bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Palliative Care Consults Reduce Patients’ Length of Stay and Overall Hospital Costs
Authors: Zaborowski Nancy , Scheu Amy , Glowacki Nicole , Lindell Mark , Battle-Miller Kimberly
Published: January 2022

Background: Palliative care improves health outcomes and satisfaction and supports decision-making for patients and families during challenging times in their lives. Earlier referral for consults has demonstrated increased costs savings.

Hypothesis: Education proposing physicians order a palliative care consult within 3 days of patient hospital admission will decrease patient length of stay (LOS) and overall costs as well as expedite the transition to next level of care.

Design/Method: A descriptive retrospective cohort study was completed using de-identified data originally captured for a system-wide initiative at a large acute care hospital in Illinois. Hospitalists were selected as the pilot group and received education encouraging physicians to order palliative care consults within 3 days of patient admission. Non-hospitalists (control group) did not receive the education. All results were compared to a 3-month baseline period.

Results: A total of 711 patients were included in this study (367 baseline, 138 pilot, 206 controls). The baseline pre-consult LOS of 4.8 days was reduced to 3.7 days in the pilot group, representing a > 1 day decrease in the timing of palliative consult. The pilot demonstrated a direct cost savings of 26% over the 3-months pilot period. Additionally, a 2-day reduction in overall LOS was demonstrated in the pilot group compared to both the baseline and control groups.

Conclusions: This pilot demonstrated an ability to change the timing of new palliative care consults, resulting in direct cost savings and LOS reduction. These results demonstrated the need for a larger study to confirm these findings.
Neuronal Circuits Associated with Fear Memory: Potential Therapeutic Targets for Posttraumatic Stress Disorder
Authors: Yan Yan , Aierken Ailikemu , Wang Chunjian , Jin Wei , Quan Zhenzhen , Wang Zhe , Qing Hong , Ni Junjun , Zhao Juan
Published: January 2022

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that is associated with long-lasting memories of traumatic experiences. Extinction and discrimination of fear memory have become therapeutic targets for PTSD. Newly developed optogenetics and advanced in vivo imaging techniques have provided unprecedented spatiotemporal tools to characterize the activity, connectivity, and functionality of specific cell types in complicated neuronal circuits. The use of such tools has offered mechanistic insights into the exquisite organization of the circuitry underlying the extinction and discrimination of fear memory. This review focuses on the acquisition of more detailed, comprehensive, and integrated neural circuits to understand how the brain regulates the extinction and discrimination of fear memory. A future challenge is to translate these researches into effective therapeutic treatment for PTSD from the perspective of precise regulation of the neural circuits associated with the extinction and discrimination of fear memories.
Effectiveness of Nursing Interventions for Patients With Cancer and their Family Members: A Systematic Review
Authors: Alfaro-Díaz Cristina , Svavarsdottir Erla Kolbrun , Esandi Nuria , Klinke Marianne E. , Canga-Armayor Ana
Published: January 2022

Cancer diagnosis poses enormous physical and psychosocial challenges for both the affected person and their families. This systematic review identifies the characteristics and effectiveness of nursing interventions offered to adult patients with cancer and their families. Five databases were searched, and 19 studies published from 2009 to 2020 were included. Interventions were categorized as follows: (a) interventions with supporting and cognitive components ( n = 3), (b) interventions that included skills training for the caregiver ( n = 3), (c) interventions to enhance care through managing symptoms ( n = 8), (d) interventions focusing on the dyad or family–patient relationship ( n = 4), and (e) interventions targeted to the patient’s condition ( n = 1). The results of this review offer an overview from which to carry out new studies and are useful for providing future directions within family nursing practice, taking into account the impact that the family has on the disease and the consequences the condition may bring to the whole family.
Implementation, utilization, and evaluation of a pharmacist-driven romiplostim dosing service for patients with immune thrombocytopenia at a multisite cancer centre
Authors: Moore Donald C. , Elmes Joseph B. , Gebru Tsion , Lavery Lesli A. , Pellegrino Annie , Plesca Dragos
Published: January 2022

Introduction

Romiplostim is a thrombopoietin receptor agonist approved for the treatment of patients with chronic immune thrombocytopenia who have had an insufficient response to corticosteroids, immune globulin, or splenectomy. Dose adjustments of romiplostim are based on platelet counts and follow a dosing schema that requires frequent monitoring. As a quality improvement initiative to increase clinical efficiency and promote clinical pharmacy services at our institution, we developed a collaborative practice agreement and implemented a novel pharmacist-driven romiplostim dosing protocol.

Methods

A retrospective chart review was conducted to evaluate the acceptance, utilization, and impact of the pharmacist-driven romiplostim dosing service. The primary outcome of our analysis was the adoption rate by providers of the romiplostim pharmacist dosing service. Secondary endpoints were focused on patients newly initiating romiplostim on the dosing service and included platelet responses and number of dose adjustments by a pharmacist

Results

A total of 54 patients received romiplostim in our analysis: 25 patients who had already been receiving romiplostim and 29 patients who newly initiated romiplostim during the study period. Of the 29 patients newly initiating romiplostim, 27 (93%) had their dosing managed by a pharmacist Twenty-one patients (84%) and 18 patients (75%) achieved an initial and durable response with romiplostim, respectively. Pharmacists made a median of 3 dose adjustments to romiplostim per patient.

Conclusion

The implementation of a pharmacist-driven romiplostim dosing service led to a significant adoption and utilization by physicians at our health system.
Desensitization to Brentuximab Vedotin after anaphylaxis in refractory Hodgkin's lymphoma
Authors: Villarreal-González Rosalaura V , González-Díaz Sandra N , Santos-Fernández Wendy J , Colunga-Pedraza Perla R , Varela-Constantino Ana Laura , Gómez-Almaguer David
Published: January 2022

Introduction

Brentuximab vedotin (BV) is a monoclonal antibody that targets CD30 antigen. It is indicated for the treatment of CD30 + lymphomas and classical Hodgkin lymphoma (HL), including advanced (stage III-IV) untreated disease, relapsed/refractory disease, and consolidation after autologous hematopoietic stem cell transplantation. In clinical trials the incidence of a hypersensitivity reaction is 1.2%.

Cases report

We present 3 cases of patients with refractory HL and anaphylaxis to the administration of BV ( Table 1 ). Symptoms are analyzed using a grading system described by Brown (2004) and a desensitization protocol was performed with a total dose of 100 mg of BV in 4 solution bags with an initial concentration of 1:1000 of total dose for cases of severe anaphylaxis, and desensitization of 3 solution bags with baseline concentration of 1: 100 for cases of moderate anaphylaxis.

Management & Outcome

Intradermal skin tests were positive. Before desensitization, premedication with methylprednisolone and chlorphenamine was administered, as well as fluid therapy with 0.9% physiological solution at 100 cc/hour at induction stage, 250 cc/hour at maintenance stage, and increased to 500 cc/hour in case of hypersensitivity reaction.

Discussion

Drug desensitization in 12 or 16 steps allows tolerable administration of brentuximab vedotin after moderate to severe anaphylaxis. The favorable response to treatment of these patients may indicate that desensitization is a viable strategy for patients with relapsed or refractory HL.
Correlation Between Retinopathy and Coronary Microcirculation Dysfunction in Patients with Type 2 Diabetes Mellitus
Authors: Wang Qian , Zhang Ziying , Chai Qian , Shan Yongyan , Lu Dexue , Chen Yangwen , Liu Meili , Wu Weihua
Published: January 2022

Purpose

The aim of this study is to evaluate the correlation between retinopathy and coronary microcirculation dysfunction (CMD) in type 2 diabetes mellitus (T2DM) patients.

Methods

198 T2DM patients with left ventricular ejection fraction (LVEF)>50%, no epicardial coronary artery stenosis diagnosis by coronary angiography (CAG) and successfully completed coronary blood flow reserve (CFR) test and laboratory examination were enrolled, and fundus examination was performed on all participants. Two groups were divided according to CFR value, including 86 patients with CMD (CFR≤2.5) in study group and 112 patients without CMD (CFR>2.5) in control group. The composition of various retinopathy in two groups was observed, and the correlation between retinopathy and CMD was analyzed using ordered logistic regression.

Results

There were 13 cases with arteriovenous (A/V) nicking, 4 cases with proliferative diabetic retinopathy (PDR), 14 cases with non-proliferative diabetic retinopathy (NPDR), 17 cases with diabetic retinopathy (DR) with A/V nicking, 38 cases without retinopathy in study group, and 18 cases, 7 cases, 20 cases, 4 cases and 63 cases for each in control group. After adjustment for age, gender, hypertension, diabetes duration, dyslipidemia, glycosylated hemoglobin (HbA1c), body mass index (BMI), A/V nicking, PDR and NPDR, the diference of DR with A/V nicking between study and control group remained statistically signifcant (OR 2.0, 95% CI 0.79 to 3.21, p = 0.001).

Conclusion

DR with A/V nicking could be used as an independent predictor of T2DM patients with CMD. CFR testing should be performed on patients with this kind of eye sign, even if they do not have any symptoms of heart disease. Meanwhile, DR with A/V nicking might be served as a reference indicator of CMD in T2DM patients with chest pain who were unable to be tested for CFR.
Ocular Behçet disease and COVID-19
Authors: Accorinti Massimo , Manni Priscilla , Sampalmieri Lorenzo , Saturno Maria Carmela
Published: January 2022

Purpose

to study in patients with Behçet disease and ocular involvement (OBD) the presence of SARS-CoV-2 infection and its influence on the course of OBD.

Methods

all the patients with OBD living in Lazio, one Italian region, and attending the Uveitis center of the Sapienza University of Rome were included in the study.

Results

SARS-CoV-2 infection was found in 12.3% of 54 patients with OBD and in 3.84% of Lazio inhabitants (p  =  0.001, OR 3.51), and it was unrelated to the use of immunosuppressive drugs. COVID-19 symptoms in OBD patients were mild, with one patient only requiring hospitalization for interstitial pneumonia. None of the SARS-CoV-2 infected patients presented any uveitis relapses during the infection and in a subsequent median follow-up of 6 months.

Conclusion

OBD seems to be a risk factor for developing SARS-CoV-2 infection. Usually this infection has a mild course and does not impact negatively on the course of uveitis.
Hybrid machine learning approach for Arabic medical web page credibility assessment
Authors: Alasmari Amal , Alhothali Areej , Allinjawi Arwa
Published: January 2022

For many people, the Internet is their primary source of knowledge in today’s modern world. Internet users frequently seek health-related information in order to better understand a health problem, seek guidance, or diagnose symptoms. Unfortunately, most of this information is inaccurate or unreliable, making it difficult for regular users to discern reliable sources of information. To determine online source reliability, specific knowledge and domain expertise are necessary. Researchers in health informatics studied a number of linguistic and non-linguistic indicators to assist ordinary individuals in judging medical web page credibility. This study proposes a method that automates the process of assessing the reliability of online medical sites based on textual and non-textual characteristics. To evaluate the proposed approach, we developed a real-world dataset of Arabic web pages that provide medical information. This dataset is the first Arabic medical web page dataset for content credibility evaluation. The hybrid approach was assessed using multiple machine learning and deep learning algorithms on the dataset, providing an accuracy and F1-score of 79 % and 77 %, respectively. We also identify the most observable patterns that help evaluate or detect unreliable web pages written in Arabic.
Comparative study of thermo-mechanical and thermogravimetric characterization of hybrid dental restorative composite materials
Authors: Yadav Ramkumar , Meena Anoj
Published: January 2022

The purpose of the study is to create resin-based micro-nano particulates-filled dental restorative composite materials and investigate the influence of variable nano-hydroxyapatite filler concentration on their thermo-mechanical and thermogravimetric properties. Two series were created by combining silane treated nano-hydroxyapatite filler particles (wt.% of 0, 2, 4, 6, and 8) with foreign ceramic particles (alumina and titanium oxide). Each series consists of five compositions. For each dental composition, the amount of foreign ceramics (20 wt.%) remained constant. The dental composite samples were polymerized for 30 s on each side using a blue LED light. Thermo-mechanical and thermogravimetric analysis was performed at various temperatures range. At preliminary temperatures (30–40°C), the hybrid nano-hydroxyapatite-TiO2 dental composite filled with 8 wt.% nano-hydroxyapatite exhibited storage modulus (about 90 MPa) whereas nano-hydroxyapatite-Al2O3 dental composite filled with 8 wt.% nano-hydroxyapatite exhibited storage modulus (about 260 MPa). Themal stability of nano-hydroxyapatite-Al2O3 and nano-hydroxyapatite-TiO2 dental composite was 99.90% and 99.82% at 90°C, respectively. The glass phase, glass transition phase, and rubbery phase were observed at various temperatures. From the results, it revealed that Al2O3-nano-hydroxyapatite filled dental composite was observed significant than TiO2–nano-hydroxyapatite filled dental composite.
Effect of layer orientation on the single tooth bending fatigue strength of polymer gears manufactured by selective laser sintering
Authors: Pandian A. Karthik , Gautam Sachin Singh , Senthilvelan S.
Published: January 2022

This study investigates the influence of tooth layer orientation on the bending fatigue behaviour of Nylon 12 spur gears manufactured by a selective laser sintering process in an ‘on-edge’ configuration. The test gears were submitted to single tooth bending fatigue tests, and the thermal response of gears was recorded using Infrared thermography. The surface morphology of failed teeth was examined using microscopy. The effect of tooth layer orientation on the fatigue strength of selective laser sintering gears was evaluated by testing each tooth configuration. The tooth configurations with the highest and lowest strength were 40° and 160°, respectively. The performance of selective laser sintering gears was compared with that of injection moulded Nylon 66 gears. The injection moulded, selective laser sintering 40°, and selective laser sintering 160° gear teeth were tested at multiple loads to investigate the high cycle fatigue and low cycle fatigue behaviour. The bending fatigue life was highest for the injection moulded gears in both low cycle fatigue and high cycle fatigue regimes. The surface temperature was higher in selective laser sintering gears, with 160° configuration exhibiting the highest temperature. The difference between the temperatures of selective laser sintering 40° configuration and injection moulded gear magnified as the applied load increased. Consequently, the strength of the selective laser sintering 40° configuration with respect to injection moulded gear deteriorated in the low cycle fatigue region. Fractography indicated that crack propagation in selective laser sintering 40° and selective laser sintering 160° configurations were cross-laminar and inter-laminar, respectively. In the cross-laminar mode of propagation, the crack propagation was impeded by the layer structure. However, the crack propagation was expedited in the inter-laminar mode, as the crack path was along the interlayer region, which presents a path of least resistance.
Enacting up: using drawing as a method/ology to explore Taiwanese pregnant women’s experiences of prenatal screening and testing
Authors: Shih Li-Wen , Schrøder Thomas Harbøll
Published: January 2022

Through studying pregnant women’s experience of prenatal screening and testing in Taiwan, this article argues that the collection of participant drawings provides a valuable contribution to feminist methodology where participants are seen as knowledgeable about their own situation. Drawings offer a context that enables us to analyse how participants (pregnant women and their partners) situated themselves in relation to their foetuses, technologies and families. This approach taught us an important methodological lesson, namely that methods always embody a particular political and epistemological location. Inspired by this line of thought, we suggest the concept enacting up, which combines the idea of enacting and the expression acting up to challenge scientific objectivity and biomedical practice while simultaneously giving voice to our participants.
How have quality newspapers covered the microbiome? A content analysis of The New York Times, The Times, and El País
Authors: Prados-Bo Andreu , Casino Gonzalo
Published: January 2022

The microbiome has captured the attention of researchers and newspapers. We studied how the subject is covered in The New York Times, The Times, and El País via DowJones Factiva (2007–2019), analyzing aspects that included article type, word count, authorship, topic, and citation of researchers, organizations, and journals. We found that 87.6% of newspaper articles (409/467) were news articles and most were longer than 300 words (396; 84.8%), with The New York Times devoting the highest proportion to newspaper articles over 1000 words (99; 45.4%). While basic science findings received the most attention from newspapers from 2007 to 2015, topics related to medicine and nutrition attracted increasing attention from 2016 to 2019. Newspapers showed a domestic preference for their respective researchers, organizations, and journals.
Resilience through Entrepreneurial Storytelling in Extreme Contexts: A Case Study of a Pharmaceutical Company in the Palestinian Territory
Authors: Haloub Radi , Khoury Grace , Masri Asem
Published: January 2022

This case presents how entrepreneurial storytelling assists entrepreneurs in attracting new investors, pursuing innovation and developing resilience in the Palestinian Territory. It also examines the role of entrepreneurial storytelling in eluding political crises and supporting the CEO's vision to adapt changes in the political environment. Moreover, this case explains how entrepreneurs respond to local competitors who operate in the same uncontrollable and unpredictable environment. The case is written based on three semi-structured interviews (total seven hours) with the Chief Executive Officer 1 of Pharmacare Pharmaceuticals Public Limited Company (PCP) 2 : Mr Bassim Khoury (BK). PCP is the third Palestinian pharmaceutical company in terms of turnover in 2021, with more than 100 products and 330 employees, and is the first company in the Palestinian Territory to expand internationally in 22 countries.
A Systematic Review of Interventions to Reduce Gender-Based Violence Among Women and Girls in Sub-Saharan Africa
Authors: Keith Thi , Hyslop Fran , Richmond Robyn
Published: January 2022

Sub-Saharan Africa (SSA) is disproportionately affected by gender-based violence (GBV). We systematically reviewed English language, peer-reviewed, quantitative evaluations of interventions to reduce violence against women and girls (VAWG) in SSA that involved a comparison group and reported GBV incidence, or GBV-related attitudes, norms and symptoms as an outcome. We identified 53 studies published between January 2000 and April 2020 and classified these programmes from an empowerment perspective using the following categories: social, economic, combined social and economic and psychological empowerment interventions. Our review found social empowerment interventions effective for transforming gender attitudes and norms and reducing GBV, and psychological empowerment interventions effective for managing GBV-related symptoms. The evidence for economic empowerment interventions was equivocal. Key elements of successful interventions included participatory group learning, engaging male partners, engaging the community, longer duration and utilising existing platforms. Promising approaches for further research included gender specific programmes, psychological empowerment interventions delivered by lay workers and psychological empowerment interventions focused on GBV reduction.
Realignment of Migrated Celiac Stent Graft After Branched Stent Graft Implantation Through Retrograde Cannulation of the Superior Mesenteric Artery Using a Single Vascular Access
Authors: Kyriakou Andreas , Oberhuber Alexander , Friesen Lia , Huelsboemer Lioba Franziska , Schaefers Johannes F.
Published: January 2022

Purpose:

The purpose of the study was to present an endovascular management of a type IIIc endoleak (EL) in a patient with migration of the bridging stent graft of the celiac trunk (CT) after branched aortic aneurysm repair with retrograde cannulation of the superior mesenteric artery (SMA).

Technique:

The therapy was applied in a 62-year-old man who underwent a branched EVAR 2 years ago. Meanwhile, the patient was treated due to type Ia EL 6 months ago. The patient suffered in the last days from unclear hemorrhage clinically correlated with weakness. In the computed tomography angiography (CTA), an EL IIIc with a migration of the bridging stent graft from the CT branch was displayed. As vascular access, the left axillar artery was used. Due to the misaligned bridging stent graft, an antegrade cannulation was impossible, so cannulation was performed retrograde through the SMA using pancreaticoduodenal and gastroduodenal arteries. Thereafter, the EL could be repaired with bridging stent grafts. The postinterventional control showed a satisfying reconstruction without EL or embolization.

Conclusion:

Most of the complications such as type IIIc EL after complex endovascular repair can also be treated endovascularly. This sophisticated treatment requires that necessary materials and experience are available.
Artistic Sensibility is Inherent to Research
Authors: Ingman Benjamin C.
Published: January 2022

Artistic sensibility is defined in this work as the sensitivity and capacity to appreciate and act upon concerns of or pertaining to art and its production. This article contends that artistic sensibility is inherent to research. This contention is supported through three points which reveal a fourth: (1) Research requires dissemination. (2) Dissemination requires representation. (3) Representation requires artistic sensibility. These three points considered in conjunction illustrate a fourth: (4) Research requires artistic sensibility. This argument has implications for research venues, evaluations of research, and the preparation of researchers in all research disciplines. Namely, certain tenets of arts-based research may be applied to a much broader array of research methodologies. Identifying, honoring, and harnessing artistic sensibility in research has the potential to improve research products and enrich discourse.
Stepping Into the Participants’ Shoes: The Trans-Positional Cognition Approach
Authors: Olekanma Obafemi , Dörfler Viktor , Shafti Farhad
Published: January 2022

To conduct a phenomenological study, researchers often follow the principles from either the descriptive or interpretive phenomenological schools of thought. This constrains researchers within the domain and limits the potentials of their data set. This paper introduces the Trans-Positional Cognition Approach (TPCA) as a novel synthesised phenomenological research method for conducting qualitative research to address this challenge. The TPCA synthesises the principles of the descriptive and interpretive phenomenological schools and helps to bridge the divide occasioned by polemical arguments between them. At the heart of TPCA is the process of trans-positional cognition or, in simple words, ‘stepping into the participants’ shoes’. TPCA, within the phenomenological tradition, proposes a structured methodological approach as a way to reduce the complexity of the extant methods, which novice researchers associate with phenomenology. The purpose of TPCA is not to pit one phenomenological research approach against another but to elucidate an inclusive approach to phenomenological research that can serve as a methodological alternative. A set of dimensions is used to compare TPCA with extant descriptive and interpretive phenomenological approaches in order to demonstrate its distinctiveness. Furthermore, an implementation study illustrates the use of the TPCA. Hence, the TPCA, by bridging the divide between the phenomenological schools of thought, could potentially help sustain the growing interest of researchers in phenomenological research.
Effect of nitrogen protection on weld metal microstructure and intergranular behavior of S32101 duplex stainless steel 15 m water depth hyperbaric laser underwater welding
Authors: Wang Kai , Jiao Xiangdong , Zhu Jialei , Shao Changlei , Li Congwei
Published: January 2022

In this study, 16-mm-thick S32101 duplex stainless steel were welded using hyperbaric underwater laser welding system in 0.15 MPa. The misorientation angle distribution of grain boundaries in the weld metal was analyzed using the electron backscatter diffraction technique. The ionic currents near the surface of metallography were measured by the Scanning Vibrating Electrode Technique (SVET) and performed to evaluate the intergranular corrosion (IGC) resistance based on corrosion current density. The volume fractions of ferrite and austenite and the grain boundary misorientation angle affect the IGC sensitivity of the welded joints. The relationship between the grain boundary misorientation angle of the austenite and corrosion resistance was analyzed. When the weld metal was shielded with nitrogen, and the volume fraction of austenite and the frequency of Σ3 coincidence site lattice boundary in the weld was increased. The misorientation angle distribution in the austenite and the frequency of Σ3 coincidence site lattice boundary influence the IGC resistance of the welded joints.
Enhanced function of NR2C/2D-containing NMDA receptor in the nucleus accumbens contributes to peripheral nerve injury-induced neuropathic pain and depression in mice
Authors: Jing Peng-Bo , Chen Xiao-Hong , Lu Huan-Jun , Gao Yong-Jing , Wu Xiao-Bo
Published: January 2022

N-methyl-d-aspartate receptors (NMDARs) dysfunction in the nucleus accumbens (NAc) participates in regulating many neurological and psychiatric disorders such as drug addiction, chronic pain, and depression. NMDARs are heterotetrameric complexes generally composed of two NR1 and two NR2 subunits (NR2A, NR2B, NR2C and NR2D). Much attention has been focused on the role of NR2A and NR2B-containing NMDARs in a variety of neurological disorders; however, the function of NR2C/2D subunits at NAc in chronic pain remains unknown. In this study, spinal nerve ligation (SNL) induced a persistent sensory abnormity and depressive-like behavior. The whole-cell patch clamp recording on medium spiny neurons (MSNs) in the NAc showed that the amplitude of NMDAR-mediated excitatory postsynaptic currents (EPSCs) was significantly increased when membrane potential held at −40 to 0 mV in mice after 14 days of SNL operation. In addition, selective inhibition of NR2C/2D-containing NMDARs with PPDA caused a larger decrease on peak amplitude of NMDAR-EPSCs in SNL than that in sham-operated mice. Appling of selective potentiator of NR2C/2D, CIQ, markedly enhanced the evoked NMDAR-EPSCs in SNL-operated mice, but no change in sham-operated mice. Finally, intra-NAc injection of PPDA significantly attenuated SNL-induced mechanical allodynia and depressive-like behavior. These results for the first time showed that the functional change of NR2C/2D subunits-containing NMDARs in the NAc might contribute to the sensory and affective components in neuropathic pain.
Haematological emergencies
Authors: Tannatt Nash Amy , Hambleton Harry
Published: January 2022

Some haematological conditions may present as emergencies in primary care. These require urgent intervention and clinical vigilance in order to diagnose and manage patients appropriately, as patients will often present with non-specific symptoms and signs. This article will discuss four major haematological presentations. We will consider the aetiology of each condition, how patients present in primary care, how to manage these presentations, and what patients are likely to experience when seen in secondary care.
Nonlinear model predictive control for improving range-based relative localization by maximizing observability
Authors: Li Shushuai , De Wagter Christophe , de Croon Guido C. H. E.
Published: January 2022

Wireless ranging measurements have been proposed for enabling multiple Micro Air Vehicles (MAVs) to localize with respect to each other. However, the high-dimensional relative states are weakly observable due to the scalar distance measurement. Hence, the MAVs have degraded relative localization and control performance under unobservable conditions as can be deduced by the Lie derivatives. This paper presents a nonlinear model predictive control (NMPC) by maximizing the determinant of the observability matrix to generate optimal control inputs, which also satisfy constraints including multi-robot tasks, input limitation, and state bounds. Simulation results validate the localization and control efficacy of the proposed MPC method for range-based multi-MAV systems with weak observability, which has faster convergence time and more accurate localization compared to previously proposed random motions. A real-world experiment on two Crazyflies indicates the optimal states and control behaviours generated by the proposed NMPC.
A systematic review and meta-analysis of women’s satisfaction with skilled delivery care and the associated factors in Ethiopia
Authors: Bishaw Keralem Anteneh , Temesgen Habtamu , Amha Haile , Desta Melaku , Bazezew Yibelu , Ayenew Temesgen , Eshete Tewodros , Bewket Bekalu , Mulugeta Henok , Tiruneh Gebrehiwot Ayalew
Published: January 2022

Evidence of variation in maternity health service practices has increased the government’s interest in quantifying and advancing the quality of institutional delivery care in the developing world, including Ethiopia. Therefore, we conducted a systematic review and meta-analysis to update and provide more representative data on women’s satisfaction with skilled delivery care and the associated factors in Ethiopia. This systematic review and meta-analysis followed the Preferred Reporting Items 2015 guideline. We searched PubMed/Medline, SCOPUS, Embase, Web of Science, and Google Scholar electronic databases for all 36 included studies. The pooled prevalence of women’s satisfaction with skilled delivery care and the associated factors were estimated using a random-effects model. Subgroup analysis and meta-regression were performed to identify the source of heterogeneity. Furthermore, publication bias was checked using eggers and funnel plots. All statistical analyses were performed using STATA version 14.0 software. The pooled prevalence of women’s satisfaction with skilled delivery care was 67.31 with 95% confidence interval (60.18–74.44). Wanted pregnancy (adjusted odds ratio = 2.86, 95% confidence interval: (2.24–3.64)), having a plan to deliver at a health facility (adjusted odds ratio = 2.09, 95% confidence interval: (1.42–3.09)), access to ambulance service (adjusted odds ratio = 1.52, 95% confidence interval: (1.00–2.31)), waiting time < 15 min (adjusted odds ratio = 3.66, 95% confidence interval: (2.51–5.33)), privacy assured (adjusted odds ratio = 3.94, 95% confidence interval: (2.23–6.94)), short duration of labour < 12 hr (adjusted odds ratio = 2.55, 95% confidence interval: (1.58–4.12)), proper labour pain management (adjusted odds ratio = 3.01, 95% confidence interval: (1.46–6.22)), and normal newborn outcome (adjusted odds ratio = 3.94, 95% confidence interval: (2.17–7.15)) were associated with women’s satisfaction. Almost two-thirds of women were satisfied with skilled delivery care. In comparison, the remaining one-third were not satisfied with the care. The quality of intrapartum care, unwanted pregnancy, lack of ambulance services, prolonged duration of labour, poor labour pain management, and complicated newborn outcome were factors affecting women’s satisfaction with skilled delivery care in Ethiopia. Therefore, strategies need to be developed to increase the satisfaction level by considering the abovementioned factors during routine delivery care.
Clinical Outcomes With Medium Cut-Off Versus High-Flux Hemodialysis Membranes: A Systematic Review and Meta-Analysis
Authors: Kandi Maryam , Brignardello-Petersen Romina , Couban Rachel , Wu Celina , Nesrallah Gihad
Published: January 2022

Background:

A novel medium cut-off (MCO) dialyzer (Theranova, Baxter Healthcare, Deerfield, IL, USA) enhances large middle molecule clearance while retaining selectivity for molecules >45 000 Da.

Objective:

We undertook a systematic review and meta-analysis evaluating clinical outcomes with MCO vs high-flux membranes.

Methods:

We searched MEDLINE, EMBASE, CINAHL, Cochrane Library, and Web of Science through July 2020, and gray literature sources from 2017. We included randomized (RS) and nonrandomized studies (NRS) comparing MCO and high-flux membranes in adults receiving maintenance hemodialysis. Pairs of reviewers performed study selection, data extraction, and risk of bias assessment in duplicate. We conducted random-effects pairwise meta-analyses to pool results across studies and used the Grading of Recommendations Assessment, Development and Evaluation approach to assess evidence certainty.

Results:

We identified 22 eligible studies (6 RS, 16 NRS; N = 1811 patients; patient-years = 1546). The MCO dialyzer improved (estimate; 95% confidence interval [CI]; certainty rating) quality of life (mean difference [MD] = 16.7/100 points; 6.9 to 26.4; moderate), Kidney Disease Quality of Life Instrument (KDQOL) subscales—burden (MD = 4.0; 1.1 to 6.9; moderate) and effects (MD = 5.4; 3.2 to 7.6; moderate), pruritus (MD = −4.4; −7.1 to −1.7; moderate), recovery time (MD = −420 minutes; −541 to −299; high), and restless legs syndrome (odds ratio = 0.39; 0.29 to 0.53; moderate). There was little to no difference in all-cause mortality (risk difference = −0.4%; −2.8 to 2.1; moderate) and serious adverse events (rate ratio = 0.63; 0.38 to 1.04; low). MCO dialysis reduced hospitalization (rate ratio = 0.48; 0.27 to 0.84; low), infection (rate ratio = 0.38; 0.17 to 0.85; moderate), hospitalization days (MD = −1.5 days; 95% CI, −2.22 to −0.78; moderate), erythropoiesis resistance index (MD = −2.92 U/kg/week/g/L; 95% CI, −4.25 to −1.6; moderate) and cumulative iron use over 12 weeks (MD = −293 mg; 95% CI, −368 to −218; moderate). We found with low certainty that MCO dialysis had little to no effect on KDQOL symptoms/problem list, pain, and physical health and moderate certainty that MCO dialysis likely has no effect on the KDQOL mental health composite.

Conclusions:

We found with predominantly moderate certainty that the MCO dialyzer improves several patient-important outcomes with no apparent risks or harms. More definitive studies are needed to better quantify the effects of MCO membranes on mortality, hospitalization, and other rare events.
A Novel Approach to Air Passenger Index Prediction: Based on Mutual Information Principle and Support Vector Regression Blended Model
Authors: Xiong Honglin , Fan Chongjun , Chen Hongmin , Yang Yun , ANTWI Collins Opoku , Fan Xiaomao
Published: January 2022

Air passenger traffic prediction is crucial for the effective operation of civil aviation airports. Despite some progress in this field, the prediction accuracy and methods need further improvement. This paper proposes an integrated approach to the prediction of air passenger index as follows. Firstly, the air passenger index is defined and classified by the K-means clustering method. And then, based on mutual information (MI) principle, the information entropy is used to analyze and select the key influencing factors of air passenger travel. By incorporating the MI principle into the support vector regression (SVR) framework, this paper presents an innovative MI-SVR machine learning model used to predict the air passenger index. Finally, the proposed model is validated by air passenger throughput data of the Shanghai Pudong International Airport (PVG), China. The experimental results prove MI-SVR model feasibility and effectiveness by comparing them with conventional methods, such as ARIMA, LSTM, and other machine learning models. Besides, it is shown that the prediction effect of each model could be improved by introducing influencing factors based on MI. The main findings are considered instrumental to the airport operation and air traffic optimization.
Exploration of Emerging Adult Virgins’ Difficulties
Authors: Leroux Audrey , Boislard Marie-Aude
Published: January 2022

Social clock theory posits that off-time transitions, such as virginity loss, are often socially reproached and stigmatized. Research suggests, however, that reasons for virginity in adulthood are heterogeneous and that some emerging adult virgins (EAVs) are struggling socially. To guide the development of interventions tailored to this population, it is important to understand their difficulties. Through individual semi-structured interviews, this study explores the difficulties and disagreeable emotions experienced by 29 heterosexual virgins aged between 20 and 29. The data were analyzed using thematic analysis. Three main themes were identified: (a) difficulties related to society, (b) difficulties related to interpersonal relationships, and (c) disagreeable emotions experienced relative to late virginity. These results reveal that difficulties expressed by EAVs are intertwined and surprisingly, the most salient difficulty was related to lack of intimacy, rather than virginity per se. Theoretical and clinical implications are discussed, along with recommendations for future research.
Am I a Successful Adult? Exploring the Influence of Ethnic Diversity in Defining Success among Former Foster Youth
Authors: Bencomo Benjamin T.
Published: January 2022

Barriers to success experienced by former foster youth are well documented; however, missing is the full exploration of the experiences of ethnic minority foster youth. This qualitative exploratory study presents a hermeneutic thematic analysis of interviews conducted with eight youth, of varying ethnic and cultural backgrounds, who recently aged out of foster care in a largely rural southwestern state. For many participants, their definition of success differed markedly from mainstream measures of successful transition into adulthood. Major themes of participant interviews included; education, family, community, and financial struggles/work. Although both education and financial difficulties have been widely documented among former foster youth, the attention to family and community factors have not been fully explored. This qualitative study encourages an expanded view of how a successful transition to adulthood can be markedly different among ethnically diverse foster care alumni and encourages continued exploration into the needs of this population.
Concussions in the National Hockey League: Analysis of Incidence, Return to Play, and Performance
Authors: Andrews Erickson , Jildeh Toufic R. , Abbas Muhammad J. , Lindsay-Rivera Kevin , Berguson Jon , Okoroha Kelechi R.
Published: January 2022

Background:

Concussion injuries are common in professional hockey; however, their effect on player performance remains unclear.

Purpose:

To quantify the effect of concussions on the performance of position players in the National Hockey League (NHL).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Concussion data from the NHL were collected using publicly available databases for the seasons between 2009-2010 and 2015-2016, coinciding with new NHL concussion rules. Age, body mass index, position, number of concussions during a player’s NHL career, games played, and time on ice were recorded. Basic and advanced performance metrics were collected for 1 season pre- and postconcussion (short-term period) and 3 seasons before and after concussion (long-term period) to assess short- and long-term changes in performance. A control group of players without an identified concussion who competed during the study period was assembled for comparison. Wilcoxon signed rank tests were used to evaluate pre- to postconcussion data in the short- and long-term settings as well as to compare the cohorts at each time point.

Results:

Overall, 48 players were identified as having a concussion during the study period. Players missed 17.2 ± 15.1 days (mean ± standard deviation) and 7.5 ± 6.9 games postconcussion. There were no significant differences in any metric when pre- and postconcussion intraseason performance was assessed. Athletes who were concussed demonstrated significantly deceased performance metrics (assists per 60 minutes, points per 60 minutes, Corsi percentage, and Fenwick percentage) in the 3 years after the concussion as compared with the year before injury ( P < .05). However, no difference was found between the concussed group and matched control group in the short- or long-term period. Players with concussion played fewer career games (856.4 ± 287.4 vs 725.7 ± 215.0; P < .05) than did controls.

Conclusion:

A high rate of NHL players were able to return to play after a concussion injury. Players with concussion did not experience a reduction in performance metrics in the short- or long-term setting when compared with matched controls. The concussed cohort maintained a similar workload up to 3 seasons postconcussion but played in fewer career games when compared with matched controls.
Passion, persistence, and firm growth: Moderating role of environmental uncertainty
Authors: Iyortsuun Akuraun Shadrach , Shakpande Comfort
Published: January 2022

This study relies on the dual model of passion to explore the direct and conditional effect of passion on firm growth. The study proposed persistence and environmental uncertainty as pathways through which passion influences firm growth. The model of firm growth was tested on a sample of 381 small-scale businesses located in Nigeria. The findings suggested that passion is significantly related to firm growth and that persistence partially mediated the link between passion and firm growth. Furthermore, the study failed to establish the conditional effect of environmental uncertainty on the indirect effect of passion on firm growth. The study has established the applicability and relevance of the dual model of passion in the context of entrepreneurship confirming its predictive power in accounting for the variation in firm growth.

JEL CLASSIFICATION: L260
Book review: Sharmistha Saha, Theatre and National Identity in Colonial India: Formation of a Community Through Cultural Practice
Authors: Kalra Preeti
Published: January 2022

Sharmistha Saha, Theatre and National Identity in Colonial India: Formation of a Community Through Cultural Practice. Aakar Books, Delhi, 2018, 253 pp., ₹695.00 (hardback), ISBN: 978-93-5002A-523-9.
Book review: Prathama Banerjee, Elementary Aspects of the Political: Histories from the Global South
Authors: Saha Wriddhibrata
Published: January 2022

Prathama Banerjee, Elementary Aspects of the Political: Histories from the Global South. Hyderabad: Orient BlackSwan, 2021. 284 pp., ₹625, ISBN: 9789354420023.
Book review: J. Daniel Elam, Impossible and Necessary: Anticolonialism, Reading, and Critique
Authors: Basu Rohan
Published: January 2022

J. Daniel Elam, Impossible and Necessary: Anticolonialism, Reading, and Critique. Hyderabad: Orient Blackswan, 2021, 212 pp., ₹895, ISBN: 9788194925835
Cavovarus with A Twist: Coronal and Axial Plane Rotational Deformity in the Midfoot of Charcot- Marie-Tooth Patients
Authors: An Tonya W. , Haupt Edward T. , Michalski Max , Salo Jari , Pfeffer Glenn B.
Published: January 2022

Category:

Hindfoot; Midfoot/Forefoot

Introduction/Purpose:

The cavovarus deformity of Charcot-Marie-Tooth (CMT) disease typically presents with hindfoot varus and forefoot valgus. This seemingly paradoxical relationship is poorly understood. Better insight into this complex three- dimensional alignment under physiologic load-bearing conditions is possible using weight-bearing computed tomography (WBCT). This is the first study to examine the extreme rotational deformity in the midfoot of CMT patients, and thereby provides a key to the successful operative correction of the CMT cavovarus foot.

Methods:

We retrospectively reviewed the WBCTs of patients with CMT who presented to a single surgeon. Those with history of bony surgical correction, severe degenerative joint disease, or open physes in the foot, were excluded. Scans were analyzed using three-dimensional analysis software (Disior Bonelogic) to generate axes of select bones and their relationship relative to the tibial plafond anterior-posterior axis in the axial plane. The coronal alignment of the foot involved angular measurements of the calcaneus, talar dome, midfoot and forefoot relative to the ground. We reported quantitative alignment parameters and compared the measurements to WBCT of 20 controls.

Results:

17 WBCT scans from 15 CMT patients (average age 24 years) met criteria for inclusion. In the axial plane, external rotation of the distal tibia accounted for the varus heel position rather than subtalar malalignment. The greatest change in axial alignment occurred between the talar neck and navicular (26 degrees). The average talonavicular (TN) medial uncoverage angle was -15 degrees for CMT patients, indicating medial overcoverage, compared to +11 degrees for controls, (p<0.01). Coronal plane analysis revealed varus rotational deformity at the calcaneus (23 degrees), a peak of 61 degrees varus across the navicular and cuboid, then compensatory rotation of the cuneiforms and metatarsals to achieve a plantigrade forefoot (11 degrees varus). In comparison, controls averaged 9 degrees coronal valgus at the calcaneus and 34 degrees varus at the naviculo-cuboid level, (p<0.01). Figure 1 shows the WBCT scans of a representative CMT patient and control case.

Conclusion:

This three-dimensional WBCT analysis is the first to characterize and quantify the axial and coronal rotational deformity in CMT. Axial plane deformity had a center of rotational angulation at the talonavicular joint, associated with medial ’overcoverage’ of the talar head, likely from chronic tibialis posterior over-pull. The peak coronal deformity was localized at the navicular and cuboid, which measured nearly twice as much as controls. These observations suggest dorsiflexion osteotomy of the 1st metatarsal would fail to address the coronal rotation; releases through the talonavicular joint may be necessary to abduct and de-rotate the midfoot to achieve a plantigrade foot.