bluuebunny/crossref_metadata_2025 huggingface dataset:
What do you call it when Jeremy Corbyn walks into a Seder? Jewishness, Gustav Landauer (1870–1919) and ethical subject-formation
Authors: Gabay Clive
Published: February 2021

Then UK Labour Party leader Jeremy Corbyn’s attendance at a Passover Seder organised by the radical leftist group, Jewdas, in April 2018, led to a brief but vitriolic controversy involving Anglo-Jewish umbrella organisations concerning who qualifies to speak as a Jew. This article uses this controversy to engage with Judith Butler’s attempt to address this question, suggesting that in decentring Zionist claims to Jewish subjectivity she fails to take account of how different Jewish subjectivities are formed, and thus ends up proposing a ‘good Jew/bad Jew’ binary that dissolves Jewishness into universal humanism. Drawing on the work of the German-Jewish mystical anarchist Gustav Landauer (1870–1919), the article proposes a different way of understanding subjectivity that retains ontological inherency as a plausible precondition for ethical solidarity. As such, the article’s argument has implications not merely for a reworked understanding of Jewish subjectivity but for the politics of subject formation more broadly.
Successful Treatment of a 19-Month-Old Boy with Hepatitis Associated Aplastic Anemia by Infusion of Umbilical Cord-Derived Mesenchymal Stromal Cells: A Case Report
Authors: Fang Liu , Meikuang Lim , Ye Guo , Xiaojuan Chen , Wenyu Yang , Min Ruan , Lixian Chang , Weiqiang Wang , Zhibo Han , Zhongchao Han , Xiaofan Zhu
Published: February 2021

Here we presented a case of a 19-month-old boy who developed severe aplastic anemia postacute hepatitis. He was treated successfully with the umbilical cord-derived mesenchymal stromal cells (UC-MSCs) infusion and cyclosporine A (CsA). The boy achieved both hematopoietic recovery and normal lymphocyte proportion. So far, his condition still remains stable. To our knowledge, there is a rare previous report on the utility of MSCs infusion for the treatment of hepatitis-associated aplastic anemia (HAAA). Considering the efficacy, safety, and strong operability, particularly for pediatric patient, the infusion of UC-MSCs combined with CsA could be an effective alternative for the treatment of HAAA.
Modelling the Enablers of e-Trading Adoption in Agricultural Marketing: A TISM-Based Analysis of eNAM
Authors: Chaudhary Sanjay , Suri P. K.
Published: February 2021

Purpose:

This research study identifies the enablers of adoption of e-trading of agricultural produce in India. It also proposes an adoption framework for promoting e-trading of the agricultural produce. The total interpretive structural modelling (TISM) method is used to develop hierarchical relationships among enablers. It brings the suggestions to improve the critical enablers for the use of policymakers, e-trading managers and market makers.

Methodology:

The research conducted in two phases, identification of variables, using literature assessment and analysing the relationship between the identified enablers using TISM. A case study of the National Agriculture Market (eNAM) project was undertaken to understand the enablers of the adoption in a common pan-India e-trading platform. Further, cross-impact matrix multiplication applied to classification (MICMAC) analysis explores the driving and the dependence power of the identified enablers.

Findings:

This research proposes an e-trading adoption framework for the Indian agricultural supply chain. The ‘perceived ease of use’, ‘facilitating conditions’, ‘social influence’ and lower ‘cost’ are identified as significant enablers in this study besides ‘trust’ and ‘perceived usefulness’. A few suggestions bought out in this paper are expected to improve these enablers, which are expected to help in enhancing eNAM adoption, thereby improving the supply chain of agricultural produce.

Research Implications:

The well-structured analysis in the hierarchical form helps to get more insight into the influence of the seven enablers identified by TISM technique on the adoption of e-trading in the Indian agricultural marketing and supply chain. The e-trading in Indian agricultural has significant economic and workforce value for the country. The suggestions of this study provide insight into practical improvement step considerations for policymakers and e-trading managers in the agricultural sector and micro, small and medium enterprises.
Consumption of OTT Media Streaming in COVID-19 Lockdown: Insights from PLS Analysis
Authors: Gupta Garima , Singharia Komal
Published: February 2021

In light of the current ecosystem of technological advancements in telecommunication and enhanced capability of devices, the present work brings to the fore the changes in consumers’ media consumption. The shift from conventional media to over-the-top (OTT) media, particularly in the lockdown period due to the COVID-19, has resulted in a war between streaming service providers to attract and retain customers. In the light of this change, the present study conducts partial least squares structural equation modeling (PLS-SEM) analysis to examine the impact of two key antecedents, namely, customer engagement (CE) and quality of service experience (QoSE) for their impact on users’ willingness to continue and subscribe (WCS) streaming services in future. The paper also delves into the indirect role of satisfaction and habit in affecting the aforesaid linkages. With the world facing the impact of the pandemic, the implications emerging from the study present an opportunity to the providers of OTT platforms to capitalize on the perceived change to the best of their advantage.
Smartphone-induced Behaviour: Utilisation, Benefits, Nomophobic Behaviour and Perceived Risks
Authors: Sharma Kshitiz , Sarathamani T. , Bhougal Sunil Kumar , Singh Hemant Kumar
Published: February 2021

Smartphone has become an essential part of human lives. People tend to treat it as another part of their body. Besides communication purposes, it is used for searching information, monetary transactions, shopping, social networking, entertainment, etc. This study aims at analysing the factors influencing smartphone usage and behavioural changes among college students under four constructs: utilisation, benefits, nomophobic behaviour and perceived risks (UBNR). An instrument was created with factors concerning the research and administered in a top-ranked private university of Bangalore, India. The research was carried out with a total of 122 responses. The results show that there is no significant difference in the attitude of males and females in most of the factors except social anxiety. Females experience more social anxiety and use smartphone more for maintaining their social relationships. There is no significant difference between the age group of students in all the four constructs. Utilisation is positively related with psychological, social, functional and financial benefits and shows that the greater the usage of smartphone, the greater are the benefits. On the other hand, the study reveals that increased usage of smartphone leads to addiction, causes nomophobia and poses threat of perceived risks. A mediation strategy like educating the students for proper use of technology is necessary to overcome the risk of addiction and developing nomophobia.
Predicting the Relationships Between Narrative Transportation, Consumer Brand Experience, Love and Loyalty in Video Storytelling Advertising
Authors: Yang Kenneth C. C. , Kang Yowei
Published: February 2021

Storytelling video advertising has emerged as a cost-effective creative technique to engage consumers with an advertised brand. Unlike traditional television commercials and print ads, long-form video ads can persuade consumers with an authentic and engaging brand story to develop favourable branding outcomes. Using a structural equation model with SPSS Amos 25.0, we empirically tested the effects of narrative transportation evoked by video storytelling ads on brand sensory, intellectual, behavioural experience, brand love, and brand loyalty. Our findings support the relationships between ad-elicited narrative transportation and branding outcomes across different product types. Discussions and implications are provided.
Study on mechanical properties and damage evolution of carbonaceous shale under triaxial compression with acoustic emission
Authors: Yang Kai , Yan Qixiang , Zhang Chuan , Wu Wang , Wan Fei
Published: February 2021

To explore the mechanical properties and damage evolution characteristics of carbonaceous shale with different confining pressures and water-bearing conditions, triaxial compression tests accompanied by simultaneous acoustic emission (AE) monitoring were conducted on carbonaceous shale rock specimens. The AE characteristics of carbonaceous shale were investigated, a damage assessment method based on Shannon entropy of AE was further proposed. The results suggest that the mechanical properties of carbonaceous shale intensify with increasing confining pressure and degrade with increasing water content. Moisture in rocks does not only weaken the cohesion but also reduce the internal friction angle of carbonaceous shale. It is observed that AE activities mainly occur in the post-peak stage and the strong AE activities of saturated carbonaceous shale specimens appear at a lower normalized stress level than that of natural-state specimens. The maximum AE counts and AE energy increase with water content while decrease with confining pressure. Both confining pressure and water content induce changes in the proportions of AE dominant frequency bands, but the changes caused by confining pressure are more significant than those caused by water content. The results also indicate that AE entropy can serve as an applicable index for rock damage assessment. The damage evolution process of carbonaceous shale can be divided into two main stages, including the stable damage development stage and the damage acceleration stage. The damage variable increases slowly accompanied by a few AE activities at the first stage, which is followed by a rapid growth along with intense acoustic emission activities at the damage acceleration stage. Moreover, there is a sharp rise in the damage evolution curve for the natural-state specimen at the damage acceleration stage, while the damage variable develops slowly for the saturated-state specimen.
Effects of high temperature on the mechanical behavior of calcium silicate hydrate under uniaxial tension and compression
Authors: Zhang Yao , Chen Qing , Ju J Woody , Bauchy Mathieu
Published: February 2021

When subjected to high temperatures, cement-based materials can dehydrate, which, in turn, affects the mechanical property of the main binding phase (calcium silicate hydrate) at the atomic scale. However, the effects of high temperature on the tensile and compressive behavior of calcium silicate hydrate (C−S−H) grains under uniaxial loading remains poorly understood. In this work, based on reactive molecular simulations, the tensile strength, compressive strength, and stress-strain relations of C−S−H grains with four calcium/silicon (C/S) ratios (1.10, 1.33, 164, and 1.80) both under and after (residual properties) high temperatures are investigated. It is shown that C−S−H grains can shrink due to the water loss induced by high temperature, and a low C/S ratio can lead to a thermo-stable molecular structure. Meanwhile, the residual tensile strength can be enhanced, particularly the tensile strength in the z-direction. Upon the residual compressive strength, in the x and y directions, high temperature can decrease the residual compressive strength for C/S = 1.10 or 1.33 but has no apparent effect for C/S = 1.64 or 1.80. While in the z-direction, the residual compressive strength can be enhanced due to the reduction in the interlayer space. In addition, high temperature can improve the residual tensile ductility but has no obvious effect on the residual compressive stress-strain relations. As for the mechanical properties under high temperature, both the tensile and compressive strengths can be weakened except that the tensile strength in the z-direction can undergo an increasing trend when the temperature is below 800 K due to significant shrinkage in the z-direction. Moreover, high temperature can make stress-strain curves exhibit good plasticity. Discussion indicates that the strength degradation of C−S−H gels or cement paste exposure to high temperatures is likely caused by the increasing porosity and coarsening of the void or defect size.
Childhood Maltreatment and Eating Disorders: A Prospective Investigation
Authors: Talmon Anat , Widom Cathy Spatz
Published: February 2021

Objectives:

To determine whether childhood maltreatment is a risk factor for two eating disorders (anorexia nervosa and bulimia nervosa) using objective and subjective case definitions.

Methods:

Using a prospective cohorts design, children with documented cases of physical abuse, sexual abuse, and neglect (ages 0–11) from 1967 to 1971 in a Midwestern metropolitan county area were matched on age, race, sex, and approximate family socioeconomic status with non-maltreated children. Both groups were followed up. Retrospective self-reports about childhood maltreatment were collected at age 29. DSM-IV anorexia nervosa (AN) and bulimia nervosa (BN) disorders were assessed at age 41 ( N = 807). Logistic and linear regression results are reported.

Results:

Using documented cases, childhood maltreatment was not a significant risk factor for AN or BN diagnoses or symptoms in adulthood. However, adults who retrospectively reported any maltreatment and physical and sexual abuse reported significantly more symptoms of AN than those who did not.

Conclusions:

The prediction that childhood maltreatment is a risk factor for anorexia nervosa and bulimia nervosa was partially supported in this longitudinal study. While misattribution of cases might have occurred, these results suggest that researchers and clinicians should use caution in drawing inferences about these relationships and designing interventions.
The COVID-19 pandemic and follow-up for shoulder surgery: The impact of a shift toward telemedicine on validated patient-reported outcomes
Authors: Sabbagh Ramsey , Shah Nihar , Jenkins Sarah , Macdonald Jacob , Foote Austin , Matar Robert , Steffensmeier Andrew , Grawe Brian
Published: February 2021

Introduction

The emergence of COVID-19 and its ensuing restrictions on in-person healthcare has resulted in a sudden shift towards the utilization of telemedicine. The purpose of this study is to assess patient satisfaction and patient-reported outcome measures (PROMs) for individuals who underwent follow-up for shoulder surgery using telemedicine compared to those who received traditional in-person clinic follow-up.

Methods

Patients who underwent either rotator cuff repair or total shoulder arthroplasty during a designated pre-COVID-19 (traditional clinic follow-up) or peri-COVID-19 (telemedicine follow-up) span of time were identified. PROMs including the American Shoulder and Elbow Surgeons standardized assessment form, the three-level version of the EQ-5D form, the 12-Item Short Form survey, and a modified version of a published telemedicine survey were administered to participants six months post-operatively via phone call.

Results

Sixty patients agreed to participate. There was no significant difference between the pre-COVID-19 and peri-COVID-19 groups in patient satisfaction with their follow-up visit ( p = 0.289), nor was there a significant difference in PROMs between the two groups. In total, 83.33% of the telemedicine group and 70.37% of the in-person clinic group preferred traditional in-person follow-up over telemedicine.

Discussion

In a cohort of patients who underwent telemedicine follow-up for shoulder surgery during the COVID-19 pandemic, there was no difference in patient satisfaction and PROMs compared to traditional in-person clinic follow-up. This study indicates that while the majority of participants preferred face-to-face visits, patients were relatively satisfied with their care and had similar functional outcome scores in both groups, despite the large disruption in healthcare logistics caused by COVID-19.
Re-Imagining Social Mobility: The Role of Relationality, Social Class and Place in Qualitative Constructions of Mobility
Authors: Folkes Louise
Published: February 2021

Discussions around social mobility have increasingly gained traction in both political and academic circles in the last two decades. The current, established conceptualisation of social mobility reduces ‘success’ down to individual level of educational achievement, occupational position and income, focusing on the successful few who rise up and move out. For many in working-class communities, this discourse is undesirable or antithetical to everyday life. Drawing upon 13 interviews with 9 families collected as part of an ethnographic study, this article asks, ‘how were social (im)mobility narratives and notions of value constructed by residents of one working-class community?’ Its findings highlight how alternative narratives of social (im)mobility were constructed; emphasising the value of fixity, anchorage, and relationality. Three key techniques were used by participants when constructing social (im)mobility narratives: the born and bred narrative; distancing from education as a route to mobility; and the construction of a distinct working-class discourse of fulfilment. Participants highlighted the value of anchorage to place and kinship, where fulfilment results from finding ontological security. The findings demonstrate that residents of a working-class community constructed alternative social mobility narratives using a relational selfhood model that held local value. This article makes important contributions to the theorisation of social mobility in which it might be understood as a collective rather than individual endeavour, improving entire communities that seek ontological security instead of social class movement and dislocation.
Forecast accuracy of existing luminance-related spectral sky models and their practical implications for the assessment of the non-image-forming effectiveness of daylight
Authors: Diakite-Kortlever AK , Knoop M
Published: February 2021

This paper analyses the forecast accuracy of current state-of-the-art, data-driven, spectral sky models. The aim is threefold: (i) to determine the forecast accuracy of existing spectral sky models based on a large dataset of spatially, spectrally and temporally resolved measurements, (ii) to investigate the practical implications of spectral forecast accuracies for the assessment of spectrally selective responses (here non-image-forming effects are expressed through melanopic irradiance) and (iii) to study if the use of spectral sky models is more appropriate to predict the non-image-forming effectiveness of daylight than the currently assumed CIE standard illuminant D65. The forecast analysis for CIE Standard Overcast Skies (CIE Sky Type 3) showed that the model published by Chain and colleagues in 1999 performed best, whereas the correlated colour temperature distribution can also be represented with the CIE standard illuminant D65. The analysis showed substantial discrepancies in the forecast for clear skies with low luminance turbidity (CIE Sky Type 12) depending on the correlated colour temperature range. Our findings suggest that for CIE 12 skies, even when simulating with the best performing spectral sky model, forecast inaccuracies affect the estimated non-image-forming effectiveness. Nonetheless, the assumption that the spectral distribution of daylight from a CIE 12 sky corresponds with the CIE standard illuminant D65 underestimates the non-image-forming effectiveness to a greater extent. The results advance the understanding of spectral characteristics of daylight and suggest that considering realistic spectral distributions instead of D65 will lead to a difference in the non-image-forming effectiveness assessment.
Not Your Parents’ Organization? Human Resource Development Practices for Sustainable Flex Work Environments
Authors: Waples Ethan P. , Brock Baskin Meagan E.
Published: February 2021

The Problem.

Everything we know and understand about flexible work arrangements (FWAs) revolves around extant research exploring the effects and effectiveness of FWAs based on samples in which organizations and/or employees freely adopted their use. In a post COVID-19 world, organizations implemented FWAs and employees who may not have been prepared for or desired such arrangements. This has resulted in implementing FWAs in situations where the job, culture, or person does not “support” FWAs.

The Solution.

We suggest the economic uncertainty of the ongoing COVID-19 pandemic should shift Human Resource Development (HRD) attention to managing the organizational climate of work and work expectations, specifically with regard to FWAs. We discuss how HRD practitioners can help, specifically by preparing managers for enhanced communication and feedback, as well as through supporting employee development via proactive job crafting, to better prepare managers and workers to accept and flourish in FWAs both short and long term.

The Stakeholders.

The stakeholders for this article include decision-makers in organizations interested in driving success through long-term initiatives rooted in developing human capital. In addition, this article should resonate with HRD professionals interested in working with managers and employees to systematically build sustainable FWA systems.
Mask Use During COVID-19: A Social-Ecological Analysis
Authors: Casola Allison R. , Kunes Brianna , Cunningham Amy , Motley Robert J.
Published: February 2021

To limit the spread of coronavirus disease 2019 (COVID-19), the Centers for Disease Control and Prevention issued recommendations that individuals wear face masks in public. Despite these recommendations, the individual decision to adhere and wear a mask may not be a simple decision. In this article, we examine the decision to wear a mask from a social-ecological perspective. Through critical analysis of societal, interpersonal and community, and intrapersonal influences, it is clear that the decision to wear a mask is multifaceted and influenced by constructs including public health recommendations and government mandates, racism and cultural norms, geography, household income, age, and personal attitudes. Understanding the multifactorial influences on mask wearing during COVID-19 is crucial for informing the creation and distribution of inclusive public health messaging regarding mask wearing now in the midst of an unprecedented health crisis, and in future unforeseen public health emergencies.
Comprehensive Analysis of ESRRA in Endometrial Cancer
Authors: Wang Shufang , Huo Xinlong
Published: February 2021

Background:

Estrogen-related receptor alpha (ESRRA) was reported to play an important role in multiple biological processes of neoplastic diseases. The roles of ESRRA in endometrial cancer have not been fully investigated yet.

Methods:

Expression data and clinicopathological data of patients with uteri corpus endometrial carcinoma (UCEC) were obtained from The Cancer Genome Atlas (TCGA). Comprehensive bioinformatics analysis was performed, including receiver operating characteristics (ROC) curve analysis, Kaplan-Meier survival analysis, gene ontology (GO) enrichment analysis, and Gene Set Enrichment Analysis (GSEA). Immunohistochemistry was used to detect the protein expression level of ESRRA and CCK-8 assay was performed to evaluate the effect of ESRRA on the proliferation ability.

Results:

A total of 552 UCEC tissues and 35 normal tissues were obtained from the TCGA database. The mRNA and protein expression level of ESRRA was highly elevated in UCEC compared with normal tissues, and was closely associated with poor prognosis. ROC analysis indicated a very high diagnostic value of ESRRA for patients with UCEC. GO and GSEA functional analysis showed that ESRRA might be mainly involved in cellular metabolism processes, in turn, tumorigenesis and progression of UCEC. Knockdown of ESRRA inhibited the proliferation of UCEC cells in vitro. Further immune cell infiltration demonstrated that ESRRA enhanced the infiltration level of neutrophil cell and reduced that of T cell (CD4+ naïve), NK cell, and cancer associated fibroblast (CAF). The alteration of immune microenvironment will greatly help in developing immune checkpoint therapy for UCEC.

Conclusions:

Our study comprehensively analyzed the expression level, clinical value, and possible mechanisms of action of ESRRA in UCEC. These findings showed that ESRRA might be a potential diagnostic and therapeutic target.
Major Limb Amputation in Parkes-Weber Syndrome With Refractory Ulceration: A Case Report and Literature Review
Authors: He Bin , Sun Ming-Sheng , Liu Jing-Wen , Nie Qiang-Qiang , Fan Xue-Qiang , Liu Peng
Published: February 2021

Parkes-Weber syndrome (PWS) is a rare congenital vascular syndrome consisting of capillary, venous, lymphatic, and arteriovenous malformation. There are many complications of PWS, such as ulceration, bleeding, infection, and cardiac failure. Among them, skin ulceration is one of the thorniest problems in PWS, requiring multidisciplinary approaches for the management. In this article, we presented the case of an elderly patient with refractory ulceration who received numerous treatments with no effect and finally underwent a major amputation to improve the quality of life. Moreover, we reviewed 23 previously reported cases to improve our understanding of the management for PWS patients with ulceration.
Risk of recurrence of subdural hematoma after EMMA vs surgical drainage – Systematic review and meta-analysis
Authors: Dian Joshua , Linton Janice , Shankar Jai JS
Published: February 2021

Objective

Chronic subdural hematoma (CSDH) is a common and debilitating neurological condition whose treatments, including burr hole drainage and craniotomy, suffer from high rates of recurrence and complication. Embolization of the middle meningeal artery (EMMA) is a promising minimally invasive approach to manage CSDH in a broad set of patients.

Methods

To evaluate the efficacy and safety of EMMA, a database search was conducted including the terms “subdural hematoma; embolization; embolized; middle meningeal” was performed and yielded a total of 260 results. Following exclusion based on predefined criteria, a total of four studies were identified and outcomes including recurrence rates and complication rates were extracted for analysis.

Results

Four studies including intervention and control groups were included with a total of n = 888 patients. The relative risk of CSDH recurrence in the EMMA (3.5%) compared to control group (23.5%) was significantly reduced when EMMA was performed (risk ratio = 0.17; 95% confidence interval (CI) 0.05–0.67). In addition, rates of complication were not significantly different between patients with conventional therapy and those who received EMMA (OR = 0.77; 95 confidence interval (CI) 0.3–1.99).

Conclusion

Based on limited data, EMMA reduces the risk of recurrence by 20% compared to surgical treatment for CSDH.
Hospitalized with stroke at the weekend: Higher cost and risk of early death?
Authors: Ghiani Marco , Mueller Sabrina , Maywald Ulf , Wilke Thomas
Published: February 2021

Objectives

Previous studies have shown that weekend hospitalizations are associated with poorer health outcomes and higher mortality (“weekend effect”). However, few of these studies have adjusted for disease severity and little is known about the effect on costs. This work investigates the weekend effect and its costs for patients with cerebral infarction in Germany, adjusting for patient characteristics and proxies of stroke severity.

Methods

Adult patients with a cerebral infarction hospitalization 10th revision of the International statistical classification of diseases and related health problems (ICD-10: I63) between 01 January 2014 and 30 June 2017 were included from German health claims (AOK PLUS dataset). Propensity score matching was used to match patients hospitalized on weekends or on public holidays (weekend group) with patients hospitalized during the working week (workday group), based on baseline characteristics and proxies for disease severity such as concomitant diagnoses of aphasia, ataxia, and coma, or peg tube at index hospitalization. Matched cohorts were compared in terms of in-hospital, 7-day, and 30-day mortality, as well as risk and costs of stroke and rehabilitation stays in the year after first stroke.

Results

Of 32,311 patients hospitalized with cerebral infarction between 01 January 2014 and 30 June 2017, 8409 were in the weekend group and 23,902 in the workday group. After propensity score matching, 16,730 patients were included in our study (8365 per group). Matched cohorts did not differ in baseline characteristics or stroke severity. In the weekend group, the risk of in-hospital death (11.2%) and the seven-day mortality rate (6.8%) were 13.1% and 17.2% higher than in the workday group, respectively (both p < 0.01). The hazard ratio for death in the weekend group was 1.1 ( p = 0.043). The risks of subsequent stroke hospitalization and rehabilitation stays for a stroke were 8.4% higher and 5.5% higher in the weekend group (both p = 0.02). As a result, the stroke-related hospitalization and rehabilitation costs per patient year were, respectively, 5.6% and 8.0% higher in the weekend group (both p = 0.01).

Conclusions

A significant weekend effect emerged after controlling for observable patient characteristics and proxies of stroke severity. This effect also resulted in higher costs for patients admitted on weekends.
Pre-stroke physical activity and admission stroke severity: A systematic review
Authors: Hung Stanley H , Ebaid Deena , Kramer Sharon , Werden Emilio , Baxter Helen , Campbell Bruce CV , Brodtmann Amy
Published: February 2021

Background

Admission stroke severity is an important clinical predictor of stroke outcomes. Pre-stroke physical activity contributes to stroke prevention and may also be associated with reduced stroke severity. Summarizing the evidence to date will inform strategies to reduce burden after stroke.

Aims

To summarize the published evidence for the relationship between pre-stroke physical activity and admission stroke severity and to provide recommendations for future research.

Summary of review

MEDLINE, Embase, Emcare, CENTRAL, and gray literature databases were searched on 14 February 2020 using search terms related to stroke and pre-stroke physical activity in adult stroke survivors. We screened 8,152 references and assessed 172 full-text references for eligibility. We included seven studies ( n = 41,800 stroke survivors). All studies were observational, assessed pre-stroke physical activity using self-reported questionnaires, and assessed admission stroke severity using the National Institute of Health Stroke Scale. Analyses were categorized as the presence of pre-stroke physical activity (four studies) or dose-response (five studies). In three studies, presence of pre-stroke physical activity was associated with milder stroke severity, and no association in one study. Greater pre-stroke physical activity duration and intensity (two studies) or amount (three studies) were associated with milder stroke severity. Studies ranged between moderate to critical risk of bias, primarily due to confounding factors. Pre-stroke physical activity may be associated with reduced risk factors for severe stroke, distal occlusion, smaller infarcts, and shorter time-to-treatment delivery.

Conclusion

Pre-stroke physical activity may be associated with reduced admission stroke severity. Lack of randomized controlled trials limited causality conclusions. Future research recommendations were provided.
A novel parking-lot intelligent selection algorithm based on gray relational analysis considering user preferences
Authors: Zhu Xiaolin , Gao Chenghui , Pang Haosheng
Published: February 2021

In order to select and recommend the optimal parking lot for the users, a novel intelligent selection algorithm based on the grey relational analysis considering user preferences is proposed. The parking-lot evaluation index system consisting of indicators in effectiveness, convenience, economy, environmental attribute and agreeableness is firstly established. The comprehensive weight determination method combining the expert estimation method with the user preference settings is proposed to determine the comprehensive weight of each evaluation index, and this method can meet the personalized needs of individual user to the greatest extent. The evaluation indexes considering various representative objective and subjective influential factors including the driving distance between the current location and the target parking lot, the walking distance between the target parking lot and the destination, the remaining parking spaces, the parking fee, the condition of the hardware facilities and service quality are determined, and the corresponding comprehensive weight of each evaluation index is calculated. Then the parking lots near the destination are evaluated by the grey relational analysis in order to select the optimal one to the user for parking reservation. This algorithm has been proven to be effective by the APP on Android mobile phones.
The addition of preoperative three-dimensional analysis alters implant choice in shoulder arthroplasty
Authors: Werner Brian C , Denard Patrick J , Tokish John M , Bedi Asheesh , Donegan Ryan P , Metcalfe Nick , Dines Joshua S
Published: February 2021

Background

The primary objective of the present study was to investigate how preoperative imaging modalities including 3D computed tomography (CT) scans with preoperative planning software affect implant choice for shoulder arthroplasty.

Methods

X-ray, uncorrected 2D CT scans, and 3D CT scans from 21 patients undergoing primary arthroplasty were reviewed by five shoulder surgeons. Each surgeon measured glenoid version, inclination and humeral head subluxation, and then selected an anatomic or reverse shoulder arthroplasty implant based only on these imaging parameters. Each surgeon virtually positioned the implant. Agreement between surgeons and changes in plan for individual surgeons between imaging modalities were assessed.

Results

Average measurements of native version, inclination, and subluxation were similar across all imaging modalities with very good interobserver reliability. Overall, there was a high rate of variability in choice of implant depending on imaging modality. Agreement on implant selection between surgeons improved from 68.6% using x-ray to 80.0% with 3D CT. Introducing age added significant variability, reducing agreement on implant choice to 61.0% with 3D CT.

Conclusions

The use of preoperative 3D planning changes implant choice in nearly one-third of cases compared to plain radiographs and improves surgeon agreement on implant choice compared to x-ray and 2D CT. Level of evidence: III.
Lessons Learned From Decentralization of an Elective Surgery Medical-Surgical Unit
Authors: Waggener Laurie , Pati Debajyoti , Rane Apoorva P. , Montenegro-Montenegro Esteban , Angelo Ellen
Published: February 2021

Objective:

The objective of this study was to examine changes in healthcare practitioners’ perception of supportiveness of their physical work environment, and trend in patient fall, when moving from a centralized to a decentralized unit configuration.

Background:

Previous studies on decentralization have not uniformly provided findings consistent with desired outcome.

Method:

A pretest–posttest study was conducted in an elective surgery medical-surgical unit in the mid-Atlantic region of the United States. The independent variable was the physical design supporting centralized versus decentralized nursing models. Data were collected from healthcare staff with a self-report survey “before” (September 2017; n = 42) and “after” (June 2019; n = 22), and interviews. Before–after data were analyzed using both parametric and nonparametric tests to identify significant differences. Qualitative responses were analyzed to identify triangulating evidences. Monthly patient fall data were collected for a 3-year period and analyzed using log-linear Poisson Regression model.

Results:

Results show favorable assessments in the areas of overall supportiveness of design, equipment and soiled utility location, peer support, process flow visualization, and overall satisfaction. A reduction in patient falls was observed. Unfavorable outcomes were found in the contexts of walking distance, multidisciplinary collaboration, alarm audibility, nurse station size, and PPE location.

Conclusions:

This study underscores that the success of a unit cannot be achieved without coordinated and successful interventions in the areas of operations, processes, policies, culture, and the physical design.
Anti-cyclic-citrullinated-protein-antibodies in psoriatic arthritis patients: how autoimmune dysregulation could affect clinical characteristics, retention rate of methotrexate monotherapy and first line biotechnological drug survival. A single center retrospective study.
Authors: Rotondo Cinzia , Corrado Addolorata , Cici Daniela , Berardi Stefano , Cantatore Francesco Paolo
Published: February 2021

Aim:

Occasional findings of anti-cyclic-citrullinated-protein-antibodies (anti-CCP) were rarely observed in psoriatic arthritis (PsA). The aim of our study is to evaluate whether the presence of anti-CCP can determine different clinical subsets and influence methotrexate monotherapy survival, and biotechnological drug retention rate.

Methods:

We conducted a retrospective study on PsA patients. All patients were required to fulfill the CASPAR criteria for PsA, and to present juxta-articular osteo-proliferative signs at X-ray. The exclusion criteria were age less than 18 years old, satisfaction of rheumatoid arthritis classification criteria, and seropositivity for rheumatoid factor. Clinical characteristics, anti-CCP titer, drug survival and comorbidities information were recorded for each patient. Statistical signiﬁcance was set at p ⩽ 0.05.

Results:

Of 407 patients with PsA screened 113 were recruited. Twelve patients were anti-CCP positive. Methotrexate monotherapy survival was shorter in patients with anti-CCP (150 ± 48.3 weeks versus 535.3 ± 65.3 weeks; p = 0.026) [discontinuation risk hazard ratio (HR) = 2.389, 95% confidence interval (CI) 1.043, 5.473; p = 0.039] than those without. Significant shorter survival of first-line biotechnological drugs (b-DMARDs) was observed in the anti-CCP positive group than in that without (102.05 ± 24.4 weeks versus 271.6 ± 41.7 weeks; p = 0.005) with higher discontinuation risk (HR = 3.230, 95% CI 1.299, 8.028; p = 0.012). A significant higher rate of multi-failure (more than second-line b-DMARDs) was found in anti-CCP positive patients than in those without (50% versus 14%, p = 0.035).

Conclusion:

Anti-CCP in PsA could be suggestive of more severe disease, with worse drug survival of both methotrexate monotherapy and first-line b-DMARDs, and higher chance to be b-DMARDs multi-failure. So, they can be considered for more intensive clinical management of these patients.
A minimal clinically important difference measured by the Cambridge Pulmonary Hypertension Outcome Review for patients with idiopathic pulmonary arterial hypertension
Authors: Bunclark Katherine , Doughty Natalie , Michael Alice , Abraham Nisha , Ali Samantha , Cannon John E , Sheares Karen , Speed Nicola , Taboada Dolores , Toshner Mark , Pepke‐Zaba Joanna
Published: February 2021

Several patient‐reported outcome measures have been developed to assess health status in pulmonary arterial hypertension. The required change in instrument scores needed, to be seen as meaningful to the individual, however remain unknown. We sought to identify minimal clinically important differences in the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) and to validate these against objective markers of functional capacity. Minimal clinically important differences were established from a discovery cohort (n = 129) of consecutive incident cases of idiopathic pulmonary arterial hypertension with CAMPHOR scores recorded at treatment‐naïve baseline and 4–12 months following pulmonary arterial hypertension therapy. An independent validation cohort (n = 87) was used to verify minimal clinically important differences. Concurrent measures of functional capacity relative to CAMPHOR scores were collected. Minimal clinically important differences were derived using anchor‐ and distributional‐based approaches. In the discovery cohort, mean (SD) was 54.4 (16.4) years and 64% were female. Most patients (63%) were treated with sequential pulmonary arterial hypertension therapy. Baseline CAMPHOR scores were: Symptoms, 12 (7); Activity, 12 (7) and quality of life, 10 (7). Pulmonary arterial hypertension treatment resulted in significant improvements in CAMPHOR scores (p < 0.05). CAMPHOR minimal clinically important differences averaged across methods for health status improvement were: Symptoms, –4 points; Activity, –4 points and quality of life –3 points. CAMPHOR Activity score change ≥minimal clinically important difference was associated with significantly greater improvement in six‐minute walk distance, in both discovery and validation populations. In conclusion, CAMPHOR scores are responsive to pulmonary arterial hypertension treatment. Minimal clinically important differences in pulmonary hypertension‐specific scales may provide useful insights into treatment response in future clinical trials.
Offshoring the invisible world? American ghosts, witches, and demons in the early enlightenment
Authors: Koslofsky Craig
Published: February 2021

The fierce debate about the reality of spirits and the “Invisible World” which flared up in the 1690’s helped define the early Enlightenment. All sides in this debate—from Spinoza and Balthasar Bekker to John Beaumont and Cotton Mather—refashioned familiar metaphors of light and darkness and connected them with the world beyond Europe in surprising new ways. This article shows how this key controversy of the early Enlightenment was built upon references to darkness, light, and the benighted pagan peoples of the world. As new street lighting and improved domestic lighting nocturnalized daily life in the Netherlands, London, and Paris, the old denizens of the night - ghosts, spirits, and witches—were increasingly relegated to the extra-European world and used to articulate new categories of human difference based on civility, reason, and skin color. These new categories of human difference—new ways of seeing and ordering the world—were essential to the formation of early modern whiteness and the Enlightenment.
A familial case of CAMK2B mutation with variable expressivity
Authors: Heiman Paige , Drewes Sarah , Ghaloul-Gonzalez Lina
Published: February 2021

Variants in CAMK2-associated genes have recently been implicated in neurodevelopmental disorders and intellectual disability. The clinical manifestations reported in patients with mutations in these genes include intellectual disability (ranging from mild to severe), global developmental delay, seizures, delayed speech, behavioral abnormalities, hypotonia, episodic ataxia, progressive cerebellar atrophy, visual impairments, and gastrointestinal issues. Phenotypic heterogeneity has been postulated. We present a child with neurodevelopmental disorder caused by a pathogenic CAMK2B variant inherited from a healthy mother. A more mildly affected sib was determined to have the same variant. Monoallelic mutations in CAMK2B in patients have previously only been reported as de novo mutations. This report adds to the clinical phenotypic spectrum of the disease and demonstrates intrafamilial variability of expression of a CAMK2B mutation.
CoachMS, an innovative closed-loop, interdisciplinary platform to monitor and proactively treat MS symptoms: A pilot study
Authors: Block Valerie J , Gopal Arpita , Rowles William , -Yueh Chu , Gelfand Jeffrey M , Bove Riley
Published: February 2021

Background

There are numerous challenges to treating co-occurring symptoms in multiple sclerosis (MS).

Objective

To pilot the feasibility of a novel symptom management platform, CoachMS, to monitor MS symptoms (bladder function, ambulation, and mood: BAM) and respond to changes in real-time.

Methods

In this 12-week randomized controlled pilot trial, participants’ symptoms were monitored using weekly questionnaires and remote ambulatory monitoring (Fitbit Flex2®). Behavioral change principles used included shared goal setting at 2 weeks. Between weeks 2-12, the CoachMS group received targeted contact and interventions if symptoms worsened; the control group were treated through usual clinic practice. Our outcomes were feasibility (retention, adherence and acceptability; primary) and proportion of recommended treatments pursued (secondary); efficacy was explored.

Results

Of 21 participants enrolled, 13 (62%) completed the study; protocol adherence was excellent. CoachMS participants demonstrated greater follow-through with clinical recommendations than controls (OR 9.3, 95% CI (0.9, 97.6)). As a cohort, each BAM symptom tended to improve. Suicidality was detected in one control participant, resulting in urgent evaluation and hospitalization.

Conclusions

The innovative CoachMS platform was feasible and acceptable in this cohort with baseline BAM symptoms. It could represent an accessible, cost-effective tool to monitor MS symptoms in real-time; a larger trial is planned.
How and why does Local Area Coordination work for people in different contexts?
Authors: Mason James , Oatley Chad , Harris Kevin , Ryan Louis
Published: February 2021

The increasing adoption of Local Area Coordination across the United Kingdom as a strengths-based approach to acting on inequalities which impact on individual health and well-being, and reducing reliance and avoidable use of health and social care services, has catalysed increasing calls for evidence to justify economic commitment. In a time of austerity where extreme pressure is on resources to prove short-term outputs, Pawson and Tilley’s realist evaluation methodology holds significant promise in asking critical questions of how and why programmes work. Ultimately, such philosophical standpoints facilitate opportunities to examine whether the sustainability of programmes are cost-effective for the system in the longer term. This article draws upon the findings of a realist evaluation of Local Area Coordination on the Isle of Wight and establishes how and why the programme works for people and local communities. A blend of realist approaches, Q-method and realist interviews were adopted within this study. The study’s sample was a cross section of 18 people who engaged with the Local Area Coordination programme across the Isle of Wight. The findings of the evaluation established that the Local Area Coordinators’ ability to facilitate a ‘golden triangle’ of listening, trust and time were factors which made Local Area Coordination work. It was also clear that Local Area Coordination worked for different people in different ways, demonstrated through the contextual differences between three subgroups who were categorised based on shared viewpoints, and presented through the holistic narratives and corroborating interview data.