bluuebunny/crossref_metadata_2025 huggingface dataset:
Writing Motivation of College Students in Basic Writing and First-Year Composition Classes: Confirmatory Factor Analysis of Scales on Goals, Self-Efficacy, Beliefs, and Affect
Authors: Philippakos Zoi A. Traga , Wang Chuang , MacArthur Charles
Published: November 2021

The purpose of the study was to validate a writing motivation questionnaire that consists of four scales for first-year college writers—students with low writing skills in basic writing classes and students in typical first-year composition (FYC)—to investigate differences between these two groups and to examine the relationship of motivational constructs with writing quality. Participants were 371 college students (142 in basic writing classes and 229 in FYC). Students completed a 49-item motivation questionnaire with scales for goal-orientation, self-efficacy, beliefs, and affect about writing and wrote an argumentative essay. Confirmatory factor analysis provided evidence for the structural construct validity of all scales for both groups. Statistically significant differences between basic writers and FYC students were found on self-efficacy for grammar and strategies and on beliefs about the importance of substance and mechanics. Structural equation modeling found statistically significant positive relationships of essay quality with all three self-efficacy scales and belief about the importance of substance to good writing, as well as negative relationships with avoidance goal orientation and belief in the importance of mechanics. Limitations and implications for motivation and instruction of basic writing students and of adults with learning disabilities are discussed.
What Kind of Electoral Outcome do People Think is Good for Democracy?
Authors: Blais André , Bol Damien , Bowler Shaun , Farrell David M , Fredén Annika , Foucault Martial , Heisbourg Emmanuel , Lachat Romain , Lago Ignacio , Loewen Peter John , Nemčok Miroslav , Pilet Jean-Benoit , Plescia Carolina
Published: November 2021

There is perennial debate in comparative politics about electoral institutions, but what characterizes this debate is the lack of consideration for citizens’ perspective. In this paper, we report the results of an original survey conducted on representative samples in 15 West European countries ( N = 15,414). We implemented an original instrument to elicit respondents’ views by asking them to rate “real but blind” electoral outcomes. With this survey instrument, we aimed to elicit principled rather than partisan preferences regarding the kind of electoral outcomes that citizens think is good for democracy. We find that West Europeans do not clearly endorse a majoritarian or proportional vision of democracy. They tend to focus on aspects of the government rather than parliament when they pass a judgment. They want a majority government that has few parties and enjoys wide popular support. Finally, we find only small differences between citizens of different countries.
Divided Attention, Divided Self: Race and Dual-mind Theories in the History of Experimental Psychology
Authors: Valasek C. J.
Published: November 2021

The duality of attention is explored by turning our focus to the political and cultural conceptions of automatic attention and deliberate attention, with the former being associated with animality and “uncivilized” behavior and the latter with intelligence and self-mastery. In this article, I trace this ongoing dualism of the mind from early race psychology in the late nineteenth century to twentieth century psychological models including those found in psychoanalysis, behaviorism, neo-behaviorism, and behavioral economics. These earlier studies explicitly or implicitly maintained a deficiency model of controlled attention and other mental processes that were thought to differ between racial groups. Such early models of attention included assumptions that Black and Indigenous peoples were less in control of their attention compared to whites. This racialized model of attention, as seen in the law of economy in the nineteenth century, with similar manifestations in psychoanalysis and neo-behaviorism in the twentieth century, can now be seen in present-day dual-process models as used in current psychological research and behavioral policy. These historical connections show that attention is not a value-neutral term and that attention studies do not stand outside of race and structural racism.
Survival Associated With Consolidated Multidisciplinary Care in Head and Neck Cancer: A Retrospective Cohort Study
Authors: Meltzer Charles , Nguyen Nathalie T. , Zhang Jie , Aguilar Jillian , Blatchins Maruta A. , Quesenberry Charles P. , Wang Yan , Sakoda Lori C.
Published: November 2021

Objective

To compare survival among patients with head and neck cancer before and after implementing a weekly multidisciplinary clinic and case conference.

Methods

A retrospective cohort study with chart review was conducted of 3081 patients (1431 preimplementation, 1650 postimplementation) diagnosed with stage I‐IVB tumors in the oral cavity, oropharynx, hypopharynx, nasopharynx, or larynx. Pre‐ and postimplementation differences in overall and disease‐specific survival 1, 2, and 3 years after diagnosis were assessed with unadjusted Kaplan‐Meier curves and multivariable Cox proportional hazard regression models adjusted for demographic characteristics, comorbidity burden, smoking status, tumor site and stage, p16 status for oropharyngeal squamous cell cancer, and initial treatment modality.

Results

Patients less commonly presented with oropharyngeal squamous cell cancer and advanced tumors (III‐IVB) and received primary treatment with surgery alone or with adjuvant therapy preimplementation than postimplementation. Overall survival at 3 years was 77.1% and 79.9% (P = .07) and disease‐specific survival was 84.9% and 87.5% (P = .05) among pre‐ and postimplementation patients, respectively. At 3 years, preimplementation patients had slightly poorer overall (hazard ratio, 1.20; 95% CI, 1.02‐1.40) and disease‐specific (hazard ratio, 1.26; 95% CI, 1.03‐1.54) adjusted survival than postimplementation patients. In unadjusted and adjusted analyses, survival improvements were more pronounced among patients with advanced disease.

Discussion

A multidisciplinary clinic and case conference were associated with improved outcomes among patients with head and neck cancer, especially those with advanced tumors.

Implications for Practice

All patients with head and neck cancer should receive multidisciplinary team management, especially those with advanced tumors.
Impact of Powered Air‐Purifying Respirator Devices on Word Recognition in Health Care Providers
Authors: Moldoff Emily J. , Eubank Miranda K. , Feng Anne Y. , Corrales C. Eduardo , Shin Jennifer J.
Published: November 2021

The coronavirus 2019 pandemic has increased the use of powered air‐purifying respirator (PAPR) devices, which produce appreciable noise levels during filtration. Our objective was to determine if active PAPR usage significantly impairs auditory communication in health care providers. We additionally sought to assess what volume of speech presentation was required for adequate communication with providers wearing a PAPR. In subjects with normal hearing at baseline, audiometric data demonstrated a 93% (95% CI, 86%‐99%) decrease in word recognition scores during active PAPR usage. Presentation at 85 to 90 dB was needed to obtain word recognition scores similar to baseline in subjects with normal hearing without a PAPR. Pure tone averages also significantly decreased with PAPR usage, by 54 dB (95% CI, 46‐62). Active PAPR usage has a substantial impact on auditory perception when utilized by health care providers. The potential longer‐term effect of these devices on providers with regular active usage is of interest for future study.
Is prolonged febrile syndrome associated with reactive thrombocytosis a possible association in the diagnosis of Takayasu’s arteritis? A case report
Authors: Birlutiu Victoria , Birlutiu Rares-Mircea , Sandu Mariana , Mihali-Oniga Emmanuel
Published: November 2021

Takayasu’s arteritis is a rare, systemic, inflammatory vasculitis of large blood vessels with an unknown aetiology that more frequently affects women of childbearing age with progression to stenosis, fibrosis or thrombogenesis. Clinical manifestations are associated either with inflammation of the vascular wall (including fever, myalgia, arthralgia, weight loss) or the development of aneurysms and extensive vascular lesions, which creates challenges for a differential diagnosis. This current report presents the case of a female Caucasian patient, aged 23 years, that presented herself repetitively at the hospital reporting symptoms including fever, productive cough, myalgia associated with physical effort, arthralgia, inconstant headache, weight loss and altered general condition. The patient was diagnosed with Takayasu’s arteritis in the context of a prolonged febrile syndrome associated with reactive thrombocytosis. This association results in the need to exclude multiple differential diagnoses. Nonspecific management was initiated, which included antibiotic treatment, antifungal medication, anticoagulants, steroidal anti-inflammatory drugs and correction of anaemia. The patient slowly improved. Takayasu’s arteritis in the inflammatory phase associated with a prolonged febrile syndrome and reactive thrombocytosis is a rare diagnosis of exclusion of a multitude of inflammatory diseases of large blood vessels, infectious diseases and neurofibromatosis, which requires multiple investigations for an accurate diagnosis and management.
Executive dismissal or retention? A study of performance, power, and survival for college basketball coaches
Authors: Wangrow David B. , Schwartz Evan , Hughes-Morgan Margaret
Published: November 2021

This study applies upper echelons theory associated with executive dismissal and power to examine the relationships of performance and four types of executive power— structural, prestige, expert, and governance concentration—with dismissal. Using the context of National Collegiate Athletic Association college basketball, in which coaches are completely responsible for strategies and human capital acquisition and retention, a curvilinear relationship between performance and dismissal is found. Significant relationships for prestige and expert power with dismissal are also found, but the “honeymoon period” is longer than prior studies of executive and coach dismissal have shown. Surprisingly, concentrated governance is found to be negatively associated with the likelihood of dismissal.
Alternative Systems and Materials for Splicing Prestressed-Precast Concrete Piles
Authors: Khedmatgozar Dolati Seyed Saman , Mehrabi Armin
Published: November 2021

The use of piles is a common method for establishing deep foundations for bridges where there is a top layer of weak soil. Among various types of pile and installation methods, driving prestressed-precast concrete piles (PPCP) is a durable and economical option compared with the alternatives. Also, since the method employs pile segments prefabricated in precast plants and delivered to the site for installation, it conforms to the principles of Accelerated Bridge Construction (ABC) and provides a rapid alternative to other methods. However, often because of limitations on shipping and transportation, the length of precast prestressed pile segments that can be delivered to the bridge site has to be reduced. Also, headroom limitations for pile driving may limit the length of pile segments such that establishing adequate resistance may not be achieved with one segment. Therefore, splicing of pile segments has to be performed at the site to produce longer lengths. A study carried out as part of research activities at the Accelerated Bridge Construction University Transportation Center (ABC-UTC) at Florida International University has reviewed various types of available pile splices and attempted to build on the experiences gathered for ABC connections to introduce an alternative configuration for splicing PPCP segments. Accordingly, a variation of grouted bar splice was introduced and designed to provide PPCPs with a time-effective, economical, and labor-friendly method of splicing. The proposed connection is completely new for connecting PPCP segments. Because many of PPCPs are driven in a marine environment, the application of corrosion-resistant material at the splice system is also emphasized. The paper summarizes these investigations. The results of this study show that the newly developed systems can provide the required strength in bending, tension, and compression with smaller sizes and numbers of bars. It also makes the installation faster and easier compared with the current methods.
Gross negligence ‘medical’ manslaughter in Ireland: Legal context and clinician concerns
Authors: Tumelty Mary-Elizabeth , Spain Eimear
Published: November 2021

In recent years, the prospect of the criminal prosecution of medical practitioners for patient safety incidents resulting in fatality which occur in the course of clinical practice has caused heightened anxiety among medical practitioners, particularly in England and Wales, where a number of high-profile cases have raised public consciousness of this issue. The full impact of this landscape on individual practitioners and the delivery of healthcare has yet to be ascertained, although research suggests that medical practice has been impacted. Of particular interest is the phenomenon of defensive medicine which occurs where physicians adopt assurance and/or avoidance behaviours in an attempt to minimise the risk of medical negligence litigation and/or to avoid complaints to regulatory bodies. While defensive medicine is traditionally conceived of in a civil context, the possibility of criminal prosecution for patient safety incidents resulting in fatality may also result in alterations to medical practice. Drawing on the findings of an empirical study (a survey), this research sought to explore the impact, if any, of the threat of criminal prosecution on surgical practice in the Republic of Ireland, including a potential rise in defensive practice.
Should we criminalize a deliberate failure to obtain properly informed consent?
Authors: Hobson Clark , Miola José
Published: November 2021

This paper takes the form of a polemic and thought experiment. The starting point is that, if medical law’s claims to place autonomy at the heart of the enterprise are to be taken seriously, then autonomy either needs to be considered a recoverable harm, or the most egregious infringements should be subject to the criminal law. This might particularly be the case where a doctor deliberately attempts to modify the patient’s decision by failing to disclose information that they know that the patient would find significant. The article considers medical law’s relationship with autonomy, before applying the criminal law – in the form of the analogous situation of defendants who deliberately fail to disclose HIV+ status to their sexual partners. What we find is a distinct difference in the way that autonomy is seen by medical and criminal law, although both are equally unsatisfactory.
Differences in Commuting Modes and Residential Locations as Factors of Turnover Intention of Healthcare Workers of Ambulatory Clinics
Authors: Malomo Bolajoko I.
Published: November 2021

Organisations require novel perspectives for achieving a stable workforce. One of such perspectives is having healthy employees, through timely medical care in ambulatory clinics. But when healthcare providers exhibit turnover intentions, and ultimately turnover behaviour, the purpose for such facilities is defeated. The study sought to understand if healthcare workers’ commuting modes and the differences in their residential locations affect their turnover intentions. These variables, which are yet to be investigated in the turnover literature, were examined within the assumptions of discrete choice model. Therefore, 137 healthcare workers of 11 ambulatory clinics, randomly selected from operating clinics in Marina, Lagos Island, were surveyed using purposive sampling method. The results suggest that the differences in residential locations did not produce statistically significant differences in turnover intention. However, there were significant differences in turnover intentions of participants who drive their cars and those who commute with public transport ( F (1, 131) = 9.14, p < 0.01). Further result negates the constant travel time hypothesis and the discrete choice model. The recommendations are focused on coordinated transport schedules, decentralised congested economic activities and polycentric city planning policies. These will enhance dispersed commuting.
Respiratory Muscle Weakness in Thyrotoxic Periodic Palsy: A Lesson to Remember
Authors: Sethi Prativa Priyadarshani , Parchani Ashwin , Pathania Monika
Published: November 2021

Thyrotoxic periodic palsy (TPP) is a sporadic form of hypokalemic periodic palsy that may occur in association with hyperthyroidism mostly with Graves’ disease. Acute thyrotoxic periodic palsy is a disorder most commonly seen in Asian men and characterized by abrupt onset of hypokalemia and paralysis. The disorder primarily affects the lower extremities and can involve all four limbs and presents as acute flaccid paralysis. The diagnosis of thyrotoxic periodic palsy is not difficult, but the disease's low incidence and many differentials for acute flaccid paralysis delay and complicate the diagnosis. TPP is not related to the etiology, severity, and duration of thyrotoxicosis. The treatment is similar to hypokalemic periodic palsy with potassium supplementation and initiation of antithyroid drugs and beta-blocker therapy. Here a similar case of quadriparesis is reported, which got precipitated after abrupt cessation of carbimazole in a young male. This initially was thought to be a case of hypokalemic periodic palsy and was later diagnosed to be TPP and recovered after initiating antithyroid drugs and potassium supplementation.
Acral Lentiginous Melanoma: A United States Multi-Center Substage Survival Analysis
Authors: Kolla Avani M. , Vitiello Gerardo A. , Friedman Erica B. , Sun James , Potdar Aishwarya , Daou Hala , Farrow Norma E. , Farley Clara R. , Vetto John T. , Han Dale , Tariq Marvi , Beasley Georgia M , Contreras Carlo M. , Lowe Michael , Zager Jonathan S. , Osman Iman , Berman Russell S. , Liebman Tracey N. , Stein Jennifer A. , Lee Ann Y.
Published: November 2021

Background

Acral lentiginous melanoma is associated with worse survival than other subtypes of melanoma. Understanding prognostic factors for survival and recurrence can help better inform follow-up care.

Objectives

To analyze the clinicopathologic features, melanoma-specific survival, and recurrence-free survival by substage in a large, multi-institutional cohort of primary acral lentiginous melanoma patients.

Methods

Retrospective review of the United States Melanoma Consortium database, a multi-center prospectively collected database of acral lentiginous melanoma patients treated between January 2000 and December 2017.

Results

Of the 433 primary acral lentiginous melanoma patients identified (median [range] age: 66 [8–97] years; 53% female, 83% white), 66% presented with stage 0–2 disease and the median time of follow-up for the 392 patients included in the survival analysis was 32.5 months (range: 0–259). The 5-year melanoma-specific survivals by stage were 0 = 100%, I = 93.8%, II = 76.2%, III = 63.4%, IIIA = 80.8%, and IV = 0%. Thicker Breslow depth ((HR) = 1.13; 95% CI = 1.05–1.21; P < .001)) and positive nodal status ((HR) = 1.79; 95% CI = 1.00–3.22; P = .050)) were independent prognostic factors for melanoma-specific survival. Breslow depth ((HR = 1.13; 95% CI = 1.07–1.20; P < .001), and positive nodal status (HR = 2.12; 95% CI = 1.38–3.80; P = .001) were also prognostic factors for recurrence-free survival.

Conclusion

In this cohort of patients, acral lentiginous melanoma was associated with poor outcomes even in early stage disease, consistent with prior reports. Stage IIB and IIC disease were associated with particularly low melanoma-specific and recurrence-free survival. This suggests that studies investigating adjuvant therapies in stage II patients may be especially valuable in acral lentiginous melanoma patients.
Application of the Failure Mode and Effects Analysis (FMEA) to identify vulnerabilities and opportunities for improvement prior to implementing a computerized prescription order entry (CPOE) system in a university hospital oncology clinic
Authors: Joly-Mischlich Thomas , Maltais Serge , Tétu Amélie , Delorme Marie-Noëlle , Boilard Brigitte , Pavic Michel
Published: November 2021

Introduction

Prior to implementing a new computerized prescription order entry (CPOE) application, the potential risks associated with this system were assessed and compared to those of paper-based prescriptions. The goal of this study is to identify the vulnerabilities of the CPOE process in order to adapt its design and prevent these potential risks.

Methods and materials

Failure mode and effects analysis (FMEA) was used as a prospective risk-management technique to evaluate the chemotherapy medication process in a university hospital oncology clinic. A multidisciplinary team assessed the process and compared the critical steps of a newly developed CPOE application versus paper-based prescriptions. The potential severity, occurrence and detectability were assessed prior to the implementation of the CPOE application in the clinical setting.

Results

The FMEA led to the identification of 24 process steps that could theoretically be vulnerable, therefore called failure modes. These failure modes were grouped into four categories of potential risk factors: prescription writing, patient scheduling, treatment dispensing and patient follow-up. Criticality scores were calculated and compared for both strategies. Three failure modes were prioritized and led to modification of the CPOE design. Overall, the CPOE pathway showed a potential risk reduction of 51% compared to paper-based prescriptions.

Conclusion

FMEA was found to be a useful approach to identify potential risks in the chemotherapy medication process using either CPOE or paper-based prescriptions. The e-prescription mode was estimated to result in less risk than the traditional paper mode.
Machine learning application for evaluating the friction stir processing behavior of dissimilar aluminium alloys joint
Authors: Verma Shubham , Msomi Velaphi , Mabuwa Sipokazi , Merdji Ali , Misra Joy Prakash , Batra Usha , Sharma Sandeep
Published: November 2021

This paper reports on the employment of the machine learning (ML) techniques, namely support vector machine (SVM), artificial neural networks (ANN), and random forest (RF), for predicting the tensile behavior of friction stir processed (FSP) dissimilar aluminium alloys joints (6083-T651 and 8011-H14). The dissimilar aluminium joints are fabricated using the friction stir welding (FSW) process. After that, the friction-stir welded joints are subjected to the FSP procedure at different combinations of process parameters. The rotational speed, traverse speed, and tilt angle are used as the input parameters, while tensile strength and grain size are used as the output parameters. In addition, three performance characteristics (i.e., coefficient of correlation (CC), mean absolute error (MAE), and root mean square error (RMSE)) are used to check the adequacy of the developed model of ML techniques. It is observed that support vector machine_radial basis function kernel is the most accurate modeling technique for predicting the tensile behavior of processes samples. Furthermore, the optical microscope is also utilized to check the grain size of the nugget zone (NZ) of the weld bead for FSP. It is found that the minimum grain size (i.e., 5.06 µm) is obtained for the FSP sample and this grain size corresponded to the high ultimate tensile strength (UTS). Moreover, the fractographic analysis showed the ductile behavior of FSW and FSP samples.
Neuroimaging-Guided Transcranial Magnetic and Direct Current Stimulation in MCI: Toward an Individual, Effective and Disease-Modifying Treatment
Authors: Hanoglu Lutfu , Velioglu Halil Aziz , Hanoglu Taha , Yulug Burak
Published: November 2021

The therapeutic approaches currently applied in Alzheimer's disease (AD) and similar neurodegenerative diseases are essentially based on pharmacological strategies. However, despite intensive research, the effectiveness of these treatments is limited to transient symptomatic effects, and they are still far from exhibiting a true therapeutic effect capable of altering prognosis. The lack of success of such pharmacotherapy-based protocols may be derived from the cases in the majority of trials being too advanced to benefit significantly in therapeutic terms at the clinical level. For neurodegenerative diseases, mild cognitive impairment (MCI) may be an early stage of the disease continuum, including Alzheimer's. Noninvasive brain stimulation (NIBS) techniques have been developed to modulate plasticity in the human cortex in the last few decades. NIBS techniques have made it possible to obtain unique findings concerning brain functions, and design novel approaches to treat various neurological and psychiatric conditions. In addition, its synaptic and cellular neurobiological effects, NIBS is an attractive treatment option in the early phases of neurodegenerative diseases, such as MCI, with its beneficial modifying effects on cellular neuroplasticity. However, there is still insufficient evidence about the potential positive clinical effects of NIBS on MCI. Furthermore, the huge variability of the clinical effects of NIBS limits its use. In this article, we reviewed the combined approach of NIBS with various neuroimaging and electrophysiological methods. Such methodologies may provide a new horizon to the path for personalized treatment, including a more individualized pathophysiology approach which might even define new specific targets for specific symptoms of neurodegenerations.
Multimodal Thromboprophylaxis in Patients With a History of Venous Thromboembolism Undergoing Primary and Revision Knee Arthroplasty
Authors: LeBrun Drake G. , Salvati Eduardo A. , Gonzalez Della Valle Alejandro
Published: November 2021

Background: Patients with a history of venous thromboembolism (VTE) undergoing total knee arthroplasty (TKA) are at a high risk of postoperative VTE. Purpose: In this high-risk population, we sought to evaluate the safety and efficacy of multimodal thromboprophylaxis. The regimen consisted of discontinuation of procoagulant medications, VTE risk stratification, regional anesthesia, rapid mobilization, perioperative use of pneumatic compression devices, vigorous ankle dorsiflexion during the recovery period, and chemoprophylaxis tailored to the patient’s risk of VTE. Methods: We conducted a retrospective chart review of 141 consecutive patients with a history of VTE who underwent 177 elective TKA procedures between 2005 and 2019 by 2 arthroplasty surgeons at a single institution. The patients had a history of deep venous thrombosis (DVT) (n = 127; 72%), pulmonary embolism (PE) (n = 20; 11%), or both (n = 30; 17%). Postoperative chemoprophylaxis included aspirin (n = 20; 11%), anticoagulation (n = 135; 77%), or a combination of aspirin and anticoagulation (n = 21; 12%). Complications within 120 days, including VTE events, wound complications, bleeding, and unplanned readmissions, were recorded, as was 1-year mortality. Results: Five patients (2.8%) developed symptomatic DVT (3 distal, 2 proximal), and 4 patients (2.3%) developed symptomatic PE. The most common postdischarge complications were wound infection (n = 6; 3.4%) and stiffness requiring manipulation under anesthesia (n = 5; 2.8%). There was 1 emergency room visit and 13 unplanned readmissions; 3 patients developed intra-articular hematomas or prolonged wound drainage and recovered uneventfully. All patients were alive 1 year after surgery. Conclusion: The findings of this retrospective study suggest that multimodal prophylaxis may be safe and effective in patients with a history of VTE undergoing primary and revision TKA. More rigorous study is warranted.
The Power of Odor Persuasion: The Incorporation of Olfactory Cues in Virtual Environments for Personalized Relaxation
Authors: Pizzoli Silvia Francesca Maria , Monzani Dario , Mazzocco Ketti , Maggioni Emanuela , Pravettoni Gabriella
Published: November 2021

Olfaction is the most ancient sense and is directly connected with emotional areas in the brain. It gives rise to perception linked to emotion both in everyday life and in memory-recall activities. Despite its emotional primacy in perception and its role in sampling the real physical world, olfaction is rarely used in clinical psychological settings because it relies on stimuli that are difficult to deliver. However, recent developments in virtual-reality tools are creating novel possibilities for the engagement of the sense of smell in this field. In this article, we present the relevant features of olfaction for relaxation purposes and then discuss possible future applications of involving olfaction in virtual-reality interventions for relaxation. We also discuss clinical applications, the potential of new tools, and current obstacles and limitations.
Clinical approach to skin eruptions induced by anti-TNF agents among patients with inflammatory bowel diseases: insights from a multidisciplinary IBD-DERMA clinic
Authors: Yanai Henit , Amir Barak Hadar , Ollech Jacob E , Avni Biron Irit , Goren Idan , Snir Yifat , Banai Eran Hagar , Broitman Yelena , Aharoni Golan Maya , Didkovsky Elena , Amitay-Laish Iris , Ollech Ayelet , Hodak Emmilia , Dotan Iris , Pavlovsky Lev
Published: November 2021

Background and Aims:

Skin eruptions are prevalent among patients with inflammatory bowel diseases (IBD), often associated with therapies and frequently leading to dermatological consults and treatment interruptions. We aimed to assess the impact of joint shared decision-making in a multidisciplinary (MDT) IBD-DERMA clinic.

Methods:

This retrospective cohort study assessed a consecutive group of patients with IBD who were referred for consultation in an MDT clinic at a tertiary referral center in Israel.

Results:

Over 1 year, 118 patients were evaluated in the MDT-IBD-DERMA clinic: 68 (57.6%) males; age – 35.2 ± 13.5 years, disease duration – 7.1 (interquartile range: 3.7–13.9) years; Crohn’s disease – 94/118 (79.6%). Skin eruption induced by an anti–tumor necrosis factor (TNF) were the most common diagnoses [46/118 (39%)], including psoriasiform dermatitis (PD) – 31/46 (67.4%) and inflammatory alopecia (IA) – 15/46 (32.6%). Of these, 18 patients (39.1%) continued the anti-TNF agent concomitantly with a topical or systemic anti-inflammatory agent to control the eruption. The remaining 28 patients (60.9%) discontinued the anti-TNF, of whom 16/28 (57.1%) switched to ustekinumab. These strategies effectively treated the majority [38/46 (82.6%)] of patients. Continuation of the anti-TNF was possible in a significantly higher proportion of patients with PD: 12/31 (38.7%) than only one in the IA group, p = 0.035. There was a higher switch to ustekinumab among the IA 7/15 (46.6%) compared with the PD 7/31 (22.6%) group, P = .09. Following IBD-DERMA advised intervention, IBD deteriorated in 9/4 6(19.5%) patients, 5/9 on ustekinumab (PD versus IA, P = NS).

Conclusion:

Shared decision-making in an integrated IBD-DERMA clinic allowed successful control of skin eruptions while preserving control of the underlying IBD in more than 80% of cases. Patients with IA profited from a switch to ustekinumab.
Unusual case of dystrophic calcification and thrombosis of an extra-anatomical graft in a patient with Takayasu’s arteritis
Authors: Jayaswal Sneha Kumar , Makwana Rohan , Mehra Siddhant , Shetty Varun
Published: November 2021

We report the case of a thrombotic occlusion of an extra-anatomical aortic bypass graft performed 37 years ago in a 46-year-old male with Takayasu’s arteritis. He presented with uncontrolled upper body hypertension, claudication pain in both the lower limbs, and kidney dysfunction which returned to normal post-surgery. On table we found a pseudoaneurysm at the proximal anastomosis along with calcification of the capsular tissue surrounding the graft. We attempt to explain the mechanism behind the graft occlusion, along with management of this late surgical complication which has not been described in the existing literature.
The Role of Social Capital on the Searching Behaviours of a Job Seeker in the Multiple Labour Markets
Authors: Thanh Hiep Truong , Bich Hong Nguyen Thi
Published: November 2021

This study aims to build a two-stage theoretical model to analyse the role of social capital on the searching behaviours of a job seeker in two different markets. As the advantage of the social capital in either market triggers the reservation wages in both two markets equally, the job seeker should prioritize his or her resources enhancing a larger amount of the social capital in a particular market. Consequently, the job seeker tends to search more intensively in the market where she or he has a higher level of social capital. That is the seeker can shorten the expected searching time. The proposed model also explains why the job seeker sometimes chooses the 2nd highest wage offer instead of the highest one.

JEL Classifications: C02, D83, J64
Book review: Chung Min Lee. 2019. The Hermit King: The Dangerous Game of Kim Jong Un
Authors: Ganeshpandian Porkkodi
Published: November 2021

Chung Min Lee. 2019. The Hermit King: The Dangerous Game of Kim Jong Un. United States: All Points Books, St. Martin’s Publishing Group. 320 pp. ISBN 9781250202833.
Book review: South Asia Conundrum: The Great Power Gambit
Authors: Singh Gunjan
Published: November 2021

B. M. Jain. 2019. South Asia Conundrum: The Great Power Gambit. Lanham, USA: Lexington Books. 171 pp. ISBN 978-1-4985-7175-3.
Prosthetic joint infections and legal disputes: a threat to the future of prosthetic orthopedics
Authors: Basile Giuseppe , Gallina Mario , Passeri Alberto , Gaudio Rosa Maria , Castelnuovo Nicolò , Ferrante Pasquale , Calori Giorgio Maria
Published: November 2021

Prosthetic joint infections (PJI) represent one of the major problems in orthopedic prosthetic surgery. The incidence of PJIs varies according to the site of intervention, and different published case studies report occurrence at 0.5 to 3.0% in the event of first implants, with a significant greater risk in the case of prosthesis revisions. The diagnosis of prosthetic infections is seldom simple, needing a multi-specialist approach, which includes the accurate collection of patient anamnesis, its clinical evaluation, the evaluation of inflammation biomarkers, and the use of imaging techniques. It is essential to identify the bacteria responsible for the infection not only for an accurate diagnosis, but also to select the correct antibiotic treatment. Failure to identify the bacteria involved makes it impossible to establish targeted systemic antibiotic therapy. In developed countries such as Italy, the right to health is guaranteed by the Constitution, where the institutions that provide health services must be staffed by a team of medical professionals that can guarantee the safest possible health pathways. Risk management represents the set of actions aimed at improving the quality of the care provided, the adherence to guidelines and good care practices with the final objective of guaranteeing patients’ safety. All hospitals, including the ones where prosthetic orthopedic surgery is performed, must adopt clinical risk management procedures which, through prospective tools aimed at preventing errors and complications and by retrospective methods, permit the identification of critical points in the different phases of the process and propose actions for improvement. The constant increase in litigation for malpractice in Western countries, especially in Italy, calls for special attention to the problem of PJIs and the in-depth assessment of medico-legal problems, also considering the new legislative initiatives in the field of medical malpractice. Hospitals need to tackle the onset of PJIs in a transparent and linear fashion by constantly informing the patient on their progress.
Perspectives of pain specialists, patients, and family members on long-term opioid use for chronic non-cancer pain: a qualitative study
Authors: Seangrung Rattaphol , Tempeetikul Thongchai , Pannarunothai Supasit , Sakdanuwatwong Supalak
Published: November 2021

Background

Opioids are currently prescribed for chronic non-cancer pain (CNCP), and some patients use opioids continuously for long-term treatment. Stakeholders’ awareness about long-term opioid therapy is essential for improving the safety and effectiveness of pain treatment. The purpose of this study is to explore the perspectives of pain specialists, patients, and family caregivers about long-term opioid use in CNCP management.

Methods

This study was a qualitative study and adhered to the COREQ guidelines. Pain specialists (n = 12), patients (n = 14), and family members (n = 9) were recruited to the study by purposive sampling at the Pain Clinic of Ramathibodi Hospital. Semi-structured interviews were recorded, verbatim transcribed, conceptually coded, and analyzed using Atlas.ti 8.0.

Results

All groups of participants described opioids as non-first-line drugs for pain management. Opioids should be prescribed only for severe pain, when non-opioid pharmacotherapy and non-pharmacological therapies are not effective. Patients reported that the benefits of opioids were for pain relief, while physicians and most family members highlighted that opioid use should improve functional outcomes. Physicians and family members expressed concerns about opioid-related side effects, harm, and adverse events, while patients did not. Patients confirmed that they would continue using opioids for pain management under supervision. However, physicians stated that they would taper off or discontinue opioid therapy if patients’ pain relief or functional improvement was not achieved. Both patients and family members were willing to consider non-pharmacological therapies if potential benefits existed. Patient education, doctor–patient/family relationships, and opioid prescription policies were proposed to enhance CNCP management.

Conclusion

Long-term opioid therapy for CNCP may be beneficial in patients who have established realistic treatment goals (for both pain relief and functional improvement) with their physicians. Regular monitoring and evaluation of the risks and benefits, adverse events, and drug-related aberrant behaviors are necessary. Integrated multimodal multidisciplinary therapies and family member collaborations are also important for improving CNCP management.
The effect of self-limiting on the prevention and control of the diffuse COVID-19 epidemic with delayed and temporal-spatial heterogeneous
Authors: Zhu Cheng-Cheng , Zhu Jiang
Published: November 2021

Background

The global spread of the novel coronavirus pneumonia is still continuing, and a new round of more serious outbreaks has even begun in some countries. In this context, this paper studies the dynamics of a type of delayed reaction-diffusion novel coronavirus pneumonia model with relapse and self-limiting treatment in a temporal-spatial heterogeneous environment.

Methods

First, focus on the self-limiting characteristics of COVID-19, incorporate the relapse and self-limiting treatment factors into the diffusion model, and study the influence of self-limiting treatment on the diffusion of the epidemic. Second, because the traditional Lyapunov stability method is difficult to determine the spread of the epidemic with relapse and self-limiting treatment, we introduce a completely different method, relying on the existence conditions of the exponential attractor of our newly established in the infinite-dimensional dynamic system to determine the diffusion of novel coronavirus pneumonia. Third, relapse and self-limiting treatment have led to a change in the structure of the delayed diffusion COVID-19 model, and the traditional basic reproduction number $$R_0$$

R
0

no longer has threshold characteristics. With the help of the Krein-Rutman theorem and the eigenvalue method, we studied the threshold characteristics of the principal eigenvalue and found that it can be used as a new threshold to describe the diffusion of the epidemic.

Results

Our results prove that the principal eigenvalue $$\uplambda ^{*}$$

λ

∗

of the delayed reaction-diffusion COVID-19 system with relapse and self-limiting treatment can replace the basic reproduction number $$R_0$$

R
0

to describe the threshold effect of disease transmission. Combine with the latest official data and the prevention and control strategies, some numerical simulations on the stability and global exponential attractiveness of the diffusion of the COVID-19 epidemic in China and the USA are given.

Conclusions

Through the comparison of numerical simulations, we find that self-limiting treatment can significantly promote the prevention and control of the epidemic. And if the free activities of asymptomatic infected persons are not restricted, it will seriously hinder the progress of epidemic prevention and control.
A p.Arg499His mutation in SPAST is associated with infantile-onset complicated spastic paraplegia: a case report and review of the literature
Authors: Nan Haitian , Shiraku Hiroshi , Mizuno Tomoko , Takiyama Yoshihisa
Published: November 2021

Background

Spastic paraplegia type 4 (SPG4) is caused by mutations in the SPAST gene, is the most common form of autosomal-dominant pure hereditary spastic paraplegias (HSP), and is rarely associated with a complicated form that includes ataxia, epilepsy, and cognitive decline. To date, the genotype-phenotype correlation has not been substantially established for SPAST mutations.

Case presentation

We present a Japanese patient with infantile-onset HSP and a complex form with coexisting ataxia and epilepsy. The sequencing of SPAST revealed a de novo c.1496G > A (p.R499H) mutation. A review of the literature revealed 16 additional patients with p.R499H mutations in SPAST associated with an early-onset complicated form of HSP. We found that the complicated phenotype of patients with p.Arg499His mutations could be mainly divided into three subgroups: (1) infantile-onset ascending hereditary spastic paralysis, (2) HSP with severe dystonia, and (3) HSP with cognitive impairment. Moreover, the c.1496G > A mutation in SPAST may occur as a de novo variant at noticeably high rates.

Conclusion

We reviewed the clinical features of the patients reported in the literature with the p.Arg499His mutation in SPAST and described the case of a Japanese patient with this mutation presenting a new complicated form. Accumulating evidence suggests a possible association between infantile-onset complicated HSP and the p.Arg499His mutation in SPAST. The findings of this study may expand the clinical spectrum of the p.Arg499His mutation in SPAST and provide an opportunity to further study the genotype-phenotype correlation of SPG4.
An analysis of the clinical features of children with early congenital Syphilis and Syphilitic Hepatitis
Authors: Yang Hongling , Zhang Huimin , Wang Caiying , Pang Lin
Published: November 2021

Background

The infection rate of congenital syphilis is gradually increasing, the clinical manifestations of some children with congenital syphilis are abnormal liver function, which is given the clinical diagnosis of syphilitic hepatitis. At present, there are few studies on the clinical features of children with early congenital syphilis combined with syphilitic hepatitis, so we set out to do such a study. We compared the liver function indicators before and after the treatment of syphilis to find the clinical features that can provide guidance for clinical diagnosis and treatment.

Methods

This study collected clinical data on 51 children with early congenital syphilis combined with syphilitic hepatitis in Beijing Ditan Hospital, affiliated with Capital Medical University, between April 2014 and October 2019. We observed their age, gender, clinical symptoms, and physical symptoms, as well as the pregnancy and childbirth history of their mothers. We also compared the liver function indicators before and after the treatment of the syphilis and analyzed the children’s clinical features.

Results

The results of this study showed that the clinical manifestations in children with early congenital syphilis combined with syphilitic hepatitis were diverse. The most common clinical manifestation was anemia (56.9 %), followed by syphilitic rash (54.9 %), hands, feet, and whole-body peeling (35.3 %), and splenomegaly (29.4 %). Liver damage caused by a syphilis infection tends to result in elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin, while albumin decreases. After the syphilis treatment, the liver function indexes were significantly improved compared with before treatment, and the difference was statistically significant (all p < 0.05).

Conclusions

A child with abnormal liver function, especially with anemia, skin rash, peeling, abdominal distension, and hepatosplenomegaly should be highly suspected of having a syphilis infection. Once the diagnosis is made, the appropriate standard penicillin treatment should be started as soon as possible to improve the condition and prognosis of the child.
Associations of FKBP5 polymorphisms and methylation and parenting style with depressive symptoms among Chinese adolescents
Authors: Guo Lan , Wang Wanxin , Guo Yangfeng , Du Xueying , Shi Guangduoji , Lu Ciyong
Published: November 2021

Background

Genetic factors may interplay with environmental stressors to contribute to risks of depressive symptoms. This study aimed to investigate the association of FKBP5 polymorphisms and DNA methylation with depressive symptoms among Chinese adolescents, considering the role of parenting style.

Methods

This study used a nested case-control study design based on a cohort study, and the case (n = 120) and control groups (n = 118) were matched with age. Depressive symptoms, parenting style, and other demographics were measured. Fourteen potential polymorphisms and one promoter region in the FKBP5 gene were selected for genotyping and methylation analysis.

Results

In the adjusted models, a significant association between FKBP5 rs7757037 and depressive symptoms was found in the codominant model (AG vs. GG; adjusted odds ratio [AOR] = 2.56, 95% CI = 1.13–5.78) and dominant model (AA+AG vs. GG; AOR = 2.38, 95% CI = 1.11–5.120); rs2817032 and rs2817035 polymorphisms were associated with depressive symptoms in the codominant model and dominant model. Significant interactions between rs7757037 and the father’s parenting style were found in the codominant model (P = 0.043) and dominant model (P = 0.043), but the gene-environment interactions were not significant after correcting for multiple testing. Moreover, the significant main effects of FKBP5 methylation status on depressive symptoms were not observed, and there was no significant interaction between FKBP5 methylation status and parenting style on depressive symptoms.

Conclusions

Further studies are required to confirm the effect of FKBP5 polymorphisms and methylation as well as their interactions with parenting styles in larger samples.