bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative Depression Influences Outcomes Following Total Ankle Arthroplasty
Authors: Wilson Jacob M. , Schwartz Andrew M. , Farley Kevin X. , Bariteau Jason T.
Published: August 2020

Introduction

Total ankle arthroplasty (TAA) is increasing in incidence. While preoperative depression is known to affect outcomes following other procedures, its effect on outcomes following TAA are unknown. Therefore, the purpose of this study was to investigate this relationship.

Methods

This is a retrospective cohort study using the Nationwide Readmission Database (NRD). All patients undergoing TAA were included. Two cohorts (those with and without preoperative depression) were created. Logistic regression was then performed to assess the contribution of a preoperative diagnosis of depression on rates of 90-day complications, while controlling for patient demographic and comorbid data.

Results

Overall, 8047 patients were included, of whom, 11.4% (918) were depressed. Compared to patients without depression, patients with depression had increased odds of the following: nonhome discharge (OR 1.61, 95% CI 1.31-1.98), extended length of stay (>2 days; OR 1.34, 95% CI 1.15-1.57), prosthetic complication (OR 1.39, 95% CI 1.10-1.74), wound complication (OR 1.59, 95% CI 1.11-2.29), prosthetic joint infection (OR 1.82, 95% CI 1.06-3.15), superficial surgical site infection (OR 1.62, 95% CI 1.02-2.58), and medical complication (OR 1.32, 95% CI 1.03-1.68).

Discussion

Depression in patients undergoing TAA is common and is associated with increased health care utilization and complications following surgery. The modifiability of depression should be investigated with future studies.

Levels of Evidence:

Prognostic, Level III: Comparative study
Phytoextraction Potential of Rhizophora Apiculata: A Case Study in Matang Mangrove Forest Reserve, Malaysia
Authors: Khan Waseem Razzaq , Rasheed Fahad , Zulkifli Syaizwan Zahmir , Kasim Mohamad Roslan bin Mohamad , Zimmer Martin , Pazi Ahmad Mustapha , Kamrudin Nur Amira , Zafar Zikria , Faridah-Hanum I. , Nazre M.
Published: August 2020

Disposal of industrial wastewater has resulted in increased concentration of heavy metals (HMs) along the coastline of Malaysia. However, little is known about the accumulation capacity of HMs by Rhizophora apiculata in Matang Mangrove Forest Reserve (MMFR) Malaysia. The aim of this study is to measure the concentration of HMs in different ages of mangrove forests. In this study, 15 and 80-year old trees of Rhizophora apiculata were selected for experimentation. Thirty samples of leaves, roots and sediments were analyzed to measure the concentration of HMs in 15 and 80-year-old trees. The measured concentrations of copper (Cu), iron (Fe), manganese (Mn) and zinc (Zn) in leaves, roots and sediments were used to compare bio- concentration and translocation factor between the abovementioned two age groups. Concentration of Mn came out to be significantly higher in leaves than in sediment. This suggested that Rhizophora apiculata was an efficient Mn-extractor. On the other hand, it was found less efficient in extracting heavier metals (Fe, Cu and Zn) from the sediment, as their concentration was lower in leaves and roots as compared to sediments. The translocation factor was highest for Mn, indicating high mobility of Mn from roots towards the leaves. Bio-concentration factor was also found highest for Mn (3.52) followed by Zn (1.88), Cu (1.33) and Fe (0.26). Therefore, it can be concluded that Rhizophora apiculata is more efficient in extracting Mn as compared to Zn, Cu and Fe.
Visual Priming and Framing During the 2020 Democratic Presidential Debates: Electoral Status Predicts Favorable Camera Treatment
Authors: Stewart Patrick A. , Eubanks Austin D. , Hersom Nicholas , Hearn Cooper A.
Published: August 2020

The 2020 Democratic presidential primary debates provide a unique opportunity to systematically evaluate network visual production choices in a multicandidate context. The joint decision of the Democratic National Committee and NBC to include an expansive field of twenty contenders through “prime-time” debates on consecutive nights (June 26 and 27, 2019) provided for a natural experiment with equal numbers of top- and second-tier candidates randomly assigned to each night. In this preregistered study, we evaluate whether candidates are treated differently in the amount of camera time they receive (visual priming) and types of camera shots they appear in (visual framing) based on electoral status. We replicate a study of the initial two Democratic and Republican 2016 presidential primary debates for each party and that found the top-two candidates received substantially better visual coverage than all others. We confirm and extend these findings by evaluating different operationalizations of electoral status (top-two, top-tier, stage position, and poll standing). Findings suggest that when visual priming is considered, stage position outperforms other electoral status indicators in terms of explaining variance for total camera and average fixation time. In terms of visual framing, head-and-shoulder “one-shots” are better predicted by top-tier status, whereas public opinion poll standing predicts increased time spent in multiple-candidate shots. Finally, appearances in “two-shots” (side-by-side and split-screen portrayals) were not significantly explained by electoral status, likely due to the paucity of these depictions.
Our Actions, Our Stories: A Readers Theater
Authors: Bloom Leslie Rebecca , Breyer Bonnie , Hoffman Chrissy , Izaguirre-Zavala Jocelyn , Jones Walter , Paglia Dafne , Parsons Sarah , Sahs Mary
Published: August 2020

This article presents the script of Our Actions, Our Stories: A Readers Theater that was researched, written, and presented by students in a women’s and gender studies (WGS) class called “Action: Intersections and Coalitions.” Based on qualitative interviews, the script illustrates six respondents’ perspectives on their activism and explores their backgrounds and intersectional identities in relation to these. The readers theater explores how activism and identity intersect and what that means for those engaged in activism. The article concludes with a discussion about the meanings that doing this project in a feminist experiential learning course had for the WGS students involved and how such experiences contribute to growing a much-needed new generation of qualitative researchers dedicated to social justice.
Muscle Atrophy After ACL Injury: Implications for Clinical Practice
Authors: Lepley Lindsey K. , Davi Steven M. , Burland Julie P. , Lepley Adam S.
Published: August 2020

Context:

Distinct from the muscle atrophy that develops from inactivity or disuse, atrophy that occurs after traumatic joint injury continues despite the patient being actively engaged in exercise. Recognizing the multitude of factors and cascade of events that are present and negatively influence the regulation of muscle mass after traumatic joint injury will likely enable clinicians to design more effective treatment strategies. To provide sports medicine practitioners with the best strategies to optimize muscle mass, the purpose of this clinical review is to discuss the predominant mechanisms that control muscle atrophy for disuse and posttraumatic scenarios, and to highlight how they differ.

Evidence Acquisition:

Articles that reported on disuse atrophy and muscle atrophy after traumatic joint injury were collected from peer-reviewed sources available on PubMed (2000 through December 2019). Search terms included the following: disuse muscle atrophy OR disuse muscle mass OR anterior cruciate ligament OR ACL AND mechanism OR muscle loss OR atrophy OR neurological disruption OR rehabilitation OR exercise.

Study Design:

Clinical review.

Level of Evidence:

Level 5.

Results:

We highlight that (1) muscle atrophy after traumatic joint injury is due to a broad range of atrophy-inducing factors that are resistant to standard resistance exercises and need to be effectively targeted with treatments and (2) neurological disruptions after traumatic joint injury uncouple the nervous system from muscle tissue, contributing to a more complex manifestation of muscle loss as well as degraded tissue quality.

Conclusion:

Atrophy occurring after traumatic joint injury is distinctly different from the muscle atrophy that develops from disuse and is likely due to the broad range of atrophy-inducing factors that are present after injury. Clinicians must challenge the standard prescriptive approach to combating muscle atrophy from simply prescribing physical activity to targeting the neurophysiological origins of muscle atrophy after traumatic joint injury.
Spotlight on the pediatric eye: a pictorial review of orbital anatomy and congenital orbital pathologies
Authors: Bhat Roopa , Al-Samarraie Mohannad , Nada Ayman , Leiva-Salinas Carlos , Whitehead Matthew , Mahdi Eman
Published: August 2020

Orbital lesions in the pediatric population vary from adults in terms of their presentation, unique pathology, and imaging characteristics. The prompt and accurate diagnosis of these lesions is imperative to prevent serious consequences in terms of visual impairment and disfigurement. Along with dedicated ophthalmologic examination, imaging is instrumental in characterizing these lesions, both for accurate diagnosis and subsequent management. In our pictorial essay, we provide a basic review of orbital embryology, anatomy, and congenital orbital pathologies, with emphasis on radiological findings.
Effects of laparoscopic sleeve gastrectomy on concentration and composition of bile acids in an Asian population with morbid obesity
Authors: Yao Jie , Kovalik Jean-Paul , Lai Oi Fah , Lee Phong Ching , Eng Alvin Kim Hock , Chan Weng Hoong , Lim Eugene Kee Wee , Bee Yong Mong , Tan Hong Chang
Published: August 2020

Background:

Bile acids (BAs) are traditionally associated with lipid absorption and phase II detoxification by forming various BA conjugates. Recently, it has been discovered that BAs also regulate glucose metabolism, and the increase in BAs in patients following bariatric surgery may contribute to the post-surgery improvement in insulin resistance (IR). However, while Roux-en-Y gastric bypass can increase BA concentrations post-surgery, this may not be the case after laparoscopic sleeve gastrectomy (LSG). We hypothesized that the profiling of BAs that include the conjugated BA species could detect post-surgery BA changes after LSG. To test our hypothesis, we performed comprehensive profiling of BAs in Asian individuals with morbid obesity at baseline, and at 6 months following LSG.

Methods:

Fourteen subjects scheduled for LSG were recruited. Anthropometric measurements, oral glucose tolerance test, and biochemistry tests were performed at baseline and at 6 months after LSG. BAs were profiled using liquid chromatography–mass spectrometry.

Results:

At 6 months, subjects lost significant weight from 117.4±5.4 to 92.1±3.8 kg and demonstrated significant improvement in IR. HOMA-IR decreased from 6.2±0.7 to 2.0±0.2 and the Matsuda index increased from 1.9±0.3 to 3.3±0.3. We did not detect any significant post-operative change in the levels of total BAs (5237.1±1219.4 vs. 3631.7±457.9, p=0.181) or non-sulfated BAs after LSG. However, sulfated BA species increased significantly after LSG.

Conclusion:

Our study showed that the serum concentrations of sulfated BA species in morbidly obese Asian individuals increased significantly 6 months after LSG; the increase in sulfated BAs after LSG might contribute to the post-surgery improvement of metabolic health.
Amodal Completion Revisited
Authors: Gerbino Walter
Published: August 2020

Amodal completion (AC) is analyzed, by looking at its historical roots and persisting conceptual difficulties. Looking at the origin of the concept, it becomes clear that it is not equivalent to perception of occluded parts. The role of fragment incompleteness is discussed, to clarify that it cannot be taken as a necessary factor for eliciting AC. The standard view of AC, depicted as a set of processes that extrapolate from veridically represented image fragments, is evaluated and rejected on the basis of evidence that AC modifies also modal parts. The theoretical importance of AC phenomena and their potential to reveal the inner forces of perceptual organization are emphasized, with specific reference to the minimum principle. Instances in which AC might be expected but does not occur are examined, to define the limits of such an integrative process.
Camouflaged propaganda: A survey experiment on political native advertising
Authors: Dai Yaoyao , Luqiu Luwei
Published: August 2020

We examine a new form of propaganda, political native advertising, in which political actors, including foreign governments, buy space in independent media outlets to publish advertisements that are camouflaged as standard news stories. Those who engage in this form of propaganda hope to exploit the higher credibility of the hosting media site to enhance the persuasiveness of their message. Despite the obvious political implications and ethical issues at stake, political native advertising has received almost no scholarly attention. Our article begins to redress this imbalance. Using an online survey experiment with real political native advertisements in the Washington Post and The Telegraph bought by the Chinese government, we provide some of the first empirical evidence on basic but important features of political native advertising. We find, among other things, that respondents struggle to distinguish political advertisements from standard news stories regardless of their level of education and media literacy, that political advertisements are more convincing if they appear on and are perceived as news from an independent hosting media site than in a government-controlled news outlet, and that trust in the hosting media site declines if the political advertisement is detected.
Epistemic clashes in network science: Mapping the tensions between idiographic and nomothetic subcultures
Authors: Jacomy Mathieu
Published: August 2020

This article maps a controversy in network science over the last 15 years, dividing the field about the epistemic status of a central notion, scale-freeness. The article accounts for the two main disputes, in 2005 and in 2018, as they unfolded in academic publications and on social media. This article analyzes the conflict, and the reasons why it reignited in 2018, to the surprise of many. It is argued that (1) the concept of complex networks is shared by the distinct subcultures of theorists and experimentalists; and that (2) these subcultures have incompatible approaches to knowledge: nomothetic (scale-freeness is the sign of a universal law) and idiographic (scale-freeness is an empirical characterization). Following Galison, this article contends that network science is a trading zone where theorists and experimentalists can trade knowledge across the epistemic divide.
Digital Contact tracing in the COVID-19 Pandemic: A tool far from reality
Authors: Hegde Ajay , Masthi Ramesh
Published: August 2020

Digital contact tracing applications are being developed by governments across the world, to track and trace contacts. With little evidence, citizens are being forced and made to believe that it is an important step in pandemic control. We discuss briefly if contact tracing will be successful in the control of the Corona virus pandemic or is it just a tool governments are using to cover their helplessness.
Factors affecting the quality and reliability of online health information
Authors: Battineni Gopi , Baldoni Simone , Chintalapudi Nalini , Sagaro Getu Gamo , Pallotta Graziano , Nittari Giulio , Amenta Francesco
Published: August 2020

Background

Internet represents a relevant source of information, but reliability of data that can be obtained by the web is still an unsolved issue. Non-reliable online information may have a relevance, especially in taking decisions related to health problems. Uncertainties on the quality of online health data may have a negative impact on health-related choices of citizens.

Objective

This work consisted in a cross-sectional literature review of published papers on online health information. The two main research objectives consisted in the analysis of trends in the use of health web sites and in the quality assessment and reliability levels of web medical sites.

Methods

Literature research was made using four digital reference databases, namely PubMed, British Medical Journal, Biomed, and CINAHL. Entries used were “trustworthy of medical information online,” “survey to evaluate medical information online,” “medical information online,” and “habits of web-based health information users”. Analysis included only papers published in English. The Newcastle Ottawa Scale was used to conduct quality checks of selected works.

Results

Literature analysis using the above entries resulted in 212 studies. Twenty-four articles in line with study objectives, and user characteristics were selected. People more prone to use the internet for obtaining health information were females, younger people, scholars, and employees. Reliability of different online health sites is an issue taken into account by the majority of people using the internet for obtaining health information and physician assistance could help people to surf more safe health web sites.

Conclusions

Limited health information and/or web literacy can cause misunderstandings in evaluating medical data found in the web. An appropriate education plan and evaluation tools could enhance user skills and bring to a more cautious analysis of health information found in the web.
Sensorimotor function in progressive multiple sclerosis
Authors: Miehm Jules D , Buonaccorsi John , Lim Jongil , Sato Sumire , Rajala Caitlin , Averill Julianna , Khalighinejad Farnaz , Ionete Carolina , Jones Stephanie L , Kent Jane A , van Emmerik Richard EA
Published: August 2020

Background

A sensitive test reflecting subtle sensorimotor changes throughout disease progression independent of mobility impairment is currently lacking in progressive multiple sclerosis.

Objectives

We examined non-ambulatory measures of upper and lower extremity sensorimotor function that may reveal differences between relapsing–remitting and progressive forms of multiple sclerosis.

Methods

Cutaneous sensitivity, proprioception, central motor function and mobility were assessed in 32 relapsing–remitting and 31 progressive multiple sclerosis patients and 30 non-multiple sclerosis controls.

Results

Cutaneous sensation differed between relapsing–remitting and progressive multiple sclerosis at the foot and to a lesser extent the hand. Proprioception function in the upper but not the lower extremity differed between relapsing–remitting and progressive multiple sclerosis, but was different for both upper and lower extremities between multiple sclerosis patients and non-multiple sclerosis controls. Foot-tap but not hand-tap speed was slower in progressive compared to relapsing–remitting multiple sclerosis, suggestive of greater central motor function impairment in the lower extremity in progressive multiple sclerosis. In addition, the non-ambulatory sensorimotor measures were more sensitive in detecting differences between relapsing–remitting and progressive multiple sclerosis than mobility assessed with the 25-foot walk test.

Conclusion

This study provides novel information about changes in sensorimotor function in progressive compared with relapsing–remitting forms of multiple sclerosis, and in particular the importance of assessing both upper and lower extremity function. Importantly, our findings showed loss of proprioceptive function in multiple sclerosis but also in progressive compared to relapsing–remitting multiple sclerosis.
Deliverance
Authors: Conley Donovan
Published: August 2020

This essay proposes thinking about civic wounds as assemblages. It draws on the historical case of antebellum Cincinnati, where the physical contagion of cholera entangled with the social contagion of slavery in ways that articulated across both cultural and physical domains of activity at once. Taking this approach reveals the ways rhetoric’s pharmakon mediates the operations of delivery within assemblages; I further suggest that the intersecting figural movements of catachresis and metonymy account for the granular pharmacological work of a given wound/assemblage’s historical emergence. Along the way we see how both rhetoric and liberal democracy are toxic enterprises wherein goods and bads commingle in fateful ways.
Registered nurses’ experiences of assessing patients with mental illness in emergency care: A qualitative descriptive study
Authors: Holmberg Mats , Hammarbäck Staffan , Andersson Henrik
Published: August 2020

Patients with mental illness are exposed and experience themselves as not being taken seriously in emergency care. Registered nurses need to assess patients with mental illness from a holistic perspective comprising both a physical and an existential dimension. The aim of the study was to describe registered nurses’ (RNs) experiences of assessing patients with mental illness in emergency care. Twenty-eight RNs in prehospital and in-hospital emergency care were individually interviewed. The interviews were analysed descriptively. The design followed the COREQ-checklist. One main theme ‘A conditional patient assessment’ and two themes; ‘A challenged professional role’ and ‘A limited openness for the patient’, comprising in turn four sub-themes emerged. Although the RNs showed willingness to understand the mental illness aspects of their patients, they were insufficient in their assessments. This implies the importance of developing emergency care RNs’ competence, knowledge and self-confidence in assessments and care of patients with mental illness.
Minimally Invasive Removal of Extra- and Intradural Spinal Tumors Using Full Endoscopic Visualization
Authors: Caballero-García Joel , Linares-Benavides Yurledys Jhohana , Leitão Ueza Laurinelis Salazar , Aparicio-García Carlos , López-Sánchez Misael
Published: August 2020

Study Design:

Retrospective cohort study.

Objective:

To evaluate the clinical efficacy of minimally invasive endoscopic surgery in patients with spinal extradural and intradural-extramedullary tumors.

Methods:

This was a study of 15 consecutive patients with spinal extradural or intradural-extramedullary tumors up to 2 levels treated by minimal invasive surgery using a full endoscopic visualization and Caspar’s retraction system (for cervical, thoracic, and lumbar tumors) over a 4-year period between January 2015 to April 2019 at a tertiary center.

Results:

A gross total remove was achieved in all patients (100%), determined by postoperative contrast computed tomography scans and magnetic resonance imaging. There was no postoperative spinal instability. All patients had equal or better neurologic functions after surgery at follow-up. The average preoperative Nurick’s grade mean was 1.9 and the postoperative was 1.1. The average preoperative McCormick’s grade mean was 2.9 versus 1.3 in the postoperative period.

Conclusions:

Selective extradural or intradural-extramedullary tumors well localized and up to 2 levels can be safely and effectively treated by minimally invasive surgery using a full endoscopic visualization and the Caspar’s retractor. However, there is insufficient evidence to recommend this approach over the classical or other microsurgical approach described.
Sacral Insufficiency Fracture Following Short-Segment Lumbosacral Fusion: Case Series and Review of the Literature
Authors: Kolz Joshua M. , Mitchell Scott A. , Elder Benjamin D. , Sebastian Arjun S. , Huddleston Paul M. , Freedman Brett A.
Published: August 2020

Study Design:

Retrospective case series.

Objective:

Sacral insufficiency fracture is a rare and serious complication following lumbar spine instrumented fusion. The purpose of this study was to describe the patient characteristics, presentation, evaluation, treatment options, and outcomes for patients with sacral insufficiency fracture after short-segment lumbosacral fusion.

Methods:

Six patients from our institutional database and 16 patients from literature review were identified with a sacral insufficiency fracture after short-segment (L4-S1 or L5-S1) lumbar fusion within 1 year of surgery.

Results:

Patients were 55% female with a mean age of 58 years and body mass index of 30 kg/m2. Osteoporosis or osteopenia was the most common comorbidity (85%). Half of patients sustained a sacral fracture after surgery from a posterior approach, while the others had anterior or anterior-posterior surgery. Mean time to fracture was 42 days with patients clinically presenting with new sacral pain (86%), radiculopathy (60%), or neurologic deficit (5%). Ultimately, 73% of patients underwent operative fixation often involving extension of the construct (75%) and fusion to the pelvis (69%). Men ( P = .02) and patients with new radicular pain or neurologic deficit ( P = .01) were more likely to undergo revision surgical treatment while women over 50 years of age were more likely to be treated conservatively ( P = .003).

Conclusions:

Spine surgeons should monitor for sacral insufficiency fracture as a source of new-onset pain in the postoperative period in patients with a short segment fusion to the sacrum. The recognition of this complication should prompt an assessment of bone health and management of underlying bone fragility.
Is Diagnostic Arthroscopy at the Time of Medial Patellofemoral Ligament Reconstruction Necessary?
Authors: Shultz Christopher L. , Schrader Samuel N. , Packard Benjamin D. , Wascher Daniel C. , Treme Gehron P. , Richter Dustin L.
Published: August 2020

Background:

Although medial patellofemoral ligament (MPFL) reconstruction is well described for patellar instability, the utility of arthroscopy at the time of stabilization has not been fully defined.

Purpose:

To determine whether diagnostic arthroscopy in conjunction with MPFL reconstruction is associated with improvement in functional outcome, pain, and stability or a decrease in perioperative complications.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent primary MPFL reconstruction without tibial tubercle osteotomy were reviewed (96 patients, 101 knees). Knees were divided into MPFL reconstruction without arthroscopy (n = 37), MPFL reconstruction with diagnostic arthroscopy (n = 41), and MPFL reconstruction with a targeted arthroscopic procedure (n = 23). Postoperative pain, motion, imaging, operative findings, perioperative complications, need for revision procedure, and postoperative Kujala scores were recorded.

Results:

Pain at 2 weeks and 3 months postoperatively was similar between groups. Significantly improved knee flexion at 2 weeks was seen after MPFL reconstruction without arthroscopy versus reconstruction with diagnostic and reconstruction with targeted arthroscopic procedures (58° vs 42° and 48°, respectively; P = .02). Significantly longer tourniquet times were seen for targeted arthroscopic procedures versus the diagnostic and no arthroscopic procedures (73 vs 57 and 58 min, respectively; P = .0002), and significantly higher Kujala scores at follow-up were recorded after MPFL reconstruction without arthroscopy versus reconstruction with diagnostic and targeted arthroscopic procedures (87.8 vs 80.2 and 70.1, respectively; P = .05; 42% response rate). There was no difference between groups in knee flexion, recurrent instability, or perioperative complications at 3 months. Diagnostic arthroscopy yielded findings not previously appreciated on magnetic resonance imaging (MRI) in 35% of patients, usually resulting in partial meniscectomy.

Conclusion:

Diagnostic arthroscopy with MPFL reconstruction may result in findings not previously appreciated on MRI. Postoperative pain, range of motion, and risk of complications were equal at 3 months postoperatively with or without arthroscopy. Despite higher Kujala scores in MPFL reconstruction without arthroscopy, the relationship between arthroscopy and patient-reported outcomes remains unclear. Surgeons can consider diagnostic arthroscopy but should be aware of no clear benefits in patient outcomes.
Patient Centeredness from a Perspective of History of the Present: A Genealogical Analysis
Authors: Siouta Eleni , Olsson Ulf
Published: August 2020

The overall aim of this study, performed in Sweden, was to problematize the contemporary national and transnational discourse on patient centeredness, which during recent decades has become a given, having become established as a dogma in conversations, writing, and thinking about patients and health care. We did that by showing that ideas such as patient centeredness can be seen differently from the way they are depicted in contemporary discourses about health care. In the presented analysis, we drew on Foucault’s concepts of governmentality, ‘history of the present’ and genealogy. This means that we reflected on contemporary conceptions of how phenomena, such as the care seeker, have been constructed within other discourses about health care. Empirically, we used different health policy documents—government reports from three different historical periods. The analysis showed that contemporary narratives about centeredness are neither more, nor less, care seeker-centered than the narratives of yesteryear. Rather, the phenomenon of the care seeker is given different frames and meanings within the framework of different economic and historical discourses about health care. Our analysis raised questions about the contemporary construction of patient centeredness. In a world with such huge economic differences between nations, as well as between citizens within most nations, the contemporary discourse may be limited as it does not problematize structural issues in the same way as previous discourses had done. Perhaps what is needed today are national and international patient-centered or person-centered discourses which also discuss policies and practices that are population- and social group-centered. In the final discussion of the analysis, we identified a new patient-centered discourse, which views the patient as a resource among other resources. The most important limitation of this type of study is that it is only about discourses and policy issues and not about daily practical activities.
What Are the Priming and Ceiling Effects of One Experience Measure on Another?
Authors: Salman Aresh Al , Kopp Benjamin J , Thomas Jacob E , Ring David , Fatehi Amirreza
Published: August 2020

Patient-reported experience measures have notable ceiling effects which can hinder efforts to learn and improve. This study tested whether an iterative (Guttman-style) satisfaction questionnaire combined with instructions intended to give people agency to critique us primes responses on an ordinal scale and reduces ceiling effects. Among the 161 subjects randomly assigned to complete an iterative satisfaction questionnaire before or after an ordinal scale, there was no difference in mean satisfaction (no priming). The Guttman scale was more normally distributed and had slightly less ceiling effect when compared to the ordinal scale. Iterative satisfaction scales partially mitigate ceiling effects. The absence of priming suggests that attempts to encourage agency and reflection have limited ability to reduce ceiling effects, and alternative approaches should be tested.
Understanding the Patient Experience: A Conceptual Framework
Authors: Oben Patrick
Published: August 2020

The patient experience is now globally recognized as an independent dimension of health-care quality. However, although patients, providers, health-care managers, and policy-makers agree on its importance, there is no standardized definition of the patient experience. A clear understanding of the basic concepts that make up the foundation of the patient experience is more important than a statement defining the patient experience. The fundamental nature of health care involves people taking care of other people in unique times of distress. Thus, the human experience is at the very core of understanding what the patient experience is. This article reviews a framework of the basic human experience of patients as they progress from being unique, healthy individuals to a state of experiencing both disease and health-care services. This novel framework naturally leads to a basic understanding of the patient experience as a human experience of health-care services.
Embedding the International Classification of Functioning, Disability and Health in Health Professions Curricula to Enable Interprofessional Education and Collaborative Practice
Authors: Moran Monica , Bickford Jane , Barradell Sarah , Scholten Ingrid
Published: August 2020

The World Health Organization’s International Classification of Functioning, Disability and Health (WHO-ICF) is a comprehensive and highly adaptable framework that provides a universal language and shared health concepts to articulate human functioning across the lifespan and from individual to population health settings. It provides a global, biopsychosocial, and holistic structure for conceptualising the human experience of health and health service provision. Consequently, the ICF framework offers hope for a universal map for health service providers that bridges professional, cultural, economic, and geographical variations. While the use of the ICF is typically mandated by health professions accreditation bodies, integration of the ICF in medical and health professional education programmes has been slow. In addition, its potential for scaffolding interprofessional education for collaborative practice has not been maximised. In this Perspective paper, we draw on our extensive experience in developing curricula and teaching within a range of health professions programmes (medicine, occupational therapy, physiotherapy, and speech-language pathology) to provide advice on conceptual, theoretical, and practical dimensions of embedding the ICF framework within curricula to support interprofessional education and collaborative practice.
Statement on Race and Injustice in the United States of America
Authors:   American Society of Missiology,   Association of Professors of Mission,   Academy for Evangelism in Theological Education
Published: August 2020

In light of recent developments in the United States and around the world, impelled by the murder of George Floyd and countless other African-Americans, the leaders of three professional missiological societies jointly announced a statement on race and injustice on June 25, 2020. Thomas J. Hastings, the OMSC executive director and IBMR editor, wholeheartedly endorses the statement.
Naïve to expert: Considering the role of previous knowledge in memory
Authors: Alonso Alejandra , van der Meij Jacqueline , Tse Dorothy , Genzel Lisa
Published: August 2020

In humans, most of our new memories are in some way or another related to what we have already experienced. However, in memory research, especially in non-human animal research, subjects are often mostly naïve to the world. But we know that previous knowledge will change how memories are processed and which brain areas are critical at which time point. Each process from encoding, consolidation, to memory retrieval will be affected. Here, we summarise previous knowledge effects on the neurobiology of memory in both humans and non-human animals, with a special focus on schemas – associative network structures. Furthermore, we propose a new theory on how there may be a continuous gradient from naïve to expert, which would modulate the importance and role of brain areas, such as the hippocampus and prefrontal cortex.
Machine Learning Applications in the Evaluation and Management of Psoriasis: A Systematic Review
Authors: Yu Kimberley , Syed Maha N. , Bernardis Elena , Gelfand Joel M.
Published: August 2020

Background:

Machine learning (ML), a subset of artificial intelligence (AI) that aims to teach machines to automatically learn tasks by inferring patterns from data, holds significant promise to aid psoriasis care. Applications include evaluation of skin images for screening and diagnosis as well as clinical management including treatment and complication prediction.

Objective:

To summarize literature on ML applications to psoriasis evaluation and management and to discuss challenges and opportunities for future advances.

Methods:

We searched MEDLINE, Google Scholar, ACM Digital Library, and IEEE Xplore for peer-reviewed publications published in English through December 1, 2019. Our search queries identified publications with any of the 10 computing-related keywords and “psoriasis” in the title and/or abstract.

Results:

Thirty-three studies were identified. Articles were organized by topic and synthesized as evaluation- or management-focused articles covering 5 content categories: (A) Evaluation using skin images: (1) identification and differential diagnosis of psoriasis lesions, (2) lesion segmentation, and (3) lesion severity and area scoring; (B) clinical management: (1) prediction of complications and (2) treatment.

Conclusion:

Machine learning has significant potential to aid psoriasis evaluation and management. Current topics popular in ML research on psoriasis are the evaluation of medical images, prediction of complications, and treatment discovery. For patients to derive the greatest benefit from ML advancements, it is helpful for dermatologists to have an understanding of ML and how it can effectively aid their assessments and decision-making.
Treatment of Palmoplantar Pustulosis Using Fixed Combination Halobetasol Propionate 0.01% and Tazarotene 0.045% Lotion: A Case Report
Authors: Kucera Kristine J. , Miller Judi Elizabeth
Published: August 2020

Background:

Psoriasis is a chronic inflammatory disease that affects skin and joints and is associated with numerous comorbidities. There are several clinical subtypes including the uncommon pustular variants, which are subdivided into generalized and localized forms. Palmoplantar pustulosis is considered a subtype of pustular psoriasis that manifests as localized eruptions of pustules affecting the palms and/or soles. The disease often persists for several years or decades, with frequent periods of exacerbation and partial remissions and may significantly impair quality of life secondary to pain, pruritus and resulting functional disability.

Case Description:

This case report documents a 54-year-old woman who presented with a painful pustular lesion on her right palm. Careful patient history and biopsy of the lesion confirmed palmoplantar pustulosis. Initial treatment with clobetasol propionate 0.25% cream resulted in no improvement so she was switched to halobetasol propionate 0.01% and tazarotene 0.045% lotion—a novel corticosteroid–retinoid combination, while awaiting payor approval for systemic biologic therapy. Within a week, the pustular lesions and pain had resolved and her quality of life was significantly improved, so the patient elected to continue with topical therapy. This improvement was maintained at 6-week follow-up and during a 2-week reduced dose treatment schedule. She reflared 5 weeks after stopping treatment, but cleared again after reintroduction of the therapy. No side effects or adverse events were reported during treatment.

Conclusion:

Halobetasol propionate 0.01% and tazarotene 0.045% lotion may be an effective option for treatment and maintenance in patients with palmoplantar pustulosis.
Failure to identify underlying autoimmunity and primary headache disorder might be the reasons for refractoriness of trochlear headaches
Authors: Ojha Pawan , Aglave Vikram , Basak Suranjana , Yadav Jayendra
Published: August 2020

Introduction:

A better understanding of etiology might improve poor outcomes of trochlear headaches (TRHs).

Aims:

To study clinical spectrum, etiology, and therapeutic response of TRH.

Methods:

Fifty-three TRH patients seen in a single center between 2015 and 2020 were included, excluding Trigeminal Autonomic Cephalalgia (TAC).

Results:

Mean age was 36.45 years (range 11–85 years), with 77.35% being females. Twenty-five patients had continuous trochlear headache (CTRH) and 28 episodic trochlear headache (ETRH). Tension-type headache (TTH) occurred in 9 ETRH patients and 24 of 25 CTRH patients, and migraine-like headaches occurred in 19 ETRH patients and 8 CTRH (trochlear migraine) patients. Prior history of headaches was noted in 22 of 28 ETRH and 11 of 25 CTRH patients. Twenty-eight responded to migraine/TTH prophylaxis, 25 being nonresponders (partial/no response). Fourteen of 25 nonresponders, 4 of 28 responders (4 of 4 secondary and 5 of 9 idiopathic trochleitis (IT), 3 of 9 primary TRH (PTRH), and 6 of 28 ETRH) had autoantibodies, that is, 11 antinuclear antibodies (ANAs) and 7 antithyroid antibodies. Ten of 14 (71.42%) antibody-positive nonresponders improved with immunosuppressants including steroids/hydroxychloroquine and only 11 required local injections. Finally, 38 patients had good response, 13 partial, and 2 no response. The etiology and refractoriness of IT can be attributed to underlying autoimmunity and a minor contribution by primary headaches, vice versa being the case for PTRH and ETRH. Refractory TRHs should be evaluated for underlying autoimmunity and primary headaches.

Conclusion:

Identification and treatment of underlying autoimmunity and primary headaches can help improve outcome of TRH.
Research-to-Resource: Use of Technology to Support 21st Century Skills in a Performing Ensemble Program
Authors: Yoo Hyesoo
Published: August 2020

In a global society, 21st century skills are fundamental for every student. Furthermore, in today’s digital world, technology is expected to be part of students’ learning experiences. In the following research-to-resource article, I provide practical strategies and ideas for integrating technology into a performing ensemble program in order to develop students’ 21st century skills. In particular, I provide specific practices which use technology to fulfill 21st century skill—creativity, critical thinking, collaboration, communication, technology literacy, and cross-cultural skills.
Surveillance of a Patient Born With Tetralogy of Fallot and Total Anomalous Pulmonary Venous Return With Recurrent Pulmonary Vein Stenosis: The Role of Echocardiography to Aid in Treatment Options
Authors: Jones Dana
Published: August 2020

Surveillance of patients with congenital heart disease is difficult in some clinical settings. This case study follows the progress of a patient, born with prenatally missed diagnoses of tetralogy of Fallot (TOF) and total anomalous pulmonary venous return (TAPVR), for over two years. The patient acquired pulmonary vein stenosis following initial TOF/TAPVR repair, which made the case an interesting longitudinal study. Multiple cardiac catheterizations for stents and balloon angioplasties of the pulmonary veins were necessary. This case study illustrates this patient’s success with treatment options such as chemotherapy medications, as well as the failure of each treatment. It was also important to note that the interval of time between each interventional treatment weighed heavily upon results of frequent echocardiograms.
The airway microbiota and exacerbations of COPD
Authors: Leiten Elise Orvedal , Nielsen Rune , Wiker Harald Gotten , Bakke Per Sigvald , Martinsen Einar Marius Hjellestad , Drengenes Christine , Tangedal Solveig , Husebø Gunnar Reksten , Eagan Tomas Mikal Lind
Published: August 2020

Aim

The aim of this study was to investigate whether the compositionality of the lower airway microbiota predicts later exacerbation risk in persons with COPD in a cohort study.

Materials and methods

We collected lower airways microbiota samples by bronchoalveolar lavage and protected specimen brushes, and oral wash samples from 122 participants with COPD. Bacterial DNA was extracted from all samples, before we sequenced the V3-V4 region of the 16S RNA gene. The frequency of moderate and severe COPD exacerbations was surveyed in telephone interviews and in a follow-up visit. Compositional taxonomy and α and β diversity were compared between participants with and without later exacerbations.

Results

The four most abundant phyla were Firmicutes, Bacteroidetes, Proteobacteria and Fusobacteria in both groups, and the four most abundant genera wereStreptococcus,Veillonella,PrevotellaandGemella. The relative abundances of different taxa showed a large variation between samples and individuals, and no statistically significant difference of either compositional taxonomy, or α or β diversity could be found between participants with and without COPD exacerbations within follow-up.

Conclusion

The findings from the current study indicate that individual differences in the lower airway microbiota in persons with COPD far outweigh group differences between frequent and nonfrequent COPD exacerbators, and that the compositionality of the microbiota is so complex as to present large challenges for use as a biomarker of later exacerbations.
German bronchoscopy unit readiness for the COVID-19 pandemic: a nationwide survey
Authors: Heidemann Clara S. , Garbe Jakob , Damm Marko , Walter Steffen , Michl Patrick , Rosendahl Jonas , Darwiche Kaid , Eisenmann Stephan
Published: August 2020

Background

The worldwide impact of the coronavirus disease 2019 (COVID-19) pandemic is unprecedented. Among the aerosol generating procedures, bronchoscopy in particular is an indispensable diagnostic and therapeutic tool that comes with a high risk of infection. Therefore, national societies have issued guidance statements. However, the individual ability of bronchoscopy units to follow these recommendations is largely unknown.

Methods

We conducted a nationwide survey from 1 April 2020 to 7 April 2020 to which 218 German endoscopy units, 105 solely bronchoscopy and 113 interdisciplinary, responded. The survey was distributed electronicallyviathe German Respiratory Society.

Results

While 17% of units did not cancel any interventions, 16% cancelled >80% of their interventions. 73% were unable to completely separate high-risk patients. Most procedural measures, such as risk stratification in patients (95%), training to handle COVID-19 patients and personal protective equipment (PPE) (91%), risk adapted use of PPE (85%) and self-monitoring for staff (84%) were adopted well. Unit managers expected shortages in PPE (74%), staff shortages (68%) and severe financial losses (63%).

Conclusion

In the short-term, PPE shortages are perceived to be the most imminent threat to bronchoscopic activity as a whole. In this era of uncertainty, sound evidence to guide bronchoscopy units and an international concerted effort are urgently needed to formulate recommendations on facts and adapted to local conditions as described in this study.
Review of the health benefits of habitual consumption of miso soup: focus on the effects on sympathetic nerve activity, blood pressure, and heart rate
Authors: Ito Koji
Published: August 2020

High salt intake increases blood pressure, and dietary salt intake has been clearly demonstrated to be associated with hypertension incidence. Japanese people consume higher amounts of salt than Westerners. It has been reported that miso soup was one of the major sources of daily salt intake in Japanese people. Adding salt is indispensable to make miso, and therefore, in some cases, refraining from miso soup is recommended to reduce dietary salt intake. However, recent studies using salt-sensitive hypertensive models have revealed that miso lessens the effects of salt on blood pressure. In other word, the intake of miso dose not increase the blood pressure compared to the equivalent intake of salt. In addition, many clinical observational studies have demonstrated the absence of a relationship between the frequency of miso soup intake and blood pressure levels or hypertension incidence. The mechanism of this phenomenon seen in the subjects with miso soup intake has not been fully elucidated yet. However, in basic studies, it was found that the ingredients of miso attenuate sympathetic nerve activity, resulting in lowered blood pressure and heart rate. Therefore, this review focused on the differences between the effects of miso intake and those of the equivalent salt intake on sympathetic nerve activity, blood pressure, and heart rate.