bluuebunny/crossref_metadata_2025 huggingface dataset:
Digital Consumer Engagement: National Cultural Differences and Cultural Tightness
Authors: Mattison Thompson Frauke , Brouthers Keith D.
Published: March 2021

The digital ecosystem makes entry into foreign markets easier and provides new ways for consumers to engage with marketing materials (through content clicking, sharing, and electronic word-of-mouth [eWOM] behavior). While evidence has emerged that between-country cultural differences may impact digital consumer engagement (particularly eWOM), far less is known about its impact on online advertising clicking and sharing engagement or how within-country cultural variation (tightness/looseness) moderates this activity. The authors develop and test the notion that between- and within-country cultural differences lead to variations in digital consumer engagement, especially clicking and sharing behavior. Using industry data provided by a programmatic advertising firm, the authors find support for the idea that between-country differences in national cultural values impact digital engagement and that within-country cultural variation moderates these relations. In this way, they provide new insights for researchers and managers about international marketing in the digital age.
Nonlinear vibration of conical shell with a piezoelectric sensor patch and a piezoelectric actuator patch
Authors: Jamshidi Rasa , Jafari Ali Asghar
Published: March 2021

In this study, nonlinear vibration of a conical shell with a piezoelectric sensor patch and a piezoelectric actuator patch is evaluated. The strain displacement relation is considered to be nonlinear and based on that the equations of motion and piezoelectric sensor output signal are extracted. For the first time, nonlinear electromechanical equations of motion for the conical shell with a piezoelectric sensor layer and a piezoelectric actuator layer are extracted in detail and presented. The producer of extraction of conical shell electromechanical equations of motions is presented for further clarifications. The output signal of the piezoelectric sensor patch considering the nonlinear strain displacement equation of motion is derived. For controlling the vibration actively, a proportional controller is defined by which the applied actuator signal is determined. The nonlinear electromechanical equations of motion are expanded based on conical shell strains. By applying the Galerkin method, the nonlinear time-domain equations are extracted. The complicated attained equations are solved using the harmonic balance method. Conical shell nonlinear frequency response in uncontrolled condition and controlled condition is computed and compared with each other. The frequency response shows that the active vibration control of the conical shell increases the nonlinearity of the system and reduces the vibration amplitude. In addition, free nonlinear vibration of the proposed system is calculated and presented. The results show higher impacts of piezoelectric patches on the conical shell free vibration response and they can reduce the vibration amplitude dramatically.
Public Trust in State-Run News Media in Rwanda
Authors: McIntyre Karen , Sobel Cohen Meghan
Published: March 2021

This study examined public trust in the media through focus groups with young, educated urbanites in Rwanda. Despite the fact media in Rwanda incited violence during the 1994 genocide, results revealed that the Rwandan public highly trust their local news, especially state-run media. The findings suggest frameworks for studying media trust should consider the public’s trust in government, as the two might be linked, and also suggest scholars think deeply about conceptualizations of trust in different socio-political contexts, as trust is part of the culture of a polity, not simply a citizen’s judgment on how well news media are doing.
Oral metronomic chemotherapy is a cost effective alternative to pazopanib in advanced soft tissue sarcoma
Authors: Sharma Aparna , Kataria Babita , Biswas Bivas , Bakhshi Sameer , Pushpam Deepam
Published: March 2021

Introduction

Soft tissue sarcoma(STS) is a rare and heterogeneous group of disorders with dismal outcomes in metastatic setting. Pazopanib and oral metronomic chemotherapy (OMT) have been evaluated as therapeutic options in this cohort.

Materials and methods

We conducted a retrospective, single center study evaluating 45 patients with unresectable and/or metastatic STS, who received pazopanib or oral metronomic regimen as per instituitonal protocol between January 2013 and December 2019. An informal cost minimisation analysis was conducted for both OMT and pazopanib arms, considering equivalent outcomes for both (PFS and OS).

Results

Median PFS in OMT and Pazopanib groups was 4.13 months and 3.53 months,respectively (HR1.31, 95% CI:0.68–2.51, p = 0.41) Only one patient in the OMT group achieved an objective response (partial response) and no objective response was noted in the pazopanib group. The incidence of grade III/IVtoxicities was higher with pazopanib than with OMT (p = 0.08). There were no toxicity related deaths noted in either arm.

Conclusions

Our study demonstrates that OMT have a similar progression free survival (PFS) and overall survival (OS) in metastatic STS. This study raises the possibility that OMT might be an equally efficacious and less toxic alternative to pazopanib, without compromising survival outcome especially in LMIC.
Awareness of myeloma care and the global impact of treatment: An international internet-based prospective study
Authors: Ailawadhi Sikander , Swaika Abhisek , Advani Pooja , Hodge David , Paulus Aneel , Khera Nandita , Hashmi Shahrukh K , Alegria Victoria R , Abdulazeez Mays , Bodepudi Srilekha , Jamwal Khushi , Roy Vivek , Sher Taimur , Chanan-Khan Asher , Ailawadhi Meghna
Published: March 2021

Objective

Outcomes in multiple myeloma (MM) have significantly improved necessitating focus on survivorship.

Methods

We undertook a web-based survey in collaboration with International Myeloma Foundation (IMF) to explore patient awareness and psycho-physical impacts of MM. The survey was viewed on the IMF website by 1,324 individuals from 32 countries.

Results

The survey responses were available from 959 individuals, with 62% who completed the survey. Treating doctors were the most frequent source of MM-related information. Only 56% patients admitted full compliance with treatment. Treatment side effects bothered 86% responders, including >50% admitting to pain, peripheral neuropathy and asthenia. Majority (57%) reported some degree of depression, 82% had discontent with their quality of life and only 35% reported being satisfied with their coping mechanisms. Patients ≥65 years of age reported more peripheral neuropathy (p = 0.007) and difficulty with ability to work (p = 0.015).

Conclusions

We report the prevalence of psychologic, social and physical domains as well as patient-physician relationship dynamics. This knowledge can help improve MM survivorship.Introduction
Fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with HER2-positive breast cancer: A multidisciplinary approach
Authors: DuMond Barbara , Patel Vidhi , Gross Anne , Fung Anita , Weber Susan
Published: March 2021

Pertuzumab plus trastuzumab, administered intravenously (IV) with chemotherapy, is standard treatment for HER2-positive metastatic or high-risk early breast cancer. Pertuzumab and trastuzumab are administered over 1–2.5 h traditionally; however, the need for IV infusions places a strain on medical centers with respect to scheduling, preparation, and administration. A novel fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection (PHESGO®, PH FDC SC) can be administered in approximately 5–8 min. PH FDC SC was non-inferior to IV pertuzumab plus trastuzumab in terms of pertuzumab and trastuzumab serum levels in the phase III FeDeriCa study, which enrolled 500 patients with HER2-positive early breast cancer. Total pathologic complete response rates were comparable after PH FDC SC (59.7%) or IV pertuzumab plus trastuzumab (59.5%), as was the incidence of grade ≥3 (48.8% vs 52.8%) and serious adverse events (16.1% vs 17.9%). The results of a phase II clinical trial (PHranceSCa) showed that a majority of patients (85%) preferred PH FDC SC treatment over IV pertuzumab plus trastuzumab. A US multicenter expanded access study (NCT04395508) is evaluating the safety of PH FDC SC administered at home by nurse providers in patients receiving maintenance HER2-targeted therapy every 3 weeks. This product takes much less time to administer than IV pertuzumab–trastuzumab and has the potential to alleviate time constraints for patients and busy clinics. In this review we provide an overview of PH FDC SC, and discuss our experience in preparing and administering this product to patients with HER2-positive breast cancer during clinical trials.
Are Women Ready to Prevent Osteoporosis? Change Stages for Preventive Behaviors
Authors: Clark Patricia , Lavielle Pilar
Published: March 2021

Objective

Evaluate the prevention behaviors for osteoporosis (OP) in women (physical activity and calcium intake) and their readiness to perform these behaviors.

Method

Women aged ≥30 years in four large cities of Mexico were interviewed. The geographical areas were selected randomly and stratified according to socioeconomic status and age. A questionnaire designed to assess OP-related prevention behaviors, as well as attitudes and stages of change of the transtheoretical model toward these behaviors, was used.

Results

Eight hundred and six women were interviewed: 4.2% reported diagnosis of osteopenia, 5% of OP, 2.3% had suffered a fracture, and 11.9% had a family history of OP. A large proportion of participants did not do physical activity (56.2%) and did not have the recommended intake of calcium (61.3%). More than 80% of these participants were in lower stages of change (precontemplation and contemplation) for performing physical activity and 86.4% for calcium intake, which means a lack of readiness to change their behaviors. The absence of readiness to change preventive behaviors was related to negative attitudes toward both behaviors ( OR = 1.81, 95% CI [1.04, 3.14] physical activity; OR = 3.09, 95% CI [1.81, 5.29] calcium intake). Both of these behaviors were associated with known risk factors for OP.

Conclusion

Very high percentage of women are not ready to perform the behaviors necessary to maintain bone health. This phenomenon was not as a result of clinical risk factors for OP but because of the negative attitudes and beliefs of women related to physical activity and calcium intake.
Tourism research for the GCC region: Current status and future research directions
Authors: Saleh Ali Salman , Bassil Charbel , Safari Arsalan
Published: March 2021

Tourism in the Gulf Cooperation Council (GCC) countries has recently been considered by policymakers as a new avenue for economic diversification. Despite the considerable literature concerning the impact of tourism worldwide, only a limited number of studies have looked at the tourism sector in the GCC region or analyzed its economic, sociocultural, and environmental impacts. This article therefore conducts a systematic review of the state of the literature related to tourism in the GCC region. It provides effective insights about the current status, gaps, and challenges and proposes future research directions in this area for academics, practitioners, and policymakers with an interest in regional tourism development. The preferred reporting items for systematic reviews and meta-analyses approach was used to identify and select the papers. Some 23 papers were identified and analyzed. The majority of these studies focused on the United Arab Emirates, specifically the Dubai emirate. We found the most dominant research theme to be tourism planning.
Assessing change in suicidal ideation intensity for youth in treatment for pediatric bipolar disorder
Authors: Gruhn Meredith A , West Amy , Hamlat Elissa , Weinstein Sally
Published: March 2021

Objective:

Suicidal ideation (SI) is significantly higher for youth with pediatric bipolar disorder (PBD), yet clinical correlates of suicidality remain poorly understood in this population. The current study investigates how change in risk factors for SI relate to change in SI intensity over a 6-month period of treatment.

Method:

Children ages 9 to 13 ( N = 71; 41% female; 54% Caucasian; Mean age = 9.17) engaged in one of two psychotherapy treatment conditions and completed assessments of SI risk factors and psychopathology symptoms at baseline (pre-treatment), 4 and 8 weeks (during treatment), 12 weeks (post-treatment), and 39 weeks (follow-up assessment at 6 months post-treatment). Children also completed assessments of SI intensity at baseline, post-treatment (12 weeks), and 6 months post-treatment.

Results:

Mixed-effects regression models indicate that increases in health-related quality of life in the family, mobilization of the family to acquire/accept help for PBD, and child self-concept were associated with decreased SI intensity over time.

Conclusions:

Findings highlight the importance of family and child level factors in influencing longitudinal change in SI intensity in youth with PBD. Clinical implications and future directions are discussed.
Non-stigmatising alternatives to anti-obesity public health messages: Consequences for health behaviour and well-being
Authors: Rathbone Joanne A , Cruwys Tegan , Jetten Jolanda
Published: March 2021

This project investigated how alternative non-stigmatising public health messages influence people’s health behaviours and well-being, relative to traditional stigmatising weight-loss messages. We conducted three experimental studies (total N = 1281) that compared traditional weight-loss messages to weight-neutral messages (Study 1), weight-inclusive messages (Study 2) and size acceptance messages (Study 3). Results revealed that public health messages have differential effects on health behaviours and well-being, depending on the audience’s BMI or perceived weight. However, campaigns that challenge weight stigma and promote body positivity have positive effects on some psychological indicators of health and well-being for people of all body sizes.
Suspicious minds? Empirical analysis of insider witness assessments at the ICTY, ICTR and ICC
Authors: Chlevickaitė Gabrielė , Holá Barbora , Bijleveld Catrien
Published: March 2021

The testimonies of insider witnesses are often key to prosecutions of international crimes, despite significant trustworthiness concerns. However, we know little about the practice of judicial assessments of insider testimonies, that is, which factors the judges consider relevant to relying on insider testimony. With this article, we set out to provide a comprehensive, explorative examination of the insider witness assessment factors used by the trial judges at the International Criminal Tribunal for the former Yugoslavia, the International Criminal Tribunal for Rwanda and the International Criminal Court in 1996–2019. By using multiple correspondence analysis, we show that the factors related to insider witness assessment outcomes are generally similar across the tribunals and tend to focus on the contents of the testimonies, with less attention given to credibility or competence concerns. This research constitutes the first systematic quantitative analysis and cross-institutional comparison of insider witness assessment practice at an international level.
Commercial Sexual Exploitation of Children and Adolescents in Europe: A Systematic Review
Authors: Benavente Beatriz , Díaz-Faes Diego A. , Ballester Lluís , Pereda Noemí
Published: March 2021

Objectives:

The objective of this review is to provide a systematic and critical summary of findings regarding empirical studies conducted on commercial sexual exploitation of children (CSEC) in Europe. The purpose is to gain an understanding of the characteristics and main topics addressed in European research on CSEC, identify gaps, and give suggestions for future studies.

Method:

The review was guided by the “Preferred Reporting Items for Systematic Review and Meta-Analysis—Protocols”. A comprehensive search on several databases was conducted to identify published and unpublished empirical research on CSEC in Europe, revealing 3,846 documents. In total, 56 research papers that focused specifically on CSEC in European samples were included.

Synthesis:

Research concerning European studies of CSEC and trafficking for purposes of sexual exploitation has developed significantly over the last 20 years but is still rather limited and mainly focused on the UK and Sweden. Most of the studies reviewed suffer from important methodological flaws such as an inaccurate definition of the phenomenon analyzed, small and convenience samples, and nonvalidated and nonspecific instruments.

Conclusions:

Findings from this study demonstrate the need for greater exploration and research around a number of areas of sexual exploitation of children in Europe. Further work is necessary in terms of capacity building, training, and awareness-raising for society as a whole and, specifically, professionals providing direct support to children and young people at risk of exploitation.
Current Advancements and Novel Strategies in the Treatment of Metastatic Melanoma
Authors: Sood Siddhartha , Jayachandiran Rahul , Pandey Siyaram
Published: March 2021

Melanoma is the deadliest form of skin cancer in the world with a growing incidence in North America. Contemporary treatments for melanoma include surgical resection, chemotherapy, and radiotherapy. However, apart from resection in early melanoma, the prognosis of patients using these treatments is typically poor. In the past decade, there have been significant advancements in melanoma therapies. Immunotherapies such as ipilimumab and targeted therapies such as vemurafenib have emerged as a promising option for patients as seen in both scientific and clinical research. Furthermore, combination therapies are starting to be administered in the form of polychemotherapy, polyimmunotherapy, and biochemotherapy, of which some have shown promising outcomes in relative efficacy and safety due to their multiple targets. Alongside these treatments, new research has been conducted into the evidence-based use of natural health products (NHPs) and natural compounds (NCs) on melanoma which may provide a long-term and non-toxic form of complementary therapy. Nevertheless, there is a limited consolidation of the research conducted in emerging melanoma treatments which may be useful for researchers and clinicians. Thus, this review attempts to evaluate the therapeutic efficacy of current advancements in metastatic melanoma treatment by surveying new research into the molecular and cellular basis of treatments along with their clinical efficacy. In addition, this review aims to elucidate novel strategies that are currently being used and have the potential to be used in the future.
A novel variant in DMXL2 gene is associated with autosomal dominant non-syndromic hearing impairment (DFNA71) in a Cameroonian family
Authors: Wonkam-Tingang Edmond , Schrauwen Isabelle , Esoh Kevin K , Bharadwaj Thashi , Nouel-Saied Liz M , Acharya Anushree , Nasir Abdul , Leal Suzanne M , Wonkam Ambroise
Published: March 2021

Approximately half of congenital hearing impairment cases are inherited, with non-syndromic hearing impairment (NSHI) being the most frequent clinical entity of genetic hearing impairment cases. A family from Cameroon with NSHI was investigated by performing exome sequencing using DNA samples obtained from three family members, followed by direct Sanger sequencing in additional family members and controls participants. We identified an autosomal dominantly inherited novel missense variant [NM_001174116.2:c.918G>T; p.(Q306H)] in DMXL2 gene (MIM:612186) that co-segregates with mild to profound non-syndromic sensorineural hearing impairment . The p.(Q306H) variant which substitutes a highly conserved glutamine residue is predicted deleterious by various bioinformatics tools and is absent from several genome databases. This variant was also neither found in 121 apparently healthy controls without a family history of hearing impairment , nor 112 sporadic NSHI cases from Cameroon. There is one previous report of a large Han Chinese NSHI family that segregates a missense variant in DMXL2. The present study provides additional evidence that DMXL2 is involved in hearing impairment etiology, and we suggest DMXL2 should be considered in diagnostic hearing impairment panels.
Indirect White Matter Pathways Are Associated With Treated Naming Improvement in Aphasia
Authors: Wilmskoetter Janina , Fridriksson Julius , Basilakos Alexandra , Phillip Johnson Lorelei , Marebwa Barbara , Rorden Chris , Warner Graham , Hickok Gregory , Hillis Argye E. , Bonilha Leonardo
Published: March 2021

Background

White matter disconnection of language-specific brain regions associates with worse aphasia recovery. Despite a loss of direct connections, many stroke survivors may maintain indirect connections between brain regions.

Objective

To determine (1) whether preserved direct connections between language-specific brain regions relate to better poststroke naming treatment outcomes compared to no direct connections and (2) whether for individuals with a loss of direct connections, preserved indirect connections are associated with better treatment outcomes compared to individuals with no connections.

Methods

We computed structural whole-brain connectomes from 69 individuals with chronic left-hemisphere stroke and aphasia who completed a 3-week-long language treatment that was supplemented by either anodal transcranial direct current stimulation (A-tDCS) or sham stimulation (S-tDCS). We determined differences in naming improvement between individuals with direct, indirect, and no connections using 1-way analyses of covariance and multivariable linear regressions.

Results

Independently of tDCS modality, direct or indirect connections between the inferior frontal gyrus pars opercularis and angular gyrus were both associated with a greater increase in correct naming compared to no connections ( P = .027 and P = .039, respectively). Participants with direct connections between the inferior frontal gyrus pars opercularis and middle temporal gyrus who received S-tDCS and participants with indirect connections who received A-tDCS significantly improved in naming accuracy.

Conclusions

Poststroke preservation of indirect white matter connections is associated with better treated naming improvement in aphasia even when direct connections are damaged. This mechanistic information can be used to stratify and predict treated naming recovery in individuals with aphasia.
Numerical study of contact wire tension affecting dropper stress of a catenary system
Authors: He Fan , Guo Dandan , Chen Liming
Published: March 2021

Dropper is the key component of in a catenary system and it is prone to fatigue fracture. Dropper stress directly affects the operation safety of high-speed railway. In this paper, a span of dropper in a catenary system is modeled to investigate the effects of contact wire tension on dropper stress. The response equation of contact wire and the theoretical equation of dropper stress are deduced. The initial and boundary conditions of each dropper are determined, and then the stress of each dropper is calculated by the finite difference method using a MATLAB program. The results show that the stress amplitude and the maximum tensile stress of the dropper decrease significantly with the increase of contact wire tension. When the tension is low, the stress changes of dropper near the load location experience three stages: instant rebound, attenuated vibration, and bending compression. However, the attenuation vibration stage disappears when the tension is increased to a certain extent. Therefore, the control of the vibration response of the contact wire can effectively reduce the stress amplitude and the maximum tensile stress of the dropper, so as to improve the working reliability of the dropper.
Relationships between physiological characteristics and match demands in elite-level male field hockey players
Authors: Lombard Wayne P , Cai Xudan , Lambert Michael I , Chen Xiaoping , Mao Lijuan
Published: March 2021

This study investigated the physical characteristics, match demands and their relationships in elite-level male field hockey players (n = 23; 24 ± 3 years). Testing data were collected to investigate the physiological profiles of the players, while match demands were quantified with GPS data over 26 matches. There were significant differences (p = <0.05) between positional groups for pull ups, relative and absolute lower body strength, and body composition. Average total match distance for all the players was (5420 ± 1518 m). There were significant differences between positional groups for defenders (5770 ± 1419 m) vs strikers (4739 ± 1409 m) and midfielders (5549 ± 1545 m) vs strikers. The most high-speed-running (>4.5 ms−1) distance was covered by midfielders (950 ± 275 m) and strikers (908 ± 284 m). Midfielders (116 ± 15 m min) and strikers (120 ± 20 m min) achieved higher intensities during matches compared to defenders (105 ± 13 m min). There were small differences between positional groups for physiological variables, but large variation between positional groups for match demands. There was a significant negative relationship between 2.4 km time trial vs high-speed running (p = <0.05), player load.min and match speed (p = <0.001). Also, there was a negative association between repeat sprint ability total time and high-speed running distance (p = <0.02) and match speed (p = <0.02). The countermovement jump height was associated with match speed (p = <0.05) and there was a negative relationship between body fat % and match speed (p = <0.02). When considering key performance indicators while using GPS devices, match speed (m.min) provides the most valuable information in field hockey players.
Customer Satisfaction and Implied Cost of Equity: Moderating Effects of Product Market Conditions and Chief Marketing Officer
Authors: Lim Youngdeok , Lee Jenny (Jiyeon) , Kim Hyungtae
Published: March 2021

A handful of prior marketing studies have examined the impact of customer satisfaction (CS) on the cost of equity (COE). These studies have estimated the COE using the ex post proxy (e.g., stock market beta) that may be susceptible to market fluctuations. Going beyond the conventional COE approach, we thus reestimate the effect of CS on COE, measured by the more robust ex ante expected returns (implied cost of equity [ICE]). Furthermore, we examine whether this relationship is subject to both external (product market conditions) and internal (chief marketing officer [CMO] presence) factors. Using 753 firm-year observations in the period 2000–2014, we find that firms with high satisfaction ratings have lower equity financing costs. The significant moderating effects of product market conditions and the presence of a CMO in firms are also observed. The negative relationship becomes weaker under conditions of greater product market competition and demand uncertainty, but stronger when a firm has a CMO in its senior management. Our findings provide useful insights for managers who need to justify and refine their marketing strategies in respect of CS to acquire a firm’s required level of equity financing costs. In addition, we highlight the importance of CMOs as significant contributors to the COE reduction. The results are also useful for investors when valuing a firm through the COE.
Exploring Subsistence Marketplaces Through a Feminist Perspective
Authors: Voola Archana , Voola Ranjit
Published: March 2021

Extant literature in the field of subsistence marketplaces adopts a gender-neutral framing of marketplace exchanges despite the overwhelming experience of disadvantage faced by women relative to men as a consequence of patriarchal structures. The authors employ feminist perspectives to render visible constructions of power inequities. First, the authors employ a gendered lens to revisit the topics and data in four published papers in the field of subsistence marketplaces, revealing new questions for future research to answer as well as opportunities to reimagine policy responses. Second, they demonstrate how a gendered analysis was conducted in a primary research study with 21 men and women involved in microfinance programs in rural South India. The findings reveal that gender is a social construction that can be “done and undone,” to transform unequal power relations between men and women in subsistence marketplace exchanges. Several implications for theory and marketing practice are then provided.
Racial Disparities in Diabetes Technology Use and Outcomes in Type 1 Diabetes in a Safety-Net Hospital
Authors: Fantasia Kathryn L , Wirunsawanya Kamonkiat , Lee Christopher , Rizo Ivania
Published: March 2021

Background:

Limited data exist regarding diabetes technology use among adults with type 1 diabetes (T1D) in urban racially/ethnically diverse safety-net hospitals. We examined racial/ethnic differences in the use of continuous glucose monitor (CGM) and continuous subcutaneous insulin infusion (CSII) in this setting.

Methods:

A retrospective review of 227 patients ≥ 18 years of age with T1D seen in an urban, safety-net endocrinology clinic during 2016-2017 was completed (mean age: 39; 80% English-speaking; 50% had public insurance). Diabetes technology use, defined as either CGM or CSII or both CGM and CSII, and clinical outcomes were examined by race/ethnicity.

Results:

Overall, 30% used CGM and 26% used CSII. After adjusting for age, language, insurance, and annual income, diabetes technology use in non-White patients was significantly lower than in White patients, predominantly lower in Black (aOR 0.25 [95% CI 0.11-0.56]) and patients identified as other race/ethnicity (aOR 0.30 [95% CI 0.11-0.77]). At the highest household income level (≥$75,000/y), Black and Hispanic individuals were significantly less likely than White individuals to use diabetes technology ( P < .0007). Mean hemoglobin A1c (HbA1c) was lower in patients using any diabetes technology compared with patients using no technology ( P < .0001). Use of CGM and CSII together was associated with the lowest HbA1c across all racial/ethnic groups.

Conclusions:

Racial/ethnic disparities in diabetes technology use and glycemic control were observed even after adjusting for sociodemographic factors. Further research should explore barriers to accessing diabetes technology in non-White populations.
Color Coding the “Labyrinth”: How Staff Perceived a Two-Part Intervention to Improve Wayfinding in an Adult Emergency Department
Authors: Madson Michael , Goodwin Kelsie
Published: March 2021

Objectives, purpose, or aim:

We report a two-part wayfinding intervention, considering four quality criteria (visibility, usability, efficiency and overall effectiveness) from staff perspectives.

Background:

Few studies to date have explored wayfinding in the Emergency Department (ED). Yet, as ED usage continues to grow, effective wayfinding in these high-stress, fast-paced environments is likely to become increasingly important. At an adult ED located in the U.S. Southeast, wayfinding has been a persistent problem. We subsequently developed a two-part wayfinding intervention: colored routes to key destinations in the ED and corresponding visitor badges.

Methods:

Quality criteria were formulated using the Donabedian model: visibility (structure), usability (process), efficiency (process), and overall effectiveness (outcome). Assessments consisted of staff surveys, which were distributed from March to early April 2019.

Results:

The strong ratings across quality criteria, added to affirmative comments from staff, provide evidence that the color coding system made a positive impact on wayfinding.

Conclusions:

While the results should be generalized with caution, the two-part intervention may be highly portable to other contexts. Future studies might examine the effect of colored routes alone. They might illuminate relations between structure, process, and outcomes as they relate to the assessment of wayfinding. They might also expand wayfinding quality criteria. Ultimately, such studies should improve not only the productivity but also the accessibility and user experience of the ED.
The risk factors for severe patients with COVID-19 in China: A systematic review and meta-analysis
Authors: Yue-liang Xie , Jiang-lin Wang , Hui-qin Yang , Ge Zhou , Hongyu Deng , Wei-jin Fang , Xiao-cong Zuo
Published: March 2021

COVID-19 is spreading exponentially. In order to optimize medical resources allocation and reduce mortality, biomarkers are needed to differentiate between COVID-19 patients with or without severe diseases early as possible. We searched Ovid MEDLINE(R), Ovid EMBASE, CNKI, Wanfang, VIP databases, the Cochrane Library, and medRxiv for primary articles in English or Chinese up to March 30, 2020 to systematically evaluate the risk factors for severe patients in China. Mean difference or standardize mean difference and odds ratio with 95% confidence intervals were performed by random-effect or fixed models in cases of significant heterogeneity between studies. We used I2 to evaluate the magnitude of heterogeneity. A total of 54 articles involving about 7000 patients were eligible for this meta-analysis. In total, 52 of 67 parameters between severe and non-severe cases were significantly different. Elderly male patients with comorbidities including hypertension, diabetes, chronic obstructive pulmonary disease (COPD) cardiovascular disease, cerebrovascular disease, chronic kidney disease, or cancer were more common in severe COVID-19 patients. Regarding the clinical manifestations on admission, fever, cough, expectoration, dyspnea, chest distress, fatigue, headache, chills, anorexia, or abdominal pain were more prevalent in severe COVID-19 patients. The results of the clinical examination showed that high C-reactive protein (CRP), high lactate dehydrogenase (LDH), high D-dimer, and decreased T lymphocytes cells subsets, decreased lymphocyte may help clinicians predict the progression of severe illness in patients with COVID-19. Our findings will be conducive for clinician to stratify the COVID-19 patients to reduce mortality under the relative shortage of medical resources.
Review on the correlation between chronic obstructive pulmonary disease and eosinophil in peripheral blood
Authors: Liu Hong-Xiang , Cui Na , Li Yi-Fan
Published: March 2021

Chronic obstructive pulmonary disease (COPD) is an irreversible disease characterized by the limitation of continuous airflow. Eosinophil (EOS) in peripheral blood plays a key role in the acute exacerbation of COPD. Eosinophil-increased COPD has become an important variant of COPD and the focus of individualized treatment of COPD. Numerous studies have shown that an increased eosinophil count or an increased percentage in the peripheral blood closely correlates to the acute exacerbation and prognosis of COPD. Therefore, this study intends to review the progress of domestic and foreign research on the correlation between COPD and EOS.
Simple and Reliable Magnetic Resonance Imaging Parameter to Predict Postoperative Ambulatory Function in Patients With Metastatic Epidural Spinal Cord Compression
Authors: Kim Young-Hoon , Ha Kee-Yong , Park Hyung-Youl , Cho Chang-Hee , Kim Hun-Chul , Heo Young , Kim Sang-Il
Published: March 2021

Study Design:

Retrospective case-control study.

Objectives:

The aim of this study was to develop a simple and reliable imaging parameter to predict postoperative ambulatory status in patients with metastatic epidural spinal cord compression (MESCC).

Methods:

Sixty-three patients with MESCC underwent spine surgery because of neurologic deficits were included. On preoperative axial MRI, the cord compression ratio was analyzed for postoperative ambulatory status. The relationship between other imaging features, such as fracture of the affected vertebra and increased T2 signal intensity of the spinal cord at the compression level, and the postoperative ambulatory status were also analyzed.

Results:

Cord compression ratio and increased T2 signal change of the spinal cord were significantly different between the postoperative ambulatory group and the non-ambulatory group. Receiver operating characteristic analysis showed that the optimal cut-off value was 0.84. In the multivariate regression analysis, only a cord compression ratio of more than 0.84 was significantly associated with postoperative ambulatory status (odds ratio = 10.80; 95% confidence interval = 2.79-41.86; P = .001). Interobserver/intraobserver agreements were strong for the cord compression ratio, however those agreements were weak for increased T2 signal intensity.

Conclusions:

On preoperative MRI, the cord compression ratio may predict postoperative ambulatory status in patients with MESCC. The measurement of this imaging parameter was simple and reliable. This imaging predictor may be helpful for both clinicians and patients.
Comparing Combined Anterior and Posterior to Posterior-Only Decompression and Fusion Crossing the Cervico-Thoracic Junction in Octogenarians
Authors: Ishak Basem , Abdul-Jabbar Amir , Glinski Alexander von , Yilmaz Emre , Unterberg Andreas W. , Hopkins Sarah , Roh Jeffrey , Oskouian Rod , Hart Robert , Chapman Jens R.
Published: March 2021

Study Design:

Retrospective cohort study.

Objective:

The purpose of the study was to compare early complication, morbidity and mortality risks associated with fusion surgery crossing the cervico-thoracic junction in patients aged over 80 years undergoing combined anterior and posterior approach versus a posterior-only approach.

Methods:

We retrospectively identified octogenarian patients with myelopathy who underwent fusion crossing the cervico-thoracic junction. Patient demographics, Nurick score, surgical characteristics, complications, hospital course, early outcome and 90-day mortality were collected. Comorbidities were classified using the age-adjusted Charlson Comorbidity Index (AACCI). Radiographic measurements for deformity correction included the C2-C7 sagittal Cobb angle, C2-7 sagittal vertical axis and T1 slope pre- and postoperatively.

Results:

Out of 8,521 surgically treated patients, 12 octogenarian patients had a combined anterior and posterior approach (AP group) and 14 were treated from posterior-only (P group). Mean age was 81.4 ± 1.2 and 82.5 ± 2.7 years, respectively. There was no significant difference in Nurick scores between the groups ( P > 0.05). The major complication risk in the AP group was significantly higher, requiring PEG tube placement due to severe dysphagia in 4 patients (33%) compared to none in the P group. A greater improvement in cervical lordosis could be achieved through a combined approach. The 90-day mortality risk was 8% for the AP group and 0% for the P group.

Conclusions:

A combined anterior and posterior approach is associated with a significantly higher major complication rate and can result in severe dysphagia requiring PEG tube placement in one-third of patients over 80 years of age.
Impacts of the 2018 M7.1 Anchorage earthquake on schools
Authors: Rodgers Janise , Hassan Wael , Motter Christopher , Thornley John
Published: March 2021

The 2018 M7.1 Anchorage earthquake damaged over 120 schools in the Anchorage and Matanuska-Susitna (Mat-Su) School Districts. Many remained closed for a week or more for cleanup and repairs, primarily due to nonstructural damage. Major structural damage occurred in three of 132 school buildings across both districts, and a number of additional schools had minor to moderate damage. Most observed damage was to nonstructural components, including suspended ceilings, lighting, architectural finishes, building utility systems, and equipment. Middle and high schools were in session at the time of the earthquake. Despite ceiling damage and fallen ceiling tiles, books, and supplies (heavy furniture was anchored) and objects swinging from the ceiling, both districts reported very few injuries. Statements by the school districts and administrators, media reports, and available video indicate that most students dropped, covered, and held on as practiced in regular drills. The combination of life-safety structural performance (with a few exceptions) due in part to moderate shaking, as well as anchoring of heavy furnishings, and student preparedness and drills to practice protective action, appears to have protected students. Both districts’ experiences provide evidence that school seismic safety programs are valuable, even if efforts to mitigate risks from older, vulnerable schools are in process and more work remains.
Students’ attitude and sleep pattern during school closure following COVID-19 pandemic quarantine: a web-based survey in south of Iran
Authors: Ranjbar Keivan , Hosseinpour Hamidreza , Shahriarirad Reza , Ghaem Haleh , Jafari Khoubyar , Rahimi Tayebeh , Mirahmadizadeh Alireza , Hosseinpour Parisa
Published: March 2021

Background

School closure is one of the main policies of global health care strategies performed worldwide. Despite all benefits, there might be some threats for younger groups spending their time in quarantine. This study aims to determine the impacts of lockdown and school closure on children’s major lifestyle aspects, especially their leisure and sleep pattern during the COVID-19 pandemic.

Methods

For the purpose of this study, an online questionnaire was distributed from 14th to 31st of March 2020 among the schools and students from the first grade to the 12th grade (before university) in Fars province, southern Iran. The questionnaire consisted of five sections which included data regarding the students’ general information, activity priorities, adherence to quarantine, attitude toward school closure, and sleep patterns.

Results

In our study, 20,697 filled questionnaires were received from the participants with an average age of 13.76 years; 29.7% of them were male, 80.6% were from urban areas, and 83.3% were from public schools. The overall first preference of students during school closure was mobile and computer games (30.1%), followed by studying (26.6%) and watching television (13.8%). Our results demonstrated that the majority of students adhered to social distancing and there was also a significant correlation among education levels and desire for schools to be closed till the end of the semester (P = 0.015). Also, regarding sleep patterns, the majority (53.5%) had above 12 h of sleep throughout the day.

Conclusion

It seems that lockdown following COVID-19 pandemic has changed various aspects of the students’ lifestyle remarkably, especially by increasing screen time and even sleep duration and pattern. We believe that certain strategies should be implemented by the Health and Educational Ministry to control not only the visible side effects of the quarantine period, but also the collateral consequences on their psychological and mental health.
AgroSeek: a system for computational analysis of environmental metagenomic data and associated metadata
Authors: Liang Xiao , Akers Kyle , Keenum Ishi , Wind Lauren , Gupta Suraj , Chen Chaoqi , Aldaihani Reem , Pruden Amy , Zhang Liqing , Knowlton Katharine F. , Xia Kang , Heath Lenwood S.
Published: March 2021

Background

Metagenomics is gaining attention as a powerful tool for identifying how agricultural management practices influence human and animal health, especially in terms of potential to contribute to the spread of antibiotic resistance. However, the ability to compare the distribution and prevalence of antibiotic resistance genes (ARGs) across multiple studies and environments is currently impossible without a complete re-analysis of published datasets. This challenge must be addressed for metagenomics to realize its potential for helping guide effective policy and practice measures relevant to agricultural ecosystems, for example, identifying critical control points for mitigating the spread of antibiotic resistance.

Results

Here we introduce AgroSeek, a centralized web-based system that provides computational tools for analysis and comparison of metagenomic data sets tailored specifically to researchers and other users in the agricultural sector interested in tracking and mitigating the spread of ARGs. AgroSeek draws from rich, user-provided metagenomic data and metadata to facilitate analysis, comparison, and prediction in a user-friendly fashion. Further, AgroSeek draws from publicly-contributed data sets to provide a point of comparison and context for data analysis. To incorporate metadata into our analysis and comparison procedures, we provide flexible metadata templates, including user-customized metadata attributes to facilitate data sharing, while maintaining the metadata in a comparable fashion for the broader user community and to support large-scale comparative and predictive analysis.

Conclusion

AgroSeek provides an easy-to-use tool for environmental metagenomic analysis and comparison, based on both gene annotations and associated metadata, with this initial demonstration focusing on control of antibiotic resistance in agricultural ecosystems. Agroseek creates a space for metagenomic data sharing and collaboration to assist policy makers, stakeholders, and the public in decision-making. AgroSeek is publicly-available at https://agroseek.cs.vt.edu/.
Range and niche expansion through multiple interspecific hybridization: a genotyping by sequencing analysis of Cherleria (Caryophyllaceae)
Authors: Moore Abigail J. , Messick Jennifer A. , Kadereit Joachim W.
Published: March 2021

Background

Cherleria(Caryophyllaceae) is a circumboreal genus that also occurs in the high mountains of the northern hemisphere. In this study, we focus on a clade that diversified in the European High Mountains, which was identified using nuclear ribosomal (nrDNA) sequence data in a previous study. With the nrDNA data, all but one species was monophyletic, with little sequence variation within most species. Here, we use genotyping by sequencing (GBS) data to determine whether the nrDNA data showed the full picture of the evolution in the genomes of these species.

Results

The overall relationships found with the GBS data were congruent with those from the nrDNA study. Most of the species were still monophyletic and many of the same subclades were recovered, including a clade of three narrow endemic species from Greece and a clade of largely calcifuge species. The GBS data provided additional resolution within the two species with the best sampling,C. langiiandC. laricifolia, with structure that was congruent with geography. In addition, the GBS data showed significant hybridization between several species, including species whose ranges did not currently overlap.

Conclusions

The hybridization led us to hypothesize that lineages came in contact on the Balkan Peninsula after they diverged, even when those lineages are no longer present on the Balkan Peninsula. Hybridization may also have helped lineages expand their niches to colonize new substrates and different areas. Not only do genome-wide data provide increased phylogenetic resolution of difficult nodes, they also give evidence for a more complex evolutionary history than what can be depicted by a simple, branching phylogeny.