bluuebunny/crossref_metadata_2025 huggingface dataset:
Prescribing – a worldwide survey on governance
Authors: Adhiyaman Vedamurthy , Chattopadhyay Indrajit , Hobson Peter
Published: January 2023

Purpose of the study

To explore the governance regarding prescribing across the world.

Study design

We used a web-based questionnaire to ask the doctors about their prescribing practices and perception of governance in relation to prescribing. We sent the questionnaire to all doctors working in our hospital and primarily targeted doctors who had acquired their medical qualifications outside the UK to get a global view.

Results

We received 139 responses describing prescribing practices from 40 countries. More than 50% of doctors said there is no restriction in prescribing for themselves and their relatives. A third of them said that they could even prescribe controlled drugs without any restriction. 56% said that one doesn’t need a prescription to get antibiotics. When analysed by countries, 80% said that they could self-prescribe and in 50% of the countries, one could get antibiotics without a prescription.

Conclusions

In many countries there is poor governance with regards to prescribing. This is due to a lack of restrictions on prescribing (both self-prescribing and for friends/family) and the public’s ability to obtain antibiotics and controlled drugs.
Fatalistic Beliefs, Cultural Beliefs and Socio-Instrumental Control Beliefs: What are the Links? Can We Speak of an Active Fatalism?
Authors: Ngueutsa Robert , Tchagneno Charles L. , Wassouo Emmanuel , Kouabenan Dongo Rémi
Published: January 2023

Taking into account beliefs and culture is essential in behaviour analysis in various areas of life and work. However, knowledge about the links between these beliefs is sparse and imprecise. This article analyses the links between fatalistic, cultural and socio-instrumental control beliefs, by a questionnaire on a sample of 515 Cameroonian partcipants including male ( N = 290) and female ( N = 225), workers from the public ( N = 208), formal private ( N = 265) and informal ( N = 40) sectors. The questionnaire consisted of the fatalism scale designed by Kouabenan (1998), the Cameroonian cultural beliefs scale by Ngueutsa et al. (2021), and the socio-instrumental control beliefs scale derived from Spector (2004). Regression analyses showed that cultural beliefs partially mediated the link between fatalistic and socio-instrumental control beliefs. The results call into question the conceptualization of fatalistic beliefs, often seen as inducers of passivity. They suggest that cultural beliefs and practices may activate a ‘non-inhibiting’ form of fatalism that would justify the use of cultural entities to exercise indirect control over events. The concept of active fatalism is discussed.
Patterns of onwards migration within the urban hierarchy of China: Who moves up and who moves down?
Authors: Wang Jiejing , Mai Xin , Zhang Lizheng
Published: January 2023

This paper examines onwards migration patterns and the factors that influence them in urban China. In contradiction to Ravenstein’s laws of step migration, we argue that movement up the urban hierarchy does not dominate onwards migration in the Chinese context. Using the 2017 China Migrants Dynamic Survey, we model how past migratory experiences intersect with migrants’ demographic and socio-economic characteristics to explain the stay-versus-move decision and who moves up as well as who moves down within China’s urban hierarchy. The general pattern of China’s domestic migration is a movement up the urban hierarchy in the first migration and a movement down in onwards migration. We identify a transition-levels effect whereby the larger the difference between the hukou-registered place and the first migration city in the urban hierarchy, the greater the probability of onwards migration, with the effect manifesting most strongly for less-educated, mid-age (the 1970s and 1980s birth cohorts) migrants with rural origins. As to onwards migration direction, mixed results were found for migrants’ demographic and socio-economic characteristics whereas educational level and the transition-levels effect are both highly predictive of movement up and down the urban hierarchy. Our findings suggest that ‘jumping too high’ in previous migration(s) predicts a greater likelihood of moving down the urban hierarchy in response to insurmountable obstacles to settling in cities classified as large and above. Our research advances migration scholarship by considering the multipolar nature of onwards migration and offering an integrated approach to analysis that foregrounds the causes and effects of multiple-step migration.
How Slack Facilitates Communication and Collaboration in Seminars and Project-Based Courses
Authors: Müller Stefan
Published: January 2023

Lectures and seminars increasingly strive for continuous interactions between learners and the instructor. I study whether the communication program Slack contributes to these goals by analyzing daily activity statistics in methodological and project-based postgraduate courses at an Irish university. Both semester-long courses were taught online during the coronavirus pandemic (Covid-19) and in person. The quantitative analysis reveals three insights. First, students are active on Slack throughout the term. Second, students post messages in public channels and extensively use private channels and direct messages. Third, many students follow the conversations, ensuring transparent and fair communication between students and instructors. Open-ended responses suggest that Slack created “team spirit.” I conclude with five recommendations: students should sign up in the first week of term; create channels for different aspects of the module; explain when students can expect a response; encourage private conversations between students; and monitor activities regularly.
Overcoming Obstacles by Enacting Resilience: How Queer Adolescents Respond to Being Estranged From Their Parents
Authors: Scharp Kristina M. , Alvarez Cimmiaron F. , Wolfe Brooke H. , Lannutti Pamela J. , Bryant Leah E.
Published: January 2023

Queer adolescents experience compounding complications especially when they are estranged from their parents. Findings from a sample of 40 estranged queer adolescents revealed four triggers, five resilience processes, and three co-occurring relationships between the triggers and processes. Based on these findings, we advance the communication theory of resilience by (a) illustrating resilience enactments with an adolescent population, (b) introducing a new facet of putting alternative logics to work, and (c) arguing how access to LGBTQ+ vocabulary and embeddedness within the LGBTQ+ community can facilitate more and less resilient enactments. We also extend a new qualitative method, thematic co-occurrence analysis, to illuminate thematic ubiquity and inverse relationships between themes. Practical applications for primary/secondary school curriculum, counselors, and public policy are discussed.
A Comparative Study of Military Communication on Instagram: A Research Note
Authors: López-Rodríguez Guillermo , Castillo-Eslava Francisco
Published: January 2023

Military organizations have adapted to the logic and dynamics of social media to transmit their institutional narratives. Instagram is the most popular social network, but one of the most understudied in relation to the Armed Forces. This research note presents a comparative study of the content of the official accounts of the Spanish, French, the United States, Israeli, and Australian armies throughout 2021 ( n = 1,922). The specific objectives are to describe and analyze the hashtags, the accounts mentioned, and the main topics of the post. Results show that armies can convey multiple messages in a single post, and reveal that armies make similar use of Instagram, notwithstanding the various differences between Israel and the other armies due to organizational and contextual elements.
Accountability Pressure and Intraorganizational Dynamics in Japan’s Public Procurement
Authors: Nakanishi Yoshinobu
Published: January 2023

Public accountability may involve dysfunction. However, few empirical studies explain when and how external accountability pressure and subsequent intraorganizational dynamics cause dysfunctions. To bridge this gap, using a case study method, we examined Japan’s public procurement after a series of scandals, focusing on the procurers’ cognition and behavior. First, we found that an administrative unit in a ministry leverages external pressure to enhance its power within the organization. Second, we identified bias toward procedural accountability rather than product accountability. Third, we noted the paradox that the excessive pursuit of procedural accountability undermines not only product accountability, but also procedural accountability.
Design and analysis of higher-order repetitive sliding mode controller for uncertain linear systems with time-varying periodic disturbances
Authors: Kurniawan Edi , Wang Hai , Septanto Harry , Adinanta Hendra , Suryadi Suryadi , Pratomo Hari , Hanto Dwi
Published: January 2023

In this article, a discrete-time design of higher-order repetitive sliding mode controller (HO-RSMC) for uncertain linear systems with time-varying periodic disturbances is presented. In the design, a higher-order repetitive control (HORC) is employed to significantly suppress the periodic exogenous disturbance with period variation. The HORC-based control system offers a slow transient response due to the multiple control delays. Moreover, since the system stability is easily affected by model uncertainties, an output-feedback sliding mode controller (SMC) is added to overcome the shortcomings of HORC. Stability analysis of the resulting closed-loop system is rigorously provided. The simulation results and comparison studies confirm the effectiveness and good performance of the proposed design.
A study of the cell morphology and mechanical properties of bumper material PP-T-EPDM composite foam
Authors: Yetgin Salih Hakan , Unal Hüseyin
Published: January 2023

In this study, cellular polypropylene based composite foams were prepared using an universal injection moulding machine. The chemical foaming agent was added to neat polypropylene (PP) polymer, talc filled polypropylene (PP-T) composite and talc filled polypropylene/ethylene-propylene-diene blend (PP-T-EPDM) composite materials at the ratio of 1% and 2% by weight. The influence of foaming agent content on the mechanical and cellular properties of both neat PP polymer and PP composites was investigated. The results showed that the tensile strength, tensile modulus, impact strength, hardness, cell diameter, foam density and viscosity values and skin layer thickness decreased while volume expansion ratio increased with the increment in chemical blowing agent content.
Scientific communication of east Asian countries on internet of things (IoT): A performance evaluation based on scientometric tools
Authors: Basumatary Bwsrang , Yuvaraj Mayank , Verma Manoj Kumar
Published: January 2023

In the twenty-first century, the Internet of Things (IoT) is rapidly becoming one of the most influential technologies that connect billions of devices to the Internet. The importance and rapid growth of IoT technology make it an undeniably significant area of study in the contemporary world. This study evaluates the performance and research trends of East Asian countries in the area of Internet of Things (IoT) using scientometric tools. This paper collected 1146 data from Scopus over a period of 5 years (2016–2020). MS Excel, VOSviewer, and Biblioshiny were used to analyze the data using various Scientometric indicators. Cluster analysis and network visualization techniques are employed to evaluate the data and results are presented in tables and graphs. The finding shows that the topic has been exponential growth in recent years. China continues to top the IoT research rankings. The joint author contributed the most publications, and “Electronics (Switzerland)” is the most preferred journal for publication, followed by IEEE journals. In addition, the study found significant growth in smart environments such as “smart factories,” “machine learning,” “smart cities,” “wireless sensor networks,” “blockchains,” etc., which pose significant concerns for many researchers. The study concludes with recommendations for future research.
Taught in America I: How Does an American Planning Education Serve Mainland Chinese Students?
Authors: Shi Linda , Chiu-Shee Colleen
Published: January 2023

American planning schools increasingly emphasize the global dimensions of planning pedagogy while also increasing enrollment from international students. However, few studies have examined how an American planning education serves the career development of international students, particularly those who return home. This study responds by exploring the experiences of students from mainland China who obtained a U.S. planning degree and then returned to work in China. Interviews with returnees highlight their struggles both in the United States and back home. Their experiences suggest opportunities to improve American planning schools’ pedagogy and services for Chinese and other students, domestic or international.
A new SysML profile for autonomous mobile robots development: ROS2ML
Authors: Guizani Amir , Aloui Khalil , Hammadi Moncef , Soriano Thierry , Haddar Mohamed
Published: January 2023

For a long time, designing complex systems has been a difficult task for designers. Traditionally, it requires physical meetings between the different stakeholders of the system, which is more time-consuming and costly. However, this method faces difficulties when dealing with large and complex design problems. Today, researchers have started to propose several approaches and methodologies to simplify the design of complex systems such as autonomous mobile robots (AMRs). But they have been confronted with hardware and software design challenges that provoke further research in this robotic field and suggest possible solutions.

In this work, we present a new integrated design approach for AMRs based on a new SysML profile (Systems Modeling Language) developed using DSL (Domain Specific Language) to include Robot Operating System (ROS2) objects and attributes. We called the new SysML profile ROS2ML. Indeed, the standard SysML diagrams have a general purpose use, they are applied to any system without specifying the way to simulate, integrate code and implement a robot on a ROS2 platform. Therefore, the new SysML profile is developed specifically for ROS2 concepts to facilitate the robotic systems integration. This new SysML profile (ROS2ML) guides the AMR developers through the design process up to the simulation of the robotic system on the ROS2 platform and the final implementation of the system. A case study was used to illustrate and confirm the effectiveness of the proposed methodology for the design of an AMR. The case study shows that the new ROS2ML profile allows robot designers, with different skills and objectives, to work together on several views, with a convention adapted to ROS2 specialists, while maintaining consistency between all views, with the aim of achieving functional, physical and software integration.
Why low-income people leave state housing in South Africa: progress, failure or temporary setback?
Authors: Beier Raffael
Published: January 2023

The delivery of houses for homeownership to low-income urban dwellers has been a cornerstone of post-apartheid policies fighting both land and socioeconomic inequalities in South Africa. In this context, policy stakeholders and scholars have been puzzled by housing beneficiaries who leave their state houses, either selling or letting them. On the one hand, this might signal upward mobility where “leavers” successfully integrate into the housing market, climbing the next rung of the “property ladder”. On the other, it could indicate that “leavers” cannot afford to stay in their state houses and are consequently displaced to worse living conditions. However, due to methodological challenges, research on the experiences and perspectives of “leavers” is scarce. Based on narrative interviews with “leavers”, this article questions the progress/failure dichotomy. Instead, it argues that “leaving” could be construed as people-led reconfigurations of pro-poor housing policy – representing alternative, individually adapted but partly constrained pathways towards inclusion, 25 years after the end of apartheid.
Long-run impact of coal usage decline on CO2 emissions and economic growth: Evidence from disaggregated energy consumption perspective for China and India by dynamic ARDL simulations
Authors: Kartal Mustafa Tevfik , Kılıç Depren Serpil , Ali Uzair , Nurgazina Zhanar
Published: January 2023

This study examines the long-run impact of coal usage decline from a disaggregated energy consumption perspective by considering the role of coal usage on carbon dioxide (CO2) emissions and economic growth. For this purpose, the study focuses on China and India as the leading coal-user countries; considers coal, oil, natural gas, and renewable energy consumption as explanatory variables; uses yearly data from 1990 to 2021, and applies a novel dynamic autoregressive distributed lag (DYNARDL) simulations. Also, the Kernel-based regularized least squares (KRLS) approach is performed for robustness checks. The outcomes show that (i) there is cointegration between coal usage and CO2 emissions, and between coal usage and economic growth in the long run; (ii) coal usage is the most important indicator among explanatory variables; (iii) coal usage has a statistically significant impact on CO2 emissions in both China and India; (iv) however, coal usage is not significantly effective on economic growth for both China and India based on DYNARDL simulations; (v) negative counterfactual shocks in coal usage have a decreasing impact on CO2 emissions; (vi) KRLS results show that coal usage has a causal impact on CO2 emissions and the results of the DYNARDL simulations are robust. Hence, counterfactual shocks present important insights about the future impacts of coal usage decline on both CO2 emissions and economic growth. Based on the empirical results, policy implications, such as decreasing the amount of coal usage on and increasing the amount of alternative energy sources in the total energy mix, are also proposed.
Distressing Deathbed Visions: Rare, Misunderstood, or Underreported?
Authors: Claxton-Oldfield Stephen
Published: January 2023

Studies reporting distressing deathbed visions (DBVs) are reviewed to determine whether these experiences are rare, misunderstood, or underreported. Possible explanations for distressing DBVs are explored and possible reasons why distressing DBVs might be underreported are offered. Given the paucity of information on distressing DBVs, more research is needed to determine their prevalence, types, meaning, and impact on dying persons and their families.
Surgical Treatment of Pancreatic Cancer: Currently Debated Topics on Vascular Resection
Authors: Pedrazzoli Sergio
Published: January 2023

Vascular resections involving the superior mesenteric and portal veins (SMV-PV), celiac axis (CA), superior mesenteric artery (SMA) and hepatic artery (HA) have multiplied in recent years, raising the resection rate for pancreatic cancer (PDAC) and the related morbidity and mortality rates. While resection is generally accepted for resectable SMV-PV, the usefulness of associated arterial resection in borderline resectable (BRPC) and locally-advanced PDAC (LAPC) is much debated. Careful selection of splenic vein reconstruction is very important to prevent left-sided portal hypertension (LSPH). During distal pancreatectomy (DP), CA and common HA resection is largely accepted, while there is debate on the value of SMA and proper HA resection and reconstruction. Their resection is useless according to several reviews and meta-analyses, and some international societies, although some high-volume centers have reported good results. Short- and long-term reconstructed vessel patency varies with the type of reconstruction, the material used, and the surgeon’s experience. Laparoscopic and robotic pancreaticoduodenectomy and DP are generally accepted if done by surgeons performing at least 10 such procedures annually. The usefulness of associated vascular resection remains highly controversial. Surgeons need to complete numerous minimally-invasive procedures to overcome the learning curve, and prevent an increase in complications and surgical mortality. Higher resectability rates and satisfactory long-term results have been reported after neoadjuvant therapy (NAT) for BRPC and LAPC requiring vascular resection. It is essential to select the most appropriate NAT for a given patient and to assess PDAC resectability preoperatively.
How We Understand Others: A Theory of How Social Perspective Taking Unfolds
Authors: Gehlbach Hunter , Mu Nan
Published: January 2023

Social perspective taking—the process through which perceivers discern the thoughts, feelings, and motivations of a target—is foundational for navigating social interactions, building relationships, maintaining mental health, promoting well-being, and a wide array of other desired outcomes. Despite its importance, little is known about how discrete social perspective taking attempts unfold. We propose a theory that the social perspective taking process consists of up to four distinguishable phases: perception of the target, motivation to engage in social perspective taking, strategy selection, and evaluation of the attempt. Scholars have emphasized two proximal outcomes of this process—social perspective taking effort and accuracy. We review the literature in support of these phases, noting the relative maturity of each area of research. In doing so, we hope this theory provides a framework for contextualizing how existing studies relate to one another across different subfields of psychology, facilitates testable predictions, prioritizes future investigations, and guides applied research designed to improve real-world social perspective taking.
The Mechanistic Rewards of Data and Theory Integration for Theory-Based Evaluation
Authors: Matta Corrado , Lindvall Jannika , Ryve Andreas
Published: January 2023

In this article, we discuss the methodological implications of data and theory integration for Theory-Based Evaluation (TBE). TBE is a family of approaches to program evaluation that use program theories as instruments to answer questions about whether, how, and why a program works. Some of the groundwork about TBE has expressed the idea that a proper program theory should specify the intervening mechanisms underlying the program outcome. In the present article, we discuss in what way data and theory integration can help evaluators in constructing and refining mechanistic program theories. The paper argues that a mechanism is both a network of entities and activities and a network of counterfactual relations. Furthermore, we argue that although data integration typically provides information about different parts of a program, it is the integration of theory that provides the most important mechanistic insights.
Supracapsular scleral sutured intraocular lens implantation in anterior segment dysgenesis patients with ectopia lentis
Authors: Chen Tian-Hui , Song Ling-hao , Jiang Lei , zhao Ye , Liu Yan , Qian Dong-jin , Chen Ze-xu , Jiang Yong-Xiang
Published: January 2023

Objective

To describe a new strategy to manage ectopia lentis in ASD patients assessing the visual outcomes and safety of supracapsular scleral sutured intraocular lens implantation and analyzing the accuracy of different intraocular lens (IOL) power calculation formulae.

Methods

Eight patients with ASD (13 eyes) were underwent supracapsular scleral suture fixation of posterior chamber (PC) IOL without capsular extirpation. The preoperative and postoperative clinical features were compared. The prediction error values from four formulae (SRK/T, Holladay 1, Hoffer Q, Haigis), with or without Wang-Koch (WK) adjustment, were calculated for the cases.

Results

Zonulodialysis and premature cataracts could be the main reason for the decreased vision in patients with ASD. There was a significant improvement in best corrected visual acuity on 3-month follow-up after applying supracapsular scleral suture fixation of PC IOL. The prediction errors of the different formulae showed a slight tendency towards postoperative myopia. The Haigis formula with WK adjustment showed the best performance.

Conclusions

Supracapsular scleral suture fixation of IOLs for retaining the capsule-zonule barrier is a good option for ASD patients. The Haigis formula is recommended for ASD patients treated with supracapsular scleral suture fixation of IOLs. The predicted IOL power should be reduced based on the effect of the new anatomic position of the IOL to achieve a satisfactory visual outcome.
Scaling in a post-growth era: Learning from Social Agricultural Cooperatives
Authors: Colombo Laura A , Bailey Adrian R , Gomes Marcus VP
Published: January 2023

It has become normative in organization and management studies literature to consider scaling as a synonym for organizational growth. Scaling is typically understood as scaling-up. This article demonstrates that, in the context of post-growth organizations, scaling involves a more complex set of dynamics. Directing scholarly attention to scaling in the context of Italian Social Agricultural Cooperatives (i.e. organizations that hold a different rationale and modus operandi from the capitalist enterprise), this research contributes to the literature on scaling the impact of post-growth organizations by identifying nine different scaling routes: organizational growth (vertical and horizontal); organizational downscaling; impact on policies; multiplication; impact on organizational culture; impact on societal culture; aggregation; and diffusion. This article demonstrates that post-growth scaling: (1) requires the synergistic interaction of different strategies; (2) focuses on impacting societal culture; (3) does not necessarily require organizational growth; and (4) is a relational process, embedded in socio-ecological systems. The typology presented in this article empowers post-growth organizations to become more aware of different available scaling routes, unlocking their transformative potential and supporting the transition towards a post-growth future, in which the goal of economics is the pursuit of human and ecological flourishing.
Deep gray matter substructure volumes and depressive symptoms in a large multiple sclerosis cohort
Authors: Hu Chen , Dewey Blake E , Mowry Ellen M , Fitzgerald Kathryn C
Published: January 2023

Background

Consistent findings on underlying brain features or specific structural atrophy patterns contributing to depression in multiple sclerosis (MS) are limited.

Objective

To investigate how deep gray matter (DGM) features predict depressive symptom trajectories in MS patients.

Methods

We used data from the MS Partners Advancing Technology and Health Solutions (MS PATHS) network in which standardized patient information and outcomes are collected. We performed whole-brain segmentation using SLANT-CRUISE. We assessed if DGM structures were associated with elevated depressive symptoms over follow-up and with depressive symptom phenotypes.

Results

We included 3844 participants (average age: 46.05 ± 11.83 years; 72.7% female) of whom 1905 (49.5%) experienced ⩾1 periods of elevated depressive symptoms over 2.6 ± 0.9 years mean follow-up. Higher caudate, putamen, accumbens, ventral diencephalon, thalamus, and amygdala volumes were associated with lower odds of elevated depressive symptoms over follow-up (odds ratio (OR) range per 1 SD (standard deviation) increase in volume: 0.88–0.94). For example, a 1 SD increase in accumbens or caudate volume was associated with 12% or 10% respective lower odds of having a period of elevated depressive symptoms over follow-up (for accumbens: OR: 0.88; 95% confidence interval (CI): 0.83–0.93; p < 0.001; for caudate: OR: 0.90; 95% CI: 0.85–0.96; p = 0.003).

Conclusion

Lower DGM volumes were associated with depressive symptom trajectories in MS.
Corpus callosum involvement in MOG antibody-associated disease in comparison to AQP4-IgG-seropositive neuromyelitis optica spectrum disorder and multiple sclerosis
Authors: Chia Nicholas H , Redenbaugh Vyanka , Chen John J , Pittock Sean J , Flanagan Eoin P
Published: January 2023

Background:

Data on corpus callosum involvement in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are limited.

Objective:

The objective of the study was to compare callosal lesions in MOGAD, multiple sclerosis (MS), and aquaporin-4-IgG positive neuromyelitis optica spectrum disorder (AQP4+NMOSD).

Results:

Callosal lesion frequency was similar in MOGAD (38/171 (22%)), MS (24/72 (33%)), and AQP4+NMOSD (18/63 (29%)). Clinical phenotypes included encephalopathy (47%) and focal supratentorial (21%) or infratentorial (45%) deficits. None had callosal-disconnection syndromes. Maximal callosal-T2-lesion diameter (median (range)) in millimeter was similar in MOGAD (21 (4–77)) and AQP4+NMOSD (22 (5–49); p = 0.93) but greater than in MS (10.5 (2–64)). Extracallosal extension (21/38 (55%)) and T2-lesion resolution (19/34 (56%)) favored MOGAD.

Conclusions:

Despite similar frequency and imaging overlap, larger lesions, sagittal midline involvement, and lesion resolution favored MOGAD.
Gestalt therapy, mundane phenomenology, and yoga philosophy: An integrated praxis in psychology
Authors: Mendonça Bruna Improta de Oliveira , Coutinho Denise Maria Barreto , Chaudhary Nandita
Published: January 2023

This inquiry proposes a theoretical-conceptual dialogue between Yoga and the philosophical bases of Gestalt therapy and mundane phenomenology. By expanding the gestaltic framework, we can better comprehend points of convergence and divergence between its theory and practice, vis-à-vis mundane phenomenology and Yoga philosophy. We posit that Yoga can offer to Gestalt therapy and phenomenology a broader perspective on contemplative somatic praxis. Conversely, phenomenology and the gestaltic approach can provide solid ground for an articulation with Yoga philosophy.
Why developers matter: The case of patient portals
Authors: Sergeeva Anastasia V.
Published: January 2023

Existing studies on patient data portals are informative with respect to the patient and physician perspectives, yet relatively little attention has been paid to the role of developers. This case study focuses on how developers view the meaning and purpose of patient portals and how their perspective differs from that of physicians. The findings show that developers and physicians have different views on whether and how the portals can help achieve transparency, efficiency, and patient empowerment. This misalignment emerges because each group makes sense of the portal through a different frame of how they see patient data, medical work, and patient behavior. The study also finds that developers cope with the frame differences by engaging in practices of coproducing, bypassing, and reframing. The implication of the study is that technological frame analysis needs to incorporate the growing complexity and institutional character of modern technology, the diversity of target groups it serves, and their corresponding frames. The study also suggests that developers, instead of being seen as mere operational IT support, may need to be seen as strategically important actor groups for healthcare organizations—since their practices matter for the strategic agenda of transforming healthcare into a more patient-centric practice.
New Life for a Legacy: The La Verne Historical Society and Inman Conety’s 1938 International Truck
Authors: Jenkins Benjamin , Best Sherry
Published: January 2023

In La Verne, California, a suburb of Los Angeles, residents have partnered with the town’s historical society to rebuild an important item from that organization’s collections: a 1938 International truck. Driven for decades by longtime La Verne resident Inman Conety, this automobile has logged over 900,000 miles since the early-twentieth century. As an expression of the collective identity of La Verne, the International has served the community as a recycling vehicle and supported civic pride with appearances in Fourth of July parades. The La Verne Historical Society recently launched a campaign to fund reconstruction of the vehicle, with the goal of returning it to the Fourth of July parade and affirming the truck’s status as a historical artifact with deep ties to the community. The 1938 International expresses the centrality of community support to the La Verne Historical Society’s collections.
Low-Grade Fibromyxoid Sarcoma of the Distal Upper Extremity: A Systematic Review
Authors: Kim Minji , Policherla Rohan K. , Linhares Samantha M. , Hui-Chou Helen G.
Published: January 2023

Background:

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue tumor that usually occurs in the proximal extremities and trunk. The purpose of this systematic review was to assess patient demographics, treatment approach, and outcomes for patients with LGFMS of the distal upper extremity.

Methods:

We performed a literature review of case reports and patient reports of LGFMS using Medical Literature Analysis and Retrieval System Online (MEDLINE) and PubMed. Inclusion criteria included case reports and case series of patients with LGFMS of the distal upper extremity. Animal studies, comments, and non-English publications were excluded. Data on available patient demographics, treatment regimen, recurrence, and metastasis were collected.

Results:

A total of 365 publications were reviewed. After applying the inclusion and exclusion criteria, 19 articles were included. There were 24 unique patients with LGFMS of the distal upper extremity. The median age was 32 years, and most patients were treated with a surgical excision. Of the 15 reported outcomes, 4 patients had local recurrences, and no patient had metastases or died due to the tumor.

Conclusions:

Although LGFMS of the distal upper extremity is less common, it is critical for surgeons to consider it as a differential. The current approach is a wide excision with negative margins, and chemotherapy or radiotherapy may not be necessary. We found decreased proportions of local recurrence and metastases in the distal upper extremity compared with other anatomical regions. We recommend that surgeons follow up with their patients indefinitely given the slow mitotic rate of LGFMS.
Diagnostic yield of cerebral angiography for intracranial hemorrhage in young patients: A single-center retrospective analysis
Authors: El-Abtah Mohamed E , Kashkoush Ahmed , Achey Rebecca , Patterson Thomas , Moore Nina Z , Bain Mark D
Published: January 2023

Background

Intracranial hemorrhage (ICH) secondary to hypertension (HTN) classically occurs in the basal ganglia, cerebellum, or pons. Vascular lesions such as aneurysms or arteriovenous malformations (AVMs) are more common in younger patients. We investigated the utility of diagnostic subtraction angiography (DSA) in young hypertensive patients with non-lobar ICH.

Methods

A retrospective review (2013–2022) identified young (18–60 years) patients who underwent DSA for ICH. HTN history, ICH location, presence/absence of subarachnoid hemorrhage (SAH), and computed tomography angiography (CTA) findings were collected. The main outcome was DSA-positivity, defined as presence of an AVM, aneurysm, Moyamoya disease, reversible cerebral vasoconstriction syndrome, or dural arteriovenous fistula on DSA.

Results

Two hundred sixty patients were included, and the DSA-positivity rate was 19%. DSA-positivity was lower in hypertensive patients with ICHs in the cerebellum, pons, or basal ganglia compared to the rest of the patient sample (9% vs 26%, p = 0.0002, Fisher's exact test). We developed the ICH-Angio score (0–5 points) based on CTA findings, ICH location, HTN history, and presence of SAH to predict risk of underlying vascular lesions. DSA-positivity was lower in those with a score of 0 (0/62; 0%) compared to a score of 1 (5/52; 10%), 2 (17/48; 35%), 3 (10/20; 50%), 4 (5/6; 83%), or 5 (3/3; 100%).

Conclusion

The ICH-Angio score was able to non-invasively rule out an underlying vascular etiology for ICH in up to one-third of patients. HTN, ICH location, CTA findings, and associated SAH can identify patients at low risk for harboring underlying vascular lesions.
Long-term outcomes of thoracic endovascular aortic repair for chronic Stanford type B aortic dissection
Authors: Hong Xiang , Lin Yue , Xie Xinsehng , Huang Yulong , Chen Gang , Chen Yihui , Hong Shichai , Lu Weifeng , Fu Weiguo , Wang Lixin
Published: January 2023

Objectives

The aim of this study was to report the long-term outcomes of proximal thoracic endovascular aortic repair (TEVAR) for chronic Stanford type B aortic dissection (cTBAD).

Methods

We retrospectively analyzed the clinical data of 48 cases of patients with cTBAD who underwent proximal TEVAR in Zhongshan Hospital Fudan University from January 2010 to September 2013. The preoperative and postoperative imaging examinations, overall survival rate, aortic-related survival rate, and freedom from reintervention rate data were collected to evaluate aortic remodeling and clinical outcomes. The enrolled patients received follow-up at 1, 3, 6, and 12 months following treatment and annually thereafter.

Results

A total of 48 patients (mean age, 58.3 ± 10.6 years; men:women, 40:8) were included, of which 38 cases (79.2%) were uncomplicated dissection and 10 cases (20.8%) were complicated. The mean follow-up time was 48.7 ± 40 months (1–120 months). The mean time interval from the initial procedure to reintervention was 50.6 ± 32.7 months (11–98 months). The following changes were observed at preoperative versus last follow-up timepoints. Descending aortic level: true lumen, 19.2 ± 7.01 mm vs. 36.9 ± 9.53 mm ( p < 0.001); false lumen, 30.47 ± 15.89 mm vs. 19.16 ± 15.33 mm ( p < 0.001); maximum diameter, 49.67 ± 13.96 mm vs. 56.66 ± 14.95 mm ( p = 0.018). Diaphragm level: true lumen, 16.24 ± 5.41 mm vs. 24.41 ± 8.04 mm ( p < 0.001); false lumen, 12.37 ± 11.49 mm vs. 14.92 ± 12.25 mm ( p = 0.196); and maximum diameter, 34 ± 7.81 mm vs. 38.04 ± 7.7 mm ( p < 0.001). The freedom from reintervention rate was 81% in 5 years and 50.6% in 10 years. The overall 10-years survival rate was 83% (6 of 48), and the aortic-related survival rate was 92.3% (3 of 48).

Conclusions

TEVAR is a safe and effective proximal repair intervention for cTBAD that can reliably induce the positive remodeling of the descending aorta.
Struggling with L2 alphabet: The role of proficiency in orthographic learning
Authors: Fu Yang , Bermúdez-Margaretto Beatriz , Wang Huili , Tang Dong , Cuetos Fernando , Dominguez Alberto
Published: January 2023

The present study examined the process of L2 orthographic learning in bilinguals with distant L1–L2 orthographies. Chinese–English bilinguals with various English proficiency levels were trained with novel L2 words during a reading task. In contrast to higher proficient learners, those with lower L2 proficiency exhibited increased effects of length, frequency, and lexicality across exposures and at-chance recognition of trained words. Importantly, an additional post-training task assessing the lexical integration of trained words evidenced the engagement in different L1–L2 reading strategies across different levels of L2 proficiency, hence suggesting the L1 holistic processing at the base of the effortful establishment of L2 orthographic representations shown by lower-proficient learners. Overall, these findings indicate the role of L2 proficiency in the influence that cross-linguistic variation exerts on L2 orthographic learning and highlight the need for English education programmes to tackle specific grapheme-to-phoneme skills in non-alphabetic target communities.
Assessing biological maturity timing by MRI and coaches’ eye in elite youth soccer players: A comparison between objective and subjective diagnostics utilizing correlation and single case analyses
Authors: Leyhr Daniel , Murr Dennis , Romann Michael , Eichler Katrin , Basten Lajos , Hauser Thomas , Lüdin Dennis , Höner Oliver
Published: January 2023

The importance of considering information related to athletes’ biological maturation within talent identification and development processes is frequently emphasized by both sport scientists and practitioners. Although there is evidence for the use of objective diagnostics for assessing biological maturation, little is known about its subjective determinations by coaches. Such approaches are particularly relevant when scientific support is limited. Therefore, the current study aimed to compare a practical subjective approach (coaches’ eye) to assess biological maturity timing (BMT) with objective reference diagnostics (MRI). For this purpose, data were collected from 63 male elite soccer players of the U12 and U14 age group who were part of the German talent promotion program. Players’ BMT (i.e., skeletal – chronological age) was assessed by MRI and a subjective rating of two coaches. Data analyses revealed high-rank correlations ( rs = .55; p < .001) for the total sample as well as for U14 players ( rs = .65; p < .001) and moderate rank correlations for U12 players ( rs = .42; p < .05). Single case analyses showed substantial agreements between the diagnostics. However, particularly for U12 players, judgements did not always correspond with the MRI rankings. Although coaches seem to have the ability for recognizing the earliest and latest maturing players in the sample, inconsistencies exist in single cases, especially for players that were identified on-time by objective MRI diagnostics. Although utilizing subjective coach assessments as an alone-standing tool to assess a player's BMT is not recommended in applied practice, its use can be beneficial when applied in addition to common objective diagnostics or in circumstances where objective data are not available.
Intravenous thrombolysis in acute ischemic stroke after antagonization of unfractionated heparin with protamine: case series and systematic review of literature
Authors: Kneer Katharina , Adeyemi Adedolapo Kamaldeen , Sartor-Pfeiffer Jennifer , Wilke Vera , Blum Corinna , Ziemann Ulf , Poli Sven , Mengel Annerose , Feil Katharina
Published: January 2023

Background and aims:

Intravenous thrombolysis (IVT) is standard of care for disabling acute ischemic stroke (AIS) within a time window of ⩽ 4.5 h. Some AIS patients cannot be treated with IVT due to limiting contraindications, including heparin usage in an anticoagulating dose within the past 24 h or an elevated activated prothrombin time (aPTT) > 15 s. Protamine is a potent antidote to unfractionated heparin.

Objectives:

The objective of this study was to investigate the safety and efficacy of IVT in AIS patients after antagonization of unfractionated heparin with protamine.

Methods:

Patients from our stroke center (between January 2015 and September 2021) treated with IVT after heparin antagonization with protamine were analyzed. National Institutes of Health Stroke Scale (NIHSS) was used for stroke severity and modified Rankin Scale (mRS) for outcome assessment. Substantial neurological improvement was defined as the difference between admission and discharge NIHSS of ⩾8 or discharge NIHSS of ⩽1. Good outcome at follow-up after 3 months was defined as mRS 0–2. Safety data were obtained for mortality, symptomatic intracerebral hemorrhage (sICH), and for adverse events due to protamine. Second, a systematic review was performed searching PubMed and Scopus for studies and case reviews presenting AIS patients treated with IVT after heparin antagonization with protamine. The search was limited from January 1, 2011 to September 29, 2021. Furthermore, we conducted a propensity score matching comparing protamine-treated patients to a control IVT group without protamine (ratio 2:1, match tolerance 0.2).

Results:

A total of 16 patients, 5 treated in our hospital and 11 from literature, [65.2 ± 13.1 years, 37.5% female, median premorbid mRS (pmRS) 1 (IQR 1, 4)] treated with IVT after heparin antagonization using protamine were included and compared to 31 IVT patients [76.2 ± 10.9 years, 45% female, median pmRS 1 (IQR 0, 2)]. Substantial neurological improvement was evident in 68.8% of protamine-treated patients versus 38.7% of control patients ( p = 0.028). Good clinical outcome at follow-up was observed in 56.3% versus 58.1% of patients ( p = 0.576). No adverse events due to protamine were reported, one patient suffered sICH after secondary endovascular thrombectomy of large vessel occlusion. Mortality was 6.3% versus 22.6% ( p = 0.236).

Conclusion:

IVT after heparin antagonization with protamine seems to be safe and, prospectively, may extend the number of AIS patients who can benefit from reperfusion treatment using IVT. Further prospective registry trials would be helpful to further investigate the clinical applicability of heparin antagonization.
Evaluation of rAAVrh74 gene therapy vector seroprevalence by measurement of total binding antibodies in patients with Duchenne muscular dystrophy
Authors: Goedeker Natalie L. , Dharia Sachi D. , Griffin Danielle A. , Coy Jesantha , Truesdale Todd , Parikh Rajan , Whitehouse Kasen , Santra Sourav , Asher Damon R. , Zaidman Craig M.
Published: January 2023

Background:

Adeno-associated virus (AAV) vectors are a promising platform for in vivo transfer of transgenes designed to treat diseases. Pre-existing humoral immunity to these vectors can potentially impact the safety and efficacy of gene therapies. Consequently, individuals with pre-existing antibodies to the specific AAV serotypes used may be excluded from clinical trials and treatments. Recombinant AAV serotype rh74 (rAAVrh74), a vector originally isolated from rhesus monkeys and potentially less immunogenic than other serotypes isolated from humans (e.g. AAV2, AAV5, and AAV9), efficiently transduces muscle and is being investigated for use in gene therapy for Duchenne muscular dystrophy (DMD).

Objective:

To evaluate prevalence of total binding antibodies (neutralizing and non-neutralizing) against rAAVrh74 in patients with DMD.

Methods:

Eligible individuals ( N = 107) were ⩾ 4 to < 18 years old with genetically confirmed DMD and were excluded from the study if they lived with a person who had known exposure to rAAVrh74 or other gene transfer therapy, or if they received prior treatment with gene transfer therapy. A single blood sample was obtained from each participant, and anti-rAAVrh74 total binding antibodies were measured by enzyme-linked immunosorbent assay. Total binding antibody level < 1:400 was defined as not elevated or seronegative. Primary endpoint was the percentage of subjects with elevated total antibody titers to rAAVrh74.

Results:

A large preponderance (86.1%) of patients with DMD in this data set was seronegative for anti-rAAVrh74 total binding antibodies. These patients would potentially meet the antibody status eligibility criterion for entry into rAAVrh74-based gene therapy clinical trials.

Conclusion:

Measuring total binding antibodies is a more comprehensive approach to assess pre-existing immune response versus measuring neutralizing antibodies alone. The low seroprevalence of total binding antibodies against rAAVrh74 shown here supports the broad applicability of rAAVrh74-based gene transfer therapy for patients with DMD and potentially other neuromuscular diseases.