bluuebunny/crossref_metadata_2025 huggingface dataset:
Do I Deserve to Spend? Online Social Support and Spending Pleasure
Authors: Kim Kawon , Baker Melissa A.
Published: November 2020

Despite evidence of people posting their consumption experiences to online social networks to fulfill the needs of social support, an understanding of how online social support affects post-consumption spending behaviors remains elusive. This research aims to examine how online social support from online social network friends and the firm influence perceptions of self-deservingness and spending pleasure. Across two studies, this research provides evidence that social support gained through online social networks influences consumers’ spending pleasure through perceptions of their own deservingness. Notably, this study reveals that people obtain social support in online social networks from two sources: social networks friends and firms through receiving “Likes” and “Comments” on their post. This study also explores boundary conditions for when online social support is more effective on spending pleasure. The findings not only broaden the social support literature but also address the benefit to the service industry by understanding how social support can enhance spending pleasure.
Cardiac complications in patients hospitalised with COVID-19
Authors: Linschoten Marijke , Peters Sanne , van Smeden Maarten , Jewbali Lucia S , Schaap Jeroen , Siebelink Hans-Marc , Smits Peter C , Tieleman Robert G , van der Harst Pim , van Gilst Wiek H , Asselbergs Folkert W ,   for the CAPACITY-COVID collaborative consortium
Published: November 2020

Aims:

To determine the frequency and pattern of cardiac complications in patients hospitalised with coronavirus disease (COVID-19).

Methods and results:

CAPACITY-COVID is an international patient registry established to determine the role of cardiovascular disease in the COVID-19 pandemic. In this registry, data generated during routine clinical practice are collected in a standardised manner for patients with a (highly suspected) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requiring hospitalisation. For the current analysis, consecutive patients with laboratory confirmed COVID-19 registered between 28 March and 3 July 2020 were included. Patients were followed for the occurrence of cardiac complications and pulmonary embolism from admission to discharge. In total, 3011 patients were included, of which 1890 (62.8%) were men. The median age was 67 years (interquartile range 56–76); 937 (31.0%) patients had a history of cardiac disease, with pre-existent coronary artery disease being most common (n=463, 15.4%). During hospitalisation, 595 (19.8%) patients died, including 16 patients (2.7%) with cardiac causes. Cardiac complications were diagnosed in 349 (11.6%) patients, with atrial fibrillation (n=142, 4.7%) being most common. The incidence of other cardiac complications was 1.8% for heart failure (n=55), 0.5% for acute coronary syndrome (n=15), 0.5% for ventricular arrhythmia (n=14), 0.1% for bacterial endocarditis (n=4) and myocarditis (n=3), respectively, and 0.03% for pericarditis (n=1). Pulmonary embolism was diagnosed in 198 (6.6%) patients.

Conclusion:

This large study among 3011 hospitalised patients with COVID-19 shows that the incidence of cardiac complications during hospital admission is low, despite a frequent history of cardiovascular disease. Long-term cardiac outcomes and the role of pre-existing cardiovascular disease in COVID-19 outcome warrants further investigation.
Cardiovascular health and lifestyle habits of hospital staff in Jeddah: A cross-sectional survey
Authors: Ghamri Ranya Alawy , Baamir Noor Jamal , Bamakhrama Basma Salah
Published: November 2020

Objectives:

Cardiovascular disease is a major cause of morbidity and mortality worldwide. Cardiovascular disease was responsible for over 17.9 million deaths in 2016, accounting for 31% of deaths globally and 37% of deaths in Saudi Arabia. With a lifetime risk exceeding 60% for the general population, healthcare professionals are continuously monitoring the health of others but often do not find time to care for themselves. This study aimed to assess the prevalence of cardiovascular risk factors; medical conditions, such as, hypertension and diabetes mellitus; stress; and attitudes and barriers against healthy lifestyle choices among healthcare professionals at King Abdulaziz University Hospital.

Methods:

A cross-sectional study based on a self-administered questionnaire was conducted among the staff at King Abdulaziz University Hospital over a period of 12 weeks. A validated questionnaire was adopted from a study that had previously been conducted in the United Kingdom.

Results:

The study included 400 healthcare workers, of whom, 78% were clinical staff and 22% were non-clinical staff. Approximately, two-thirds of the clinical staff were aged ⩽25 years, whereas 43.2% of the non-clinical staff were aged 26–35 years. Most of the clinical staff (70.5%) were female, compared to 56.8% of the non-clinical staff. Significantly higher rates of hypertension and smoking were observed among the non-clinical staff than among the clinical staff. However, no other significant differences were observed in the prevalence of diseases between the groups. Overall, poor lifestyle, in terms of low compliance with the recommended dietary and physical activity guidelines, was observed in both groups.

Conclusion:

The prevalence of cardiovascular risk factors among the clinical staff at King Abdulaziz University Hospital was not markedly different from that among the non-clinical staff, except the prevalence of hypertension and smoking, which was significantly higher among the non-clinical staff. Further studies that include staff from other institutions are recommended.
Prevalence of non-communicable diseases and their risk factors in Papua New Guinea: A systematic review
Authors: Rarau Patricia , Guo Shuaijun , Baptista Shaira Nicole , Pulford Justin , McPake Barbara , Oldenburg Brian
Published: November 2020

Introduction:

The mortality associated with non-communicable diseases has increased significantly in most countries in the World Health Organization Western Pacific Region over the last 20 years, as have the underlying risk factors. This study aimed to collate evidence on the prevalence of four major non-communicable diseases and their risk factors in Papua New Guinea in order to inform appropriate policy for their prevention and management.

Methods:

We performed a systematic review of Papua New Guinea-based population prevalence studies of cardiovascular diseases, type 2 diabetes mellitus, chronic respiratory diseases, and cancers, as well as non-communicable disease risk factors published before 2016. Five online databases were searched and screened against eligibility criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results:

A total of 57 articles were included in this review, most of which (n = 48) were published prior to 2000. Eleven articles reported on diabetes, six reported on chronic lung disease/asthma, two reported on cardiovascular diseases, and two reported cancer as the primary outcome, while the remaining 36 papers reported non-communicable disease risk factors.

Conclusion:

This review demonstrated variations in the prevalence of non-communicable diseases (0%–19%) and their risk factors (0%–80.6%) attributed to the lifestyle and genetic diversity of the Papua New Guinea population. There is a strong suggestion that the prevalence of non-communicable diseases (particularly type 2 diabetes mellitus) and key non-communicable disease risk factors (hypertension, overweight, and obesity) has increased, but there is a lack of recent data. As such, there is an urgent need for new and up-to-date data in all areas of Papua New Guinea.
Serum interferon-gamma level is associated with drug-naïve major depressive disorder
Authors: Daria Sohel , Proma Maliha Afrin , Shahriar Mohammad , Islam Sardar Mohammad Ashraful , Bhuiyan Mohiuddin Ahmed , Islam Md. Rabiul
Published: November 2020

Objectives:

Major depressive disorder is a leading heterogeneous psychiatric illness manifested by persistent low mood, a feeling of sadness, and diminished interest in daily activities. Many biological, genetic, and social factors are thought to be linked with depression. But any suitable early risk assessment markers are absent for this illness. Therefore, we aimed to investigate the serum levels of IFN-γ in major depressive disorder patients to further investigate the association between serum levels of this cytokine and major depression.

Methods:

This prospective case-control study enrolled 120 major depressive disorder patients and 100 healthy controls matched by age, sex, and body mass index. A qualified psychiatrist diagnosed the major depressive disorder patients and evaluated healthy controls according to the Diagnostic and Statistical Manual of Mental Health Disorders (5th ed.; DSM-5). The Hamilton depression rating scale was applied for all the study participants to measure the severity of depression. Serum IFN-γ levels were measured by a commercially available enzyme-linked immunosorbent assay kit (Boster Biological Technology, Pleasanton, CA, USA).

Results:

This study observed that serum IFN-γ levels were significantly decreased in major depressive disorder patients compared to healthy controls. A significant negative correlation ( r = −0.375; p < 0.001) was obtained between serum IFN-γ levels and Hamilton depression scores. Receiver operating characteristic analysis showed good diagnostic performance of lowered serum IFN-γ levels in depression with an area under the curve at 0.790.

Conclusion:

We suggest the altered serum IFN-γ levels are associated with the pathophysiology of depression. The reduced levels of serum IFN-γ might be used as an early risk assessment tool for major depression.
Ankle arthroscopy–assisted closed reduction in Bosworth fracture dislocation
Authors: He Shuangjian , Zhu Jian
Published: November 2020

The Bosworth fracture dislocation is a rare type of ankle fracture and is usually unrecognized on initial radiographs, therefore early open reduction is recommended. This study reports a 51-year-old female with uncommon imaging and clinical features. Preoperative X-ray, computed tomography, and magnetic resonance imaging of the ankle showed posterior detached dislocation of the intact distal fibula, the loose osteochondral fragments located in the tibiotalar joint, and the rupture of the deltoid ligament. Due to the initial infected wound on the severely swollen ankle, delayed arthroscopy-assisted closed reduction and internal fixation, removal of loose bodies, and repair of the deltoid ligament were performed, 19 days after injury. Postoperative imaging, including the X-ray, computed tomography, and magnetic resonance imaging, demonstrated the anatomic reduction of the ankle joint. After 6 months of follow-up, the patient gained a pain-free motion of the ankle with a range of passive 10° dorsiflexion and 40° plantar flexion, and resumed her normal gait and activity. This report indicates that the detached posterior dislocation of the intact distal fibula is a rare variant of the Bosworth fracture dislocation, and suggests that arthroscopy-assisted closed reduction and removal of loose osteochondral fragments in joint space are useful technique for this special type of the Bosworth lesions.
Going Overboard: How Ironic Group Style Becomes Political on an Anonymous Imageboard
Authors: Ylä-Anttila Tuukka , Eranti Veikko , Hardwick Sam
Published: November 2020

Anonymous online groups such as imageboards have increasing cultural influence. Recently, they have been connected with far-right political movements. This mixed-methods study investigates politics on Overboard, a Finnish imageboard. We use a convolutional neural network to learn linguistic features of the community’s own understanding of politics, studying two large text corpora, collected in 2014–2015 and 2018–2019. This enables us to find political messages in nominally non-political subforums and discount non-political “noise”—finding the “needles in the haystack.” We quantify the prevalence of political talk on Overboard, assess its themes using topic modeling, and evaluate changes in their popularity. Finally, we qualitatively analyze the style of Overboard. We find that around one-tenth of messages on Overboard are identifiable as “political.” Often, but not univocally, they voice far-right opinions, usually somewhat ironically. The prevalence of far-right themes has increased, likely because of importing global imageboard culture and in parallel with the increased popularity of nationalist-right politics in the broader Finnish public sphere. In terms of group style, the strong boundary between members and outsiders, together with the ironic and cynical speech norms, creates a bond between members. Such a group style lends itself to politicizing the collective.
Application of structural equation modeling in assessing the self-management activities of patients with type 2 diabetes
Authors: Ansari Rashid M. , Harris Mark , Hosseinzadeh Hassan , Zwar Nicholas
Published: November 2020

Objective

This study aimed at assessing the self-management activities of type 2 diabetes patients using Structural Equation Modeling (SEM) which measures and analyzes the correlations between observed and latent variables. This statistical modeling technique explored the linear causal relationships among the variables and accounted for the measurement errors.

Methods

A sample of 200 patients was recruited from the middle-aged population of rural areas of Pakistan to explore the self-management activities of type 2 diabetes patients using the validated version of the Urdu Summary of Diabetes Self-care Activities (U-SDSCA) instrument. The structural modeling equations of self-management of diabetes were developed and used to analyze the variation in glycemic control (HbA1c).

Results

The validated version of U-SDSCA instrument showed acceptable psychometric properties throughout a consecutive reliability and validity evaluation including: split-half reliability coefficient 0.90, test-retest reliability (r = 0.918, P  ≤ .001), intra-class coefficient (0.912) and Cronbach’s alpha (0.79). The results of the analysis were statistically significant (α = 0.05, P-value < .001), and showed that the model was very well fitted with the data, satisfying all the parameters of the model related to confirmatory factor analysis with chi-squared = 48.9, CFI = 0.94, TLI = 0.95, RMSEA = 0.065, SPMR = 0.068. The model was further improved once the items related to special diet were removed from the analysis, chi-squared value (30.895), model fit indices (CFI = 0.98, TLI = 0.989, RMSEA = 0.045, SPMR = 0.048). A negative correlation was observed between diabetes self-management and the variable HbA1c (r = –0.47; P < .001).

Conclusions

The Urdu Summary of Diabetes Self-Care Activities (U-SDSCA) instrument was used for the patients of type 2 diabetes to assess their diabetes self-management activities. The structural equation models of self-management showed a very good fit to the data and provided excellent results which may be used in future for clinical assessments of patients with suboptimal diabetes outcomes or research on factors affecting the associations between self-management activities and glycemic control
Capital, the State, and Environmental Pollution in Nigeria
Authors: Miapyen Buhari Shehu , Bozkurt Umut
Published: November 2020

This research discusses the environmental pollution by the capital in the oil-rich Niger Delta region of Nigeria and identifies two historical agents that have the potential to harmonize their social power through a common language that may create a new social and political agency. We argue that the working class and the community-based social movements are necessary but not sufficient agents of transformation in the Nigerian oil-dependent capitalist economy. The cooperation between the global and local sites of resistance is an imperative: a synergy and deliberate action by the conglomerate of trade unions, community-based social movements, nongovernmental organizations, local and global activists, nurtures the potential to transform the capitalist domination, exploitation, and expropriation in Nigeria. Using secondary literature sources, we re-visit the conversation on the role of capital and the pollution of environment in Nigeria through the concept of “Movement of Movements”.
Dr. Reddy’s Laboratories Ltd: Searching Its Glorious Days
Authors: Abraham Balaji , Kumar Rohit
Published: November 2020

This case explores the phenomenon of organization decline and the dilemma around the different paths that may be traversed by Dr. Reddy’s Laboratories Ltd. There are multiple theories of organizational decline, and mostly they encompass both the external environment and the internal aspects of the firm, including the context of decision-making. Moreover, the organization decline-and-turnaround model highlights the different causes of decline, response factor, firm action and outcomes in a unified and comprehensive manner. To that end, based on secondary data sources and the study of the phenomenon of organization decline in a pharmaceutical industry setting, this case depicts the application of one of the organizational decline-and-turnaround models. The case highlights the company’s trigger for the decline, industry structure, market dynamics, current threats, the competitive landscape along with the fall and the way forward. The case attempts to trigger discussion in the classroom on why organizations decline from their seemingly high standards and what paths can be explored during the decline to enable turnaround.
Long-Term Observation of a Man With Severe Obesity and Undiagnosed Monogenic Diabetes Serendipitously Treated With Metabolic Surgery
Authors: Pandian Bhuvaneswari , Moh Mei Chung , Tan Clara , Lai Wanxin , Ang Su Fen , Lim Boon Khim , Tan Chun Hai , Sum Chee Fang , Subramaniam Tavintharan , Cheng Anton , Lim Su Chi
Published: November 2020

A 43-year-old man, with severe obesity (43 kg/m2) and diabetes (presumed as type 2 diabetes [T2D]), underwent vertical sleeve gastrectomy in 2009 and Roux-en-Y gastric bypass in 2013. Recently, whole exome sequencing (conducted to search for monogenic obesity) serendipitously revealed that the individual harbored a heterozygous glucokinase ( GCK) variant p.(Arg422Leu) that was bioinformatically strongly predicted to be likely pathogenic. Therefore, he is likely to have concomitant maturity-onset diabetes of the young (MODY) type 2 ( GCK-MODY). A retrospective evaluation of the clinical data showed that the subject was diagnosed with T2D (given his severe obesity) in 2005 and was treated with oral antidiabetic monotherapy. His hyperglycemia was mostly mild (HbA1c [hemoglobin] < 8.1%), consistent with that of MODY2, despite severe obesity. After vertical sleeve gastrectomy, complete diabetes remission (HbA1c <6.0% and fasting plasma glucose <5.6 mmol/L without use of antidiabetic medication) was achieved. The percentage of maximum body weight loss attained after surgery was 23.6%. Euglycemia was maintained during the subsequent decade, up to the last follow-up in 2019, without any sign of hypoglycemia. In conclusion, we report a decade-long clinical experience of a man with severe obesity and diabetes likely due to the coexistence of GCK-MODY and T2D, serendipitously treated with metabolic surgery. Interestingly, metabolic surgery was effective and safe for him.
Listed Buildings as Socio-material Hybrids: Assessing Tangible and Intangible Heritage Using Social Network Analysis
Authors: Djabarouti Johnathan
Published: November 2020

Immaterial manifestations of culture have received increasing attention over the past two decades. This is of particular relevance to the contemporary built heritage professional who must not only consider intangible heritage within assessments but attempt to understand its relationship with the physical building fabric. Underpinned by a ‘Practice Theory’ ontology, this research explores how social network analysis (SNA) can reveal entanglements between tangible and intangible heritage by focussing on practices and relationships. Using the Grade II* Long Street Methodist Church and Sunday School, Greater Manchester, UK, the study demonstrates how the basic use of SNA for built heritage assessment can offer a deeper insight into the significance of a listed building. The study demonstrates how SNA can support: an equality of visibility across heritage domains, a better understanding of tangible–intangible relationships and the illumination of underlying practices that sustains these relationships. Perhaps most importantly, it emphasizes the dynamic and unpredictable nature of heritage by de-emphasizing the centrality of the building within heritage assessment processes and reconceptualizing it as an inherent part of social phenomena. In doing so, it suggests one must accept the notion that socio-material practices should be considered for conservation and safeguarding, alongside the physical building itself.
Double plating with autogenous bone grafting as a salvage procedure for recalcitrant humeral shaft nonunion
Authors: Feng Dongxu , Wang Xiaolong , Sun Liang , Cai Xiao , Zhang Kun , Wang Zhan , Zhu Yangjun
Published: November 2020

Background

Although most cases of humeral shaft nonunion respond well to surgical intervention, surgeons still encounter patients with humeral shaft nonunion who have already undergone repeated surgeries for nonunion. This study retrospectively analyzed the efficacy of double locking compression plate (LCP) fixation in combination with autogenous iliac crest bone grafting for recalcitrant humeral shaft nonunion.

Methods

A consecutive series of patients with aseptic recalcitrant humeral shaft nonunion underwent surgical treatment between May 2010 and August 2017 in our institution. Standardized treatment included thorough debridement, double LCP and screw fixation, and autogenous iliac bone grafting. The injury type and the duration of nonunion were recorded for all patients. The main outcome measurements were the Constant and Murley scale for shoulder function, Mayo elbow performance index (MEPI) for elbow function, and visual analog scale (VAS) for pain. In addition, all complications were documented.

Results

The study cohort comprised six females and nine males with a mean age of 45.3 ± 13.1 years. Each patient had already undergone at least one failed surgery for humeral shaft nonunion. The average duration of nonunion before the index intervention was 126.8 ± 124.2 months. All patients achieved bone union without implant failure. At final follow-up, the mean Constant and Murley score and mean MEPI were significantly improved, and the mean VAS score was significantly decreased. Each patient was very satisfied with the treatment. Four patients had complications, including one with a superficial wound infection, one with radial nerve palsy, one with ulnar nerve palsy, and one with discomfort at the iliac crest.

Conclusion

Double plate fixation combined with autogenous iliac crest bone grafting results in successful salvage of humeral shaft nonunion after prior failed surgical interventions.
Achilles tendon enthesitis evaluated by MRI assessments in patients with axial spondyloarthritis and psoriatic arthritis: a report of the methodology of the ACHILLES trial
Authors: Baraliakos Xenofon , Sewerin Philipp , de Miguel Eugenio , Pournara Effie , Kleinmond Christine , Wiedon Annette , Behrens Frank
Published: November 2020

Background

The currently available scoring methods for enthesitis are often measures of pain but not of inflammation at entheseal sites. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) psoriatic arthritis (PsA) magnetic resonance imaging (MRI) scoring system (PsAMRIS) assesses inflammation and damage in PsA and was particularly developed for the hands. The ACHILLES trial used clinical measures for heel enthesitis in combination with MRI scoring based on PsAMRIS.

Methods

Patients (age ≥ 18 years) with spondyloarthritis (SpA) and PsA were included in the trial if they presented with clinical and MRI-positive heel enthesitis. MRI of the affected heel was performed at three time points: screening, Week 24 and Week 52. Inflammatory MRI findings (tendinitis, bursitis and bone marrow oedema [BME]) in the area of the Achilles tendon and/or plantar aponeurosis, periarticular inflammation of the ankle joint and heel erosion were assessed qualitatively (absent/present). In addition, BME and bone erosion were quantitatively assessed based on PsAMRIS, where their proportion was compared to the volume of the affected bone. Mean scores of BME and bone erosion quantification were calculated, and the mean composite score (based on PsAMRIS) was calculated based on the individual score of each subject for periarticular inflammation, BME and bone erosion and further extended for bursitis and tendinitis. Modifications to PsAMRIS were introduced by categorising oedema length as ≤/> 0.5 cm and locating bone erosion.

Conclusions

In ACHILLES, MRI was used to assess and evaluate heel enthesitis. Due to the lack of a validated scoring system for heel enthesitis at the time of ACHILLES initiation, this trial applied quantitative scoring based on PsAMRIS, with specific adaptations for the heel.

Trial registration

National Clinical Trial Registry, NCT02771210. Registered 13 May 2016.
Celebrating 20 years of open access publishing at BMC Musculoskeletal Disorders
Authors: Fitzpatrick Ciarán Martin , Athwal Amanpreet
Published: November 2020

Twenty years ago, on October 23, the first article published by BMC Musculoskeletal Disorders appeared free online. Over 5700 publications later, we celebrate our anniversary as the largest Open Access journal in the ‘Orthopaedics and Sports Medicine’ and ‘Rheumatology’ fields. Our ‘open, inclusive, and trusted’ ethos, along with our efficient and robust peer review services, are recognized by the musculoskeletal field.

The early pioneers of BMC Musculoskeletal Disorders pushed the Open Access publishing model, in order to better support the needs of both the clinical and research communities. We pride ourselves on the continual innovation of author services, data transparency, and peer review models. These advances would not have been possible without your efforts - so a massive thank you to all the authors, editorial teams, and reviewers who have contributed to our success. Excellent reviewers are the nucleus of any thriving journal, and we have been lucky to collaborate with so many talents.
A cross-sectional survey on respiratory disease in a cohort of Irish pig farms
Authors: Rodrigues da Costa Maria , Fitzgerald Rose Mary , Manzanilla Edgar Garcia , O’Shea Helen , Moriarty John , McElroy Máire C. , Leonard Finola Catherine
Published: November 2020

Background

Respiratory disease is one of the most important factors impacting pig production worldwide. There is no available information on the prevalence of key pathogens implicated in Irish pig production. The objective of this study was to describe the prevalence of pleurisy, pneumonia, lung abscesses, pericarditis and liver milk spots in finisher pigs of a cohort of Irish pig farms, and to describe the seroprevalence of: influenza A virus (IAV), porcine reproductive and respiratory syndrome virus (PRRSv), Mycoplasma hyopneumoniae (Mhyo) and Actinobacillus pleuropneumoniae (APP).

Results

In brief, 56 farrow-to-finish farms (29% of the Irish breeding herd) were enrolled in the study in 2017. Data on lungs, heart, and liver lesions were assessed for each farm at slaughter. An average of 417 (range 129–1154) plucks per farm were assessed for pleurisy, pneumonia, lung abscesses, pericarditis, and liver milk spots. Blood samples from 32 finisher pigs were collected at slaughter for each farm. The observed prevalence of pleurisy and pneumonia was one of the lowest reported in similar studies in Europe (13 and 11% estimated average within farm, respectively). Pleurisy lesions were mostly moderate and severe. Pneumonia lesions affected a low level of lung surface (5.8%). Prevalence of pericarditis was mid-high (8%) and the prevalence of liver milk spots was high, with an average of 29% of the livers affected. For serology, 78.6% of the farms were positive for IAV, 50% were positive for PRRSv, 71.4% were positive for Mhyo, and 98.2% were positive for APP. Influenza virus was the main pathogen associated with pleurisy (P < 0.001) and Mhyo was the main pathogen associated with pneumonia (P < 0.001) and pericarditis (P = 0.024).

Conclusions

Farms affected with pleurisy had moderate to severe lesions. Farms affected with pneumonia had mild lesions, which could be the effect of the generalised use of Mhyo vaccination in piglets. The seroprevalence of IAV, PRRSv, Mhyo and APP in the present study sample is similar to or lower than in other European countries. Further research on the PRRSv and APP strains circulating in Ireland is necessary to support the design of national or regional control plans.
Research on simulation in radiography education: a scoping review protocol
Authors: Vestbøstad Mona , Karlgren Klas , Olsen Nina Rydland
Published: November 2020

Background

Today, there are fewer opportunities for health care students and staff for skills training through direct patient contact. The World Health Organization therefore recommends learning about patient safety through hands-on experience and simulation. Simulation has the potential to improve skills through training in a controlled environment, and simulation has a positive effect on knowledge and skills, and even patient-related outcomes. Reviews addressing the use of simulation across the different radiography specialties are lacking. Further knowledge on simulation in radiography education is needed to inform curriculum design and future research. The purpose of this scoping review is to explore, map, and summarize the extent, range, and nature of published research on simulation in radiography education.

Methods

We will follow the methodological framework for scoping reviews originally described by Arksey and O’Malley. We will search the MEDLINE, Embase, Epistemonikos, The Cochrane Library, ERIC, Scopus, and sources of grey literature. A comprehensive search strategy for Ovid MEDLINE was developed in collaboration with a research librarian. An example of a full electronic search from the Ovid MEDLINE (1641 articles records, January 9, 2020) is provided and will be used to adapt the search strategy to each database. Two independent review authors will screen all abstracts and titles, and full-text publications during a second stage. Next, they will extract data from each included study using a data extraction form informed by the aim of the study. A narrative account of all studies included will be presented. We will present a simple numerical analysis related to the extent, nature, and distribution of studies, and we will use content analysis to map the different simulation interventions and learning design elements reported. Any type of simulation intervention within all types of radiography specializations will be included. Our search strategy is not limited by language or date of publication.

Discussion

An overview of publications on simulation in radiography education across all radiography specialties will help to inform future research and will be useful for stakeholders within radiography education using simulation, both in the academic and clinical settings.

Systematic review registration

Open Science Framework (OSF). Submitted on October 18, 2020
Wide-awake local anaesthesia no tourniquet (WALANT) vs regional or general anaesthesia for flexor tendon repair in adults: protocol for a systematic review and meta-analysis
Authors: Nolan Grant S. , Kiely Ailbhe L. , Madura Tomas , Karantana Alexia
Published: November 2020

Background

Flexor tendon injuries most commonly occur following a penetrating injury to the hand or wrist. These are challenging injuries and the standard treatment is surgical repair under general or regional anaesthesia.

‘Wide-awake’ surgery is an emerging technique in hand surgery where a conscious patient is operated on under local anaesthetic. The vasoconstrictive effect of adrenaline (epinephrine) creates a ‘bloodless’ operating field and a tourniquet is not required. The potential advantages include intra-operative testing of the repair; removal of the risks of general anaesthesia; reduced costs; no aerosol generation from intubation therefore reduced risk of COVID-19 spread to healthcare professionals. The aim of this study will be to systematically evaluate the evidence to determine if wide-awake surgery is superior to general/regional anaesthetic in adults who undergo flexor tendon repair.

Methods

We designed and registered a study protocol for a systematic review and meta-analysis of comparative and non-comparative studies. The primary outcome will be functional active range of motion. Secondary outcomes will be complications, resource use (operative time) and patient-reported outcome measures. A comprehensive literature search will be conducted (from 1946 to present) in MEDLINE, EMBASE, CINAHL, and Cochrane Library. Grey literature will be identified through Open Grey, dissertation databases and clinical trials registers. All studies on wide-awake surgery for flexor tendon repair will be included. The comparator will be general or regional anaesthesia. No limitations will be imposed on peer review status or language of publication. Two investigators will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion or referral to a third author when necessary. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct a random effects meta-analysis.

Discussion

This systematic review will summarise the best available evidence and definitively establish if function, complications, cost, or patient-reported outcomes are improved when flexor tendons are repaired using wide-awake technique. It will determine if this novel approach is superior to general or regional anaesthesia. This knowledge will help guide hand surgeons by continuing to improve outcomes from flexor tendon injuries.

Systematic review registration

PROSPEROCRD42020182196
Does early tracking affect learning inequalities? Revisiting difference-in-differences modeling strategies with international assessments
Authors: Contini Dalit , Cugnata Federica
Published: November 2020

The development of international surveys on children’s learning like PISA, PIRLS and TIMSS—delivering comparable achievement measures across educational systems—has revealed large cross-country variability in average performance and in the degree of inequality across social groups. A key question is whether and how institutional differences affect the level and distribution of educational outcomes. In this contribution, we discuss the difference-in-differences strategies employed in the existing literature to evaluate the effect of early tracking on learning inequalities exploiting international assessments administered at different age/grades. In their seminal paper, Hanushek and Woessmann (Econ J 116:C63–C76, 2006) analyze with two-step estimation the effect of early tracking onoverallinequalities, measured by test scores’ variability indexes. Later work of other scholars in the economics and sociology of education focuses instead on inequalities among children of differentfamily background, using individual-level models on pooled data from different countries and assessments. In this contribution, we show that individual pooled difference-in-differences models are quite restrictive and that in essence they estimate the effect of tracking by double differentiating the estimated cross-sectional family background regression coefficients between tracking regimes and learning assessments. Starting from a simple learning growth model, we show that if test scores at different surveys are not measured on the same scale, as occurs for international learning assessments, pooled individual models may deliver severely biased results. Instead, the scaling problem does not affect the two-step approach. For this reason, we suggest using two-step estimation also to analyzefamily-backgroundachievement inequalities. Against this background, using PIRLS-2006 and PISA-2012 we conduct two-step analyses, finding new evidence that early tracking fosters both overall inequalities and family background differentials in reading literacy.
Establishment of a Novel Human Fetal Adrenal Culture Model that Supports de Novo and Manipulated Steroidogenesis
Authors: Melau Cecilie , Nielsen John E , Perlman Signe , Lundvall Lene , Langhoff Thuesen Lea , Juul Hare Kristine , Schou Hammerum Mette , Frederiksen Hanne , Mitchell Rod T , Juul Anders , Jørgensen Anne
Published: November 2020

Context

Disorders affecting adrenal steroidogenesis promote an imbalance in the normally tightly controlled secretion of mineralocorticoids, glucocorticoids, and androgens. This may lead to differences/disorders of sex development in the fetus, as seen in virilized girls with congenital adrenal hyperplasia (CAH). Despite the important endocrine function of human fetal adrenals, neither normal nor dysregulated adrenal steroidogenesis is understood in detail.

Objective

Due to significant differences in adrenal steroidogenesis between human and model species (except higher primates), we aimed to establish a human fetal adrenal model that enables examination of both de novo and manipulated adrenal steroidogenesis.

Design and Setting

Human adrenal tissue from 54 1st trimester fetuses were cultured ex vivo as intact tissue fragments for 7 or 14 days.

Main Outcome Measures

Model validation included examination of postculture tissue morphology, viability, apoptosis, and quantification of steroid hormones secreted to the culture media measured by liquid chromatography-tandem mass spectrometry.

Results

The culture approach maintained cell viability, preserved cell populations of all fetal adrenal zones, and recapitulated de novo adrenal steroidogenesis based on continued secretion of steroidogenic intermediates, glucocorticoids, and androgens. Adrenocorticotropic hormone and ketoconazole treatment of ex vivo cultured human fetal adrenal tissue resulted in the stimulation of steroidogenesis and inhibition of androgen secretion, respectively, demonstrating a treatment-specific response.

Conclusions

Together, these data indicate that ex vivo culture of human fetal adrenal tissue constitutes a novel approach to investigate local effects of pharmaceutical exposures or emerging therapeutic options targeting imbalanced steroidogenesis in adrenal disorders, including CAH.
Clinical Outcomes of Pregnant and Postpartum Extracorporeal Membrane Oxygenation Patients
Authors: Lankford Allison S. , Chow Jonathan H. , Jackson Amanda M. , Wallis Marianne , Galvagno Samuel M. , Malinow Andrew M. , Turan Ozhan M. , Menaker Jay A. , Crimmins Sarah D. , Rector Raymond , Kaczorowski David , Griffith Bartley , Kon Zachary , Herr Daniel , Mazzeffi Michael A.
Published: November 2020

BACKGROUND:

The use of extracorporeal membrane oxygenation (ECMO) as a rescue therapy for cardiopulmonary failure is expanding in critical care medicine. In this case series, we describe the clinical outcomes of 21 consecutive pregnant or postpartum patients that required venovenous (VV) or venoarterial (VA) ECMO. Our objective was to characterize maternal and fetal survival in peripartum ECMO and better understand ECMO-related complications that occur in this unique patient population.

METHODS:

Between January 2009 and June 2019, all pregnant and postpartum patients treated with ECMO for respiratory or circulatory failure at a single quaternary referral center were identified. For all patients, indications for ECMO, maternal and neonatal outcomes, details of ECMO support, and anticoagulation and bleeding complications were collected.

RESULTS:

Twenty-one obstetric patients were treated with ECMO over 10 years. Thirteen patients were treated with VV ECMO and 8 patients were treated with VA ECMO. Six patients were pregnant at the time of cannulation and 3 patients delivered while on ECMO; all 6 maternal and infant dyads survived to hospital discharge. The median gestational age at cannulation was 28 weeks (interquartile range [IQR], 24–31). In the postpartum cohort, ECMO initiation ranged from immediately after delivery up to 46 days postpartum. Fifteen women survived (72%). Major bleeding complications requiring surgical intervention were observed in 7 patients (33.3%). Two patients on VV ECMO required bilateral orthotopic lung transplantation and 1 patient on VA ECMO required orthotopic heart transplantation to wean from ECMO.

CONCLUSIONS:

Survival for mother and neonate are excellent with peripartum ECMO in a high-volume ECMO center. Neonatal and maternal survival was 100% when ECMO was used in the late second or early third trimester. Based on these results, ECMO remains an important treatment option for peripartum patients with cardiopulmonary failure.
Efficiency Metrics at an Academic Freestanding Ambulatory Surgery Center: Analysis of the Impact on Scheduled End-Times
Authors: Reeves J. Jeffery , Waterman Ruth S. , Spurr Kristin R. , Gabriel Rodney A.
Published: November 2020

BACKGROUND:

Understanding the impact of key metrics on operating room (OR) efficiency is important to optimize utilization and reduce costs, particularly in freestanding ambulatory surgery centers. The aim of this study was to assess the association between commonly used efficiency metrics and scheduled end-time accuracy.

METHODS:

Data from patients who underwent surgery from May 2018 to June 2019 at an academic freestanding ambulatory surgery center was extracted from the medical record. Unique operating room days (ORDs) were analyzed to determine (1) duration of first case delays, (2) turnover times (TOT), and (3) scheduled case duration accuracies. Spearman’s correlation coefficients and mixed-effects multivariable linear regression were used to assess the association of each metric with scheduled end-time accuracy.

RESULTS:

There were 1378 cases performed over 300 unique ORDs. There were 86 (28.7%) ORDs with a first case delay, mean (standard deviation [SD]) 11.2 minutes (15.1 minutes), range of 2–101 minutes; the overall mean (SD) TOT was 28.1 minutes (19.9 minutes), range of 6–83 minutes; there were 640 (46.4%) TOT >20 minutes; the overall mean (SD) case duration accuracy was −6.6 minutes (30.3 minutes), range of −114 to 176; and there were 389 (28.2%) case duration accuracies ≥30 minutes. The mean (SD) scheduled end-time accuracy was 6.9 minutes (68.3 minutes), range of −173 to 229 minutes; 48 (15.9%) ORDs ended ≥1 hour before scheduled end-time and 56 (18.6%) ORDs ended ≥1 hour after scheduled end-time. The total case duration accuracy was strongly correlated with the scheduled end-time accuracy (r = 0.87, 95% confidence interval [CI], 0.84-0.89, P < .0001), while the total first case delay minutes (r = 0.12, 95% CI, 0.01-0.21, P = .04) and total turnover time (r = −0.16, 95% CI, 0.21-0.05, P = .005) were less relevant. Case duration accuracy had the highest association with the dependent variable (0.95 minutes changed in the difference between actual and schedule end time per minute increase in case duration accuracy, 95% CI, 0.90-0.99, P < .0001), compared to turnover time (estimate = 0.87, 95% CI, 0.75-0.99, P < .0001) and first case delay time (estimate = 0.83, 95% CI, 0.56-1.11, P < .0001).

CONCLUSIONS:

Standard efficiency metrics are similarly associated with scheduled end-time accuracy, and addressing problems in each is requisite to having an efficient ambulatory surgery center. Pursuing methods to narrow the gap between scheduled and actual case duration may result in a more productive enterprise.
Examining Neuromuscular Control of the Vastus Medialis Oblique and Vastus Lateralis Muscles During Fundamental Dance Movements
Authors: Weighart Hannah , Morrow Noelle , DiPasquale Sarah , Ives Stephen J.
Published: November 2020

Elite dancers have a higher rate of injury than college athletes. This may be due, in part, to improper alignment during dance movements. Electromyography (EMG) can be an important indicator of such activity. This study aimed to examine how turnout (maximal hip external rotation) impacts
activation of the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles during fundamental dance movements. Thirty female collegiate dancers were recruited from intermediate and advanced ballet and modern technique classes. Surface EMG was used to examine activation of the VMO and
VL during maximal isokinetic knee extension in demi-pliés and sautés in parallel and turned-out positions. The mean VMO:VL ratio was determined as a percentage of the highest repetition of maximal extension. The ratio was significantly lower during parallel sautés (0.921
± 0.258) in comparison to turned-out sautés (1.008 ± 0.384; p = 0.033) and parallel pliés (1.185 ± 0.509; p = 0.002). No significant relationships were found between the VMO:VL ratio and injury history or predominant style of dance. Further investigation
is warranted to examine the relationships between VMO:VL activation, patellofemoral alignment, and risk of pathology during simple and complex dance movements.
Theory of Mind deficits in childhood mental and neurodevelopmental disorders
Authors: Szamburska-Lewandowska Katarzyna , Konowałek Łukasz , Bryńska Anita
Published: November 2020

Teoria umysłu jest złożonym procesem poznawczym, dzięki któremu rozumiemy, że inni ludzie posiadają stany mentalne i emocjonalne takie jak przekonania, plany, pragnienia, nadzieje, intencje czy wiedzę, które różnią się od naszych własnych. Teoria umysłu umożliwiając rozumienie zachowań innych ludzi jest umiejętnością niezbędną do prawidłowego funkcjonowania społecznego. Początkowo cel badań nad teorią umysłu stanowiło opisanie i udokumentowanie rozwoju poznawczego dzieci w wieku przedszkolnym. Wraz z odkryciem, 30 lat temu, deficytów w teorii umysłu u pacjentów z zaburzeniami ze spektrum autyzmu, rozpoczęto badanie nieprawidłowości w funkcjonowaniu teorii umysłu u pacjentów z różnymi zaburzeniami. Wyniki badań wskazują na obecność deficytów w teorii umysłu u pacjentów z zaburzeniami psychicznymi wieku rozwojowego, takimi jak: zaburzenia ze spektrum autyzmu, zespół nadpobudliwości psychoruchowej, zaburzenia opozycyjno-buntownicze, zespół Tourette’a, alkoholowy zespół płodowy, zaburzenia nastroju, zaburzenia jedzenia czy zaburzenie obsesyjno-kompulsyjne. Niniejszy artykuł stanowi przegląd istotnych badań dotyczących nieprawidłowości w funkcjonowaniu teorii umysłu w poszczególnych zaburzeniach wieku rozwojowego i wybranych zaburzeniach psychicznych.