bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Health and Health Sector Crisis Leadership During Pandemics: A Review of the Medical and Business Literature
Authors: Sriharan Abi , Hertelendy Attila J. , Banaszak-Holl Jane , Fleig-Palmer Michelle M. , Mitchell Cheryl , Nigam Amit , Gutberg Jennifer , Rapp Devin J. , Singer Sara J.
Published: September 2021

The global scale and unpredictable nature of the current COVID-19 pandemic have put a significant burden on health care and public health leaders, for whom preparedness plans and evidence-based guidelines have proven insufficient to guide actions. This article presents a review of empirical articles on the topics of “crisis leadership” and “pandemic” across medical and business databases between 2003 (since SARS) and—December 2020 and has identified 35 articles for detailed analyses. We use the articles’ evidence on leadership behaviors and skills that have been key to pandemic responses to characterize the types of leadership competencies commonly exhibited in a pandemic context. Task-oriented competencies, including preparing and planning, establishing collaborations, and conducting crisis communication, received the most attention. However, people-oriented and adaptive-oriented competencies were as fundamental in overcoming the structural, political, and cultural contexts unique to pandemics.
Forming strong cultural identities in an intersecting space of indigeneity and autism in Canada, the United States, Australia, and New Zealand
Authors: Simpson Heather A
Published: September 2021

Through its hegemonic ideologies, colonialism and its constituent underpinnings of religious and racial superiority, necessitates the erasure of the cultural identity of people outside the dominant Euro-Western culture and as non-normative groups, Indigenous Peoples and autistic people disabled per colonized paradigms, experience oppression, and subjugation harmful to self-identity and mental health. This article discusses culturally responsive interventions aimed at supporting strong cultural identity formation and safeguard Indigenous and autistic people from stigmatization, misrepresentation, and erasure of identity. Promising research uses Indigenous knowledges in education and arts programming to disrupt patterns of social injustice, exclusion, and cultural genocide while promote positive identity formation, pride, and resilience for Indigenous autistics. While Indigenous and autistic people exist globally, this article reviews literature from Canada, the United States, Australia, and New Zealand.
A more comprehensive measure of vaccine hesitancy: Creation of the Multidimensional Vaccine Hesitancy Scale (MVHS)
Authors: Howard Matt C.
Published: September 2021

This article aimed to develop the Multidimensional Vaccine Hesitancy Scale (MVHS). In Study 1 ( n = 336), we identified 13 possible vaccine hesitancy dimensions and developed an item list. In Study 2 ( n = 444), we performed an exploratory factor analysis that supported an eight-dimension structure and reduced our measure to 32 items. We supported its validity by establishing relations with associated variables, even while controlling for measures of the same and similar constructs. In Study 3 ( n = 575), we confirmed its factor structure and replicated its validity results. Support was provided for the psychometric properties and validity of the MVHS.
Productive Efficiency and Non-performing Assets of Indian Banks in the Post-global Financial Crisis Period
Authors: Khati Karan Singh , Mukherjee Deep
Published: September 2021

This study endeavours to augment the existing literature on the productive efficiency of Indian domestic banks in the presence of non-performing assets (NPAs), by employing the Weighted Russell Directional Distance Model (WRDDM). Following the intermediation approach, the banking technology set includes three inputs, three desirable outputs and one undesirable output, namely NPAs. Due to their inherent technological heterogeneity, public sector banks (PSBs) and private banks (PVBs) have been analysed as separate groups. Balanced panels of 26 PSBs and 18 PVBs are constructed from 2010-2011 to 2016-2017. The results indicate a considerable scope of improvement in the productive performance of both categories of banks. The break-up of overall inefficiency into input- and output-specific components reveals some stimulating information. For PSBs, the inefficiencies primarily result due to physical capital, while for PVBs they emerge mainly from other incomes. However, NPAs are also a key contributor to inefficiency for both the categories of banks. The inefficiency scores also indicate that, across ownership categories, medium-sized banks are poorer performers than their smaller and larger counterparts.

JEL: C14, C61, D24, G21
Hospital healthcare flows: A longitudinal clustering approach of acute coronary syndrome in women over 45 years
Authors: Pinaire Jessica , Aze Jérôme , Bringay Sandra , Poncelet Pascal , Genolini Christophe , Landais Paul
Published: September 2021

Acute coronary syndrome (ACS) in women is a growing public health issue and a death leading cause. We explored whether the hospital healthcare trajectory was characterizable using a longitudinal clustering approach in women with ACS. From the 2009–2014 French nationwide hospital database, we extracted spatio-temporal patterns in ACS patient trajectories, by replacing the spatiality by their hospitalization cause. We used these patterns to characterize hospital healthcare flows in a visualization tool. We clustered these trajectories with kmlShape to identify time gap and tariff profiles. ACS hospital healthcare flows have three key categories: Angina pectoris, Myocardial Infarction or Ischemia. Elderly flows were more complex. Time gap profiles showed that readmissions were closer together as time goes by. Tariff profiles were different according to age and initial event. Our approach might be applied to monitoring other chronic diseases. Further work is needed to integrate these results into a medical decision-making tool.
“Emotional strip-mining”: Sympathy sockpuppets in online communities
Authors: Greyson Devon , Costello Kaitlin L
Published: September 2021

Sympathy sockpuppets are false online identities used for purposes of extracting care work from others. While online community infiltration for nefarious purposes is a well-documented phenomenon, people may also join online communities using deceptive personas (“sockpuppet” accounts) for non-nefarious reasons, such as to gain sympathy or cultivate a sense of belonging in a group. In comparison with scamming and trolling, this more subtle form of online deception is not well understood, and to date, its impacts on individuals and communities have not been fully articulated. This knowledge gap leaves communities without guidance when managing the impacts of this sympathy sockpuppet deception. We interviewed people who had been members of online communities that discovered sympathy sockpuppets in their midst to explore and characterize the phenomenon of sympathy sockpuppetry and to provide guidance for other individuals and communities that encounter similar forms of online deception.
Utilisation of an 810 nm diode laser for surgical management of oral soft tissues related to orthodontic treatment: A case series
Authors: Dalvi Snehal , Lingala Saurabh , Khetal Namrata , Benedicenti Stefano , Hanna Reem
Published: September 2021

The present case series demonstrates the efficacy of an 810 nm diode laser for the surgical management of oral soft tissues related to orthodontic treatment. Three orthodontic patients aged 16–23 years underwent operculectomy, ablation of soft-tissue overgrowth over orthodontic appliance and gingivectomy along with gingival recontouring procedures, respectively, using the 810 nm diode laser. In each case, an initiated laser fibre tip was utilised to ablate the tissue at the treatment site by making a light contact with the tissue (average power output = 1–1.6 W, continuous wave emission mode, fibre diameter = 400 µm, spot size = 0.0013 cm2, energy density = 124.9–199.9 J/cm2, irradiance = 796–1273 W/cm2, total energy dose = 300–480 J). The maximum total length of treatment was 300 s (5 min). None of the patients reported any instantaneous or delayed postoperative complications over six months. Utilisation of the 810 nm diode laser for surgical management of oral soft tissues related to orthodontic treatments can be considered safe, effective and justifiable over the conventional scalpel technique; however, it must be performed by trained and experienced clinicians only.
An experimental study on fuel energy saving in gasoline engines using GNP as a lubricant additive
Authors: Singh Gurtej , Wani Mohammad Farooq , Marouf Wani Mohammad
Published: September 2021

This study concentrates on enhancing the performance of the gasoline engine through nano-lubrication. The effect of Graphene nano-platelets (GNP) as lubricant additives in SAE 15W40 oil on the fuel energy consumption and piston ring wear is investigated. GNP-filled lubricating oil boosted the brake strength, engine torque, and mechanical efficiency, whereas the gasoline engine’s brake specific fuel consumption (BSFC) decreased by 5.3%–6.5% due to a 1.7%–3.46% improvement in engine mechanical efficiency. Further, emission results showed that the GNP-filled lubricating oil reduced the emissions of the engine by approximately 3%–6% as compared to the virgin lubricating oil. Furthermore, the piston ring wear was found to reduce by using GNP-filled nano-lubricant. The characterization of the worn piston ring surfaces showed that the tribo-film formed on wear tracks resulted in the improved performance of the engine thereby reducing abrasive wear and surface roughness. From these studies, an attempt has been made to co-relate engine performance characteristics with tribological perception to contribute in the direction of energy savings and fuel economy.
Educational policy shifts: A critical review of the emerging trend of mindfulness in education
Authors: Duff Celeste
Published: September 2021

Globally, mindfulness is an emerging and innovative trend in education. Specifically, in school-based education, there has been growing excitement surrounding the implementation of mindfulness. Although policy, political and economic shifts and powers may seem quite far removed from the realities of children and mindfulness, the political economy does indeed saturate and shape children’s lives in multiple ways. The purpose of this review is to chart some of the economic and political contexts and highlight some of the shifts that may speak to the emerging trend of mindfulness in education. This critical review addresses the themes and shifts in economies and educational policy, highlights links between neuroscience-based discourses, mindfulness, social-emotional learning and emotional well-being in education.
Investigating the challenges and opportunities of a bilingual equity knowledge brokering network: A critical and reflective perspective from university partners
Authors: Bélanger Nathalie , Dulude Eliane
Published: September 2021

Public education systems are often large, diverse, fragmented, and historically very hard to change. While previous reforms targeted primarily school staff, large-scale policies now include a broader audience including non-system organizations (e.g., knowledge brokering organizations) that may influence directly or indirectly policy implementation. Arguing that knowledge brokering organizations can contribute to policy implementation by bridging equity policy and research and practice at the local level, we put forward that their networks and relationships with districts, schools, and community organizations can bring about substantial changes to the organization and practices of schools on equity issues, even though they may face obstacles in implementing change due to particular contexts. We aim to better understand the role of knowledge brokering networks and of the university partners who act as knowledge brokers to bridge Ontario Ministry of Education policy goals with equity research and practice. As knowledge brokers working in a bilingual province-wide equity knowledge brokering network, we use our experiences as a particular case of a non-system role in system-wide reforms. We build on these experiences to question and self-reflect on our role as knowledge brokers who accompanied practitioners and community coalition leaders towards equity and inclusion over a 2-year period. By analyzing knowledge brokering functions, we show the challenges and opportunities we faced as knowledge brokers in guiding local equity and inclusion initiatives: 1) the roles we carried out during interactions and practices that could take on different meanings as knowledge producers and mobilizers; 2) we point out how and why these knowledge brokering functions and our roles within a bilingual province-wide network needed to adapt to local realities by providing for a more flexible planning process that allowed for sufficient time to identify local needs and to produce, if necessary, the knowledge that incorporated cultural context considerations or particularities.
Chinese Herbal Medicine to Reduce Radiation-Induced Oral Mucositis in Head and Neck Cancer Patients: Evidence From Population-Based Health Claims
Authors: Li Hsin-Hua , Livneh Hanoch , Chen Wei-Jen , Lu Ming-Chi , Chiou Wen-Yen , Hung Shih-Kai , Yeh Chia-Chou , Tsai Tzung-Yi
Published: September 2021

Background:

Subjects with head and neck cancer (HNC) often experience post-treatment side effects, particularly radiation-induced oral mucositis (RIOM). This study aimed to explore the association of Chinese herbal medicine use with the sequent risk of RIOM among them.

Methods:

This cohort study used a nationwide health insurance database to identify subjects newly diagnosed with HNC, aged 20 to 60 years, who received treatment between 2000 and 2007. Among them, a total of 561 cases received CHM after HNC onset (CHM users); the remaining 2395 cases were non-CHM users. All patients were followed to the end of 2012 to identify any treatment for RIOM as the end point. Cox proportional hazards regression was used to compute the adjusted hazard ratio (aHR) of RIOM by CHM use.

Results:

During the follow-up period, 183 CHM users and 989 non-CHM users developed RIOM at incidence rates of 40.98 and 57.91 per 1000 person-years, respectively. CHM users had a lower RIOM risk than the non-CHM users (aHR: 0.68; 95% Confidence Interval: 0.58-0.80). The most potent effect was observed in those taking CHM for more than 1 year. Use of Baizhi, Danshen, Shao-Yao-Gan-Cao-Tang, Gan-Lu-Yin, Huangqin, Shu-Jing-Huo-Xue-Tang, and Xin-Yi-Qing-Fei-Tang, was significantly related to a lower risk of RIOM.

Conclusion:

Findings of this study indicated that adding CHM to conventional clinical care could be helpful in protecting those with HNC against the onset of RIOM. Further clinical and mechanistic studies are warranted.
“They Don’t Know What They Need”: A Call for Critical Reflection in Community School Leadership to Address the Pervasive Creep of Deficit Perspectives
Authors: Lewis-Durham Tiffanie , Saastamoinen Monique
Published: September 2021

Washington Hunt is an urban community school attempting to balance the implementation of equity initiatives that meet the needs of minoritized students and families while preventing the adoption of deficit perspectives among school staff. The purpose of this case is to describe how “deficit-creep”—the subtle infusion of deficit-based perspectives from well-meaning administrators—can thwart sincere attempts at community building and social justice. This case study provides an opportunity for emerging leaders to use critical reflexivity to identify deficit-creep and shed light on the strengths and assets of the community it serves. Finally, this case provides students with an opportunity to grapple with how policy makers and school leaders make sense of inequity that is linked to classism and racism.
Hybrid Glenoid Designs in Anatomic Total Shoulder Arthroplasty: A Systematic Review
Authors: Haleem Ahmed , Sedrak Phelopater , Gohal Chetan , Athwal George S. , Khan Moin , Alolabi Bashar
Published: September 2021

Background:

Hybrid glenoid components in total shoulder arthroplasty (TSA) utilize both polyethylene and metal components to provide short-term stability and long-term biologic fixation through bone ingrowth.

Questions/Purpose:

We sought to systematically review the literature for studies that assessed outcomes of TSA performed using hybrid glenoid components.

Methods:

PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase were searched systematically for articles measuring clinical and patient-reported outcomes and rates of complication and revision following TSA using a hybrid glenoid component.

Results:

Seven studies with 593 shoulders were included in this review. The mean age of patients was 65 ± 1 years, and 46% of the population was male. Mean follow-up was 50 months (4.2 years). The overall complication rate was 7% and rate of revision was 2.5%; glenoid radiolucency was present in 33% of shoulders at mean follow-up of 50 months. Mean improvements in forward elevation, external rotation, internal rotation score, and abduction were 49°, 28°, 2 points, and 42°, respectively. Mean improvements in Constant, American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were 36 points, 52 points, and 17 points, respectively.

Conclusion:

Our review found that TSA using hybrid glenoid components results in low rates of complication and revision at early follow-up. Long-term studies are warranted to understand more fully the role of hybrid glenoid components in TSA.
Current Perspectives on Contemporary Rheumatic Mitral Valve Repair
Authors: Dejsupa Chaninda , Chotivatanapong Taweesak , Caputo Massimo , Vohra Hunaid A.
Published: September 2021

The surgical management of rheumatic mitral valve disease remains a challenge for cardiac surgeons. Durability of mitral valve repair (MVr) is likely compromised not simply due to high technical demand, but surgeon reluctance, despite boasting copious advantages over MV replacement. This comprehensive review aims to evoke a deeper understanding of MVr concepts necessary to abate these limitations and shift mindset towards a more holistic approach to repair. Details of commonly utilized techniques in contemporary MVr for rheumatic heart disease will be discussed. Of importance, the reparative procedures will be mapped to an in-depth physiological exploration of the mitral complex-dynamism and rheumatic interplay. This is further emphasized by outlining the current “aggressive” resection strategy in contemporary rheumatic MVr.
Assessing the impact of a cannabis course on pharmacy students’ understanding, beliefs and preparedness regarding medical and recreational cannabis
Authors: Parihar Vikas , Beazely Michael A. , Katz Laura , Dhami Rita , Patterson Lisa Laureen
Published: September 2021

Background:

With the legalization of cannabis in Canada in 2018, pharmacists are increasingly likely to encounter patients using this substance. The primary objective of this pre-post questionnaire study was to evaluate the impact of an accredited cannabis course on the understanding, beliefs, perceptions and knowledge of undergraduate PharmD students.

Methods:

A 38-question, web-based survey generated in REDCap was administered to third-year PharmD students at the University of Waterloo, prior to and right after taking an accredited cannabis course. The pre- and postsurvey data were analyzed using SPSS version 25. Pearson chi-square tests were performed on questions in which answers consisted of qualitative categorical data. Two-sided t tests were performed to test the significance of mean differences of questions measuring continuous variables.

Results:

In a class of 120 students, 110 completed the presurvey and 79 students completed the postsurvey. After the course, students were more likely to report being knowledgeable and prepared for patient encounters dealing with medical and recreational cannabis, understanding that medical cannabis should be prescribed for select (vs all) medical conditions, rating the quality of evidence as poor to moderate for medical use of cannabis, understanding that medical documents should be more prescriptive and understanding that cannabis should not be sold in pharmacies ( p < 0.05).

Interpretation:

With cannabis education a part of their curriculum, pharmacy students felt more prepared to engage patients using cannabis both medically and recreationally. Furthermore, students were more cautious regarding the potential use of cannabis therapeutically and indicated that more oversight should be in place. Can Pharm J (Ott) 2021;154:xx-xx.
An algorithm combining coordinate descent and split Bregman iterative for fractional image denoising model
Authors: Zhao Donghong , Fan Yonghua , Liu Haoyu , Yang Yafeng
Published: September 2021

The split Bregman algorithm and the coordinate descent method are efficient tools for solving optimization problems, which have been proven to be effective for the total variation model. We propose an algorithm for fractional total variation model in this paper, and employ the coordinate descent method to decompose the fractional-order minimization problem into scalar sub-problems, then solve the sub-problem by using split Bregman algorithm. Numerical results are presented in the end to demonstrate the superiority of the proposed algorithm.
The Surgical Care Practitioner role in Achilles tendon re-rupture: A case study
Authors: Julies Elda , Williams Tim , Hall Susan
Published: September 2021

The value of a Surgical Care Practitioner to an orthopaedic team is demonstrated in this case study of a patient who presented with a re-ruptured Achilles tendon. It highlights the role the practitioner plays in the patient journey and illustrates it’s value throughout the clinical course from consultation through to discharge. The Surgical Care Practitioner, as a member of the extended surgical team can help to explain the diagnosis and associated treatment options, facilitate informed consent and provide expert procedural assistance to the surgeon. A Surgical Care Practitioner is ideally placed to answer patient queries and aid in rehabilitation.
Monitoring and management of fibrosing interstitial lung diseases: a narrative review for practicing clinicians
Authors: Nambiar Anoop M. , Walker Christopher M. , Sparks Jeffrey A.
Published: September 2021

Close monitoring of patients with fibrosing interstitial lung diseases (ILDs) is important to enable prompt identification and management of progressive disease. Monitoring should involve regular assessment of physiology (including pulmonary function tests), symptoms, and, when appropriate, high-resolution computed tomography. The management of patients with fibrosing ILDs requires a multidisciplinary approach and should be individualized based on factors such as disease severity, evidence of progression, risk factors for progression, comorbidities, and the preferences of the patient. In this narrative review, we discuss how patients with fibrosing ILDs can be effectively monitored and managed in clinical practice.
Re-envisioning health promotion: Thinking and acting salutogenically towards equity for historically resilient communities
Authors: Ottemöller Fungisai Gwanzura , Matenga Tulani Francis L. , Corbin J. Hope , Nakhuda Humaira , Delobelle Peter , Ayele Christa , Boston-Fisher Nikita , Leitch Stephanie , Wicker Josette , Mweemba Oliver
Published: September 2021

This paper explores how the salutogenic theory can enable us to re-envision health promotion work with marginalized communities, towards an approach that acknowledges and honours their resilience. We use the three core concepts in Antonovsky’s salutogenic model of health – sense of coherence, generalized resistance resources and specific resistance resources – to explore the theory’s relevance to health equity, thus presenting new opportunities for how we might radically re-evaluate current health promotion approaches. We conclude that a more equitable health promotion requires increased participation of marginalized communities in shaping their futures and suggest a new model for historically grounded salutogenic health promotion.
Planetary health indicators for the local level: opportunities and challenges in applying the happy planet index in Victoria, Australia
Authors: Patrick Rebecca , Henderson-Wilson Claire , Lawson Justin , Capetola Teresa , Shaw Amy , Davison Mia , Freeman Alison
Published: September 2021

The United Nations Sustainable Development Goals, New Urban Agenda and Paris Agreement on Climate Change are blueprints for health promotion action that mandate human health is linked inextricably to the health of the environment. In the Anthropocene, new indicators are required to promote community engagement with, and measurement of, healthy and sustainable wellbeing for people and planet. This study explored the need for a metric such as the Happy Planet Index that explicitly links human health to health of the environment for a local level scale in Australia. The project arose from an international coalition of health promoters advocating for ‘planetary health’ approaches. Qualitative description methods guided the study design involving key informant interviews ( n = 17) and four focus groups ( n = 27 participants) with health and/or sustainability academics, practitioners and policy-makers. Document analysis of health and environment indices and policy mandates augmented the analysis. Qualitative content analysis techniques were used to analyse the findings. There was strong interest for a local level composite indicator, such as a rescaled Happy Planet Index (life expectancy × life satisfaction × equity adjustment/ecological footprint) for use at a local level. The value of a composite index was: its ability to promote community engagement with planetary health thinking; an advocacy tool for joint health and sustainability policy; to justify programs on health and environmental co-benefits; and to provide a mechanism for correlative comparisons between local governments and national comparisons. However, disciplinary silos currently limit partnerships for health promotion and planetary health and a local composite index could help bridge these divides.
Wandering Eyes: Using Gaze-Tracking Method to Capture Eye Fixations in Unfamiliar Healthcare Environments
Authors: Ghamari Hessam , Golshany Nasrin
Published: September 2021

Objective:

This study aims to investigate the elements of wayfinding in indoor complex healthcare environments.

Background:

The study replicates Ghamari and Pati’s 2018 study to identify the environmental attributes that attract eye fixation during wayfinding by objectively tracking eye movements and fixation as healthy subjects navigate through a complex, unfamiliar indoor healthcare setting. The study addressed what do people look at while navigating in unfamiliar healthcare environments? What are the relative time periods of eye fixations on different visual environmental elements of the healthcare-designed environments? And what role do visual environmental attributes in healthcare facilities, such as configuration, color, art, directories, maps, furniture, and so on, play during the wayfinding process.

Method:

Twenty-four adults in different genders and various age groups participated in this study and navigated five routes with different degrees of difficulty. The sequence of the destinations in this study was randomized. The data were collected by tracking gaze fixations while human subjects navigated an indoor complex healthcare environment.

Results:

The findings show that identifying signs (29.1%), informative signs (20.8%), and architectural features (11.3%) constituted the most frequent elements attracting gaze, substantially more than the other classes of information. Four types of signage (identifying signs, informative signs, directional, and safety/regulatory signs) were accounted for 62.3% of the total gaze fixation time.

Conclusions:

The comparison of the ordered list based on frequencies and time of eye fixations on various elements developed in Ghamari and Pati’s study shows a vast degree of similarities.
Intra-Articular Injections of Curcumin Monoglucuronide TBP1901 Suppresses Articular Cartilage Damage and Regulates Subchondral Bone Alteration in an Osteoarthritis Rat Model
Authors: Nakahata Akihiro , Ito Akira , Nakahara Ryo , Kishimoto Atsuhiro , Imaizumi Atsushi , Hashimoto Tadashi , Mukai Shogo , Nakagawa Yasuaki , Kuroki Hiroshi
Published: September 2021

Objective

Curcumin monoglucuronide (TBP1901) is highly water soluble and can convert to free form curcumin, which has pharmacological effects, on intravenous administration. This study aimed to investigate the effectiveness of TBP1901 intra-articular injections in an osteoarthritis (OA) rat model.

Methods

Sixty-four male Wistar rats (12 weeks old) who underwent destabilized medial meniscus (DMM) surgery were randomly separated into the TBP1901 injection or saline solution (control) injection group. They were sacrificed at 1, 2, 6, or 10 weeks postoperatively (weeks 1, 2, 6, and 10; n = 8 for each group). TBP1901 (30 mg/mL) or saline solution of 50 μL was injected into the knee joints twice a week during weeks 1 and 2 to investigate the effects in the acute phase of posttraumatic (PT) OA or once a week during weeks 6 and 10 to investigate it in the chronic phase of PTOA. Histology, immunohistochemistry, and micro-computed tomography were performed to evaluate the changes in OA.

Results

TBP1901 injections significantly reduced synovial inflammation at weeks 1 and 2, and tumor necrosis factor-α expression in the articular cartilage at week 6. The TBP1901 injections also significantly suppressed articular cartilage damage, subchondral bone (SB) plate thickening, SB plate perforation, and osteophyte formation at week 10.

Conclusions

TBP1901 intra-articular injections suppressed synovial inflammation in the acute phase of PTOA in DMM rats. In the chronic phase, TBP1901 suppresses articular cartilage damage and regulates SB plate changes.
Neurocritical care management of poor-grade subarachnoid hemorrhage: Unjustified nihilism to reasonable optimism
Authors: Al-Mufti Fawaz , Mayer Stephan A , Kaur Gurmeen , Bassily Daniel , Li Boyi , Holstein Matthew L , Ani Jood , Matluck Nicole E , Kamal Haris , Nuoman Rolla , Bowers Christian A , S Ali Faizan , Al-Shammari Hussein , El-Ghanem Mohammad , Gandhi Chirag , Amuluru Krishna
Published: September 2021

Background and purpose

Historically, overall outcomes for patients with high-grade subarachnoid hemorrhage (SAH) have been poor. Generally, between physicians, either reluctance to treat, or selectivity in treating such patients has been the paradigm. Recent studies have shown that early and aggressive care leads to significant improvement in survival rates and favorable outcomes of grade V SAH patients. With advancements in both neurocritical care and end-of-life care, non-treatment or selective treatment of grade V SAH patients is rarely justified. Current paradigm shifts towards early and aggressive care in such cases may lead to improved outcomes for many more patients.

Materials and methods

We performed a detailed review of the current literature regarding neurointensive management strategies in high-grade SAH, discussing multiple aspects. We discussed the neurointensive care management protocols for grade V SAH patients.

Results

Acutely, intracranial pressure control is of utmost importance with external ventricular drain placement, sedation, optimization of cerebral perfusion pressure, osmotherapy and hyperventilation, as well as cardiopulmonary support through management of hypotension and hypertension.

Conclusions

Advancements of care in SAH patients make it unethical to deny treatment to poor Hunt and Hess grade patients. Early and aggressive treatment results in a significant improvement in survival rate and favorable outcome in such patients.
Superficial siderosis associated with an iatrogenic posterior fossa dural leak identified on CT cisternography
Authors: Madhavan Ajay A , Wood Christopher P , Aksamit Allen J , Schwartz Kara M , Atkinson John L , Kumar Neeraj
Published: September 2021

Superficial siderosis refers to hemosiderin deposition along the pial surface of the brain and spinal cord. It results from chronic and repetitive low-grade bleeding into the subarachnoid space. Dural tears are a common cause of superficial siderosis. Although such tears typically occur in the spine, dural tears can also occur in the posterior fossa. In many cases, posterior fossa dural tears are iatrogenic, and patients may present with neuroimaging evidence of postoperative pseudomeningoceles. We present a case of superficial siderosis caused by a persistent posterior fossa dural leak. The patient presented with superficial siderosis 30 years after a Chiari I malformation repair. A pinhole-sized dural tear was identified preoperatively using computed tomography cisternography. The dural defect was successfully repaired. An additional small tear that was not seen on imaging was also identified at surgery and successfully repaired.
Reconstructive endovascular treatment of basilar artery fenestration aneurysms: A multi-centre experience and literature review
Authors: Styczen Hanna , Fischer Sebastian , Gawlitza Matthias , Meyer Lukas , Goertz Lukas , Maurer Christoph , Alexandrou Maria , Khanafer Ali , Lobsien Donald , Deuschl Cornelius , Klisch Joachim , Kabbasch Christoph , Fiehler Jens , Berlis Ansgar , Papanagiotou Panagiotis , Henkes Hans , Maus Volker
Published: September 2021

Background

Data on outcome after endovascular treatment of basilar artery fenestration aneurysms (BAFAs) is limited. This study presents our multi-centre experience of BAFAs treated by different reconstructive techniques including coils, stent-assisted coiling (SAC), flow diversion and intra-saccular flow disruption with the Woven Endobridge (WEB).

Methods

Retrospective analysis of 38 BAFAs treated endovascularly between 2003 and 2020. The primary endpoint was complete aneurysm obliteration defined as Raymond–Roy occlusion classification (RROC) I on immediate and follow-up (FU) angiography. The secondary endpoints were procedure-related complications, rate of re-treatment, and clinical outcome.

Results

Endovascular treatment was feasible in 36/38 aneurysms (95%). The most frequent strategy was coiling (21/36, 58%), followed by SAC (7/36, 19%), WEB embolization (6/36, 17%) and flow diversion (2/36, 6%). A successful aneurysm occlusion (defined as RROC 1 and 2) on the final angiogram was achieved in 30/36 (83%) aneurysms including all patients presenting with baseline subarachnoid haemorrhage and 25/36 (69%) were occluded completely. Complete occlusion (RROC 1) was more frequently achieved in ruptured BAFAs (15/25, 60% v. 2/11, 18%; p = 0.031). Procedure-related complications occurred in 3/36 (8%) aneurysms. Re-treatment was executed in 12/36 (33%) aneurysms. After a median angiography FU of 38 months, 30/31 (97%) BAFAs were occluded successfully and 25/31 (81%) showed complete occlusion.

Conclusion

Reconstructive endovascular treatment of BAFAs is technically feasible with a good safety profile. Although in some cases re-treatment was necessary, a high rate of final aneurysm occlusion was achieved.
Acute cerebral microbleeds at the edge of lacunar strokes: cause or result
Authors: Koizumi Keisuke , Sato Hiromasa , Ebitani Masahiro , Kaneko Kikuko , Oguchi Kazuhiro , Hashimoto Takao
Published: September 2021

We investigated the pathogenic relationship between cerebral microbleeds and lacunar strokes. Two cases of lacunar strokes in the region of the basal ganglia, a 72-year-old man and a 67-year-old man, were studied; both cases showed cerebral microbleeds in the stroke areas. The cerebral microbleeds were surrounded by oedema, and the oedema faded out over time, suggesting the cerebral microbleeds had developed acutely. The cerebral microbleeds were located at the ventrolateral edge of the lacunar infarctions, and the locations appeared to be at or near the sites of occlusion of the lenticulostriatal branches. Although a cerebral microbleed and a lacunar infarction may be two unrelated events on juxtapositioned vessels, or a cerebral microbleed may be haemorrhagic conversion of an infarction, a cerebral microbleed could cause an occlusion of the arterial branch, leading to lacunar infarction of its supplying territories.
Reasons for refusing parenteral therapy: a qualitative study of patients with pulmonary arterial hypertension
Authors: Morland Kellie , Raina Amresh , Nails Abigail , Classi Peter , Etschmaier Martine , Frantz Robert P.
Published: September 2021

While parenteral prostacyclin (pPCY) therapy, delivered either subcutaneously or intravenously, is recommended for pulmonary arterial hypertension patients with severe or rapidly developing disease, some patients refuse this treatment. This study aimed to understand, directly from patients with pulmonary arterial hypertension, why pPCY was refused and, in some cases, later accepted. Interviews were conducted with 25 pulmonary arterial hypertension patients who previously refused pPCY therapy (Group A: Refused/Never initiated (n = 9) and Group B: Refused/Initiated (n = 16)). Patients in both groups believed that pPCY could improve their symptoms, slow disease progression, and provide them a greater ability to perform activities. Reasons for refusal included concern over side effects and the perceived limitations of pPCY on daily activities. Group A perceived their decision as a balance between quality of life and prolonging life and most acknowledged they would reconsider pPCY if other treatment options were exhausted. Group B cited they initiated therapy due to a worsening of symptoms, disease progression, to improve quality of life, to be there for their family, or a desire to live. Following initiation, Group B indicated their experience met expectations with reduced symptoms, slowed disease progression, and perception of improved survival; concerns related to pPCY were described as manageable. Given the efficacy of pPCY therapy, clinicians should apply knowledge of these findings in clinical practice. Patients noted improvements to parenteral pump technologies to include smaller size, water resistance, and implantability may increase their acceptance of this modality. Development efforts should focus on technologies that increase the acceptance of pPCY when indicated.
Inappropriate use of antibiotics, its reasons and contributing factors among communities of Yirgalem town, Sidama regional state, Ethiopia: A cross-sectional study
Authors: Dache Azmach , Dona Aregahegn , Ejeso Amanuel
Published: September 2021

Objectives:

The aim of this study was to assess the inappropriate use of antibiotics, its reasons and contributing factors among communities of Yirgalem town, Sidama regional state, Ethiopia.

Methods:

The study was conducted in Yirgalem town from 1 March to 30 March 2019. A cross-sectional study with interviewer administered structured and pretested questionnaire was used. A multistage sampling procedure was employed involving a total of 568 participants who used antibiotics in the past 1 year prior to the study period. Data were entered into Epi data version 3.1, and then exported to statistical package for social science version 20 for analysis. Descriptive statistics, bivariate and multivariate logistic regression analysis were done. p-value < 0.05 was used to consider significant variables.

Results:

The magnitude of inappropriate use of antibiotics was 37.9% (95% confidence interval (34.0, 41.5)). Main reason(s) for inappropriate use were long delays in health facility, cost-cutting and busy day’s program. Being employed (adjusted odds ratio = 3.45, 95% confidence interval (1.98, 6.02)), age 25–34 years (adjusted odds ratio = 2.89, 95% confidence interval (1.43, 5.84)), being male (adjusted odds ratio = 1.90, 95% confidence interval (1.20, 3.02)), seeking modern healthcare in private clinic (adjusted odds ratio = 2.54, 95% confidence interval (1.20, 5.36)), delayed waiting time in healthcare facilities (adjusted odds ratio = 4.87, 95% confidence interval (2.17, 10.91)), experienced with similar symptom/disease (adjusted odds ratio = 3.02, 95% confidence interval (1.89, 4.83)) and family size above five (adjusted odds ratio = 8.92, 95% confidence interval (3.56, 22.38)) were predictors positively associated with inappropriate use of antibiotics.

Conclusion:

The magnitude of inappropriate antibiotics use was high. Attention should be given to community education through involvement of the private health sector and healthcare providers about rational use of antibiotics.
Good budget or good care: The dilemma of social health insurance in Vietnam
Authors: Vuong Quan-Hoang , La Viet-Phuong , Nguyen Minh-Hoang , Nguyen Thanh-Huyen T , Ho Manh-Toan
Published: September 2021

Objective:

2014 marked a rising public commitment to universal health coverage in Vietnam to eliminate the financial burden for patients, but there are lots of hindrances. It is evident that patients met difficulties to validate their insurances, so health insurance does not significantly address out-of-pocket payments issues. Furthermore, the unequal geographical distribution of hospitals in Vietnam has created an inequality between non-residing patients and residing patients; the former usually pay more. This calls into question how the validity of healthcare insurance and patient’s residence could be related to patient’s financial status and their satisfaction with health insurance.

Methods:

Bayesian regression models are employed to analyze a data set of 1042 inpatients in hospitals of all levels in Northern Vietnam.

Result:

The results show that living in the same region as the hospital and having valid insurance is negatively correlated with the impoverishing risk. Regarding patients’ satisfaction with health insurance, it is negatively correlated with having a residence in the same region as the hospital but positively correlated with higher socioeconomic status and insurance validity. Finally, on average, the satisfaction of patients who have already recovered from the illness and those who quit early is lower than that of patients who needed follow-up in medical care or stop in the middle.

Conclusion:

This article suggests that policymakers consider addressing the unequal geographical distribution of hospitals and healthcare quality to help patients avoid going to hospitals outside their regions, which may generate a financial burden for patients and lower their satisfaction with health insurance.
Implementation challenges of an integrated One Health surveillance system in humanitarian settings: A qualitative study in Palestine
Authors: Abuzerr Samer , Zinszer Kate , Assan Abraham
Published: September 2021

Objectives:

Several factors have changed interactions between people, animals, plants, and the environment – renewing the relevance of the One Health surveillance system in the fight against zoonotic diseases such as COVID-19. Therefore, this study aimed to explore barriers to implementing an integrated One Health surveillance system in Palestine.

Methods:

This qualitative study was conducted from April 2020 until August 2020. Data were collected using semi-structured interview guides. Seven key stakeholders were interviewed during data collection. A thematic analysis was performed.

Results:

Four overarching themes emerged explaining barriers to integrated implementation of the One Health surveillance system. They are lack of policy coherence, limited financial resources, poor governance and leadership, and lack of One Health training programmes.

Conclusion:

Improved understanding of the transmission and effective control (including One Health approach) of zoonotic disease and better governance and leadership are critical in the diseases that threaten public health, such as the COVID-19.
Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal
Authors: Marasine Nirmal Raj , Shrestha Shakti , Sankhi Sabina , Paudel Nabina , Gautam Ashish , Poudel Arjun
Published: September 2021

Background:

High utilization and irrational use of antibiotics in an intensive care unit increases microbial resistance, morbidity, mortality, and costs.

Objective:

This study aimed to evaluate the utilization, sensitivity and cost analysis of antibiotics used in the medical intensive care unit of a tertiary care teaching hospital of Nepal.

Methods:

A prospective cohort study was conducted on patients admitted to the medical intensive care unit at a tertiary care teaching hospital in central Nepal from July to September 2016. Antibiotic utilization, defined daily dose per 100 bed-days and the cost of antibiotics per patient were calculated. Descriptive statistics were performed using IBM-SPSS 20.0.

Results:

A total of 365 antibiotics were prescribed in 157 patients during the study period, with an average of 2.34 prescriptions per patient. Total antibiotic utilization in terms of defined daily dose per 100 bed-days was 49.5. Piperacillin/tazobactam (45.2%) was the most commonly prescribed antibiotic, and meropenem was the most expensive antibiotics (US$4440.70). The median (interquartile range) cost of antibiotics used per patient was US$47.67 (US$63.73). Escherichia coli, Acinetobacter, and Pseudomonas sp. were the common organisms isolated and were found to be resistant to some of the commonly used antibiotics.

Conclusion:

This study suggests that the utilization and cost of antibiotics are high in medical intensive care unit of the hospital and E. coli was resistant to multiple antibiotics. The findings highlight an urgent need for the implementation of antibiotic stewardship program in order to improve antibiotic utilization in such hospital settings.
A Process Model of Leveraging Survival Crisis Towards Building Innovation as Core Competence: Theorization from the Journey of a Textile Firm
Authors: Biswas Samir , De Souvik , Subalova Madina , Ghosh Anjan
Published: September 2021

Although the extant research in entrepreneurial innovation shows how organizational challenges could enact such innovations, the relationship between organizational challenges and organizational innovation under the small and medium enterprise (SME) context requires attention. Especially considering that SMEs face supply chain challenges, we need to know whether such challenges consistently enact supply chain innovations. Moreover, although those innovations can address the immediate SME challenges, extant research does not capture the life cycle of the innovations efficiently. To find an answer to this theoretical quest, we conduct participatory case research at Saha Textile, India. The founder of Saha Textile started his journey as a small garment shop owner in a Bazar. Within two decades, Saha Textile became one of the most prominent vertically integrated organizations in the Indian textile sector. Our reflexive process study reveals that the organization faced multiple survival threats throughout its journey. The uniqueness of the organizational crisis enacted sensemaking in the organization. The organization looked at unusual and unconventional resources within its access and creatively converted those into valuable resources to address the challenges. If successful with the creative attempts in addressing the pressing challenges—the organization further strengthened those resources into core competence. Over time, the organizational learning in converting crisis to core competencies through creative utilization of resources became rational heuristics and acted as a (higher-order) dynamic capability. Our inductive theorization makes a significant academic contribution as it proposes a generalizable dynamic capability process model of converting crisis into innovation and capitalizing such innovations as a core competence. Our research points out the possibility of standardizing and leveraging innovations-as-crisis-responses as core competence towards a sustainable competitive advantage for practice.