bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiviral Therapy of Haemorrhagic Fevers and Arbovirus Infections
Authors: Bray Mike , Huggins John
Published: August 2021

RNA viruses of the families Arena-, Bunya-, Filo-, Flavi-and Togaviridae cause illness in humans ranging from mild, non-specific febrile syndromes to fulminant, lethal haemorrhagic fever. They are transmitted from animals to humans and from human to human by arthropods, aerosols or contact with body fluids. Antiviral compounds, convalescent plasma and interferon inhibit many of these agents in vitro and in virus-infected animals. Drug or plasma treatment is now in use for several human diseases, and would probably be beneficial for a number of others for which there is only limited treatment experience. Success is linked to early diagnosis and initiation of therapy. Ribavirin is used to treat Lassa fever and haemorrhagic fever with renal syndrome, and would probably be effective for Crimean-Congo haemorrhagic fever and for all New World arenavirus diseases. The value of ribavirin in the early treatment of hantavirus pulmonary syndrome is under evaluation. Convalescent plasma is the therapy of choice for Argentine haemorrhagic fever, and would also probably be effective for other New World arenaviruses and some other infections if a safe supply of plasma could be maintained. Ribavirin and interferon-α have both shown protective efficacy in non-human primates infected with Rift Valley fever virus. No effective therapy has yet been identified for filovirus infections, but results in animal models are encouraging. More clinical research is urgently needed. Even if placebo-controlled drug trials cannot be performed, conscientious reports of the results of therapy in limited numbers of patients can still provide evidence of antiviral drug effects.
A Randomized Controlled Study for the Evaluation of the Activity of a Triple Combination of Zidovudine, Thymosin-α1 and Interferon-α in HIV-Infected Individuals with CD4 Counts between 200 and 500 cells/mm3
Authors: Garaci Enrico , Milanese Giuseppe , Vella Stefano , Aiuti Fernando , D'Agostini Cartesio , Francavilla Ermenegildo , Lazzarin Adriano , Macri Giulia , Sarmati Loredana , Rocchi Giovanni
Published: August 2021

Our objective was to determine the safety and the activity of thymosin-α1 (Tα1) plus interferon-α (IFN-α) and zidovudine in human immunodeficiency virus (HIV)-infected patients with CD4 counts between 200 and 500 cells/mm3. The study was multicentre, Phase II, randomized and open label. Patients were randomized to receive triple therapy, or zidovudine plus IFN-α, or zidovudine alone. Ninety-two patients were enrolled. After 12 months, in the triple combination group there was a median increase from baseline of 69 CD4 cells/mm3; a decrease of 52 cells/mm3 and of 65.5 cells/mm3 was seen in the zidovudine plus IFN-α and in the zidovudine monotherapy groups, respectively. In the triple combination arm the increase in mean CD4 counts was significantly greater than that observed in the other arms, particularly in patients with baseline CD4 counts less than 350 cells/mm3. The plasma HIV RNA load in triple therapy group showed a mean peak decrease from baseline of 16 000 copies/ml after 5 months (versus a decrease of 5000 copies/ml in the zidovudine monotherapy group) that was sustained at 12 months (versus a mean increase of 7000 copies/ml in the zidovudine monotherapy group at 12 months). The triple combination was superior to both the other arms in terms of virological and immunological response. Our study, although based on regimens of clearly sub-optimal antiretroviral potency, addressed the issue of combined therapy directed at two different targets: the HIV replicative cycle and the immune system. The use of immunomodulating agents deserves further investigation in the context of more potent antiretroviral combinations.
Association of turn-taking functions with joint attention in toddlers with autism
Authors: Lee Kwangwon , Schertz Hannah H
Published: August 2021

Nonverbal turn taking, defined as back-and-forth exchanges, may be used to convey instrumental or social intent. It has been theorized that social turn taking is foundational to joint attention and, as such, it has been incorporated as a component of early interventions for children with autism, who often have challenges in joint attention competency. The purpose of this study was to analyze the relationships between two turn-taking functions and joint attention as observed during interactions between 20 toddlers with autism who received intervention and their caregivers. It was hypothesized that socially driven turn taking would be positively related to joint attention, but instrumentally motivated turn taking would not. Video analysis revealed a positive relationship between social turn taking and joint attention, but not between instrumental turn taking and joint attention. While not causal, the findings support the promotion of social content in intervention and the concept that social turn taking may be a precursory competency to joint attention.

Lay abstract

Back-and-forth interaction, or turn taking, may support later joint attention, a more complex form of interaction, when promoted in interventions for young children with autism, especially depending on the child’s intent when interacting. In the present study, we observed videos of 20 toddlers with autism engaging in turn taking with their caregivers during an intervention designed to support children’s joint attention. We sought to identify when the children displayed turn taking socially and when they were using it for nonsocial purposes in the intervention videos. We also observed videos after the intervention was complete to identify when children used joint attention when interacting with their caregivers. After these observations, we used these video data to explore the relationship of social turn taking to joint attention, and the relationship of nonsocial turn taking to joint attention. We found a significant relationship between social turn taking and joint attention, but not between nonsocial turn taking and joint attention. These findings support the importance of considering social turn taking in interactions between young children with autism and their caregivers.
Do squeaky wheels get the grease? Understanding when and how municipalities respond to online requests
Authors: Epstein Ben , Bode Leticia , Connolly Jennifer M
Published: August 2021

Citizens often attempt to interact with government through online modes of communication such as email and social media. Using an audit study, we examine when and how American municipalities with populations of over 50,000 respond to online requests for information. We develop baselines for municipal responsiveness, including the average rate, time, and quality of responses, and examine whether these response attributes vary based on the mode of communication or the tone of the request. Overall, municipalities responded to 54% of email requests and 38% of Twitter requests. A majority of responses were received on the same business day. Responses are slightly faster on Twitter, but of higher quality on email. Governments are more likely to respond to frustrated constituents on email, but respond faster to frustrated queries on Twitter, though with lower quality responses. These findings contribute to our understanding of local government responsiveness and have significant implications for democratic accountability and resident compliance with and the effectiveness of local government policies. Furthermore, our scholarly understanding of local government communications with residents, and particularly the promise of social media as a tool of two-way communication, may be underdeveloped.
Using social media images as data in social science research
Authors: Chen Yan , Sherren Kate , Smit Michael , Lee Kyung Young
Published: August 2021

We conducted a scoping review to identify and describe trends in the use of social media images as data sources to inform social science research in published articles from 2015 to 2019. The identified trends include the following: (1) there is increasing interest in social media images as research data, especially in disciplines like sociology, cultural studies, communication and environmental studies; (2) the photo sample size is often smaller than that is typically used in text-based social media analysis and usually is collected manually; (3) thematic coding, object recognition and narrative analysis are the most popular analysis methods that are often conducted manually; (4) computer vision and machine-learning technologies have been increasingly but still infrequently used and are not fit for all purposes; and (5) relatively few papers mention ethics and privacy issues, or apply strategies to address ethical issues. We identify noteworthy research gaps, and opportunities to address limitations and challenges.
Algorithm design for young children
Authors: Lee Joohi , Joswick Candace , Pole Kathryn , Jocius Robin
Published: August 2021

Algorithms are the essence of computational thinking, which refers to a set of problem-solving processes that help children become logical thinkers in this increasingly digital society. It is important for teachers of young children to carefully plan and implement algorithm design tasks that involve repeated step-by-step procedures to build strong foundational computational thinking skills. In this article, the authors present algorithm tasks, including following a recipe, creating a treasure map, modeling how to perform a task, and sharing a routine, which can be easily integrated in the daily activities in early childhood classrooms. Fostering young children’s aptitude for algorithm-specific thinking-and-doing processes creates a foundation for logical thinking.
X-linked hypophosphatemic rickets: Orthodontic considerations and management. A case report
Authors: Gibson Clara , Mubeen Suhaym , Evans Robert
Published: August 2021

X-linked hypophosphatemic rickets (XLH) is a rare condition affecting bone metabolism. It has characteristic dental features such as poorly mineralised dentine, spontaneous abscess formation in the absence of caries and taurodontism. There are limited published data about patients with this condition undergoing orthodontic treatment, and there is no clear guideline on the suitability of orthodontic treatment in this cohort. We present a case report of a patient with XLH with a confirmed PHEX gene mutation undergoing orthodontic treatment and clinical recommendations to support treatment.
The diagnostic value of orthopantomograms in detecting resorption of lateral incisors associated with ectopic canines: a CBCT study
Authors: Hershaw Catherine Maria , Mhani Nizar , Brown Angharad
Published: August 2021

Objective:

To examine the diagnostic value of orthopantomograms (OPG) in the identification of root resorption of lateral incisors, secondary to an impacted canine, as confirmed by a cone-beam computed tomography (CBCT) scan.

Design:

Retrospective observational cohort study.

Setting:

South Wales secondary care setting: Royal Gwent Hospital, Newport and Nevill Hall Hospital, Abergavenny.

Methods:

A total of 40 consecutive patients with impacted canines between January 2018 and December 2019 were selected. For each patient, one consultant orthodontist examined the OPG in isolation to detect the presence and extent of resorption of lateral incisors. The CBCT report was then studied to confirm the presence and extent of pathology. Sensitivity, specificity, accuracy, positive predictive values and negative predictive values were calculated.

Results:

In total, 19 maxillary right canines, 18 maxillary left canines, one mandibular right canine and two mandibular left canines were examined. Impactions were more prevalent in the maxilla (92.5%) with higher predilection towards female patients (65%). There was higher prevalence of root resorption in the maxillary right quadrant (57.1%), in concordance with other studies. OPGs were found to have a sensitivity of 81.0% and a specificity of 10.5%, with an accuracy value of 47.5%. Positive and negative predictive values were found to be 50.0% and 33.3%, respectively. The extent of root resorption was incorrectly estimated from the OPG in 84% of cases. Correct estimation occurred in 16% of cases, with overestimation and underestimation occurring in equal proportion (42%).

Conclusion:

This study demonstrates the limitations of plain film radiographs and the merits of using CBCT in the accurate diagnosis of resorption of lateral incisors with an associated impacted canine. It also gives an indication into the location prevalence of resorption in a small cohort of patients. This preliminary study establishes the basis for future, larger-scale studies where outcomes can be generalisable at a population level.
Building community through hospitality: Indirect obligations to reciprocate in a transnational speech community
Authors: Fians Guilherme
Published: August 2021

Anthropologists largely draw on the theoretical assumption that the interactional practices underlying hospitality are akin to those of gifting. Yet, by focussing on the giving and receiving of hospitality, such scholarship has failed to address these exchanges’ third element: reciprocating. Faced with this, this article reflects on travelling among Esperanto speakers in France, aiming to grasp how hospitality gains prominence in turning people into fully fledged Esperanto speakers through promoting intercultural, multilingual and cross-border exchanges. Asking what Mauss, Pitt-Rivers and Sahlins would have written about reciprocity had they come across backpackers, couchsurfers and Esperanto speakers, I explore why reciprocity and hospitality are vital for the existence of the Esperanto speech community and, more broadly, what is the place of reciprocity in hospitality. From the ethnography presented, I argue that hospitality can also emerge as a community-building mechanism, stemming from indirect obligations to reciprocate that may paradoxically constitute both short-lived dyadic relationships and long-standing communities.
Work engagement, organizational embeddedness, and life satisfaction among frontline employees of star-rated hotels in Ghana
Authors: Ampofo Emmanuel Twumasi , Owusu Joseph , Coffie Rosemary Boateng , Asiedu-Appiah Felicity
Published: August 2021

To expand the literature on embeddedness and life satisfaction, the present study examines the mediating role of work engagement in the relationship between organizational embeddedness and life satisfaction among hotel employees in Ghana. Multi-wave data were conveniently collected from 274 employees working as full timers in selected rated hotels in Accra. Structural equation modeling results demonstrated that organizational embeddedness positively influenced life satisfaction and links positively affected life satisfaction. Moreover, work engagement mediated the organizational embeddedness-life satisfaction nexus. Lastly, the results showed that work engagement mediated the effects of link and fit on life satisfaction. Managers of hotels should provide employees who offer frontline services with several important organizational resources such as fit and links to enhance their work engagement and therefore augment their satisfaction with life.
Effects of screen-responsive visualization on data comprehension
Authors: Badam Sriram Karthik , Elmqvist Niklas
Published: August 2021

Visualization interfaces designed for heterogeneous devices such as wall displays and mobile screens must be responsive to varying display dimensions, resolution, and interaction capabilities. In this paper, we report on two user studies of visual representations for large versus small displays. The goal of our experiments was to investigate differences between a large vertical display and a mobile hand-held display in terms of the data comprehension and the quality of resulting insights. To this end, we developed a visual interface with a coordinated multiple view layout for the large display and two alternative designs of the same interface – a space-saving boundary visualization layout and an overview layout – for the mobile condition. The first experiment was a controlled laboratory study designed to evaluate the effect of display size on the perception of changes in a visual representation, and yielded significant correctness differences even while completion time remained similar. The second evaluation was a qualitative study in a practical setting and showed that participants were able to easily associate and work with the responsive visualizations. Based on the results, we conclude the paper by providing new guidelines for screen-responsive visualization interfaces.
Model experiments with different cycloidal propeller algorithms using same electric controller
Authors: Nandy Subhashis , Nagarajan Vishwanath , Sha Om Prakash
Published: August 2021

This article presents a methodology of controlling the cycloidal propeller electronically in model scale by an experimental approach. It establishes the function of single-unit controlled multiple propeller models such as Kirsten-Boeing and Voith-Schneider propeller. It also deals with the execution of different maneuvering cases like straight acceleration, autopilot, zigzag, crash stop. Blade motors independently control the pitching of the propeller-blades unlike the mechanism of the conventional cycloidal propeller. PID control and heuristic control are investigated for this purpose. Mathematical models for system identification, pulse generation, position, and speed control of propeller blades, and disc and synchronizations are demonstrated. Based on model experimental results, advantages/disadvantages of PID and heuristic control are discussed.
Performance impact analysis of services under a time-based moving target defense mechanism
Authors: Mendonça Júlio , Cho Jin-Hee , Moore Terrence J , Nelson Frederica F , Lim Hyuk , Dongseong Kim Dan
Published: August 2021

Moving target defense (MTD) is a promising proactive defense technique to enhance system or network security. One caveat in developing a time-based MTD-enabled system is the potential performance degradation due to MTD operations being triggered periodically. In this work, we present our developed stochastic models based on deterministic stochastic Petri net (DSPN) formalism to assess the performance degradation introduced by periodic MTD operations. In addition, we demonstrate the effect of triggering a time-based MTD operation on performance degradation (e.g., jobs dropped or response time) and quality-of-service (QoS) of the system. We conducted comparative performance analysis with five DSPN models implemented in software packages such as TimeNet and Mercury under five different system configuration scenarios. Our key findings from this study include the following: (1) the deployment of MTD with the switchover strategy can improve the performance of services; (2) the switchover strategy showed the best cost-effectiveness among all strategies considered in this work; and (3) the interval of triggering MTD operations introduced a modest impact on job completion probability.
Understanding the Use of Optimal Formatting and Plain Language When Presenting Key Information in Clinical Trials
Authors: Solomon Erin D. , Mozersky Jessica , Wroblewski Matthew P. , Baldwin Kari , Parsons Meredith V. , Goodman Melody , DuBois James M.
Published: August 2021

Recent revisions to the Common Rule require that consent documents begin with a focused presentation of the study's key information that is organized to facilitate understanding. We surveyed 1,284 researchers working with older adults or individuals with Alzheimer's disease, supplemented with 60 qualitative interviews, to understand current use and barriers to using evidence-based formatting and plain language in key information. Researchers reported using formatting in 42% of their key information sections, and plain language in 63% of their key information sections. Perceived barriers included lack of knowledge, Institutional Review Board, other members of their team, and the burden associated with implementation. Education and training are required to increase adoption of the practices.
Communicating With Diverse Patients About Participating in a Biobank: A Randomized Multisite Study Comparing Electronic and Face-to-Face Informed Consent Processes
Authors: Simon Christian M. , Wang Kai , Shinkunas Laura A. , Stein Daniel T. , Meissner Paul , Smith Maureen , Pentz Rebecca , Klein David W.
Published: August 2021

Some individuals’ understanding of informed consent (IC) information may improve with electronic delivery, but others may benefit from face-to-face (F2F). This randomized, multisite study explores how individuals from diverse backgrounds understand electronic IC documents versus F2F, their confidence in understanding, and enrollment in research. A total of 501 patients at two U.S. biobanks with diverse populations participated. There were no overall differences between electronic and F2F understanding, but F2F predicted higher confidence in understanding and enrollment. Ethnicity and a higher educational level predicted higher understanding and confidence. Study findings suggest that electronic consent may lead to better understanding for non-Hispanic patients of higher socioeconomic status. F2F processes may lead to better understanding and higher enrollment of patients from Hispanic and lower socioeconomic levels. Researchers should carefully consider how they implement electronic IC processes and whether to maintain an F2F process to better address the needs and limitations of some populations.
Patients’ beliefs toward generic medication in Yemen
Authors: Jaber Ammar Ali Saleh , Al-Worafi Yaser Mohammed , Dhabali Abdullah Ahmed
Published: August 2021

Purpose

This study aims to explore patients’ knowledge and beliefs toward generic medicines and identify the factors affecting their beliefs toward them in Yemen.

Patients and methods

A cross-sectional study was conducted from April 1 to July 1, 2016. A self-administered questionnaire was distributed to 590 adult patients in Sana’a. The data were analyzed using Statistical Package for the Social Sciences® (IBM SPSS) version 26 for Windows.

Results

Overall, 370 patients participated in this study. The study identified that a majority of the respondents did not know the similarities and differences between generic and branded medication and had negative beliefs toward generic medication. The study identified the factors contributing to the patients’ beliefs toward generic medication.

Conclusion

Yemeni patients had poor knowledge and negative beliefs toward generic medication. Educational programs provided to patients and healthcare professionals regarding generic medication can improve patients’ knowledge and correct their beliefs in this regard.
Outcomes of secondary trapeziectomy after revision of trapeziometacarpal implants: a retrospective comparative matched study
Authors: Cerlier Alexandre , Guinard Didier , Gay André M , Legré Régis
Published: August 2021

We evaluated secondary trapeziectomy for revision of trapeziometacarpal implants and compared this to primary trapeziectomy with a matched retrospective single centre study performed between October 2003 and February 2015. Thirty-one patients with trapeziometacarpal prosthesis failure who had a secondary trapeziectomy were matched with a primary trapeziectomy regarding sex, date of the operation and age. We evaluated function, mobility, autonomy, pain, strength, complications and shortening of the thumb on radiographs. The median time until removal of the implant was 37 months. The median age in both groups was similar. Median follow-up was more than 7 years in both groups. There was no statistically significant difference in terms of function, mobility, autonomy, pain, strength, complications and shortening of the thumb. Secondary trapeziectomy after revision of trapeziometacarpal implants provides results comparable with primary trapeziectomy.

Level of evidence: III
Differences in management and treatment of traumatic adult pan brachial plexus injuries: a global perspective regarding continental variations
Authors: Shin Alexander Y. , Socolovsky Mariano , Desai Ketan , Fox Michael , Wang Shufeng , Spinner Robert J.
Published: August 2021

An expert opinion study was designed to query five countries and six brachial plexus surgeons regarding the demographics, mechanisms of injury, evaluation, timing of surgery, reconstructive strategies and controversies in adult traumatic pan brachial plexus injuries. Variations in assessing outcomes, management of neuropathic pain and future considerations were elucidated. Clear differences in regional demographics, mechanisms of injury, patient evaluation and treatment strategies were identified. The role of phrenic nerve and contralateral C7 transfer, acute use of free functioning muscle transfers, root reimplantation and amputation/myoelectric prosthetic fitting were regional/surgeon dependent. Comparison of outcomes across regions requires an understanding of the regional nuances of patient demographics, injury mechanisms, preferred reconstructive strategies and how outcomes are measured. Future studies are required to allow accurate regional comparisons.
(Re)Gaining Our Voice: Future of Marketing in Australasia
Authors: Conduit Jodie , Lu Vinh , Veer Ekant
Published: August 2021

Marketing academia in Australasia is facing unprecedented challenges to ensure the relevance and impact in modern business practices and public policy making. This crisis in identity and professional pressures suggest we must pay significant attention to nurturing the mental, emotional, and social well-being of academics; protecting those most vulnerable; and championing our cause. To be at the forefront of institutional decision-making, the academy must act decisively and proactively. In this commentary, we argue that the future shape of the academy will require collective engagement of academics within the Australasian community, driven by a shared vision with society embedded as the central tenant of universities around which research and education activities are focused. Individual alignment with this vision will be fundamental, facilitated by collaborative ways of working and shared resource investments across universities, businesses, and society. For this future vision to be realized, aligned institutional frameworks (i.e., performance metrics and measurement) need to be developed in a manner that enhances academic well-being going forward.
Knowledge assessment of anti-snake venom among healthcare practitioners in northern Nigeria
Authors: Bala Auwal A. , Jatau Abubakar I. , Yunusa Ismaeel , Mohammed Mustapha , Mohammed Al-Kassim H. , Isa Abubakar M. , Wada Abubakar S. , Gulma Kabiru A. , Bello Inuwa , Malami Sani , Michael Godpower C. , Chedi Basheer AZ.
Published: August 2021

Introduction:

Anti-snake venom (ASV) is the standard therapy for the management of snakebite envenoming (SBE). Therefore, the knowledge of ASV among healthcare practitioners (HCPs) is essential for achieving optimal clinical outcomes in snakebite management. This study aimed to assess knowledge of ASV among the HCPs in northern Nigeria.

Methods:

We conducted a cross-sectional study involving eligible HCPs from different healthcare settings in northern Nigeria. The participants were recruited into the study using a combination of online (via Google Form) and face-to-face paper-based survey methods. The ASV knowledge of the respondents was measured using a validated anti-snake venom knowledge assessment tool (AKAT). Inadequate overall knowledge of ASV was defined as scores of 0–69.9%, and 70–100% were considered adequate overall knowledge scores. The predictors of ASV knowledge were determined using multiple logistic regression.

Results:

Three hundred and thirty-one (331) eligible HCPs were included in the study analysis (310 from online and 21 from paper-based survey). Overall, an estimated 12.7% of the participants had adequate knowledge of ASV. Adequate ASV knowledge was higher among physicians compared with other HCPs (21.7%; χ2 = 8.1; p = 0.04). Those without previous training on ASV (adjusted odds ratio [aOR], 0.37; 95% confidence interval [CI], 0.18–0.73; p = 0.004) and who have not previously administered/dispensed ASV (aOR, 0.31; 95% CI, 0.15–0.63; p < 0.001) were less likely to have adequate knowledge of ASV.

Conclusion:

The knowledge of ASV among healthcare practitioners in northern Nigeria is grossly inadequate. Experience with administering or dispensing ASV predicts ASV knowledge. Therefore, appropriate interventions are needed to improve ASV knowledge, particularly among the HCPs, for optimal healthcare outcomes.
Mobile consulting as an option for delivering healthcare services in low-resource settings in low- and middle-income countries: A mixed-methods study
Authors: Harris Bronwyn , Ajisola Motunrayo , Alam Raisa Meher , Watkins Jocelyn Anstey , Arvanitis Theodoros N , Bakibinga Pauline , Chipwaza Beatrice , Choudhury Nazratun Nayeem , Kibe Peter , Fayehun Olufunke , Omigbodun Akinyinka , Owoaje Eme , Pemba Senga , Potter Rachel , Rizvi Narjis , Sturt Jackie , Cave Jonathan , Iqbal Romaina , Kabaria Caroline , Kalolo Albino , Kyobutungi Catherine , Lilford Richard J , Mashanya Titus , Ndegese Sylvester , Rahman Omar , Sayani Saleem , Yusuf Rita , Griffiths Frances
Published: August 2021

Objective

Remote or mobile consulting is being promoted to strengthen health systems, deliver universal health coverage and facilitate safe clinical communication during coronavirus disease 2019 and beyond. We explored whether mobile consulting is a viable option for communities with minimal resources in low- and middle-income countries.

Methods

We reviewed evidence published since 2018 about mobile consulting in low- and middle-income countries and undertook a scoping study (pre-coronavirus disease) in two rural settings (Pakistan and Tanzania) and five urban slums (Kenya, Nigeria and Bangladesh), using policy/document review, secondary analysis of survey data (from the urban sites) and thematic analysis of interviews/workshops with community members, healthcare workers, digital/telecommunications experts, mobile consulting providers, and local and national decision-makers. Project advisory groups guided the study in each country.

Results

We reviewed four empirical studies and seven reviews, analysed data from 5322 urban slum households and engaged with 424 stakeholders in rural and urban sites. Regulatory frameworks are available in each country. Mobile consulting services are operating through provider platforms ( n = 5–17) and, at the community level, some direct experience of mobile consulting with healthcare workers using their own phones was reported – for emergencies, advice and care follow-up. Stakeholder willingness was high, provided challenges are addressed in technology, infrastructure, data security, confidentiality, acceptability and health system integration. Mobile consulting can reduce affordability barriers and facilitate care-seeking practices.

Conclusions

There are indications of readiness for mobile consulting in communities with minimal resources. However, wider system strengthening is needed to bolster referrals, specialist services, laboratories and supply chains to fully realise the continuity of care and responsiveness that mobile consulting services offer, particularly during/beyond coronavirus disease 2019.
Intersections Between Masculinities and Sexual Behaviors Among Young Men at the University of KwaZulu-Natal, South Africa
Authors: Khumalo Sinakekelwe , Mabaso Musawenkosi , Makusha Tawanda , Taylor Myra
Published: August 2021

The university period provides a critical developmental transition from adolescence to adulthood. During this period, young people establish patterns of behaviors and make lifestyle choices that affect their current and future health. Using the social constructionist paradigm that examines the development of masculinities as a mutual construct of individual, social, cultural, and historical context, this article explores the interactions between masculinities and sexual behaviors of young men at the University of KwaZulu-Natal, South Africa. The study used a qualitative approach and employed purposive sampling to recruit 36 young Black male students aged between 18 and 30 years. Four focus group discussions consisting of 8 to 10 participants were conducted according to the current year of study of male students. Data were transcribed, coded, and analyzed thematically. Our results show that the freedom and independence acquired from being away from home enabled students to enact their masculinities freely. Our findings further reveal that an individual has multiple masculinities which are often exerted to suit the present discourse they are in at any given point.
Sentiment Analysis of Public Opinions on the Higher Education Expansion Policy in China
Authors: Yu Xiaoyan , Wu Shiyong , Chen Wei , Huang Mingxi
Published: August 2021

Drawing on sentiment analysis, this study explores public opinions on the higher education expansion policy that was specifically implemented by China’s government to navigate graduate employment difficulties against the impact of COVID-19. The results indicated that the overall degree of acceptance of the expansion plan was highly positive, but some people expressed negative opinions and concerns about over-education and deferral of employment pressure. The results also suggested that the government is expected to deal with the balance between higher education expansion and graduate employment difficulties by prioritizing domestic graduate employment rather than opening up permanent resident applications for foreigners, allocating a regionally balanced expansion quota, covering social science disciplines, and creating more employment opportunities. The findings provide important suggestions for policymakers to improve policy practice and offer a referable sample for other countries in their management of graduate employment issues influenced by COVID-19.
Adolescents’ Online Coping: When Less Is More but None Is Worse
Authors: Modecki Kathryn L. , Duvenage Megan , Uink Bep , Barber Bonnie L. , Donovan Caroline L.
Published: August 2021

Mobile technologies are omnipresent across adolescent life and require better characterization of their potential benefits. Adolescents also experience high rates of daily stress so that investigating youths’ technology use in relation to their stress response is of practical importance. We employed experience sampling data from a subset of 115 youths ( n = 1,241 time points) who reported on their technology-based coping and assessed how these related to emotion change throughout the day and controlled for important covariates. Models testing for the benefits of moderate use (relative to no or heavy use; i.e., Goldilocks effect) showed a clear pattern of positive effects of moderate coping online, particularly in relation to support seeking and self-distraction. Moderate online coping was adaptive and often fostered declines in negative emotion.
A Systematic Review of Definitions for Dysphagia and Dysphonia in Patients Treated Surgically for Degenerative Cervical Myelopathy
Authors: Tetreault Lindsay , Lange Stefan F. , Chotai Silky , Lupo Mercedes , Kryshtalskyj Michael T. , Wilson Jefferson R. , Martin Allan R. , Davies Benjamin M. , Nater Anick , Devin Clinton , Fehlings Michael G.
Published: August 2021

Study Design:

Systematic review. Surgical decompression for degenerative cervical myelopathy (DCM) is associated with perioperative complications, including difficulty or discomfort with swallowing (dysphagia) as well as changes in sound production (dysphonia). This systematic review aims to (1) outline how dysphagia and dysphonia are defined in the literature and (2) assess the quality of definitions using a novel 4-point rating system.

Methods:

An electronic database search was conducted for studies that reported on dysphagia, dysphonia or other related complications of DCM surgery. Data extracted included study design, surgical details, as well as definitions and rates of surgical complications. A 4-point rating scale was developed to assess the quality of definitions for each complication.

Results:

Our search yielded 2,673 unique citations, 11 of which met eligibility criteria and were summarized in this review. Defined complications included odynophagia (n = 1), dysphagia (n = 11), dysphonia (n = 2), perioperative swelling complications (n = 2), and soft tissue swelling (n = 3). Rates of dysphagia varied substantially (0.0%-50.0%) depending on whether this complication was patient-reported (4.4%); patient-reported using a modified Swallowing Quality of Life questionnaire (43.1%) or the Bazaz criteria (8.8%-50.0%); or diagnosed using an extensive protocol consisting of clinical assessment, a bedside swallowing test, evaluation by a speech and language pathologist and a modified barium swallowing test/fiberoptic endoscopy (42.9%). The reported incidences of dysphonia also ranged significantly from 0.6% to 38.0%.

Conclusion:

There is substantial variability in reported rates of dysphagia and dysphonia due to differences in data collection methods, diagnostic strategies, and definitions. Consolidation of nomenclature will improve evaluation of the overall safety of surgery.
Posterior Temporary C1-2 Pedicle Screws Fixation for the Treatment of Unstable C1-2 Complex Fractures: Minimum of 2-Year Follow-Up
Authors: Ibrahim Yakubu , Li Hao , Zhao Geng , Yuan Suomao , Zhao Yiwei , Liu Wubo , Tian Yonghao , Wang Lianlei , Liu Xinyu
Published: August 2021

Study Design:

Retrospective.

Objectives:

To present rarely reported complex fractures of the upper cervical spine (C1-C2) and discuss the clinical results of the posterior temporary C1-2 pedicle screws fixation for C1-C2 stabilization.

Methods:

A total of 19 patients were included in the study (18 males and 1 female). Their age ranged from 23 to 66 years (mean age of 39.6 years). The patients were diagnosed with complex fractures of the atlas and the axis of the upper cervical spine and underwent posterior temporary C1-2 pedicle screws fixation. The patients underwent a serial postoperative clinical examination at approximately 3, 6, 9 months, and annually thereafter. The neck disability index (NDI) and the range of neck rotary motion were used to evaluate the postoperative clinical efficacy of the patients.

Results:

The average operation time and blood loss were 110 ± 25 min and 50 ± 12 ml, respectively. The mean follow-up was 38 ± 11 months (range 22 to 60 months). The neck rotary motion before removal, immediately after removal, and the last follow-up were 68.7 ± 7.1°, 115.1 ± 11.7°, and 149.3 ± 8.9° ( P < 0.01). The NDI scores before and after the operation were 42.7 ± 4.3, 11.1 ± 4.0 ( P < 0.01), and the NDI score 2 days after the internal fixation was removed was 7.3 ± 2.9, which was better than immediately after the operation ( P < 0.01), and 2 years after the internal fixation was removed. The NDI score was 2.0 ± 0.8, which was significantly better than 2 days after the internal fixation was taken out ( P < 0.001).

Conclusions:

Posterior temporary screw fixation is a good alternative surgical treatment for unstable C1-C2 complex fractures.
Reduction in Diameter of Hamstring Autograft With Additional Circumferential Preconditioning During ACL Reconstruction in a Pediatric Population
Authors: Weltsch Daniel , Chan Calvin , Dale Kevin M. , Koehler Ryan J. , Talwar Divya , Ganley Theodore J. , Lawrence J. Todd R.
Published: August 2021

Background:

Over 130,000 anterior cruciate ligament (ACL) reconstructions (ACLRs) are performed annually in the United States. Previous studies have shown that circumferential preconditioning reduces the diameter of fresh-frozen allografts, but no studies have described the effect in ACL autografts used during ACLR.

Purpose:

To characterize the changes in the hamstring autograft diameter as a result of preparatory circumferential preconditioning.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 135 patients with ACLR, with a median age of 15 years (interquartile range, 14-16 years; 50.4% boys), were identified in 2 pediatric hospitals. Three orthopaedic surgeons recorded hamstring autograft diameters at 2 time points during graft preparation. Hamstring tendons were prepared using a standardized procedure, tensioned to 15 to 20 lbs, and measured using cylindrical sizing guides. The graft was left with passive compression in the smallest initial rigid sizing guide for 10 minutes on both the tibial and femoral sides and then measured again immediately before implantation. Tunnels were drilled based on the second measurement of graft size. Comparisons were made between the graft diameter before and after circumferential preconditioning. A random-effects regression model and a linear regression model were performed to capture any unexplained variance on the linear predictor scale and determine correlations between demographics and graft characteristics.

Results:

The median initial diameter for both femoral and tibial sides was 9.5 mm. After longitudinal tension and circumferential preconditioning, the median autograft diameter of both sides decreased by 1 mm ( P < .001) to 8.5 mm. In the random-effects model, decreased patient height was a significant predictor of greater reduction in graft diameter. Increased height was a significant predictor for greater initial graft diameter (average beta coefficient = 3.08; P < .01). No intraoperative complications were noted with implantation of the preconditioned grafts in smaller diameter tunnels.

Conclusion:

The median diameter of hamstring ACL autografts decreases by 1 mm after circumferential preconditioning within standard cylindrical sizing guides. This allowed for drilling of tunnels that were an average of 1 mm smaller without any noted intraoperative complications with graft insertion.
Is Radiographic Imaging Necessary for Identifying Late Developmental Dysplasia of the Hip in Breech Infants with Normal Ultrasounds?
Authors: Antoniak Katherine , Lee Christopher , Goldstein Rachel Y. , Abousamra Oussama
Published: August 2021

Purpose. The goal of our study was to investigate the prevalence of late DDH cases in breech infants who had a normal screening hip ultrasound and subsequent follow-up hip x-ray imaging. Methods. Infants with a history of intrauterine breech position, normal hip ultrasound within 3-months of birth, and follow-up hip x-rays within 2-years were included. Acetabular indices were measured on a supine AP pelvis radiograph. Results. Fifty-six patients had breech presentation at birth, a normal hip ultrasound, and returned for radiographic evaluation within 2 years. Of those, 11/112 (10%) of hips had late DDH based on their radiographic images at 1 standard deviation greater than normative values from age-adjusted controls. No infants showed hip dysplasia at 2 standard deviations greater than normative values from age-adjusted controls. Conclusions. Our results support previous studies that follow up should be considered for infants with breech presentation and normal hip ultrasounds near birth. Level of evidence. II.
Patient Engagement Approaches in Total Joint Arthroplasty: A Review of Two Decades
Authors: Alokozai Aaron , Bernstein David N. , Samuel Linsen T. , Kamath Atul F.
Published: August 2021

Patient engagement is a comprehensive approach to health care where the physician inspires confidence in the patient to be involved in their own care. Most research studies of patient engagement in total joint arthroplasty (TJA) have come in the past 5 years (2015-2020), with no reviews investigating the different patient engagement methods in TJA. The primary purpose of this review is to examine patient engagement methods in TJA. The search identified 31 studies aimed at patient engagement methods in TJA. Based on our review, the conclusions therein strongly suggest that patient engagement methods in TJA demonstrate benefits throughout care delivery through tools focused on promoting involvement in decision making and accessible care delivery (eg, virtual rehabilitation, remote monitoring). Future work should understand the influence of social determinants on patient involvement in care, and overall cost (or savings) of engagement methods to patients and society.
Norms, Norm Sets, and Reference Groups: Implications for Household Interest in Energy Technologies
Authors: Horne Christine , Familia Thomas
Published: August 2021

Household adoption of rooftop solar panels and battery storage can potentially reduce the negative environmental impacts of the electric grid. We argue that the number of socially close (friends and family) and geographically close (neighbors) others who have rooftop solar panels will affect norm expectations regarding how much others approve of solar panels and battery storage and expectations about how personally beneficial those technologies are likely to be. We test our hypotheses using survey data collected from California homeowners and find partial support. We find evidence for the significance of socially close others (rather than neighbors), highlighting the importance of identifying the appropriate reference groups when studying norms. Our results also provide insight into how one category of behavior (adoption of solar panels) can influence norm expectations about another less visible behavior (battery storage), suggesting a mechanism that may contribute to norms regulating private behaviors.
Starting Pitch Selection is Precise in Exploratory Study of Collegiate Nonmusic Majors
Authors: Nichols Bryan E. , Liu Annie
Published: August 2021

Starting pitch selection—whether intentional or habitual or otherwise— has been theorized to vary according to multiple variables. The purpose of this study was to explore starting pitch selection in undergraduate nonmusic major singers by using four well known songs and nonsinging tasks. Participants were actively singing in a college choir and majoring in fields outside of music. Performances indicated very small deviations in the median starting pitch for each criterion song (100–200 cents). Data indicated discrimination in starting pitch selection between songs. Active singers may place songs in the middle portion of the vocal range compared with the tendency toward lower range in nonsingers in previous research. A history of voice lessons was significantly associated with a positive response to a follow-up questionnaire item “I chose an intentional range for my voice.”
Neutrophil HIF-1α stabilization is augmented by mitochondrial ROS produced via the glycerol 3-phosphate shuttle
Authors: Willson Joseph A. , Arienti Simone , Sadiku Pranvera , Reyes Leila , Coelho Patricia , Morrison Tyler , Rinaldi Giulia , Dockrell David H. , Whyte Moira K. B. , Walmsley Sarah R.
Published: August 2021

Neutrophils are predominantly glycolytic cells that derive little ATP from oxidative phosphorylation; however, they possess an extensive mitochondrial network and maintain a mitochondrial membrane potential. Although studies have shown neutrophils need their mitochondria to undergo apoptosis and regulate NETosis, the metabolic role of the respiratory chain in these highly glycolytic cells is still unclear. Recent studies have expanded on the role of reactive oxygen species (ROS) released from the mitochondria as intracellular signaling molecules. Our study shows that neutrophils can use their mitochondria to generate ROS and that mitochondrial ROS release is increased in hypoxic conditions. This is needed for the stabilization of a high level of the critical hypoxic response factor and pro-survival protein HIF-1α in hypoxia. Further, we demonstrate that neutrophils use the glycerol 3-phosphate pathway as a way of directly regulating mitochondrial function through glycolysis, specifically to maintain polarized mitochondria and produce ROS. This illustrates an additional pathway by which neutrophils can regulate HIF-1α stability and will therefore be an important consideration when looking for treatments of inflammatory conditions in which HIF-1α activation and neutrophil persistence at the site of inflammation are linked to disease severity.