bluuebunny/crossref_metadata_2025 huggingface dataset:
“If I Ever Leave, I Have a List of People That Are Going With Me:” Principals’ Understandings of and Responses to Place Influences on Teacher Staffing in West Virginia
Authors: McHenry-Sorber Erin , Campbell Matthew P. , Sutherland Daniella Hall
Published: November 2021

Purpose: Schools across the predominately rural state of West Virginia are experiencing widespread teacher shortages, though recruitment and retention difficulties are unevenly distributed across place. Using spatial in/justice as our framework, we explore how principals define place, how place influences principal perceptions of teacher recruitment and retention, and how principals respond to these staffing challenges given their leadership experiences, relationship to school community, and understandings of place affordances and disadvantages. Research Methods/Approach This research utilized interviews with eight principals across six school districts in West Virginia over a four-month time frame. We inductively coded interview transcripts in iterative cycles using our research framework as a guide for emic and etic codes. Findings: We find principals’ understanding of place influences on staffing to be specific to the unique attributes of each community and the placement of their leadership experiences – as community returners, seasoned though not originally from the community, and new-to-place. Their understandings of spatial in/justice as it relates to teacher staffing shape ideas of place affordances and disadvantages and recruitment and retention practices. These findings complexify the teacher staffing picture across geographically diverse rural places and the responses available to leaders given their leadership experience and relationship to place. Implications for Research and Practice The place-specific influences on teacher staffing problematize statewide policy mechanisms for ameliorating teacher shortages. The findings also suggest the need for further in-depth qualitative research within districts and across states, with an emphasis on racially diverse rural places.
Is Indian sedition law colonial? J. F. Stephen and the jurisprudence on free speech
Authors: Kumar Sunny
Published: November 2021

This article critically evaluates the characterisation of sedition law as colonial by analysing the arguments made by J. F. Stephen in opposing such a claim. While Stephen obfuscated the close links between the sedition law and the requirements of colonial governance, he made a persuasive case for how the sedition law was completely consistent with British ideas of liberty, utility, and the rule of law. Stephen’s arguments about legitimate limits to political liberties, particularly his critique of J. S. Mill in this regard, offer us an opportunity to question the presumed antithesis between colonial and metropolitan jurisprudence and trace their shared origins in British political thought. To that end, with Stephen as an interlocutor, this article critically analyses themes such as the defence of empire, colonialism, and the idea of improvement within a wider set of writings by British political philosophers, to arrive at an alternative understanding of British political liberalism. My article concludes that rather than ‘colonial difference’, the constitutive relation between sedition law and liberal jurisprudence better explains the prevalence of similar authoritarian laws within democratic regimes across the globe.
Book review: Suhita Sinha Roy, The Cultural Economy of Land: Rural Bengal, Circa 1860–1940
Authors: Dasgupta Rajarshi
Published: November 2021

Suhita Sinha Roy, The Cultural Economy of Land: Rural Bengal, Circa 1860–1940 (Edited by Mallarika Sinha Roy), Delhi: Tulika Books, 2019, 186 pp.
Book review: Tarangini Sriraman, In Pursuit of Proof: A History of Identification Documents in India
Authors: Sarcar Aprajita
Published: November 2021

Tarangini Sriraman, In Pursuit of Proof: A History of Identification Documents in India, New Delhi: Oxford University Press, 2018, 323 pp.
Herbert Ekwe-Ekwe: A Tribute
Authors: Ejiogu EC
Published: November 2021

The brilliant and erudite scholar and public intellectual of the state, genocide and ‘wars in Africa in the post-1966 epoch, beginning with the Igbo genocide, 29 May 1966 to 12 January 1970’, which he aptly designated as ‘the foundational and most gruesome genocide of post (European) conquest Africa’, Herbert Ekwe-Ekwe, who passed in 17 October 2019, was one of the select slate of scholars who were invited to contribute to this Special Issue of the journal. Characteristic of him and his dedication to the seriousness of purpose in scholarship, he was the first to complete and submit his contributed piece, which appears here in the Special Issue under the title, ‘Africans had no business fighting in either the 1914–1918 war or the 1939–1945 war’. That was a mere 4 months prior to his passing. This is a deserving tribute to him that captures his scholarship in all of its essence and complexity – Ekwe-Ekwe wrote more than 15 insightful books and published numerous articles in top-ranked academic journals and general interest publications in both the English and Portuguese languages, all of which are well-received in the communities of scholars and lay people. Rethinking Africa is the ‘forward looking blog’ that he founded and ‘dedicated to the exchange of innovative thinking on issues affecting the advancement of African peoples wherever they are’. It is indeed a medium that he used to provide ‘rigorous and insightful analyses on the issues affecting Africans and their vision of the world’. He was until his transition a ‘visiting professor in graduate programme of constitutional law at Universidade de Fortaleza, Brazil’.
A parameterized unit cell model for 3D braided composites considering transverse braiding angle variation
Authors: Zhang Weijie , Yan Shibo , Yan Ying , Li Yiding
Published: November 2021

In this paper, a parameterized unit cell model for 3D braided composites considering transverse braiding angle variation is proposed, to assist the mechanical characterization of such materials. According to the geometric characteristics of 3D braided composites, a method for automatically generating textile geometries based on practical braiding parameters, including the main braiding angle, the transverse braiding angle, and the fiber volume fraction, is established and implemented in a CAD software package. In this model, the addition of transverse braiding angle educes a more flexible control of fiber volume fraction distribution, and with the combination of control parameters according to the actual fiber distribution needs of users, it can suggest the appropriate parameters for the unit cell. The generated unit cell models are used in finite element analysis and the results are validated against experiments for a number of 3D braided composites in terms of fiber volume fraction and elastic constants, and good agreement is observed. Based on the parameterized unit cell model, the effects of main braiding parameters on the elastic properties of 3D braided composites are discussed.
Comparing the Cognitive Functioning Effects of Aerobic and Pilates Exercises for Inactive Young Adults: A Randomized Controlled Trial
Authors: Kaya Begum Kara , Alpozgen Ayse Zengin
Published: November 2021

Aerobic exercises (AE) have been found to have short-term positive effects on certain aspects of cognitive functioning. Pilates exercises (PE) may have similar benefits. In this randomized controlled study, we compared the effectiveness of PE and AE on participants’ cognitive functions. We randomly assigned 52 physically inactive young adult volunteers into either a PE group ( Mage = 20.85, SD = 2.11 years; 18 females and 8 males) or an AE group ( Mage = 19.88, SD = 0.91 years; 18 females and 8 males). In both groups, participants engaged in a moderately intense exercise program three days a week for four weeks. We tested participants on cognitive measures of selective attention and inhibitory control (Stroop test), verbal fluency (verbal fluency tests (letter and category); VFTs), and speed of movement (Nelson’s Speed of Movement Test; NSMT). There were no group differences on the Stroop and the VFTs ( p>0.05). However, there was a significant pre- to post-exercise difference for participants in both groups with a medium-large effect size (ES) on Stroop sections 1, 3, 4, and 5, respectively (PE: p < 0.001, ES = 0.58, p = 0.001, ES = 0.54, p < 0.001, ES = 0.88, p = 0.001, ES = 0.60; AE: p < 0.001, ES = 0.70, p < 0.001, ES = 0.89, p < 0.001, ES = 0.86, p = 0.006, ES = 0.65). There was a large effect size pre- to post-exercise detected for VFT sections labeled letter (PE: p < 0.001, ES = 1.45; AE: p < 0.001, ES = 1.11), and category (PE: p < 0.001, ES = 1.11; AE: p < 0.001, ES = 0.83), and there was a large ES for NSMT in the PE group ( p < 0.001, ES = 1.07). Both PE and AE may lead to short-term improvements in selective attention, verbal fluency, and executive control in inactive young adults, and PE may benefit speed of movement.
Reducing Trauma from Behind Bars: Enhancing Parent-Child Attachment Through a Digitally Distributed Reading Program
Authors: McLeod David A. , B. Pharris Angela , Marcus-Mendoza Susan , Winkles Rachael A. M. , Chapman Rachel , Fuller Cheri
Published: November 2021

Incarceration impacts families by disrupting routine attachment, creating negative consequences for both the parent and child. This article examines the use of an intervention videoing incarcerated parents reading to their children and then delivering those videos to improve child outcomes. Using a mixed-methods approach, a total of 587 surveys were completed by program participants and analyzed for parental perceptions of the program effectiveness. The intervention appeared to increase the frequency of correspondence between the parent and child, improved the sense of parent-child relationship, and increased a sense of involvement, attachment, and connectedness.
Which English Should We Stand For? Voices from Lecturers in Thai Multicultural Universities
Authors: Boonsuk Yusop
Published: November 2021

The rapid transformation of English linguistic landscapes has introduced the world to newly emerging English varieties or World Englishes, which are not typically employed in the Inner Circle. To address the defying phenomenon, this qualitative study explored the perceptions of Thai university lecturers on World Englishes, Thai English and the feasibility of implementing World Englishes and Thai English in the classrooms. Data were collected from semi-structured interviews with 15 English lecturers in 5 universities across the Thai regions. Analyzed by content analysis, findings revealed that the participants demonstrated mixed perceptions. While most of the participants viewed British and American Englishes as representations of standard English varieties and questioned the legitimacy of World Englishes and Thai English, others reportedly recognized and accepted the existence of World Englishes and considered Thai English as a tool to convey Thai identities and cultures. The findings also indicated that most participants outright disapproved of World Englishes and Thai English in teaching practices, and these varieties were substantially marginalized and devalued. However, to prepare learners for realistic use of English and increase their awareness of World Englishes and Thai English, the remaining participants suggested that English language teaching should embrace flexible linguistic conventions that allow spaces for Inner Circle, Outer Circle and Expanding Circle Englishes.
An analytical approach of filament bundle swinging dynamics, Part II: identifying equivalent dynamic constitutive parameters of filament bundles
Authors: Ma Xunxun , Wang Yongxing , Li Shujia , Wang Shengze , Ye He
Published: November 2021

A filament bundle is a type of yarn, which is composed of nearly parallel and highly oriented polymer monofilaments. Due to its nonlinearity both in material constitutive properties and structure, the filament bundle possesses nonlinear viscoelastic properties. It is important to study the dynamic behavior of the filament bundle accurately during its high-speed movement. Therefore, an accurate expression of the constitutive relation of the filament bundle is an essential prerequisite for its dynamic simulation and analysis. Continued the previous study in Part I: modeling filament bundle method, in this paper, an approach was proposed to identify the equivalent dynamic constitutive parameters of the filament bundle considering frequency-dependent characteristics. Firstly, the identification formulas of the dynamic elastic modulus and viscoelastic coefficients were derived based on the Kelvin model. Then, a testing method of the cross-sectional parameters of the filament bundle under a certain tension was proposed, and the testing device was developed to obtain the area of the filament bundle; The dynamic loading test of the bundle filament was conducted in a DMA Q800 dynamic mechanical tester. Thirdly, the equivalent dynamic elastic modulus and viscoelastic coefficients were obtained through the experimental test. Finally, an analytical method was proposed to verify the correctness of experimental results through simulation. The results show that the excitation frequency has a significant influence on the dynamic elastic modulus and viscoelastic coefficient, and the curves of the equivalent dynamic elastic modulus and viscoelastic coefficient present nonlinear variation characteristics.
Preliminary Evaluation of the Moving Rubber Foot Illusion in a Sample of Female University Students
Authors: Teaford Max , Gilliland Jason , Hodkey Olivia , McVeigh Tara , Perry Caleb , Rains-Bury Lyric , James Smart L.
Published: November 2021

The Rubber Foot Illusion (RFI) is an illusion in which one is made to feel that a model foot is their own through synchronous visuo-tactile stimulation. Previous research suggests that the conditions the RFI can be elicited under are similar to those of the Rubber Hand Illusion (RHI). However, it was unknown if the RFI could be elicited by synchronous movement of a participant’s foot and a model foot. To examine this, we developed the Moving Rubber Foot Illusion (mRFI) and compared participants’ experience of it to the RFI. The results of this study suggests that the RFI can be elicited through synchronous movement, and results in more proprioceptive drift than a static variant of the RFI. More work is needed to better understand the mechanisms underlying the mRFI.
Failure mechanics analysis of AISI 4340 steel using finite element modeling of the milling process
Authors: Muaz Muhammed , Khan Sanan H
Published: November 2021

A slot cutting operation is studied in this paper using a rotating/translating flat end milling insert. Milling operation usually comprises up-milling and down-milling processes. These two types of processes have different behaviors with opposite trends of the forces thus making the operation complex in nature. A detailed Finite Element (FE) model is proposed in this paper for the failure analysis of milling operation by incorporating damage initiation criterion followed by damage evolution mechanism. The FE model was validated with experimental results and good correlations were found between the two. The failure criteria field variable (JCCRT) was traced on the workpiece to observe the amount and rate of cutting during the machining process. It was found that the model was able to predict different failure energies that are dissipated during the machining operation which are finally shown to be balanced. It was also shown that the variation of these energies with the tool rotation angle was following the actual physical phenomenon that occurred during the cutting operation. Among all the energies, plastic dissipation energy was found to be the major contributor to the total energy of the system. A progressive failure analysis was further carried out to observe the nature of failure and the variation of stress components and temperature occurring during the machining process. The model proposed in this study will be useful for designers and engineers to plan their troubleshooting in various applications involving on-spot machining.
‘The challenge now is for us to remain relevant’: Australian public libraries and the COVID-19 crisis
Authors: Wakeling Simon , Garner Jane , Hider Philip , Jamali Hamid , Lymn Jessie , Mansourian Yazdan , Randell-Moon Holly
Published: November 2021

The COVID-19 crisis has had a significant impact on public libraries around the world. In Australia, almost all public libraries experienced some period of building closure, requiring libraries to adapt their services and delivery models. This article reports findings from a large-scale survey of public library managers in Australia, which was conducted in August 2020. In particular, it presents the results of a thematic analysis of the participants’ free-text responses to open questions asked as part of the survey. This analysis reveals important insights relating to responses to library closures, staffing issues, new and expanded services and programmes, relationships with parent bodies, and the role of public libraries during the crisis and beyond. While public libraries are perceived by managers to have been agile and adaptable, and to have utilised technology effectively, the findings clearly demonstrate the value to users of library buildings, with important consequences for understanding the role of public libraries.
Basic emotion theory, social constructionism, and the universal ethogram
Authors: TenHouten Warren D.
Published: November 2021

While emotion researchers with an evolutionary and biological orientation increasingly agree that small sets of discrete emotions are basic or primary, other researchers – particularly social constructionists – instead argue that all emotions are expressions of language and culture largely unconstrained by biology. Emotions are indeed socially and psychologically constructed, but not from scratch, for the basic emotions have evolved as biologically-structured adaptive reactions to the most fundamental problems of life, and have a deep evolutionary history. These life-problems were first identified in herpetology, and elaborated in Plutchik’s universal ethogram, a behavioral profile of four problems of life – identity, temporality, hierarchy, and territoriality – shared by a wide range of animal species. Plutchik proposed that the opposite poles of each of these dimensions can represent prototypical life-situations requiring rapid adaptive reactions; these reactions comprise the eight primary emotions. By hypothesizing that these dimensions have evolved into elementary social-relations models, we establish a continuity between the sociorelational and biological levels of emotional experience. Identification of eight basic emotions enables a classification of 24 secondary and 56 tertiary level emotions.
The Cogs and Wheels of Authenticity: How Descriptive and Evaluative Beliefs Explain the Unequal Appreciation of Authentic Products
Authors: Weingartner Sebastian , Schenk Patrick , Rössel Jörg
Published: November 2021

In times of cultural omnivorousness, authentic products are highly valued by high-status consumers. The article scrutinizes the social and individual preconditions for attributing hedonic and economic value to authentic products. Taking the concept of cultural capital as a starting point, it argues that cues indicating a product’s authenticity affect taste and price evaluations only if individuals perceive authenticity cues correctly (descriptive beliefs) and regard authenticity as an important product feature (evaluative beliefs). This interplay of descriptive and evaluative beliefs explains the appreciation of authentic products. The model is tested by combining an experimental tasting of apple juice samples with a survey. We find that cues of authenticity causally influence the hedonic evaluation of products only for consumers with both strong descriptive and evaluative beliefs. Attribution of economic value depends on descriptive beliefs only. In addition, such beliefs are socially structured: descriptive beliefs correlate with higher formal education, whereas evaluative beliefs covary with highbrow cultural practices.
Mission Impossible? Challenging Police Credibility in Suppression Motions
Authors: Liu Siyu , Nir Esther
Published: November 2021

Suppression motions are the means by which defendants challenge the constitutionality of stops, searches, and seizures, and move the court to exclude illegally recovered evidence. However, defendants face insurmountable obstacles in challenging police credibility in these motions. Using 31 motions with factual disputes from a northeastern state, we dissect the types of defense challenges related to stops, searches, seizures, and arrests, as well as the prevalence and types of corroborating evidence presented by the defense. We find that most defense challenges to police credibility are not corroborated, and evidence of prior police misconduct is not presented. Furthermore, judges typically rule in favor of the police when adjudicating uncorroborated factual disputes between police officers and defendants. As a result, suppression motions generally fail to serve as an accountability structure for police conduct and rarely provide defendants with a viable remedy to address rights violations.
“I’m just a TA”; From mixing paints to managing safeguarding and class teaching: An exploration of teaching assistant's perceptions and roles in school
Authors: Bradwell Marie , Bending Hazel
Published: November 2021

This small-scale piece of research listened to the stories, experiences and perceptions of teaching assistants to hear their lived experiences of the role of teaching assistant. To hear how expectations have altered with/without legislative and framework guidance and consideration of the individuals who take up teaching assistant roles, in a climate where there is a succinct lack of legal requirement for any training or qualifications to be undertaken prior to or during the job role. The findings indicated that there appears to be an ethos within primary educational settings that teaching assistants can ‘do it all’ at ‘all times’, that there is a lack of clarity in role and responsibilities across the ‘unqualified staff’, and furthermore that they self-position as “Just a TA”.
Borrower Discouragement: Loan Delays and Loan Rejection: Evidence from MSMEs in the State of Assam in India
Authors: Sarda Rashmi , Baruah Devi
Published: November 2021

In India micro, small and medium enterprises (MSMEs) play a vital role in the development of economy through their contribution to GDP, employment generation, regional development, export promotion, etc. Irrespective of the achievements of the small and medium enterprise (SME) sector, there are certain issues which eclipse desired growth. Availability of ample and timely credit at reasonable rate of interest is vital for the development of these sectors. There seems to be a gap between demand for and supply of the bank credit to SMEs. The delay in processing of credit and the rate of rejections discourage the borrowers from applying for credit. Hence, this article aims to analyse the discouragement faced by MSME loan applicants from the evidence of rejections and delays in advancing loans in Jorhat district in the state of Assam in India.
What does a social justice lawyer need to know?
Authors: Rice Simon
Published: November 2021

Social justice lawyers work to address social phenomena such as inequality, disadvantage, discrimination, marginalisation, oppression and abuse, addressing the immediate needs of a client, or the structural causes of those needs, or both. But social justice lawyers are rarely explicit about the specific knowledge and qualities that their lawyering demands, and that they demonstrate. Across doctrine, theory, values, skills and ethics, there is benefit in setting out what it can mean to be a social justice lawyer, for discussion, comment, criticism, reflection and refinement.
How Immigrant Parents and Local Parents Were Involved in Children's Education in Macau
Authors: Ng Shun W. , Cheong Ka W.
Published: November 2021

The objective of this case study is to analyze how two groups of parents, a group who have newly arrived in Macau from Mainland China and the other who have resided in Macau for more than three decades, interact with the class teachers at the levels of “two-way communication,” “supervision of children at home,” and “participating in decision making” in a secondary school. The findings will redound to the benefits of school leaders, teachers, and indirectly the parents in a sense that looking closely at the ethnic and cultural differences between parents can promote effective cooperation between parents and teachers.
Analysis of scenarios to reduce the probability of acquiring hemolytic uremic syndrome associated with beef consumption
Authors: Costa Magdalena , Brusa Victoria , Padola Nora Lia , Etcheverría Analía , Sampedro Fernando , Fernández Pablo S. , Leotta Gerardo A. , Signorini Marcelo
Published: November 2021

The objective of this study was to develop a quantitative microbial risk assessment (QMRA) model to evaluate potential risk mitigation strategies to reduce the probability of acquiring hemolytic uremic syndrome (HUS) associated with beef consumption in Argentina. Five scenarios were simulated to evaluate the effect of interventions on the probability of acquiring HUS from Shiga toxin-producing Escherichia coli (STEC)-contaminated ground beef and commercial hamburger consumption. These control strategies were chosen based on previous results of the sensitivity analysis of a baseline QMRA model. The application of improvement actions in abattoirs not applying Hazard Analysis and Critical Control Points (HACCP) for STEC would result 7.6 times lower in the probability that consumers acquired HUS from ground beef consumption, while the implementation of improvements in butcher shops would lead to a smaller reduction. In abattoirs applying HACCP for STEC, the risk of acquiring HUS from commercial hamburger consumption was significantly reduced. Treatment with 2% lactic acid, hot water and irradiation reduced 4.5, 3.5 and 93.1 times the risk of HUS, respectively. The most efficient interventions, in terms of case reduction, being those that are applied in the initial stages of the meat chain.
Tourism and struggles for domination: Local tourism communities and symbolic violence in Kashmir
Authors: Ahmad Rafiq
Published: November 2021

Community-based tourism development in rural tourist destinations is hindered by the complex interplay of power struggles between the State, hoteliers, travel agents, local tourism players, host community and activists. Following Bourdieu’s ‘epistemologically reflexive’ sociology of everyday life, including his concepts of ‘capital’, ‘habitus’ and ‘field’, I examine the power relations between the Indian State, the regional government, the armed forces, private urban hoteliers and travel agencies, religious corporations, local tourism service providers (e.g. the ponymen and taxi operators) and the host communities operating at the tourism destination of Pahalgam in the Himalayan territory of the Indian-administered Kashmir. Drawing on ethnographic material collected during June–September 2017 and October 2018, I analyse the power relations in the context of a growing political conflict in the region. The central question this article addresses is how and to what extent these actors, particularly the Indian State, engage in contestations for dominance, insurrection and subversion over Pahalgam tourist destination. Theorising the embodiment of ponywālā1 habitus, I demonstrate that ‘subaltern’ dispositions of the ponymen and their corresponding tourism practices of offering pony rides to tourists and pilgrims create boundaries within the destination ‘field’ of Pahalgam. Subsequently, I aim to show that such dispositions cultivate internalised beliefs or doxa among local community players, thus limiting their access to capitals (economic, social, cultural and symbolic) and ensuring the (re)production of their dominated position in the destination field of Pahalgam.
A Comparison of Clinical Outcomes of Endovascular Repair Versus Open Surgery for Ruptured Descending Thoracic Aorta
Authors: Xie Xinsheng , Shu Xiaolong , Zhang Wei , Guo Daqiao , Zhang Wayne W. , Wang Lixin , Fu Weiguo
Published: November 2021

Objective:

The comparisons between thoracic endovascular aortic repair for ruptured thoracic aorta (TEVAR) and open surgery (OS) have not been well documented, although both procedures have been widely utilized. We performed a systematic review and meta-analysis to investigate the effectiveness and safety between TEVAR and OS in the repair of ruptured descending thoracic aorta.

Methods:

PubMed, Embase, and Cochrane Library databases were searched to find relevant studies to assess TEVAR and OS outcomes. The comparative parameters were perioperative mortality (30 day/in-hospital), 1 year mortality, paraplegia or paraparesis, renal insufficiency, stroke, pulmonary embolism, re-intervention rate, pulmonary complications, and cardiac complications. A fixed-effects model was applied to calculate the odds ratio (OR) with a 95% confidence interval (CI) on pooled outcomes from different studies.

Results:

Eighteen observational trials involving 2088 patients were evaluated (TEVAR=560; OS=1528). Meta-analysis showed that TEVAR in repairing the ruptured descending thoracic aorta was associated with lower perioperative mortality (OR=0.47; 95% CI: 0.34–0.66; p<0.01), 1 year mortality (OR=0.46; 95% CI: 0.29–0.75; p<0.01), renal insufficiency incidence (OR=0.56; 95% CI: 0.33–0.93; p=0.03), and pulmonary complications (OR=0.69; 95% CI: 0.52–0.92; p=0.01) when compared with OS. There was no significant difference between TEVAR and OS in terms of paraplegia, stroke, pulmonary embolism, cardiac complications, and early re-intervention rates. However, the late re-intervention rate was higher in the TEVAR group than that in the OS group.

Conclusions:

When repairing the ruptured descending thoracic aorta, TEVAR may be performed rapidly and safely. TEVAR is associated with lower rates of perioperative morbidity and early postoperative complications than OS.
Efficacy and Safety of Pentoxifylline for Venous Leg Ulcers: An Updated Meta-Analysis
Authors: Sun Shi-Yi , Li Yan , Gao Yun-Yi , Ran Xing-Wu
Published: November 2021

The venous leg ulcers are debilitating, painful, and often unresponsive to advanced dressing treatments, so drugs used locally and systematically are essential adjuvant therapy—pentoxifylline (PTX) whose anti-inflammatory effects may offer a promising avenue to treat venous leg ulcers. However, the current results are controversial. To further evaluate the efficacy and safety of PTX, we performed an updated meta-analysis of randomized placebo-controlled trials of PTX in the treatment of venous leg ulcers. We systematically searched multiple electronic databases PubMed, Web of Science, Embase, the Cochrane Library, the Cochrane Central Register of Controlled Trials, China Science and Technology Journal Database, WanFang Data, China National Knowledge Infrastructure, and the Chinese Biomedical Literature Database to identify eligible studies. Randomized clinical trials of pentoxifylline versus placebo treatment in patients with venous leg ulcers were considered for inclusion. The primary outcomes included ulcer healing rate and the incidence of adverse events after treatment. The secondary outcomes were the ulcer significant improvement (the ulcer size shrank by more than 60% after treatment) rate, mean duration of complete wound healing and changes in mean ulcer size. A meta-analysis and qualitative analysis were conducted to estimate endpoints. A total of 13 randomized clinical trials, including 921 individuals, were finally included. Compared with placebo, pentoxifylline significantly improved the ulcer healing rate (RR = 1.59, 95%CI 1.22 to 2.07, P < .001) and significant improvement rate (RR = 2.36, 95%CI 1.31 to 4.24, P = .004) while increased the incidence of gastrointestinal disturbances (RR = 2.29, 95%CI 1.04 to 5.03, P = .04) at the same time. Moreover, pentoxifylline also shortened mean duration of complete wound healing ( P = .007) and shrank ulcer size ( P = .02). Currently available evidence suggests that pentoxifylline could help venous leg ulcers heal more quickly and effectively. However, the evidence is insufficient to prove the results due to moderate-certainty evidence. Large-scale, well-designed randomized clinical trials are warranted.
Comparison of two simple stitches and modified Mason-Allen suture for medial meniscus posterior root tear based on the progression of meniscal posterior extrusion: A retrospective cohort study
Authors: Kintaka Keisuke , Furumatsu Takayuki , Okazaki Yuki , Masuda Shin , Hiranaka Takaaki , Kodama Yuya , Kamatsuki Yusuke , Ozaki Toshifumi
Published: November 2021

Purpose: Medial meniscus (MM) posterior root (PR) tear leads to severe MM posterior extrusion (PE), resulting in rapid knee cartilage degeneration. MMPR repairs are recommended to reduce MMPE, especially during knee flexion. However, the difference in MMPE between different repair techniques remains unknown. This study aimed to investigate preoperative and postoperative MMPE following several pullout repair techniques. We hypothesized that a technique using two simple stitches (TSS) would be more useful than FasT-Fix-dependent modified Mason-Allen suture (F-MMA) to prevent the progression of MMPE in knee extension. Methods: This retrospective study included 35 patients who underwent MMPR repair. To compare MMPE, patients were divided into two groups according to the use of F-MMA while grasping the posterior capsule and TSS without grasping it. Open magnetic resonance imaging was performed at 10° and 90° knee flexion preoperatively, and at 3 and 12 months postoperatively, and the MMPE of both groups was evaluated. Results: A significant difference was observed between preoperative and 3-month postoperative MMPE at 90° knee flexion in both groups ( p < .01). A significant difference was observed in 3- and 12-month postoperative MMPE at 10° knee flexion between both groups ( p = .04/.02), whereas no significant difference in the preoperative MMPE at 10° knee flexion was observed between them ( p = .45). Conclusions: Both repairs were found to be useful to reduce MMPE in knee flexion. Further, F-MMA repair increased MMPE in knee extension, unlike TSS repair. These findings suggest that TSS might have more advantages for load distribution when standing or walking.
Rate of Incidental Parathyroidectomy in a Pediatric Population
Authors: Sahyouni Grace , Osterbauer Beth , Park Soyun , Paik Connie , Austin Juliana , Gomez Gabriel , Kwon Daniel
Published: November 2021

Objective

Incidental parathyroidectomy is a relatively common occurrence in thyroid surgery, which may lead to hypoparathyroidism and postoperative hypocalcemia, but it is not well studied in children. The objectives of this study were to determine the rate of incidental parathyroidectomy, identify potential risk factors, and investigate postoperative complications in children undergoing thyroidectomy.

Study Design

Retrospective cohort study.

Setting

Patients who underwent thyroidectomy over a 10‐year period at a tertiary children’s hospital.

Methods

Pathology reports were reviewed to determine incidental parathyroid gland tissue. Additional data collected included patient demographics, type of procedure, underlying thyroid pathology, as well as immediate and long‐term postoperative clinical outcomes.

Results

Of 209 patients, 65 (31%) had incidental parathyroidectomy. Several variables were associated with incidental parathyroidectomy on univariable analysis. However, in the final multivariable model, only thyroidectomy with lymph node dissection was associated with increased odds of having incidental parathyroidectomy (odds ratio, 3.3; P =. 04; 95% CI, 1.1‐9.8). After a median follow up of 1 year, a significantly higher percentage of patients with incidental parathyroidectomy had evidence of long‐term hypoparathyroidism (9/62 [15%] vs 3/144 [2%], P =. 001).

Conclusion

Incidental parathyroidectomy was relatively common in our pediatric thyroidectomy population, which may be a result of several anatomic, clinical, and surgeon‐related factors. Close attention to parathyroid preservation with meticulous surgical technique is the most practical method of preventing long‐term hypoparathyroidism and hypocalcemia.
The Implementation and Effectiveness of Digital Cognitive Behavioral Therapy for Insomnia in Primary Care: A Pilot Study
Authors: Hermes Eric D.A. , Rosenheck Robert A. , Burrone Laura , Dante Greg , Lukens Carrie , Martino Steve
Published: November 2021

Background

Digital interventions delivering Cognitive Behavioral Therapy for insomnia (Digital CBTi) may increase utilization of effective care for a common and serious condition. A low-intensity implementation strategy may facilitate digital CBTi use in healthcare settings. This pilot study assessed the feasibility of implementing a digital CBTi in Veterans Health Administration (VA) primary care through iterative modifications to a low-intensity implementation strategy, while evaluating clinical outcomes of a specific digital CBTi program.

Methods

A self-directed digital CBTi was implemented in the primary care clinics of a single VA facility using a cohort trial design that iteratively modified an implementation strategy over three 8-month phases. The phase 1 implementation strategy included (1) provider education; (2) point-of-care information via pamphlets; and (3) provider referral to digital CBTi through phone calls or messages. Phases 2 and 3 maintained these activities, while (1) adding a clinic-based coach who performed initial patient education and follow-up support contacts, (2) providing additional recruitment pathways, and (3) integrating the referral mechanism into provider workflow. Implementation outcomes included provider adoption, patient adoption, and acceptability. Clinical outcomes (insomnia severity, depression severity, and sedative hypnotic use) were compared among enrollees at baseline and 10 weeks.

Results

Across all phases 66 providers (48.9%) made 153 referrals, representing 0.38% of unique clinic patients. Of referrals, 77 (50.3%) enrolled in the study, 45 (29.4%) engaged in the program, and 24 (15.7%) completed it. Provider and patient adoption did not differ meaningfully across phases. Among enrollees, digital CBTi was acceptable and the Insomnia Severity Index decreased by 4.3 points (t = 6.41, p < 0.001) and 13 (18.6%) reached remission. The mean number of weakly sedative-hypnotic doses decreased by 2.2 (35.5%) (t = 2.39, p < 0.02).

Conclusions

Digital CBTi implementation in VA primary care is feasible using low-intensity implementation strategy, resulting in improved clinical outcomes for users. However, iterative implementation strategy modifications did not improve adoption. The trial was registered at clinicaltrials.gov (NCT03151083).
Transcriptomic responses to drought stress in Polygonatum kingianum tuber
Authors: Qian Huali , Xu Zhe , Cong Kun , Zhu Xinyan , Zhang Lei , Wang Junfeng , Wei Jiankun , Ji Pengzhang
Published: November 2021

Background

Polygonatum kingianumColl. et Hemsl. is an important plant in Traditional Chinese Medicine. The extracts from its tubers are rich in polysaccharides and other metabolites such as saponins. It is a well-known concept that growing medicinal plants in semi-arid (or drought stress) increases their natural compounds concentrations. This study was conducted to explore the morpho-physiological responses ofP. kingianumplants and transcriptomic signatures ofP. kingianumtubers exposed to mild, moderate, and severe drought and rewatering.

Results

The stress effects on the morpho-physiological parameters were dependent on the intensity of the drought stress. The leaf area, relative water content, chlorophyll content, and shoot fresh weight decreased whereas electrolyte leakage increased with increase in drought stress intensity. A total of 53,081 unigenes were obtained; 59% of which were annotated. We observed that 1352 and 350 core genes were differentially expressed in drought and rewatering, respectively. Drought stress driven differentially expressed genes (DEGs) were enriched in phenylpropanoid biosynthesis, flavonoid biosynthesis, starch and sucrose metabolism, and stilbenoid diarylheptanoid and gingerol biosynthesis, and carotenoid biosynthesis pathways. Pathways such as plant-pathogen interaction and galactose metabolism were differentially regulated between severe drought and rewatering. Drought reduced the expression of lignin, gingerol, and flavonoid biosynthesis related genes and rewatering recovered the tubers from stress by increasing the expression of the genes. Increased expression of carotenoid biosynthesis pathway related genes under drought suggested their important role in stress endurance. An increase in starch and sucrose biosynthesis was evident from transcriptomic changes under drought stress. Rewatering recovered the drought affected tubers as evident from the contrasting expression profiles of genes related to these pathways.P. kingianumtuber experiences an increased biosynthesis of sucrose, starch, and carotenoid under drought stress. Drought decreases the flavonoids, phenylpropanoids, gingerol, and lignin biosynthesis. These changes can be reversed by rewatering theP. kingianumplants.

Conclusions

These results provide a transcriptome resource forP. kingianumand expands the knowledge on the effect of drought and rewatering on important pathways. This study also provides a large number of candidate genes that could be manipulated for drought stress tolerance and managing the polysaccharide and secondary metabolites’ contents inP. kingianum.
Coordination of leaf hydraulic, anatomical, and economical traits in tomato seedlings acclimation to long-term drought
Authors: Li Shuang , Hamani Abdoul Kader Mounkaila , Zhang Yingying , Liang Yueping , Gao Yang , Duan Aiwang
Published: November 2021

Background

Leaf hydraulic and economics traits are critical for balancing plant water and CO2 exchange, and their relationship has been widely studied. Leaf anatomical traits determine the efficiency of CO2 diffusion within mesophyll structure. However, it remains unclear whether leaf anatomical traits are associated with leaf hydraulic and economics traits acclimation to long-term drought.

Results

To address this knowledge gap, eight hydraulic traits, including stomatal and venation structures, four economics traits, including leaf dry mass per area (LMA) and the ratio between palisade and spongy mesophyll thickness (PT/ST), and four anatomical traits related to CO2 diffusion were measured in tomato seedlings under the long-term drought conditions. Redundancy analysis indicated that the long-term drought decreased stomatal conductance (gs) mainly due to a synchronized reduction in hydraulic structure such as leaf hydraulic conductance (Kleaf) and major vein width. Simultaneously, stomatal aperture on the adaxial surface and minor vein density (VDminor) also contributed a lot to this reduction. The decreases in mesophyll thickness (Tmes) and chlorophyll surface area exposed to leaf intercellular air spaces (Sc/S) were primarily responsible for the decline of mesophyll conductance (gm) thereby affecting photosynthesis. Drought increased leaf density (LD) thus limited CO2 diffusion. In addition, LMA may not be important in regulating gm in tomato under drought. Principal component analysis revealed that main anatomical traits such as Tmes and Sc/S were positively correlated to Kleaf, VDminor and leaf thickness (LT), while negatively associated with PT/ST.

Conclusions

These findings indicated that leaf anatomy plays an important role in maintaining the balance between water supply and CO2 diffusion responses to drought. There was a strong coordination between leaf hydraulic, anatomical, and economical traits in tomato seedlings acclimation to long-term drought.
Context and general practitioner decision-making - a scoping review of contextual influence on antibiotic prescribing
Authors: Al-Azzawi Resha , Halvorsen Peder A. , Risør Torsten
Published: November 2021

Background

How contextual factors may influence GP decisions in real life practice is poorly understood. The authors have undertaken a scoping review of antibiotic prescribing in primary care, with a focus on the interaction between context and GP decision-making, and what it means for the decisions made.

Method

The authors searched Medline, Embase and Cinahl databases for English language articles published between 1946 and 2019, focusing on general practitioner prescribing of antibiotics. Articles discussing decision-making, reasoning, judgement, or uncertainty in relation to antibiotic prescribing were assessed. As no universal definition of context has been agreed, any papers discussing terms synonymous with context were reviewed. Terms encountered included contextual factors, non-medical factors, and non-clinical factors.

Results

Three hundred seventy-seven full text articles were assessed for eligibility, resulting in the inclusion of 47. This article documented the experiences of general practitioners from over 18 countries, collected in 47 papers, over the course of 3 decades.

Contextual factors fell under 7 themes that emerged in the process of analysis. These were space and place, time, stress and emotion, patient characteristics, therapeutic relationship, negotiating decisions and practice style, managing uncertainty, and clinical experience. Contextual presence was in every part of the consultation process, was vital to management, and often resulted in prescribing.

Conclusion

Context is essential in real life decision-making, and yet it does not feature in current representations of clinical decision-making. With an incomplete picture of how doctors make decisions in real life practice, we risk missing important opportunities to improve decision-making, such as antibiotic prescribing.
Clinical characteristics of single human papillomavirus 53 infection: a retrospective study of 419 cases
Authors: Chen Ruizhe , Fu Yunfeng , You Bingbing , Li Ying , Yao Yeli , Wang Xinyu , Cheng Xiaodong
Published: November 2021

Background

Human papillomavirus (HPV) infection is the main cause of cervical cancer. Characteristics of HPV infections, including the HPV genotype and duration of infection, determine a patient’s risk of high-grade lesions. Risk quantification of cervical lesions caused by different HPV genotypes is an important component of evaluation of cervical lesion. Data and evidence are necessary to gain a deeper understanding of the pathogenicity of different HPV genotypes. The present study investigated the clinical characteristics of patients infected with single human papillomavirus (HPV) 53.

Methods

This retrospective study analyzed the clinical data of patients who underwent cervical colposcopy guided biopsy between October 2015 and January 2021. The clinical outcomes and the follow-up results of the patients with single HPV53 infection were described.

Results

82.3% of the initial histological results of all 419 patients with single HPV53 infection showed negative (Neg). The number of patients with cervical intraepithelial neoplasia (CIN)1, CIN2, CIN3, vaginal intraepithelial neoplasia (VaIN)1, CIN1 + VaIN1, CIN1 + VaIN2, and CIN2 + VaIN2 was 45, 10, 2, 9, 6, 1, and 1, respectively. Cancer was not detected in any patient. When the cytology was negative for intraepithelial lesion or malignancy (NILM), atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesion (LSIL), we observed a significant difference in the distribution of histological results (P < 0.05). 95 patients underwent follow-up with cytology according to the exclusion criteria. No progression of high-grade lesions was observed during the follow-up period of 3–34 months.

Conclusions

The lesion caused by HPV53 infection progressed slowly. The pathogenicity of a single HPV53 infection was low.