bluuebunny/crossref_metadata_2025 huggingface dataset:
Using relative-speed-of-processing to explain the shielding function of task rules
Authors: Huang Liang , Li Bingxin , Yan Panjie , Xu Chen , Tian Xueyin , Han Chengyang , Li Xiangqian
Published: December 2021

In choice reaction tests, applying task rules instead of responding associatively can help participants shield against interference from distractors. However, the mechanism of such shielding functions remains unclear. Through four experiments, we show how the shielding function can be explained by the relative-speed-of-processing theory. Experiment 1A demonstrated that applying task rules can reduce the relative processing advantage of the distractor by facilitating the target processing speed, thereby eliminating the interference effect. In Experiment 1B and 1C, we manipulated the relative processing advantage between targets and distractors by adjusting the temporal sequence of the presence of the targets and distractors: stimuli appearing first would gain more relative processing advantage. The results showed that when the relative processing advantage of a distractor was large enough, applying task rules cannot help participants shield against the interference. Contrarily, when the relative processing advantage of the distractor was small, even without applying task rules, participants did not experience the interference. In Experiment 2, we directly manipulated the processing speed of the targets and the distractor, so that participants who responded associatively would facilitate target processing speed, but participants who applied task rules would not. Contrary to previous studies but in line with our prediction, in Experiment 2, only participants who applied task rules had interference effects. Our results suggested that applying the task rule might not help shield against the interference directly. Instead, applying task rules improves target processing speed, which in turn reduces the relative processing advantage of the distractor and eliminates the interference.
Operational reliability and quality loss of diversely configurated manufacturing cells with heterogeneous feedstocks
Authors: Ye Zhenggeng , Cai Zhiqiang , Si Shubin , Zhou Fuli
Published: December 2021

Machine reliability in cellular manufacturing is a challenging engineering problem in the formation and design of manufacturing cells. The heterogeneity of feedstock quality is also common in manufacturing industry. However, so far, no work has been done to investigate the performance of diversely configurated manufacturing cells under the heterogeneous feedstocks. In this paper, considering the actual engineering condition, the uniformly random arrival and the clustered arrival of low-quality feedstocks are proposed and modeled by the homogeneous Poisson process and Hawkes process, respectively. Also, to study the mixed reliability of a machine under the impact of heterogeneous feedstocks, a mixed failure-rate model is constructed by the mixture of exponential and Weibull distributions, and the processing quality is modeled by a non-homogeneous Poisson process with a dynamic intensity function. Then, we achieve a contrastive analysis for operational reliability and quality loss of manufacturing cells with basic serial and parallel configurations under the impact of heterogeneous feedstocks. At last, the designed simulation illustrates the effectiveness of our proposed models, and some results are concluded to provide some guidelines for the design of manufacturing cells.
Analysis of the correlation between key gene mutations and breast cancer
Authors: Shen Ziyuan , Zhu Dongyue , Gu Yunjing , Zhu Ping
Published: December 2021

The purpose of this study is to investigate whether mutations in key genes affect the prognosis of breast cancer patients, and base mutations is discussed by combining the physical properties of the electron–ion interaction pseudopotential. We study 994 breast cancer mutation samples, including 15,015 mutation genes, and use social network algorithm to screen key genes. In order to analyze the relationship between electron–ion interaction pseudopotential and mutation of key genes, this paper proposes the [Formula: see text] difference formula. It not only analyses gene mutation at the physical level, but also explains the mutation rule of single base. Simultaneously, we use the Kaplan–Meier to analyze the overall survival rate of breast cancer samples and use Tarone-Ware to test. The results showed that mutations in GATA3, PIK3CA, and TP53 are significant difference in overall survival rate of breast cancer ([Formula: see text], [Formula: see text]). Proteins often interact to form protein complexes, and driving protein function. Therefore, by constructing protein–protein interaction network and finding modular proteins of key genes, we can find genes closely related to key genes. Finally, the results of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and gene ontology function enrichment analysis show that key genes played an important role in metabolic pathways and biological functions. In clinical medicine, screening for key gene mutations may help predict survival in breast cancer patients.
Economic security & the regulation of gig work in California: From AB5 to Proposition 22
Authors: Dubal Veena B.
Published: December 2021

Employment is the primary legal and political means to address economic inequality in the United States. With the evisceration of the welfare state, employment is also key to democratic outcomes. Despite this, self-employed work deployed by labour platforms like Uber has grown in recent years. What can we learn from worker demands and recent regulatory attempts to clarify and extend who is covered by employment protections? Based on a decade of legal and ethnographic research in the state of California, I situate the legal and regulatory history of labour platform work in the context of platform workers’ experiences and responses to the insecurities and poverty promulgated by their putative status as independent contractors. In highlighting this history, I argue that self-organised labour platform workers were critical to the passage of a state law (AB5) that would have forced companies to treat them as employees—with access to predictable living wages, unemployment insurance, workers’ compensation, and health insurance, among other safety net protections. Finally, I show how, leveraging tremendous structural and instrumental power, the major labour platform companies, in the middle of the global Coronavirus pandemic, sponsored a successful referendum on AB5, and lay out the anti-democratic implications of the referendum's passage.
The role of motivation in the digital divide: The moderating effect of device access
Authors: Wang Lian , Liu Chun
Published: December 2021

Socioeconomic status and demographic determinants are the most commonly examined factors in the study of the second-order digital divide regarding the differences associated with Internet use. The role of motivation in digital inequalities is comparatively less studied. We examine motivation and access variables in this paper. Statistical analysis based on a representative survey conducted in China indicates that motivation is a salient predictor of Internet use when other factors are controlled. In addition, device access significantly moderates the association between motivation and certain types of Internet use. While mobile-only users show the same, if not stronger, motivation for using the Internet for the purposes of study, entertainment, and e-commerce, they actually use those functions to a lesser extent than multimodal users. Hence, the digital divide is a multifaceted issue that requires a comprehensive solution.
Elderly care in Nepal: Are existing health and community support systems enough
Authors: Shrestha Sharad , Aro Arja R , Shrestha Bipna , Thapa Subash
Published: December 2021

In Nepal, a few governmental and community-based programmes for elderly care are in place; however, information about successful implementation and overall effectiveness of these programmes is not well understood. In this article, we introduced these programmes and discussed existing programmes’ gaps and implementation problems in light of existing grey and peer-reviewed evidence. A few notable governmental programmes, such as providing monthly allowances, pensions and free health care, have targeted specifically the elderly individuals. Yet, most health care institutions and providers are privately owned and profit-oriented, and there is a general lack of proper governmental health as well as social security systems for the elderly in the country. Generally, Nepalese communities consist of neighbourhood-based and religious-based groups that provide emotional and spiritual support to elderly individuals as well as provide support for health care access when needed. However, the influence that these groups can have on health and social well-being of elderly remains not well understood. Traditional family-based support systems may be feasible only for some families, while for others it could impose financial and psychological burdens. The role of the state is important in the effective implementation of existing programmes as well as in the development and implementation of additional programmes to ensure health and social well-being of elderly individuals. Furthermore, there is a need to establish partnerships with existing community structures and to mobilize them in the implementation of community-based programmes.
How Race and Gender Impact the Perceived Objectivity of Broadcast Women of Color on Twitter
Authors: Boling Kelli S. , Walker Denetra
Published: December 2021

Using an online survey ( N = 528), this study examines the impact of race/ethnicity and gender on the perceived objectivity of broadcasters who are women of color. Findings show that when the broadcaster is a woman of color, Twitter engagement does not necessarily lead to positive perceived objectivity. Most respondents (52.6%) following broadcasters on Twitter agreed that broadcast women of color were more biased than other broadcasters they follow on Twitter, with men being more likely to agree than others. In addition to perceived objectivity, 38.7% of respondents either agree or strongly agree that the race/ethnicity of the journalist impacts their objectivity. Of the respondents who follow broadcast women of color on Twitter, 57.4% either agree or strongly agree that they share too many opinions. Practical and theoretical implications are discussed.
Systemic Gendering in Facebook Group Participation
Authors: Kim Jiyoung Ydun , Fusaroli Riccardo , Park Han Woo , Bechmann Anja
Published: December 2021

Communication is increasingly taking place in Facebook Groups around the world. Yet, we have little scientific knowledge of Facebook Groups at scale, especially the extent to which general systemic gendering is a pattern in participation in such groups. This knowledge deficit is problematic for digitalized and data-driven democratic societies. Therefore, this article aims to investigate gender differences in open, closed, and secret Facebook Groups. The study relies on a unique large-scale Facebook Group dataset from a sample that reflects the gender of Facebook users and the Facebook Groups they belong to in both Denmark and South Korea. By applying Bayesian models and developing a notion of participation that consists of both structural and actual participation, the study finds that the relation between country, gender, and participation is strongly modulated by gender differences. Females are more engaged than males in Denmark, while the opposite is true for South Korea. In both countries, privacy affects females’ participation more than males’. This article contributes to the field by presenting new large-scale findings that explore gender differences on three levels of Facebook Group privacy settings (open, closed, and secret) in a hitherto understudied communication space and, by doing so, it highlights the importance of privacy and country in predicting systemic gendering.
New media and political protest: Framing analysis of news content on Twitter
Authors: Ashfaq Muhammad , Shahid Noor-ul-Ain , Zubair Javairia
Published: December 2021

This article examines the frames used by Pakistani news media while covering a political protest in 2019 on Twitter. The study deploys quantitative content analysis based on thematic framing, episodic framing, genre, types and subject matter of tweets. In recent years, there has been growing recognition of the use of Twitter in political and protest communication. Twitter is a platform with the potential to manage and coordinate protest activities and movements effectively. The current study is carried out to demonstrate the importance of one of the aspects of political protest communication. Tweets (N = 498) posted between 20 October and 20 November 2019 by three mainstream Pakistani media organizations ( Dawn, The News, Express Tribune) were collected and analysed. Results show that straight news was used more in episodic frames by the media organizations on Twitter. Results of the study add to the increasing body of studies showing that media outlets have also embraced modern media to use frames while covering political issues.
Exploring the Utility of the Emerging Adulthood Theory Among Military Members and Veterans with Risky Substance Use
Authors: Clary Kelly Lynn , Lavi Topaz , Smith Douglas C. , Saban Jessica
Published: December 2021

Emerging adult (EA; aged 18–29) military members experience major career, life, and developmental transitions. The conglomeration of these changes may influence or exacerbate anxiety or stress, produce challenges, and lead to negative coping mechanisms, such as substance use. This study sought to understand the utility of the five Emerging Adulthood Theory (EAT) dimensions among a sample of military members and veterans with risky substance use. To our knowledge, the applicability of EAT has not been explored with United States military populations. During 2019, we completed 24 semi-structured interviews. On average, participants were 24.9 years old, male, white, and in the United States Marine Corps. We asked about experiences transitioning into adulthood, military culture, and experiences of the five EAT dimensions. Three coders employed rigorous theory-driven thematic analysis procedures to piece together themes. We report EA military members’ experiences with the EAT dimensions, focusing on nuances related to the influence of military culture.
Competing Landed Interests: Customary Claims, Land Titles and Formal Law in Manipur, Circa 1890–1990
Authors: Haokip Lalsanglen
Published: December 2021

This article provides a long-term perspective on the history of land tenure for over a century in the colonial and post-colonial eras of Manipur, India. Modernisation theory assumes too rigid division between traditional and modern attributes of land laws. The article, however, endorses the view that ‘the Anglo-Indian legal system was distinctly Janus-faced and rested on two contradictory principles’ of public law and personal law (D. A. Washbrook, Modern Asian Studies 15, no. 3 [1981]: 653). The flagship land legislation of Manipur (MLR & LR Act 1960) has been framed within the hill–valley framework. But the hill–valley binary of this public law provided too rigid mechanism to understand the history of legal formalisation. In theory, statutory (public) laws in land apply to only the valley areas of Manipur and customary (personal) law applies to the hill areas. But in practice, there exist different degrees of legal formality.
Predictive models for cochlear implant outcomes: Performance, generalizability, and the impact of cohort size
Authors: Shafieibavani Elaheh , Goudey Benjamin , Kiral Isabell , Zhong Peter , Jimeno-Yepes Antonio , Swan Annalisa , Gambhir Manoj , Buechner Andreas , Kludt Eugen , Eikelboom Robert H. , Sucher Cathy , Gifford Rene H. , Rottier Riaan , Plant Kerrie , Anjomshoa Hamideh
Published: December 2021

While cochlear implants have helped hundreds of thousands of individuals, it remains difficult to predict the extent to which an individual’s hearing will benefit from implantation. Several publications indicate that machine learning may improve predictive accuracy of cochlear implant outcomes compared to classical statistical methods. However, existing studies are limited in terms of model validation and evaluating factors like sample size on predictive performance. We conduct a thorough examination of machine learning approaches to predict word recognition scores (WRS) measured approximately 12 months after implantation in adults with post-lingual hearing loss. This is the largest retrospective study of cochlear implant outcomes to date, evaluating 2,489 cochlear implant recipients from three clinics. We demonstrate that while machine learning models significantly outperform linear models in prediction of WRS, their overall accuracy remains limited (mean absolute error: 17.9-21.8). The models are robust across clinical cohorts, with predictive error increasing by at most 16% when evaluated on a clinic excluded from the training set. We show that predictive improvement is unlikely to be improved by increasing sample size alone, with doubling of sample size estimated to only increasing performance by 3% on the combined dataset. Finally, we demonstrate how the current models could support clinical decision making, highlighting that subsets of individuals can be identified that have a 94% chance of improving WRS by at least 10% points after implantation, which is likely to be clinically meaningful. We discuss several implications of this analysis, focusing on the need to improve and standardize data collection.
Exploring Predictors of eHealth Literacy Among Older Adults: Findings From the 2020 CALSPEAKS Survey
Authors: Berkowsky Ronald W.
Published: December 2021

With the Internet continuously being used as a means of providing health education and promotion to the public, consumers are increasingly going online to gather pertinent health information. However, disparities exist with regards to consumers’ ability in finding, evaluating, and applying online health information (collectively referred to as eHealth literacy). Identifying these disparities may elucidate which segments of the population would benefit from targeted eHealth literacy interventions and ways to adapt online health promotion materials. This study uses data from the 2020 CALSPEAKS survey to identify disparities in eHealth literacy among older adults aged 65+ residing in California, USA ( N = 237). eHealth literacy is self-assessed using the previously validated 8-item eHEALS questionnaire. Ordinary least squares regression analyses are performed on individual eHEALS items and on a summed eHealth literacy score, with demographic and technology use-related characteristics as predictors. Results show that the strongest and most consistent predictors of eHealth literacy include education, frequency of Internet use, and breadth of Internet activities regularly performed. Findings suggest that those seeking to increase eHealth literacy specifically among older Californians may benefit from tailoring their interventions and online health promotion materials towards those with less education and those with less Internet experience.
Doctoral Students as Agents for Change: Shaping Our Public Health Training Environment
Authors: McSorley Anna-Michelle M. , Manalo-Pedro Erin , Bacong Adrian Matias
Published: December 2021

This reflective article describes how we, a trio of doctoral students, applied critical pedagogical approaches to identify gaps in our public health training, reflect on the value of our lived experiences and ancestral histories, and take action toward advancing change within our School of Public Health. Additionally, we argue that our future effectiveness in leading systemic change toward health justice requires our public health training institutions to deliver course content that addresses racism and other systemic forms of oppression, largely responsible for reproducing health inequities. We also reflect upon how our efforts to find spaces in which to critically engage with content related to social and structural determinants of health transformed into a collaborative learning opportunity that has served to strengthen our skills as public health researchers, advocates, and future educators. We conclude by calling upon our schools of public health to take the lead in preparing the public health workforce of tomorrow for the challenges of addressing systemic causes of health inequities. Our goal is to share our experiences so that graduate students across public health training institutions may look to this piece as a concrete example of how we can shape our schools of public health to meet our needs.
Scientific Racism Attitudes Among Diverse Undergraduate Pre–Health Professions Students
Authors: Chowdhury Karina , Madden Erin Fanning
Published: December 2021

Scientific racism, or the belief that racial hierarchies are explained by biological differences, among health care professionals may contribute to the oversight of social causes of health problems and result in poor quality of care. This study examines the extent to which scientific racism may permeate undergraduate pre–health professions student worldviews before entering advanced training. Undergraduate students ( n = 251) pursuing training in health professions from The University of Texas at San Antonio completed a survey in 2018 measuring respondent level of agreement with statements about biological differences between U.S. racial and ethnic groups, as well as agreement with statements about cognitive differences, health behaviors, and systemic racism. Analyses showed that the students agreed with false statements regarding biological, behavioral, and cognitive differences among races and agreement was significantly stronger among students at earlier stages of education but did not differ by student race/ethnicity. Adjusted analyses showed that third- and fourth-year undergraduate students exhibited less agreement with false statements about race than first- and second-year students ([Formula: see text] 95% CI [−18.33, −3.39], p < .00). The joint effect of higher class level and public health major ([Formula: see text] 95% CI [−11.98, −1.16], p = .02) was also significantly associated with less agreement with false statements regarding systemic racism. This exploratory study suggests that even among diverse student populations, scientific racism persists but may improve over educational careers. Future research may determine how structural reforms and training can further improve student understandings of race as a social construct and not a biological reality.
Usefulness of a Health Education and Promotion Book Club to Teach About Race and Social Justice
Authors: Rich Rebecca
Published: December 2021

Emphasizing the value of utilizing both facts and stories to teach and learn about health, race, and social justice, this reflection makes a case for using The Immortal Life of Henrietta Lacks and Well: What We Need to Talk About When We Talk About Health to create a dialogue with undergraduate health education students. The unique combination of facts and stories that the two books provide sparked conversations from which both my students and I were grateful to learn.
Developing Equity-Focused Education in Academic Public Health: A Multiple-Step Model
Authors: Perez Julianna , Leonard William R. , Bishop Virginia , Neubauer Leah C.
Published: December 2021

Education and training support public health practitioners in identifying and addressing challenges related to equitable health concerns. This article details a four-step Curricular Responsive Review Model (CRRM) generated by educators in a Council on Education for Public Health–accredited public health program to systematically understand and gather feedback on how to develop a responsive curriculum for their students. A review of all course syllabi was conducted by two faculty members and a doctoral student to identify curricular gaps and overlap. These findings, critical team dialogues, and a review of the literature informed the development of a survey to identify the health equity concepts and skills needed by MPH students. Community partners ( n = 4) responded to health equity education questions to detail the essential concepts and skills needed to teach students. Health equity educators (HEEs; n = 4) were then consulted on how to address knowledge gaps through pedagogy and educational resources. Community partners provided a list of areas that students should be educated in to enrich their health equity understandings. Recommendations were generated for integrating those concepts/skills into course teaching plans. The four-step CRRM in health equity education provides an opportunity for public health programs to engage in systematic mapping and critically reflective review processes to address curricular gaps and overlap. Mechanisms to receive real-world knowledge on health equity from a variety of stakeholders are essential to ensure real-word practical learning. The CRRM identifies systematic, responsive curricular mapping and review in public health as essential for meaningful, real-world equity education in disciplines beyond public health and health promotion.
Countering Hesitancy and Misinformation on Side Effects to Complete the Course of COVID Vaccination
Authors: Dasgupta Nabarun
Published: December 2021

It has been well-documented that concerns about side effects prevent many from soliciting immunization. And family medicine providers play a key role in addressing concerns about COVID vaccines. However, there are few documented examples of the decision-making process regarding second shots after the emergence of a concerning and previously unknown side effect. Therefore, we present a case where a primary care provider and patient worked together to analyze real-time adverse event data on post-vaccination shingles to decide whether to receive the second dose.
Foreign Language Curricula and the Influence of Immigrant-Origin Groups
Authors: Diaz Christina J.
Published: December 2021

Despite theoretical claims that assimilation is a multidirectional process, most studies assess the behaviors of immigrants and their children. The author departs from this tradition to ask whether immigrant-origin populations influence the availability of Advanced Placement Spanish and Chinese/Japanese language courses. Building on past work, the author treats foreign language programs as a marker of institutional change and a greater acceptance of immigrant culture. County-level data are pooled from the American Community Survey, the Common Core of Data, the Voting and Elections Collection (CQ Press), and the College Board between 2000 and 2017. The results indicate that Hispanic and Chinese/Japanese populations exert an influence on school curricula, but this relation varies depending on historical patterns of immigrant settlement. The author also finds that Spanish and Asian foreign language programs are most likely to be demanded in locations with highly educated populations. This article provides evidence that mainstream institutions can move toward immigrant and minority culture.
The Emergence of Circular Economy in Integrated Agriculture-Livestock Livelihoods
Authors: Dhaske Govind , Dhaske Anamika , Shah Nirali , Gore Navnath
Published: December 2021

Circularization has been viewed as a core strategic instrument for achieving sustainable development. Along the same lines, applying circularization in an integrated rural livestock development project is essential considering the importance of biomass in the circular economy. However, the geoecological variations, community motivations for sustainability, availability of appropriate technology, and dynamics associated with the livestock product markets outline challenges for the circular economy in biomass-rich rural India. An impact assessment survey of an integrated rural livestock development project revealed an early stage emergence of the circular economy. The survey charted the important role of blended traditional and modern practices in livestock keeping along with biomass management through appropriate technologies conjoined with green value chain-based enterprises for monetizable incentivization. The impact assessment highlighted challenges such as affordability of modern technology, improper microenterprise management, and consumer awareness, which implied policy-based interventions for adequate circularization to ensure sustainable biomass, and allied livelihoods.
A case of immune-complex mediated glomerulonephritis associated with pembrolizumab
Authors: Bonilla Marco , Bijol Vanesa , Corona Antonio Gabriel De Leon , Sullivan Kevin M. , Jhaveri Kenar D.
Published: December 2021

Introduction:

Immune checkpoint inhibitors (ICI) are changing the way we treat cancer. However, these novel agents have various systemic adverse events that may preclude its use and cause poor patient outcomes. ICI-associated acute kidney injury is an emerging complication of this treatment. While tubulointerstitial disease is the most common pathologic finding of patients with ICI-associated AKI, there is sparse data in medical literature describing its association with glomerular disease.

Case report:

Here, we present a patient with metastatic lung adenocarcinoma who developed acute kidney injury and significant proteinuria after receiving pembrolizumab. The kidney biopsy revealed a membranoproliferative and diffuse segmental endocapillary proliferative pattern of glomerular injury.

Management and outcome:

Pembrolizumab was then held and high-dose prednisone was initiated, resulting in a rapid and dramatic improvement in kidney function and proteinuria.

Discussion:

We highlight a report of a patient diagnosed with immune-complex mediated glomerulonephritis associated with the use of pembrolizumab, who was successfully treated with drug withdrawal and corticosteroids.
Brolucizumab for persistent macular fluid in neovascular age-related macular degeneration after prior anti-VEGF treatments
Authors: Hussain Rehan M. , Neal Andrea , Yannuzzi Nicolas A. , Patel Kevin H. , Huo Siya , Hariprasad Seenu M. , Bhatia Sumit P.
Published: December 2021

Background:

Some patients with neovascular age-related macular degeneration (nAMD) have persistent intraretinal/subretinal fluid (IRF/SRF) despite being treated with anti-VEGF agents. There is limited data on efficacy of switching to intravitreal brolucizumab (IVBr) in these patients.

Purpose:

To determine anatomic and visual outcomes of eyes with nAMD treated with for persistent IRF/SRF.

Methods:

Retrospective series of eyes with nAMD treated initially with aflibercept (IVA, n = 48) and bevacizumab (IVBe, n = 10), then switched to IVBr for persistent IRF/SRF.

Results:

In the IVA-IVBr group, a mean of 42 days after one IVBr, mean logMAR changed from 0.50 to 0.49 ( p = 0.73) and mean CSFT changed from 340 to 305 µm ( p < 0.001); 31% of eyes had no fluid, 42% had persistent but reduced fluid, 25% had stable fluid, and 2% had increased fluid. For a subgroup of 25 eyes that completed a series of 3 IVBr, mean logMAR changed from 0.44 to 0.40 ( p = 0.35) and mean CSFT changed from 325 to 277 µm ( p = 0.001); 24% of eyes had no fluid at last follow-up, a mean of 54 days after last IVBr. In the IVBe-IVBr group, a mean of 44 days after one IVBr, mean logMAR changed from 0.46 to 0.40 ( p = 0.114) and mean CSFT from 401 to 325 µm ( p = 0.009); 30% of eyes had no fluid and 70% had persistent but reduced fluid. For a subgroup of four eyes that completed a series of three IVBr, mean logMAR changed from 0.33 to 0.35 ( p = 0.391) and mean CSFT improved from 375 to 275 µm ( p = 0.001); 50% of eyes had no fluid at last follow-up, a mean of 65 days after last IVBr.

Conclusion:

In nAMD eyes previously treated with IVA and IVBe, switching to IVBr significantly reduced persistent IRF/SRF but did not significantly affect visual outcomes.
Consequences of Growth at Freedom AV Life Insurance
Authors: Pareek Manoj
Published: December 2021

The case deals with ethical issues in marketing in a larger context encountered while managing channels. Freedom AV Life Insurance, established in 2002, was a laggard in terms of revenue generation among private life insurers in the country. A new CEO, Ramesh Ramachandran, was hired to improve revenues, which drastically improved post his joining and upon on him hiring a new sales head. However, customer grievances multiplied, and Rajesh Bhardwaj, the customer services head, was questioned by the CEO and was asked to submit an action plan to stem the rising complaints. Bhardwaj felt this was the result of mis-selling by agents and the salesforce of the company. Bhardwaj proposed a solution by emailing the sales head. Just as he had finished writing the mail, he was surprised to find a new mail from the CEO asking him to prepare a presentation before the company’s board of directors in two days. At the end of the case, Bhardwaj becomes engulfed with self-doubt and anxiety on what to present before the board members. The case deals with ethical issues in marketing financial products like life insurance and looks at solutions to the practice of mis-selling financial services. Students would attempt to find answers to the question of whether they can achieve sales goals without resorting to unethical practices.
Using Test Positivity Rate (TPR) as an Indicator for Strategic Action in COVID-19: A Situational Analysis in Kerala, India
Authors: Vaman Raman Swathy , Valamparampil Mathew J. , Augustine Anu Elizabeth
Published: December 2021

Administrators and policymakers have relied on test positivity rate (TPR) for making policy decisions regarding local, regional, and national lockdowns. It has the advantage of easily available data with an easy technique for calculation on day-to-day basis. However, concerns are being raised regarding its use as a sole indicator for determining movement restrictions and lockdowns. The present review provides a perspective of the alterations in TPR in Kasaragod district of Kerala during the first half of 2021. The variations in the number of antigen and reverse transcription polymerase chain reaction (rt-PCR) tests along with the trend of proportion of rt-PCR test are depicted. In places like Kerala where primary care system and contact tracing is comparatively robust than several other regions, testing the appropriate persons in a timely fashion alone is sufficient to cause an upswing in the TPR. Rather than daily change, the overall change in a larger time frame of 1 to 2 weeks could give early warning regarding the emergence of a new wave. TPR alone may not be able to reflect the transmission patterns of COVID-19. Using 7-day median value of TPR along with weekly tests done per 10,000 population, 7-day rolling average of active cases per 10,000 population, or daily number of new positive cases per 10,000 population could bring out a more composite indicator. Such an indicator reflecting the disease dynamics at regional levels will enable people to improve their livelihood without compromising on COVID-19.
Extranodal Non-Hodgkin Lymphoma: A Rare Presentation Involving the Pancreas
Authors: Cerwin Savannah
Published: December 2021

Non-Hodgkin lymphoma (NHL) is a cancer of the immune system, and accounts for 90% of all lymphomas. When lymphoma is discovered outside of the immune system, it is considered extranodal lymphoma. Any organ can be the primary site of NHL, with the gastrointestinal tract being the most common site of involvement. This case study explores the sonographic discovery of an uncommon presentation of NHL with an extranodal mass originating from the pancreatic body and tail, and further extending into the splenic hilum.
A Comparison of Different Thyroid Imaging Reporting and Data Systems to Reduce Unnecessary FNAs and Missed Malignancies
Authors: Seif Ehsan , Qorbani Mostafa , Mousavi Shaghayegh , Salahshoor Ali
Published: December 2021

Objective:

The Thyroid Imaging Reporting and Data System (TIRADS) has been proposed to reduce the number of unnecessary fine needle aspirations (FNA) from thyroid nodules.

Materials and Methods:

An individual radiologist provided sonographic examinations and FNA on a collection of 188 thyroid nodules. The recommendations based on the TIRADS system, for each nodule, was determined and evaluated against the cytology results.

Results:

The American College of Radiology (ACR), artificial intelligence (AI), European (EU), and Korean (K) scoring systems reduced FNAs by 53%, 56%, 48%, and 28%, respectively. Among those lesions without a recommendation for immediate FNA, The ACR would have missed four malignant nodules, the AI would have missed four malignant nodules, and K TIRADS would have missed three malignant nodules but with a recommended follow-up imaging. The ACR would have missed three malignant nodules, the AI would have missed four malignant nodules, and EU TIRADS would have missed four malignant nodules, without a recommended follow-up examination. The highest and lowest kappa interrelated agreements were between ACR and AI (0.902) and AI and K (0.448).

Conclusion:

The ACR and AI TIRADS could substantially decrease the number of FNAs but rely on follow-up imaging. The EU TIRADS reduced the number of FNAs, the least however this system had less dependence on follow-up imaging. The K TIRADS was the most conservative method and the least dependent on follow-up diagnostics.
Case Series: Superficial Sonography in Urgent Care
Authors: Nanni Garth S. , Cofsky Samantha
Published: December 2021

Sonography is an essential imaging modality, known for its real-time capabilities, relative low cost, and multiple diagnostic applications. Although there are protocols which are well-established for specific examinations, there are not clear guidelines for sonographic examinations of soft tissues. Many sonographers have to establish their own imaging protocols when completing a soft tissue examination. This case series details five soft tissue examinations that represent just a few of the clinical requests generated in an Urgent Care (UC) facility. Since UC usage has increased over the past several years, it appears likely that any sonographer working in such outpatient settings will benefit from as much exposure to soft tissue examinations as possible.
How Power Influences Behavior in Projects: A Theory of Planned Behavior Perspective
Authors: Wynn Conor , Smith Liam , Killen Catherine
Published: December 2021

While the effect of power on organizations has been well researched, how power influences behavior in projects is less well understood. Taking a case-study approach and using the Theory of Planned Behavior (TPB), we traced the thoughts of project managers subject to power, particularly those who resisted. We discovered that power bore down on project managers through new injunctive norms, encouraging them either not to resist or eventually to compromise and yield to new norms that changed their experiential attitudes. The TPB brings a new perspective to project management research, illustrating how power affected project managers’ behavior and influenced project outcomes.
Rab31-dependent regulation of transforming growth factor ß expression in breast cancer cells
Authors: Soelch Susanne , Beaufort Nathalie , Loessner Daniela , Kotzsch Matthias , Reuning Ute , Luther Thomas , Kirchner Thomas , Magdolen Viktor
Published: December 2021

Background

The small GTP-binding protein Rab31 plays an important role in the modulation of tumor biological-relevant processes, including cell proliferation, adhesion, and invasion. As an underlying mechanism, Rab31 is presumed to act as a molecular switch between a more proliferative and an invasive phenotype. This prompted us to analyze whether Rab31 overexpression in breast cancer cells affects expression of genes involved in epithelial-to-mesenchymal transition (EMT)-like processes when compared to Rab31 low-expressing cells.

Methods

Commercially available profiler PCR arrays were applied to search for differentially expressed genes in Rab31 high- and low-expressing CAMA-1 breast cancer cells. Differential expression of selected candidate genes in response to Rab31 overexpression in CAMA-1 cells was validated by independent qPCR and protein assays.

Results

Gene expression profiling of key genes involved in EMT, or its reciprocal process MET, identified 9 genes being significantly up- or down-regulated in Rab31 overexpressing CAMA-1 cells, with the strongest effects seen for TGFB1, encoding TGF-ß1 (> 25-fold down-regulation in Rab31 overexpressing cells). Subsequent validation analyses by qPCR revealed a strong down-regulation of TGFB1 mRNA levels in response to increased Rab31 expression not only in CAMA-1 cells, but also in another breast cancer cell line, MDA-MB-231. Using ELISA and Western blot analysis, a considerable reduction of both intracellular and secreted TGF-ß1 antigen levels was determined in Rab31 overexpressing cells compared to vector control cells. Furthermore, reduced TGF-ß activity was observed upon Rab31 overexpression in CAMA-1 cells using a sensitive TGF-ß bioassay. Finally, the relationship between Rab31 expression and the TGF-ß axis was analyzed by another profiler PCR array focusing on genes involved in TGF-ß signaling. We found 12 out of 84 mRNAs significantly reduced and 7 mRNAs significantly increased upon Rab31 overexpression.

Conclusions

Our results demonstrate that Rab31 is a potent modulator of the expression of TGF-ß and other components of the TGF-ß signaling pathway in breast cancer cells.
Incidence and prevalence of violence toward health care workers in emergency departments: a multicenter cross-sectional survey
Authors: Alshahrani Mohammed , Alfaisal Razan , Alshahrani Khalid , Alotaibi Leyan , Alghoraibi Hissah , Alghamdi Eman , Almusallam Lulwah , Saffarini Zaineh , Alessa Salihah , Alwayel Faten , Saffarini Lubna , Alrawdhan Ali , Mapusao Charlene , Asonto Laila Perlas , Alsulaibikh Amal , Aljumaan Mohammed
Published: December 2021

Background

Workplace violence and abuse in the emergency department (ED) has increasingly become a serious and alarming phenomenon worldwide where health care professionals are more prone to violence compared with other specialties.

Aims

We aimed to estimate prevalence, and types of work place violence made against health care workers (HCW) in emergency departments of Arabian Gulf area.

Methods

We performed a descriptive cross-sectional study at several emergency departments in Saudi Arabia and United Arab Emirates wherein a previously validated questionnaire was distributed among health care workers. The survey consisted of 22 questions that assessed respondent’s workplace violence and/or abuse encounters, protective measures, available work place policies, and actions implemented to detect and deal with violence and abuse against healthcare providers. Descriptive statistics was used and P value < 0.05 was considered significant for all statistical tests performed.

Results

Seven hundred HCW in eleven emergency departments agreed to participate in the survey. Four hundred ninety-two completed the questionnaire with a response rate of 70%. More than 90% of the respondents were in the 20–39 years old bracket with an approximately equal gender distribution. Then, 20.9% of the respondents stated that they were physically attacked and 32.3% were attacked with a weapon. Most of the respondents (75.6%) reported that they were verbally abused or bullied by patients or relatives of patients. Staff responses to emotional abuse varied among respondents with the most frequent response of “told the person to stop” (22%), followed by “took no action” (19%). Further, 83.3% of respondents stated that there was an existing policy and procedure guidelines for reporting work place violence while 30.1% reported that they had not used any of these measures.

Conclusion

Workplace violence among HCW in the emergency departments are common in the Gulf area and can be serious in as far as use of weapons. Staff awareness focus on this under reported issue, and staff training to recognize and report potential aggression can predict a significant reduction of incidents.
Feasibility and efficacy of text messaging to promote care among trauma patients screened for HIV at an urban emergency department in Tanzania
Authors: Hyuha Gimbo M. , Sawe Hendry R. , Kilindimo Said , Mussa Raya Y. , Gulamhussein Masuma A. , Rwegoshora Shamila S. , Shayo Frida , Mdundo Winnie , Mfinanga Juma A. , Weber Ellen J.
Published: December 2021

Background

Due to the high prevalence of human immunodeficiency virus (HIV) in Tanzania, provider-initiated HIV testing for patients attending any health care setting is recommended. However, follow-up and linkage to care by those tested remain poor. We determined the feasibility and efficacy of text messaging to promote follow-up among otherwise healthy trauma patients who underwent provider-initiated HIV testing and counseling at an emergency department (ED) in Tanzania.

Material and methods

This randomized controlled trial (RCT) was conducted at Muhimbili National Hospital (MNH) ED between September 2019 and February 2020. Adult trauma patients consenting to HIV testing and follow-up text messaging were randomized to standard care (pre-test and post-test counseling) or standard care plus a series of three short message service (SMS) text message reminders for follow-up in an HIV clinic, if positive, or for retesting, if negative. Investigators blinded to the study assignment called participants 2 months after the ED visit if HIV-positive or 4 months if HIV-negative. We compared the proportion of people in the intervention and control groups completing recommended follow-up. Secondary outcomes were the proportion of patients agreeing to testing, proportion of patients agreeing to receiving text messages, and the proportion of HIV-positive and HIV-negative patients in each study arm who followed up.

Results

Of the 290 patients approached, 255 (87.9%) opted-in for testing and agreed to receive a text message. The median age of the study population was 29 [IQR 24–40] years. There were 127 patients randomized to the intervention group and 128 to the control group. The automated SMS system verified that 381 text messages in total were successfully sent. We traced 242 (94.9%) participants: 124 (51.2%) in the intervention group and 18 (488%) in the control group. A total of 100 (39.2%) subjects reported completing a follow-up visit, of which 77 (60.6%) were from the intervention group and 23 (17.9%) were from the control group (RR = 3.4, 95% CI 2.3–5.0). This resulted in a number needed to treat (NNT) of 2.3. Of the 246 HIV-negative participants, 37% underwent repeat screening: 59% of those in the intervention group and 16% in the control group (RR = 3.7, P = < 0.0001, NNT 2.3). Among the nine positive patients, all five in the intervention group and only three in the controls had follow-up visits.

Conclusion

Automated text message is a feasible and effective way to increase follow-up in HIV-tested individuals in a limited income country.