bluuebunny/crossref_metadata_2025 huggingface dataset:
Intermittent Convective Therapies in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis
Authors: Côté Jean Maxime , Pinard Louis , Cailhier Jean-Francois , Lévesque Renée , Murray Patrick T. , Beaubien-Souligny William
Published: April 2021

Introduction: In critically ill patients requiring intermittent renal replacement therapy (RRT), the benefits of convective versus diffusive clearance remain uncertain. We conducted a systematic review and meta-analysis to determine the safety, clinical efficacy, and clearance efficiency of hemofiltration (HF) and hemodiafiltration (HDF) compared to hemodialysis (HD) in patients with acute kidney injury (AKI) receiving intermittent RRT. Method: We searched Medline, Embase, Cochrane Library, and PROSPERO. We included clinical trials and observational studies that reported the use of intermittent HF or HDF in adult patients with AKI. The following outcomes were included: mortality, renal recovery, clearance efficacy, intradialytic hemodynamic stability, circuit loss, and inflammation modulation. Results: A total of 3,169 studies were retrieved and screened. Four randomized controlled trials and 4 observational studies were included (n: 615 patients). Compared with conventional HD, intermittent convective therapies had no effect on in-hospital mortality (relative risk, 1.23; 95% confidence interval (CI), 0.76–1.99), renal recovery at 30 days (RR, 0.98; 95% CI, 0.82–1.16), time-to-renal recovery (mean difference [MD], 0.77; 95% CI, −6.56 to 8.10), and number of dialysis sessions until renal recovery (MD, −1.34; 95% CI, −3.39 to 0.72). The overall quality of included studies was low, and dialysis parameters were suboptimal for all included studies. Conclusion: This meta-analysis suggests that there is no significant difference in short-term mortality and renal recovery in patients with severe AKI when treated with intermittent HF or HDF compared to conventional HD. This systematic review emphasizes the need for further trials evaluating optimal convective parameters in AKI patients treated with intermittent dialysis.
Glimpse of climber diversity in Saharanpur District, Uttar Pradesh, India
Authors: Saini Lalita , Tyagi Archasvi , Mohammad Inam , Malik Vijai
Published: April 2021

The present paper focuses on the herbaceous and woody climbers of Saharanpur District.  A total of 66 species of herbaceous climbers, 33 species of woody climbers, 15 species of climbing shrubs, and two species of parasitic climbers belonging 27 different families have been recorded.  Climbers belonging to the families such as Convolvulaceae, Cucurbitaceae, Fabaceae, and Apocynaceae were found to be dominant in this region.  This study also records the occurrence of 14 species of threatened climbers.
The endangered Himalayan Red Panda: first photographic evidence from its westernmost distribution range
Authors: Shrestha Saroj , Lama Sony , Sherpa Ang Phuri , Ghale Dinesh , Lama Sonam Tashi
Published: April 2021

An endangered species, the Himalayan Red Panda Ailurus fulgens is one of the most iconic and sought-after species in the world. Although a symbolic species of the Himalayas, it is threatened by habitat loss, fragmentation, and poaching. The data collection was carried out in accordance with the Red Panda community-based monitoring protocol. Threats to the Himalayan Red Panda within the study area are reported based on key informant interviews and direct field observation. This paper provides new evidence for the presence of Himalayan Red Pandas beyond their previously-known westernmost limit (81.687778°E) across its distribution range. An average encounter rate of 0.92 signs/km was recorded from the surveyed community forests. Trees were the most preferred substrates used for defecation. Extensive resource collection, poaching, overgrazing and forest fires are identified as some of the most significant threats. In general, the study contributes to the conservation of the Himalayan Red Panda in western distribution ranges.
Marine mammal strandings in the northern Palk Bay from 2009 to 2020
Authors: Balaji Vedharajan , Sekar Veeramuthu
Published: April 2021

Globally, the marine mammal population has been under threat due to various human activities.  Data on stranding of these animals that are important for effective conservation planning and management, however, are not available in most of the developing countries.  This paper presents observations on marine mammal strandings in northern Palk Bay, the southeastern coast of India over the last decade.  In total, 21 stranding events consisting of 23 marine mammals were observed from 2009 to 2020.  These stranded mammals include a Humpback Dolphin, a Blue Whale, two Finless Porpoises, and 19 Dugongs.  The evident reason for the death of the dugongs and the porpoise being fishing activities, regulations on fishing practices, and intensive monitoring of the existing dugong population and their habitats are necessary.  This study recommends for establishment of conservation reserve, and setting up district-level marine mammal rescue and release units in Nagapattinam, Tiruvarur, Thanjavur, Pudukkottai, and Ramanathapuram districts, comprising fishers and line departments. These units need to be sufficiently equipped in terms of equipment and infrastructure, and periodical technical training and workshops on marine mammal rescue and release procedures to quickly respond and handle marine mammal strandings in the area.
Seamless Multimodel Postprocessing for Air Temperature Forecasts in Complex Topography
Authors: Keller Regula , Rajczak Jan , Bhend Jonas , Spirig Christoph , Hemri Stephan , Liniger Mark A. , Wernli Heini
Published: April 2021

Statistical postprocessing is applied in operational forecasting to correct systematic errors of numerical weather prediction models (NWP) and to automatically produce calibrated local forecasts for end-users. Postprocessing is particularly relevant in complex terrain, where even state-of-the-art high-resolution NWP systems cannot resolve many of the small-scale processes shaping local weather conditions. In addition, statistical postprocessing can also be used to combine forecasts from multiple NWP systems. Here we assess an ensemble model output statistics (EMOS) approach to produce seamless temperature forecasts based on a combination of short-term ensemble forecasts from a convection-permitting limited-area ensemble and a medium-range global ensemble forecasting model. We quantify the benefit of this approach compared to only postprocessing the high-resolution NWP. The multimodel EMOS approach (“mixed EMOS”) is able to improve forecasts by 30% with respect to direct model output from the high-resolution NWP. A detailed evaluation of mixed EMOS reveals that it outperforms either one of the single-model EMOS versions by 8%–12%. Temperature forecasts at valley locations profit in particular from the model combination. All forecast variants perform worst in winter (DJF); however, calibration and model combination improves forecast quality substantially. In addition to increasing skill as compared to single-model postprocessing, it also enables us to seamlessly combine multiple forecast sources with different time horizons (and horizontal resolutions) and thereby consolidates short-term to medium-range forecasting time horizons in one product without any user-relevant discontinuity.
A comparative study of Chinese and Western aesthetics in translation aesthetics
Authors: Zhao Yuhan , Li Feng
Published: April 2021

Although literary translation and aesthetics belong to different categories, they are inextricably linked. No matter what kind of language is the target of literary translation, it will be branded with relevant aesthetic thoughts to a great extent. This phenomenon can be seen everywhere in the field of literary translation in the East and the West. There are similarities between Chinese and Western aesthetics, for example, their origins are related to philosophy, and they are inseparable from literary aesthetics; there are also differences certainly, such as different psychological origins, different characteristics of development track, different attention to beauty, different methodology and so on. Through the comparative analysis of the similarities and differences between the two sides in aesthetic ideas, this paper aims to enhance its guiding role in translation practice.
The time-course of competition from the L1 grammar in L2 sentence processing: Evidence from cross-linguistic structural priming
Authors: Hopp Holger , Grüter Theres
Published: April 2021

In two visual-world eye-tracking experiments, we explore the extent to which conflicting first-language (L1) based grammatical parses influence second-language (L2) learners’ on-line and off-line interpretation of sentences in the L2. We used cross-linguistic structural priming to potentially boost competition from the L1 grammar during the processing of wh-questions in English. For L1-German learners (Experiment 1), sentence-final interpretations showed effects of conflicting L1 parses in the greater number of misinterpretations of English subject as object wh-questions than vice versa. In a follow-up experiment with a comparison group of L1-Japanese learners (Experiment 2), we found the reverse pattern in sentence-final interpretations, with lower accuracy on English object than subject wh-questions. The asymmetry in comprehension accuracy between Experiments 1 and 2 demonstrated that the effect observed among L1-German learners reflected grammar competition from the L1 rather than general L2 effects. In both experiments, we observed cross-linguistic priming from L1 object questions to L2 object questions in on-line processing. Yet, cross-linguistic priming did not enhance competition from L1 object questions on L2 subject questions in Experiment 1 as reflected in comprehension accuracy or eye-gaze during processing. Together, these findings present evidence of cross-linguistic structural priming for equivalent interpretations (object–object), but indicate that priming does not extend to competing L1 interpretations of word-order equivalent structures cross-linguistically (object–subject). We suggest that interference from conflicting L1-based grammatical parses is narrowly delimited in intermediate to advanced L2 sentence processing.
The Marketing of Female Escorts: A Gendered Perspective of Online Companionship Advertisements
Authors: Snow Natalie M. , Radatz Dana , Rhodes Trisha
Published: April 2021

Advancement of technology has broadened possibilities for people working in the sex industry. Specifically, sex workers’ use of online classified advertisement websites to market companionship and escort services has increased in recent years, yet research has lagged behind these developments. This study addresses the gap in research by examining female companionship advertisements on one of the most popular websites: Backpage.com . The lead author qualitatively analyzed over 1,500 advertisements to identify common themes and patterns in how escort companions were described. This study explores the type of identity claims escort companions make and how they formulate advertisements to appeal to a broad client base. Research on gendered stereotypes is used to interpret escort companions’ use of language, symbols, and photography, through covert and overt messaging. Study results revealed that women offering companion services promoted and reinforced traditional gendered stereotypes through their online advertisements. Findings may be used to understand the context of sex work.
Bayesian Approach to Developing Context-Based Crash Modification Factors for Medians on Rural Four-Lane Roadways
Authors: Li Xiaobing , Liu Jun , Yang Chenxuan , Barnett Timothy
Published: April 2021

Rural four-lane roadways provide important transportation accessibility and mobility to populations in rural areas. It is a challenge for practitioners to determine cross-section types when both benefits and costs need to be considered. Crash Modification Factors (CMFs) are developed to evaluate the safety effectiveness of alternative designs. However, safety effectiveness could vary significantly across contexts. Thus, this study aims to estimate CMFs for alternative cross sections of rural four-lane roadways under different contexts characterized by traffic volume, truck percentage, and access point density. Using Georgia state-wide crash data, this study developed Safety Performance Functions (SPFs) to predict crash frequencies for different contexts. Considering linearity and independence assumptions of traditional negative binomial SPFs, this study adopts Bayesian generalized negative binomial modeling approaches to relax those assumptions and only follows the Bayes rule to form SPFs for CMF estimation. This study focuses on four typical cross-sections including: (1) non-traversable medians; (2) two-way-left-turn lanes; (3) 4-ft flush medians; and (4) undivided roadways with double-yellow lines (the base cross-section design). The results show that CMFs vary significantly across different contexts. Compared with the base cross-section design, safety benefits of the other three designs can be either positive or negative under different traffic or road conditions. For example, 4-ft flush medians are found to have positive safety benefits (CMF < 1) under lower average daily traffic volumes (e.g., ≤ 6,000) and negative benefits (CMF > 1) under greater average daily traffic volumes (e.g., ≥ 15,000). The findings suggest that, to enhance roadway safety, practitioners should vary cross-section designs for different rural contexts.
Simple Index to Assess the Calibration Quality of Safety Performance Functions Based on Multiple Goodness-of-Fit Metrics
Authors: Avelar Raul E. , Dixon Karen , Kutela Boniphace , Klump Sam , Wemple Beth , Storm Richard , Morgan Mary
Published: April 2021

The calibration of safety performance functions (SPFs) is a mechanism included in the Highway Safety Manual (HSM) to adjust SPFs in the HSM for use in intended jurisdictions. Critically, the quality of the calibration procedure must be assessed before using the calibrated SPFs. Multiple resources to aid practitioners in calibrating SPFs have been developed in the years following the publication of the HSM 1st edition. Similarly, the literature suggests multiple ways to assess the goodness-of-fit (GOF) of a calibrated SPF to a data set from a given jurisdiction. This paper uses the calibration results of multiple intersection SPFs to a large Mississippi safety database to examine the relations between multiple GOF metrics. The goal is to develop a sensible single index that leverages the joint information from multiple GOF metrics to assess overall quality of calibration. A factor analysis applied to the calibration results revealed three underlying factors explaining 76% of the variability in the data. From these results, the authors developed an index and performed a sensitivity analysis. The key metrics were found to be, in descending order: the deviation of the cumulative residual (CURE) plot from the 95% confidence area, the mean absolute deviation, the modified R-squared, and the value of the calibration factor. This paper also presents comparisons between the index and alternative scoring strategies, as well as an effort to verify the results using synthetic data. The developed index is recommended to comprehensively assess the quality of the calibrated intersection SPFs.
People’s Forest Dependence: A Case Study of Similipal Biosphere Reserve, India
Authors: Saha Debolina , Agarwalla Shradha
Published: April 2021

A forest, as a rich ecosystem, is the source of livelihood of a large number of people residing in its fringe areas. Forest dwellers’ dependence on the forest varies across forest zones due to several factors, such as natural features and socio-economic-demographic characteristics of the people in different zones. Using econometric tools, this study evaluates the forest dependence of people residing in and around the Similipal Biosphere Reserve in India, constructs an index, and determines key factors affecting the extent of the forest dependence. The study explores household size and non-forest income as sources of alternative livelihood. Forest-zonal characteristics have significant impact on determining the extent of the forest dependence. People’s forest dependence is likely to be more in the periphery compared to the core zone. Therefore, in any initiative for reducing people’s forest dependence, zone-wise differentiation is needed to ensure sustainable development.
The Effects of Child Support Payment Factors on Satisfaction With Levels of Parental Involvement by Noncustodial Fathers
Authors: White Gerry L. , Banks Leon , Briggs Harold E. , Allen Junior Lloyd , Lowe Tony
Published: April 2021

Purpose:

Research on the influences of child support on the parental involvement of non-custodial father is mixed.

Method:

This study uses one-way multivariate analysis of variance (MANOVA) to examine non-custodial fathers’ satisfaction with levels of accessibility to his child, degree of engagement in daily activities, level of responsibility for child’s wellbeing and custodial parents parenting practices. These variables were measured against child support payment related behaviors to include income levels, monthly child support obligation, view of fairness of payment, maintaining a current status, and the number of additional child support cases.

Results:

Results indicated significant mean differences in the combined parental satisfaction variable and specifically within custodial parent parenting practices. Mean differences in parental satisfaction with reference to degree of responsibility for the child were also effected by monthly child support payment amounts. No significance differences in parental satisfaction were found regarding fairness of child support payment amount or having multiple child support cases. However, small differences were noted concerning payment status of current or behind.

Discussion:

Implications for future study of fatherless families are explored.
Reluctance to Accept Palliative Care and Recommendations for Improvement: Findings From Semi-Structured Interviews With Patients and Caregivers
Authors: Cardenas Valeria , Rahman Anna , Zhu Yujun , Enguidanos Susan
Published: April 2021

Background:

Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care.

Aim:

To identify patients’ and caregivers’ perceived barriers to home-based palliative care and their recommendations for overcoming these barriers.

Design:

We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants’ perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care.

Setting/Participants:

Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone.

Results:

Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients’ self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly.

Conclusion:

Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.
A Photovoice Inquiry Into the Impacts of a Subsidized CSA Program on Participants’ Health
Authors: Martin Allea , Coplen Amy , Lubowicki Lauren , Izumi Betty
Published: April 2021

Although consumption of fruits and vegetables is associated with reduced risk of disease, many Americans do not eat the recommended quantity or variety. This is especially true for low-income populations, who may face significant barriers to accessing fresh produce, including cost. Community-supported agriculture (CSA) Partnerships for Health is a subsidized community-supported agriculture program designed to reduce barriers to accessing fresh produce in a low-income population. This Photovoice study gave participants ( n = 28) an opportunity to take photos representing how the program affects their lives. The aim was to understand the program’s impact from the perspective of CSA members. Participants had 2 to 4 weeks to take photographs, and then selected a few to discuss during a subsequent focus group. Through this discussion, we learned that participants see the program as (a) supporting positive changes to their physical and social health and (b) facilitating learning about new foods, cooking, and agriculture. The study suggests that a reduced-cost CSA membership that incorporates cooking education supports participants’ ability to try new foods, build skills, and improve health outcomes.
Protective effects of molecular hydrogen on lung injury from lung transplantation
Authors: Quan Lini , Zheng Bin , Zhou Huacheng
Published: April 2021

Lung grafts may experience multiple injuries during lung transplantation, such as warm ischaemia, cold ischaemia, and reperfusion injury. These injuries all contribute to primary graft dysfunction, which is a major cause of morbidity and mortality after lung transplantation. As a potential selective antioxidant, hydrogen molecule (H2) protects against post-transplant complications in animal models of multiple organ transplantation. Herein, the authors review the current literature regarding the effects of H2 on lung injury from lung transplantation. The reviewed studies showed that H2 improved the outcomes of lung transplantation by decreasing oxidative stress and inflammation at the donor and recipient phases. H2 is primarily administered via inhalation, drinking hydrogen-rich water, hydrogen-rich saline injection, or a hydrogen-rich water bath. H2 favorably modulates signal transduction and gene expression, resulting in the suppression of pro-inflammatory cytokines and excess reactive oxygen species production. Although H2 appears to be a physiological regulatory molecule with antioxidant, anti-inflammatory and anti-apoptotic properties, its exact mechanisms of action remain elusive. Taken together, accumulating experimental evidence indicates that H2 can significantly alleviate transplantation-related lung injury, mainly via inhibition of inflammatory cytokine secretion and reduction in oxidative stress through several underlying mechanisms. Further animal experiments and preliminary human clinical trials will lay the foundation for the use of H2 as a treatment in the clinic.
Identification of key biomarkers for thyroid cancer by integrative gene expression profiles
Authors: Tian Jinyi , Bai Yizhou , Liu Anyang , Luo Bin
Published: April 2021

Thyroid cancer is a frequently diagnosed malignancy and the incidence has been increased rapidly in recent years. Despite the favorable prognosis of most thyroid cancer patients, advanced patients with metastasis and recurrence still have poor prognosis. Therefore, the molecular mechanisms of progression and targeted biomarkers were investigated for developing effective targets for treating thyroid cancer. Eight chip datasets from the gene expression omnibus database were selected and the inSilicoDb and inSilicoMerging R/Bioconductor packages were used to integrate and normalize them across platforms. After merging the eight gene expression omnibus datasets, we obtained one dataset that contained the expression profiles of 319 samples (188 tumor samples plus 131 normal thyroid tissue samples). After screening, we identified 594 significantly differentially expressed genes (277 up-regulated genes plus 317 down-regulated genes) between the tumor and normal tissue samples. The differentially expressed genes exhibited enrichment in multiple signaling pathways, such as p53 signaling. By building a protein–protein interaction network and module analysis, we confirmed seven hub genes, and they were all differentially expressed at all the clinical stages of thyroid cancer. A diagnostic seven-gene signature was established using a logistic regression model with the area under the receiver operating characteristic curve (AUC) of 0.967. Seven robust candidate biomarkers predictive of thyroid cancer were identified, and the obtained seven-gene signature may serve as a useful marker for thyroid cancer diagnosis and prognosis.
New Gatekeepers in Town: How Groups in Social Networking Sites Influence Information Flows in Russia’s Provinces
Authors: Dovbysh Olga
Published: April 2021

The study focuses upon “city public groups” (“gorodskie pabliki,” local newsgroups on social networking sites)—the new entrants in the local media space of the Russian province that have recently become important actors of regional public communication. Such groups combine news posting and citizen discussions, report on local affairs and gossip, and entertain. Some groups are based on user-generated content; others create their own content or act as aggregators. Being non-registered and grassroots initiatives, these media enjoy higher freedom in comparison to official local newsrooms. Given the popularity of city public groups among local citizens and local authorities’ interest toward them, owners and moderators of these media are playing an influential role for local mediated discourse. Based on the gatekeeping theory and its extensions for digital space, this article explores the emerging roles of these new gatekeepers in the local communities. Based upon 28 in-depth interviews collected by the author in Russian towns in 2017–2018, the article also analyses the professional norms and values of the owners and moderators of local city groups that they employ to perform their gatekeeping function.
Student Conceptions of Assessment: Regulatory Responses to Our Practices
Authors: Brown Gavin T. L.
Published: April 2021

Purpose:

Universities assess and evaluate students concerning competence in essential disciplinary knowledge and skills. Those assessments impact learners’ attitudes, beliefs, and emotions. Negative impacts may be overcome if students regulate their responses to assessment and feedback.

Design/Approach/Methods:

This article systematically locates research studies that cite three key early papers around student conceptions of assessment (SCoA). A narrative synthesis is based on 22 papers.

Findings:

In addition to the SCoA, 11 different research inventories reveal a variety of regulatory responses that are enhanced when assessments are deliberately formative, fair, and trustworthy. There is broad interest in this phenomenon but little consistency in methods, and even the SCoA has little consistency in factor structure across jurisdictions. Only one study provided an objective behavioral measure to validate self-reports, which are the dominant form of research.

Originality/Value:

This review gives readers insights into how assessment influences student thinking and how student cognition can regulate success.
An Overview of Domestic Artifacts in Masulih’s Houses, Gilan, Iran
Authors: Daneshyar Ehsan
Published: April 2021

The principal goal of this article is to study domestic artifacts in Masulih’s houses. This article points to the multidimensionality of domestic artifacts which can be categorized as being signifiers of research respondent’s beliefs and values, being part of the household’s social relations, and eliciting memories of the household. Research findings also highlight that some domestic artifacts have a life cycle and go through various phases in their life span. Qualitative research methods were used for data collection. Various extended field works were conducted in Masulih’s houses between 2008 and 2019. The principal techniques used for data collection were object interview, photo elicitation, and participant observation. The principal focus of interview sessions was on displayed objects and photographs in Masulih’s houses. During various interview sessions, respondents were asked to describe and narrate the stories of their domestic artifacts. Respondent narratives regarding their domestic artifacts highlight that the mentioned artifacts can be part of a complex web which mainly contains local inhabitants, houses, landscapes, memories, rituals, and values and beliefs. Furthermore, the study of domestic artifacts suggests that Masulih houses should not be considered solely as sites for the consumption of artifacts but places for the production of artifacts such as textiles. In this way, it can be said that local inhabitants are in constant connection with artifacts.
Right Atrial Appendage Thrombus in Atrial Fibrillation: A Case Report and Review of the Literature
Authors: Richardson Aaron C. , Omar Michael , Velarde Gladys , Missov Emil , Percy Robert , Sattiraju Srinivasan
Published: April 2021

Atrial fibrillation (Afib) is the most common abnormal heart rhythm in adults and has become a significant public health concern affecting 2% to 3% of the population in Europe and North America. Left atrial appendage (LAA) thrombi is the source of 90% of left-sided cardiac thrombi in patients with Afib, which can cause stroke and other systemic vascular events. Right atrial appendage (RAA) thrombi formation in Afib is much less common but complications include pulmonary embolism or paradoxical migration across patent foramen ovale with risk of systemic embolization. The prevalence and subsequent clinical complications of RAA thrombi formation in Afib patients is not well understood. Management of RAA thrombi should be similar to that of LAA thrombi which includes delaying cardioversion and anticoagulating with warfarin therapy to achieve international normalized ratio of 2 to 3.
Correction of Orbital Deformity in Camurati-Engelmann Disease with PEEK Lateral Wall Implants
Authors: Howe Thomas E. , Goonesekera Damithri T. , Lee Nicolas J. , Salvi Sachin M.
Published: April 2021

Camurati-Engelmann Disease is a rare congenital sclerosing bone dysplasia condition. Affected patients manifest bony abnormalities including thickening of the skull base and orbital bones. The resulting orbital volume reduction associated with this condition can cause exophthalmos, distorting the facial profile. The authors report a 33-year-old man with a diagnosis of Camurati-Engelmann Disease exhibiting exophthalmos who was successfully treated with the insertion of bilateral lateral orbital wall patient specific PEEK implants via a bi-coronal flap approach. This case highlights the novel application of modern cutting-edge technology in the treatment of proptosis in Camurati-Engelmann Disease.
Competency-Based Methods in Adult Cardiac Sonography and its Application to Credentialing
Authors: Dunstatter Douglas
Published: April 2021

Objectives:

This research examined the effects of multiple combined competency-based methods in an adult cardiac Commission on Accreditation of Allied Health Education Programs (CAAHEP) accredited diagnostic medical sonography program on clinical and didactic scores.

Materials and Methods:

A quasi-experimental nonequivalent group research design was used to evaluate students enrolled in an adult cardiac CAAHEP accredited echocardiography curriculum. Their cumulative final examination and clinical competency evaluation scores from multiple cohorts (pre- and post-intervention) were used for statistical analyses.

Results:

There were no significant differences between multiple competency-based assessments and didactic or clinical scores but unveiled reasons that coincide with the literature, such as nonvalid and subjective clinical assessment.

Conclusion:

These results suggest further evaluation of the credentialing process to ensure clinical competency.
Systematic review and meta-analysis of outcomes in patients with suspected pulmonary embolism
Authors: Patel Parth , Patel Payal , Bhatt Meha , Braun Cody , Begum Housne , Nieuwlaat Robby , Khatib Rasha , Martins Carolina C. , Zhang Yuan , Etxeandia-Ikobaltzeta Itziar , Varghese Jamie , Alturkmani Hani , Bahaj Waled , Baig Mariam , Kehar Rohan , Mustafa Ahmad , Ponnapureddy Rakesh , Sethi Anchal , Thomas Merrill , Wooldridge David , Lim Wendy , Bates Shannon M. , Lang Eddy , Le Gal Grégoire , Haramati Linda B. , Kline Jeffrey , Righini Marc , Wiercioch Wojtek , Schünemann Holger , Mustafa Reem A.
Published: April 2021

Prompt evaluation and therapeutic intervention of suspected pulmonary embolism (PE) are of paramount importance for improvement in outcomes. We systematically reviewed outcomes in patients with suspected PE, including mortality, incidence of recurrent PE, major bleeding, intracranial hemorrhage, and postthrombotic sequelae. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. We included 22 studies with 15 865 patients. Among patients who were diagnosed with PE and discharged with anticoagulation, 3-month follow-up revealed that all-cause mortality was 5.69% (91/1599; 95% confidence interval [CI], 4.56-6.83), mortality from PE was 1.19% (19/1597; 95% CI, 0.66-1.72), recurrent venous thromboembolism (VTE) occurred in 1.38% (22/1597; 95% CI: 0.81-1.95), and major bleeding occurred in 0.90% (2/221%; 95% CI, 0-2.15). In patients with a low pretest probability (PTP) and negative D-dimer, 3-month follow-up revealed mortality from PE was 0% (0/808) and incidence of VTE was 0.37% (4/1094; 95% CI: 0.007-0.72). In patients with intermediate PTP and negative D-dimer, 3-month follow-up revealed that mortality from PE was 0% (0/2747) and incidence of VTE was 0.46% (14/3015; 95% CI: 0.22-0.71). In patients with high PTP and negative computed tomography (CT) scan, 3-month follow-up revealed mortality from PE was 0% (0/651) and incidence of VTE was 0.84% (11/1302; 95% CI: 0.35-1.34). We further summarize outcomes evaluated by various diagnostic tests and diagnostic pathways (ie, D-dimer followed by CT scan).
The evolution of opsin genes in five species of mirid bugs: duplication of long-wavelength opsins and loss of blue-sensitive opsins
Authors: Xu Pengjun , Lu Bin , Chao Jiangtao , Holdbrook Robert , Liang Gemei , Lu Yanhui
Published: April 2021

Background

Color vision and phototactic behavior based on opsins are important for the fitness of insects because of their roles in foraging and mate choice. Related topics, including the duplication and loss of opsin genes, have been well investigated in insect orders such as Coleoptera, Lepidoptera, Hymenoptera, Odonata and Orthoptera, and the findings have been used to develop pest management strategies involving light trapping. Mirid bugs of Hemiptera, which are pests that cause heavy economic losses, show capacity for color discrimination and phototaxis. However, the opsins in mirid bugs remain uncharacterized. Herein, we examined five species to investigate the evolution of opsins in the family Miridae.

Results

Using RNA-seq, we identified several contigs showing high identity with opsins, including four contigs inApolygus lucorumand three contigs each inAdelphocoris suturalis,Adelphocoris fasciaticollis,Adelphocoris lineolatusandNesidiocoris tenuis. Phylogenetic analyses indicated that one of these genes clustered with ultraviolet-sensitive (UV) opsins and that the others clustered with long-wavelength (LW) opsins, suggesting that duplication of LW opsins and loss of blue light-sensitive (B) opsins occurred in mirid bugs. The existence of introns in the LW opsins of mirid bugs suggested that the duplication events were DNA based. Both LW1 and LW2 opsins of mirid bugs were found to be under strong purifying selection. The LW1 opsins were significantly more highly expressed than the LW2 and UV opsins.

Conclusions

We identified the opsins of mirid bugs using five selected mirid species as a representative sample. Phylogenetic analyses clustered one of the genes with UV opsins and the others with LW opsins, suggesting the occurrence of LW opsin duplication and B opsin loss during the evolution of mirid bugs. Intron detection suggested that the identified duplication event was DNA based. The evidence of strong purifying selection and the relatively high expression levels suggested that these opsins exhibit fundamental functions in mirid bugs.
Neutral theory: applicability and neutrality of using generic health-related quality of life tools in diseases or conditions where specific tools are available
Authors: Jandhyala Ravi
Published: April 2021

Background

Health-related quality of life (HRQoL) tools are limited by the indicators included in the construct and variation in interpretation by different researchers. Neutral Theory describes the ideal construct that includes all relevant indicators and, therefore, complete accuracy, or neutrality. Neutral Theory can thereby provide the framework to develop or test constructs. To assess the application of Neutral Theory, the neutrality of generic tools (SF-36 and EQ-5D) at measuring HRQoL was compared to disease/condition-specific tools, with the latter considered surrogates for the Neutral construct.

Methods

Full descriptions of all disease/condition-specific HRQoL tools published on PubMed (to 01-Jul-19) were sourced. For each tool, the number of items with and without a direct match within the SF-36 and EQ-5D was recorded and the sensitivity/specificity calculated.

Results

The SF-36 and EQ-5D did not achieve a sensitivity/specificity both > 50% against any of the 163 disease/condition-specific tools identified. At 20% prevalence of poor HRQoL, the false positive rate (FPR) was > 75% for all but two tools against the SF-36 and six tools against the EQ-5D. Increasing poor HRQoL to 80%, 47 tools for the SF-36 and 48 tools for the EQ-5D had a FPR < 50%. For rare disease tools (< 1/2000 population; n = 17), sensitivity/specificity ranged from 0 to 40%/5–31% for the SF-36 and 0–22%/29–100% for the EQ-5D. For non-rare (n = 75) and symptom-specific tools (n = 71) sensitivity/specificity was: 0–100%/0–100% (SF-36) and 0–50%/0–100% (EQ-5D); and 0–60%/0–19% (SF-36) and 0–25%/0–100% (EQ-5D), respectively. No concordance was recorded for 18% (2/11) of results from studies of rare disease tools versus the SF-36 (no data vs EQ-5D). For non-rare, disease-specific tools, results were discordant for 30% (25/84) and 35% (23/65) of studies against the SF-36 and EQ-5D, respectively. For symptom-specific tools, corresponding results were 36% (24/66) and 16% (5/31).

Conclusions

Generic HRQoL tools appear poorly correlated with disease/condition-specific tools, which indicates that adoption of Neutral Theory in the development and assessment of HRQoL tools could improve their relevance, accuracy, and utility in economic evaluations of health interventions.
Long-term condition management for prisoners: improving the processes between community and prison
Authors: Wright NMJ , Hankins F , Hearty P
Published: April 2021

Background

Prisoner populations have a disproportionately high prevalence of risk factors for long-term conditions (LTCs), and movement between community and prisons is a period of potential disruption in the ongoing monitoring and management of LTCs.

Method

Nineteen qualitative interviews with staff, recruited by purposive sampling for professional background, were conducted to explore facilitators and barriers to screening, monitoring and medicines management for LTCs.

Results

There is variability in prisoner behaviours regarding bringing community GP-prescribed medication to prison following arrest and detention in police custody, which affects service ability regarding seamless continuation of community prescribing actions. Systems for actively inputting clinical data into existing, nationally agreed, electronic record templates for QOF monitoring are under-developed in prisons and such activity is dependent upon individual “enthusiast(s)”.

Conclusion

There is a pressing need to embed standardised QOF monitoring systems within an integrated community/prison commissioning framework, supported by connectivity between prison and community primary care records, including all activity related to QOF compliance.
The prevalence and prescribing patterns of benzodiazepines and Z-drugs in older nursing home residents in different European countries and Israel: retrospective results from the EU SHELTER study
Authors: Lukačišinová Anna , Fialová Daniela , Peel Nancye May , Hubbard Ruth Eleanor , Brkic Jovana , Onder Graziano , Topinková Eva , Gindin Jacob , Shochat Tamar , Gray Leonard , Bernabei Roberto
Published: April 2021

Background

Benzodiazepines (BZDs) and Z-drugs have high potential for developing frequent adverse drug events in older adults (e.g., psychomotor sedation, drug-related dementia, deliria, drug dependence, etc.). Knowledge of the prevalence and patterns of the use of BZDs/Z-drugs in vulnerable older patients is important in order to prevent and reduce the burden caused by their drug-related complications. Our study focused on international comparisons of the prevalence, country-specific prescribing patterns and risk factors of regular BZD/Z-drug use in nursing home (NH) residents.

Methods

This cross-sectional study retrospectively analysed data of 4156 NH residents, prospectively assessed in the Services and Health in the Elderly in Long TERm care (SHELTER) project conducted from 2009 to 2014. Residents aged 65+ in 57 NHs in 7 European countries and Israel were assessed by the InterRAI Long-Term Care Facilities instrument. Descriptive statistics and multiple logistic regression models were used to describe the country-specific prevalence, patterns and risk factors of BZD/Z-drug use.

Results

The mean age of the participants was 83.4 ± 9.4 years, 73% were female and 27.7% used BZDs/Z-drugs. The prevalence of BZD/Z-drug use differed significantly across countries, ranging from 44.1% in Israel to 14.5% in Germany. The most frequently prescribed were zopiclone (17.8%), lorazepam (17.1%) and oxazepam (16.3%). Lorazepam, oxazepam and diazepam were used in most of the countries. Brotizolam, temazepam and zolpidem showed highest prevalence in Israel (99.4% of all regular users of this medication in the sample), the Netherlands (72.6%) and France (50.0%), respectively. Residing in Israel was the most significant factor associated with the use of BZDs/Z-drugs or BZDs only (odds ratio [OR] 6.7; 95% confidence interval [CI] 4.8–9.2 and OR 9.7, 95%CI 6.5–14.5, respectively). The use of Z-drugs only was most significantly associated with residing in France (OR 21.0, 95%CI 9.0–48.9).

Conclusions

Despite global recommendations and warnings, the preference for and extent of use of individual BZDs and Z-drugs in vulnerable NH residents differ significantly across countries. The strong association with country of residence compared to clinical and functional factors denotes that prescribing habits, social, cultural, behavioural, and regulatory factors still play an important role in the current diverse use of these medications.
Predicting intention to receive COVID-19 vaccine among the general population using the health belief model and the theory of planned behavior model
Authors: Shmueli Liora
Published: April 2021

Background

This study aim to explore the intentions, motivators and barriers of the general public to vaccinate against COVID-19, using both the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) model.

Methods

An online survey was conducted among Israeli adults aged 18 years and older from May 24 to June 24, 2020. The survey included socio-demographic and health-related questions, questions related to HBM and TPB dimensions, and intention to receive a COVID-19 vaccine. Associations between questionnaire variables and COVID-19 vaccination intention were assessed by univariate and multivariate analyses.

Results

Eighty percent of 398 eligible respondents stated their willingness to receive COVID-19 vaccine. A unified model including HBM and TPB predictor variables as well as demographic and health-related factors, proved to be a powerful predictor of intention to receive COVID-19 vaccine, explaining 78% of the variance (adjusted R squared = 0.78). Men (OR = 4.35, 95% CI 1.58–11.93), educated respondents (OR = 3.54, 95% CI 1.44–8.67) and respondents who had received the seasonal influenza vaccine in the previous year (OR = 3.31, 95% CI 1.22–9.00) stated higher intention to receive COVID-19 vaccine. Participants were more likely to be willing to get vaccinated if they reported higher levels of perceived benefits of COVID-19 vaccine (OR = 4.49, 95% CI 2.79–7.22), of perceived severity of COVID-19 infection (OR = 2.36, 95% CI 1.58–3.51) and of cues to action (OR = 1.99, 95% CI 1.38–2.87), according to HBM, and if they reported higher levels of subjective norms (OR = 3.04, 95% CI 2.15–4.30) and self-efficacy (OR = 2.05, 95% CI 1.54–2.72) according to TPB. Although half of the respondents reported they had not received influenza vaccine last year, 40% of them intended to receive influenza vaccine in the coming winter and 66% of them intended to receive COVID-19 vaccine.

Conclusions

Providing data on the public perspective and predicting intention for COVID-19 vaccination using HBM and TPB is important for health policy makers and healthcare providers and can help better guide compliance as the COVID-19 vaccine becomes available to the public.
A Q methodology study on divergent perspectives on CRISPR-Cas9 in the Netherlands
Authors: Schuijff Mirjam , De Jong Menno D. T. , Dijkstra Anne M.
Published: April 2021

Background

CRISPR-Cas9, a technology enabling modification of the human genome, is developing rapidly. There have been calls for public debate to discuss its ethics, societal implications, and governance. So far, however, little is known about public attitudes on CRISPR-Cas9. This study contributes to a better understanding of public perspectives by exploring the various holistic perspectives Dutch citizens have on CRISPR-Cas9.

Methods

This study used Q methodology to identify different perspectives of Dutch citizens (N = 30) on the use of CRISPR-Cas9. The Q-sort method aims at segmenting audiences based on the structural characteristics of their perspectives. Participants individually ranked 32 statements about CRISPR-Cas9 and discussed their rankings in small groups. By-person factor analysis was performed using PQMethod. Participants’ contributions to the discussions were used to further make sense of the audience segments identified.

Results

Five perspectives on CRISPR-Cas9 were identified: (1) pragmatic optimism (2) concerned scepticism; (3) normative optimism; (4) enthusiastic support; and (5) benevolent generalism. Each perspective represents a unique position motivated by different ranking rationales. Sorting rationales included improving health, preventing negative impacts on society, and fear of a slippery slope. Overall, there is broad, but not universal support for medical uses of CRISPR-Cas9.

Conclusions

Research on CRISPR-Cas9 should prioritise the broadly supported applications of the technology. Research and public debates on CRISPR-Cas9, its uses, its broader implications, and the governance of CRISPR-Cas9 are recommended. A discourse that includes all perspectives can contribute to the embedding of future uses of CRISPR-Cas9 in society. This study shows that Q methodology followed by group discussions enables citizens to contribute meaningfully to discourses about research.