bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined Effect of Dynapenia and Abdominal Obesity on the Prevalence of Peripheral Artery Disease in Older Adults Over 75 Years Old in China
Authors: Zheng Yue , Sun Yuechao , Zhang Ziwei , Chen Xiaoyu , Han Peipei , Xu Che , Yao Huyi , Zhao Wenyu , Wang Ruoyan , Zhang Ying , Shen Yiyao , Zheng Yaqing , Li Ming , Guo Qi
Published: May 2023

The objective is to examine the separate and joint effects of dynapenia and abdominal obesity on the prevalence of peripheral artery disease (PAD) in older adults of different ages (60-74 and over 75 years old). This study comprised 1293 community-dwelling Chinese participants recruited from Shanghai, China, who were aged at least 60 years (753 women; mean age: 72.0 ± 5.9 years). Dynapenia was defined as low-grip strength (<28.0 kg for males and <18.0 kg for females) but normal skeletal muscle index (≥7.0 kg/m2 for males and ≥5.7 kg/m2 for females). Abdominal obesity was determined according to waist circumference (≥90 cm for males and ≥85 cm for females), and PAD was diagnosed by an ankle-brachial index  ≤ 0.9. Binary logistic regression models were performed to determine associations between dynapenia, abdominal obesity, and the combination of dynapenia and abdominal obesity and PAD. According to dynapenia and abdominal obesity status stratified by age (60-74 or over 75), the patients were divided into 4 groups: normal, dynapenia alone, abdominal obesity alone, and co-occurring groups. A logistic regression showed that the co-occurring groups (odds ratio = 4.63, 95% confidence interval = 1.41-15.21) had a higher prevalence of PAD than the normal group after adjusting for the covariates in older adults over 75 years of age. The combination of dynapenia and abdominal obesity increase the prevalence of PAD in older adults over 75 years. The present findings have important implications for the early identification of older adults with PAD and appropriate interventions should be implemented.
Inferior implant of XEN63 Gel stent in a refractory open-angle glaucoma due to silicone oil tamponade: A case report
Authors: Savastano Alfonso , Carlà Matteo Mario , Gambini Gloria , Giannuzzi Federico , Boselli Francesco , Rizzo Stanislao
Published: May 2023

Background

To discuss the efficacy of an inferior implant of XEN 63 gel stent in a patient with refractory glaucoma after trabeculectomy failure and vitreoretinal surgery with silicone oil tamponade.

Case Description

We report the case of a 73-year-old man with a history of refractory open glaucoma with trabeculectomy failure. He experienced recurrent retinal detachments with silicone oil tamponade, with uncontrolled intra-ocular pressure (IOP) after silicone oil removal. Due to the presence of oil emulsion in the anterior chamber, the chosen location for XEN 63 implantation was the infero-temporal quadrant. Mild hyphema and vitreous hemorrhage were seen post-operatively, but were self-limiting. At week 1, the intraocular pressure was 8 mmHg with a well-formed bleb seen in anterior segment optical coherence tomography (AS-OCT). At 6 month follow up, the patient maintained a IOP of 12 mmHg without topical hypotensive drugs. Slit lamp examination revealed a widespread, developed bleb with no signs of inflammation.

Conclusion

In this case of refractory glaucoma in a vitrectomized eye with previous oil tamponade, the inferior placement of the XEN 63 gel stent delivered an adequate intraocular pressure even at 6-months follow up, with a diffuse functional infero-nasal bleb seen with AS-OCT.
Assessment of Safety Requirements and Their Practices Among Teaching Laboratories of Health Institutes
Authors: Aliyo Alqeer , Edin Alo
Published: May 2023

Background:

Laboratory work provides students with the ability to process skills, perform experiments and tests, and interpret experimental data. Instead of traditional teaching methods, there are good laboratory experiences to develop a conceptual understanding of science. A lack of laboratory safety requirements and practice can affect the health of students, staff, and the environment. Therefore, the current study provides updated safety requirements and practice information.

Objective:

The purpose of this study was to evaluate safety requirements and practices among teaching laboratories at the Health Institute 2021.

Methods:

An institutional-based descriptive study design was conducted on November 15-20, 2020, among staff members of the Bule Hora University Institute of Health. Seventeen randomly selected academic staffs and laboratory assistants from 2 departments participated in the study. Data were collected through a self-administered questionnaire and an observational checklist. Finally, the data were coded and entered into Statistical Package for Social Sciences (SPSS) version 20 for analysis. Data were then analyzed using simple quantitative descriptions such as frequency counts and percentages. The data are presented in a table.

Results:

Of the safety requirements evaluated, only 33.3% (6) were available in the laboratory. Of the safety practices evaluated, 44.6% were used all the time, 37.7% were used occasionally, and 17.6% were never practiced in the laboratory by the respondents. Of his respondents, 58.8% had never been regularly inspected for laboratory safety, and 77% had never received training in laboratory safety. Observations show that teaching laboratories in health organizations lack safety manuals/first aid diaries or guidelines, laboratory building drainage systems, adequate ventilation, water flow, and appropriate laboratory sizes.

Conclusions:

This study reveals poor laboratory safety practices and safety requirements in teaching laboratories. These limitations may cause health problems, environmental pollution, contamination, and chemical spills. Stakeholders should improve safety requirements and create awareness among staff, students, and lab assistants.
The epistemic injustice in conflict reporting: Reporters and ‘fixers’ covering Ukraine, Israel, and Palestine
Authors: Kotišová Johana
Published: May 2023

This paper investigates the epistemic injustice in conflict reporting, where foreign parachute reporters collaborate with local producers and ‘fixers.’ Drawing from existing research on ‘fixers’ and other media professionals covering conflict zones and the philosophy of emotion and knowledge, I address the following questions: What is the role of local and foreign media professionals’ affective proximity and professional distance in the social epistemology of conflict news production and the epistemic hierarchy among the collaborators? What implications is this particular social epistemology believed to have for conflict reporting accuracy and ethics? Based on 36 semi-structured to in-depth interviews with foreign and local media professionals covering Ukraine, Israel, and Palestine and further online and offline contact with the Ukrainian ecosystem of foreign/conflict news production, I argue that the collaboration between foreign and local media professionals is sometimes marked by identity-prejudicial credibility deficit granted to local media professionals because of their affective proximity to the events they cover. This epistemic injustice mirrors other power vectors and the dominant journalistic professional ideology that values disinvolvement, distance, and detachment. In practice, the (local) media professionals’ affective proximity to their contexts is often appreciated as embodied knowledge beneficial to the nuance, accuracy, and ethics of journalistic practices and outcomes.
Accessing Dementia Care in Brazil: An Analysis of Case Vignettes
Authors: Figueiredo Da Mata Fabiana Araújo , Oliveira Déborah , Mateus Elaine , Franzon Ana Carolina Arruda , Godoy Carolina , Salcher-Konrad Maximilian , De-Poli Chiara , Comas-Herrera Adelina , Ferri Cleusa P , Lorenz-Dant Klara
Published: May 2023

Background and Objectives

Despite the rapid increase in the number of people living with dementia in Brazil, dementia care is limited. This study describes how people living with dementia and their carers access care, treatment, and support, and identifies what characteristics are likely to enable or prevent access.

Research Design and Methods

We created 10 vignettes to illustrate fictitious but realistic scenarios involving people living with dementia in Brazil. The vignettes explore a combination of socioeconomic and demographic variables. They were completed using an in-depth desk review of the dementia care landscape in Brazil; a Strengths, Opportunities, Weaknesses, and Threats (SWOT) analysis of the desk review; and expert knowledge. The analysis focused on identifying common sources of service provision, barriers of access to care and support, and specific issues experienced by some population groups.

Findings

Access to a dementia diagnosis, care, and support for people living with dementia in Brazil is limited. Demographic and socio-economic circumstances play a role in determining the type of services to which a person might have access. Poor knowledge about dementia, lack of capacity in the health system, and lack of formal long-term care support are among the identified barriers to accessing timely diagnosis, care, and support in the country.

Discussion and Implications

Understanding the barriers and facilitators of access to diagnosis, treatment, and support for people with dementia and families with different demographic and socioeconomic characteristics is crucial for designing dementia policies that are context-specific and responsive to the care needs of different socioeconomic groups in Brazil.
Unsupervised deep learning-based ground penetrating radar image translation for internal defect recognition of underground engineering structures
Authors: Wang Zhengfang , Lei Ming , Wang Jing , Li Bo , Xu Jing , Jiang Yuchen , Sui Qingmei , Li Yao
Published: May 2023

Anomaly detection of internal defects in underground engineering structures is critical. This paper proposes an unsupervised deep learning image-to-image translation method tailored for ground penetrating radar (GPR) images. The proposed model can translate real-world GPR images to simulated ones. In this manner, labeling real GPR images is not necessary, and only the target detection model trained on simulated GPR images is required to directly identify defects in real GPR images. The unsupervised deep learning network introduces geometry-consistency constraints into the CycleGAN, which largely prevents the problem of semantic distortion in translation. Validation of the proposed method was performed using GPR data collected in various scenarios using GPR of different center frequencies and manufacturers. Moreover, to verify its adaptability and feasibility for defect recognition, commonly used deep learning-based defect recognition methods, which were trained only on simulated GPR images, were used to detect the translated GPR images. The findings indicate that the type and location of internal defects in translated GPR images can be accurately identified using the proposed method.
Dutch first in Dutch higher education policy
Authors: Schiltmans Jessica
Published: May 2023

In the past 15 years, the number of international students in tertiary education doubled to reach 5.6 million students in 2018 and is expected to grow to 6.9 million in 2030 (Choudaha and Van Rest, 2018). In the Netherlands, the percentage of international degree seeking students is relatively high and growing fast from 4% in 2010 to more than 10% in 2017 where the average in OECD countries was 6% (OECD, 2020). Initially, this growth was perceived as positive, seen as a sign of good quality of Dutch higher education, and it was stimulated by government policy. However in the past few years, this development has led to a public debate on the downsides of this growth; the accessibility- and the quality of higher education (IBO, 2019). The latter being impacted by increased pressure on HEI because of growing student numbers. The use of the English language is also part of the discussion on quality. The debate eventually resulted in a policy proposal called Taal en Toegankelijkheid which translates into Language and Accessibility that was sent to the House of Representatives by the Minister of Education, Culture and Science (OCW) in September 2019 (Van Engelshoven, 2019b). The aim of the bill is to safeguard the quality of education, promote Dutch language skills, to guarantee accessibility of higher education and to control the influx of international students in the Netherlands (Van Engelshoven, 2019a). Before the bill was approved by the Senate, the Dutch Cabinet stepped out of power in January 2021 and the bill was declared controversial which means no decision will be made until a new Cabinet is installed (Bikker, 2021). Using the Multiple Streams Framework (MSF), this paper unravels the agenda-setting process that has led to the aforementioned government policy proposal.
The 2010–15 coalition government and the legacy of free schools in England
Authors: Williams Ben
Published: May 2023

Free schools were a flagship policy of the Conservative-Liberal Democrat coalition (2010–15), aligned with the broader academisation programme, yet both consolidating and transcending New Labour’s educational narrative between 1997 and 2010. Driven by political ‘modernisers’ such as Prime Minister David Cameron and his Education Secretary Michael Gove, these schools were framed as an innovative and revitalised educational policy approach, aspiring to eclipse previous ‘failed’ policies of both left and right. They proposed greater autonomy and liberation from statist bureaucracy, incorporating non-state bodies as providers, while remaining within the broader state educational structure. Primarily exported from Scandinavia as ‘all-ability’ schools, and with a distinctive autonomous and communitarian element, yet analysis and measurement of the impact of free schools both internationally and domestically has since been mixed. The article seeks (with the benefit of added hindsight and perspective) to focus on the circumstances in which this policy was implemented from 2010, assessing various challenges it faced within a coalition government environment, while ultimately analysing its overall impact on the English educational system in subsequent years.
Symptoms burden and rehabilitation preference after an episode of COVID-19: A patients survey
Authors: Alhotye Munyra , Daynes Enya , Gerlis Charlotte , Singh Sally J
Published: May 2023

Background

After COVID-19 infection, individuals can experience a variety of symptoms that might require further treatment. Early data showed the value of adapted pulmonary rehabilitation programmes and technology-based interventions. To develop appropriate services, it is important to understand the symptom burden and the preferred mode of rehabilitation delivery.

Methods

Post-hospital discharge (H) and post-community-managed (C) individuals received a follow-up call. A survey was completed to assess the most burdensome symptoms for which the patients would require support and their preference for the mode of rehabilitation delivery.

Results

Overall, 160 individuals who received a follow-up call completed the survey (51.2% male, mean [SD] age 54 [15] years) and 126 (78.8%) were post-hospital, while 34 (21.3%) had community-managed infections. A total of 101 (63.1%) reported that COVID-19-related symptoms were affecting their daily activities, and 106 (66.3%) reported their desire to be more active. The most common symptoms identified as needing support were fatigue and shortness of breath. Both groups expressed a preference for a face-to-face group programme (C: 54.8%; H: 46.8%), while (38.7%) of post-community-managed individuals and (40.3%) post-hospital patients preferred a supported digital rehabilitation programme. Few opted a non-digital home-based programme (C: 3.2%; H:12.9%, respectively).

Conclusion

The survey responses indicated a significant symptom burden that may benefit from an intervention such as rehabilitation. Preferences for rehabilitation indicated that a face-to-face intervention was preferred by the majority, with a large proportion preferring digital intervention.
Ikelos-RWA. Validation of an Automatic Tool to Quantify REM Sleep Without Atonia
Authors: Papakonstantinou Alexandra , Klemming Jannis , Haberecht Martin , Kunz Dieter , Bes Frederik
Published: May 2023

Study Objectives. To present and evaluate an automatic scoring algorithm for quantification of REM-sleep without atonia (RWA) in patients with REM-sleep behaviour disorder (RBD) based on a generally accepted, well-validated visual scoring method, (“Montreal” phasic and tonic) and a recently developed, concise scoring method (Ikelos-RWA). Methods. Video-polysomnographies of 20 RBD patients (68.2 ± 7.2 years) and 20 control patients with periodic limb movement disorder (65.9 ± 6.7 years) were retrospectively analysed. RWA was estimated from chin electromyogram during REM-sleep. Visual and automated RWA scorings were correlated, and agreement ( a) and Cohen's Kappa ( k) calculated for 1735 minutes of REM-sleep of the RBD patients. Discrimination performance was evaluated with receiver operating characteristic (ROC) analysis. The algorithm was then applied on the polysomnographies of a cohort of 232 RBD patients (total analysed REM-sleep: 17,219 minutes) and evaluated, while correlating the different output parameters. Results. Visual and computer-derived RWA scorings correlated significantly (tonic Montreal: rTM = 0.77; phasic Montreal: rPM = 0.78; Ikelos-RWA: rI = 0.97; all p < 0.001) and showed good to excellent Kappa coefficients ( kTM = 0.71; kPM = 0.79; kI = 0.77). The ROC analysis showed high sensitivities (95%-100%) and specificities (84%-95%) at the optimal operation points, with area under the curve (AUC) of 0.98, indicating high discriminating capacity. The automatic RWA scorings of 232 patients correlated significantly ( rTM{I} = 0.95; rPM{I} = 0.91, p < 0.0001). Conclusions. The presented algorithm is an easy-to-use and valid tool for automatic RWA scoring in patients with RBD and may prove effective for general use being publicly available.
Determining the Optimal Dosage of Corticosteroid Injection in Trigger Finger
Authors: Bookman Jared , Rocks Madeline , Noh Karen , Ayalon Omri , Hacquebord Jacques , Catalano Louis , Glickel Steven
Published: May 2023

Background:

Corticosteroid injection is the mainstay of nonoperative treatment for trigger finger (stenosing tenosynovitis), but despite substantial experience with this treatment, there is minimal available evidence as to the optimal corticosteroid dosing. The purpose of this study is to compare the efficacy of 3 different injection dosages of triamcinolone acetonide for the treatment of trigger finger.

Methods:

Patients diagnosed with a trigger finger were prospectively enrolled and treated with an initial triamcinolone acetonide (Kenalog) injection of 5 mg, 10 mg, or 20 mg. Patients were followed longitudinally over a 6-month period. Patients were assessed for duration of clinical response, clinical failure, Visual Analog Scale (VAS) pain scores, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores.

Results:

A total of 146 patients (163 trigger fingers) were enrolled over a 26-month period. At 6-month follow-up, injections were still effective (without recurrence, secondary injection, or surgery) in 52% of the 5-mg group, 62% of the 10-mg group, and 79% of the 20-mg group. Visual Analog Scale at final follow-up improved by 2.2 in the 5-mg group, 2.7 in the 10-mg group, and 4.5 in the 20-mg group. The QuickDASH scores at final follow-up improved by 11.8 in the 5-mg group, 21.5 in the 10-mg group, and 28.9 in the 20-mg group.

Conclusions:

Minimal evidence exists to guide the optimal dosing of steroid injection in trigger digits. When compared with 5-mg and 10-mg doses, a 20-mg dose was found to have a significantly higher rate of clinical effectiveness at 6-month follow-up. The VAS and QuickDASH scores were not significantly different between the 3 groups.
Unusual cause of mediastinal tumor: A case of calcified pericardial cyst
Authors: Rahman S M Tajdit , Rhaman Mia Mofizur , Hoque Mohammad Anamul , Proma Sanghita Banik
Published: May 2023

Pericardial cysts are rare benign intrathoracic lesions, and calcified pericardial cysts are even more uncommon. Most pericardial cysts are asymptomatic, but patients may present with chest pain, dyspnea and any complications of pericardial effusion. We present a case of a left-sided calcified pericardial cyst, highlighting its rarity and symptoms in relation to its location.
Incidence of surgical site infection, bacterial isolate, and their antimicrobial susceptibility pattern among patients who underwent surgery at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia
Authors: Ali Abdurrahman , Gebretsadik Daniel , Desta Kassu
Published: May 2023

Objective:

Surgical site infection is the most common postoperative complication worldwide, representing a major burden for patients and health systems. The aim of the study is to determine the incidence and bacterial profile that cause surgical site infection among patients who underwent surgery in parts of Northeast Ethiopia.

Methods:

A health facility-based cross-sectional study was conducted in Dessie Comprehensive Specialized Hospital from July 22 to October 25, 2016. A total of 338 patients from the obstetrics and gynecology and general surgical wards were included, through consecutive sampling technique. The specimens were collected aseptically on the first day when the patients had presented with clinical evidence of infection and then sent to the microbiology laboratory. The data were entered and analyzed by SPSS version 20, and the results were explained by frequency distribution in tables and figures.

Results:

The majority of participants were female (74.3%) and more than half (61.2%) of the surgeries were performed in the gynecology and obstetrics ward. Clinically, 49 patients (14.5%) were diagnosed as developing surgical site infection, and wound swabs were taken for bacteriological study. About 41 (83.7%) swabs showed bacterial growth, indicating 12.13% overall prevalence of bacterial surgical site infection. Out of 48 bacterial isolates, more than half (56.25%) of them were Gram negative. The most frequent isolate was Staphylococcus aureus, 14 (66.67%), followed by Escherichia coli, 9 (33.33%). Out of the total bacterial isolates, 38 (79.2%) isolates were found to be multidrug resistant, and the rate of multidrug resistant was higher among Gram-negative isolates.

Conclusion:

An average rate of surgical site infection was found to be reported and significant numbers of bacterial isolates were also detected. The highest rate of surgical site infection was reported in prostate surgery, followed by small bowel, vaginal hysterectomy, and exploratory laparotomy surgical procedures. Periodic surveillance on the incidence rate and bacterial profile along with the determination of their antibiotic susceptibility should be performed.
Assessing survey mode effects in the 2019 EP elections: A comparison of online and face-to-face-survey data from six European countries
Authors: Heyne Lea
Published: May 2023

The quality of online survey data is sometimes seen as inferior compared to probabilistic face-to-face surveys. Extending existing research beyond the commonly studied cases, we analyse six European countries, comparing data from a representative online survey fielded for the 2019 EP elections to the European Social Survey 9 and EB 91.5. We assess the effects of survey mode in terms of representativeness compared to validated benchmarks, as well as with inferences about party identification and vote choice. While we do find some differences in the marginal distributions compared to sociodemographic and electoral benchmarks, the inferential models when using online survey data as compared to face-to-face surveys are not substantially different.
The politics of the NPC meme: Reactionary subcultural practice and vernacular theory
Authors: Gallagher Rob , Topinka Robert
Published: May 2023

The acronym ‘NPC’ originates from videogame culture, where it refers to computer-controlled drones whose behaviour is dictated by their programming. By 2018 the term had gained traction within right-wing subcultural spaces as shorthand for individuals apparently incapable of thinking for themselves. By the autumn of 2018, these spaces were awash with NPC memes accusing liberals and leftists of uncritically accepting progressive doxa and parroting left-wing catchphrases. In mid-October, with midterm elections looming in the US, Twitter banned over 1000 NPC roleplay accounts created by supporters of Donald Trump, citing concerns over disinformation. This event was much discussed both within right-wing subcultural spaces and by mainstream media outlets, serving as an occasion to reassess the political effects of digital media in general and reactionary memes in particular. Here we use a combination of computational analysis and theoretically informed close reading to trace the NPC meme's trajectory and explore its role in entrenching affectively charged political and (sub)cultural faultlines. We show how mainstream attention at once amplified the meme and attenuated its affective resonance in the subcultural spaces where it originated. We also contend that while the NPC meme has served as a vehicle for antidemocratic bigotry, it may yet harbour critical potential, providing a vocabulary for theorising the cultural and political impacts of communicative capitalism.
Implementing an Innovative Lipid Management Technique Using siRNA LDL-C Lowering Therapy: Lessons Learned in an NHS Primary Care Practice With Worked Case Examples
Authors: Deaney Carl , Donaldson Meredith , Meskauskiene Agne
Published: May 2023

Introduction:

The UK Government partnered with industry to tackle cardiovascular disease (CVD) in the first NHS population health agreement. The ambition was to prevent 150 000 strokes, heart attacks and dementia cases over the next 10 years with a new siRNA LDL-C lowering therapy (Inclisiran) delivered within Integrated Care Services by primary care to support a comprehensive approach to lipid management. Following the approval of inclisiran, and guidance published by the National Institute for Health & Care Excellence (NICE) on its use, this paper has been created by a UK general practice to share real-world observations of cases and the potential service benefits of rolling out this innovative drug treatment. The process of identifying patients at risk of atherosclerotic cardiovascular disease (ASCVD) and lessons learned from implementing in practice is also addressed. Workstreams were developed to rapidly roll out a low clinical burden enhanced lipid management program incorporating siRNA LDL-C lowering therapy into primary care practice.

Approach/Method:

(1) Multi-disciplinary team (MDT) education program based on freely available Academic Health Science Network (AHSN), National Institute for Health & Care Excellence (NICE), and commercial materials. (2) Automated searches using a software program were run to identify “at-risk” patients alongside manual case-finding in everyday clinics. (3) Patients were invited for review using multi-channel modalities. (4) Where appropriate, treatment was commenced after consent was obtained. (5) Automated recall systems are used to ensure follow-up; initially at 3 months, then every 6 months.

Discussion and Conclusions:

Enhanced lipid management as a secondary prevention measure is achievable in line with national guidance and objectives. The methodology and education/training processes used in combination with reconstructing the management process can help practice staff realize the program benefits, which in turn can lead to a shift in behavior where all staff embed manual case-finding of high-risk patients into everyday consultations and reviews; enabling rapid identification of eligible patients. Taking a multi-disciplinary, holistic approach to new initiatives reduces service burden, particularly for GPs. Leveraging resources from the AHSN and others removes additional training pressures often associated with new initiatives and provides a wealth of educational material to support primary care MDT upskilling.
The Effectiveness of the Multiple-Attending-Physicians System Compared With the Single Attending-Physician System in Inpatient Setting: A Mixed-Method Study
Authors: Park Daeho , Son Daisuke , Hamada Toshihiro , Imaoka Shintaro , Lee Young , Kamimoto Minako , Inoue Kazuoki , Matsumoto Hiromi , Shimosaka Takuya , Sasaki Shuichi , Koda Masahiko , Taniguchi Shin-ichi
Published: May 2023

Objectives:

Medical facilities have been required to effectively utilize insufficient human resources in many countries. Therefore, we qualitatively and quantitively compared physicians’ working burden, and assessed advantages and disadvantages of the single- and the multiple-attending physicians systems in inpatient care.

Methods:

In this cross-sectional study, we extracted electronic health record of patients from a hospital in Japan from April 2017 to October 2018 to compare anonymous statistical data between the single-attending and multiple-attending-physicians system. Then, we conducted a questionnaire survey for all physicians of single and multiple-attending systems, asking about their physical and psychiatric workload, and their reasons and comments on their working styles.

Results:

The average length of hospital stay was significantly shorter in the multiple-attending system than in the single-attending system, while patients’ age, gender, and diagnoses were similar. From the questionnaire survey, no significant difference was found in all categories although physical burden in multiple-attending system tended to be lower than that in single-attending system. Advantages of multiple-attending system extracted from qualitative analysis are (1) improvement of physicians’ quality of life (QOL), (2) lifelong-learning effect, and (3) improving the quality of medical care, while disadvantages were (1) risk of miscommunications, (2) conflicting treatment policies among physicians, and (3) patients’ concern.

Conclusions:

The multiple-attending physician system in the inpatient setting can reduce the average length of stay for patients and also reduce the physical burden on physicians without compromising their clinical performance.
Managing Myocardial Bridge and Right Ventricular Outflow Tract Obstruction in an Adolescent With Hypertrophic Cardiomyopathy
Authors: Joseph Alysha , Hernandez Nathanya Baez , Davies Ryan , Tan Weiyi
Published: May 2023

We report a case of symptomatic myocardial bridge in an adolescent with dynamic right ventricular outflow tract obstruction and history of congenital pulmonary valve stenosis as well as hypertrophic cardiomyopathy. Definitive treatment was surgical infundibular myectomy and coronary unroofing, resulting in improvement in right ventricular outflow tract gradient and ischemic symptoms.
Socially and Educationally Distanced: Examining the Views of University Students
Authors: Güngör Cumhur
Published: May 2023

Although for many students’ stress is a natural part of university life, new stress sources have come into the picture with the pandemic. A “phenomenological” method, one of the qualitative analysis methods, was used in this study, which seeks to reveal the effects of various aspects of the pandemic on the life of university students. The findings show that students want to return to face-to-face education in terms of educational life and, in parallel, find distance education inefficient, have difficulty in adjusting to the new order, have psychological problems, their work habits are negatively affected and they experience performance loss. In addition, they need social interaction since they are deprived of the university environment. On the other hand, limitation of social life, change in social behavior, personal development and devoting more time to themselves are the leading behavioral changes that students observe in themselves.
Stock Market Prediction, COVID Pandemic, and Neural Networks: An Levenberg Marquardt Algorithm Application
Authors: Goel Himanshu , Singh Narinder Pal
Published: May 2023

Stock market forecasting has always piqued the interest of a wide range of investors, practitioners, and researchers. Stock prediction is a complex process due to the presence of an inherent noisy and volatile environment. The stock market’s movement is influenced by a variety of factors. The study of ANN models began in 1969, “when Minsky and Papert discovered two critical flaws in the Artificial Neural Network technique. The first was the machine’s ability to solve complex problems, and the second was the computers’ inability to run large ANN models efficiently”. The study aims to forecast the Nifty 50 using macroeconomic factors as input variables in the two sub-periods, that is, pre-COVID (February 2018–February 2020) and during COVID (March 2020–December 2021). A model trained using the LM algorithm was used for predicting the NSE’s flagship index Nifty 50. The findings reveal that the LM algorithm achieved 95.18% accuracy in predicting the Nifty 50 in the pre-COVID scenario. Whereas during COVID period, the proposed ANN model achieved 94.21% accuracy. The empirical results have important implications for every class of investors, such as FIIs, DIIs, retail investors, and so on.
L1CAM expression in human gastrointestinal tract development: From tongue to colon-rectum
Authors: Flaviana Cau , Monica Piras , Terenzio Congiu , Raffaele Murru , Valentina Aimola , Giulia Cerrone , Peter Van Eyken , Giorgio La Nasa , Massimo Castagnola , Ferdinando Coghe , Germano Orru’ , Daniela Fanni , Clara Gerosa
Published: May 2023

Background:

L1CAM (L1 cell adhesion molecule) is a member of the L1 family of neural adhesion molecules, involved in the development of multiple organs and tissues, including kidneys, the enteric nervous system, and adrenal glands. The aim of this study was to analyze, at the immunohistochemical level, the expression of L1CAM in the human tongue, parotid glands, and the different segments of the gastrointestinal tract during human development.

Design and method:

Immunohistochemical analysis for L1CAM was performed in the human tongue, parotid glands, and in the different segments of the gastrointestinal tract during development, starting from the 8th up to the 32nd week of gestation.

Results:

Our results were given by the expression of the L1CAM protein in different segments of the gastrointestinal tract during development, starting from the 8th week up to the 32nd week of gestation. L1CAM-reactive cells appeared aggregated in small bodies, irregular in shape, showing L1CAM storage in the cytoplasm. L1CAM expressing bodies were frequently found to be connected one to the next by thin fibers, a finding suggestive of the existence of an L1CAM network inside the developing tissue.

Conclusion:

Our study confirms that L1CAM is involved in gut development, as well as in tongue and salivary gland development. These findings confirm that the role of L1CAM in fetal development is not restricted to the central nervous system and are necessary for further studies on the role of this molecule in human development.
Influence of Medial Patellofemoral Ligament Reconstruction on Patellofemoral Contact in Patients With Low-Flexion Patellar Instability: An MRI Study
Authors: Siegel Markus , Taghizadeh Elham , Lange Thomas , Fuchs Andreas , Yilmaz Tayfun , Maier Philipp , Meine Hans , Schmal Hagen , Izadpanah Kaywan
Published: May 2023

Background:

Medial patellofemoral ligament (MPFL) reconstruction is a well-established procedure for the treatment of patients with patellofemoral instability (PFI) at low flexion angles (0°-30°). Little is known about the effect of MPFL surgery on patellofemoral cartilage contact area (CCA) during the first 30° of knee flexion.

Purpose/Hypothesis:

The purpose of this study was to investigate the effect of MPFL reconstruction on CCA using magnetic resonance imaging (MRI). We hypothesized that patients with PFI would have a lower CCA than patients with healthy knees and that CCA would increase after MPFL reconstruction over the course of low knee flexion.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

In a prospective matched-paired cohort study, the CCA of 13 patients with low-flexion PFI was determined before and after MPFL reconstruction, and the data were compared with those of 13 healthy volunteers (controls). MRI was performed with the knee at 0°, 15°, and 30° of flexion in a custom-designed knee-positioning device. To suppress motion artifacts, motion correction was performed using a Moiré Phase Tracking system via a tracking marker attached to the patella. The CCA was calculated on the basis of semiautomatic cartilage and bone segmentation and registration.

Results:

The CCA (mean ± SD) at 0°, 15°, and 30° of flexion for the control participants was 1.38 ± 0.62, 1.91 ± 0.98, and 3.68 ± 0.92 cm2, respectively. In patients with PFI, the CCA at 0°, 15°, and 30° of flexion was 0.77 ± 0.49, 1.26 ± 0.60, and 2.89 ± 0.89 cm2 preoperatively and 1.65 ± 0.55, 1.97 ± 0.68, and 3.52 ± 0.57 cm2 postoperatively. Patients with PFI exhibited a significantly reduced preoperative CCA at all 3 flexion angles when compared with controls ( P ≤ .045 for all). Postoperatively, there was a significant increase in CCA at 0° of flexion ( P = .001), 15° of flexion ( P = .019) and 30° of flexion ( P = .026). There were no significant postoperative differences in CCA between patients with PFI and controls at any flexion angle.

Conclusion:

Patients with low-flexion patellar instability showed a significant reduction in patellofemoral CCA at 0°, 15°, and 30° of flexion. MPFL reconstruction increased the contact area significantly at all angles.
Efficacy of Subchondroplasty in the Treatment of Pain Associated With Bone Marrow Lesions in the Osteoarthritic Knee
Authors: Randelli Pietro , Compagnoni Riccardo , Ferrua Paolo , Ricci Martina , La Verde Luca , Mekky Ahmed Farid , De Silvestri Annalisa , Menon Alessandra
Published: May 2023

Background:

Bone marrow lesions (BMLs) are common subchondral defects revealed by magnetic resonance imaging (MRI) in patients with osteoarthritis, often associated with pain and functional limitation. Subchondroplasty (SCP) is a relatively new technique in which bone substitute material (BSM) is injected inside BML areas to provide structural support to the subchondral bone, preventing its collapse and reducing pain.

Purpose/Hypothesis:

The purpose of this study was to characterize changes in pain, functional and radiological outcomes, conversion to knee replacement, and complications after SCP. We hypothesized that ≥70% of patients would achieve a reduction in pain of ≥4 points on a numeric rating scale (NRS) at a 6-month follow-up after SCP.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients with symptomatic knee BMLs who underwent SCP were prospectively evaluated preoperatively and at 1, 6, 12, and 24 months postoperatively. Functional outcomes were measured with the NRS for pain, Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and International Knee Documentation Committee (IKDC) scores. Radiographs and MRI were performed preoperatively and at 6- and 12-month follow-ups to verify edema healing and changes in bone structure.

Results:

A total of 50 patients were included in the study. The mean follow-up was 26 months (24-30 months). Compared with preoperative values, the mean NRS score decreased at every follow-up point ( P < .0001 for all) and the IKDC, WOMAC, and KSS scores improved significantly at 6- and 12-month follow-ups. At 6 months postoperatively, 27 patients (54%) registered a reduction on the NRS of ≥4 points. Postoperative MRI revealed a hypointense zone surrounded by a hyperintense signal at the injection site. Standard radiography showed osteoarthritis grade worsening in 4 (8%) patients. Knee replacement was performed in 11 patients —in 7 patients due to the worsening or persistence of disabling symptoms and in 4 patients due to the progression of osteoarthritis. The leakage of BSM occurred in 6 patients without any clinical consequences during the study period.

Conclusion:

About half of the study patients achieved a reduction in the NRS of 4 points at the 6-month follow-up after SCP.

Registration:

NCT04905394 ( ClinicalTrials.gov identifier).
My Favorite Assignment: Selections From the ABC 2022 Annual International Conference, Tampa, Florida, USA: Sharing Teaching Innovations With a Porpoise Pod’s Coordination, Speed, and Grace
Authors: Whalen D. Joel , Drehmer Charles
Published: May 2023

Business communication teachers navigate a constantly changing pedagogical geography shaped by technology and breakthrough discoveries in linguistics, psychology, and neurobiology. My Favorite Assignment is designed to speed new teaching methods to the classroom. This article gives readers 11 teaching innovations on report writing, intercultural communication, and analysis and critical thinking debuted at the 2022 Association for Business Communication’s (ABC) 87th Annual International Conference in Tampa, Florida, USA. Additional support materials—instructions to students, stimulus materials, slides, grading rubrics, frequently asked questions, and sample student projects—are downloadable from the ABC and DePaul University Center for Sales Leadership websites.
Predictors of Parents’ Willingness to Vaccinate Their Children Against COVID-19 in India: A Web-Based Cross-Sectional Survey
Authors: Goruntla Narayana , Ayisha M Umaira , Sreeram Manjunath
Published: May 2023

Background

Parents are more concerned about the available evidence of the safety, efficacy, and tolerability of the pediatric COVID-19 vaccine.

Aim

To assess the parents’ willingness to vaccinate their children against COVID-19 and associate it with health belief model constructs.

Materials and Methods

A countrywide, online, self-administered, cross-sectional survey was conducted from December 15, 2021 to March 8, 2022. The HBM approach was used as a theoretical context to assess the predictors of parents’ willingness to vaccinate their children against COVID-19.

Results

The majority (1,563; 95.4%) of parents are intended to immunize their children against COVID-19. Parent education, financial status, job, number of children, age-related vaccination status of the child, and household suffering from chronic disorders were significantly associated with a parent's willingness to recommend the COVID-19 vaccine for their children. The findings of HBM constructs indicated that perceived benefits (OR 14.222; 95% CI 7.192-28.124) of the COVID-19 vaccine in children, susceptibility (OR 7.758; 95% CI 3.508-17.155) of children toward COVID-19, and severity (OR 3.820; 95% CI 2.092-6.977) of COVID-19 infection in children were significantly associated with parent acceptance to vaccinate their children. Parents’ higher perception of barriers (OR 0.609; 95% CI 0.372-0.999) to vaccination reduces the intention to vaccinate children against COVID-19.

Conclusion

The findings of our study reveal that the value of HBM constructs in the identification of predictors associated with the parents’ willingness to encourage COVID-19 vaccine for their children. It is important to improve health and reduce the barriers to COVID-19 vaccination among Indian parents having children less than 18 years.
The Stages of Team Development: Examples From the Real World
Authors: Young Stephen P.
Published: May 2023

Studies have revealed the challenges facing management and the role the manager has with respect to facilitating team development. This exercise builds upon the knowledge a management student gains via textbook and/or classroom lecture concerning the stages of team development and offers real-world examples of the challenges facing managers when assigned the role of a team leader. The activities found in this exercise reinforce what students learn about the stages of team development by reviewing how a manager contributes to the development of a team and offers students the opportunity to assume the role of a manager in response to real-world situations they may face as future managers.
Assessing patient safety culture among healthcare professionals in Ibadan South-west region of Oyo State, Nigeria
Authors: Abel Chukwuemeka , Oliver Ezechi , Folahanmi Akinsolu
Published: May 2023

Objectives

Patient safety culture is essential to improve care, prevent adverse events, and deliver quality healthcare service. The levels of patient safety culture and adverse events in Nigerian healthcare institutions are still widely underreported. The main objective of this study was to assess patient safety culture among healthcare professionals in primary and secondary healthcare facilities in Ibadan South-west local government area of Oyo State, Nigeria.

Methods

In this cross-sectional study, investigators collected data with the English version of the Hospital Survey on Patient Safety Culture version 2.0 questionnaire. They analyzed data using the Statistical Package for the Social Sciences (SPSS) software with descriptive statistics, Pearson Correlation Analysis, and one-way analysis of variance.

Results

A total of 271 healthcare professionals participated in the study. Study findings showed the overall perception of patient safety culture to be 72.1%. Among patient safety dimensions, Teamwork (88.5%) and Reporting Patient Safety Events (47.4%) were the highest and lowest percentage of positive responses, respectively.

Conclusions

Patient safety culture is an emerging concept in Nigeria. The assessed dimensions showed the need to improve the safety culture among healthcare professionals. Therefore, stakeholders, policymakers, and managers should employ policies, strategies, and programs to enhance safety culture across all healthcare institutions.
Inclusion of Infants and Toddlers With Significant Support Needs Across Natural Environments: What Can Early Interventionists Do?
Authors: Williams Crystal S. , Sawyer Grace E. , Alexander Jonathan R. , Ostrosky Michaelene M.
Published: May 2023

Infants and toddlers with significant support needs (SSNs) receive early intervention services under Part C of the Individuals with Disabilities Education Improvement Act. These services occur in a variety of children’s natural environments, which may include their home, child care, community parks, extended family members’ homes, etc. It is important that early interventionists who provide developmental services to children with SSNs and their caregivers are equipped with strategies they can use to promote meaningful inclusion of this unique population. This paper illustrates what high-quality inclusion can look like and provides strategies that early interventionists can implement with various caregivers in a child’s life.