higher rates of sexual misconduct among active-duty military and service academy women, no research has examined the risk for Reserve Officers’ Training Corps (ROTC) women. A total of N = 1,562 college women were sampled from a sexual misconduct campus climate survey. ROTC women reported higher victimization rates for all variants of sexual misconduct and violence relative to the broader student population, as well as previously established high-risk groups. Directions for future research and implications for prevention programming/response are presented and discussed.
A study on deformation-induced degradation of the compressible polymeric pressurized vessel through a non-equilibrium thermodynamic framework
Authors: Kazemian M. , Moazemi Goudarzi A. , Hassani A.
Published: September 2021

The present paper investigates the degradation of compressible polymers based on the proposed model on strain-induced degradation of incompressible polymers. In a non-equilibrium thermodynamic framework, constitutive equations and evolution laws are derived using the principle of maximum energy dissipation rate and specifying how energy can be stored and dissipated. As a computational model, the governing equations are applied to the pressurized polymeric vessel subjected to the Ogden–Hill compressible hyperelastic material model. To analyze the axisymmetric plane-strain degradable vessel, programming in ANSYS Parametric Design Language (APDL) and the Standard Galerkin Finite Element Method (SGFEM) are applied. The results show that the degradable compressible Ogden–Hill model can also predict the degradation of incompressible polymers subjected to the neo-Hookean model. Results also reveal that the highest dissipation rate and material softening occur at the inner radius of the inflated degradable vessel. Creep-like and stress-relaxation-like responses of the polymeric vessel with time-position-dependent material properties are examined. ANSYS coding indicates good accuracy and efficiency in studying the compressible vessel subjected to inhomogeneous degradation.
ProTG4: A Web Server to Approximate the Sequence of a Generic Protein From an in Silico Library of Translatable G-Quadruplex (TG4)-Mapped Peptides
Authors: Kundu Siddhartha
Published: September 2021

An RNA G-quadruplex in the protein coding segment of mRNA is translatable [Formula: see text] and may potentially impact protein translation. This can be consequent to staggered ribosomal synthesis and/or result in an increased frequency of missense translational events. A mathematical model of the peptides that encompass the substituted amino acids, ie, the [Formula: see text]-mapped peptidome, has been previously studied. However, the significance and relevance to disease biology of this model remains to be established. ProTG4 computes a confidence-of-sequence-identity [Formula: see text]-score, which is the average weighted length of every matched [Formula: see text]-mapped peptide in a generic protein sequence. The weighted length is the product of the length of the peptide and the probability of its non-random occurrence in a library of randomly generated sequences of equivalent lengths. This is then averaged over the entire length of the protein sequence. ProTG4 is simple to operate, has clear instructions, and is accompanied by a set of ready-to-use examples. The rationale of the study, algorithms deployed, and the computational pipeline deployed are also part of the web page. Analyses by ProTG4 of taxonomically diverse protein sequences suggest that there is significant homology to [Formula: see text]-mapped peptides. These findings, especially in potentially infectious and infesting agents, offer plausible explanations into the aetiology and pathogenesis of certain proteopathies. ProTG4 can also provide a quantitative measure to identify and annotate the canonical form of a generic protein sequence from its known isoforms. The article presents several case studies and discusses the relevance of ProTG4-assisted peptide analysis in gaining insights into various mechanisms of disease biology (mistranslation, alternate splicing, amino acid substitutions).
Divide to conquer? Strategic parliamentary opposition and coalition government
Authors: Whitaker Richard , Martin Shane
Published: September 2021

Parliamentary elections often result in the formation of a coalition government. While the legislative process allows actors within a coalition government to monitor each other, little attention has focused on how opposition parties respond to coalition government. We argue that opposition parties have incentives to uncover and highlight differences and tensions within the governing coalition. A strategy by the opposition to use legislative tools to uncover policy conflicts and ministerial drift within the coalition increases intra-coalition tensions, potentially generating electoral costs for the governing parties, and potentially even hastening the coalition’s demise. To test our argument, we build and analyse a new dataset of parliamentary questions in the British House of Commons covering the 2010–15 coalition. As expected, the main opposition party appears to strategically focus questions towards policy areas that uncover intra-coalition tensions. This research highlights the importance of opposition parties in parliamentary democracies.
Ways of seeing digital disconnection: A negative sociology of digital culture
Authors: Kaun Anne
Published: September 2021

In this contribution, I do not engage in digital disconnection merely as an empirical phenomenon but as a way of seeing digital culture and as a heuristic. I do not ask whether or not digital disconnection is possible, is good or bad, or should be advocated or overcome. Instead, I adopt Eva Illouz’s framework of a negative sociology of social bonds to explore what it would mean to study digital culture from the perspective of negative choice. The conceptual framework is illustrated with three empirical cases that show what it would mean to engage in a negative sociology of digital culture. The shift in perspective from positive bonds to the choice to disengage, not use, or exit certain fora makes visible how digital culture is not only increasingly characterized by polarization, but also how disconnection emerges as a civic virtue that puts the individual user’s responsibility at the forefront.
Intensity-dependent effects of exercise therapy on walking performance and aerobic fitness in symptomatic patients with lower-extremity peripheral artery disease: A systematic review and meta-analysis
Authors: Fassora Mattia , Calanca Luca , Jaques Cécile , Mazzolai Lucia , Kayser Bengt , Lanzi Stefano
Published: September 2021

We investigated how nonpain-based exercise therapy intensity (light-to-moderate or vigorous) affects improvements in walking performance and cardiorespiratory fitness of patients with symptomatic lower-extremity peripheral artery disease (PAD). We searched the Embase, MEDLINE, Cochrane, Web of Science, and Google Scholar databases up to April 2021 and included randomized controlled trials reporting training therapies targeting exercise intensity (heart rate, oxygen consumption, or perceived exertion). The main outcomes were walking performance (pain-free [PFWD] and maximal [MWD] walking distance) and cardiorespiratory fitness (V̇O2peak). Secondary subanalyses examined the training modality (walking or other modalities) and the approach (high-intensity interval or moderate-intensity training). A total of 1132 patients were included. Light-to-moderate was superior to vigorous exercise intensity in improving MWD (223 m [95% CI 174 to 271], p < 0.00001; 153 m [95% CI 113 to 193], p < 0.00001; respectively) and PFWD (130 m [95% CI 87 to 173], p < 0.00001; 83 m [95% CI 61 to 104], p < 0.00001; respectively). When training modalities were considered, walking at a vigorous intensity (272 m [95% CI 207 to 337], p < 0.00001) showed the largest improvement in MWD compared to other exercise modalities. A larger increase in V̇O2peak was observed following vigorous (3.0 mL O2·kg−1·min−1 [95% CI 2.4 to 3.6], p < 0.00001) compared to light-to-moderate (1.1 mL O2·kg−1·min−1 [95% CI 0.4 to 1.7], p = 0.001) exercise intensity. These results indicate that vigorous was less effective than light-to-moderate intensity in improving walking performance, whereas it was more effective in improving V̇O2peak. When the training modalities were considered, walking at a vigorous intensity showed the greatest improvement in MWD. (PROSPERO Registration No.: CRD42020199469)
Multifactorial causal beliefs and colorectal cancer screening: A structural equation modeling investigation
Authors: Allen Caitlin , Waters Erika A , Hamilton Jada G , Vu Milkie , Gabriel Jazmine , Roberts Megan C
Published: September 2021

We tested a conceptual model that describes the relationship between individuals’ understanding of the multifactorial nature of cancer and their self-reported colorectal cancer screening. We collected cross-sectional survey data from 205 men and women age 50–75. Data were analyzed using structural equation modeling. The proposed model had reasonable fit (RMSEA = 0.09, CFI = 0.65). Multifactorial causal beliefs were associated with cancer risk perceptions (β = 0.16, p = 0.019) and more optimistic cancer cognitions (β = 0.17, p = 0.013). However, these constructs were not associated with colorectal cancer screening ( p’s > 0.05). Further testing could reveal whether this model can be applied to other cancer-related health behaviors including lifestyle changes and genetic testing.
Collaborative learning between Chinese and international students in an English as a medium of instruction environment: Friend or foe?
Authors: Yuan Rui , Tsang Art , Li Sifei
Published: September 2021

The study examined international and home students’ perceptions of intercultural collaborative learning in an English as a medium of instruction (EMI) environment in a Chinese university. Drawing on data from in-depth interviews, the findings showed that international students held a positive view, reporting gains from the cultural, subject knowledge and language learning dimensions but also hurdles which impeded intercultural communication and content learning in the EMI curriculum. The Chinese students were less positive, viewing such a mode of learning somewhat as a ‘burden’ due primarily to the differences in their and international students’ academic goals and expectations. In response to the negative experiences, the Chinese students demonstrated resilience and ingenuity in devising strategies for achieving their own academic goals. This article concludes with practical implications for EMI teachers and curriculum designers regarding how to improve EMI instruction and intercultural learning in higher education.
EGR cylinder deactivation strategy to accelerate the warm-up and restart processes in a Diesel engine operating at cold conditions
Authors: Galindo José , Dolz Vicente , Monsalve-Serrano Javier , Bernal Maldonado Miguel Angel , Odillard Laurent
Published: September 2021

The aftertreatment systems used in internal combustion engines need high temperatures for reaching its maximum efficiency. By this reason, during the engine cold start period or engine restart operation, excessive pollutant emissions levels are emitted to the atmosphere. This paper evaluates the impact of using a new cylinder deactivation strategy on a Euro 6 turbocharged diesel engine running under cold conditions (−7°C) with the aim of improving the engine warm-up process. This strategy is evaluated in two parts. First, an experimental study is performed at 20°C to analyze the effect of the cylinder deactivation strategy at steady-state and during an engine cold start at 1500 rpm and constant load. In particular, the pumping losses, pollutant emissions levels and engine thermal efficiency are analyzed. In the second part, the engine behavior is analyzed at steady-state and transient conditions under very low ambient temperatures (−7°C). In these conditions, the results show an increase of the exhaust temperatures of around 100°C, which allows to reduce the diesel oxidation catalyst light-off by 250 s besides of reducing the engine warm-up process in approximately 120 s. This allows to reduce the CO and HC emissions by 70% and 50%, respectively, at the end of the test.
Fuel reformation by piston compression of rich air-fuel mixture
Authors: Shibata Gen , Asai Go , Ishiguro Shuntaro , Watanabe Yusuke , Kobashi Yoshimitsu , Ogawa Hideyuki
Published: September 2021

The purpose of this paper is to investigate and describe the fuel reformation by diesel piston compression to change the ignitability of commercial fuels for marine engines. The engine operational conditions were first investigated by CHEMKIN Pro with n-heptane as a fuel, an HCCI engine with port fuel injection was operated by n-heptane based on simulation results, and the production of reformed gases (hydrogen, carbon monoxide, methane, and ethylene) were measured by emission analyzers. The fuel reformation becomes active above a 2.0 equivalence ratio and higher intake air temperature conditions, and the molar fractions of the reformed gases can be varied by the maximum in-cylinder average temperature during the reforming processes. An indirect injection diesel engine was newly introduced and the diesel fuel reformation characteristics were evaluated. Further, the fuel decomposition processes were investigated by CHEMKIN Pro. The results suggest that the hydrogen and carbon monoxide are produced via a number of production paths in the fuel decomposition into small hydrocarbons and chemical production controls of hydrogen and carbon monoxide will be difficult. However, the production paths of methane and ethylene formation are limited by the decomposition of hydrocarbons and this suggests the possibility of chemical production control of methane and ethylene.
The Impact of Diet Type on Weight Loss in Patients with Alzheimer’s Disease
Authors: Nakamura Tomiyo
Published: September 2021

Objectives: To compare differences in weight loss in patients with Alzheimer’s disease on normal, diabetic, or texture-modified diets. Methods: This prospective interventional study examined the data of patients with Alzheimer’s disease who were admitted to a long-term care hospital in Japan from February to April 2013. Dietary elements and weight loss over a 3-month period were examined. Results: Of the 75 patients examined, 6 were on a normal diet, 10 were on a diabetic diet, and 59 were on a texture-modified diet. Weight loss was significantly associated with body weight, Mini Nutritional Assessment®, and diet type. In the non-malnourished patients, there was a significant difference between the three types of diets in terms of eating rate and weight loss. Conclusion: Diet type was independently associated with weight loss in patients with Alzheimer’s disease. Research using larger sample sizes is necessary to eliminate the differences between these diet types.
Three-dimensional loading control of a pneumatic three-universal–prismatic–universal robot
Authors: Liu Yu , Zhu Qingling , Zhao Guoxin , Ma Shuchao
Published: September 2021

Multidimensional force loading has been widely used in the fields of component and material testing. The pneumatic-driven multidimensional force loading parallel mechanism can meet the requirements of complex force loading. A three-dimensional loading robot based on a pneumatic three-universal–prismatic–universal parallel mechanism is designed to apply time-varying three-dimensional loads on a target. Based on the principle of vector superposition, inverse and forward kinematics are deduced. A second-order mathematical model of a metal seal pneumatic cylinder driven by a flow proportional valve is established. Based on the immersion and invariance technique, the leakage flow in the cylinder is taken as the interference term and estimated. Meanwhile, because of the strong nonlinearity of the actuator, based on suitable disturbance estimation, the control rate of the system is designed through the sliding mode surface, and the stability of the control algorithm is analyzed on the basis of the Lyapunov stability theory. The experimental results show that the immersion and invariance controller exhibits a better control performance than the proportional–integral–differential controller: the steady-state control mean square error is reduced by approximately 21% on average and the dynamic (0.2 Hz) tracking mean square error is approximately 10.35 N.
No evidence for loss of natalizumab effectiveness with every-6-week dosing: a propensity score–matched comparison with every-4-week dosing in patients enrolled in the Tysabri Observational Program (TOP)
Authors: Butzkueven Helmut , Kappos Ludwig , Spelman Tim , Trojano Maria , Wiendl Heinz , Su Ray , Liao Shirley , Hyde Robert , Licata Stephanie , Ho Pei-Ran , Campbell Nolan
Published: September 2021

Background:

Extended interval dosing of natalizumab is associated with significantly lower progressive multifocal leukoencephalopathy risk compared with every-4-week (Q4W) dosing in patients with relapsing-remitting multiple sclerosis. Previous studies have suggested that natalizumab effectiveness is maintained in patients who switch from Q4W to extended interval dosing but have been limited by a lack of well-matched patient cohorts.

Methods:

Tysabri Observational Program (TOP) data as of November 2019 were used to identify patients with relapsing-remitting multiple sclerosis treated with natalizumab Q4W and those with a single physician-indicated dosing change from Q4W to every-6-week (Q6W) dosing after ⩾1 year of Q4W treatment. Patients were propensity score matched at the time of the switch from Q4W to Q6W dosing. Clinical outcomes (annualized relapse rate and probability of remaining relapse free or free of 24-week confirmed disability worsening) and safety outcomes were assessed for the two cohorts.

Results:

This study included 219 pairs of propensity score–matched Q6W and Q4W patients. Annualized relapse rates were similar for Q6W (0.150) and Q4W (0.157) patients. The probability of remaining relapse free [hazard ratio = 1.243 (95% confidence interval = 0.819–1.888); p = 0.307] and of remaining free of 24-week confirmed disability worsening [hazard ratio = 0.786 (95% confidence interval = 0.284–2.176); p = 0.644] did not differ significantly between Q6W and Q4W patients. Summarized safety results for the matched Q6W and Q4W patients are also presented.

Conclusion:

These real-world findings in well-matched patient cohorts from TOP demonstrate that natalizumab effectiveness is maintained in patients who switch to Q6W dosing after ⩾1 year of Q4W dosing.

ClinicalTrials.gov identifier:

NCT00493298
Research as an Act of Resistance: Responsive, Temporally Framed Narrative Inquiry
Authors: Salter Leah
Published: September 2021

In this paper I frame systemic, narrative informed, group work practice as an act of solidarity; and narrative inquiry as an act of resistance and activism. I describe research I have been part of as an intervention into (and a resistance against) discourses of individualised psychopathology that exist within the mental health services (where I have worked for the last decade) and colonising practices that can and do exist in academia. Part of the narrative is my own story of movement from research informed practitioner to practice based researcher which includes an exploration of an evolving relationship with power. I also describe how I have devised a five-step process to inquire into my own group work practices – a process I have called a responsive, temporally framed narrative inquiry. Responsive because it has been designed to be adaptive and attuned to the inevitable movement between research ‘material’ and people involved in any such inquiry. Temporally framed, and with an emphasis on narrative, because it pays attention to past stories (of abuse and oppression), present feelings in relation to those stories and narratives that develop through inquiry that are ‘future forming’ and speak to ‘preferred futures’.
The prognostic value of thyroid-stimulating immunoglobulin in the management of Graves’ disease
Authors: Zhou Yulin , Zhou Mengxi , Qi Yicheng , Wang Weiqing , Chen Xinxin , Wang Shu
Published: September 2021

Background:

The bioassay of thyroid-stimulating immunoglobulin was reported to have a similar performance to the commonly used thyroid-stimulating hormone binding inhibition assay, also known as thyroid receptor antibody assay. The normal reference range of thyroid receptor antibody levels indicates the withdrawal of anti-thyroid drugs in the recent clinical guidelines.

Methods:

A prospective, longitudinal observational study was conducted to evaluate the prognostic value of thyroid-stimulating immunoglobulin in patients with Graves’ disease.

Results:

A total of 77 patients with Graves’ disease treated with anti-thyroid drugs were in a continuous follow-up until 1 year after anti-thyroid drugs discontinuation. Commercial kits of thyroid-stimulating immunoglobulin and M22-thyroid-stimulating hormone binding inhibition assay were used and compared. Thyroid-stimulating immunoglobulin was all negative in healthy controls, Hashimoto thyroiditis, and subacute thyroiditis. Thyroid-stimulating immunoglobulin value was highest in untreated patients with Graves’ disease ( p < 0.001). Under anti-thyroid drugs treatment, thyroid-stimulating immunoglobulin value decreased gradually. A total of 21 patients had positive thyroid-stimulating immunoglobulin at the end of treatment. According to clinical fate of patients with Graves’ disease after withdrawal of anti-thyroid drugs, thyroid-stimulating immunoglobulin value and positivity in patients with relapse were significantly higher than that reported in patients with remission ( p = 0.001, p < 0.001). After adjustment for age, gender, initial thyroid receptor antibody, initial thyroid-stimulating immunoglobulin, and thyroid receptor antibody at the end of treatment, the odds ratio of positive thyroid-stimulating immunoglobulin for the risk of relapse was 33.271 (95% confidence interval: 4.741–233.458, p < 0.001) and odds ratio of quantitative thyroid-stimulating immunoglobulin was 1.009 (95% confidence interval: 1.002–1.015, p < 0.001).

Conclusion:

Thyroid-stimulating immunoglobulin is a good predictor of relapse in patients with Graves’ disease treated with anti-thyroid drugs. It might be safer to discontinue anti-thyroid drugs when thyroid-stimulating immunoglobulin and thyroid receptor antibody were both negative.
“Prevalence of chronic pain following resection of pelvic bone tumours: A single centre prospective observational survey”
Authors: Bakshi Sumitra , Rana Meenal , Gulia Ashish , Puri Ajay , Harsha Tadala SS , Tiwari Shashank , Gotur Aparna
Published: September 2021

Background

Hemipelvectomy is a major surgery most often performed for pelvic malignancy. These complex surgeries often involve dissection around major neurovascular bundle and resection of tumour being bone along with involved tissues. This may result in short and long term morbidities. There is very little literature about incidence of chronic pain after pelvic resections. We conducted a prospective study at a tertiary cancer hospital to assess the prevalence of chronic pain post hemipelvectomy.

Method

This is a single centre prospective observational study conducted over 30 months. Pain scores were recorded using Brief pain inventory (BPI) and pain detect questionnaire. The quality of life was assessed using musculoskeletal tumour society (MSTS) score. Intra-operative details like extent of surgical resection, nerves spared, details of intra-operative and post-operative analgesia were retrieved from the patient files. Data were analysed using SPSS 21 version.

Results

Neuropathic pain post hemipelvectomy was uncommon. The prevalence of mild to moderate somatic pain was around 30%. Functional limitation was minimal as assessed by BPI and MSTS score. A high incidence of numbness was seen to persist in and around the area of surgical incision (50%).

Conclusion

This is first study to report the incidence of chronic pain post hemipelvectomy done for pelvic tumour resections. Despite the extensive nature of resection involved, there is a low prevalence of neuropathic pain in this population. However, incidence of persistent somatic pain is high and there is a need for further studies for evaluating the causality
Knowledge of cervical cancer screening and associated factors among women attending maternal health services at Aira Hospital, West Wollega, Ethiopia
Authors: Aredo Megersa Argaw , Sendo Endalew Gemechu , Deressa Jembere Tesfaye
Published: September 2021

Background:

Cervical cancer is one of the major noncommunicable public health problems among women globally. About 500,000 women develop cervical cancer each year, with an estimated 85% or more occurring in developing countries, including Ethiopia.

Objective:

The main objective of the study was to assess the knowledge of cervical cancer screening and its associated factors among women attending maternal health services at Aira hospital, West Wollega, Ethiopia.

Methods:

An institutional-based cross-sectional study design was conducted among 421 reproductive-age women. A systematic sampling method was used for the study. Data were collected using a pretested and structured questionnaire. Data analysis included descriptive statistics and the statistical association between the outcome variable and the explanatory variables tested by the binary logistic regression. Multivariable logistic regression was used to control confounding factors, the magnitude of the association between the different independent and dependent variable was measured using 95% confidence interval, and p values below 0.05 were considered as statistically significant.

Results:

A total of 421 women were responded with 100% response rate and with the mean age of 26.0 ± 5.15 (M ± SD) years. About 95.0% of the respondents ever heard of cervical cancer and 46.8% of the respondents had good knowledge about cervical cancer screening. Age, occupation, educational level, and monthly income were predictors associated with knowledge about cervical cancer screening.

Conclusion:

The study revealed 46.8% of study participants had knowledge about cervical cancer screening. The age of the participant, occupation, level of education, and monthly income were determinants of knowledge about cervical cancer screening. Prevention programs should focus on cervical cancer screening according to identified factors in the study.
The multidisciplinary, theory-based co-design of a new digital health intervention supporting the care of oesophageal cancer patients
Authors: Sun Kristi , Goodfellow Henry , Konstantara Emmanouela , Hill Alison , Lennard Debby , Lloyd-Dehler Elizabeth , Mughal Muntzer , Pritchard-Jones Kathy , Robson Chris , Murray Elizabeth
Published: September 2021

Objective

Oesophageal cancer patients have complex care needs. Cancer clinical nurse specialists play a key role in coordinating their care but often have heavy workloads. Digital health interventions can improve patient care but there are few examples for oesophageal cancer. This paper aims to describe the multidisciplinary co-design process of a digital health intervention to improve the experience of care and reduce unmet needs among patients with oesophageal cancer.

Methods

A theory-based, multi-disciplinary, co-design approach was used to inform the developmental process of the digital health intervention. Key user needs were elicited using mixed methodology from systematic reviews, focus groups and interviews and holistic need assessments. Overarching decisions were discussed among a core team of patients, carers, health care professionals including oncologists and cancer clinical nurse specialists, researchers and digital health providers. A series of workshops incorporating a summary of findings of key user needs resulted in the development of a minimum viable product. This was further refined after a pilot study based on feedback from end users.

Results

The final digital health intervention consists of a mobile app feature for patients and carers connected to a dashboard with supporting additional features for clinical nurse specialist. It contains a one-way messaging function for clinical nurse specialists to communicate with patients, functions for patients to record weight and holistic need assessment results which could be viewed by their clinical nurse specialists as well as a library of informative articles.

Conclusions

The multidisciplinary co-design of a digital health intervention providing support for oesophageal cancer patients and health care professionals has been described. Future studies to establish its impact on patient outcomes are planned.
The Medical Management of Gastroesophageal Reflux Disease: A Narrative Review
Authors: Kröner Paul T. , Cortés Pedro , Lukens Frank J.
Published: September 2021

Objective

The medical management of gastroesophageal reflux disease (GERD) continues to evolve. Our aim was to systematically assess the literature to provide an updated review of the evidence on lifestyle modifications and pharmacological therapy for the management of GERD.

Background

The cornerstones of GERD medical management consist of lifestyle modifications and pharmacologic agents. Most recently, evidence has emerged linking anti-reflux pharmacologic therapy to adverse events, such as kidney injury, metabolic bone disease, myocardial infarction, and even dementia, among others.

Methods

A systematic search of the databases of PubMed/MEDLINE, Embase, and Cochrane Library was performed for articles on the medical management of GERD between inception and March 1, 2021.

Conclusion

Although pharmacological therapy has been associated with potential adverse events, further research is needed to determine if this association exists. For this reason, lifestyle modifications should be considered first-line, while pharmacologic therapy can be considered in patients in whom lifestyle modifications have proven to be ineffective in controlling their symptoms or cannot institute them. Naturally, extra-esophageal causes for GERD-like symptoms must be considered on suspected high-risk patients and excluded before considering treatment for GERD.
Cervical disc arthroplasty: What we know in 2020 and a literature review
Authors: Shin Jun Jae , Kim Kwang-Ryeol , Son Dong Wuk , Shin Dong Ah , Yi Seong , Kim Keung-Nyun , Yoon Do-Heum , Ha Yoon , Riew K Daniel
Published: September 2021

Cervical disc arthroplasty (CDA) is a safe and effective option to improve clinical outcomes (e.g., NDI, VAS, and JOA) in degenerative cervical disc disease and compressive myelopathy. CDA’s two main purported benefits have been that it maintains physiologic motion and thereby minimizes the biomechanical stresses placed on adjacent segments as compared to an ACDF. CDA might reduce the degeneration of adjacent segments, and the need for adjacent-level surgery. Reoperation rates of CDA have been reported to range from 1.8% to 5.4%, with a minimum 5-year follow-up. As the number of CDA procedures performed continues to increase, the need for revision surgery is also likely to increase. When performed skillfully in appropriate patients, CDA is an effective surgical technique to optimize clinical outcomes and radiological results. This review may assist surgical decision-making and enable a more effective and safer implementation of cervical arthroplasty for cervical degenerative disease.
“Will America Work? Racial and Economic Equity in a Post-COVID World”
Authors: Wingfield Adia Harvey
Published: September 2021

Due to a variety of structural, political, and economic changes, the US is currently in the midst of record levels of economic inequality. At the same time, the country is rapidly becoming more racially diverse (and dealing with the backlash of these demographic changes). In this article, I use Kalleberg’s (2003) framework of “good jobs” and “bad jobs” in conjunction with several sociological theories of race and racism to assess the implications of these changes. I suggest that the United States is at an inflection point that will either result in a shift toward policies that produce more racial and economic parity, or a commitment to forces that will further entrench these inequalities.
Can You Hear Me Now? Effects of Patient-Centered Communication With Young Adults Aged 26 to 39
Authors: Nichols Helen M , Dababnah Sarah , Berger Zackary , Long Caroline , Sacco Paul
Published: September 2021

Patient-centered communication (PCC) is critical to the delivery of quality health care services. Although numerous health outcomes have been connected to patient–provider communication, there is limited research that has explored the processes and pathways between communication and health. Research among young adults (ages 26-39 years) is even more scarce, despite findings that health communication does vary with age. This cross-sectional study used data from the 2014 Health Interview National Trends Survey to explore the relationship between PCC, patient trust, patient satisfaction, social support, self-care skills, and emotional well-being among young adults aged 26 to 39 years. Our results showed that income, history of depression diagnosis, PCC, patient trust, social support, and patient self-efficacy (self-care skills) were all significantly related to emotional well-being. These findings suggest the need to explore the means through which communication can impact emotional well-being, specifically among young adults who are in poor health or have a history of depression. Future research should also include longitudinal studies, in order to determine causality and directionality among constructs.
Teaching addition strategies to students with learning difficulties
Authors: Polo-Blanco Irene , González López Eva M
Published: September 2021

Background & aims

In recent years, there has been an increased interest in analyzing the mathematical performance of students with learning difficulties in order to provide them with teaching methods adapted to their needs. In particular, the importance of studying the type of informal strategy that students use when solving problems has been highlighted. Observing how these strategies emerge and develop in children with learning difficulties is crucial, as it allows us to understand how they develop a subsequent understanding of arithmetic operations. In this paper we study the effect of explicit instruction in addition strategies, focusing on the minimum addend strategy, and analyze the difficulties that arise during this process.

Methods

An adapted multiple-probe design across students with a microgenetic approach was employed to assess the effectiveness of the teaching instruction and the acquisition of the minimum addend strategy while solving addition word problems. The participants were three primary-school children (two boys and one girl) with learning difficulties, one of them diagnosed with autism spectrum disorder. The instruction on the minimum addend strategy was sequenced into levels of abstraction based on the addends represented with and without manipulatives.

Results

The results show that the three participants were able to acquire the minimum addend strategy and transfer it to two-step problems. They all showed difficulties during the instructional process, with quantity comparison difficulties predominating. The instruction provided to address these and other difficulties is detailed for each participant.

Conclusions

The teaching of the minimum addend strategy has proven effective, and all three students acquired it throughout the instruction. The results concerning the student diagnosed with autism spectrum disorder are especially interesting given the lack of studies that focus on the strategies employed by students with this disorder to solve arithmetic problems. In this sense, the use of the microgenetic approach was especially useful to observe the type of spontaneous strategies used by this participant, and how they varied in response to the instruction.

Implications

Each study participant faced different difficulties and needed different periods of time to assimilate the new strategy. Conclusions are drawn for educators to help children with learning difficulties advance to more sophisticated strategies, so they can acquire these and subsequent mathematical concepts.
Multiple Evanescent White-Dot Syndrome in a 9-Year-Old Girl
Authors: Shepherd E. Anne , Herst Brian S. , Parlitsis George J. , Shapiro Michael J. , Goldstein Debra A. , Merrill Pauline T.
Published: September 2021

Purpose:

This work describes a case of multiple evanescent white-dot syndrome (MEWDS) in a 9-year-old girl.

Methods:

A case report is presented.

Results:

A case of MEWDS in a 9-year-old girl is described.

Conclusions:

To our knowledge this is the youngest presentation of MEWDS discussed in the literature. MEWDS should be considered in the differential diagnosis of ocular inflammation in the first decade of life.
Don’t you forget about me(gakaryocytes)
Authors: Tilburg Julia , Becker Isabelle C. , Italiano Joseph E.
Published: September 2021

Platelets (small, anucleate cell fragments) derive from large precursor cells, megakaryocytes (MKs), that reside in the bone marrow. MKs emerge from hematopoietic stem cells in a complex differentiation process that involves cytoplasmic maturation, including the formation of the demarcation membrane system, and polyploidization. The main function of MKs is the generation of platelets, which predominantly occurs through the release of long, microtubule-rich proplatelets into vessel sinusoids. However, the idea of a 1-dimensional role of MKs as platelet precursors is currently being questioned because of advances in high-resolution microscopy and single-cell omics. On the one hand, recent findings suggest that proplatelet formation from bone marrow–derived MKs is not the only mechanism of platelet production, but that it may also occur through budding of the plasma membrane and in distant organs such as lung or liver. On the other hand, novel evidence suggests that MKs not only maintain physiological platelet levels but further contribute to bone marrow homeostasis through the release of extracellular vesicles or cytokines, such as transforming growth factor β1 or platelet factor 4. The notion of multitasking MKs was reinforced in recent studies by using single-cell RNA sequencing approaches on MKs derived from adult and fetal bone marrow and lungs, leading to the identification of different MK subsets that appeared to exhibit immunomodulatory or secretory roles. In the following article, novel insights into the mechanisms leading to proplatelet formation in vitro and in vivo will be reviewed and the hypothesis of MKs as immunoregulatory cells will be critically discussed.
The menin-MLL1 interaction is a molecular dependency in NUP98-rearranged AML
Authors: Heikamp Emily B. , Henrich Jill A. , Perner Florian , Wong Eric M. , Hatton Charles , Wen Yanhe , Barwe Sonali P. , Gopalakrishnapillai Anilkumar , Xu Haiming , Uckelmann Hannah J. , Takao Sumiko , Kazansky Yaniv , Pikman Yana , McGeehan Gerard M. , Kolb Edward A. , Kentsis Alex , Armstrong Scott A.
Published: September 2021

Translocations involving the NUP98 gene produce NUP98-fusion proteins and are associated with a poor prognosis in acute myeloid leukemia (AML). MLL1 is a molecular dependency in NUP98-fusion leukemia, and therefore we investigated the efficacy of therapeutic blockade of the menin-MLL1 interaction in NUP98-fusion leukemia models. Using mouse leukemia cell lines driven by NUP98-HOXA9 and NUP98-JARID1A fusion oncoproteins, we demonstrate that NUP98-fusion-driven leukemia is sensitive to the menin-MLL1 inhibitor VTP50469, with an IC50 similar to what we have previously reported for MLL-rearranged and NPM1c leukemia cells. Menin-MLL1 inhibition upregulates markers of differentiation such as CD11b and downregulates expression of proleukemogenic transcription factors such as Meis1 in NUP98-fusion-transformed leukemia cells. We demonstrate that MLL1 and the NUP98 fusion protein itself are evicted from chromatin at a critical set of genes that are essential for the maintenance of the malignant phenotype. In addition to these in vitro studies, we established patient-derived xenograft (PDX) models of NUP98-fusion-driven AML to test the in vivo efficacy of menin-MLL1 inhibition. Treatment with VTP50469 significantly prolongs survival of mice engrafted with NUP98-NSD1 and NUP98-JARID1A leukemias. Gene expression analysis revealed that menin-MLL1 inhibition simultaneously suppresses a proleukemogenic gene expression program, including downregulation of the HOXa cluster, and upregulates tissue-specific markers of differentiation. These preclinical results suggest that menin-MLL1 inhibition may represent a rational, targeted therapy for patients with NUP98-rearranged leukemias.
Impact of sickle cell trait on morbidity and mortality from SARS-CoV-2 infection
Authors: Merz Lauren E. , Mistry Kavita , Neuberg Donna , Freedman Revital , Menard Gerda , Dorfman David M. , Park Hae Soo , Jolley Katherine , Achebe Maureen O.
Published: September 2021

The COVID-19 pandemic has highlighted racial health disparities within the United States. Although social determinants of health are the most likely drivers of this disparity, it is possible that genetic traits enriched in the black population like sickle cell trait (SCT) could worsen the morbidity and mortality of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients admitted for SARS-CoV-2 infection who identified as black or African American were included in the study (n = 166). Blood remnants were tested for SCT, and clinical data were abstracted from the chart. There was no difference in mortality between those with SCT and those without. There was no difference in respiratory complications between groups, but those without SCT had a much higher burden of chronic lung disease (P = .004). Those with SCT had higher creatinine on admission (P = .004), but no difference in in-hospital renal complications (P = .532). Notably, 12% of the cohort had SCT, which is higher than the expected 7.31% (P = .025). Our study did not show any evidence of increased end organ damage, morbidity, or mortality from SARS-CoV-2 infection among patients with SCT but did show differences in admission creatinine and preexisting lung disease.