bluuebunny/crossref_metadata_2025 huggingface dataset:
Estradiol Regulates Circadian Responses to Acute and Constant Light Exposure in Female Mice
Authors: Michaud Julie M. , Waring Caitlin T. , Medeiros Contini Fernanda , Burns Meredith E. , Price John C. , Quintana Janessa , Concepcion Holly A. , Deane Hannah V. , Seggio Joseph A.
Published: June 2023

Sex hormones are well known to modulate circadian timekeeping as well as the behavioral and physiological responses to circadian disruption. Gonadectomy, reducing the amount of circulating gonadal hormones, in males and females produces alterations to the free-running rhythm and the responses to light exposure by the central oscillator of the suprachiasmatic nucleus (SCN). In this study, we tested whether estradiol plays a role in regulating the circadian responses to acute (light pulses) and chronic light exposure (constant light [LL] vs standard light:dark [LD] cycle) in female C57BL6/NJ mice. Mice were either ovariectomized or given sham surgery and given a placebo (P) or estradiol (E) pellet for hormone replacement so that there were 6 groups: (1) LD/Sham, (2) LL/Sham, (3) LD/OVX + P, (4) LL/OVX + P, (5) LD/OVX + E, and (6) LL/OVX + E. After 65 days of light cycle exposure, blood and SCNs were removed and serum estradiol plus SCN estradiol receptor alpha (ERα) and estradiol receptor beta (ERβ) were measured via ELISA. The OVX + P mice exhibited shorter circadian periods and were more likely to become arrhythmic in LL compared with mice with intact estradiol (sham or E replacement mice). The OVX + P mice exhibited reduced circadian robustness (power) and reduced circadian locomotor activity in both LD and LL compared with sham controls or OVX + E mice. The OVX + P mice also exhibited later activity onsets in LD and attenuated phase delays, but not advances, when given a 15-min light pulse compared with estradiol intact mice. LL led to reductions in ERβ, but not ERα, regardless of the surgery type. These results indicate that estradiol can modulate the effects of light on the circadian timing system and that estradiol can enhance responses to light exposure and provide protection against a loss of circadian robustness.
Motivations for academic engagement and commercialisation: A case study of actors’ collaboration in third mission activities from three European universities
Authors: Taxt Randi Elisabeth
Published: June 2023

This multiple case study explores how researchers are motivated to perform their third mission activities in terms of collaborative projects with public and private actors. The study also investigates the involvement of universities’ third mission support personnel and technology transfer executives in the collaboration. The study contributes new insights into individual motivations for academic engagement and commercialisation. This is done by empirically demonstrating that commercialisation projects are based on ideas originated from novel and basic research, while academic engagement is based more on the general knowledge and capabilities of researchers and their research groups. The findings also revealed that motivations for taking on third mission activities were mainly about disseminating the results of research to wider society, rather than being driven by monetary rewards. This is demonstrated not only for the researchers, but also for the external partners, the support personnel, and technology transfer executives. The findings further imply that researchers are more satisfied with the support structure set up at their university for academic engagement projects than with the support structures for commercialisation of research, such as technology transfer offices. The findings can have implications for both policymakers and practitioners within knowledge and technology transfer.
Study of fluid-dynamic behavior in a convergent–divergent nozzle by shape optimization using evolutionary strategies algorithms
Authors: Bahamon Jhan , Martinez Manuel
Published: June 2023

The performance and thrust of a rocket propulsion system are based mainly on the utilization of the enthalpy of the propellants in the combustion chamber. This accumulated energy is transformed into kinetic energy by the expansion and acceleration of the gases produced by the chemical reaction of combustion, using a device known as a nozzle. This project studies the aerodynamic profile to trace the wall contour of a C-D nozzle based on the technical operating conditions of a rocket engine. The wall contour is traced using different design methods and, for each nozzle section, the behavior of the fluid-thermal properties of the flow field along the flow trajectory of the aerospace nozzle is analyzed. This is necessary because, in each wall contour suggested by the models, the angle of inclination of the curvature is different (the concavity or shape of the curve changes) and, therefore, the physical magnitudes of the properties vary according to the contour. To determine which design complies with the concept that processes occurring within a nozzle are isentropic and reversible, a statistical analysis of data dispersion is performed to choose the design with the lowest energy losses as a function of friction and entropy. An unconstrained optimization is applied to maximize or minimize the cross-sectional area of the nozzle geometric profile through genetic algorithms. To corroborate the nozzle wall contour and the design methodology used, a simulation is performed to evaluate the similarities between the operating characteristics and Mach number with another nozzle of a J-2 rocket engine.
Transitioning to low carbon economy among OECD countries: Do renewable energy, globalization and higher economic growth matter?
Authors: Ali Ernest Baba , Gyamfi Bright Akwasi , Kwakwa Paul Adjei , Agbozo Ebenezer
Published: June 2023

Facts have proven that humanity has incurred a significant environmental cost in the process of gaining economic success due to a surge in carbon dioxide emissions. Nevertheless, if carbon emissions are not curbed at the same time, economic growth may be slowed or stopped completely. It is for this reason that OECD member countries have set out plans to cut emissions. For this reason, the current paper scrutinizes the consequence of renewable energy intake, nonrenewable energy usage, economic globalization and economic progress on environmental destruction among 28 OECD countries by means of data spanning 1990 to 2019 period. The augmented mean group heterogeneous panel model and the common correlated effects mean group regression technique revealed evidence of a positive and negative significant connection between economic progress, and square of economic progress and carbon emission respectively (thus justifying the presence of the reversed U-shaped curve hypothesis) for OECD countries. Moreover, both renewable energy intake and economic globalization reveal a destructive connection with environmental destruction while nonrenewable energy intake has positive significant relationship with the environment. It was also disclosed that renewable energy intensifies the environmental destruction reducing effect of globalization and negatively moderates the impact of economic progress on environmental destruction. On the basis of the findings, appropriate policy recommendations have been developed to assist these economies in their efforts to dissociate economic progress from environmental destruction.
Thin Slices of Initial Group Rapport Predict Social Bonding
Authors: Goodwin Madeline E. , Sayette Michael A.
Published: June 2023

Rapport plays a key role in small group interaction, yet there remain gaps in understanding the construct. The current study examined whether initial group rapport among triads of strangers could predict later social bonding and group emotion. Results indicated that initial group rapport reliably predicted subsequent social bonding and emotional experience across multiple measures. These findings support use of global thin slice rapport measures in small groups. Further, they suggest that rapport can be assessed reliably within the first minute of meeting and that ratings of group experience in just this first minute offer valuable insight into subsequent group formation.
Are We Together in This? Relationship Experiences of Parents of Children with Craniofacial Anomalies
Authors: Myhre Anita , Råbu Marit , Feragen Kristin Billaud
Published: June 2023

Objective

The birth of a child with a craniofacial anomaly (CFA) can have a profound psychological impact on the family and the parental relationship. The purpose of this study was to qualitatively investigate how a child's CFA condition affected parents’ couple relationship.

Setting

All patients with a CFA are followed-up by the National Unit for Craniofacial Surgery, a specialized and multidisciplinary team. Hence, participants were recruited within a centralized treatment setting.

Design

We used a qualitative approach to explore the relationship experiences of parents of children with CFAs. The interviews were analysed using a hermeneutic-phenomenological approach.

Participants

The study included 13 parents, nine mothers and four fathers of children with a range of different CFAs. At the time of the interview, 10 participants were married, one was cohabiting, and two were divorced.

Results

Most participants perceived their partners as committed and engaged in caring for their affected child and involved in the family's everyday life, and described a strengthened relationship to their partner after the child with a CFA was born. However, some participants struggled in their relationships with their partners, and did not receive the comfort and support they needed during this critical time, leading to feelings of distance and loneliness.

Conclusions

Craniofacial teams should be mindful of the importance of the environment surrounding the child, such as parental relationship and family function. Therefore, a comprehensive approach should be included in team-based care, and couples and families in need of extra support should be referred to relevant specialists.
Outcomes in Patients With von Willebrand Disease Receiving Recombinant von Willebrand Factor on Demand and in Surgical Settings: Chart Review
Authors: Sun Shawn X. , Lowndes Shannely , Willock Rosa , Jones Cheryl , Brighton Sarah
Published: June 2023

This European observational chart review assessed the efficacy/safety of recombinant von Willebrand factor (rVWF) for on-demand treatment of spontaneous/traumatic bleeds and prevention and/or treatment of surgery-related bleeding in adults with von Willebrand disease (VWD). Patients (n = 91) were enrolled at first rVWF administration (index). Data were collected for the 12 months before index and until death, loss to follow-up, or end of study (3-12 months after index). Fifteen patients reported an rVWF-treated spontaneous/traumatic bleed at index. Bleed resolution was obtained for 14 patients (unknown status, n = 1), and investigators assessed treatment satisfaction for 13 rVWF prescriptions (2 moderate, 5 good, and 6 excellent). rVWF was used to prevent/treat surgery-related bleeds at index in 76 patients. Bleed resolution was achieved in 25/58 rVWF-treated surgeries; bleed resolution was not applicable for 33 surgeries. In both groups, there were no reports of treatment-emergent adverse events after initiating rVWF, including hypersensitivity reactions, thrombotic events, and VWF inhibitor development. rVWF was shown to be effective for the on-demand treatment of spontaneous/traumatic bleeds, and for the prevention and treatment of surgical bleeds in this real-world VWD population.
Commentary on “From the War on Terror to the Moral Crusade Against Female Genital Mutilation: Anti-Muslim Racism and Femonationalism in the United States”
Authors: Bootwala Yasmin
Published: June 2023

I am a practicing urologist with expertise in female genital cutting. In this commentary, I respond to Dr Dina Bader's article “From the War on Terror to the Moral Crusade Against Female Genital Mutilation.” I outline the current climate around genital cutting, the various actors shaping female genital cutting (FGC) legislation, and public perceptions surrounding the issue. I conclude that legislative changes sweeping across the United States to ban FGC have a variety of motivations. Some are to lift politicians’ profiles; some are to prevent destination FGC cutting domestically. The possibility of increased racial profiling or increased Islamophobia is perhaps underrecognized by liberals, and perhaps a discreet and intentional agenda for conservative lawmakers. The effect of this legislation also increases attention on the genital alteration of all children, male, female, and intersex, which could be the greatest benefit of all.
Pet Protection Orders for Domestic Violence Survivors: Are They Being Used?
Authors: Randour Mary Lou , González Dylan , Schurr Emily M. , Conforti Serena
Published: June 2023

This study examines if and how pet protection orders have been used by domestic violence survivors in the 36 states and the District of Columbia in which they have been enacted. A review of court websites determined if there was a specific item to include a pet in the temporary and/or final protection order. In addition, individual court administrators were contacted in various states to determine if statistics were available on the number of pet protection orders issued. Another mode of investigation included examining appropriate websites in each state to ascertain if the state issued a report on domestic violence statistics, and if so, if that report contained information on pet protection orders. Only one state, New York, keeps track of the number of protection orders that have been issued that include pets.
The Effects of Traumatic Events on Mental Health Among Women Experiencing Homelessness: A Longitudinal Study
Authors: Guillén Ana I. , Panadero Sonia , Vázquez José Juan
Published: June 2023

In this longitudinal study, we aim to evaluate the prevalence and impact of interpersonal and non-interpersonal traumatic events among women experiencing homelessness in Madrid (Spain) ( N  =  136). The information was collected through a structured interview and standardized instruments at baseline and at a 12-month follow-up. The most prevalent events were physical assaults, intimate partner violence, and severe illnesses or accidents. Path analysis revealed that personal and non-interpersonal traumatic events had direct effects on mental health, but also had differential indirect effects. Greater efforts are needed to address the effects of various types of potentially traumatic events and to design effective trauma-informed interventions for women experiencing homelessness.
Myocardial bridge in a patient with castration-resistant metastatic prostate cancer treated with enzalutamide
Authors: Giordano Giulia , Mastrantoni Luca , Colloca Giuseppe Ferdinando
Published: June 2023

Introduction

Myocardial bridge is a morphological anomaly of the heart characterised by the presence of a myocardial segment above a coronary artery, which results in a higher risk of cardiovascular events. In patients with prostate cancer treated with androgen receptor-targeted agents, a higher risk of cardiotoxicity was observed.

Case report

An 88 years old man with metastatic castration-resistant prostate cancer in treatment with enzalutamide, denosumab, and triptorelin presented to our attention complaining dyspnoea and angina pectoris.

Management and outcome

Blood examinations revealed normal Troponin I levels. Transthoracic echocardiography revealed no signs of acute myocardial ischaemia. The treadmill stress test revealed S-T tract under levelling in V4–V6 with a very slow resolution. Coronary angiography identified a myocardial bridge in the medium tract of the interventricular anterior artery. Due to these findings, ranolazine and simvastatin were started and, after multidisciplinary assessment, we decided to continue the treatment with enzalutamide. At the first follow-up visit echocardiography found out the cardiological reports stability and no therapy changes were performed. During follow-up visit cardiological revaluation showed reports stability and no therapy changes were performed.

Discussion

Due to the high prevalence of prostate cancer in elderly patients at high cardiovascular risk and the increasing use of androgen receptor-targeted agent, a multidisciplinary approach is highly recommended to weigh survival benefits on toxicities. This case report may support the use of androgen receptor-targeted agent in elderly patients with controlled cardiovascular diseases, a population that is often excluded from randomised trials.
Atezolizumab-associated myositis in a patient with unresectable hepatocellular carcinoma
Authors: Baigi Tania , Brown Erika N , De La Torre Rodrigo M , Abu-Shahin Fadi I
Published: June 2023

Introduction

Combination treatment with atezolizumab and bevacizumab is the preferred first-line treatment for patients with unresectable or metastatic hepatocellular carcinoma with a Child-Pugh Class A liver function. Reactivation of the antitumor immune response with atezolizumab can result in the development of immune-related adverse events including colitis, skin rash, endocrinopathies, pneumonitis, and nephritis with renal dysfunction. However, the occurrence of myositis with immune checkpoint inhibitors is rare.

Case report

We report on a 67-year-old male patient with an initial diagnosis of hepatocellular carcinoma, stage IV, unresectable with underlying cirrhosis who experienced atezolizumab-associated myositis.

Management and outcome

Utilization of the American Society of Clinical Oncology guideline on managing immune checkpoint inhibitors adverse events helped guide the ordering of pertinent labs for monitoring and pharmacologic treatment. In our case, atezolizumab-induced myositis was resolved via a combination of corticosteroids, intravenous immunoglobulins, and plasmapheresis.

Discussion

Recognition of the signs and symptoms of atezolizumab-associated myositis is recommended and utilization of the American Society of Clinical Oncology guideline to guide management and treatment of associated symptoms.
Epidemiology, Treatment Patterns, Comorbidities, and Concomitant Medication in Patients with ADHD in Sweden: A Registry-Based Study (2018–2021)
Authors: Giacobini MaiBritt , Ahnemark Ewa , Medin Emma , Freilich Jonatan , Andersson Magnus , Ma Yuanjun , Ginsberg Ylva
Published: June 2023

Objective:

To evaluate treatment patterns for ADHD in Sweden.

Method:

Observational retrospective study of patients with ADHD from the Swedish National Patient Register and Prescribed Drug Register, 2018 to 2021. Cross-sectional analyses included incidence, prevalence, and psychiatric comorbidities. Longitudinal analyses (newly diagnosed patients) included medication, treatment lines, duration, time-to-treatment initiation, and switching.

Results:

Of 243,790 patients, 84.5% received an ADHD medication. Psychiatric comorbidities were common, particularly autism among children, and depression in adults. Most frequent first-/second-line treatments were methylphenidate (MPH; 81.6%) and lisdexamfetamine dimesylate (LDX; 46.0%), respectively. In the second-line, LDX was most frequently prescribed (46.0%), followed by MPH (34.9%), then atomoxetine (7.7%). Median treatment duration was longest for LDX (10.4 months), followed by amphetamine (9.1 months).

Conclusion:

This nationwide registry study provides real-life insights into the current epidemiology of ADHD and the changing treatment landscape for patients in Sweden.
Attack adjudication in neuromyelitis optica spectrum disorder: Substantiation of criteria by magnetic resonance imaging and biomarkers in N-MOmentum
Authors: Weinshenker Brian G , Wingerchuk Dean M , Green Ari J , Bennett Jeffrey L , Kim Ho Jin , Pittock Sean J , Fujihara Kazuo , Paul Friedemann , Cutter Gary , Marignier Romain , Aktas Orhan , Hartung Hans-Peter , She Dewei , Smith Michael , Rees William , Patterson Kristina , Cimbora Daniel , Katz Eliezer , Cree Bruce AC
Published: June 2023

Background:

The N-MOmentum trial investigated safety and efficacy of inebilizumab in participants with neuromyelitis optica spectrum disorder (NMOSD).

Objective:

Evaluate the attack identification process and adjudication committee (AC) performance in N-MOmentum.

Methods:

Adults ( n = 230) with NMOSD and Expanded Disability Status Scale score ⩽8 were randomized (3:1) to inebilizumab 300 mg or placebo. The randomized controlled period was 28 weeks or until adjudicated attack. Attacks were adjudicated according to 18 predefined criteria. Magnetic resonance imaging (MRI) and biomarker (serum glial fibrillary acidic protein [sGFAP]) analyses were performed.

Results:

A total of 64 participant-reported neurological events occurred; 51 (80%) were investigator-determined to be attacks. The AC confirmed 43 of the investigator-determined attacks (84%). There was high inter- and intra-AC-member agreement. In 25/64 events (39%) and 14/43 AC-adjudicated attacks (33%), MRI was reviewed during adjudication. Retrospective analysis revealed new domain-specific T1 and T2 MRI lesions in 90% of adjudicated attacks. Increased mean sGFAP concentrations (>2-fold change) from baseline were observed in 56% of adjudicated attacks versus 14% of investigator-determined attacks rejected by the AC and 31% of participant-reported events determined not to be attacks.

Conclusion:

AC adjudication of NMOSD attacks according to predefined criteria appears robust. MRI lesion correlates and sGFAP elevations were found in most adjudicated attacks.
Carceral racialization, prison segregation, and the Integrated Housing Program in Arizona
Authors: Bloch Stefano , Olivares-Pelayo Enrique Alan
Published: June 2023

Prisoners in the Arizona Department of Corrections, Rehabilitation, and Reentry (ADCRR) coordinate to circumvent full racial housing integration, revealing how “race” and adherence to the “racial code” is used as an organizing concept in carceral settings that is distinct from conceptualizations of race and politics of identity within free society. In addition to providing a review of the literature on the complexity of prison racialization, we base our discussion of racialization and adherence to the racial code on our combined experience as formerly racialized and gang-affiliated inmates, as well as on insights from informal and semi-structured interviews with prisoners who have navigated attempts at racial integration as part of the ADCRR's recently adopted Integrated Housing Program.
Is Australia Ready for Autonomous Vehicles? Examining the Factors Influencing AV Adoption through Expert Interviews
Authors: Lim Wesley , Lee Sean , Sung Billy , Cronin Sophie
Published: June 2023

As Autonomous Vehicles (AVs) on public roads today becomes an increasingly realistic possibility, there is growing need to better understand the factors that will facilitate their successful introduction. This study focuses specifically on Australia and investigates various micro and macro environmental factors that may either hinder or support their adoption in the country. The study comprised 18 in-depth interviews with experts from both the public and private sectors who possess direct experience working with AVs. These experts provided valuable insights into several areas, including the legislation and regulations governing AV use, the technical and infrastructure requirements necessary for safe operation on public roads, and the importance of public sentiment in driving AV adoption and introduction. Based on the study’s findings, an integrated framework has been developed to identify and classify the key factors related to AV adoption, as well as their interrelatedness with each other. This framework seeks to guide the development of national strategies to accommodate the necessary political, legal, and social adjustments required for the successful implementation of AVs.
Numerical and experimental investigation on parameters determination of the suspension system for a high-speed train aiming at cross-line operation
Authors: Li Yixiao , Sun Jianfeng , Dai Liangcheng , Guo Zhaotuan , Chi Maoru
Published: June 2023

Cross-line operation that can improve the utilization of railway equipment and transportation efficiency is expected to be the development of the future, and the key to realizing this is to guarantee the dynamics performance of high-speed trains operating on different railway lines. To this end, this study focuses on determining the parameters of a suspension system for a high-speed train equipped with semi-active dampers. Multi-body dynamics method is used to establish a mathematical model of a high-speed vehicle, and a numerical integration method is applied to calculate the system response. An improved genetic algorithm adopting the dynamic Hamming distance, dynamic crossover, and mutation coefficients is integrated into the numerical simulation process to determine the parameters. Based on the numerical analysis, the optimized damping values for various hydraulic dampers in their passive modes are obtained. Finally, an experimental validation based on roller-rig and field loop-line tests is performed, and the test results verify the effectiveness of the optimized parameters. Thus, the study findings can serve as a reference to enhance the realization of cross-line operation.
Extending co-operative inquiry beyond the human: Ontopoetic inquiry with rivers
Authors: Reason Peter
Published: June 2023

Co-operative inquiry was conceived as an authentic science of humans as self-determining persons. But what if we extend our definition of persons to include beings in the more-than-human world – and indeed the cosmos itself – as sentient and responsive? This paper gives some account of a series of co-operative inquiries with human and river persons worldwide, drawing on living cosmos panpsychism to address questions of the kind, What would it be like to live in a world of sentient beings rather than inert objects? The paper includes some narratives of encounters with animals who appear at our river encounters, and reflects on the veracity claims we are making.
The treatment effects and cardiovascular events of high-dose intravenous iron for hemodialysis patients with renal anemia: A systematic review and meta-analysis
Authors: Zhang Shanbao , Ouyang Meng , Liu Lei
Published: June 2023

Background

Hemodialysis patients are common to have renal anemia in the nephrology practice. For the renal anemia, the high-dose iron from the intravenous route is an important treatment option. We can understand the treatment effects and cardiovascular events of high-dose intravenous iron reviewing the randomized clinical trials.

Methods

We compared the high-dose and low-dose iron treatments to find if the high-dose intravenous iron can influence the hematological parameters more significantly than the low-dose iron. The cardiovascular events were also analyzed for the high-dose iron treatment. Six studies with a total of 2422 renal anemia patients under hemodialysis were enrolled. We focused the outcomes of hemoglobin, transferrin saturation percentage, ferritin, erythropoietin dose, and cardiovascular events.

Results

The high-dose intravenous iron might be associated with a greater number of ferritin, transferrin saturation percentage, and hemoglobin. In addition, the erythropoietin dose was less needed to maintain the ideal hemoglobin range in the high-dose intravenous iron group.

Conclusions

In current meta-analysis, the high-dose intravenous iron might show the superior effects on the ferritin, transferrin saturation percentage, and hemoglobin levels and needed dose of erythropoietin when compared to low-dose iron treatment.
Evaluation of menstrual symptoms after Coronavirus disease 2019 vaccination in women with endometriosis
Authors: Martínez-Zamora María Ángeles , Feixas Georgina , Gracia Meritxell , Rius Mariona , Quintas Lara , de Guirior Cristian , Carmona Francisco
Published: June 2023

Background:

Vaccination can have an impact on menstruation, and this impact may be more notable in women with inflammatory gynecological pathologies such as endometriosis.

Objectives:

We aimed to investigate the impact of mRNA-based SARS-CoV-2 vaccines on menstrual cycle–related symptoms in women with endometriosis and assess the effect of hormonal therapy on potential SARS-CoV-2 vaccination-induced menstrual changes.

Design:

A total of 848 women who received at least two doses of mRNA-based COVID-19 vaccines were prospectively recruited: 407 with endometriosis (endometriosis group) and 441 healthy controls (non-endometriosis group).

Methods:

Data regarding demographics, clinical characteristics, hormonal treatment, and menstrual-associated symptoms in the first and second cycle after vaccination were collected through an online survey.

Results:

A similar percentage of patients in both the endometriosis and the non-endometriosis group self-reported menstrual-associated changes the first (52.6% versus 48.8%, respectively) and second cycle after vaccination (29.0% versus 28.1%, respectively). Although the total symptoms recorded were not different between the two groups, several specific symptoms were statistically more frequent in the endometriosis group. These were pain disorders and fatigue in the first cycle after vaccination and pain disorders, menstrual headache and fatigue in the second cycle after vaccination. Bleeding frequency/regularity disorders were found to be more frequent in the non-endometriosis group in the first cycle after vaccination. Patients under hormonal treatment reported fewer changes in menstrual symptoms in the first and second cycle after vaccination compared with those not receiving this treatment. Similarly, patients in the endometriosis group receiving hormonal treatment reported fewer changes in menstrual-associated symptoms compared with those not following any hormonal treatment in the first and second menstrual cycle after the last vaccination.

Conclusion:

Women with endometriosis immunized with mRNA-based SARS-CoV-2 vaccines did not perceive greater worsening or new menstrual-associated symptoms after complete COVID-19 vaccination compared with healthy controls. Hormonal treatment may have a protective effect against worsened or new menstrual symptoms induced by COVID-19 vaccination.
Ankle Telemedicine Planning Considerations
Authors: Applewhite Andres I. , Denay Keri L. , Hilgefort Jordan , Bertasi Raphael A. O. , Arizpe Azael , Kinaszczuk Anja M. , Hodgens Blake H. , Aiyer Amiethab , Pujalte George G. A.
Published: June 2023

A virtual medical visit, also known as telemedicine or telehealth, is a valuable alternative method of providing health care to patients who do not have easy access to a hospital, or during times when limited social interaction is crucial such as our current COVID-19 pandemic. A virtual approach to evaluating musculoskeletal system ailments is particularly challenging, for diagnosis of these conditions generally rely greatly on physical examination, which may be challenging. However, a properly planned and executed telemedicine visit will yield successful results in most cases. Our aim is to produce a document with instructions and suggestions, including physical examination maneuvers, to help physicians carry out a proper virtual medical visit with patients complaining of ankle musculoskeletal problems. Virtual visits should not be thought of as a replacement for traditional face-to-face medical consultations, but rather a complementary method to provide health care when deemed appropriate. By following this guide, and tailoring it to the specific case at hand, medical providers should be able to effectively carry out a successful telemedicine consultation for musculoskeletal ailments relating to the ankle.

Levels of Evidence: Level V
Contracted EU civil servants in EU common security and defence policy missions: Procedural routes to judicial remedies
Authors: Butler Graham
Published: June 2023

The right of judicial review for EU civil servants against their employer has historically been guaranteed by both EU primary law and EU secondary law. This has been through staff regulations having regard to Articles 270, 298, and 336 TFEU providing for judicial redress of employment disputes. However, an increasing number of EU civil servants fall outside the scope of such staff regulations, for example, contracted EU civil servants working for the EU's international missions in third states. These Common Security and Defence Policy (CSDP) missions employ thousands of people in different operational military and civilian capacities in the most dangerous regions of the world. There is a growing body of case law that has been developed at the Court of Justice of the European Union regarding access to justice for such staff, and how their employment-related disputes are to be adjudicated upon in the absence of staff regulations. This article probes the issue, and analyses the procedural difficulties, notably in terms of access to remedies, choice of applicable law, and the distinction between contractual and non-contractual issues, which such staff face. The article argues in favour of the introduction of specific staff regulations to cover contracted EU civil servants in CSDP missions, to ensure their procedural rights are protected, and that they have equal access to judicial protection.
Determining the fundamental dynamics of global sustainability in the Anthropocene from a vulnerability perspective
Authors: Phillips Jason
Published: June 2023

This paper conducts a detailed quantitative study of the indicated long-term levels, nature and dynamics of sustainability at the global spatial scale over time, within the context of the vulnerability of the environment-human relationship and system. In this study, the Sustainability Dynamics Framework is applied to the results of the Notre Dame Global Adaptation Initiative index for the period 1995–2018. The study indicates that the obtained S-values at the global spatial scale throughout the specified period were consistent with very weak unsustainability occurring. Through statistical analysis, the study indicates that the triumvirate of influencing factors (Population, GDP, Greenhouse Gases) have a significant influence and impact individually and cumulatively upon obtained S-values. The study then determines the net change in obtained E, HNI and S-values, and consequently evaluates the dynamics of the rate of change of the Earth System ( dE/dt), as defined in the Anthropocene Equation theory. To support this, Fourier analysis of net change of S-values is applied for the first time within the SDF application methodology, using eight time periods of 16 years’ duration over the period 1996–2018. The analysis indicates continuous overlapping cycles of 7 years’ duration, consisting of a lag time of 3 years leading to an impact period of 4 years. The Fourier analysis potentially indicates clearly for the first-time humanity’s footprint signal upon the environment-human relationship and system in the Anthropocene. The study concludes that humanity’s actions and inactions have resulted in the indicated unsustainability and vulnerability of the environment-human relationship and system. As a consequence, there is a potential realistic risk of systemic collapse unless fundamental changes occur in respect to the global environment-human relationship.
Political Influencers on Social Media: An Introduction
Authors: Riedl Martin J. , Lukito Josephine , Woolley Samuel C.
Published: June 2023

Influencers are omnipresent on social media platforms. They occupy important digital real estate across a range of topical domains including beauty, fashion, and gaming. While researchers have contributed important work on the respective role that authenticity plays for influencers’ success and have described a burgeoning industry within the larger domain of social media entertainment, comparably little is known about what happens when influencers get involved in politics, when they harness their digital clout to promote political causes and social issues, and thereby become political influencers. This introduction to the special issue on political influencers provides a definition of what makes someone a political influencer. It theoretically locates political influencers within the larger field of media and communication scholarship, and delineates the term from other, related concepts such as that of opinion leader. Building on eight contributions focused across more than six countries and nine platforms, the article showcases important strands of current and future research. It provides the foundation for a more systemic understanding of political influencers on social media, situating them within a media ecology complicated by a diverse array of traditional and nontraditional actors, tactics, and dynamics. The article concludes with recommendations for future research.
Colorectal Cancer Screening in Rural and Urban Primary Care Practices Amid Implementation of the Medicare Access and CHIP Reauthorization Act
Authors: Borders Tyrone F. , Morgan Zachary J. , Peterson Lars E.
Published: June 2023

Purpose:

The Medicare Access and CHIP Reauthorization Act (MACRA) incentivized primary care practices to improve colorectal cancer screening rates. This study examined if colorectal screening rates improved among rural and urban primary care practices amid implementation of MACRA.

Methods:

Colorectal cancer screening data are from a national registry of 139 primary care practices. Repeated measures regression tested for rural/urban differences and changes in screening rates between 2016 and 2020, adjusting for county demographic factors and social deprivation.

Results:

Screening rates were 64% in both rural and urban practices in the first quarter of 2016 and increased to 80% and 83% in rural and urban practices, respectively, in the last quarter of 2020. In adjusted analyses, screening rates increased by 4% per year and there were no rural/urban differences. Lower screening rates were associated with higher county proportions of persons who were 45 to 74 years of age and Hispanic. Higher screening rates were associated with higher county proportions of persons who were White, Black, and Asian and higher social deprivation.

Conclusions:

Colorectal screening rates improved among rural and urban primary care practices during implementation of MACRA, but disparities persist among practices serving county populations that are relatively older, more Hispanic, and have higher social deprivation.
Strategies to Tackle Microfinance Delivery Challenges
Authors: Das Siddharth
Published: June 2023

Financial inclusion was the most challenging mission as far as the economically weaker sections of society in India. Microfinance was given to the underprivileged for sustaining themselves and starting their own businesses. However, a number of operational and legal barriers that threatened the efficient operation of microfinance institutions (MFIs) restrained its growth. The purpose of this study was to understand the macro and micro challenges involved in the delivery of microfinance services in rural India. For the study of macro and micro issues faced by various institutions in providing microfinance, secondary data collection and informal interviews were done. The effective execution of delivery methods for microfinance was investigated in this article along with techniques that addressed the problems mentioned. In other words, the delivery challenges explained the macro and micro issues that different organisations encountered when delivering microfinance. Strategies were discussed making it workable and adoptable by various institutions participating in microfinance to counter or tackle the macro and micro delivery challenges faced. The findings showed the difficulties of people from rural areas, their inaccessibility to microfinance and the inability of MFIs in controlling transaction costs. The article has highlighted ways to provide as many rural residents as possible with the necessary credit money.
Association of Coracoacromial Ligament Degeneration With Rotator Cuff Tear Patterns and Retear Rate
Authors: Chuang Hao-Chun , Hong Chih-Kai , Hsu Kai-Lan , Kuan Fa-Chuan , Chen Yueh , Yen Joe-Zhi , Chiang Chen-Hao , Chang Hao-Ming , Su Wei-Ren
Published: June 2023

Background:

Coracoacromial ligament (CAL) degeneration is thought to be a factor in external impingement in bursal-sided rotator cuff tears, but CAL release is associated with adverse effects.

Purpose:

To investigate the association between CAL degeneration and the patterns of massive rotator cuff tears using multiple modalities and to assess the effect of CAL degeneration on supraspinatus tendon retear rates.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

The authors prospectively recruited 44 patients who had undergone arthroscopic rotator cuff repair without acromioplasty or CAL release. Preoperative radiographs and magnetic resonance imaging (MRI) scans were reviewed to determine acromial morphology and CAL thickness, respectively. Rotator cuff tears were categorized as isolated supraspinatus or massive (involvement of ≥2 tendons), with massive tears categorized using the Collin classification. Acromial degeneration was analyzed using the Copeland-Levy classification. The CAL was biopsied intraoperatively and histologically analyzed using the Bonar score. At 6-month follow-up, the integrity of the repaired supraspinatus tendon was analyzed on MRI using the Sugaya classification. Finally, the associations among CAL degeneration, rotator cuff tear pattern, and arthroscopic grading were investigated.

Results:

Patients with Collin type B rotator cuff tear had significantly higher CAL Bonar scores than those with Collin type A or isolated supraspinatus tears (10.0 vs 6.8 and 3.4; P = .03 and P < .001, respectively). Patients with a degenerative acromial undersurface of Copeland-Levy stage 2 or 3 had CALs with significantly higher Bonar scores than those with an intact acromial undersurface (8.4 and 8.2 vs 3.5; P = .034 and P = .027, respectively). The CAL Bonar scores of patients with different stages of the 6-month postoperative Sugaya classification were comparable (6.5, 7.2, 8.0, and 7.8 for stages 1, 2, 3, and 4, respectively; P = .751).

Conclusion:

CAL degeneration was more severe in anterosuperior-type massive rotator cuff tears. Interestingly, even without acromioplasty, the severity of CAL degeneration did not affect the retear rate of the supraspinatus tendon.
The Importance of Diverse User Goals When Designing an Automated COVID Risk Counselor
Authors: Cox Eugene , Hasegawa-Johnson Mark , Bhat Suma , Umashankar Mukhil , Lane H. Chad , Morrow Daniel
Published: June 2023

The COVID-19 Pandemic has required everyone to understand and respond to the ever-evolving threats during daily life. The overall goal of our work is to develop a system based on an interactive conversational agent that functions as a ‘risk counselor’ by providing personalized information to people who have concerns about the risk of COVID infection when participating in daily situations. Such a system could also be useful for people who have concerns about other kinds of infection (e.g., HIV), and more broadly, risk in other domains (e.g., radon exposure in the home). As an initial step, we conducted MTurk surveys to elicit people’s concerns about COVID risk in daily situations. A key takeaway from this study is that when designing an agent, there needs to be a better framing of risk-related recommendations about daily situations, which may be particularly effective for educating people about the risk and encouraging actions that address risk. This framing should also address diverse user goals, including emotional responses, uncertainty, planning, and opinions about these situations.
Modeling and simulation for situation awareness distribution and transactions for intrahospital patient transports
Authors: Alhaider Abdulrahman A. , Lau Nathan , Davenport Paul B. , Smith Stimis R. , DeWeese Darrell W.
Published: June 2023

Intrahospital transports rely on effective transmission of information between medical staff and information systems to support Distributed Situation Awareness (DSA) on patient status and transport requirements. This study presents the preliminary results a simulation model combining discrete event simulation (DES) and agent-based modeling (ABM) to quantify SA distribution and transactions for intrahospital transportation. The simulation model captured the transport requests, transport processes, and knowledge distribution and transactions between (human or machine) agents for intrahospital transports. Specifically, this paper presents the simulation results for the successful patient transport from 17 hospital inpatient units to the radiology department for (1) transport times and (2) transport cancellations. One-way t-tests did not reveal any significant differences in average transport time and number of cancelations between outputs of 100 simulation replications and historical data for 18-month operation. These results indicate that the simulation model represents real-world operation that can subsequently be used to test potential intervention to improve DSA in patient flow.
Implementing front-line ownership to improve safety in Labor & Delivery and Postpartum Units
Authors: Bañez Carleene , Engel Katrina , Soung Yee Anthony , Nercessian Silva , Slomka Ashley , Marr Jo-anne , Noble Joanna , Hooper Wendy , Gelmi Stefano , Farshait Nataly , Gaulton Catherine , Hall Trevor
Published: June 2023

Oak Valley Health, a community healthcare organization located in Ontario, Canada collaborated with the Healthcare Insurance Reciprocal of Canada (HIROC) on a quality improvement initiative. In March 2022, HIROC introduced a multi-modal approach to support the Childbirth and Children’s Service (CCS) program at Oak Valley Health to better understand teamwork and communication across the program to support patient safety. In partnership with Oak Valley Health, HIROC facilitated focus groups, interviews, and two workshops with the front-line multidisciplinary team members. CCS leaders implemented change ideas to increase teamwork and communication, and also improved culture, psychological safety, and empathy between interdisciplinary and interdepartmental teams across CCS. Examples of these changes included a new Access and Flow Report, CCS Specific Bed Meetings, Education Days, and Joint Charge Nurse Meetings. Since implementing these changes, employee engagement results have been positive. The CCS leaders plan to maintain implemented changes.
Implementation and Use of Real-Time Location Systems in Hospital Environments – Rapid Scoping Review of Human Factors Considerations
Authors: Waldie Piers , Attef Maryam , Trudel Chantal , Chan Adrian D. C. , Wallace Bruce
Published: June 2023

Real-Time Location Systems (RTLS) are rapidly being adopted in healthcare environments to monitor or track patients, workers, equipment, supplies and more, with numerous studies discussing the impact of this emerging technology. However, a more global view of such studies, those focused on human factors considerations in implementing RTLS is lacking. In response, we present preliminary findings from a rapid scoping review of factors related to implementing RTLS in healthcare environments, with a specific focus on impact to healthcare workers. We conducted keyword searches of databases such as CINAHL, EI Engineering Village, Scopus, IEEE, Web of Science, and several ProQuest journals between July and September 2022. The results were screened to identify results pertaining specifically to the experience of implementing RTLS in recent years. The extracted studies offer insight into the human factors that affect the implementation and use of this technology. Namely, the literature points to undesirable outcomes that occur when organizational efficiency is emphasized over providing demonstrable benefits to workers. Conversely, successful implementations are shown to feature increased worker involvement in the design process and increased communication and training following implementation. Further, the reviewed literature supports the involvement of human factors practitioners in future research activities investigating RTLS implementation and its impact on hospital infrastructure and operations.