bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparities in Access to Cranial Remodeling Orthosis for Deformational Plagiocephaly
Authors: Junn Alexandra , Dinis Jacob , Long Aaron , Hauc Sacha , Phillips Sarah , Junn Adam H , Reategui Alvaro , Lopez Joseph , Persing John A , Alperovich Michael
Published: December 2021

Objective

Moderate to severe cases of deformational plagiocephaly (DP) may be treated with cranial remolding orthoses (CRO). This study investigated the socioeconomic disparities in access to care for CRO for DP correction.

Design

This was a retrospective review of medical records from a single CRO company in Connecticut from 2014 to 2020.

Methods

Demographic variables were collected from all patients. Univariable logistic regressions were used to identify differences for presenting age at consultation, whether CRO was pursued, and length of CRO treatment by insurance payor and household income quartile.

Results

Of the 5620 patients identified, 4100 (73.0%) received CRO, with 674 (12.0%) receiving a second helmet. Of those receiving CRO, 1536 (37.5%) had Medicaid insurance while 2558 (62.4%) were commercially insured. Patients on Medicaid were 1.30 times more likely to have delayed presentation ( P  =  .017), while patients from the lowest income quartile were 1.26 1.50 ( P < .001) and 1.58 ( P < .001) times more likely to have a delayed presentation relative to those in the highest and second-highest income quartiles, respectively. Patients in the highest and second-highest income quartiles were also 1.55 ( P < .001) and 1.45 ( P < .001) more likely, respectively, to receive CRO after consultation than those from the lowest income quartile.

Conclusions

Lower income and Medicaid-insured patients had delayed presentation for CRO consultation. Those from the lowest income quartile were more likely to never receive CRO than those from wealthier backgrounds. Low socioeconomic status and Medicaid insurance, which can have more restrictive coverage policies for CRO, may result in the delayed treatment of DP.
Experiences of Stress – A Focus Group Interview Study Among Swedish Adolescents During the COVID-19 Pandemic
Authors: Hörbo Moa , Johansson Camilla , Garnow Tide , Garmy Pernilla , Einberg Eva-Lena
Published: December 2021

Adolescence can be a stressful period in life. The period contains challenges associated with the transition from childhood to adulthood (body changes, changes in interpersonal relationships, and identity changes). The aim was to investigate experiences of stress among adolescents in addition to stress related to the COVID-19 pandemic. Focus group interviews (n = 8) were conducted with girls (n = 22) and boys (n = 19) aged 13–15 in southern Sweden. The transcribed interviews were analyzed with qualitative content analysis. Analysis of the collected material resulted in two categories with four sub-categories each of which highlights adolescents’ experiences of stress. The results show that adolescents’ have a variety of experiences of stress, i.e., what they mean are the sources of stress and how stress is manifested. The adolescents experienced how stress was manifested both physically and emotionally. This affected both their sleep and performance. The adolescents reflected on both positive and negative manifestations of stress.
Country Calls: A Creative Practice of Deep Time Walking in Darug Country
Authors: Somerville Margaret J.
Published: December 2021

This article presents my personal story, as a non-Indigenous settler woman, of walking along a ridge close to my home at the foot of the Blue Mountains west of Sydney, after the fires of 2019 to 2020. In this article, I want to invite the reader into my love of this country through sharing my record of this walking over a 12-month seasonal cycle. Every walk presented me with new understandings of this Country where I live, which I already knew as Darug Country, having explored the nature of this country in collaboration with my Darug friends Jacinta and Leanne Tobin.
Climate Sadness: The Fragile Beauty of Tonlé Sap
Authors: Burns Edgar A.
Published: December 2021

Tonlé Sap is the large fresh water lake-river near the geographic center of Cambodia. Visiting Tonlé Sap, following an academic conference in Phnom Penh, demanded a response at a personal and more visceral human level. Writing this poem attempted to express disquiet beyond academic examination of the biophysical dimensions of Tonlé Sap. The poem is sad for Tonlé Sap, for Cambodia, and implicitly for all of us on this planet. For thousands of years people have lived around Tonlé Sap, adapting to weather, the flow of water from mountain to sea, and the changing ebb and flow of civilizations. Anthropogenic sea level rise challenges all of this human history, unnecessarily.
On prismatic and bending bifurcations of fiber-reinforced elastic membranes under swelling with application to aortic aneurysms
Authors: Al-Chlaihawi Murtadha J. , Topol Heiko , Demirkoparan Hasan , Merodio José
Published: December 2021

The influence of swelling on prismatic and bending bifurcation modes of inflated thin-walled cylinders under axial loading is examined. The bifurcation criteria for a membrane cylinder subjected to combined axial loading, internal pressure, and swelling is provided. We consider orthotropic materials with two preferred directions which are mechanically equivalent and symmetrically disposed. The mechanical behavior of the matrix is described by a swellable isotropic model. The isotropic material is augmented with two functions that are equal, each one of them accounting for the existence of a unidirectional reinforcement. Two reinforcing models that depend only on the stretch in the fiber direction are considered: the so-called standard reinforcing model and an exponential one. The analysis of bifurcation modes for these models under the conditions at hand may establish the connection with modeling of the normal and diseased aorta in arterial wall tissue. The effects of the axial stretch, the strength of the fiber reinforcement and the fiber winding angle on the onset of prismatic and bending bifurcations are investigated. It is shown that for membranes without fibers, prismatic bifurcation is not feasible. On the other hand, bending bifurcation is more likely to occur for swollen cylinders. However, for a particular model of fiber-reinforced membranes, the standard model, there exists a domain of deformation values together with material constant values that may trigger prismatic bifurcation. The exponential model does not allow prismatic bifurcations. Both models allow bending bifurcation and may or may not trigger it depending on the deformation together with material parameters.
Electromechanics of lipid-modulated gating of potassium channels
Authors: Thomas Nidhin , Mandadapu Kranthi K , Agrawal Ashutosh
Published: December 2021

Experimental studies reveal that the anionic lipid phosphatidic acid (POPA), non-phospholipid cholesterol, and cationic lipid DOTAP inhibit the gating of voltage-sensitive potassium (Kv) channels. Here, we develop a continuum electromechanical model to investigate the interaction of these lipids with the ion channel. Our model suggests that: (i) POPA lipids may restrict the vertical motion of the voltage-sensor domain through direct electrostatic interactions; (ii) cholesterol may oppose the radial motion of the pore domain of the channel by increasing the mechanical rigidity of the membrane; and (iii) DOTAP can reduce the effect of electrostatic forces by regulating the dielectric constant at the channel–lipid interface. The electromechanical model predictions for the three lipid types match well with the experimental observations and provide mechanistic insights into lipid-dependent gating of Kv channels.
Food Storage on the Appalachian Trail: A Theory of Planned Behavior Approach to Understanding Backpacker Bear Canister Use
Authors: Freeman Stephanie , Lawhon Ben , Newman Peter , Derrick Taff Brendan
Published: December 2021

Improper food storage fuels human-bear conflicts in parks and protected areas around the globe. Bear-resistant food storage canisters provide an extremely effective solution for reducing food-related human-bear conflicts, especially for overnight visitors in backcountry settings. However, the success of this intervention depends on recreationists’ willingness to use and comply with such food storage methods. This study used internet-based surveys to identify Appalachian Trail backpackers’ attitudes, norms, perceived behavioral control, and intentions regarding the use of bear canisters through an application of the Theory of Planned Behavior. Results indicate attitudes and subjective norms provide potential leverage points for messaging under voluntary conditions; messaging incorporating attitudes, subjective norms, and perceived behavioral control may help influence food storage behavior under required conditions. Specific recommendations for effective, theory-based interpretation strategies aimed at reducing human-black bear conflicts on the Appalachian Trail are provided.
Keepers of the Grave: Ritual Guides, Ghosts, and Hidden Narratives in Indonesian History
Authors: Leong Kar-Yen
Published: December 2021

The 1965 killings in Indonesia brought about the incarceration, disappearances, and deaths of 500,000 to one million alleged members of the Indonesian Communist Party. This article concentrates on several suspected mass graves in Central Java reputed to have supernatural energy emanating from the violent deaths of the individuals buried there. These sites also have gatekeepers or juru kunci bridging the living and the spirits inhabiting these spaces. This research asks, How do these sites, through their juru kunci, elucidate a past which continues to be silenced? I posit that through contact with the souls of the executed, these gatekeepers utilize an ethereal connection to subvert the state’s enforced silence. These sites also provide a ritual space transforming these ghosts into ancestors worthy of remembrance. By reclaiming the identities of those murdered, the living and the dead can achieve a kind of localized spiritual reconciliation.
The adventurous tourist amidst a pandemic: Effects of personality, attitudes, and affect
Authors: Torres Edwin N , Wei Wei , Ridderstaat Jorge
Published: December 2021

To better understand travel and hospitality consumers’ purchasing behavior amidst a worldwide emergency commonly referenced as COVID-19, the present research set out to assess the impacts of sensation-seeking, consumer affect, and risk-taking attitude on consumers’ willingness to purchase travel-related activities. A sample of 775 adult U.S. consumers were recruited with the help of a professional research consulting company. Simple and multiple regression analyses were performed for the purpose of hypotheses testing. Results demonstrate that individuals with higher sensation-seeking levels, lower negative affectivity, and who identify themselves as risk-takers are more willing to engage in various travel and commercial hospitality activities. Furthermore, sensation-seeking proves to be the most influential factor in driving consumers’ willingness to purchase amidst the COVID-19 pandemic. The authors conclude by proposing a typology (illustrated in two different grids) of consumers based on their levels of sensation-seeking (high vs. low), affect (positive vs. negative), and risk-taking attitude (high vs. low). Theoretically, the model helps predict which consumers are most likely to engage in travel-related activities despite of the challenges posed by global pandemics.
The family experiences in the daily local-guided tours: Evidence from the sharing economy platform (Withlocals)
Authors: Atsız Ozan
Published: December 2021

Despite the increasing popularity of family travels and the importance of the daily local tours in the sharing economy, there is no research combining both and it is still very much lacking. Hence, this paper seeks to explore family experiences of the daily local-guided tours offered on a sharing economy platform, Withlocals, utilizing online narratives. To attain this aim, this study applies netnography approach and involves a total of 867 family experience reviews. As a result of the analysis, eight components revealed: local guides’ attributes, awe, learning, memorable, child-friendly activities, engaging tour members, family-friendly tips, and novelty. The outcomes serve as indicators for local guides in addressing the essentials and expectations in family local-guided experience. As well as having practical implications, the results yield valuable theoretical insights for family tourism literature by opening a new door for future studies.
Teaching the pragmatics of English as an international language: A focus on pragmatic markers
Authors: Sánchez-Hernández Ariadna , Martínez-Flor Alicia
Published: December 2021

The current era of globalization and emergence of English as an international language (EIL) has brought about new opportunities for L2 pragmatic learning and teaching. The common view of pragmatic learning as an approximation to native-likeness is changing towards conceiving pragmatic ability as a tool to interact with people of different cultural and linguistic backgrounds, the majority of whom are non-native speakers (NNSs) of English. While such reality is widely acknowledged, few attempts have been made to teach pragmatic competence in EIL. Addressing this concern, the present study investigates the effects that a pedagogical intervention on EIL pragmatics has on the oral use of pragmatic markers (PMs): a key tool for successful communication in the current increasingly multicultural and multilingual society. Seventy-three Spanish EFL students were divided into an instructional ( n = 34) and a control group ( n = 39). The instructional group received 4 interventional sessions that included (1) awareness of the legitimacy of EIL, (2) meta-pragmatic awareness of pragmatic behavior across the world, (3) task-supported instruction on PMs, and (4) strategy-based instruction. Pragmatic competence was assessed by students’ use of PMs in oral academic presentations. The results revealed that the instructional group had more significant changes in the frequency and variety of PMs used than the control one, as they widened the repertoire of PMs uttered in their academic presentations. These findings project the future of pragmatic instruction in EIL and provide directions for reorienting the EIL curriculum towards the integration of L2 pragmatics.
DNA as ‘ready-made evidence’: An analysis of Portuguese judges’ views
Authors: Costa Susana
Published: December 2021

The introduction of biological evidence in judicial settings raises particular modes of entanglement between professional cultures and perceptions of the probative value of evidence. When DNA evidence reaches court, it also challenges the perceived margins of critical assessment of the work and understandings of previous links in the chain of custody, like the criminal police, forensic experts and the public prosecution services. Given the apparent neutrality of judicial institutions, how do Portuguese judges perceive and value biological evidence? And how do judges see their articulation with other operators of the criminal justice system? An analysis of 14 interviews carried out with Portuguese judges reveals the challenges in the evaluation of biological evidence, which is characterised as a ‘safe haven’, grounded as it is on an indisputable scientific authority. The suggestion of the presence of a cultural rift emerges, which, taken with the work of other epistemic cultures, leads to biological evidence being seen as ‘ready-made evidence’ on its arrival in court, thus limiting the role of judges in its appraisal.
Life-course socioeconomic circumstances in acute, chronic and disabling pain among young employees: a double suffering
Authors: Fagerlund Pi , Salmela Jatta , Pietiläinen Olli , Salonsalmi Aino , Rahkonen Ossi , Lallukka Tea
Published: December 2021

Background:

Pain is known to be socioeconomically patterned and associated with disability. However, knowledge is scarce concerning life-course socioeconomic circumstances and pain among young adults. Our aim was to examine the associations of childhood and current socioeconomic circumstances with acute pain and chronic pain with low and high disability levels among young Finnish municipal employees.

Methods:

We analysed questionnaire data retrieved from the Young Helsinki Health Study ( n=4683) covering 18–39-year-old employees of the City of Helsinki, Finland. We included multiple indicators of childhood and current socioeconomic circumstances and examined their associations with acute pain and with chronic pain with low and high disability levels. The level of chronic pain-related disability was assessed by the chronic pain grade questionnaire. Multinomial logistic regression analyses were conducted with stepwise adjustments for sociodemographic, socioeconomic and health-related covariates.

Results:

Childhood and current socioeconomic disadvantage were associated with acute and chronic pain, particularly with chronic pain with high disability level. The strongest associations after adjustments for covariates remained between chronic pain with high disability level and low educational level (odds ratio (OR) 3.38, 95% confidence interval (CI) 2.18–5.24), manual occupation (OR 3.75, 95% CI 1.92–7.34) and experiencing frequent economic difficulties (OR 3.07, 95% CI 2.00–4.70).

Conclusions:

Pain is a common complaint that contributes to disability among young employees, particularly the most socioeconomically vulnerable. There is a socioeconomic gradient in both pain chronicity and the level of chronic pain-related disability. Life-course socioeconomic factors should be considered in pain-preventing strategies and in clinical practice.
Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015–2016 and the Know Your Heart study 2015–2018
Authors: Hopstock Laila A. , Kudryavtsev Alexander V. , Malyutina Sofia , Cook Sarah
Published: December 2021

Aim:

Harmful use of alcohol is a worldwide public health concern. Cultural differences may affect responses to questions on alcohol problems, making international comparisons difficult. We aimed to compare self-reported alcohol consumption and problem drinking between Norwegian and Russian populations.

Methods:

We used data from women and men aged 40–69 years participating in the Tromsø Study seventh survey (Tromsø7, N=17646, participation 65%), Tromsø (2015–2016), Norway, and the Know Your Heart study (KYH, N=4099, participation 51%), Arkhangelsk and Novosibirsk (2015–2018), Russia. Alcohol consumption and problem drinking were measured by the Alcohol Use Disorders Identification Test (AUDIT) via questionnaires (Tromsø7) and interviews (KYH). We compared AUDIT scores and components between populations, by sex.

Results:

Non-drinking was more commonly reported in KYH compared with Tromsø7 (men 15.5% versus 4.9%, women 13.3% versus 7.3%). In men, hazardous consumption (41.4% versus 31.5%) and problem drinking (24.8% versus 19.6%) was higher in KYH compared with Tromsø7, but opposite for women (6.5% versus 12.0%, and 2.3% versus 5.8%). KYH men were less likely to report problem drinking behaviours than Tromsø7 men, with the exception of needing a drink first thing in the morning (13.2% versus 2.4%). KYH women consistently reported less consumption and problem drinking than Tromsø7 women.

Conclusions:

We found between-study differences in hazardous drinking, but in men these were lower than suggested by differences in country-level statistics on alcohol consumption and alcohol-related health-harms. Study sample selection, stronger social desirability bias effects in the Russian samples, and cultural differences in responding could have affected the results.
Connecting in-game performance, need satisfaction, and psychological well-being: A comparison of older and younger players in World of Tanks
Authors: Liu Mingxuan , Choi Sukyoung , Kim Do Own (Donna) , Williams Dmitri
Published: December 2021

The need satisfaction and psychological benefits derived from gameplay are generally understudied for older video game players. This study connects the Self-Determination Theory, Motivational Theory of Life-Span Development, and Socioemotional Selectivity Theory to understand players’ in-game behaviors and their corresponding need satisfaction from a developmental perspective. Survey data from 1213 randomly sampled World of Tanks players were combined with their behavioral data to investigate how players’ behaviors and their corresponding need satisfaction differ or converge across age. Age and in-game behaviors were tested as moderators for the relationship between perceived need satisfaction and psychological well-being. The results showed that despite underperforming and having fewer in-game connections, older players reported no significant difference in their perceived competence and relatedness than younger players. Perceived competence and relatedness contributed to psychological well-being for both older and younger players, although it carried more weight for the younger. Theoretical and practical implications are discussed.
Emotional talk about robotic technologies on Reddit: Sentiment analysis of life domains, motives, and temporal themes
Authors: Savela Nina , Garcia David , Pellert Max , Oksanen Atte
Published: December 2021

This study grounded on computational social sciences and social psychology investigated sentiment and life domains, motivational, and temporal themes in social media discussions about robotic technologies. We retrieved text comments from the Reddit social media platform in March 2019 based on the following six robotic technology concepts: robot ( N = 3,433,554), AI ( N = 2,821,614), automation ( N = 879,092), bot ( N = 21,559,939), intelligent agent ( N = 15,119), and software agent ( N = 18,324). The comments were processed using VADER and LIWC text analysis tools and analyzed further with logistic regression models. Compared to the other four concepts, robot and AI were used less often in positive context. Comments addressing themes of leisure, money, and future were associated with positive and home, power, and past with negative comments. The results show how the context and terminology affect the emotionality in robotic technology conversations.
Exploring a Novel Tool to Measure Wandering Behavior in the Early Childhood Classroom
Authors: Wallisch Anna , Irvin Dwight , Kearns William D. , Luo Ying , Boyd Brian , Rous Beth
Published: December 2021

Wandering, or random movement, affects cognitive and social skills. However, we lack methods to objectively measure wandering behavior. The purpose of this pilot study was to explore the use of the Ubisense real-time location system (RTLS) in an early childhood setting to explore wandering in typically developing (TD) children ( n = 2) and children with or at risk for developmental disabilities (WA-DD; n = 3). We used the Ubisense RTLS, a tool for capturing locations of individuals in indoor environments, and Fractal Dimension (FD) to measure the degree of wandering or the straightness of a path. Results of this descriptive, observational study indicated the Ubisense RTLS collected 46,229 1-s location estimates across the five children, and TD children had lower FD ( M = 1.36) than children WA-DD ( M = 1.42). Children WA-DD have more nonlinear paths than TD children. Implications for measuring wandering are discussed.
Can Respectful Employees Create Equitable Institutions? Promoting a Culture of Respect in the Higher Education Workplace
Authors: Banner Francine , Martin Lisa , Aronson Pamela , Bradley Grace , Jaffal Islam , Linker Maureen
Published: December 2021

This paper describes challenges to changing the culture around yellow zone sexual harassment in the higher education workplace. The yellow zone comprises harassment that is often undetected or misunderstood but nonetheless is harmful. Based on a random sample, we surveyed 4554 staff and faculty at a large Midwestern university after they completed a mandatory online training module, assessing perceptions of sexual harassment, reactions to the training, and workplace personal experiences. Findings are that a majority of respondents know where to report incidents and that the training improved knowledge about sexual and gender-based harassment. However, almost half reported problematic workplace experiences.
Did They Move on? An Outcome Evaluation of the Gender-Responsive Program, Girls...Moving On
Authors: Belisle Linsey A. , Salisbury Emily J. , Keen Jaclyn
Published: December 2021

The current study is an outcome evaluation of the gender-responsive program, Girls...Moving On (GMO). Outcomes for treatment ( n = 135) and control group ( n = 135) participants reflected mixed findings, with no significant reductions in recidivism, which may have been due to problems with implementation. Nevertheless, girls who completed the program had significantly larger reductions in risk scores and increases in strength scores compare to non-completers, but little to no differences in recidivism. Additionally, GMO completers showed improvements in self-efficacy scores. Several implications and considerations regarding the outcomes are discussed to guide future gender-responsive programs for system-impacted girls.
Post-regime-change Afghan and Iraqi media systems: Strategic ambivalence as technology of media governance
Authors: Salih Mohammed A
Published: December 2021

This article investigates the governance of post-US invasion Afghan and Iraqi media systems by analyzing provisions pertinent to public broadcasting, licensing, and defamation in 14 laws and policy documents in the two nations. The author argues that the results point to a regime of regulatory ambivalence whereby state authorities have established an ontologically incongruent complex of legal and policy structures characterized by a simultaneous cohabitation of democratic and authoritarian tendencies. This ambivalence, born of struggles and contestations between state authorities, domestic civil societies and external supporters and donors, is a deliberate technology of media governance. The authoritarian tendencies of this regulatory regime have implications for media/journalists’ self-regulation as they are designed to curtail the agency of media institutions and journalists, and assert government control over speech and the flow of information.
A cluster analysis of basketball players for each of the five traditionally defined positions
Authors: Anıl Duman Eyüp , Sennaroğlu Bahar , Tuzkaya Gülfem
Published: December 2021

Determining the players’ playing styles and bringing the right players together are very important for winning in basketball. This study aimed to group basketball players into similar clusters according to their playing styles for each of the traditionally defined five positions (point guard (PG), shooting guard (SG), small forward (SF), power forward (PF), and center (C)). This way, teams would be able to identify their type of players to help them determine what type of players they should recruit to build a better team. The 17 game-related statistics from 15 seasons of the National Basketball Association (NBA) were analyzed using a hierarchical clustering method. The cluster validity indices (CVIs) were used to determine the optimum number of groups. Based on this analysis, four clusters were identified for PG, SG, and SF positions, while five clusters for PF position and six clusters for C position were established. In addition to the definition of the created clusters, their individual achievements were examined based on three performance indicators: adjusted plus-minus (APM), average points differential, and the percentage of clusters on winning teams. This study contributes to the evaluation of team compatibility, which is a significant part of winning, as it allows one to determine the playing styles for each position, while examining the success of position pair combinations.
Correction of Posttraumatic Medial Growth Arrest of the Distal Tibia in Adolescents
Authors: Kotlarsky Pavel , Abu Dalu Khaled , Eidelman Mark
Published: December 2021

Background

Partial growth arrest of the medial part of the distal tibial physis following fractures that penetrated the epiphysis is relatively common. We present the results of treatment, based on a protocol of supramalleolar tibial and fibular osteotomy for ankle alignment correction, and contralateral epiphysiodesis of distal tibia and fibula to balance leg length discrepancy (LLD).

Methods

This case series study describes the results of 7 patients with a median age of 14 years (range = 10-15 years) who were operated in our institution. All were treated by closed or open reduction and internal fixation after Salter-Harris (SH) types 3 and 4 fractures of the distal tibia. All patients had a partial medial growth arrest, distal tibial varus, relative overlengthening of the distal fibula, and slight leg shortening.

Treatment Protocol

Contralateral distal tibial and fibular epiphysiodesis to prevent significant LLD, completion of closure of the ipsilateral epiphysis, supramalleolar osteotomy of the distal tibia and fibula, and insertion of a triangular wedge cortical allograft into the tibial osteotomy creating a normal ankle joint orientation. The osteotomy was supported by a medial anatomically contoured locking plate. The fibula was fixed with an intramedullary wire.

Results

All patients had uneventful healing of the osteotomy after 6 weeks. At the latest follow-up (mean 3 years, range 1.5-5 years), 6 out of 7 patients reached maturity, and the lateral distal tibial angle was within normal limits. The LLD in all patients was less than 8 mm.

Conclusions

Our protocol provides anatomic correction with the restoration of the ankle joint and prevents the progression of LLD.

Levels of Evidence:

Level IV
The ‘Maxillary Pull-through’ Technique: A Minimally Invasive Endoscopic-Assisted Approach to Nasal Septum Neoformations with Maxillary Bone Infiltration
Authors: Priore Paolo , Giovannetti Filippo , Battisti Andrea , Di Giorgio Danilo , Della Monaca Marco , Raponi Ingrid , Cassoni Andrea , Valentini Valentino
Published: December 2021

Study Design

Description and validation of a surgical technique.

Objective

En-bloc maxillectomy with removal of the nasal septum is a rare procedure; preservation of the nasal bones and integrity of the alveolar ridge is even rarer. These procedures traditionally required a combined transfacial-transoral approach based on lateral rhinotomy. We describe a combined endoscopic transnasal-transoral approach for treatment of nasal septal malignancies that involve the hard palate.

Methods

Excision of malignant tumours arising from the nasal septum was achieved in 4 patients using a transnasal-transoral endoscopic approach. Using 4-mm optics angled at 0° and 30°, the septum was freed from the ethmoid and removed en-bloc with the hard palate, by pulling the septum down through the hard palate.

Results

Of the 4 patients, 2 underwent complete removal of septal chondrosarcomas, one removal of a sinonasal undifferentiated carcinoma and one removal of a mucoepidermoid carcinoma. In two cases, the palatal mucosa was spared and repositioned to restore separation between the nose and oral cavity. The remaining two cases underwent complete resection of the hard palate; one palate was reconstructed using a pedicled temporalis muscle flap and the other by employing an obturator. No infection was encountered. Partial ethmoidectomy was performed in all four cases. The mean hospital stay was 5 days. All patients are free of disease after a mean follow-up of 4 years (range: 2–7 years).

Conclusions

Our new approach allows for minimally invasive resection of nasal septal malignancies that extend to the palate. Our maxillary pull-through technique is a valuable new surgical procedure for malignant pathologies of the nasal septum; the only drawback is that endoscopic surgery has a steep learning curve.
Association between health insurance enrolment and maternal health care service utilization among women in Ethiopia
Authors: Seid Abdu , Ahmed Mohammed
Published: December 2021

Background

Health insurance was considered as the third global health transition which can increase access to health care services by eliminating monetary obstacles to maternal health care use, particularly in emerging nations. Hence, this study aimed to assess the association between health insurance enrolment and maternal health care service utilization among women in Ethiopia.

Methods

A cross-sectional study was conducted using the 2016 Ethiopia Demographic and Health Survey (EDHS) data set. About 4278 mothers who had delivered at least one child in the last five years of the survey were selected in the study. Multivariate logistic regression analysis was performed to measure the relationship between health insurance enrolment and maternal health care service utilization by controlling confounders An adjusted odds ratio with a 95% confidence interval and p-values < 0.05 were well-thought-out to state the imperative association.

Results

The overall health insurance coverage among the women was 4.7%. About, 18.1% of women from households in the poorest wealth quantile had no health insurance coverage for maternal health care services. Moreover, 84% of women lived in a rural area did not enclose by health insurance. According to multivariate logistic regression, the likelihoods of ANC utilization were 1.54 times (AOR: 1.54; 95% CI: 1.06–2.25) higher among mothers who were enrolled in health insurance compared to their counterparts. In the same vein, the likelihoods of been attended by a skilled birth attendant were 1.84 times (AOR: 1.84; 95% CI: 1.1–3.08) higher among mothers who were enrolled in health insurance.

Conclusions

This study has shown that women enrolled in health insurance were associated with skilled delivery and recommended ANC utilization than women who did not enroll in health insurance. Health insurance enrolment enterprises must be available to all pregnant women, particularly those of poorer socioeconomic rank.
Anterior intrapelvic approach and suprapectineal quadrilateral surface plate for acetabular fractures with anterior involvement: a retrospective study of 34 patients
Authors: Ciolli Gianluca , De Mauro Domenico , Rovere Giuseppe , Smakaj Amarildo , Marino Silvia , Are Lorenzo , El Ezzo Omar , Liuzza Francesco
Published: December 2021

Background

The purpose of the study is to evaluate the use of the suprapectineal quadrilateral surface (QLS) plates associated with the anterior intrapelvic approach (AIP) to the acetabulum in the surgical treatment of acetabular fractures with anterior involvement.

Methods

We did a retrospective study of patients surgically treated with QLS plates and AIP for acetabular fractures with the involvement of the anterior column, between February 2018 and February 2020, in our Hospital. The following data were recorded: mechanism of injury, the pattern of fracture, presence of other associated injuries, the time before performing the surgery, surgical approach, position on operating table, time of surgery, intraoperative bleeding, hospitalization time, intraoperative and postoperative complications. Follow-ups were performed at 1, 3, 6, 12 months, then annually. The clinical-functional outcome was assessed with the Merle d’Aubigne Postel score (MAP) modified by Matta; while the radiological outcome with the Matta Radiological Scoring System (MRSS). A Chi-square test was utilized to examine associations between parametric variables.

Results

We included 34 patients, mean age 62.1, with an average follow-up of 20.7 months. The most frequent traumatic mechanism was road trauma. There were 15 isolated anterior columns and 19 associated patterns. There were 5 cases of associated visceral injuries, and 10 cases of other associated skeletal fractures. All patients were in the supine position. The surgical approach used was the AIP in all cases, with the addition of the first window of the ilioinguinal approach in 16 cases and of the Kocher-Langenbeck approach in 2 cases. The average time before performing the surgery was 8.5 days. The mean time of the surgery and the mean length of stay after surgery were 227.9 min and 8.2 days, respectively. There weren’t cases of intra-operative complications, while there were postoperative complications in 5 patients. The MRSS was judged anatomical in 26 cases, imperfect in 7 cases and poor in 1 case. The average MAP value was 15.2. We observed a significant relationship between the radiological outcome and the clinical outcome (p < 0.05).

Conclusions

The QLS plates in association with the AIP approach represent an effective treatment strategy for the treatment of acetabular fractures with anterior involvement.
Designing a resilience model for pharmaceutical supply chain during crises: a grounded theory approach
Authors: Bastani Peivand , Sadeghkhani Omid , Ravangard Ramin , Rezaei Rita , Bikine Parisa , Mehralian Gholamhossein
Published: December 2021

Background

During disasters or crises, the traditional models of supply chain encounter failure and skewedness under the inevitable and unknown pressures. The procurement and transformation of required equipment to the involved areas is considered as one of the main triggers of decreasing damages and losses during crisis. In this regard, a breakdown in pharmaceutical supply chain can lead to intensive, undesired consequences.

Methods

This was a qualitative study applying a grounded theory approach. The study was conducted with attending of 32 informant participants who were qualified in supply chain during natural disasters and crisis. In order to collect the data, deep semi-structured interviews were applied along with investigating the documents, observation, field notes and theoretical memos. For data analysis, a continuous comparison was used according to Corbin and Strauss method.

Results

Results of the study were categorized in 8 main categories as the main themes. “Wasting” appeared as the main factor of the resilience of pharmaceutical and consumable medical equipment supply chain. Wasting included two subthemes of loss of resources and wasting time.

Conclusion

In order to make resilience in pharmaceutical and consumable medical equipment during disasters, it is necessary to reinforce the various dimensions of the resilience model to increase the rate of supply chain responsiveness. This study particularly contributes to broadening and deepening our understanding of how to mitigate the risk of undesirable outcomes of pharmaceutical supply chain during the disasters or crises.
Leptomeningeal metastasis from melanoma emulating chronic subdural hematoma: a case report
Authors: Yadav Pawan , Mangal Govind , Bhaumik Uday , Agarwal Sanjeev , Thakor Poojan , Lakhanpal Vaibhav
Published: December 2021

Background

Melanoma is a disease in which the patient doesn’t know about the primary lesion, and it has a propensity to metastases to any organ in the human body. Amongst melanoma, leptomeningeal metastasis has the least incidence.

Case presentation

In this case, we report a 56-year-old lady presenting with headache, recurrent vomiting and slurring of speech which on imaging was suggestive of chronic subdural hematoma which had led to surgical preparation but upon further examination, and radioimaging was found to be leptomeningeal metastasis from melanoma for which systemic therapy was started.

Conclusions

The concern is vigilance that is much needed in any case presenting in emergency. When the diagnosis is chronic subdural hematoma, it is followed by surgical treatment which is not done for leptomeningeal metastasis.
Earthen architecture in the Iberian Peninsula: a portrait of vulnerability, sustainability and conservation
Authors: Mileto Camilla , López-Manzanares Fernando Vegas , Cristini Valentina , Soriano Lidía García
Published: December 2021

For more than a decade, a wide range of Spanish case studies, relating especially to rural inner or abandoned sites and areas, have been analysed by the authors as part of different research projects linked with traditional and monumental architecture, conservation strategies and earthen buildings. On one hand the studies have been undertaken in the framework of a project concerning the conservation of rammed earth in the Iberian Peninsula, including criteria, techniques, results and perspectives and, on the other, by a project about the conservation and rehabilitation of traditional earthen architecture in the Iberian Peninsula, providing guidelines and tools for its sustainable intervention. In all cases the researchers’ efforts focused on enhancing new perspectives and opportunities for rural earthen buildings, analysing landscapes, contexts, constructive features, decay and problems. The final common aim of this research is to stress these crucial topics to improve tangible or intangible opportunities for conservation strategies.
GCM2Variants in Familial and Multiglandular Primary Hyperparathyroidism
Authors: Vincze Sarah , Peters Nicholas V , Kuo Chia-Ling , Brown Taylor C , Korah Reju , Murtha Timothy D , Bellizzi Justin , Riccardi Aaliyah , Parham Kourosh , Carling Tobias , Costa-Guda Jessica , Arnold Andrew
Published: December 2021

Context

Multiglandular and familial parathyroid disease constitute important fractions of primary hyperparathyroidism (PHPT). Germline missense variants of GCM2, a regulator of parathyroid development, were observed in familial isolated hyperparathyroidism and sporadic PHPT. However, as these previously reported GCM2 variants occur at relatively high frequencies in the population, understanding their potential clinical utility will require both additional penetrance data and functional evidence relevant to tumorigenicity.

Objective

Determine the frequency of GCM2 variants of interest among patients with sporadic multigland or familial parathyroid disease and assess their penetrance.

Design and Patients

DNA-encoding PHPT-associated GCM2 germline variants were polymerase chain reaction–amplified and sequenced from 107 patients with either sporadic multigland or suspected/confirmed familial parathyroid tumors.

Results

GCM2 variants were observed in 9 of 107 cases (8.4%): Y282D in 4 patients (6.3%) with sporadic multigland disease; Y394S in 2 patients (11.1%) with familial PHPT and 3 (4.8%) with sporadic multigland disease. Compared with the general population, Y282D was enriched 5.9-fold in multigland disease, but its penetrance was very low (0.02%). Y394S was enriched 79-fold in sporadic multigland disease and 93-fold in familial PHPT, but its penetrance was low (1.33% and 1.04%, respectively).

Conclusions

Observed in vitro–activating GCM2 variant alleles are significantly overrepresented in PHPT patients with multiglandular or familial disease compared to the general population, yet penetrance values are very low; that is, most individuals with these variants in the population have a very low risk of developing PHPT. The potential clinical utility of detecting these GCM2 variants requires further investigation, including assessing their possible role as pathogenic/low-penetrance alleles.
The Rise and Fall of India’s Relative Investment Price: A Tale of Policy Error and Reform
Authors: Johri Alok , Rahman Md Mahbubur
Published: December 2021

India’s relative price of investment rose 44 percent from 1981 to 1991 and fell 26 percent from 1991 to 2006. We build a simple DGE model, calibrated to Indian data, in order to explore the impact of capital import substitution policies and their reform post-1991 in accounting for this rise and fall. Our model delivers a 23 percent rise before reform and a 31 percent fall thereafter. GDP per effective labor was 3 percent lower in 1991 compared to 1981 due to import restrictions on capital goods. Their removal, and a 71 percentage point reduction in tariff rates, raised GDP per effective labor permanently by 20 percent. (JEL E22, E23, F13, O11, O16, O19)
Collateral Shocks
Authors: Becard Yvan , Gauthier David
Published: December 2021

We estimate a macroeconomic model on US data where banks lend to households and businesses and simultaneously adjust lending requirements on the two types of loans. We find that the collateral shock, a change in the ability of the financial sector to redeploy collateral, is the most important force driving the business cycle. Hit by this unique disturbance, our model quantitatively replicates the joint dynamics of output, consumption, investment, employment, and both household and business credit quantities and spreads. The estimated collateral shock generates accurate movements in lending standards and tracks measures of market sentiment. (JEL E21, E23, E24, E32, E44, G21)
Declining Worker Turnover: The Role of Short-Duration Employment Spells
Authors: Pries Michael J. , Rogerson Richard
Published: December 2021

Using the Quarterly Workforce Indicators database, we document that a significant amount of the decline in labor market turnover during the last two decades is accounted for by the decline in employment spells that last just one or two quarters. This phenomenon is pervasive: short-term employment spells have declined across industries, firm size categories, demographic groups, and geographic regions. Using a search-and-matching model in the Diamond-Mortensen-Pissarides tradition that incorporates noisy signals about the quality of a worker-firm match, we argue that improved screening by workers and firms can account for much of the decline in short-lived employment spells. (JEL E24, J23, J41, J63, M51)
At War in Swaddling Clothes: Stirner’s Unique One as a Conative Existence
Authors: Galanopoulos Kostas
Published: December 2021

In its simplest and primary sense, conatus is about self-preservation. It further involves the obligation, the duty, the imperative even, deriving from the Law of Nature for man to do whatever within his power to maintain his life. Even though this idea has been an old one, it was reintroduced in a more sophisticated form by modern philosophy as no longer a cruel necessity of life but ontologically tied to Reason and Natural law. It was with Hobbes that the idea of self-preservation was put at the core of his anthropological narration (with well known political connotations) and with Spinoza that conatus was delved into within his ontological universe. Regardless of their ontological starting points, both philosophers ended up eventually in a resolution with regard to that primary anthropological tension between individuals, whether this was a common legislator, the political society or the state. Somewhat radical at the beginning, Hobbes and Spinoza had to make some mitigations in order to arrive at a resolution. Yet, that was not Stirner’s case. On the contrary, Stirner’s opening ontological statement was rather too extreme and inconceivable even: it is also the newborn child that gets to war with the world and not only the other way around. It is the purpose of this paper to argue that this extreme trailhead leads the Stirnerian egoist to his fulfillment as the Unique One through ownership and that this agonistic tremendous striving constitutes the Stirnerian notion of conatus. That notion offers no resolution to the ontological animosity between individuals; on the contrary, that animosity is required as ontological precondition and prefiguration of conatus' conclusion as well.