bluuebunny/crossref_metadata_2025 huggingface dataset:
Improved theoretical analysis and design guidelines of a two-degree-of-freedom galloping piezoelectric energy harvester
Authors: Hu Guobiao , Liang Junrui , Tang Lihua , Wang Junlei
Published: May 2021

This paper presents an improved analysis of a two-degree-of-freedom (2DOF) galloping-based piezoelectric energy harvester (GPEH). First, an overview of the 2DOF GPEH, together with some discussions on its physical implementation, are presented. The theoretical model of the 2DOF GPEH is then developed. The analytical solutions are derived using the harmonic balance method. The dynamic behaviour of the 2DOF GPEH is predicted according to the solution characteristics. Moreover, the mode activation mechanism of the 2DOF GPEH is theoretically unveiled: depending on the system parameters; there may exist a single or multiple stable solutions which correspond to different vibration modes of the 2DOF GPEH. Subsequently, an equivalent circuit model of the 2DOF GPEH is established. Circuit simulations are performed to verify the analytical solutions. Case studies through detailed theoretical analysis and circuit simulation give in-depth insights into the dynamic behaviour of the 2DOF GPEH. It is demonstrated that by tuning the stiffness of the auxiliary oscillator, either the first or the second mode vibration of the 2DOF GPEH can be activated, resulting in completely different dynamic behaviours and energy harvesting performance. Finally, from the perspectives of reducing the cut-in wind speed and improving the voltage output, several design guidelines are provided.
Midterm Outcome of Subtalar Joint Revision Arthrodesis
Authors: Chraim Michel , Recheis Simon , Alrabai Hamza , Wenzel-Schwarz Florian , Trnka Hans-Jörg , Bock Peter
Published: May 2021

Background:

The outcomes of revision subtalar arthrodesis have received relatively little focus in research compared with primary subtalar arthrodesis outcomes. This study aimed to assess the midterm clinical and radiologic results of subtalar joint revision arthrodesis and to analyze the risk factors that might influence the outcome of this procedure.

Methods:

We performed a retrospective review of 20 patients after subtalar joint revision arthrodesis for malunion, using interposition of iliac crest bone graft. The mean age was 55.75 years and the average follow-up lasted for 48.93 months. Eighty-five percent of the patients had at least 1 risk factor identified prior to revision. Patients’ satisfaction and functional outcomes were evaluated with the American Orthopaedic Foot & Ankle Society Scale (AOFAS), the Foot and Ankle Outcome Score (FAOS), the Foot Function Index (FFI), and dynamic pedobarography.

Results:

A fusion rate of 80% was recorded whereas 20% of the cases ended with a painful pseudarthrosis requiring additional surgery. Pedobarographic measurements demonstrated that loading has a propensity toward the lateral column, but no substantial effect on the gait of patients. In this group, the following patient-reported outcomes were observed: 70% of the patients were satisfied, 20% of the patients found the result fair, and 10% were not satisfied with the results. Compared with the preoperative evaluation, postoperative functional scores showed significant improvement on the FOAS, AOFAS, and FFI outcome scales.

Conclusion:

Revision arthrodesis of the subtalar joint remains a challenging issue with a relatively high rate of nonunion, especially in a population of patients with multiple risk factors.

Level of Evidence:

Level IV, retrospective case series.
Systematicity in Organizational Research Literature Reviews: A Framework and Assessment
Authors: Simsek Zeki , Fox Brian , Heavey Ciaran
Published: May 2021

In this study, we first develop a framework that presents systematicity as an encompassing orientation toward the application of explicit methods in the practice of literature reviews, informed by the principles of transparency, coverage, saturation, connectedness, universalism, and coherence. We then supplement that conceptual development with empirical insights into the reported practices of systematicity in a sample of 165 published reviews across three journals in organizational research. We finally trace implications for the future conduct of literature reviews, including the potential perils of systematicity without mindfulness.
Segmentation of physician-assisted suicide as a niche tourism market: An Initial Exploration
Authors: Wen Jun , Goh Edmund , Yu Chung-En
Published: May 2021

Suicide travel, in which potential suicide candidates visit certain destinations to perform physician-assisted suicide (PAS), is an emerging topic in tourism. Despite noted discrepancies between suicide travel and traditional definitions of tourism, PAS practices in tourism have gained the attention of scholars and practitioners. This type of travel is inherently complex, and its segmentation remains ambiguous. This study examines a sample of PAS-related videos and viewer comments to identify relevant travel segments. Based on two rounds of thematic content analysis, the resultant segmentation offers a preliminary perspective on this emerging market. Theoretically, this study is among the first to provide a comprehensive overview of the roles of PAS practices in tourism in terms of specific target groups. Practically, the findings offer novel insight for industry practitioners and policy makers.
Outsourcing problems or regulating altruism? Parliamentary debates on domestic and cross-border surrogacy in Finland and Norway
Authors: Eriksson Lise
Published: May 2021

This article employs the concept of respectability and the discursive representation of gender equality policies to discuss how surrogacy is represented in Nordic parliamentary debates and policy documents. The article’s objective is to study how respectability, problems and equality are represented and discursively and rhetorically produced through a comparative study of Finnish and Norwegian political discourses on domestic unpaid surrogacy and cross-border commercial surrogacy. The article uses rhetorical and discursive analysis to analyse the Finnish and Norwegian Parliaments’ bills, members’ initiatives and proceedings from 2002 to 2018. Finland’s policy on surrogacy has evolved from an unregulated and permissive approach towards a more restrictive one, with discourses focusing on medicalisation, equality, altruism and safety concerning domestic surrogacy and problems and risks concerning cross-border surrogacy. Norway’s policy on surrogacy has been restrictive consistently, with discourses focusing on surrogacy as a transnational social problem involving exploitation of women and children, and biocentrism. Analysing surrogacy regulation in Nordic welfare states, the author concludes that policies and parliamentary debates in both countries have expressed expectations for inclusive health policies and social security for families. Cross-border surrogacy is characterised as an unwanted consequence of globalisation and marketisation of reproduction. Surrogate mothers’ respectability is constructed through rhetoric on differences in terms of nationality, class and binary representations of female caring and instrumentalism.
Vicarious Trauma Experienced by Health Care Providers Involved in Traumatic Childbirths: A Meta-Synthesis
Authors: Shorey Shefaly , Wong Phyllis Zhi En
Published: May 2021

Health care providers are often “second victims” of traumatic childbirth events and should be adequately supported by their organizations to alleviate occupational stress and burnout. Therefore, this review aimed to explore and understand the vicarious traumatic childbirth experiences of health care providers, including obstetricians, midwives, nurses, and students. A systematic review of qualitative studies was conducted. Seven electronic databases, namely, PubMed, CINAHL, Embase, PsycINFO, Cochrane, Scopus, and Web of Science, were searched from each database’s inception to May 2020. In total, 1,575 studies were retrieved and screened according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventeen studies were included in this review and were meta-summarized and then meta-synthesized using the Sandelowski and Barroso approach. The overarching theme of “Tunneling through the trauma with a hope of finding an end” was derived, and four main themes along with 15 subthemes were identified. The four main themes were (1) “instantaneous response to the trauma,” (2) “finding hope in the midst of chaos,” (3) “dealing with the aftermath,” and (4) “resolution to move on.” Communication and teamwork among health care team members were identified as challenges contributed by professional hierarchy and lack of role clarity. Midwives and labor and delivery nurses expressed powerlessness in advocating for women on many occasions, and health care providers often had feelings of guilt and self-blame after adverse events. Health care providers also reported inadequate support from their colleagues and organizations, which influenced their ability to cope with the aftermath of trauma and their decision to stay in the profession.
Theatre Connect: Key Strategies for Facilitating LGBTQQ Youth Theatre Programs
Authors: Pufahl Jeffrey , Reina-Munoz Camilo , Bayne Hannah
Published: May 2021

Youth who identify as lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQQ) often experience heterosexism, homophobia, prejudice, and bullying in addition to the typical demands of adolescent development. Applied theatre programs have been shown to empower youth, improve mental health and well-being, and create positive identity and interpersonal relationships and, as such, have the potential to strengthen a range of protective factors for LGBTQQ youth. However, when programs engage participants in personal narratives, practitioners must be prepared to deftly navigate between the two domains of theatre in health and drama therapy. Since 2017, the University of Florida’s (UF) Center for Arts in Medicine has offered an afterschool theatre program for LGBTQQ youth in partnership with clinicians from UF Health’s Youth Gender Clinic and faculty in the Mental Health Counseling training program in the College of Education. Theatre practitioners lead the program in partnership with mental health professionals, who participate in sessions and are “on call” for participants. Program facilitators have developed a set of guidelines for organizations attempting to start LGBTQQ or other youth theatre programs in their local communities, which include the following recommendations: (1) prioritize safe and ethical practice through creating sustainable partnerships between mental health counsellors, experienced theatre practitioners, and local LGBTQQ organizations; (2) develop a clear contract between participants and facilitators regarding program goals; (3) utilize Baim’s drama spiral as a conceptual tool and limit program activities to the first four spiral rings; (4) emphasize “play” and skill building rather than LGBTQQ topics.
Creating a Scalable Physical Activity Breaks Resource Through the Multisensory Multilevel Health Education Model: H.Y.P.E. The Breaks!
Authors: Swierad Ewelina M. , Benson Lori Rose , Williams Olajide
Published: May 2021

Physically active children have lower rates of obesity, diabetes, hypertension, and depression than their inactive counterparts, and further evidence suggests that integrating physical activity breaks into the school day improves children’s classroom behavior, fitness, and cognitive functions. The current article focuses on the development and implementation of free, scalable, short activity breaks called H.Y.P.E. The Breaks! (Helping Young People Energize)—a series of 2-, 6-, and 10-minute-long dance and hip-hop–based physical activity videos, which can be used in the classroom or at home. H.Y.P.E. The Breaks! is deconstructed through the lens of the multisensory multilevel health education model, which leverages art, culture, and science in the design and implementation of health programs, and highlights the importance of framing and operationalizing program components across the different behavioral levels of influence of the socioecological model. The article also discusses the uptake of H.Y.P.E. The Breaks! during the COVID-19 (coronavirus disease 2019) pandemic, when major declines in children’s physical activity were observed.
Systematic Review of Arts-Based Interventions to Address Suicide Prevention and Survivorship in Australia, Canada, the United Kingdom, and the United States of America
Authors: Sonke Jill , Sams Kelley , Morgan-Daniel Jane , Pumariega Andres , Mallick Faryal , Pesata Virginia , Olsen Nicola
Published: May 2021

Study Objective. Suicide is a serious health problem that is shaped by a variety of social and mental health factors. A growing body of research connects the arts to positive health outcomes; however, no previous systematic reviews have examined the use of the arts in suicide prevention and survivorship. This review examined how the arts have been used to address suicide prevention and survivorship in nonclinical settings in Australia, Canada, the United Kingdom, and the United States of America. Design and Setting. Ten bibliographic databases, five research repositories, and reference sections of articles were searched to identify published studies. Articles presenting outcomes of interventions conducted between 2014 and 2019 and written in English, were included. Primary Results. Nine studies met inclusion criteria, including qualitative, quantitative randomized controlled trials, quantitative nonrandomized, quantitative descriptive, and mixed-methods studies. The programs studied used film and television (n = 3), mixed-arts (n = 3), theatre (n = 2), and quilting (n = 1). All nine interventions used the arts to elicit emotional involvement, while seven also used the arts to encourage engagement with themes of health. Study outcomes included increased self-efficacy, awareness of mental health issues, and likelihood for taking action to prevent suicide, as well as decreases in suicidal risk and self-harming behaviors. Conclusions. Factors that influence suicide risk and survivorship may be effectively addressed through arts-based interventions. While the current evidence is promising with regard to the potential for arts programs to positively affect suicide prevention and survivorship, this evidence needs to be supplemented to inform recommendations for evidence-based arts interventions.
A Framework for Integrating Arts, Science, and Social Justice Into Culturally Responsive Public Health Communication and Innovation Designs
Authors: Edmonds Theo , Drake Hannah , Miller Josh , Trabue Nachand , Lister Cameron , Salunkhe Sonali S. , O’Keefe Molly , Alzahrani Sahal , White Kelsey , Levinson Amanda
Published: May 2021

Objectives. To increase the scale and efficacy of health promotion practice, culturally responsive approaches to well-being are needed in both communication and practice innovation. This mixed-methods evaluation sought to identify specific mechanisms used in a promising practice model and offers a potential theoretical framework to support public health programs in integrating culture and social justice into communication and intervention programs. Study Design. Rooted at the intersection of ethnographic and phenomenological worldviews, this mixed-methods, retrospective process evaluation used publicly available empirical and experiential data centered on the arts, science, and social justice to identify critical mechanisms used and incorporate them into an emergent theoretical framework. Method. The retrospective process evaluation used an ethnography-informed approach combined with scientific literature reviews. To integrate adjacent ideas into the emergent theoretical framework, a phenomenologically informed theme development approach was used. Results. The evaluation resulted in a five-step framework, called MOTIF, with the potential to be utilized in diverse situational and geographic contexts. Data that surfaced from related literature reviews revealed adjacent mechanisms from positive psychology, critical consciousness theory, and innovation design that were incorporated into the emergent framework. Conclusion. MOTIF may offer a culturally responsive public health communication and innovation process capable of promoting health equity through the cultivation of relationships between artists, community participants, and public health agencies and researchers who collectively endeavor to craft innovative solutions for population health and well-being.
The Arrival of Graded Music Exams in New Zealand: A Case Study of Dunedin up to 1916
Authors: Jane, PhD Philip
Published: May 2021

Toward the end of the nineteenth century a number of external music examining systems were introduced to New Zealand. Two of them, Trinity College, London, and the Associated Board, gained a strong following and became de facto standards in the absence of a national music conservatorium. This article briefly outlines the beginning of external exams in England and follows their export to various overseas members of the British Empire. Graded music exams as a form of tuition engendered considerable debate as to efficacy, merit, and overall validity. Trinity College arrived first in New Zealand, in 1888, followed by the Associated Board in 1897, and their rapid assumption in the southern city of Dunedin is documented and used as a case study of their progress up until 1916. There is a background discussion on the growth and use of post-nominal letters in the local music teaching profession, and the increasing use of formal qualifications by music teachers is noted. These included the professional diplomas from both schools, and the role they played in the formation of a local professional body is explored.
User experience with the Ask Your Pharmacist teleconsultation platform
Authors: Guénette Line , Chagnon Alexandre , Turcotte Véronique
Published: May 2021

Background:

An increasing number of pharmacists use technology and social media to connect with patients. However, such means may pose confidentiality issues and legal problems. To correct this situation, a platform of teleconsultation services provided by pharmacists, titled “Ask Your Pharmacist,” was created in Quebec, Canada.

Methods:

A web-based satisfaction survey was carried out among patients and pharmacists who have used the Ask Your Pharmacist platform to describe their experience and satisfaction with the platform and explore the perceived usefulness of this service in the province of Quebec.

Results:

A total of 53 patients and 27 pharmacists completed the survey. Most patients were satisfied or very satisfied with their experience with Ask Your Pharmacist (96.2%), said that it met their need (88.7%), and agreed they would not have to consult again about the matter discussed with the pharmacist (75.5%). The main motivation of pharmacists for volunteering on Ask Your Pharmacist was to meet the needs of patients (85.1%), promote their profession (55.6%), improve drug utilization in the population (55.6%) and increase accessibility to a pharmacist (51.9%). Most (81.5%) felt that providing written consultation (rather than oral) required more research on their part.

Discussion:

Most patients judged they would not have to have another consultation about the matter discussed with the pharmacist, suggesting that Ask Your Pharmacist may avoid the need for physician and emergency department visits.

Conclusion:

Most patients and pharmacists were satisfied with their experience with Ask Your Pharmacist and perceived this service as useful. Further studies should assess the impact of this platform on the utilization of other health care services. Can Pharm J (Ott) 2021;154:xx-xx.
Effect of quality of opposition on game performance indicators in elite male volleyball
Authors: Drikos Sotirios , Barzouka Karolina , Balasas Dimitrios G , Sotiropoulos Konstantinos
Published: May 2021

Performance in a volleyball match is the result of a dynamic and interactive process between two teams. The current study aimed to investigate the influence of the quality of opposition on skill performance indicators. A total of 550 teams’ performances (N = 550) from 275 sets of men’s European Championship 2019 was recorded and the effectiveness of 12 parameters from 5 basic volleyball skills was analyzed. A two-step cluster analysis was performed to divide 24 teams into three quality groups (upper, middle, lower) and 6 types of match status were created according to the quality of the opponents. Binomial logistic regression showed that for each type of match, the key performance factors that discriminate win and loss are differentiated, while the efficacy of attack win is associated with the success almost with all contexts studied. Other significant parameters were serve aces for matches between upper-quality teams, opponent’s errors for matches between teams of different quality and avoidance of blocked attacks for balanced matches. The findings emphasize the need for coaches to plan strategies that allow players with special serving abilities to risk for an ace, to enhance the side-out skills of their team and to work detailed on attack coverage systems.
From FAIR data to fair data use: Methodological data fairness in health-related social media research
Authors: Leonelli Sabina , Lovell Rebecca , Wheeler Benedict W , Fleming Lora , Williams Hywel
Published: May 2021

The paper problematises the reliability and ethics of using social media data, such as sourced from Twitter or Instagram, to carry out health-related research. As in many other domains, the opportunity to mine social media for information has been hailed as transformative for research on well-being and disease. Considerations around the fairness, responsibilities and accountabilities relating to using such data have often been set aside, on the understanding that as long as data were anonymised, no real ethical or scientific issue would arise. We first counter this perception by emphasising that the use of social media data in health research can yield problematic and unethical results. We then provide a conceptualisation of methodological data fairness that can complement data management principles such as FAIR by enhancing the actionability of social media data for future research. We highlight the forms that methodological data fairness can take at different stages of the research process and identify practical steps through which researchers can ensure that their practices and outcomes are scientifically sound as well as fair to society at large. We conclude that making research data fair as well as FAIR is inextricably linked to concerns around the adequacy of data practices. The failure to act on those concerns raises serious ethical, methodological and epistemic issues with the knowledge and evidence that are being produced.
The effects of a mobile-based vocational skill building coaching technology intervention for people with cognitive disabilities: A pilot feasibility study
Authors: Heyn Patricia C , Goldberg Aleaza , McGrew Greg , Bodine Cathy
Published: May 2021

We designed a feasibility study to evaluate a mobile-based vocational skill building coaching technology (aka Mobile Coach) intervention by using an ecological design approach. We compared the Mobile Coach to a standard job coach (no Mobile Coach technology) assistance in a facility that employs adults with significant cognitive disabilities (CDs). Twenty working-age adults with CDs were enrolled in this feasibility study and were asked to use the Vocational Mobile Coach Technology (on an iPad) to assist with their daily job functions. Project-specific usability and self-satisfaction survey was used to evaluate the user experience in performing the selected work assembly tasks with the Mobile Coach and without it. This report has the goal to describe our feasibility study design, methods, and results.
Interposition Technique for Pulmonary Valve Replacement
Authors: Sinha Lok , Chery Josue , Jonas Richard A. , Sinha Pranava
Published: May 2021

Background:

Stented bioprosthesis implant at surgical pulmonary valve replacement (PVR) ideally should be 25 to 27 mm to facilitate future percutaneous PVR. This often requires accommodating 35 to 37 mm diameter sewing ring in the pulmonary position and requires anterior patch augmentation of the right ventricular outflow tract (RVOT). We present a novel “interposition” technique of PVR that allows upsizing the valve without RVOT patch augmentation.

Methods:

Using standard cardiopulmonary bypass, the main pulmonary artery (MPA) is dissected and transected at an appropriate level. The remnants of pulmonary valve leaflets are excised. The valve stent posts are telescoped into distal MPA, the MPA continuity is restored by end-to-end anastomosis of the proximal and distal MPA, with the interposed prosthetic valve sewing ring in the suture line between the two edges of the MPA with the bulk of the sewing ring extravascular.

Result:

A total of seven patients (tetralogy of Fallot, three; congenital pulmonary stenosis, four; age range: 15-33 years) underwent the procedure. No patient required RVOT patch augmentation, all patients were extubated in the operating room and were fast-tracked to recovery. Our proposed technique of PVR has the following advantages: accommodate larger size valve, eliminates risk of a paravalvar leak, coronary compression, and anterior tilting of the prosthesis.

Conclusion:

The valve interposition technique avoids the need for RVOT patch, allows implantation of an adequate sized prosthetic valve, maintains native geometry of the pulmonary artery without the risk of tilting of the prosthesis, and eliminates the risk of paravalvular regurgitation and left coronary compression.
Alternative Uses of the Ozaki Technique: Aortic Valved Conduit in a Bentall Operation and Right Ventricle-to-Pulmonary Artery Conduit
Authors: Raju Vijayakumar , Padmanabhan Chandrasekar , Baird Christopher W.
Published: May 2021

The modified Ozaki technique within a conduit is reproducible and is an alternative to the use of homografts and commercially available conduits which may have special appeal in a low resource setting.
Current Management of Anomalous Aortic Origin of a Coronary Artery: A Pan-Canadian Survey
Authors: Rahmouni Kenza , Bernier Pierre-Luc
Published: May 2021

Background:

Anomalous aortic origin of a coronary artery (AAOCA) is a significant cause of sudden cardiac death (SCD) in children and adolescents. The natural history of AAOCA and the pathophysiology of AAOCA-related SCD are poorly understood. Therefore, the evaluation and management of AAOCA remain controversial. This survey-based study aims to report the current AAOCA management tendencies in Canada.

Methods:

We built a 23-question survey on AAOCA. Questions pertained to patient presentation, investigations, morphology of the anomaly, management, and follow-up. We sent the survey to all the Canadian congenital cardiac surgeons, pediatric cardiologists, and adult congenital cardiologists. Data were anonymized and analysis was performed using descriptive statistics.

Results:

According to our survey participants (N = 47), patient age (94%) and amount of physical activity (60%) are the most influential factors when deciding whether to offer surgical correction. Aborted SCD, exercise-induced syncope, typical chest pain, and left jaw or arm pain are the most important clinical presentations indicating surgery. The most commonly used preoperative investigations are rest echocardiography (75%), electrocardiogram (68%), and exercise stress test (62%). Most respondents favor the unroofing procedure (78%) for surgical correction. For nonsurgical candidates, most physicians choose competitive exercise restriction (64%).

Conclusion:

We found a divergence between current practices and expert consensus guidelines regarding the treatment of asymptomatic left AAOCA with high-risk features. Our survey also revealed a lack of consensus among clinicians regarding the management of asymptomatic patients, very young patients, and those with right-sided AAOCA. Evidence-based criteria derived from sufficiently powered studies remain to be established to standardize AAOCA treatment.
Health Care Worker Violent Deaths in the Workplace: A Summary of Cases From the National Violent Death Reporting System
Authors: Braun Barbara I. , Hafiz Hasina , Singh Shweta , Khan Mushira M.
Published: May 2021

Background:

Violent workplace deaths among health care workers (HCWs) remain understudied in the extant literature despite the potential for serious long-term implications for staff and patient safety. This descriptive study summarized the number and types of HCWs who experienced violent deaths while at work, including the location in which the fatal injury occurred.

Methods:

Cases were identified from the Centers for Disease Control and Prevention’s National Violent Death Reporting System between 2003 and 2016. Coded variables included type of HCW injured, type of facility, and location within the facility and perpetrator type among homicides. Frequencies were calculated using Excel.

Findings:

Among 61 HCW deaths, 32 (52%) were suicides and 21 (34%) were homicides; eight (13%) were of undetermined intent. The occupations of victims included physicians (28%), followed by nurses (21%), administration/support operations (21%), security and support services (16%), and therapists and technicians (13%). Most deaths occurred in hospitals (46%) and nonresidential treatment services (20%). Within facility, locations included offices/clinics (20%) and wards/units (18%). Among homicide perpetrators, both Type II (perpetrator was client/patient/family member) and Type IV (personal relationship to perpetrator) were equally common (33%).

Conclusion/ Applications to Practice:

Suicide was more common than homicide among HCW fatal injuries. Workplace violence prevention programs may want to consider both types of injuries. Although fatal HCW injuries are rare, planning for all types of violent deaths could help minimize consequences for staff, patients, and visitors.
Comparison Between Hip Arthroscopic Surgery and Periacetabular Osteotomy for the Treatment of Patients With Borderline Developmental Dysplasia of the Hip: A Systematic Review
Authors: Murata Yoichi , Fukase Naomasa , Martin Maitland , Soares Rui , Pierpoint Lauren , Dornan Grant J. , Uchida Soshi , Philippon Marc J.
Published: May 2021

Background:

The treatment for borderline developmental dysplasia of the hip (BDDH) has historically been arthroscopic surgery or periacetabular osteotomy (PAO). As orthopaedic surgery is constantly evolving, a lack of comparison of outcomes for these 2 treatment methods could potentially be stalling the progression of treatment for patients with BDDH.

Purpose:

To evaluate the existing literature on patient characteristics, procedures, clinical outcomes, and failure rates for patients with BDDH and to determine whether PAO or hip arthroscopic surgery is a better treatment method for patients with BDDH.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Studies included were found using the following search words: “hip” and “borderline dysplasia,” “osteotomy” or “arthroscopy,” and “outcome” or “procedure.” Articles were included if they detailed participants of all sexes and ages, reported on isolated hips, and had patients diagnosed with BDDH.

Results:

A search was conducted across 3 databases, resulting in 469 articles for consideration, from which 12 total studies (10 on arthroscopic surgery and 2 on PAO) were chosen for a review. There were 6 studies that included patients with a lateral center-edge angle of 18° to 25°, while the remainder included patients with a lateral center-edge angle of 20° to 25°. All the studies reviewing arthroscopic surgery reported concomitant/accessory procedures, while the articles on the topic of PAO did not. It was determined that, whether treated using arthroscopic surgery or PAO, outcomes improved across all patient-reported outcome measures. Revision surgery was also common in both procedures.

Conclusion:

There is a lack of consensus in the literature on the best treatment option for patients with BDDH. Preoperative patient characteristics and concomitant injuries should be considered when evaluating which surgical procedure will result in the most favorable outcomes.
Prevalence, population structure, distribution of serotypes, pilus islands and resistance genes among erythromycin-resistant colonizing and invasive Streptococcus agalactiae isolates recovered from pregnant and non-pregnant women in Isfahan, Iran
Authors: Motallebirad Tahereh , Fazeli Hossein , Ghahiri Ataollah , Shokri Dariush , Jalalifar Saba , Moghim Sharareh , Esfahani Bahram Nasr
Published: May 2021

Background

The information on antibiotic resistance and molecular features of Group B Streptococcus (GBS) are essential for epidemiological purposes as well as vaccine development. Therefore, we aimed to assess the antimicrobial resistance profiles and molecular characteristics of GBS isolates in Isfahan, Iran. A total number of 72 colonizing and invasive GBS were collected from pregnant and non-pregnant women. The GBS isolates were analyzed for resistance profiles, capsular genotyping, and detection of PI-1, PI-2a, PI-2b, hvgA, ermB, ermTR, lnuB and, mefA genes. Besides, erythromycin-resistant strains were subjected to multilocus sequence typing (MLST).

Results

The prevalence of colonizing and invasive GBS were 11 and 0.05%, respectively. The frequency of capsular serotypes was as follows: III (26.3%), Ia (20.83%), Ib and V (each 15.2%), IV (9.7%), II (8.3%), VII (2.7%), and VI (1.3%). Overall frequencies of PIs were as follows: PI-1, 37.5%, PI-1 + PI-2a, 30.5%, PI-1 + PI-2b, 29.1% and PI-2b, 2.7%. Two maternal colonizing GBS (2.6%) were hvgA positive and were belonged to ST-17/CPS-III/PI-1 + PI-2b lineage. Among 30(41.6%) erythromycin resistant GBS, 21 isolates (70%) harbored ermB gene, followed by ermTR (23.3%) and mefA (10%). One clindamycin-resistant isolate harbored the lnuB gene. MLST analysis revealed the following five clonal complexes (CCs) and nine STs: (CC-19/ST-335, ST-19, and ST-197), (CC-12/ST-43, ST-12), (CC-23/ST-163, ST-23), (CC-17/ST-17) and (CC-4/ST-16).

Conclusion

The study shows an alarmingly high prevalence of erythromycin-resistant GBS in Iran. In addition, we report dissemination of ST-335/CPS-III clone associated with tetracycline and erythromycin resistance in our region. The distribution of capsular and pilus genotypes varies between invasive and colonizing GBS that could be helpful for vaccine development.
Impact of antiviral treatment on long-term prognosis in non-immunocompromised patients with CMV reactivation
Authors: Park Ga Eun , Ki Hyun Kyun , Ko Jae-Hoon
Published: May 2021

Background

Reactivation of human cytomegalovirus (CMV) occurs in non-immunocompromised patients with or without specific organ involvement, but it is still unknown whether it has a clinical implication on long-term prognosis or not.

Methods

A retrospective cohort study evaluating non-immunocompromised adult patients with CMV reactivation was conducted during the period between January 2010 and February 2018. Patients were divided into ganciclovir-treated and non-treated groups. Patients who died within 30 days from CMV reactivation were excluded as they died from complex causes of conditions. Survivors were followed for 30-months to evaluate long-term prognosis.

Results

A total of 136 patients with CMV reactivation was included, consisting of 66 ganciclovir-treated (48.5%) and 70 non-treated (51.5%) patients. Overall, patients were old-aged (median 70 years old) and most were treated with pneumonia of any cause (91.2%). More patients in ganciclovir-treated group were treated at intensive care unit (43.9% vs 24.3%, respectively) and had higher viral load over 5000 copies/ml (48.5% vs 22.9%) than non-treated group (all P < 0.05). Primary and secondary endpoints including 30-months survival (28.0 vs 38.9%, respectively) and 12-months survival (40.3% vs 49.2%) were not statistically different between the ganciclovir-treated and non-treated groups. In the multivariate analyses, ganciclovir treatment was not associated with 30-months survival (HR 1.307, 95% CI 0.759–2.251) and 12-months survival (HR 1.533, 95% CI 0.895–2.624).

Conclusion

In a retrospective cohort study evaluating non-immunocompromised patients with CMV reactivation, ganciclovir treatment was not associated with long-term prognosis. Antiviral treatment in this condition would not be necessary unless organ involvement is suspected.
Influence of the second stage of labor on maternal and neonatal outcomes in vaginal births after caesarean section: a multicenter study in Germany
Authors: Gitas G. , Proppe L. , Ertan A. K. , Baum S. , Rody A. , Kocaer M. , Dinas K. , Allahqoli L. , Laganà A. S. , Sotiriadis A. , Sommer S. , Alkatout I.
Published: May 2021

Background

The American College of Obstetricians and Gynecologists (ACOG) introduced a new standard of care in 2014, extending the duration of the second stage of labor in order to reduce caesarean delivery (CD) rates and its severe complications. The aim of the present study is to evaluate success rates of trial of labor after caesarean section (TOLAC), as well as maternal and neonatal outcomes after the establishment of the recent guidelines.

Methods

A retrospective study was performed at two large departments in Germany from January 2008 to January 2018. Patients undergoing TOLAC were divided into two groups. Group I (958 patients) was constituted before the establishment of the current guidelines, and Group II (588 patients) after the establishment of the guidelines. A subgroup analysis was performed to compare neonatal outcomes after successful TOLAC and operative vaginal delivery with those after failed TOLAC and secondary CD.

Results

The success rate of vaginal births after cesarean section (VBAC) fell from 66.4% in Group I to 55.8% in Group II (p < 0.001). The median duration of the second stage of labor was statistically significantly longer in Group II than in Group I (79.3 ± 61.9 vs. 69.3 ± 58.2 min) for patients without previous vaginal birth. The incidence of operative vaginal delivery decreased from Group I to Group II (9.6% vs. 6.8%). The incidence of third- and fourth-degree perineal lacerations, blood loss and emergency CD were similar in the two groups. Concerning the neonatal outcome, our groups did not differ significantly in regard of rates of umbilical artery cord pH < 7.1 (p = 0.108), the 5-min Apgar scores below 7 (p = 0.224) and intubation (p = 0.547). However, the transfer rates to the neonatal care unit were significantly higher in Group II than in Group I (p < 0.001). Neonatal outcomes did not differ significantly in the subgroup analysis.

Conclusion

Extending the second stage of labor does not necessarily result in more vaginal births after TOLAC. Maternal and neonatal outcomes were similar in both groups. Further studies will be needed to evaluate the role of operative vaginal delivery and the duration of the second stage of labor in TOLAC.
Household chaos, family routines, and young child movement behaviors in the U.S. during the COVID-19 outbreak: a cross-sectional study
Authors: Kracht Chelsea L. , Katzmarzyk Peter T. , Staiano Amanda E.
Published: May 2021

Background

The home environment is an important facilitator of young child movement behaviors, including physical activity (PA), sleep, and screen-time. Household chaos, characterized by crowding, noise, and disorder in the home, may hinder efforts to obtain adequate amounts of movement behaviors. The COVID-19 outbreak impacted many families, and social distancing during this time may create conditions for more household chaos. Family routines can help establish order in the home and encourage an appropriate balance of movement behaviors, such as less screen-time and more sleep. The purpose of this study was to evaluate the association between household chaos and young child movement behaviors during the COVID-19 outbreak in the United States, and the role of family routines in this relationship.

Methods

A national online survey including 1836 mothers of preschoolers (3.0–5.9 years) was conducted during May 2020. Mothers reported demographic characteristics, household chaos, family routines, and the preschooler’s movement behaviors during the outbreak. Mothers completed a household chaos questionnaire and were grouped into chaos categories (low, moderate/low, moderate/high, and high) for analysis. Linear regression was used to assess the association between chaos category, family routines, and movement behaviors with adjustment for covariates.

Results

Mothers were 35.9 ± 4.1 years of age, middle income (47.8%), and preschoolers were 3.8 ± 0.8 years of age. Most mothers reported their preschooler was less physically active (38.9%), slept the same amount of time (52.1%), and increased their screen-time (74.0%) after the COVID-19 outbreak. Preschoolers in the high chaos households performed less total PA (β = − 0.36 days/week, 95% CI:-0.62 to − 0.09, p = 0.008), slept less (β = − 0.42 h, 95% CI:-0.59 to − 0.25, p = 0.001) and had more screen-time (β = 0.69 h, 95% CI:0.45 to 0.92, p = 0.001) compared to those in low chaos households. In most chaos categories, having a bed-time ritual was related to more child sleep, and mothers who viewed routines as “less/not important” reported more preschooler screen-time compared to mothers who viewed routines as “very important”.

Conclusion

Promoting bed-time rituals and prioritizing routines, even somewhat, may be related to an improved balance of child movement behaviors. Innovative measures are needed to support families during periods of disruption such as that experienced in the COVID-19 pandemic.
Ethnic inequalities in hospital admissions in England: an observational study
Authors: Petersen Jakob , Kandt Jens , Longley Paul A.
Published: May 2021

Background

Ethnic inequalities in health are well-known and partly explained by social determinants such as poorer living and working conditions, health behaviours, discrimination, social exclusion, and healthcare accessibility factors. Inequalities are known both for self-reported health and for diseases such as diabetes, cardiovascular diseases, respiratory diseases, and non-specific chest pains. Most studies however concern individual diseases or self-reported health and do not provide an overview that can detect gaps in existing knowledge. The aim of this study is thus to identify ethnic inequalities in inpatient hospital admission for all major disease categories in England.

Methods

Observational study of the inpatient hospital admission database in England enhanced with ethnicity coding of participants’ surnames. The primary diagnosis was coded to Level 1 of the Global Burden of Disease groups. For each year, only the first admission for each condition for each participant was included. If a participant was readmitted within two days only the first admission was counted. Admission risk for all major disease groups for each ethnic group relative to the White British group were calculated using logistic regression adjusting for age and area deprivation.

Results

40,928,105 admissions were identified between April 2009 and March 2014. Ethnic inequalities were found in cardiovascular diseases, respiratory diseases, chest pain, and diabetes in line with previous studies. Additional inequalities were found in nutritional deficiencies, endocrine disorders, and sense organ diseases.

Conclusions

The results of this study were consistent with known inequalities, but also found previously unreported disparities in nutritional deficiencies, endocrine disorders, and sense organ diseases. Further studies would be required to map out the relevant care pathways for ethnic minorities and establish whether preventive measures can be strengthened.
Feasibility and impact of laparoscopic sleeve gastrectomy after renal transplantation on comorbidities, graft function and quality of life
Authors: AlEnazi Naif A. , Ahmad Khaled S. , Elsamahy Ilham A. , Essa Mohamed S.
Published: May 2021

Background

The aim of this study is to clarify the feasibility and effect of laparoscopic sleeve gastrectomy (LSG) on comorbidities, graft function and quality of life in patients who underwent renal transplantation (RT).

Methods

This is a retrospective review of five patients who underwent LSG after RT. Demographic data, anthropometric parameters, the effect on comorbidities, postoperative course, immunosuppressive medications, causes of RT, renal function, the survival of graft, and quality of life after SG in obese patients with a history of RT were assessed using BAROS–Moorhead–Ardelt survey

Results

From September 2015 to September 2019, 5 renal transplant patients underwent LSG; three female, and two male. Median body mass index (BMI) decreased from 42.17 kg/m2 (range 36–55) before surgery to 28.16 kg/m2 (range 25–42) after surgery. Improvement in blood pressure, triglyceride, and cholesterol levels was observed, and all cases were able to decrease their medications. Insulin was stopped and replaced with linagliptin in all diabetic patients. Graft function improved, and proteinuria level decreased in all cases. All patients reported to have an excellent quality of life.

Conclusion

LSG showed excellent outcomes in this high-risk group of patients regarding comorbidities, graft function and quality of life
Survey analysis to determine the impact of evidence informed practice education upon East Asian medicine faculty clinical instruction and students’ skills, knowledge, attitudes and behaviors within a master’s degree program
Authors: Anderson Belinda J. , Dudla Saikaew , Marantz Paul R. , Kligler Benjamin E. , Leininger Brent D. , Evans Roni
Published: May 2021

Background

Between 2013 and 2018 Pacific College of Health and Science (formerly Pacific College of Oriental Medicine) trained faculty and developed curriculum in evidence informed practice (EIP), with support from a grant from the National Institutes of Health (NIH). A three-credit (45 h) Foundations of EIP course, and online EIP learning modules (developed as part of a previous NIH R25 award), were used for faculty and student training. In addition, EIP was incorporated into 73% of the East Asian medicine degree program. Clinical integration of EIP in the College clinic was enhanced by improving access to reference sources, including additional EIP-related questions to the patient intake forms, requiring the use of a patient-centered outcome instrument, and assessing students’ clinical EIP competencies.

Methods

Master’s degree students’ self-reported EIP skills, knowledge, attitudes and behaviors were assessed before and after taking the Foundations of EIP course using a 17-question paper-based survey with an additional open-ended comments section. The survey was administered in 29 courses across all three Pacific College campuses. Clinical faculty self-reported EIP instruction, focusing on the EIP content and instructional approaches that were utilized, was evaluated on the New York City campus using a paper-based survey before and after changes were made to enhance the clinical integration of EIP.

Results

A total of 1181 completed EIP-course surveys consisting of 657 pre-EIP course surveys and 524 post-EIP course surveys were analyzed. There was a statistically significant improvement in students’ EIP skills, knowledge and behaviors after completing the EIP course. Students’ perception of the importance of EIP was high before and after the EIP course. Little change in Faculty’s EIP-related clinical instruction was evident following the EIP-related changes that were made to the Clinic.

Conclusion

Our study suggests that the three-credit (45 h) EIP course was effective at improving the EIP skills, knowledge and behaviors of this group of East Asian medicine students who were undertaking a master’s degree that qualified them for licensure in acupuncture in the US. These students also demonstrated a high level of recognition for the importance of research and EIP both before and after the course. Training faculty clinical supervisors and providing greater access to evidence sources in the College clinic did not appear to increase EIP instructional activity.