bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparison of the Effects of Augmented Reality N-Back Training and Traditional Two-Dimensional N-Back Training on Working Memory
Authors: Zhang Bo , Robb Nigel
Published: May 2021

We compared two versions of an n-back training program, differing from the graphical perspective, on the effects of working memory (WM) training and transfer. Sixty participants were trained on a traditional n-back task (2D perspective) or an augmented reality (AR) version of the same program. The AR version was rated more engaging and graphically stimulating. Pre- and post-performance on a 2D spatial working memory (SWM) test showed that while both groups improved, the distributions of improvement differed significantly between the groups; the group using traditional training showed generally more improvement on the easier levels of the SWM test. These results may be explained by the fact that the traditional (2D) version of the n-back training was more similar than the AR version to the SWM outcome measure (in virtue of its 2D presentation). This may support the common demands theory of training transfer, which claims that shared demands between training and transfer tasks accounts for near-transfer improvements.
The Half-Empty/Full Glass in Mental Health: A Reference-Dependent Computational Model of Evaluation in Psychopathology
Authors: Rigoli Francesco , Martinelli Cristina , Pezzulo Giovanni
Published: May 2021

Evaluation (the process attributing value to outcomes) underlies “hot” aspects of cognition, such as emotion, affect, and motivation. In several psychopathologies, such as depression and addiction, impairments in evaluation are critical. Contemporary theories highlight the reference-dependent nature of evaluation, whereby outcomes are evaluated relative to their context. Surprisingly, reference-dependent evaluation remains to be explored in the context of psychopathology. We offer a computational theory of how impaired reference-dependent evaluation might underlie mental illness. The theory proposes that evaluation derives from comparing an outcome against a reference point parameter and by weighting any discrepancy by an uncertainty parameter. Maladaptive evaluation is proposed to occur when these parameters do not reflect the true context statistics. Depending on which parameter is altered, different forms of maladaptive evaluation emerge, each associated with specific clinical conditions. This model highlights how the concept of reference-dependent evaluation can elucidate several clinical conditions, including perfectionism, depression, and addiction.
Mid- to Long-Term Outcomes After Resection of Thoracic Dumbbell Tumors Managed by Laminectomy and Unilateral Total Facetectomy Without Instrumented Fusion
Authors: Ishikawa Yuya , Ohashi Masayuki , Hirano Toru , Matsuda Michiharu , Akabane Takeru , Kanno Haruo , Hashimoto Ko , Handa Kyoichi , Aizawa Toshimi , Suzuki Tomoto , Shimamura Yukihide , Watanabe Kei
Published: May 2021

Study Design:

Retrospective multicenter study.

Objective:

To evaluate mid- to long-term surgical outcomes of thoracic dumbbell tumors managed by laminectomy and unilateral total facetectomy without instrumented fusion.

Methods:

A total of 15 patients with thoracic dumbbell tumors who underwent primary resection by laminectomy and unilateral total facetectomy without spinal instrumented fusion between 2000 and 2015 were reviewed. Patient characteristics, surgical outcomes (including spinal alignment and stability), disc degeneration, pain, disability, and health-related quality of life were evaluated. Additionally, to analyze the impact of the affected levels on these outcomes, we divided the patients into 2 groups: a middle thoracic group and a thoracolumbar group.

Results:

The mean duration of follow-up was 100.5 months (range, 36-190 months). The affected level was T3-T4 or below in all patients. Although the local kyphosis angle (8.1° to 12.7°), thoracic kyphosis angle (25.6° to 33.9°), and coronal Cobb angle (6.6° to 9.5°) significantly increased from preoperative to the final visit ( P ≤ .02), no patient demonstrated spinal instability. From magnetic resonance imaging, no patient had a worse grade of disc degeneration in the affected level than those in the adjacent levels. The percentage of patients who presented with an Oswestry disability index ≤ 22% was 80%. Moreover, the surgical region did not adversely affect the outcomes. No patient required additional surgery due to spinal instability or deformity.

Conclusions:

Unilateral total facetectomy without fusion to resect thoracic dumbbell tumors caused neither spinal deformity nor instability requiring additional surgery at the mid- to long-term follow-up.
Coronal Compensation Mechanism of Pelvic Obliquity in Patients With Developmental Dysplasia of the Hip
Authors: Yu Yang , Song Kai , Wu Bing , Chi Pengfei , Liu Jinjin , Wang Zheng , Wang Yan
Published: May 2021

Study Design:

Descriptive retrospective study.

Objective:

DDH is a common lower limb deformity. It has been reported that this deformity can change the sagittal alignment of spine and pelvis. Sacral obliquity (SO) and iliac obliquity (IO) have been proven simple and reliable pelvic-lower limb coronal parameters to evaluate the coronal balance of the pelvis. To study the spine-pelvic coronal compensation mechanism of pelvic obliquity in patients with developmental dysplasia of the hip (DDH).

Methods:

We collected the data of 110 patients with DDH in our hospital from January 2009 to December 2019, who underwent total hip arthroplasty. We used ICC (Intraclass correlation coefficient) to test the reliability of the measurement result of SO and IO in patients with DDH. A paired t-test was used for the statistical analysis.

Results:

The intra observer reliability of IO and SO was 0.965 and 0.875 respectively, and the inter observer reliability of IO and SO was 0.887 and 0.889 respectively. The sacroiliac joint and spine can compensate for pelvic obliquity in patients with DDH. We classified the compensatory mechanism into 3 types according to the different imaging performances.

Conclusions:

The sacroiliac joint has a considerable compensatory ability to ensure coronal balance. We clarified and classified the compensatory mechanism of pelvic obliquity into 3 types. We differentiated the pelvic obliquity in patients with DDH and in those with scoliosis, which is clinical significant to understand the process of development of the disease.
Financial Sustainability of Microfinance Institutions and Macroeconomic Factors: A Case of South Asia
Authors: Memon Ainan , Akram Waqar , Abbas Ghulam , Chandio Abbas Ali , Adeel Sultan , Yasmin Iram
Published: May 2021

This study explores the financial sustainability of microfinance institutions (MFIs) in the economic context to identify how macro-level economic decisions affect the micro-level decisions in the microfinance sector in South Asia. For that purpose, the data of 409 South Asian MFIs combined with the macroeconomic variables of respective countries are used over the period 1999–2017. The empirical analysis uses a fixed-effect model (FEM) to analyse the unbalance panel data of microfinance institutions and macroeconomic variables. We employ two-stage least squares (2SLS) model for robustness and System Generalized Method of Moment (GMM) to address the potential endogeneity and over-identification bias. The results reveal that economic indicators such as foreign investment, human development, inflation, interest rate, private credit, and labour force participation have negatively influenced financial sustainability except for the GDP growth. The overall economic results seem imperative from the good-governance perspective of MFIs. Besides, the government and microfinance policymakers need to give due consideration to the macro-level economic decisions to achieve the financial sustainability of MFIs.

JEL Classification: A12, G21, G28, O1, Q01
An Econometric Investigation of Dynamic Linkages Between CO2 Emissions, Energy Consumption, and Economic Growth: A Case of India and China
Authors: Shahani Rakesh , Bansal Aastha
Published: May 2021

The article investigates the co-integrating relationship between economic growth, energy, and environment for India and China for the period 1970–2014 (using log transformed yearly data). Whereas gross domestic product per capita is taken as the growth proxy, CO2 emissions per capita represents environmental degradation and fossil fuel consumption is the proxy for energy consumption. The methodology adapted is autoregressive distributed lag “F” Bounds test with single structural break. The results of the study showed that co-integrating relation was established among all the variables except when CO2 (China) is taken as dependent variable. The “error correction model” term was negative and significant in all the cases (except for CO2 China again). Further the speed of adjustment toward equilibrium was highest at 16% per annum (p.a.) for CO2 in India while it was between 3% and 8% p.a. for rest of the variables. Chow breakpoint test even confirmed that India CO2 emissions had a break in 1996.
A Novel Silicone Simulation Model for Microvascular Anastomosis
Authors: Winter Jessica M. , Petropolis Christian
Published: May 2021

Purpose:

Surgical simulation of microvascular anastomosis has become increasingly popular. There are several living and silicone models available. Current silicone models fail to accurately reproduce a vessel’s loose adventitial layer, which may lead to the development of improper microsurgical technique. Our purpose is to create a realistic 3-dimensional microsurgical simulator that incorporates an adventitial vessel layer for higher fidelity manipulation of vessels.

Methods:

A microvascular anastomosis simulator was manufactured using metal moulds and inorganic materials. Synthetic tubing was created with a metal cylinder, 1.65 mm in diameter, painted with 2 sequential layers of silicon with a shore hardness of 2A. Silicone was allowed to fully cure in-between layers. Vessel adventitia was created with a 100-micron polyester mesh adhered to the silicone vessel exterior. Once dry, the synthetic tube is removed from the metal cylinder is then clipped to reveal the inner lumen. Both Resident and attending physicians evaluated the model with and without the adventitial layer and completed a questionnaire.

Results:

Grasping and manipulation of the vessel were scored on Average score 4.5 and 3 out of 5, with adventitia and without, respectively ( P = .00906). Usefulness as a teaching tool was scored on average 4.9 and 4.2, with adventitia and without, respectively ( P = .0232). The analysis included: simulation realism, educational utility, and overall satisfaction. Responses in all domains were favourable, suggesting the utility of this model.

Conclusion:

We created a realistic, high fidelity microvascular anastomosis simulator that is low cost and easily reproducible. Initial feedback is encouraging regarding realism, educational utility, and overall usefulness. Further validation is required to assess its effectiveness in resident education and skill transfer to the operating room.
WALANT Hand and Upper Extremity Procedures Performed With Minor Field Sterility Are Associated With Low Infection Rates
Authors: Avoricani Alba , Dar Qurratul-Ain , Levy Kenneth H. , Kurtzman Joey S. , Koehler Steven M.
Published: May 2021

Background:

The use of minor field sterility in hand/upper extremity cases has been shown to improve workflow efficiency while maintaining patient safety. As this finding has been limited to specific procedures, we investigated the safety of performing a wide array of hand/upper extremity procedures outside the main operating room using minimal field sterility with Wide-Awake Local Anaesthesia No Tourniquet (WALANT) anaesthesia by evaluating superficial and deep infection rates across a diverse series of cases.

Methods:

This study was a case series conducted between October 2017 and June 2020. Of all, 217 patients underwent hand/upper extremity procedures performed in a minor procedure room via WALANT technique with field sterility. Primary outcome measures include superficial and deep surgical site infections within 14 days post-surgery.

Results:

Of all, 217 patients were included in this study; 265 consecutive hand/upper extremity operations were performed by a single surgeon, with notable case diversity. The majority of patients (n = 215, 99.1%) did not report or present with signs of infection before or after their operation. We report 0% 14-day and 0.37% 30-day surgical site infection rates for such hand/upper extremity procedures performed in a minor procedure room with field sterility.

Conclusion:

Hand/upper extremity procedures performed via WALANT technique with field sterility in a minor procedure room are associated with low surgical site infection rates. These rates are comparable to surgical site infection rates for similar surgeries performed in main operating rooms with standard sterilization procedures. Thus, the implementation of this technique may allow for improved workflow efficiency and reduced waste, all while maintaining patient safety.
Unravelling the Multifaceted Development Consequences of Agricultural Land Grabbing on Rural Migrant Women in Ghana
Authors: Abubakari Mohammed , Nyamadi Victoria Mensah , Arhin Patrick
Published: May 2021

The study examines how agricultural land grabbing has affected rural migrant women in Ghana. This has been done through the use of the convergent parallel mixed method of case study design, with emphasis on two land grabbed communities—Kobre in Brong Ahafo region and Agogo in Ashanti region of Ghana. The results showed that the manifestations of land grabbing have led to: (a) Strong experiences of land alienation and thwarted re-connection of rural migrant women to alternative lands; and (b) coerced participation of rural migrant women in low-value economic fields and changes in their geographical positions. These outcomes have affected the livelihood conditions of the migrant women negatively. The study, therefore, recommends the State and other key stakeholders to develop comprehensive guidelines that specifically protect rural migrant women in their access to and use of land and related resources in the phase of land-based investments.
Recurrent Colon Cancer: Presentation With Disseminated Intravascular Coagulation From Disseminated Carcinomatosis of the Bone Marrow
Authors: Desikan Sai Prasad , Mclaughlin Nathan , McClain Charles , Desikan Raman
Published: May 2021

Diffuse carcinomatosis of the bone marrow (DCBM) is a rare clinical condition characterized by diffuse bone marrow involvement with hematological changes. This case study concerns a patient who presented with DCBM secondary to colon cancer with diffuse intravascular coagulation. This is a rare presentation of DCBM in colon cancer. The case study also elaborates on clinical features, pathogenesis, and therapy of this unique presentation.
Mycobacterial Spindle Cell Pseudotumor of the Lymph Nodes
Authors: Singh Balraj , Kaur Parminder , Majachani Nicole , Guragai Nirmal , Gupta Sachin , Maroules Michael
Published: May 2021

Mycobacterial spindle cell pseudotumor (MSP) is characterized by benign proliferation of spindle-shaped histiocytes containing acid-fast Mycobacterium. It is usually seen in immunocompromised patients. Limited literature is available regarding MSP. In this article, we report a case of 36-year-old African American male with past medical history of HIV (diagnosed in 2005), noncompliance who presented with generalized weakness, fever, and dizziness on ambulation and was found to have generalized lymphadenopathy and underwent biopsy of the lymph nodes, which was consistent with MSP.
A Rare Case of Double Antibody-Positive Rapidly Progressive Glomerulonephritis: A Therapeutic Challenge
Authors: Bell Stephen , Lattanzio Natalia , Abdelal Qassem , Teklie Yeshanew , Alkayali Talal , Wiese-Rometsch Wilhelmine , Sastry Ashok
Published: May 2021

Crescentic glomerulonephritis, also known as rapidly progressive glomerulonephritis, is a syndrome characterized by progressive and rapid deterioration of renal function over the course of weeks to months. Oliguria, hematuria, azotemia, and hypertension are characteristic features of this condition. Crescentic glomerulonephritis is further classified according to the staining pattern on immunofluorescence. In rare instances, a mixed pattern of injury is encountered as in the case of double antibody-positive rapidly progressive glomerulonephritis (RPGN). This case illustrates the challenge in treatment of double antibody-positive RPGN in an elderly female with no previous renal disease. The patient was found to be positive for anti-GBM antibody and MPO-ANCA. Treatment was initially targeted against MPO-ANCA as the biopsy was most consistent with this process; however, the patient failed to respond to treatment and was subsequently transitioned to oral cyclophosphamide directed against anti-GBM disease. In cases of doubly antibody-positive RPGN with anti-GBM disease and ANCA-associated vasculitis, initial treatment should focus on inducing remission of anti-GBM disease as double antibody-positive disease often presents with the aggressive morbidity and mortality seen in anti-GBM disease, and the chronic risk of relapse seen in ANCA-mediated vasculitis.
HTLV-1-Associated Lymphoma Presented as Massive Lymphadenopathy
Authors: Chen Pei Ting , Onukogu David , Gotlieb Gregory , Chaudhry Rashid , Jaswani Vijay , Josan Karan , Akhtar Cheema , Wang Jen Chin
Published: May 2021

Adult T-cell leukemia/lymphoma is an aggressive T-cell malignancy caused by the long-term infection of human T-cell lymphotropic virus type 1 (HTLV-1). Our understanding of clinical features still largely relies on the Shimoyama classification developed 30 years ago, which described the 4 clinical subtypes (the smoldering, chronic, lymphoma, and acute types) based on the manifestations of lymphocytosis, elevated lactate dehydrogenase, hypercalcemia, lymphadenopathy, and involvement of the skin, lung, liver, spleen, central nervous system, bone, ascites, pleural effusion, and gastrointestinal tract. HTLV-1-associated lymphoma has a variety of presentations but the presentation of massive lymphadenopathy and compression symptoms is rare and has not been emphasized in the literature. In this article, we describe 2 cases of adult T-cell leukemia/lymphomas that presented with massive cervical nodes or mediastinal nodes with compressing symptoms as the major presenting clinical features. Clinicians should remain aware of this type of presentation by HTLV-1-associated lymphoma, especially in patients who came from endemic areas, even if not all clinical features are present and particularly with hypercalcemia and lytic bone lesions.
Supplementary Lateral Extra-articular Tenodesis for Residual Anterolateral Rotatory Instability in Patients Undergoing Single-Bundle Anterior Cruciate Ligament Reconstruction: A Meta-analysis of Randomized Controlled Trials
Authors: Mao Yunhe , Zhang Kaibo , Li Jian , Fu Weili
Published: May 2021

Background:

The combination of lateral extra-articular tenodesis (LET) with primary single-bundle anterior cruciate ligament (ACL) reconstruction (ACLR) remains controversial.

Purpose:

To determine whether the combination of LET with single-bundle ACLR provides greater control of anterolateral rotatory instability and improved clinical outcomes compared with ACLR alone.

Study Design:

Systematic review; Level of evidence, 2.

Methods:

PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases were searched between inception and July 1, 2020. Level 1 or 2 randomized controlled trials that compared isolated single-bundle ACLR with combined LET with ACLR were included. Data were meta-analyzed for the primary outcome measure of knee stability and the secondary outcome measures of patient-reported outcome scores, return to sports, and graft failure. Dichotomous variables were presented as relative risks (RRs), and continuous variables were presented as mean differences (MDs) and standardized MDs (SMDs).

Results:

A total of 6 studies involving 1010 patients were included. Pooled data showed that the ACLR+LET group had a lower incidence of the pivot shift (RR, 0.56 [95% CI, 0.45 to 0.69]; P < .00001), a higher postoperative activity level (MD, 0.47 [95% CI, 0.15 to 0.78]; P = .004), and a lower risk of graft failure (RR, 0.35 [95% CI, 0.21 to 0.59]; P < .00001) than did the ACLR group. However, there were no statistically significant differences in primary outcomes including positive Lachman test findings (RR, 0.76 [95% CI, 0.48 to 1.21]; P = .26) or side-to-side differences (SMD, –0.43 [95% CI, –0.95 to 0.09]; P = .11) or in secondary outcomes including International Knee Documentation Committee scores (SMD, 0.25 [95% CI, –0.06 to 0.56]; P = .11) or Lysholm scores (SMD, 0.28 [95% CI, –0.06 to 0.62]; P = .11). Although the overall rate of return to sports was not significantly different between the groups (RR, 0.97 [95% CI, 0.90 to 1.03]; P = .33), the activity level was higher in the ACLR+LET group.

Conclusion:

The addition of LET to primary single-bundle ACLR produced greater knee stability, a higher activity level, and a lower incidence of graft failure than did ACLR alone. There may be a role for adding LET to ACLR for the treatment of ACL injuries.
The 2020 NBA Orthobiologics Consensus Statement
Authors: Cole Brian J. , Gilat Ron , DiFiori John , Rodeo Scott A. , Bedi Asheesh
Published: May 2021

This 2020 NBA Orthobiologics Consensus Statement provides a concise summary of available literature and practical clinical guidelines for team physicians and players. We recognize that orthobiologic injections are a generally safe treatment modality with a significant potential to reduce pain and expedite early return to play in specific musculoskeletal injuries. The use of orthobiologics in sports medicine to safely reduce time loss and reinjury is of considerable interest, especially as it relates to the potential effect on a professional athlete. While these novel substances have potential to enhance healing and regeneration of injured tissues, there is a lack of robust data to support their regular use at this time. There are no absolutes when considering the implementation of orthobiologics, and unbiased clinical judgment with an emphasis on player safety should always prevail. Current best evidence supports the following:  Key Points  There is support for the use of leukocyte-poor platelet-rich plasma in the treatment of knee osteoarthritis.  There is support for consideration of using leukocyte-rich platelet-rich plasma for patellar tendinopathy.  The efficacy of using mesenchymal stromal cell injections in the management of joint and soft tissue injuries remains unproven at this time. There are very few data to suggest that current cell therapy treatments lead to any true functional tissue regeneration. Meticulous and sterile preparation guidelines must be followed to minimize the risk for infection and adverse events if these treatments are pursued. Given the high variability in orthobiologic formulations, team physicians must stay up-to-date with the most recent peer-reviewed literature and orthobiologic preparation protocols for specific injuries. Evidence-based treatment algorithms are necessary to identify the optimal orthobiologic formulations for specific tissues and injuries in athletes. Changes in the regulatory environment and improved standardization are required given the exponential increase in utilization as novel techniques and substances are introduced into clinical practice.
Systemwide Quality Improvement in Early Childhood Education: Evidence From Louisiana
Authors: Bassok Daphna , Magouirk Preston , Markowitz Anna J.
Published: May 2021

Despite substantial federal, state, and local investments in improving early care and education (ECE), we know little about whether ECE program quality has improved over time. The lack of data tracking the quality of publicly funded ECE programs at scale creates a substantial evidence gap for policymakers attempting to weigh the returns on, and future of, quality improvement policies. Data from Quality Rating and Improvement Systems (QRIS) provide a promising opportunity to address this problem. Using 4 years of data from a mandatory, statewide QRIS covering subsidized child care, Head Start, and state prekindergarten, we document systemwide quality and improvement trends over a period of targeted investment in quality improvement statewide. We find improvements in quality overall, across sectors and communities over this period. Results also reveal differential growth across sectors such that quality gaps diminished. This study highlights the potential of statewide ECE data for informing quality improvement efforts.
Effect of COVID-19 Lockdown on Young Egyptian Soccer Players
Authors: Nassar May Fouad , Allam Mohamed Farouk , Shata Mennatallah Osama
Published: May 2021

The present study was designed to highlight the physical and psychological health hazards that a young Egyptian soccer team faced during the first COVID-19 wave lockdown. The study included 37 young Egyptian male soccer players. History taking and anthropometric measurements were taken. Two questionnaires were filled covering the athletes’` sleep habits and quality of life (QoL). Finally, the mothers were asked to fill in a questionnaire concerned with depression, anxiety, and stress. More than 50% of the enrolled athletes gained weight during the lockdown especially those without compliance to home exercises. The mothers’ anxiety score correlated positively with the increased body mass index (BMI) of the athletes. The athletes mean QoL Score worsened significantly and significant negative correlation was found between the increased BMI and the change of QoL. The increased BMI was significantly reported among the athletes who didn’t do home exercises and had a negative correlation with their QoL change throughout the lockdown. The mothers’ anxiety had a possible reflection on their youngsters’ weight gain. These findings highlight the need for weight control when outdoors physical activity is restricted during pandemics with better compliance to home exercising schedules and less screen time.
The Differential Diagnosis of Sterile Pyuria in Pediatric Patients: A Review
Authors: Bendig Donald W.
Published: May 2021

Sterile pyuria is a common finding in pediatric patients. Literature describing the diagnoses as well as clinical characteristics of children with sterile pyuria is lacking. This review was performed to establish an evidence-based approach to the differential diagnosis by way of an extensive literature search. The definition of pyuria is inconsistent. The various causes of pediatric sterile pyuria identified were classified as either Infectious or Non-Infectious. Sub-categories of Infectious causes include: Viral Infection, Bacterial Infection, Other Infections (tuberculosis, fungal, parasitic), Sexually Transmitted Infections, Recent Antibiotic Therapy. Non-Infectious causes include: Systemic Disease, Renal Disease, Drug Related, Inflammation adjacent to Genitourinary Tract. Clinicians that encounter pediatric patients with sterile pyuria and persistent symptoms should consider the substantial differential diagnosis described in this study.
Assessing Technical Efficiency of the Indian Higher Education: An Application of Data Envelopment Analysis Approach
Authors: Kaur Harpreet
Published: May 2021

Due to resource constraints in the Indian education sector, efficiency assessment of the higher education is more essential for the proper allocation and the effective utilization of financial and human resources. Moreover, much of the research in the higher education sector has mainly focused on the quality of education and ignored the role of efficiency. Therefore, the present study analyzes the technical efficiency of the higher education in the Indian states. Secondary data for the study were collected from reports of the Ministry of Human Resource Development (MHRD), UGC Reports, Economic Survey of India and Reports of the All India Survey on Higher Education (AISHE). Data Envelopment Analysis was used to analyze the data. The efficiency results suggest that the states analyzed in this study are operating at a moderate level of efficiency relative to each other.
Factors Affecting Intention to Use Blended Learning Approach in the Tertiary Level: A Quantitative Approach
Authors: Cabauatan Ronaldo R. , Uy Chin , Manalo Ronaldo A. , Castro Belinda de
Published: May 2021

The technological innovations greatly influenced the educators’ teaching approaches. From the traditional face-to-face and teacher-centred approaches, most of the educators now shifted to blended learning and more student-centred activities. Many countries are allocating sufficient budget for the technology infrastructure in order to sustain the quality of education particularly in remote areas. This helped many universities to design courses that students can acquire even outside the formal classrooms and regular class sessions or in a blended learning environment. It allows students to access information and communicates with their instructors online. Despite the benefits of the blended-learning approach, many instructors are not motivated to use it because of the amount of time required for preparing materials, checking online submissions and communicating with the students. In the case of a Philippine comprehensive university, the use of blended learning requires additional time on top of the regular class hours. This study examines if instructors are well equipped to use the blended-learning approach and use the technology for storing lecture notes and learning activities. Problems in internet connection and site restrictions prevented the instructors from appreciating online learning. The study suggests that the institutional support should be strengthened in order to provide opportunities for instructors that will help them realize the importance of their role and that of the technology for the success of blended learning.
Democratic Governance, Inclusive Policies and People Standing at the Margins
Authors: Deep Pankaj
Published: May 2021

State, democracy and good governance are mutually related to each other, and as India is a democratic welfare state, it is the central concern of the government to provide inclusive governance through inclusive policies to its citizen in general, and the disadvantaged people like scheduled tribes/scheduled castes (ST/SCs) in particular. Democracy and inclusive governance are conceptually linked to each other. Democracy and democratic values and practices curb the undemocratic rule, exclusion and discrimination in the society. The study argues that in spite of many legal provisions and pro-state action, the condition of STs/SCs are very vulnerable. They are lag behind in all parameters of human development to other people. Their representation in the public institution is not adequate and fair enough except in legislature. Democratic text of inclusive society could not be made possible and is far from realisation contextually. In this article, attempt has been made to evaluate and examine the democratic ethos of inclusiveness, constitutional provisions for inclusive policies and its achievement to know the status of inclusion of the excluded groups till date in the case of SC/STs in Odisha.
Towards a new image archive for the built environment
Authors: Date Kartikeya , Allweil Yael
Published: May 2021

The ever-growing online corpus of images of the built environment, on social media and mapping platforms, offers a new kind of archive of the built environment. Recent advances in computer vision, specifically convolutional neural networks, offer new ways of querying and analyzing large image corpuses. In this paper, we propose a new method by which historians of the built environment can use these vast image corpuses in their study, enabling new research questions. To demonstrate proof of need, we report on an ongoing case study in Tel Aviv that attempts to show the feasibility of our proposed method for enabling a Historic Urban Landscapes (HUL)-based approach to the study of the built environment. In so doing, we show how such image corpuses could potentially form a new type of archive for architectural and urban history.
Seasonal Migration from Beed District of Maharashtra: A Livelihood Struggle of Dalit and Adivasi Households
Authors: Abdul Jaleel C.P.  , Chattopadhay Aparajita
Published: May 2021

Due to the scarcity of water, frequent crop failure and low returns from cultivation, agriculture in the state of Maharashtra is in a distressed condition. With a semi-arid topography, below average rainfall and limited irrigation infrastructure, Beed—a predominantly rural district—subsists through rainfed agriculture and wage employment. Every year, during dry season (November to May), villages in the district are face with severe seasonal unemployment. To tide over the lean season, thousands of small and marginal peasant households migrate to other districts of the state, and even outside the state, to work in sugar factories and brick kilns. The social experience and consequences of migration are far from uniform, but shaped by class, caste and gender. Drawing connections between seasonal migration and rural crisis, our narrative show how seasonal migration compensates for the lack of employment opportunities and reduces seasonal income variability of the poor households in Beed district. At the same time, this article also explains how seasonal migration traps these households in the vicious cycle of economic and social backwardness.
Indian Inclusion Efforts Relevance to Scavenger Community: A Cross-sectional Study in Haryana
Authors: Kumar Krishan , Deepalatha R
Published: May 2021

Manual scavenging is a caste-based occupation (Shahid, 2015, Social Change, 45(2), 242–255). It involves the manual removal of human excreta from dry latrines and septic tanks (using basic tools such as tin boards, buckets and baskets lined with sacking) and then carrying it on the head or shoulder and disposing it away (Kumar, 2014, Scavenger community at the crossroads: Reflection on state intervention). Broadly, these people work in municipal corporation, railways, households, cleaning of open defecation area, industries and hotels where they deal with human and animal excreta. Dealing in sewerage and manholes, garbage loading and caring and cleaning animal carcass is also included in manual scavenging. Historically, the scavenger community is considered to be untouchable (Singh, 2014, Contemporary Voice of Dalit, 7(1), 81–94), because of lowest caste status and lowest occupational status. Their lowest social status made them to face exclusion in almost all domains in society. They are protected through constitutional rights in documents and are provided with some welfare services for their development. This study aims to understand the current status of social exclusion of scavenger community and usefulness of government inclusion policies on social and occupational status of scavenger community. This is a cross-sectional study, following mixed method research design. The study was conducted in four towns of Haryana: Ladwa, Kurukshetra, Indri and Radwar. The safai karamchari (sanitary workers) of municipalities from these four towns were selected as respondents. Data was collected through semi-structured interview and structured tool was used for assessing social exclusion. Here, the results show that all respondents ( safai karamchari) belong to Balmiki caste and all were Hindu by religion. Among them, 62% respondents were illiterate, more than 80% reported that this work was transferred from ancestors or lack of opportunity, and 98% reported no protective gears provided while working. Social exclusion found prevalent in almost all domains, while the face exclusion was in social, cultural, educational, occupational, political domains and accessing social services. The result shows that Indian policies for social inclusion fail in case of scavenger community. Therefore, this is matter of dealing for social work profession.
Central Retinal Thickness and Visual Acuity Outcomes After Vitrectomy for Epiretinal Membrane With and Without Internal Limiting Membrane Peel
Authors: Burckhard Braden A. , Mathews Nathan R. , Altaweel Michael M. , Chang Jonathan S. , Ip Michael S. , Gottlieb Justin L.
Published: May 2021

Purpose:

This work compares best-corrected visual acuity (BCVA) and central retinal thickness (CRT) outcome measures following pars plana vitrectomy (PPV) with and without internal limiting membrane (ILM) peel for epiretinal membrane (ERM).

Methods:

A retrospective cohort study was conducted of 114 eyes of 114 patients with visually significant ERM undergoing PPV with membrane peel (PPV/MP) at a single institution. CRT measurements were collected from Heidelberg and Zeiss spectral-domain optical coherence tomography imaging units. Results compared preoperative and postoperative CRT and BCVA among patients with at least 60 days of follow-up.

Results:

A total of 114 eyes with ERM met the inclusion criteria. Eighty-one eyes (71%) underwent PPV/MP with ILM peel and 33 eyes (29%) underwent PPV/MP without ILM peel. There was no statistically significant difference between preoperative CRT between the 2 study groups ( P = .95). The mean follow-up time of eyes undergoing PPV/MP without ILM peel and with ILM peel was 391 days and 319 days, respectively. There was no statistical difference in the mean reduction of CRT between the 2 groups ( P = .470). Both groups had improvement of BCVA following surgery and there was no statistical difference in final logMAR visual acuity when comparing the 2 groups ( P = .738).

Conclusions:

There was an overall improvement of CRT and BCVA among patients undergoing PPV/MP for ERM with or without ILM peel. There was no statistically significant difference in the final BCVA or CRT between the 2 groups.
Implantable Cardioverter-Defibrillator and Lipomas: A Case-Series
Authors: Holmes Scott , McEdwards Gregor , Healey Jeff S , Cin Arianna Dal
Published: May 2021

Lipomas are hamartomas of adipose tissue that can be found in various anatomical locations. Herein we describe 3 cases of de-novo lipomata formation over implanted defibrillators, characterize their incidence and speculate on possible mechanisms for their development.
Plastic Surgeons Add Value in Upper Extremity Melanoma Oncologic Resection and Reconstruction
Authors: Lafreniere Ann-Sophie , Brenn Thomas , Temple-Oberle Claire F.
Published: May 2021

We present a pediatric patient with an ASMT of the wrist with the unique approach of a plastic and reconstructive surgeon to surgical oncologic resection and reconstruction: WLE, ICG and NIRF imaging-assisted SLNB followed by reconstruction with a keystone perforator flap.
Towards enriched narrative political ecologies
Authors: Harris Leila M.
Published: May 2021

Work on narrative, story, and storytelling has been on the rise across the humanities and social sciences. Building on significant work on these themes from Indigenous, Black, and Feminist scholarship, and other varied traditions, this piece explores and elaborates the potential regarding the elicitation, sharing, and analysis of stories for nature-society studies. Specifically, the piece examines core contributions along these lines to date, as well as the methodological, analytical, political, and transformative potential of story and storytelling to enrich, broaden, and deepen work in nature-society, political ecology, and environmental justice. All told, focus on story and storytelling, offers a number of relevant and rich openings to understand and engage complex, unequal, and dynamic socio-natures. While these elements have been present in nature-society work from some traditions and lines of inquiry, the time is ripe to broaden and deepen these engagements to more fully imagine, and respond to, key nature-society challenges.
The role of KPI-121 0.25% in the treatment of dry eye disease: penetrating the mucus barrier to treat periodic flares
Authors: Gupta Preeya K. , Venkateswaran Nandini
Published: May 2021

The tear film, which includes mucins that adhere to foreign particles, rapidly clears allergens and pathogens from the ocular surface, protecting the underlying tissues. However, the tear film’s ability to efficiently remove foreign particles during blinking can also pose challenges for topical drug delivery, as traditional eye drops (solutions and suspensions) are cleared from the ocular surface before the drug can penetrate into the conjunctival and corneal epithelium. In the past 15 years, there has been an increase in the development of nanoparticles with specialized coatings that have reduced affinity to mucins and are small enough in size to pass through the mucus barrier. These mucus-penetrating particles (MPPs) have been shown to efficiently penetrate the mucus barrier and reach the ocular surface tissues. Dry eye disease (DED) is a common inflammatory ocular surface disorder that often presents with periodic flares (exacerbations). However, currently approved immunomodulatory treatments for DED are intended for long-term use. Thus, there is a need for effective short-term treatments that can address intermittent flares of DED. Loteprednol etabonate, an ocular corticosteroid, was engineered to break down rapidly after administration to the ocular surface tissues and thereby reduce risks associated with other topical steroids. KPI-121 is an ophthalmic suspension that uses the MPP technology to deliver loteprednol etabonate more efficiently to the ocular tissues, achieving in animal models a 3.6-fold greater penetration of loteprednol etabonate to the cornea than traditional loteprednol etabonate ophthalmic suspensions. In clinical trials, short-term treatment with KPI-121 0.25% significantly reduced signs and symptoms of DED compared with its vehicle (placebo). Recently approved KPI-121 0.25%, with its novel drug delivery design and ease of use, has the potential to effectively treat periodic flares of DED experienced by many patients.
Role of S100β Glial Protein as a Serological Marker for Analysis of Acute Ischemic Stroke
Authors: Buddharaju Kiran , Javali Mahendra , Mehta Anish , Srinivasa R , Acharya Purushottam
Published: May 2021

Background:

Stroke is a major cause of neurological disability, which can be often predicted with serological markers. Glial-derived S100β protein is a potential biomarker for cerebral ischemia and may be helpful in predicting the severity, outcome, and recovery of stroke.

Aim:

This study aimed to study the role of S100β glial protein as a serological marker in predicting the severity of acute ischemic stroke (AIS), outcome, and functional recovery after 1 month.

Methods:

A hospital-based prospective case control study included 43 consecutive patients, >18 years old, who were admitted with acute middle cerebral artery (MCA) territory infarcts within 72 h of onset of neurological deficits. Control group comprised of 43 age-matched asymptomatic volunteers. Independent t-test and chi square test were used to compare the means and evaluate the association between protein level and various parameters. P ≤ .05 was statistically significant.

Results:

S100β protein level in AIS patients was significantly higher compared to controls ( P < .05). Elevated serum S100β protein level was found to be associated with larger infarct volumes, higher National Institute Health Stroke Scale scores, and higher modified Rankin Scale scores at admission ( P < .05). Patients with higher S100β protein levels at admission had poor recovery at 1 month compared to patients having normal S100β protein levels.

Conclusion:

S100β protein levels at admission after an acute MCA territory infarct may be used as a reliable serological tool in predicting the severity, outcome, and functional recovery in stroke.
A narrative approach for a client with irritable bowel syndrome
Authors: Oshita Yumi , Kamo Kiyoshi , Gant Larry
Published: May 2021

This article aimed to illustrate a new narrative approach that transformed a client’s story of suffering by differentiating the meaning construction of a particular speech act of other people. The new narrative approach has fundamental roots in coordinated management of meaning theory. The authors reformed this as “modified coordinated management of meaning” (MCMM), and called the refined model the refined MCMM (RMCMM). The client was a 21-year-old woman who was diagnosed with irritable bowel syndrome (IBS) in high school. Her story of suffering concerned odors related to her IBS-diarrhea symptoms, which resulted in her experiencing difficulties in college life. The social worker intervened the client’s meaning construction of the locutionary act of another person’s speech act “something really stinks.” The client acquired the skills for generating new meaning constructions and speech act selections to transform her story of suffering. The RMCMM was an efficacious narrative approach that allowed the client with IBS to transform her story of suffering over a short period.
Identity, lifestyle, and face-mask branding: A social semiotic multimodal discourse analysis
Authors: Wang Yilei , Feng Dezheng (William) , Ho Wing Yee Jenifer
Published: May 2021

The massive introduction of face-masks across the world after the outbreak of the COVID-19 pandemic has transformed how they are designed and branded. Instead of merely focusing on functional qualities, face-mask producers have started to draw upon symbolic values in their branding discourse. Against this background, the present study investigates how face-masks are branded in Hong Kong by analyzing the design, packaging and websites for face-mask products, as well as the design of offline franchised stores using a social semiotic approach. Analysis of the multimodal data of four leading Hong Kong brands, with a focus on the use of verbal evaluation, iconography, typography, color, and materiality, reveals three symbolic meanings that are used in face-mask branding: (1) professionalism, which refers to the representation of face-masks as a symbol of advanced technology, (2) Hong Kong identity, which includes evoking pride in the past economy and exploiting the cultural symbol of the Lion Rock, and (3) fashion lifestyle, in which face-masks are associated with the values of stylishness, individuality, and luxuriousness. The exploitation of symbolic values and multimodal design in face-mask branding reflects the influence of the neoliberal ideology in the highly marketized Hong Kong society.
Hyperemesis gravidarum induced refeeding syndrome causes blood cell destruction: a case report and literature review
Authors: Pan Xiyu , Chu Ran , Meng Jinyu , Wang Qiannan , Zhang Yue , Song Kun , Yang Xingsheng , Kong Beihua
Published: May 2021

Background

Hyperemesis gravidarum (HG) is a common complication during pregnancy, however, HG associated simultaneous onset of blood cell destruction due to electrolyte abnormalities is rare. In this case, a woman with refeeding syndrome (RFS) secondary to electrolyte abnormalities caused by severe HG was diagnosed and managed in our hospital.

Case presentation

A 29-year old woman was sent to the local hospitals because of severe HG with appetite loss, weight reduction, general fatigue, and she was identified to have severe electrolyte abnormalities. However, the electrolyte abnormalities were not corrected promptly, and then she had the symptoms of stillbirth, altered mental status, visual hallucination, hemolytic anemia and thrombocytopenia. After transferred to our hospital, we continued to correct the electrolyte abnormalities and the labor induction was performed as soon as possible. The symptoms of blood cell destruction were relieved obviously, and the patient discharged four days later. The electrolyte disturbances and physio-metabolic abnormalities caused by HG helped us diagnose this case as RFS.

Conclusions

This case emphasizes that patients with RFS should be diagnosed appropriately and intervened promptly in order to prevent electrolyte imbalance induced blood cell destruction.