bluuebunny/crossref_metadata_2025 huggingface dataset:
Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than 40 Years: A Randomized Controlled Trial
Authors: Martin Scott D. , Abraham Paul F. , Varady Nathan H. , Nazal Mark R. , Conaway William , Quinlan Noah J. , Alpaugh Kyle
Published: March 2021

Background:

Previous observational studies have suggested poor results of arthroscopic surgery for the treatment of acetabular labral tears in patients older than 40 years.

Purpose:

To compare hip arthroscopy versus nonoperative management for symptomatic labral tears in patients older than 40 years who have limited radiographic osteoarthritis.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

In this single-surgeon, parallel randomized controlled trial, patients older than 40 years who had symptomatic, MRI-confirmed labral tears and limited radiographic osteoarthritis (Tönnis grades 0-2) were randomized 1:1 to arthroscopic surgery with postoperative physical therapy (SPT) or physical therapy alone (PTA) using an electronic randomization program. PTA patients who achieved unsatisfactory improvement were permitted to cross over to SPT after completing ≥14 weeks of physical therapy. The primary outcomes were International Hip Outcome Tool (iHOT-33) and modified Harris Hip Score (mHHS) at 12 months after randomization, and secondary outcomes included other patient-reported outcome measures and the visual analog scale. Outcomes were assessed at baseline and at 3, 6, and 12 months after randomization. Primary analysis was performed on an intention-to-treat basis using linear mixed-effect models. Sensitivity analyses included modified as-treated analysis and treatment-failure analysis. Due to infeasibility, patients and health care providers were both unblinded.

Results:

The study enrolled 90 patients (46 [51.1%] SPT; 44 [48.9%] PTA); of these, 81 patients (42 [51.9%] SPT; 39 (48.1%) PTA) completed 12-month follow-up. A total of 28 of the 44 PTA patients crossed over to SPT within the study period (63.6% crossover). Intention-to-treat analysis revealed significantly greater iHOT-33 scores (+12.11; P = .007) and mHHS scores (+6.99 points; P = .04) in the SPT group than the PTA group at 12 months. Modified as-treated analysis revealed that these differences exceeded the minimal clinically important difference of 10.0 points (SPT-PTA iHOT-33, +11.95) and 8.0 points (SPT-PTA mHHS, +9.76), respectively.

Conclusion:

In patients older than 40 years with limited osteoarthritis, arthroscopic acetabular labral repair with postoperative physical therapy led to better outcomes than physical therapy alone. Thus, age over 40 years should not be considered a contraindication to arthroscopic acetabular labral repair.

Registration:

NCT03909178 (ClinicalTrials.gov identifier)
Effect of Early Residual Laxity After Anterior Cruciate Ligament Reconstruction on Long-term Laxity, Graft Failure, Return to Sports, and Subjective Outcome at 25 Years
Authors: Lindanger Line , Strand Torbjørn , Mølster Anders Odd , Solheim Eirik , Inderhaug Eivind
Published: March 2021

Background:

In spite of supposedly successful surgery, slight residual knee laxity may be found at follow-up evaluations after anterior cruciate ligament reconstruction (ACLR), and its clinical effect is undetermined.

Purpose:

To investigate whether a 3- to 5-mm increase in anterior translation 6 months after ACLR affects the risk of graft failure, rate of return to sports, and long-term outcome.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

From a cohort of 234 soccer, team handball, and basketball players undergoing ACLR using bone–patellar tendon–bone graft, 151 athletes were included who attended 6-month follow-up that included KT-1000 arthrometer measures. A tight graft was defined as <3-mm side-to-side difference between knees (n = 129), a slightly loose graft as 3 to 5 mm (n = 20), and a loose graft as >5 mm (n = 2). Graft failure was defined as ACL revision surgery, >5-mm side-to-side difference, or anterolateral rotational instability 2+ or 3+ at 2-year follow-up. Finally, a 25-year evaluation was performed, including a clinical examination and questionnaires.

Results:

The rate of return to pivoting sports was 74% among athletes with tight grafts and 70% among those with slightly loose grafts. Also, return to preinjury level of sports was similar between those with slightly loose and tight grafts (40% vs 48%, respectively), but median duration of the sports career was longer among patients with tight grafts: 6 years (range, 1-25 years) vs 2 years (range, 1-15 years) ( P = .01). Five slightly loose grafts (28%) and 6 tight grafts (5%) were classified as failures after 2 years ( P = .002). Thirty percent (n = 6) of patients with slightly loose grafts and 6% (n = 8) with tight grafts had undergone revision ( P = .004) by follow-up (25 years, range, 22-30 years). Anterior translation was still increased among the slightly loose grafts as compared with tight grafts at long-term follow-up ( P < .05). In patients with tight grafts, 94% had a Lysholm score ≥84 after 24 months and 58% after 25 years, as opposed to 78% ( P = .02) and 33% ( P = .048), respectively, among patients with slightly loose grafts.

Conclusion:

A slightly loose graft at 6 months after ACLR increased the risk of later ACL revision surgery and/or graft failure, reduced the length of the athlete’s sports career, caused permanent increased anterior laxity, and led to an inferior Lysholm score.
Creating a Competency-Based Medical Education Curriculum for Canadian Diagnostic Radiology Residency (Queen’s Fundamental Innovations in Residency Education)-Part 2: Core of Discipline Stage
Authors: Mishra Siddharth , Chung Andrew , Rogoza Christina , Islam Omar , Mussari Benedetto , Wang Xi , Dagnone Damon , Cofie Nicholas , Dalgarno Nancy , Kwan Benjamin Y. M.
Published: March 2021

Purpose:

All postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) model divided into 4 stages of training. Queen’s University has been the first Canadian institution to mandate transitioning to CBME across all residency programs, including Diagnostic Radiology. This study describes the implementation of CBME with a focus on the third developmental stage, Core of Discipline, in the Diagnostic Radiology residency program at Queen’s University. We describe strategies applied and challenges encountered during the adoption and implementation process in order to inform the development of other CBME residency programs in Diagnostic Radiology.

Methods:

At Queen’s University, the Core of Discipline stage was developed using the Royal College of Physicians and Surgeons of Canada’s (RCPSC) competence continuum guidelines and the CanMEDS framework to create radiology-specific entrustable professional activities (EPAs) and milestones for assessment. New committees, administrative positions, and assessment strategies were created to develop these assessment guidelines. Currently, 2 cohorts of residents (n = 6) are enrolled in the Core of Discipline stage.

Results:

EPAs, milestones, and methods of evaluation for the Core of Discipline stage are described. Opportunities during implementation included tracking progress toward educational objectives and increased mentorship. Challenges included difficulty meeting procedural volume requirements, inconsistent procedural tracking, improving feedback mechanisms, and administrative burden.

Conclusion:

The transition to a competency-based curriculum in an academic Diagnostic Radiology residency program is significantly resource and time intensive. This report describes challenges faced in developing the Core of Discipline stage and potential solutions to facilitate this process.
Multi-response optimization of the actively driven rotary turning for energy efficiency, carbon emissions, and machining quality
Authors: Nguyen Trung-Thanh , Duong Quoc-Dung , Mia Mozammel
Published: March 2021

Boosting energy efficiency and machining quality are prominent solutions to achieve sustainable production for turning operations. In this work, a machining condition-based optimization has been performed to decrease the total specific energy (SEC), carbon emission (CE), and average roughness (AR) of the actively driven rotary turning (ADRT) process. The processing factors are the tool rotational speed (Tv), depth of cut (a), feed rate (fr), and workpiece speed (Wv). The turning experiments of the mold material labeled SKD11 have been conducted on a CNC lathe. The regression method is employed to develop comprehensive models of the total specific energy, carbon emissions, and average roughness. The entropy approach is then applied to drive out the weight value of each ADRT response. Finally, the non-dominated sorting particle swarm optimization (NSPSO) is utilized to determine the optimal parameters. The findings indicated that the optimal values of the Tv, a, fr, and Wv are 77 m/min, 0.32 mm, 0.25 mm/rev., and 128 m/min, respectively. The SEC, AR, and CE are decreased by 18.07%, 10.46%, and 5.02%, respectively, as compared to the initial approach. Moreover, the developed active rotary turning operation can be considered as an effective technical solution to boost the machining efficiency of hardened steels.
The Impact of COVID-19 on the Migrant Workers and Remittances Flow to Bangladesh
Authors: Chowdhury Mamta B , Chakraborty Minakshi
Published: March 2021

This study examines the impact of COVID-19 on the migrant workers and remittances flow to Bangladesh, the fastest growing South Asian country. Migrant workers have been playing an important role in propelling the economic activities of the country for a vast majority of the low-income population. Bangladesh is one of the major remittance recipient countries and earned US$21.8 billion in 2020. Over half a million workers from Bangladesh are employed in foreign countries annually, which eases the pressure on the domestic labour market considerably. However, the inflow of these enormous remittances has been encountered by various challenges including the ongoing COVID-19 pandemic, which has brought numerous adverse socio-economic impacts on the migrant workers. Policy recommendations suggest designing and implementing well-coordinated public–private migrant workers’ inclusive policies and creating a supportive environment for the returnee migrant workers to overcome this crisis. Initiating dialogues and negotiation with the employing countries to protect the jobs and workers’ rights can restore the employment and remittances during and after the pandemic, facilitate the expansion of the labour market across borders, and harness the valuable remittances for the overall welfare of the country.
Book review: Ashwini Tambe. 2019. Defining Girlhood in India: A Transnational History of Sexual Maturity Laws
Authors: Krishnan Sneha
Published: March 2021

Ashwini Tambe. 2019. Defining Girlhood in India: A Transnational History of Sexual Maturity Laws. University of Illinois Press. 218 pp., paperback, £19.99. ISBN: 978-0252084560.
Women-Led Businesses: An Ethnographic Study of Gendered Entrepreneurship in Gilgit-Baltistan, Pakistan
Authors: Dinar Humera
Published: March 2021

As a result of the growing global economy and a development model with entrepreneurialism at its heart, women in remote and high-mountain societies in Gilgit-Baltistan, the northernmost part of Pakistan, have begun to venture outside the traditional and gendered economies by embarking on new forms of income-generating activities. This ethnographic study of women entrepreneurs in Gilgit-Baltistan, Pakistan, provides a critical analysis of the promotion of women’s entrepreneurship as a key strategy by development organizations to address gender inequities. The ethnographic accounts of women’s diverse experiences as entrepreneurs featured in this article demonstrate that the neoliberal development model and the global capitalist market serve as an opportunity for women in these high-mountain communities that allows them to push against socio-cultural pressures. Within these environments, women strive to become economic actors and make space for themselves in conventionally male-dominated economic trades such as business and entrepreneurship. In contrast to the NGOs’ narratives that glorify women as entrepreneurs in uncontentious ways, my ethnographic research views women as complex subjectivities whose lived experiences are embedded within socio-economic, religious and political dimensions of notions of legitimacy that dictate women’s participation in public spaces. The ethnographic accounts in this article illustrate how women navigate, negotiate, contest and reproduce the patriarchal sovereignties and development regimes.
Prevalence of Congenital Hypothyroidism and G6PD Deficiency in Newborns in a Tertiary Care Hospital of Central India
Authors: Patel Suprava , Priya Ritu , Padhi Phalguni , Naik Tripty , Abraham Jessy , Nanda Rachita , Mohapatra Eli , Agrawal Sarita
Published: March 2021

Objectives:

The fundamental prerequisite of a screening program is the accessible epidemiological data regarding disease burden and awareness regarding the disorder. This is the foremost study in this state to estimate the burden of congenital hypothyroidism (CH) and glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency in infants born or attending a tertiary care hospital, pursuing skill development for the technical staffs, and creating awareness for parents.

Study Design:

A cross-sectional study for 21 months was conducted in the Department of Biochemistry in collaboration with the Department of Pediatrics and Department of Obstetrics and Gynecology.

Methods:

The screening was conducted on 1282 babies, 48 hours subsequent to birth and up to 8 weeks of age. The dried blood spot specimens collected were analyzed for thyroid stimulating hormone (TSH) level and G6PD enzyme activity by fluoroimmunoassay method. Prevalence was calculated by percentage.

Results:

The proficiency of the program for all live birth babies delivered in the institute was 94.6%. In consequence to improper sampling, 4.1% samples could not be analyzed. The screening tests reported elevated TSH levels in 1.6% of total population and G6PD enzyme deficiency in 2.6% of all babies enrolled. Confirmatory tests revealed that 4 (3.1/1000) babies were declared positive for CH and 8 (6.2/1000) were announced to be G6PD deficient.

Conclusion:

The new prevalence observed is one of the highest prevalence of CH published in India that urges mandatory and immediate need for development of newborn screening program in the state, and improvisation and upgradation of regional diagnostic center with facilities for primary- and secondary-level testing.
Alternative Public Spaces in Hybrid Media Environments: Dissent in High Uncertainty
Authors: Issawi Fatima el
Published: March 2021

Independent news websites and press played a vital role in creating spaces of contention in the context of the Moroccan pro-democracy movement of 2011. This article looks at the role of this press in disseminating alternative narratives in the hybrid media and political environment that followed the pro-democracy movement. Based on extensive interviews with journalists, this article examines journalists’ practices in countering hegemonic media and political discourse, to understand how they contribute to—or hinder—the formation of counter publics under tough repression. The article uses the critical frameworks of dominant and counter-publics and Judith Butler’s concept of silencing.
On the polar nature and invariance properties of a thermomechanical theory for continuum-on-continuum homogenization
Authors: Mandadapu Kranthi K , Abali B Emek , Papadopoulos Panayiotis
Published: March 2021

This paper makes a rigorous case for considering the continuum derived by the homogenization of extensive quantities as a polar medium in which the balances of angular momentum and energy contain contributions due to body couples and couple stresses defined in terms of the underlying microscopic state. The paper also addresses the question of invariance of macroscopic stress and heat flux and form-invariance of the macroscopic balance laws.
Experience with netarsudil 0.02% and latanoprostene bunod 0.024% as adjunctive therapy for glaucoma
Authors: Mehta Amy A , Kanu Levi N , Sood-Mendiratta Shalini , Quinones Richard , Hawkins Anjali , Lehrer Richard A , Malhotra Kiran , Papas Robert , Hillman David , Wilensky Jacob T , Aref Ahmad A , Vajaranant Thasarat Sutabutr , Edward Deepak P
Published: March 2021

Purpose:

To assess the effectiveness and safety of adjunctive topical netarsudil 0.02% and latanoprostene bunod 0.024% in patients with glaucoma.

Methods:

A retrospective, multi-center, cohort study of patients with glaucoma treated with netarsudil 0.02% or latanoprostene bunod from five tertiary care centers. Inclusion criteria included patients with glaucoma treated with either medication as adjunctive therapy. Outcomes included mean absolute intraocular pressure (IOP) reduction and relative IOP reduction from baseline. Adverse reactions and reasons for discontinuation were reported. One-way analysis of variance, Kruskal-Wallis rank sum test, and Mann Whitney U test compared the outcomes.

Results:

A total of 95 eyes (95 patients) on netarsudil and 41 eyes (41 patients) on latanoprostene bunod were analyzed. Mean duration of use was 54.3 ± 28 days for netarsudil and 82.9 ± 51.2 days for latanoprostene bunod. At the final visit, mean IOP reduction was 3.9 ± 4.6 mmHg (17.5 ± 6.0%) ( p < 0.0001) with netarsudil and 2.9 ± 3.7 mmHg (13.6 ± 16.3%) ( p < 0.0001) with latanoprostene bunod. IOP lowering did not depend on baseline number of IOP-lowering medications. The most common reason for discontinuation was non-effectiveness in both groups

Conclusion:

Similar to monotherapy, netarsudil and latanoprostene bunod demonstrated efficacy in lowering IOP when used as adjunctive therapy.
A CT-free protocol to treat osteoid osteoma of the hip region in childhood and adolescence by percutaneous drilling and by hip arthroscopy
Authors: Eberhardt Oliver , von Kalle Thekla , Matthis Rebecca , Doepner Richard , Wirth Thomas , Fernandez Francisco
Published: March 2021

Introduction:

It is often difficult to clinically and radiologically diagnose intra-articular osteoid osteomas and osteoid osteomas of the hip joint. Treatment can also be difficult due to complex locational relationships. CT-guided radiofrequency ablation is currently the standard form of treatment. In this paper we report on a minimally-invasive concept for treating osteoid osteomas near the hip joint in children and adolescents which does not involve using computed tomography.

Material and method:

10 patients with an average age of 12.1 years underwent treatment for osteoid osteomas in the hip joint region. The diagnosis was made using a contrast-enhanced MRI. The osteoid osteomas were marked percutaneously using x-ray and MRI guidance. MRI-guided drilling/curettage was performed in 4 cases and arthroscopic resection in 6 cases.

Results:

All lesions were successfully treated using the MRI-guided method. All patients were free of pain after the treatment. There was no instance of recurrence during the follow-up period, which averaged 10 months. The effective dose for marking the lesion was between 0.0186 mSv and 0.342 mSV (mean 0.084 mSV).

Conclusions:

Our MRI diagnostics protocol, the MRI-guided drilling and the minimally invasive hip arthroscopy represent an alternative to CT-guided radiofrequency ablation in the treatment of osteoid osteomas. Radiation exposure can thereby be significantly reduced. Hip arthroscopy can also be used to treat secondary pathologies such as femoroacetabular impingement.
‘I Don’t Want to Completely Lose Myself’: Social Mobility as Movement Across Classed, Ethnicised, and Gendered Spaces
Authors: Scandone Berenice
Published: March 2021

This article explores how subjective experiences of social mobility are informed by dimensions of identity other than class (e.g. ethnicity, gender). Drawing on in-depth interviews with British-born young women of Bangladeshi Muslim, working class origins in higher education, I critically interrogate their articulations of class positioning and trajectory and the interplay between participation in education and employment and gendered identities. Findings evidence the multifarious and value-ridden character of class signifiers, the relational nature of class positioning and the entrenchment of middle-classness and Whiteness, and testify to the compounding tensions experienced by upwardly mobile individuals of minority ethnic origins. The pursuit of upward mobility through participation in higher education and employment is also shown to entail shifts in gendered expectations and strains in performing valued gendered identities. Ultimately, I argue that social mobility processes are better understood as involving a movement across material and symbolic spaces where markers, dispositions, and practices linked to individuals’ class, ethnicity, religion, and gender acquire differential value. This intersectional lens enables a complex and nuanced picture to emerge, which foregrounds multiple tensions, displacements, and resulting inequalities in experiences and outcomes.
Feeding and eating problems in children and adolescents with autism: A scoping review
Authors: Baraskewich Jessica , von Ranson Kristin M , McCrimmon Adam , McMorris Carly A
Published: March 2021

Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other feeding and eating problems (e.g. disordered eating, fear of trying new foods, and insistence on specific food presentation) are also common in this population. This scoping review describes the nature and extent of feeding and eating problems in autistic youth and reports characteristics of autistic youth who experience such issues. Thirty-four studies were included in the current review, with almost all studies (91%) investigating feeding problems. Only 9% of studies examined concern with weight, shape, and/or body image, but several authors noted that disordered eating attitudes and behaviors may occur more frequently in those with autism than their peers without autism. No common individual characteristics (e.g. cognitive functioning and autism symptom severity) were identified for youth who experience feeding or eating problems. Although differentiating “feeding” from “eating” problems is critical for accurate identification and treatment of these issues, the existing literature has failed to do so. We propose that in future research “eating problems” be used when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” be used when such preoccupation is absent.

Lay abstract

Feeding problems, such as picky eating and food avoidance, are common in youth with autism. Other, broader difficulties with feeding and eating (eating disorder symptoms such as restricting food intake or preoccupation with body shape or weight and insistence on specific food presentation) are also common in autistic individuals. Here, we describe the nature and extent of feeding and eating problems in youth with autism. We found no common characteristics (such as severity of autism symptoms) that best describe autistic youth who experience problems with feeding or eating. Almost all studies we reviewed focused on problems with feeding (selective or picky eating), and only a few studies focused on eating disorder symptoms (concern with weight, shape, and/or body image). However, some researchers reported that eating disorder symptoms may occur more often in autistic individuals compared to their peers without autism. Many studies used the terms “feeding” and “eating” problems interchangeably, but understanding the difference between these problems is important for researchers to be consistent, as well as for proper identification and treatment. We suggest future researchers use “eating problems” when behaviors involve preoccupation with food, eating, or body image, and “feeding problems” when this preoccupation is absent. We highlight the importance of understanding whether feeding or eating problems are separate from autism traits, and the role of caregivers and other adults in the child’s treatment. Considerations for health-care providers to assist with diagnosis and treatment are also provided.
What Now for British Politics? Reflections on Gonzalez Ginocchio, Hindmoor and Stanley
Authors: Allen Peter
Published: March 2021

A response to Pluralism and Political Studies in the UK: A Pilot Study into Who Gets What in the Discipline by Brenda Gonzalez Ginocchio, Andrew Hindmoor and Liam Stanley.
Institutions and Pastoralist Conflicts in Africa: A Conceptual Framework
Authors: Penu Dennis Amego Korbla , Paalo Sebastian Angzoorokuu
Published: March 2021

Pastoralist conflicts are important global development outcomes, especially in Africa. Analysing relevant literature on this phenomenon, we identify “institutions” as a key but fragmented theme. This blurs a composite understanding of how institutions affect these conflicts and their management. Hence, this article proposes a conceptual framework that brings harmony to this discourse by analysing 172 relevant publications. The framework was then tested using evidence from interviews and policy documents collected on a typical case in Agogo, Ghana. The findings show that pastoralist conflicts in Africa are shaped from three main dimensions: institutional change, institutional pluralism, and institutional meanings. Thus, state-level institutional changes create different institutions at the community level, and stakeholders using these institutions place different evaluations on them based on obtained outcomes. These dynamics contribute to conflict management dilemmas. Hence, the study recommends that intervention efforts examine whether new institutions contradict existing ones and to resolve them before implementation.
Injury Trends in Irish Amateur Rugby: An Epidemiological Comparison of Men and Women
Authors: Yeomans Caithriona , Kenny Ian C. , Cahalan Roisin , Warrington Giles D. , Harrison Andrew J. , Purtill Helen , Lyons Mark , Campbell Mark J. , Glynn Liam G. , Comyns Thomas M.
Published: March 2021

Background:

Rugby union is a physically demanding sport that carries an inherent risk of injury. Despite being a popular and widely played team sport, little is known about injuries occurring across the male and female amateur game.

Purpose:

To establish and compare injury incidence, nature, and severity in male and female Irish amateur rugby union.

Study Design:

Prospective cohort study.

Level of Evidence:

Level 3.

Methods:

Data were collected prospectively from 25 male teams (959 players) and 8 female teams (234 players) over 2 full seasons. Both time-loss (24-hour time-loss injury definition) and non-time-loss match injury reports were collected, alongside match exposure data.

Results:

Time-loss match injury incidence rates were 49.1/1000 and 35.6/1000 player-hours for male and female players, respectively. Concussion and ankle ligament sprains were the most common diagnoses for male (5.6/1000 and 4.4/1000 player-hours, respectively) and female players (5.5/1000 and 3.9/1000 player-hours, respectively). Anterior cruciate ligament injuries presented the highest injury burden for male and female players with 200.3 and 307.2 days of absence per 1000 player-hours, respectively. In female players, 83% of noncontact injuries occurred in the fourth quarter of match play.

Conclusion:

While female players had a lower overall injury incidence rate compared with male players, concussion and ankle ligament injuries were the most common injuries in both cohorts. In female players, a high rate of noncontact injuries in the second half points to the need for strength and conditioning training programs to reduce fatigue-related injuries.

Clinical Relevance:

Establishing the incidence and burden of rugby-related injuries is an essential step in minimizing injury risk. This epidemiological information will aid the development of future reduction strategies, including education and coaching strategies and strength and conditioning programs, informed by the most common injuries observed and the mechanism of injury.
Childhood drawing: The making of a deficit aesthetic
Authors: Schulte Christopher M
Published: March 2021

This article introduces and explores the concept of the deficit aesthetic. Particular attention is given to how the deficit aesthetic was made and the extent to which it continues to be sustained in early art education, especially in the United States. For many children, particularly at this time, the deficit aesthetic factors as yet another lingering obstacle to negotiate, one that re-centers the assumption of childhood drawing as a neutral practice for a natural child. As an interpretive frame, the deficit aesthetic distorts the experience of drawing by disempowering the child, decontextualizing their drawing, and re-prioritizing white Western and middle-class subjectivities.
Do Constitutions Matter? The Dilemma of a Radical Lawyer
Authors: Shivji Issa G.
Published: March 2021

Constitutions do not make revolutions. Revolutions make constitutions. No constitution envisages its own death, for that is what a revolution entails. But constitutions matter. Some of the finest constitutions have been erected on ugly socio-economic formations wrought with extreme inequalities and inequities. South Africa and Kenya are examples. But constitutions do matter. They rarely herald fundamental transformations. They are the product of major transformations to consolidate a new status quo. Yet, constitutions do matter. Why do they matter? Why do we need them? Why does every revolution and major change in modern societies give birth to a new constitution? This is the question I want to reflect on: why do constitutions matter?
When the Desire for Lifestyle Medicine Counseling Remains Unfulfilled: A Case Report
Authors: Storz Maximilian Andreas
Published: March 2021

More and more patients are suffering from multiple concomitant chronic conditions, which are often associated with an unhealthy lifestyle, including inadequate physical activity and poor nutrition. Patients increasingly seek thorough advice on lifestyle counseling, however, many physicians encounter this development with a pharmacotherapy-centered strategy—thereby paying insufficient attention to lifestyle modifications. This case report attempts to capture the concerning experience of a particular patient, who was hospitalized for uncontrolled type-2-diabetes in an American hospital. Despite curiosity and a great interest in lifestyle modifications, his desire for lifestyle medicine counseling was not addressed during a long inpatient stay. This case illustrates that patients wish to make sustainable lifestyle changes but apparently receive insufficient support from their physicians. This applies for both, dietary and exercise counseling. To address the patients’ needs and the increasing burden from chronic diseases, physicians must practice lifestyle medicine now. Appropriate educational resources for physicians are provided.
Shear-wave velocity measurements and their uncertainties at six industrial sites
Authors: Darvasi Yaniv
Published: March 2021

This study assesses the variability of shear-wave ( VS) profile determinations for a suite of methods at six industrial sites. The methods include active, consisting of multi-channel analysis of surface waves (MASW), as well as passive, consisting of refraction microtremor (ReMi), and extended spatial autocorrelation (ESAC). The purpose is to ascertain the effect of the higher level of ambient noise on the results from the different methods, as only a few of these many methods are commonly used for site characterization. The measured dispersion curves are in fair agreement with one another. The average coefficient of variation (CoV; the percentage ratio of the standard deviation to the mean) for the dispersion curves varied from 2.5% to 12.6%. In contrast, over the VS-depth domain, the average shear-wave velocity profiles to a depth z ( VS,Z) vary from 11.6% to 16.5% between the various methods at the different sites. This indicates that the variance among the individual methods can lead to significant misinterpretation of the shallow subsurface, while the average VS,Z is much more robust. This reaffirms its use (mainly as VS,30) in building codes and within ground motion prediction equations (GMPEs). At all six sites, because of inversion processes, the variability within each method ranges from 4% up to 14%. There is no correlation between the test type and the CoV. Our study focused on surface-wave measurements in noisy industrial environments, where the signals processed are typically complex. Despite this complexity, our results suggest that such tests are also applicable to industrial zones, where the noisy environment constitutes an energy source.
How I manage acquired pure red cell aplasia in adults
Authors: Gurnari Carmelo , Maciejewski Jaroslaw P.
Published: March 2021

Pure red cell aplasia (PRCA) is a rare hematological disorder with multiple etiologies. The multifaceted nature of this disease is emphasized by the variety of concomitant clinical features. Classic idiopathic presentation aside, prompt recognition of pathogenetic clues is important because of their diagnostic and therapeutic implications. As a consequence, treatment of PRCA is diverse and strictly dependent on the presented clinical scenario. Here, we propose a series of clinical vignettes that showcase instructive representative situations derived from our routine clinical practice. Using these illustrative clinical cases, we review the diagnostic workup needed for a precise diagnosis and the currently available therapeutic options, discussing their applications in regard to the various PRCA-associated conditions and individual patients’ characteristics. Finally, we propose a treatment algorithm that may offer guidance for personalized therapeutic recommendations.
Measuring biology trainee teachers’ professional knowledge about evolution—introducing the Student Inventory
Authors: Fischer Julian , Jansen Thorben , Möller Jens , Harms Ute
Published: March 2021

Background

To teach evolution efficiently teachers must be able to diagnose their students’ ideas and understanding of the phylogeny of organisms. This encompasses different facets of content-specific professional knowledge, that is, knowledge about core ideas and theories, as well as knowledge about respective misconceptions. However, as findings from the field of psychology have shown, diagnostic activities comprise a further facet, namely, teachers’ judgment accuracy. This refers to the question of whether achievement-irrelevant information about the student influences teachers’ diagnoses. Against this background we conducted a study (1) to assess trainee teachers’ abilities to diagnose (a) the scientific correctness of students’ written answers, (b) students’ misconceptions about evolution, and (2) to investigate the interplay of evolution specific and generic facets of professional knowledge during the diagnosis. For this purpose, we applied a digital instrument, the Student Inventory (SI). Using this instrument, the trainee teachers (N = 27) first diagnosed written answers (N = 6) from virtual students regarding their scientific correctness and regarding students’ misconceptions about the natural selection of the peppered moth. Second, to test for judgment accuracy, the trainee teachers received—via the SI—achievement-irrelevant information about each virtual student, that is, the previous result of a multiple-choice questionnaire about evolution, before diagnosing the written answers.

Results

The trainee teachers were able to distinguish between scientifically correct (90.8%) and scientifically incorrect (91.7%) written answers. Trainee teachers faced problems when diagnosing specific misconceptions categories. Anthropomorphic misconceptions were diagnosed significantly more often (61.1%) than teleological misconceptions (27.8%). The achievement-irrelevant information influenced the trainee teachers’ assessment of written answers (F [1,26] = 5.94, p < .022, η2 = .186) as they scored the written answers higher if the performance in the questionnaire was good and vice versa.

Conclusion

The findings indicate that the diagnosis is easier or more difficult depending on the particular misconception category. However, the findings also reveal that, besides the evolution-specific facets of professional knowledge, generic facets interrelate with the quality of the diagnosis result. We conclude from these findings that an integration of evolution-specific and generic knowledge into the education of biology teachers is critical.
Negative effects of accompanying psychiatric disturbances on functionality among adolescents with chronic migraine
Authors: Uyar Cankay Tugba , Besenek Mert
Published: March 2021

Background

Chronic migraine is a condition with gradually increasing prevalence among adolescents which causes severe headaches resulting in functionality loss. Factors contributing to migraine becoming chronic and negatively affecting quality of life in adolescence are still unclear. Parallel with these, we aimed to examine the effect of psychiatric symptoms on headache severity and functionality loss among adolescents with chronic migraine.

Methods

We evaluated features of 50 adolescents who were diagnosed with chronic migraine according to International Classification of Headache Disorders-3 for the first time in their lives by an experienced neurologist. Sociodemographic and clinical data were collected and Pediatric Migraine Disability Assessment Score, Visual Analogue Score and DSM-5 Level 1 Cross-Cutting Symptom Measure Scores (CCSM-5) were evaluated. Semi-structured psychiatric interviews were done to those who scored higher than cut-off scores on CCSM-5. Healthy control group was constituted of cases which had similar age and sex distribution to case group.

Results

Majority of the case group was female (%78). There was a positive correlation between headache severity and computerized tomography history in emergency department. All of the psychiatric symptom scores were significantly higher in case group except for psychotic symptoms; but attention problems and manic symptoms clusters did not have significant difference according to the thresholds of CCSM-5. Receiving a psychiatric diagnosis did not affect frequency, severity or duration of headaches. There were also no relationship between depression/anxiety diagnosis and severity of headache/functionality loss.

Conclusion

Findings suggest that; more rational treatment methods with lesser functionality loss should be developed by adopting multidisciplinary and prospective approach via psychiatric screening for adolescents with chronic migraine.
The role of social capital in COVID-19 deaths
Authors: Imbulana Arachchi Janaki , Managi Shunsuke
Published: March 2021

Background

The COVID-19 pandemic has shown a continuously increasing trend with a large variation in the number of COVID-19 deaths across countries. In response, many countries have implemented non pharmaceutical methods of intervention, such as social distancing and lockdowns. This study aims to investigate the relationship of four dimensions of social capital (community attachment, social trust, family bond, and security) and several control variables with COVID-19 deaths.

Methods

We retrieved data from open access databases and a survey. COVID-19 death-related data were collected from the website “Centre for Systems Science and Engineering (CSSE) at Johns Hopkins University”. Social capital-related data were collected from a large-scale survey that included web-based and face-to-face surveys covering 100,956 respondents across all regions/provinces/states of 37 countries in 2017. Data regarding population density, number of hospital beds, and population aged 65 or older were retrieved from the World Development Indicators (WDIs). Data on country lockdowns were obtained from the website “National responses to the 2019-20 coronavirus pandemic”. Linear regressions were applied to identify the relationship between social capital and COVID-19 deaths.

Results

We found that COVID-19 deaths were associated with social capital both positively and negatively. Community attachment and social trust were associated with more COVID-19 deaths, and family bond and security were associated with fewer deaths. COVID-19 deaths were positively associated with population density, ageing population, and interactions between four dimensions of social capital-related factors and the ageing population. Furthermore, the number of hospital beds and early lockdown policy were negatively associated with COVID-19 deaths.

Conclusions

The results indicate that the role of social capital in dynamically evolving threats, such as the current COVID-19 pandemic, is not always negative or positive. Therefore, people’s behaviour should be changed to support countries’ response to the COVID-19 threat.
A case report of Hirschsprung’s disease presenting as sigmoid volvulus and literature review, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Gosaye Abay Wondimu , Nane Temesgen Setato , Negussie Tihitena Mammo
Published: March 2021

Background

Sigmoid volvulus is an uncommon problem in children and adolescents, and is rarely considered a diagnosis in this group. A high index of suspicion is necessary to reach a diagnosis and avoid morbidity and mortality. Sigmoid volvulus is a rare complication of Hirschsprung’s disease, which has been reported in neonates, children, and adults. Here we report a case of sigmoid volvulus accompanied by undiagnosed Hirschsprung's disease.

Case presentation

A 9 years old boy who presented with sudden onset of colicky abdominal pain of 4 h duration associated with gross abdominal distension and 2 episodes of non-bilious vomiting. A plain abdominal radiographs showed single hugely dilated bowel loops in the left lower quadrant with single air fluid level. Sigmoid volvulus was considered and rectal tube deflation was done and it was successful. Full thickness rectal biopsy was done and it was consistent with aganglionic megacolon. A primary trans-anal Soave endo-rectal pull through was done 3 weeks later, after biopsy result arrived, which yielded loss of symptoms and regular bowel movement.

Conclusions

Sigmoid volvulus should be considered in the differential for children presenting with acute onset of abdominal obstruction. It should be known that when its’s diagnosed in children, it is often associated with Hirschsprung's disease. Therefore, a proper diagnostic and treatment algorithm should be followed in order not to miss associated HD and to give optimum care to such patients.
Effects of mineral complex material treatment on 2,4- dinitrochlorobenzene-induced atopic dermatitis like-skin lesions in mice model
Authors: Bajgai Johny , Xingyu Jing , Fadriquela Ailyn , Begum Rahima , Kim Dong Heui , Kim Cheol-Su , Kim Soo-Ki , Lee Kyu-Jae
Published: March 2021

Background

Atopic dermatitis (AD) is a chronic allergic inflammatory skin disease characterized by complex pathogenesis including skin barrier dysfunction, immune-redox disturbances, and pruritus. Prolonged topical treatment with medications such as corticosteroids, calcineurin inhibitors, and T-cell inhibitors may have some potential side-effects. To this end, many researchers have explored numerous alternative therapies using natural products and mineral compounds with antioxidant or immunomodulatory effects to minimize toxicity and adverse-effects. In the current study, we investigated the effects of mineral complex material (MCM) treatment on 2, 4-dinitrochlorobenzene (DNCB)-induced AD-like skin lesions in SKH-1 hairless mice.

Methods

Animals were divided into four groups; normal control (NC), negative control treated with DNCB only (DNCB only), positive control treated with DNCB and tacrolimus ointment (PC) and experimental group treated with DNCB and MCM patch (MCM). Skin inflammation and lesion severity were investigated through analyses of skin parameters (barrier score and strength, moisture and trans-epidermal water loss level), histopathology, immunoglobulin E, and cytokines. In addition, reactive oxygen species (ROS), nitric oxide (NO), glutathione peroxidase (GPx), and catalase (CAT) levels were measured in both serum and skin lysate.

Results

Our results demonstrates that MCM patch improved the progression of AD-like skin lesions by significantly increasing skin barrier strength and decreasing trans-epidermal water loss. Additionally, dermal administration of MCM patch significantly reduced epidermal thickness, ROS, and NO levels in skin lysate. Furthermore, we found that MCM suppressed the levels of AD-involved (Th1and Th2) cytokines such as IL-2, IFN-γ, and IL-4 in blood. In addition, the levels of other Th1,and Th2and inflammatory cytokines such as IL-1β, TNF-α, IL-6, IL-12(p70) and IL-10 were found lowest in the MCM group than in the DNCB only and PC groups. Moreover, we found total serum IgE level significantly increased after DNCB treatment, but decreased in the PC and MCM groups.

Conclusion

Taken together, our findings suggest that MCM application may have beneficial effects either systemic or regional on DNCB-induced AD lesional skin via regulation of the skin barrier function and immune-redox response.
Circulating Vitamin D levels status and clinical prognostic indices in COVID-19 patients
Authors: Ricci Alberto , Pagliuca Alessandra , D’Ascanio Michela , Innammorato Marta , De Vitis Claudia , Mancini Rita , Giovagnoli Simonetta , Facchiano Francesco , Sposato Bruno , Anibaldi Paolo , Marcolongo Adriano , De Dominicis Chiara , Laghi Andrea , Muscogiuri Emanuele , Sciacchitano Salvatore
Published: March 2021

Background

Several immune mechanisms activate in COVID-19 pathogenesis. Usually, coronavirus infection is characterized by dysregulated host immune responses, interleukine-6 increase, hyper-activation of cytotoxic CD8 T lymphocytes. Interestingly, Vitamin D deficiency has been often associated with altered immune responses and infections. In the present study, we evaluated Vitamin D plasma levels in patients affected with different lung involvement during COVID-19 infection.

Methods

Lymphocyte phenotypes were assessed by flow cytometry. Thoracic CT scan involvement was obtained by an image analysis program.

Results

Vitamin D levels were deficient in (80%) of patients, insufficient in (6.5%) and normal in (13.5%). Patients with very low Vitamin D plasma levels had more elevated D-Dimer values, a more elevated B lymphocyte cell count, a reduction of CD8 + T lymphocytes with a low CD4/CD8 ratio, more compromised clinical findings (measured by LIPI and SOFA scores) and thoracic CT scan involvement.

Conclusions

Vitamin D deficiency is associated with compromised inflammatory responses and higher pulmonary involvement in COVID-19 affected patients. Vitamin D assessment, during COVID-19 infection, could be a useful analysis for possible therapeutic interventions.

Trial registration: 'retrospectively registered'.