bluuebunny/crossref_metadata_2025 huggingface dataset:
A Failed Attempt at Participatory Video With Takatāpui/LGBTIQ+ People Who Had Experienced Homelessness
Authors: Fraser Brodie , Chisholm Elinor , Pierse Nevil
Published: May 2022

This paper provides insights into a failed attempt at participatory video (PV). PV has long been favoured by researchers working with marginalised communities. However, there is limited discourse about when the method is and is not appropriate, and few published examples of when it has failed. It is important to critique research methods, and for researchers to be transparent about when research is not carried out as originally intended. Such reflection allows us to refine the methods we use and improve our research. This paper explores what a failed PV project with Takatāpui/LGBTIQ+ people who had experienced homelessness taught us about the stigmatised nature of both homelessness and LGBTQ+ identities. Furthermore, it shows how methods that do not allow for participants to maintain their anonymity are sometimes not the right choice when researching stigmatised issues.
What Do We Know About Aging and Emotion Regulation?
Authors: Isaacowitz Derek M.
Published: May 2022

Older adults report surprisingly positive affective experience. The idea that older adults are better at emotion regulation has emerged as an intuitively appealing explanation for why they report such high levels of affective well-being despite other age-related declines. In this article, I review key theories and current evidence on age differences in the use and effectiveness of emotion-regulation strategies from a range of studies, including laboratory-based and experience sampling. These studies do not yet provide consistent evidence for age differences in emotion regulation and thus do not clearly support the assertion that older adults are better at emotion regulation. However, current approaches may be limited in describing and testing possible age-related changes in emotion regulation. Future work will need to more directly investigate individual trajectories of stability and change in emotion-regulation strategy use and effectiveness over time and also consider the possible roles of context, physiological reactivity, neural changes, acceptance, and personality.
Examining the association between feeling excluded at school and political trust in four Nordic countries
Authors: Brezicha Kristina F , Leroux Audrey J
Published: May 2022

Students’ positive experiences in schools positively predicts students’ political trust. However, little research has examined how individual students’ feelings of exclusion at their schools may relate to students’ political trust. Moreover, how does an overall sense of exclusion from the school relate to political trust apart from individual students’ feelings of exclusion? Lastly, do immigrant students have a different level of political trust, on average, than non-immigrant students? Using data from the 2009 International Civic and Citizenship Education Study, this study employed multilevel modeling to investigate these questions in Denmark, Finland, Norway, and Sweden. The results revealed that students feeling like an outsider at school was a statistically significant predictor of lower feelings of political trust in the four Nordic countries. In three countries the school’s overall sense of exclusion was also a statistically significant predictor. The discussion explores the implication of the findings for students’ political trust.
Age-stratified trends in the progression of spinal radiographic damage in patients with ankylosing spondylitis: a longitudinal study
Authors: Lee Tae-Han , Koo Bon San , Nam Bora , Kim Yun Jin , Son Donghee , Lee Seunghun , Joo Kyung Bin , Kim Tae-Hwan
Published: May 2022

Objective:

The objective of this study was to investigate spinal radiographic progression in specific age ranges of ankylosing spondylitis (AS) patients.

Methods:

Longitudinal data for 1125 AS patients at a single hospital from 2000 to 2018 were retrospectively reviewed. Radiographic intervals were obtained from patients with consecutive spinal radiographs. The radiographic progression rate was defined as the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) change per year within each interval. Using generalized estimating equations (GEEs), estimated marginal means were calculated for the mSASSS progression rate across age groups after adjusting for potential confounders.

Results:

We obtained 4016 radiographic intervals and stratified them into five groups based on patient age at the interval start: <20 ( n = 122); 20–29 ( n = 1124); 30–39 ( n = 1690); 40–49 ( n = 794); and ⩾50 years ( n = 286). The mean (SD) mSASSS progression rate for all the intervals was 0.8 (1.9). The GEE-estimated mean mSASSS progression rate increased with age, peaking in the 30–39 age group with a value of 1.15 [95% confidence interval (CI) 1.03, 1.27], and decreased slightly thereafter. In the presence of risk factors, rapid progression occurred at earlier ages: the GEE-estimated mean mSASSS progression rate in those with elevated C-reactive protein levels and preexisting syndesmophytes was 2.82 (95% CI 1.93, 3.71) in the 20–29 age group.

Conclusion:

Spinal structural damage in AS seems to progress most rapidly when patients are age 30–39 years. An awareness of the trends in radiographic progression with advancing age could improve understanding of the natural course of AS.
Network Pharmacology and Molecular Docking-Based Prediction of the Molecular Targets and Signaling Pathways of Ginseng in the Treatment of Parkinson's Disease
Authors: Zhang Wei , Chen Jingya , Liu Hongquan
Published: May 2022

Objective: The present study was aimed at exploring the molecular mechanism underlying the action of ginseng in the treatment of Parkinson's disease (PD) using network pharmacology. Methods: The main effective ginseng ingredients were obtained from the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP) database and screened for oral bioavailability (OB), as well as drug-like properties (DL). A platform of PD targets was established using GeneCards and Online Mendelian Inheritance in Man (OMIM) databases, and then an “effective ingredient-target-disease” interaction network was constructed using Cytoscape 3.7.1 software. A STRING database was used to construct a protein–protein interaction (PPI) network, and the related protein interactions were analyzed. Finally, we performed functional analyses of core targets using the Gene Ontology (GO) and Kyoto Gene and Gene Encyclopedia (KEGG) pathway enrichment, and then conducted molecular docking of the effective ingredients with disease targets. Results: Ninety-seven effective ginseng ingredients and 168 potential targets of PD were identified in the present study. Network analysis showed that the targets were mainly involved in regulating cell metabolism, apoptosis, and other biological processes (BPs). Further, it was noted that the effects of the targets on treatment of PD involved regulation of several signaling pathways, such as mitogen-activated protein kinase (MAPK), advanced glycation end products (AGE), and receptors of advanced glycation end products (RAGE). The results of molecular docking showed that the active ginseng ingredients bind well with the targets of MAPK3 and MAPK14. Conclusion: The main active compounds of ginseng in the treatment of PD may be ginsenosides, and the molecular mechanism may be related to key targets such as MAPK3, MAPK14, and EGFR. The MAPK and AGE-RAGE signaling pathways may also be involved.
Efficacy and safety of intravenous immunoglobulin for treating refractory livedoid vasculopathy: a systematic review
Authors: Gao Yimeng , Jin Hongzhong
Published: May 2022

Introduction:

Intravenous immunoglobulin (IVIG) was reported to be the third most used monotherapy in livedoid vasculopathy (LV). There is currently a lack of randomized controlled clinical trials and no standardized therapeutic regimen for IVIG therapy in LV.

Methods:

We performed a systematic review of the efficacy and safety of IVIG in treating patients with LV using PubMed, Cochrane, and Embase databases.

Results:

Eighty LV patients from 17 articles were included, receiving IVIG therapy at a dose of 1–2.1 g/kg body weight every 4 weeks. The effective rate of IVIG therapy in LV patients was 95% (76/80) in published studies, showing a good clinical response for resolution of pain, skin ulcerations, and neurological symptoms, and reducing the dependence on glucocorticoids and immunosuppressive agents. IVIG therapy was well tolerated, and no severe adverse events were observed.

Conclusion:

Overall, to a certain degree, IVIG is probably a safe and effective treatment alternative for refractory LV patients, which still need to be confirmed by large-scale randomized controlled clinical trials.
Perfectionism, life stress, and suicidal ideation among college students: A protective role of self-compassion
Authors: You Sukkyung , Kwon Minkyung , Kim Eui Kyung
Published: May 2022

Suicidal behavior among South Korean young adults has been a serious social concern. When college students have a maladaptive desire for perfectionism in life, they may experience more significant life stress and, in turn, higher devaluation of their lives. However, not every individual is equally influenced by perfectionism and develops adverse emotional outcomes. Some researchers proposed that self-compassion, being warm and understanding toward oneself rather than ignoring or criticizing oneself, might act as a protective factor against mental health concerns. Therefore, using a sample of 420 Korean college students, this study conducted structural equation modeling to examine self-compassion as a potential protective factor for the mediation effect of life stress in the relationship between maladaptive perfectionism and suicidal ideation. Results supported the hypothesized model, with students with higher self-compassion reporting more negligible adverse impacts of maladaptive perfectionism on suicidal ideation mediated by life stress. Implications and future directions are discussed.
Voluntary blood donation practice and its associated factors among civil servants in Bale Robe town, Southeast Ethiopia, 2021
Authors: Mohammed Ahmed Seid , Yassin Ahmed , Aliyi Ahmednur Adem
Published: May 2022

Objective:

The objective of this study was to assess voluntary blood donation practice and associated factors among Bale Robe town civil servants in Oromia, Southeast Ethiopia, 2021.

Methods:

An institution-based cross-sectional study was conducted among 601 civil servants selected by a stratified systematic random sampling technique. Data were collected using a structured self-administered questionnaire. The questionnaire was pre-tested on 5% of the total sample size before actual data collection. Data were coded and entered into EpiData version 3.1 and analyzed using SPSS version 25. Frequency distribution, descriptive statistics, and diagrams were used to summarize and present data. Binary logistic regression was performed to assess the association between independent variables and voluntary blood donation practice. An adjusted odds ratio (AOR) with its 95% confidence interval (CI) was calculated to identify factors associated with the outcome variables. And p-value < 0.05 was used to declare significance.

Result:

Of the total of 630 selected civil servants, 601 give a complete response to the questionnaire yielding a response rate of 95%. The mean age of participants was 34.19 years, and 328 (54.6%) of them were rural residents before they joined the governmental work. The lifetime voluntary blood donation practice among civil servants was 27%; 95% confidence interval = (23%–31%). The major reason for not donating blood was fear related to blood donation 186 (42.4%). From multivariable logistic regression, four variables were found as significant independent variables associated with voluntary blood donation practice. Accordingly, having a family member or relative who previously donate blood (adjusted odds ratio = 2.48; 95% confidence interval = (1.39, 4.39)), previous participation in a blood donation campaign (adjusted odds ratio = 5.84; 95% confidence interval = (3.39, 1.04)), and willingness to donate blood (adjusted odds ratio = 5.04; 95% confidence interval = (2.21, 11.48)) were variables significantly and positively associated with voluntary blood donation practice, respectively. Civil servants who had no opportunity to donate blood previously were less likely to give voluntary blood donation (adjusted odds ratio = 0.15 (95% confidence interval = 0.063, 0.367)).

Conclusion:

The study identified a low level of voluntary blood donation. Having family members/relatives who donate blood, previous participation in a blood donation campaign, and willingness to donate blood were significantly associated with voluntary blood donation. Therefore, there should be regularly scheduled campaigns encouraging civil servants’ voluntary blood donation.
Hormone replacement therapy subcutaneous implants for refractory menopause symptoms; the patient’s perspective
Authors: Dixit Anushka , Carden Nikkita , Stephens Elaine , Chadwick Mark , Tamblyn Jennifer , Robinson Lynne
Published: May 2022

Objective:

For women with menopause symptoms refractory to standard hormone replacement therapy (HRT) preparations, HRT implants offer an alternative. The primary objective of this study was to evaluate women’s perceptions regarding efficacy, tolerability, satisfaction and safety of implant therapy.

Study design:

A single centre service evaluation study performed at Birmingham Women’s & Children’s Foundation Hospital Trust. An anonymised semi-structured survey link was posted to all women ( n = 397) recorded to have received HRT implant(s) at a tertiary Menopause clinic (May 1982 and Dec 2018). Women attending clinic (June 2020 to Sept 2020) were opportunistically invited to complete a written version of the survey.

Main outcome measures:

Data collected included demographics, medical and surgical history, therapy duration, type, indication and complications. Climacteric symptoms were assessed using the Greene Climacteric Scale.

Results:

Data was obtained for 119 women. The written survey yielded higher response rates ( n = 73, 61.3%). Most respondents were 51–60 years old ( n = 51 42.9%) and 87.4% ( n = 104) were ‘White British’. 70 women used estradiol only implants. 30.1%% ( n = 34) of patients reported a low Greene Climacteric Scale score (0–5). Subgroup analysis showed prevalence of sexual dysfunction and vasomotor symptoms across ages. There was a lower prevalence of psychological symptoms amongst ≥51 year olds. High satisfaction rates were reported.

Conclusions:

Data from a large cohort is presented. Good symptom control, satisfaction and long-term efficacy was demonstrated. This study supports the value of HRT implants for refractory menopause symptoms. A national database of implant users would be a useful tool to record satisfaction scores and adverse events.
Investigating the needs and concerns of older adults with multimorbidity and their healthcare professionals for conceivable digital psychotherapeutic interventions
Authors: Moran Orla , Doyle Julie , Smith Suzanne , Giggins Oonagh , Dinsmore John
Published: May 2022

Multimorbidity, defined as the concurrent experience of more than one chronic health condition in an individual, affects ∼65% of people over 65 and 85% of those over 85 years old with 30% of those also experiencing mental health concerns. This can lead to reduced quality of life and functioning as well as poorer outcomes in terms of condition management, adherence to treatment, and ultimately disease prognosis and progression. Digital health interventions offer a viable means of condition self-management, as well as psychological support, particularly for those who may have difficulty accessing in-person services. To best meet the needs of older adults with multimorbidity, deeper insights are needed into their specific concerns and issues around condition management, particularly with regard to distress in relation to managing one's condition. The present study aimed to explore this using one-to-one qualitative interviews and focus groups with people with chronic health conditions and healthcare professionals. Participants were 11 older adults with multimorbidity (4 males; mean age: M = 72.7 years) and 14 healthcare professionals including five clinical nurse specialists, four pharmacists, two general practitioners, one occupational therapist, one speech and language therapist and one dietician. Thematic analysis was used to identify key themes, which included: patient feelings of anxiety or worry leading to an unwillingness to access essential information; the various mental health challenges faced by those with multimorbidity; the importance of personal values in providing motivation; and the importance of social support. Findings are discussed in relation to the potential development of transdiagnostically applicable digital interventions for the management of distress in those with multimorbidity.
Usability and effectiveness of adherence monitoring of a mobile app designed to monitor and improve adherence to event-driven and daily HIV pre-exposure prophylaxis among men who have sex with men in Taiwan
Authors: Wu Huei-Jiuan , Yu Yi-Fang , Ku Stephane Wen-Wei , Tseng Yuan-Chi , Yuan Chien-Wen , Li Chia-Wen , Huang Po-Hsien , Ko Nai-Ying , Anderson Peter L. , Strong Carol
Published: May 2022

Objective

The UPrEPU mobile app is a self-monitoring system to enable men who have sex with men to optimize their pre-exposure prophylaxis adherence for HIV prevention. The app was designed to accommodate a rather complicated event-driven dosing schedule. We aim to evaluate the usability of the UPrEPU app and its effectiveness in improving adherence monitoring.

Methods

From May to October 2020, 35 participants were enrolled for the usability study and followed up for 4 months. Blood samples for the drug concentration in the dried blood spots were obtained once during the second to fourth follow-up visits. The effectiveness of adherence monitoring was analyzed using Cohen's kappa statistic to calculate the concordance between the average number of pills taken and drug concentration in the dried blood spots.

Results

Overall retention was 91.4% (32 participants) at the end of the study. Participants used the app for a mean of 29 days and made 2565 data entries in total, with an average of 76 data entries. The average systematic usability scale score for the app was 71.5, indicating acceptable usability. Slight agreement was reached between the dried blood spots measurement and the number of pills taken and recorded in the app (weighted kappa: 0.21).

Conclusions

Our user-centered UPrEPU app demonstrated that it could accommodate both daily and event-driven dosing schedules for men who have sex with men clients with acceptable usability scores. We confirmed that complex behaviors such as different drug-dosing regimens that are contingent on sexual behaviors could be incorporated into the design of a mobile app.
The role of digital mobile technology in elderly health management among health care workers in Indonesia: Analysis of knowledge, attitudes, and practice
Authors: Dinakrisma Anastasia A. , Laksmi Purwita Wijaya , Abdiel Teofilus , Fernandez Johannes P. , Indahwati Nuri , Susanto Anindya Pradipta , Indrajaya Lukmana Arya Ananda , Yusuf Prasandhya Astagiri
Published: May 2022

Background

Technology, including information and communication technology (ICT), plays a significant role in the quality of health services. However, its application in elderly health services is still lacking. The aim of this study was to determine the knowledge of, attitudes toward, and practices of cell phone and mobile application use for elderly health care among Indonesian health care workers.

Methods

This was a cross-sectional study conducted with health care workers in Jakarta, Indonesia. The potential subjects were contacted through instant messenger application and/or through conventional short message service or telephone calls from August through November 2020.

Results

There were 134 subjects. All the subjects had used various health applications to assist with their daily work, including telemedicine (64.2%), guidelines (60.4%), and medical calculators (46.3%). However, 96.3% of the subjects were not aware of the existence of a health application for geriatric assessment. Furthermore, 98.5% of subjects thought that it is important to use ICT to manage geriatric patients, and 94.8% felt that comprehensive geriatric assessment (CGA) in digital form would help them manage geriatric patients better. Nevertheless, 35.10% of subjects had never applied CGA to their geriatric patients.

Conclusions

The current health care system has begun to enter a period of using ICT in performing health services for geriatric patients. Nevertheless, only a few Indonesian health care workers were aware of or were using the geriatric mobile application. It is essential to improve the dissemination of geriatric health care and e-health literacy among them to improve the quality of elderly health care.
Exploring the Relationship Between Family Involvement and Innovative Capability in Chinese Family SMEs: The Role of HR Redundancy
Authors: Sun Kaiyang , Wickramasekera Rumintha , Tan Alvin
Published: May 2022

The aim of this research is to investigate the relationship between family involvement and innovative capability in Chinese family small-medium sized enterprises (SMEs). Although previous studies based on the behavior agency model have investigated how financial factors could influence the relationship between family involvement and innovative capability, there is a dearth of studies with an emphasis on the impact of non-financial factors. Notably, the moderating role played by family firms’ human resource (HR) redundancy in this relationship has not been sufficiently explored in the literature. Our research analyzed secondary data of Chinese family SMEs listed in the China Stock Market and Accounting Research (CSMAR) database. Standard multiple regression and moderated multiple regressions were conducted to test the main and moderating effects, respectively. According to the results of our study, the three dimensions of family involvement (ownership, management, and governance) have a negative influence on Chinese SMEs innovative capability, but this influence can be partially moderated by HR redundancy. Based on the socio-emotional wealth (SEW) perspective, this research contributes to family business literature by addressing previously noted research gaps in related studies.
The Transformation of Residential Segregation in the Pearl River Delta, China: A Planning-Driven Form
Authors: Gong Yue , Wei Yanning
Published: May 2022

Constrained by the hukou system and market mechanisms, Chinese rural migrants normally live in dormitories and urban villages (villages-in-the-city or chengzhongcun) quite distinct from the dwellings of more privileged social groups yet they are often located quite close together. This pattern may be described as a hukou-based yet market-driven form of residential segregation. This paper addresses an extreme level of segregation in China’s newest urban developments. By examining six key development zones in the Pearl River Delta (PRD), this paper argues that besides hukou and the market, urban planning contextualized in state-market engagement and socialist features is a crucial factor creating extreme residential segregation in these zones. This paper also argues that two planning instruments—large-scale land use zoning and the provision of public housing to migrants—play a significant role in creating segregation. The extreme segregation created by the state’s dominant planning practices in new urban developments demonstrates a transformation of China’s prevalent market-driven segregation.
Clinical and Radiographic Outcomes of Modified Posterior Atlantoaxial Temporary Fixation with Preservation of Semispinalis Cervicis: A Comparative Study
Authors: Liu Jia , Liu Shu , Jiang Enze , Tan Yixuan , Bao Xiaogang , Niu Dongyang , Guo Chao , Qi Junqiang , Shi Zhicai , Xu Guohua
Published: May 2022

Study Design:

Retrospective study.

Objective:

Current studies suggested that the posterior cervical deep muscles should be preserved during the atlantoaxial posterior approach. This study aimed to modify the conventional temporary posterior fixation by preserving the semispinalis cervicis and to evaluate the radiographic and clinical outcomes compared with the conventional technique.

Methods:

Applied anatomical and imaging study were assessed prior to the clinical studies. Thirty patients with odontoid fracture were enrolled. 12 patients underwent modified operation with preservation of semispinalis cervicis (Group P-SSC), and 18 patients underwent conventional approach with detachment of the semispinalis cervicis (Group D-SSC) as controls. Clinical and radiological assessments were evaluated postoperatively, including activities of daily living (ADL), axial symptom scoring system (Ass), cervical range of motion (ROM), and the average atrophy rate of muscles.

Results:

All patients experienced fracture healed within 10 months after temporary fixation. At early follow-up, ADL accompanying extension and flexion were significantly different between the two groups. The Ass scores in the Group P-SSC were constantly higher than that in Group D-SSC. Flexion-Extension ROM in Group P-SSC was significantly larger than that of Group D-SSC. The average atrophy rate at the C3 and C5 level in Group P-SSC was 7.62±3.38% and 7.55±3.89%, repectivcly, while 15.67±5.97% and 8.56±4.76% in Group D-SSC, respectively. Significant differences in the atrophy rate were found between groups at C3 level.

Conclusions:

Compared with the conventional technique, the modified surgical technique with preservation of semispinalis cervicis was effective in improving axial symptoms, decreasing the atrophy rate of muscles, and increasing the cervical ROM.
The Drivers of Persistent Opioid Use and Its Impact on Healthcare Utilization After Elective Spine Surgery
Authors: Gerlach Erik B. , Plantz Mark A. , Swiatek Peter R. , Wu Scott A. , Arpey Nicholas , Fei-Zhang David , Divi Srikanth N. , Hsu Wellington K. , Patel Alpesh A.
Published: May 2022

Study Design

Retrospective cohort study

Objective

The aim of this study was to determine the incidence of and risk factors for persistent opioid use after elective cervical and lumbar spine procedures and to quantify postoperative healthcare utilization in this patient population.

Methods

Patients were retrospectively identified who underwent elective spine surgery for either cervical or lumbar degenerative pathology between November 1, 2013, and September 30, 2018, at a single academic center. Patients were split into 2 cohorts, including patients with and without opioid use at 180-days postoperatively. Baseline patient demographics, underlying comorbidities, surgical variables, and preoperative/postoperative opioid use were assessed. Health resource utilization metrics within 1 year postoperatively (ie, imaging studies, emergency and urgent care visits, hospital readmissions, opioid prescriptions, etc.) were compared between these 2 groups.

Results

583 patients met inclusion criteria, of which 16.6% had opioid persistence after surgery. Opioid persistence was associated with ASA score ≥3 (P = .004), diabetes ( P = .019), class I obesity ( P = .012), and an opioid prescription in the 60 days prior to surgery ( P = .006). Independent risk factors for opioid persistence assessed via multivariate regression included multi-level lumbar fusion (RR = 2.957), cervical central stenosis (RR = 2.761), and pre-operative opioid use (RR = 2.668). Opioid persistence was associated with higher rates of health care utilization, including more radiographs ( P < .001), computed tomography (CT) scans (.007), magnetic resonance imaging (MRI) studies ( P = .014), emergency department (ED) visits (.009), pain medicine referrals (P < .001), and spinal injections ( P = .003).

Conclusions

Opioid persistence is associated with higher rates of health care utilization within 1 year after elective spine surgery.
Influence of Ankle Injury on Subsequent Ankle, Knee, and Shoulder Injuries in Competitive Badminton Players Younger Than 13 Years
Authors: Liu Xiaoxuan , Imai Kazuhiro , Zhou Xiao , Watanabe Eiji
Published: May 2022

Background:

In recent years, there has been a trend in badminton toward more specialized training at an earlier age. Accompanying this trend is the increased frequency of injuries in young players. Ankle injury is the most common injury in pediatric sports; however, its influence on subsequent injuries is rarely considered.

Purposes:

To evaluate the incidence of ankle, knee, and shoulder injuries in youth badminton and to investigate the influence of ankle injuries on subsequent ankle, knee, and shoulder injuries.

Study Design:

Descriptive epidemiology study; Level of evidence, 3.

Methods:

A custom-designed questionnaire was used to survey Japanese players 7 to 12 years of age who attended national elementary school–level badminton tournaments between May and September 2019. Information including the players’ characteristics, training history, injuries in the previous 12 months, and ankle injury histories were collected. Logistic regression was used for analysis.

Results:

A total of 478 players were included in the study, with 71 ankle injuries, 74 knee injuries, and 48 shoulder injuries reported. The injury incidence rates (per 1000 hours of play) were 0.23 (95% CI, 0.18-0.29) for the ankle, 0.24 (95% CI, 0.19-0.30) for the knee, and 0.16 (95% CI, 0.11-0.20) for the shoulder; 90.1% of ankle injuries, 25.7% of knee injuries, and 33.3% of shoulder injuries were acute. Previous ankle injury was significantly associated with subsequent ankle injury (adjusted Odds Ratio (OR), 3.05; 95% CI, 1.54-6.07; P < .05), knee injury (adjusted OR, 2.03; 95% CI, 1.12-3.69; P < .05), and shoulder injury (adjusted OR, 2.46; 95% CI, 1.26-4.83; P < .05).

Conclusion:

The study results indicated that previous injury to the ankle significantly increased the occurrence of subsequent ankle, knee, and shoulder injuries. Emphasizing protection and prevention of ankle injuries may help lower future injury risk in young badminton players.
Utility of Diagnostic Ultrasound in the Assessment of Patellar Instability
Authors: Bhimani Rohan , Ashkani-Esfahani Soheil , Mirochnik Karina , Lubberts Bart , DiGiovanni Christopher W. , Tanaka Miho J.
Published: May 2022

Background:

The use of imaging to diagnose patellofemoral instability is often limited by the inability to dynamically load the joint during assessment. Therefore, the diagnosis is typically based on physical examination using the glide test to assess and quantify lateral patellar translation. However, precise quantification with this technique remains difficult.

Purpose:

To quantify patellar position using ultrasound imaging under dynamic loading conditions to distinguish between knees with and without medial patellofemoral complex (MPFC) injury.

Study Design:

Controlled laboratory study.

Methods:

In 10 cadaveric knees, the medial patellofemoral distance was measured to quantify patellar position from 0° to 40° of knee flexion at 10° increments. Knees were evaluated at each flexion angle under unloaded conditions and with 20 N of laterally directed force on the patella to mimic the glide test. Patellar position measurements were made on ultrasound images obtained before and after MPFC transection and compared for significant differences. To determine the ability of medial patellofemoral measurements to differentiate between MPFC-intact and MPFC-deficient states, area under the receiver operating characteristic (ROC) curve analysis and the Delong test were used. The optimal cutoff value to distinguish between the deficient and intact states was determined using the Youden J statistic.

Results:

A significant increase in medial patellofemoral distance was observed in the MPFC-deficient state as compared with the intact state at all flexion angles ( P = .005 to P < .001). When compared with the intact state, MPFC deficiency increased medial patellofemoral distance by 32.8% (6 mm) at 20° of knee flexion under 20-N load. Based on ROC analysis and the J statistic, the optimal threshold for identifying MPFC injury was 19.2 mm of medial patellofemoral distance at 20° of flexion under dynamic loading conditions (area under the ROC curve = 0.93, sensitivity = 77.8%, specificity = 100%, accuracy = 88.9%).

Conclusion:

Using dynamic ultrasound assessment, we found that medial patellofemoral distance significantly increases with disruption of the MPFC.

Clinical Relevance:

Dynamic ultrasound measurements can be used to accurately detect the presence of complete MPFC injury.
Mechanisms, Pattern and Outcome of Pediatrics Trauma At Agaro General Hospital, Southwest Ethiopia, 2021
Authors: Dagnaw Yalemtsehay , Fenta Belete , Yetwale Aynalem , Biyazin Tsegaw , Sayih Alemayehu , Dessalegn Nigatu , Adugnaw Emebet , Ali Fatuma , Tesfa Yitbarek
Published: May 2022

Introduction

Over 80% of trauma related deaths in children occur in low income and middle-income countries including Ethiopia. Trauma affects several aspects of child life and is still a major concern. Despite the Ethiopian federal ministry of health (FMoH) conducting away different trials, there was an increased burden and high projection of pediatric trauma. In Ethiopia, There is insufficient evidence about the mechanisms, patterns and outcomes of pediatric trauma including this study area, Therefore this study aimed to assess the mechanisms, patterns, and outcomes of pediatric trauma in Agaro General Hospital, Southwest Ethiopia, 2021.

Methods and Materials

This cross-sectional study was study conducted on randomly selected 405pediatric patients who visited the Agaro General Hospital between 1/1/2018 and 30/8/2021. Data were extracted from each medical chart using a structured checklist. Data were entered into Epi-data 4.4.2.1for cleaning and analyzed using SPSS version 24. Tables, charts, and text are used to report the results.

Results

A total of 405 patients were included in the study. This study revealed that majority 271 (66.9%) of injured children were males. Most 188 (46.4%) of the traumas were occurred on the street. Fall down injury were the most common 151(37.3%) cause of trauma, followed by road traffic accidents 98 (24.2%). Trauma caused by falls accounted for 43.7% and 34.4% % of all traumas in the 5–12 year and the <5 year age groups respectively. Most 126 (31.1%) of the subjects were exposed to head and face trauma. Majority 256 (63.2%) of children were discharged with improvement, while12 (3.0%) of them have died.

Conclusions

Pediatric trauma remains a major public health concern. Most of trauma occurred among boys and falldown injury was the most frequent trauma, and the majority of the subjects were exposed to head and face trauma. Therefore, children should receive safety precautions, more supervision, and identification of specific risk factors for these injuries, and should be prohibited from risky practices by concerned bodies including families and traffic officers.
Parent Participation in Morbidity and Mortality Review: Parent and Physician Perspectives
Authors: de Loizaga Sarah R , Clarke-Myers Katherine , R Khoury Philip , Hanke Samuel P
Published: May 2022

This study examined Morbidity and Mortality (M&M) review practices and perspectives of physicians and parents regarding parent participation in M&M review. Surveys were distributed to parents of children with a prior hospitalization for congenital heart disease (CHD) and physicians caring for pediatric CHD patients. Response distributions and Fisher’s exact tests were performed to compare parent and physician responses. Qualitative survey data were thematically analyzed. Ninety-two parent and 36 physician surveys were analyzed. Physicians reported parent input or participation was rarely sought in M&M review. Parents with direct experience of adverse events or death of their child reported providers discussed events with them in a timely manner and answered their questions; however, nearly half wished their healthcare team had done something differently during the disclosure. There was no statistical difference between groups regarding transparency ( P = .37, .79); however, there was a significant difference in perspectives regarding parental involvement in the M&M review ( P < .001). Common themes important to parents which emerged from the qualitative analysis were being adequately informed, feeling their perspectives were acknowledged and respected, having attentive and empathetic providers, and receiving consistent messaging. Although rarely included in current practice, parent participation in M&M could offer unique insight and increase accountability to proposed change elucidated by M&M review.
Employability and ‘Marginal Efficiency’ of Labour in Post-COVID Economy
Authors: Irshad S. Mohammed , Raj Vimal
Published: May 2022

COVID-19-induced lockdown resulted into a differential impact and the most vulnerable among them are the labour. State is ineffective in preventing income and livelihood loss of the workers. Higher supply and lower wages resulted in a huge reserve labour force in developed and developing countries. The employer in a post-COVID economy is going to be highly selective and labour market also would be selective to labour. The labour is going to be free to move, however, the freedom of labour to move does not ensure better employability. This article explains about employability in the post-COVID economy.
Where land meets sea: Islands, erosion and the thing-power of hard coastal protection structures
Authors: Arnall Alex
Published: May 2022

In the last few decades, hard coastal protection structures, such as seawalls and groynes, have become increasingly commonplace around the world. Conventionally, the effects of such structures have been considered within a modernist framework that evaluates the degree of human control over the land–sea interface. However, this dominant viewpoint overlooks the central role that sea defences play in the ongoing production of coastal communities, particularly in small island states. This paper responds to these issues by revealing how coastal protection structures, as contingently performed material configurations, are devised and come into being and the social relations that these structures create and influence. Drawing on empirical research undertaken on a small island in the Maldives over a period of 6 years, the paper demonstrates not only the challenges that coastal communities face in attempting to exert control over the unruly sea but also the thing-power of the protection measures themselves that are made and unmade as part of this process. These findings suggest the need for sensitivity towards the social roles and effects of hard coastal protection structures when devising approaches and policies that might see the decommissioning of such structures in favour of softer, ‘nature-based’ responses to the vitality of the non-human world. As structures with their own unique material complexities, hard defence measures are deeply involved in the production of multinatural island futures.
Comorbidities of Female Patients with Sexual Dysfunction in a Psychiatry Clinic: A Cross-Sectional Study
Authors: Das Jnanamay , Yadav Shailly , Arora Bhawna
Published: May 2022

Background:

Previous studies showed the association of female sexual dysfunction (FSD) with various specific organic, psychiatric, and social factors separately, but rarely evaluated the extent of association of various disorders all together in cases of FSD.

Aim:

This study was conducted to explore the comorbidities associated with FSD from physical, psychiatric, and social perspectives.

Materials and Methods:

All female patients aged between 18 and 60 years reporting sexual problems to the psychiatry outpatient department were evaluated with Arizona sexual experiences scale for females. Their assessment included detailed medical and psychiatric history including the history of social contributing factors and medicine intake followed by physical and mental status examinations. Relevant biochemical investigations and hormonal assessments were done. Data were analyzed using Pearson correlation coefficients, linear regression analysis, and independent samples t tests.

Results:

Seventy-three females were diagnosed as cases of FSD according to the Arizona sexual experiences scale in one year. Among them, 1.37% had no comorbidity and the rest 98.63% had psychiatric comorbidities which were combined with physical comorbidities (mostly hypothyroidism, hyperprolactinemia, and abnormal menstrual cycle) in 35.62% cases and social contributing factors (mostly husbands’ substance abuses and various family-related problems) in 32.88% cases. The duration of FSD predicted its severity.

Conclusion:

The severity of FSD increased with duration. Thus, all cases of FSD should be assessed early in detail for physical, psychiatric, and social contributing factors to treat them holistically. Psychiatrists should play a key role in assessing, diagnosing, treating, and referring them to the appropriate treatment providers.
NOTCH1 signaling during CD4+ T-cell activation alters transcription factor networks and enhances antigen responsiveness
Authors: Wilkens Alec B. , Fulton Elena C. , Pont Margot J. , Cole Gabriel O. , Leung Isabel , Stull Sylvia M. , Hart Matthew R. , Bernstein Irwin D. , Furlan Scott N. , Riddell Stanley R.
Published: May 2022

Adoptive transfer of T cells expressing chimeric antigen receptors (CAR-T) effectively treats refractory hematologic malignancies in a subset of patients but can be limited by poor T-cell expansion and persistence in vivo. Less differentiated T-cell states correlate with the capacity of CAR-T to proliferate and mediate antitumor responses, and interventions that limit tumor-specific T-cell differentiation during ex vivo manufacturing enhance efficacy. NOTCH signaling is involved in fate decisions across diverse cell lineages and in memory CD8+ T cells was reported to upregulate the transcription factor FOXM1, attenuate differentiation, and enhance proliferation and antitumor efficacy in vivo. Here, we used a cell-free culture system to provide an agonistic NOTCH1 signal during naïve CD4+ T-cell activation and CAR-T production and studied the effects on differentiation, transcription factor expression, cytokine production, and responses to tumor. NOTCH1 agonism efficiently induced a stem cell memory phenotype in CAR-T derived from naïve but not memory CD4+ T cells and upregulated expression of AhR and c-MAF, driving heightened production of interleukin-22, interleukin-10, and granzyme B. NOTCH1-agonized CD4+ CAR-T demonstrated enhanced antigen responsiveness and proliferated to strikingly higher frequencies in mice bearing human lymphoma xenografts. NOTCH1-agonized CD4+ CAR-T also provided superior help to cotransferred CD8+ CAR-T, driving improved expansion and curative antitumor responses in vivo at low CAR-T doses. Our data expand the mechanisms by which NOTCH can shape CD4+ T-cell behavior and demonstrate that activating NOTCH1 signaling during genetic modification ex vivo is a potential strategy for enhancing the function of T cells engineered with tumor-targeting receptors.
CD19/22 CAR T cells in children and young adults with B-ALL: phase 1 results and development of a novel bicistronic CAR
Authors: Shalabi Haneen , Qin Haiying , Su Angela , Yates Bonnie , Wolters Pamela L. , Steinberg Seth M. , Ligon John A. , Silbert Sara , DéDé Kniya , Benzaoui Mehdi , Goldberg Sophia , Achar Sooraj , Schneider Dina , Shahani Shilpa A. , Little Lauren , Foley Toni , Molina John C. , Panch Sandhya , Mackall Crystal L. , Lee Daniel W. , Chien Christopher D. , Pouzolles Marie , Ahlman Mark , Yuan Constance M. , Wang Hao-Wei , Wang Yanyu , Inglefield Jon , Toledo-Tamula Mary Anne , Martin Staci , Highfill Steven L. , Altan-Bonnet Gregoire , Stroncek David , Fry Terry J. , Taylor Naomi , Shah Nirali N.
Published: May 2022

Remission durability following single-antigen targeted chimeric antigen receptor (CAR) T-cells is limited by antigen modulation, which may be overcome with combinatorial targeting. Building upon our experiences targeting CD19 and CD22 in B-cell acute lymphoblastic leukemia (B-ALL), we report on our phase 1 dose-escalation study of a novel murine stem cell virus (MSCV)-CD19/CD22-4-1BB bivalent CAR T-cell (CD19.22.BBζ) for children and young adults (CAYA) with B-cell malignancies. Primary objectives included toxicity and dose finding. Secondary objectives included response rates and relapse-free survival (RFS). Biologic correlatives included laboratory investigations, CAR T-cell expansion and cytokine profiling. Twenty patients, ages 5.4 to 34.6 years, with B-ALL received CD19.22.BBζ. The complete response (CR) rate was 60% (12 of 20) in the full cohort and 71.4% (10 of 14) in CAR-naïve patients. Ten (50%) developed cytokine release syndrome (CRS), with 3 (15%) having ≥ grade 3 CRS and only 1 experiencing neurotoxicity (grade 3). The 6- and 12-month RFS in those achieving CR was 80.8% (95% confidence interval [CI]: 42.4%-94.9%) and 57.7% (95% CI: 22.1%-81.9%), respectively. Limited CAR T-cell expansion and persistence of MSCV-CD19.22.BBζ compared with EF1α-CD22.BBζ prompted laboratory investigations comparing EF1α vs MSCV promoters, which did not reveal major differences. Limited CD22 targeting with CD19.22.BBζ, as evaluated by ex vivo cytokine secretion and leukemia eradication in humanized mice, led to development of a novel bicistronic CD19.28ζ/CD22.BBζ construct with enhanced cytokine production against CD22. With demonstrated safety and efficacy of CD19.22.BBζ in a heavily pretreated CAYA B-ALL cohort, further optimization of combinatorial antigen targeting serves to overcome identified limitations (www.clinicaltrials.gov #NCT03448393).
Impact of MRD status in patients with AML undergoing allogeneic stem cell transplantation in the first vs the second remission
Authors: Jentzsch Madlen , Bischof Lara , Backhaus Donata , Brauer Dominic , Schulz Julia , Franke Georg-Nikolaus , Vucinic Vladan , Niederwieser Dietger , Platzbecker Uwe , Schwind Sebastian
Published: May 2022

Allogeneic hematopoietic stem cell transplantation (HSCT) offers the best chance for relapse-free survival to most patients with acute myeloid leukemia (AML). It may be performed during complete remission or delayed until after the first relapse because of relevant treatment-related morbidity and mortality. The measurable residual disease (MRD) status at HSCT adds refined prognostic information to the assigned European LeukemiaNet (ELN) 2017 genetic risk at diagnosis. We analyzed 580 patients with AML who underwent allogeneic HSCT during either the first (79%) or second (21%) remission. Although, because of common treatment strategies, some adverse risk characteristics, such as monosomal or complex karyotypes, were less frequent in patients who underwent transplant in the second remission, those patients had worse outcomes compared with patients who had transplant in the first remission. The MRD status at HSCT was an independent prognostic factor, irrespective of the number of remissions at HSCT. Notably, patients who were MRD+ who underwent HSCT in the first remission and those who were MRD− and underwent transplant in the second remission had similar outcomes. In the clinically highly relevant group of individuals who had ELN2017 intermediate risk, the MRD status provided the highest prognostic value with very dismal outcomes for patients who were MRD+ and underwent second-remission transplants. The adverse outcomes of patients who are MRD+ and of those who undergo transplant in the second remission should be considered when planning consolidation treatment, to avert an allogeneic HSCT in MRD+ second remission when possible.