bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic response analysis for multi-degrees-of-freedom parallel mechanisms with various types of three-dimensional clearance joints
Authors: Yonghao Jia , Xiulong Chen
Published: May 2021

For spatial multibody systems, the dynamic equations of multibody systems with compound clearance joints have a high level of nonlinearity. The coupling between different types of clearance joints may lead to abundant dynamic behavior. At present, the dynamic response analysis of the spatial parallel mechanism considering the three-dimensional (3D) compound clearance joint has not been reported. This work proposes a modeling method to investigate the influence of the 3D compound clearance joint on the dynamics characteristics of the spatial parallel mechanism. For this purpose, 3D kinematic models of spherical clearance joint and revolute joint with radial and axial clearances are derived. Contact force is described as normal contact and tangential friction and later introduced into the nonlinear dynamics model, which is established by the Lagrange multiplier technique and Jacobian of constraint matrix. The influences of compound clearance joint and initial misalignment of bearing axes on the system are analyzed. Furthermore, validation of dynamics model is evaluated by ADAMS and Newton–Euler method. This work provides an essential theoretical basis for studying the influences of 3D clearance joints on dynamic responses and nonlinear behavior of parallel mechanisms.
A systematic review and meta-analysis of the Endometriosis and Mental-Health Sequelae; The ELEMI Project
Authors: Delanerolle Gayathri , Ramakrishnan Rema , Hapangama Dharani , Zeng Yutian , Shetty Ashish , Elneil Sohier , Chong Sam , Hirsch Martin , Oyewole Molola , Phiri Peter , Elliot Kathryn , Kothari Trusha , Rogers Bryony , Sandle Natasha , Haque Nyla , Pluchino Nicola , Silem Martin , O’Hara Rebecca , Hull M Louise , Majumder Kingshuk , Shi Jian Qing , Raymont Vanessa
Published: May 2021

Background:

It is important to evaluate sequalae for complex chronic health conditions such as endometriosis and mental health disorders. Endometriosis impacts 1 in 10 women. Mental health outcomes can be a primary determinant in many physical health conditions although this is an area not well researched particularly in women’s health. This has been problematic for endometriosis patients in particular, who report mental health issues as well as other key comorbidities such as chronic pelvic pain and infertility. This could be partly due to the complexities associated with comprehensively exploring overlaps between physical and mental health disorders in the presence of multiple comorbidities and their potential mechanistic relationship.

Methods:

In this evidence synthesis, a systematic methodology and mixed-methods approaches were used to synthesize both qualitative and quantitative data to examine the prevalence of the overlapping sequalae between endometriosis and psychiatric symptoms and disorders. As part of this, an evidence synthesis protocol was developed which included a systematic review protocol that was published on PROSPERO (CRD42020181495). The aim was to identify and evaluate mental health reported outcomes and prevalence of symptoms and psychiatric disorders associated with endometriosis.

Findings:

A total of 34 papers were included in the systematic review and 15 were included in the meta-analysis. Anxiety and depression symptoms were the most commonly reported mental health outcomes while a pooled analysis also revealed high prevalence of chronic pelvic pain and dyspareunia.

Interpretation:

It is evident that small-scale cross-sectional studies have been conducted in a variety of settings to determine mental health outcomes among endometriosis patients. Further research is required to comprehensively evaluate the mental health sequalae with endometriosis.
Value of adjunctive evidence from MII-pH monitoring and high-resolution manometry in inconclusive GERD patients with AET 4–6%
Authors: Jiang Ya , Jiang Liuqin , Ye Bixing , Lin Lin
Published: May 2021

Objectives:

Gastro-esophageal reflux disease (GERD) is a common disease in gastroenterology outpatients. However, some patients with typical reflux symptoms does not satisfy diagnostic criteria. This study was to explore the value of adjunctive evidence from multichannel intraluminal impedance-pH (MII-pH) monitoring and esophageal high-resolution manometry (HRM) in inconclusive GERD patients with acid exposure time (AET) 4–6%.

Methods:

Endoscopy, MII-pH monitoring and esophageal HRM were retrospectively analyzed from consecutive patients with typical reflux symptoms in a tertiary hospital from 2013 to 2019. Patients were categorized as conclusive or inconclusive GERD according to AET. Adjunctive evidence for GERD diagnosis from Lyon Consensus were collected and analyzed.

Results:

Among 147 patients with typical reflux symptoms, conclusive GERD was found in only 31.97% of patients ( N = 47). The remaining 100 patients (68.03%) were inconclusive GERD, of whom 28% ( N = 28) had AET 4–6%. These patients suffered similar reflux burden and impaired esophageal movement. Inconclusive GERD patients with AET 4–6% had lots of positive adjunctive evidence from HRM and MII-pH monitoring. In receiver operating characteristic analysis, mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave index (PSPWI) had an area under the curve (AUC) of 0.839 (CI: 0.765–0.913, p < 0.001) and 0.897 (CI: 0.841–0.953, p < 0.001), respectively, better than total reflux episode (AUC of 0.55, p = 0.33). When MNBI was combined with PSPWI, the AUC was elevated to 0.910 (CI: 0.857–0.963, p < 0.001).

Conclusions:

Inconclusive GERD patients with AET 4–6% have similar acid burden and esophagus motility dysfunction to GERD patients. MNBI and PSPWI are pivotal adjunctive evidence for diagnosing GERD when AET is borderline.
Evaluation of a novel colonoscope offering flexibility adjuster – a retrospective observational study
Authors: Gerges Christian , Neumann Helmut , Ishaq Sauid , Sivanathan Visvakanth , Galle Peter R. , Neuhaus Horst , Neumann Helmut
Published: May 2021

Background:

Although colonoscopy is the gold standard for colorectal cancer screening, colonic looping may make complete colonoscopy challenging. Commonly available stiffening device colonoscopy has been described as helpful but not effective enough to prevent looping. In this context the effect on cecal intubation time and rate was described differently in various studies and in some studies had no impact on cecal intubation time at all. The aim of this study was to evaluate whether a novel colonoscope with gradual stiffness (Fujifilm EC760R-V/I- flexibility adjuster, Tokyo, Japan) using four significantly different grades of stiffness can be an alternative to established devices in terms of loop prevention, cecal intubation rate and time, adverse events, and patient/examiner satisfaction.

Methods:

Consecutive patients without previous colorectal surgery were analyzed retrospectively. Colonoscopy was performed with the new colonoscope and performance characteristics, including time to cecum, withdrawal time, total examination time, and patient and endoscopist satisfaction were recorded.

Results:

Among 180 consecutive procedures, 98.3% of examinations were complete to the cecum. The endoscopic flexibility adjuster was used in 150 of 180 cases (83.3%). Overall, the device was scored by the examiner as helpful to prevent looping in 146 of the 150 cases (97.7%). Mean cecal intubation time was 6.5 min, with 35% of examination performed in under 5 min with a mean withdrawal time of 7 min. Mean total examination time was 18 min. Patient satisfaction was rated as high in all examinations performed.

Conclusion:

The new flexibility adjuster colonoscope was shown to be helpful in loop prevention, allowed for fast and successful cecal intubation, and led to a high rate of patients satisfaction.
Long-term safety and efficacy study of a medical device containing xyloglucan, pea protein reticulated with tannins and xylo-oligosaccharides, in patients with diarrhoea-predominant irritable bowel syndrome
Authors: de los Rios Constanza Ciriza , Falcón Blanca Serrano , Arguelles-Arias Federico , Pérez Esperanza , Teruel Carlos , Geijo Fernando , Rey Enrique
Published: May 2021

Background:

Irritable bowel syndrome with diarrhoea (IBS-D) is a frequent problem associated with a significant socioeconomic implication. Increased gut permeability is an important pathophysiological mechanism. A medical device containing xyloglucan (XG), pea protein and tannins (PPT) from grape-seed extract, and xylo-oligosaccharides (XOS) has proven restoration of intestinal barrier function. Our objective was to evaluate the efficacy and safety of treatment with the medical device XG + PPT + XOS (XG-PPT-XOS) in adult patients with IBS-D in a clinical setting for 6 months.

Material and methods:

This was a multicentre, open-label, prospective, observational study conducted to evaluate long-term safety and efficacy of XG-PPT-XOS. IBS-D adult patients (Rome IV criteria) were included and received two tablets twice daily for 6 months. IBS Symptom Severity Score (IBS-SSS) and bowel habit were registered at baseline and monthly, until the end of follow up. Efficacy was evaluated by comparison of mean scores at each time point.

Results:

50 patients were included, of which 19 completed the 6 months. IBS-SSS score decreased from 312.2 ± 82.2 to 213.6 ± 109.9 ( p < 0.0001) at 1 month and 192.0 ± 108.9 at the last visit completed; diarrhoea score decreased from 45.6 ± 17.9 to 25.7 ± 17.7 and 25.3 ± 17.2 at 1 month and at the last visit completed, respectively. Pain score decreased from 107.8 ± 49.9 at baseline to 73.2 ± 57.3 ( p < 0.0001) at 1 month and bloating score from 56.4 ± 28.8 at baseline to 42.8 ± 32.6 ( p < 0.001) at 1 month, reaching 62.4 ± 56.0 and 40.4 ± 34.3, respectively, at the last visit completed. Adverse effects were mild and mostly not related to treatment.

Conclusion:

Treating IBS-D patients with XG-PPT-XOS is effective and safe in the long term within a clinical setting, improving all IBS-D symptoms from the first month of treatment and showing a sustained response over the term of therapy.
Predictions of FluSurge 2.0 methodology on hospital utilization during the Covid-19 outbreaks in several countries
Authors: Reyes-Santias Francisco , Barrachina-Martinez Isabel , Vivas-Consuelo David
Published: May 2021

Application of the Flusurge 2.0 methodology to predict the needs of conventional hospital treatment, intensive care, and respiratory support resources as a consequence of coronavirus disease (COVID-19) in several countries. Different countries of the following continents have been selected: Europe, Asia, Africa, North America, South America, and Oceania. Variables: Total population and age distribution; Number of COVID19 infections; Number of deaths from COVID19; Number of non-ICU hospital beds; Number of ICU beds; Number of ventilators. Method: The proposed possible scenario planning is based on the application of FluSurge 2.0 Software, developed by The Johns Hopkins Center for Health Security (CHS/CDC). Saturation of conventional hospitalization is expected in India, Uganda, Nepal, and Haiti; there is a forecast of saturation for ICU beds in all sample countries except Turkey. Ventilator saturation is expected in all countries of the sample except Argentina, Austria, Brazil, France, United Kingdom, Japan, South Korea, Norway, Poland, Turkey and the USA. The model shows, for a percentage greater than 50% of the countries, difficulties related to the saturation of their ICU units, and the use of ventilators.
A New Asymmetric Synthesis of (S)-14-Methyl-1-Octadecene, the Sex Pheromone of the Peach Leafminer Moth
Authors: He Guo-Guo , Liu Si-Fan , Rao Bao-Qi , Bai Hong-Jin , Du Zhen-Ting
Published: May 2021

An asymmetric synthesis of 14-methyl-1-octadecene, the sex pheromone of the peach leafminer moth, has been efficiently achieved. A key chiral intermediate, ( R)−4-(benzyloxy)−3-methylbutanal, which has been developed as the resource chemical, can be obtained in large quantities from the steroid industry. 1,11-Undecanediol is selectively masked, and then converted into a phosphonium salt derivative, thereby effectively constructing a carbon skeleton. The target molecule is synthesized in 8 linear steps, with a 42% yield. The key characteristic of our synthesis lies in its chiral-pool strategy.
A Comprehensive Mini-Review of Curcumae Radix: Ethnopharmacology, Phytochemistry, and Pharmacology
Authors: Hu Dongyi , Gao Jiayu , Yang Xiao , Liang Ying
Published: May 2021

Curcumae Radix is an efficacious ingredient with various medicinal properties empirically used in traditional Chinese medicine (TCM) formula for the treatment of cancer, depression, chest pain, dysmenorrhea, epilepsy, and jaundice. However, either phytochemical or pharmacological information of Curcumae Radix underlying its traditionally medicinal uses is rarely summarized and systematically analyzed. To provide evidence for clinical trials, a comprehensive literature review has been prepared of the phytochemicals, and ethnopharmacological and pharmacological mechanisms of this herb. The review approach consisted of searching several web-based scientific databases, including PubMed, Web of Science, and Elsevier. The keywords included “Curcumae Radix,” “ Curcuma wenyujin,” “ Curcuma longa,” “ Curcuma kwangsiensis,” and “ Curcuma phaeocaulis.” Based on the proposed criteria, 57 articles were evaluated in detail. The accumulated data indicate that Curcumae Radix contains a number of bioactive phytochemicals, mainly sesquiterpenes, diarylheptanoids, and diarylpentanoids, which account for a variety of medicinal values, such as anticancer, anti-inflammation, anti-hepatic fibrosis, and antioxidant. A wide range of apoptotic proteins, cell adhesion molecules, inflammatory cytokines, and enzymic and nonenzymic antioxidants could be modulated by either Curcumae Radix or its bioactive compounds, thus underpinning a fundamental understanding for the pharmacological effects of this herb. This review highlights the therapeutic potential of Curcumae Radix to progress the development of versatile adjuvants or therapeutic agents in the future.
Ferumoxytol for the treatment of iron deficiency and iron-deficiency anemia of pregnancy
Authors: Gerb Jesse , Strauss William , Derman Richard , Short Vanessa , Mendelson Ben , Bahrain Huzefa , Auerbach Michael
Published: May 2021

Introduction:

A litany of recent evidence supports the morbidity of intra-natal iron-deficiency anemia and its prodrome, iron deficiency. Oral iron administered during second and third trimesters does not get to the developing fetus if the mother is iron deficient. This is especially concerning as the rapidly developing fetal brain is in particular need of iron sufficiency. Intra-natal iron deficiency is associated with autism, schizophrenia and abnormal brain structure. The obstetrical literature reports an unacceptably high incidence of gastrointestinal adverse events with oral iron. The time iron honored standard in the United States for intravenous iron replenishment in gravidas is iron sucrose. While safe and effective, four to seven visits are required to accomplish what newer formulations can achieve with one.

Methods:

Ferumoxytol is a superparamagnetic iron oxide linked to polyglucose sorbitol carboxymethylether-binding elemental iron tightly allowing administration of complete replacement doses in 15–30 min. Herein, we report the results of 131 consecutive, non-selected, iron-deficient second- and third-trimester pregnant women who received either 510 mg of intravenous (IV) ferumoxytol twice or 1020 mg once.

Results:

Hemoglobin and iron parameter increments were highly statistically significant. No adverse events were reported. We report how a single infusion is safe and effective as the same dose over two visits, saving an unnecessary visit and IV placement, while reducing cost.

Conclusion:

Ferumoxytol represents an efficacious and safe method of administration of IV iron which improves convenience for patients and practitioners, and is cost saving due to fewer visits.

Plain language summary

One or two infusions of intravenous iron for iron deficiency or iron-deficiency anemia of pregnancy simplifies care This study was conducted to highlight the inconvenience of multiple doses of IV iron and how administering the same dose in one or two infusions simplifies care. We report how a single infusion is as safe and effective as the same dose over two visits, saving an unnecessary visit and IV placement, while reducing cost. This study supports a growing body of evidence, to date, unreported, with ferumoxytol in pregnancy, reporting improved convenience and decreased costs with higher doses of IV iron in one or two visits.
Natural-killer cell cytotoxicity as a diagnostic and prognostic marker for adult patients with secondary hemophagocytic lymphohistiocytosis: a prospective phase II observational study
Authors: Oh Eun-Jee , Yoon Jae-Ho , Park Ki Hyun , Bae Hyun Joo , Yun So Jeong , Min Gi June , Park Sung-Soo , Park Silvia , Lee Sung-Eun , Cho Byung-Sik , Eom Ki-Seong , Kim Yoo-Jin , Lee Seok , Kim Hee-Je , Min Chang-Ki , Cho Seok-Goo , Han Kyungja , Lee Jong Wook
Published: May 2021

Background:

Hemophagocytic lymphohistiocytosis (HLH) can be life-threatening if not detected and treated appropriately. The diagnosis of HLH can be confusing due to other similar febrile diseases that present with cytopenia. Natural-killer cell (NK)-cytotoxicity is an important diagnostic parameter for primary HLH; however, its role in secondary HLH in adults has not been well-elucidated.

Methods:

We prospectively enrolled 123 adult patients with febrile conditions accompanied by cytopenia or marrow hemophagocytosis. A diagnosis of HLH was based on HLH-2004 criteria and treated based on HLH-94 protocol. NK-cytotoxicity was calculated at the time of diagnosis by K562-cell direct lysis using flow-cytometry.

Results:

HLH ( n = 60) was determined to be caused by Epstein–Barr virus (EBV) ( n = 11), infection other than EBV ( n = 16), malignancies ( n = 19), and unknown ( n = 14). Febrile diseases other than HLH ( n = 63) were diagnosed as autoimmune disease ( n = 22), malignancies ( n = 21), infection ( n = 12), non-malignant hematological diseases ( n = 6), and unknown ( n = 2). A lower NK-cytotoxicity level was observed at diagnosis in patients with HLH, compared with other causes of febrile disease (12.1% versus 26.2%, p < 0.001). However, NK-cytotoxicity had a borderline effect on diagnosis of HLH, with an area under receiver operation characteristic curve of 0.689. It also showed no significant role for the prediction of survival outcome. Multivariate analysis revealed that malignant disease and high ferritin level were related with poor survival outcome. In non-malignant disease subgroups, old age, EBV-association, and low NK-cytotoxicity were related with poor survival.

Conclusions:

Febrile disease with cytopenia was associated with decreased NK-cytotoxicity, especially in adults with HLH; however, its diagnostic role for adult HLH is still arguable. The diagnostic criteria for adult HLH should be further discussed.

Trial registration:

Clinical Research Information Service [Internet]; Osong (Chungcheongbuk-do), Korea, Centers for Disease Control and Prevention, Ministry of Health and Welfare (Republic of Korea); https://cris.nih.go.kr/cris/index.jsp ; Feb, 16th 2016; KCT0001886 (KC15TISE0936);
Increased insulin resistance in intensive care: longitudinal retrospective analysis of glycaemic control patients in a New Zealand ICU
Authors: Knopp Jennifer L. , Chase J. Geoffrey , Shaw Geoffrey M.
Published: May 2021

Background:

Critical care populations experience demographic shifts in response to trends in population and healthcare, with increasing severity and/or complexity of illness a common observation worldwide. Inflammation in critical illness impacts glucose–insulin metabolism, and hyperglycaemia is associated with mortality and morbidity. This study examines longitudinal trends in insulin sensitivity across almost a decade of glycaemic control in a single unit.

Methods:

A clinically validated model of glucose–insulin dynamics is used to assess hour–hour insulin sensitivity over the first 72 h of insulin therapy. Insulin sensitivity and its hour–hour percent variability are examined over 8 calendar years alongside severity scores and diagnostics.

Results:

Insulin sensitivity was found to decrease by 50–55% from 2011 to 2015, and remain low from 2015 to 2018, with no concomitant trends in age, severity scores or risk of death, or diagnostic category. Insulin sensitivity variability was found to remain largely unchanged year to year and was clinically equivalent (95% confidence interval) at the median and interquartile range. Insulin resistance was associated with greater incidence of high insulin doses in the effect saturation range (6–8 U/h), with the 75th percentile of hourly insulin doses rising from 4–4.5 U/h in 2011–2014 to 6 U/h in 2015–2018.

Conclusions:

Increasing insulin resistance was observed alongside no change in insulin sensitivity variability, implying greater insulin needs but equivalent (variability) challenge to glycaemic control. Increasing insulin resistance may imply greater inflammation and severity of illness not captured by existing severity scores. Insulin resistance reduces glucose tolerance, and can cause greater incidence of insulin saturation and resultant hyperglycaemia. Overall, these results have significant clinical implications for glycaemic control and nutrition management.
Clozapine-associated neutropenia following augmentation with sodium valproate
Authors: Jakobsen Michelle Iris , Grønborg H , Hansen H V , Fink-Jensen A
Published: May 2021

Clozapine is gold standard for the management of treatment-resistant schizophrenia. It can offer life-changing symptom reduction where other antipsychotics have failed, and for these patients, treatment with clozapine should be maintained, if in any possible way. However, treatment with clozapine comes with a risk of developing potentially fatal adverse reactions, for example, severe neutropenia or agranulocytosis, in which case, treatment must be discontinued. Here, we present a case of clozapine-related neutropenia that commenced after the addition of sodium valproate. A subsequent re-challenge to clozapine resulted in severe neutropenia and led to the permanent cessation of clozapine treatment. The patient had been tolerating clozapine for more than a year before the addition of sodium valproate. The awareness of an interaction between clozapine and sodium valproate could help reduce the risk of clozapine-induced neutropenia and subsequent clozapine discontinuation.
Femoral venous aneurysms are rare, yet confer significant mortality risk due to venous thromboembolism; consider in venous thromboembolism of unknown aetiology
Authors: Baljer Bence Csongor , Shelmerdine Lauren , Stansby Gerard
Published: May 2021

Femoral venous aneurysms are a rare disease entity, yet they carry the risk of significant mortality due to venous thromboembolism, as demonstrated by a case report of an otherwise fit and well 74-year-old gentleman.
Does culture moderate the relationship between body dissatisfaction and quality of life? A comparative study of Australian and Malaysian emerging adults
Authors: Santhira Shagar Pravina , Donovan Caroline L , Boddy Jennifer , Tapp Caley , Harris Neil
Published: May 2021

Investigating moderating effects of culture between body dissatisfaction (BD) and quality of life (QoL) is paramount, as BD affects psychosocial functioning. Participants include 866 females (18–25) years old from Australia ( n = 464) M (20.88) SD (3.38) and Malaysia ( n = 402) M (20.63) SD (2.05). Higher levels of BD predicted lower levels of QoL across all four domains. BD had the strongest effect on psychological QoL for both cultures. Culture moderated the relationship between BD and: (i) physical QoL and (ii) environmental QoL. The adverse impact of BD on all domains of QoL, highlights the importance of BD as a public health problem.
Discrepancies and Disagreements in Classical Chamber Musicians’ Characterisations of a Performance
Authors: Spiro Neta , Schober Michael F.
Published: May 2021

To what extent do classical chamber musicians converge in their characterisations of what just happened in their live duo performance, and to what extent do audience members agree with the performers’ characterisations? In this study a cello-piano duo performed Schumann’s Phantasiestücke, Op. 73, no. 1 as part of their conservatory studio class in which members critique performances in development. Immediately after, the listeners and players individually characterised what had most struck them about the performance, first writing comments from memory and then marking scores while listening to a recording on their personal devices. They all then rated (on a 5-point scale) their agreement with comments by two other class members. Findings demonstrate that classical chamber performers can characterise the performance quite differently than their partner does and that they can disagree with a number of their partner’s characterisations, corroborating previous findings in case studies of jazz performance. Performers’ characterisations can overlap less in which moments strike them as worthy of comment and in their content than their listeners’ characterisations do, and they can agree with a non-partner’s characterisations more than with their partner’s characterisations. At the same time, the data show that listeners who have played the piece before—though not necessarily those who play the same kind of instrument (strings vs. piano)—can be more likely to endorse comments by others who have also played the piece before, even if the comments they make don’t overlap with each other more in timing, content or theme.
Building scientific capacity in disaster risk reduction for sustainable development
Authors: Chen Fang , Shirazi Zeeshan , Wang Lei
Published: May 2021

As climate warming intensifies, the frequency and intensity of disasters are also increasing, posing challenges to global sustainable development. The concept of disaster risk reduction (DRR) provides strong impetus for reducing disaster risk and vulnerabilities by employing the scientific and technological developments of recent decades. However, there is a need to enhance the capacities of different communities to use emerging digital infrastructure, not only in promoting DRR but also in ensuring sustainable future development. Limited access to and availability of data are restricting comprehensive understanding of these challenges. In many countries, the key areas for capacity development include collecting information from alternative and emerging data sources and meaningfully integrating it with data from traditional sources. Software and data analysis are becoming widely accessible due to open-source initiatives, while cloud computing technologies and programmes such as CASEarth provide valuable resources for multisource data integration, contributing to information-driven policy and decision-support systems for DRR.
Feasibility of Utilizing PREMM Score for Lynch Syndrome Identification in an Urban, Minority Patient Population
Authors: Adviento Brigid , Conner Michael , Sarkisian Alexander , Walano Nicolette , Andersson Hans , Karlitz Jordan
Published: May 2021

The PREMM5 model is a web-based clinical prediction algorithm that estimates the gene-specific risk of an individual carrying a Lynch syndrome germline mutation based on targeted family history questions. The objectives of our study were to determine the feasibility of screening for LS in an urban, minority patient population in a primary care setting using the PREMM5 model and characterize patient barriers associated with difficulty completing the questions. Participants were recruited from Tulane Internal Medicine primary care clinics on 9 random collection dates. Our data illustrates the difficulty patients have in recalling important details necessary to answer the PREMM questionnaire.
Workforce Models to Screen for and Address Patients’ Unmet Social Needs in the Clinic Setting: A Scoping Review
Authors: Sandhu Sahil , Xu Jacqueline , Eisenson Howard , Prvu Bettger Janet
Published: May 2021

Objectives

While healthcare organizations increasingly aim to address the social determinants of health (SDOH) in the clinic setting, there is little guidance on which staff are best equipped to assume this role. The present study is a scoping review of the peer-reviewed literature to characterize workforce models used to screen for and respond to patients’ unmet social needs in ambulatory settings.

Methods

Four online databases were used to identify papers published until February 2021. Eligible articles were original research studies or systematic reviews that described the implementation of a standardized assessment for multiple SDOH domains and resulting activities to respond to individual patient needs (eg, referral to community resources) in ambulatory care settings.

Results

Of the 1569 articles identified, 65 met study eligibility criteria. Majority of studies had observational study designs (11% were randomized control trials). For screening-related activities, more articles reported using traditional healthcare staff (51%), such as medical providers, medical assistants, and front-desk staff, than social care staff (32%), such as social workers and student volunteers. In contrast, for response-related activities, more articles reported using social care staff (88%) than traditional healthcare staff (60%). While we found wide variations in specific team configurations and training for the roles, social care staff generally provided more intensive forms of assistance than traditional healthcare staff.

Conclusion

While this review demonstrates the breadth of models for building or deploying a workforce to integrate health and social care, it also identifies the need for rigorous research on workforce development, implementation, and effectiveness.
Managers’ Perceptions Regarding the Effect of Leadership on Organizational Performance: Mediating Role of Green Supply Chain Management Practices
Authors: Ahmad Ahmad Fathulla , Karadas Georgiana
Published: May 2021

The primary purpose of this research is to test a research model that examines the perceptions of Cihan Group managers regarding the impact of effective leadership in improving organizational performance: Green supply chain management practices as a mediating mechanism. As a data collection method, a survey instrument was considered that included three dimensions of effective leadership, Green supply chain management (GSCM), and organizational performance. The data were analyzed by using partial least squares–structural equation modeling (PLS-SEM). The research found positive and significant causal relationships among the leading organization, leading people, and leading self with GSCM practices. In addition, GSCM practices positively correlated with organizational performance. The findings confirmed that GSCM practices fully mediate the relationship among the leading organization, leading people, and organizational performance, as the leading organization and leading people constructs indirectly correlated with organizational performance. The findings also showed that GSCM practices partially mediated the relationship between the leading self and organizational performance, as leading self, directly and indirectly, correlated to organizational performance. The research contributes to the literature by indicating that effective leadership via its dimensions—leading organization, people, and self— indirectly improves organizational performance by the mediating role of GSCM practices. Meanwhile, GSCM practices improve social and environmental performance.
Student and Parent Perceptions of Government-Funded Private Special Education Schools
Authors: Sakız Halis , Tören Zeliha , Yıldırım Hatice
Published: May 2021

We investigated the perceptions of students with disabilities (SWD) and their parents about the education offered in private special education institutions in Turkey, called “Special Education and Rehabilitation Centers” (SERCs). Data were collected from a survey administered to 453 SWD and 479 parents and interviews that were conducted with 38 parents. Survey findings indicated both satisfaction and, largely, dissatisfaction with the quality of special education offered in SERCs. Findings indicated that (i) parents were satisfied with the opportunities provided for their children to receive free special education and (ii) there was discontent about the use of government-funded resources, the quality of teaching, environmental arrangements, attitudes and beliefs toward SWD, inspection and supervision, and the way policy was designed and implemented. Findings demonstrate the need to reconsider the quality of education offered in private special education centers and the ways to improve the quality level.
Focusing on India’s Look East Policy: India–China relationship from 1947 to 2020
Authors: Roy Kaushik
Published: May 2021

Before the onset of the industrial revolution, China and India were the two biggest powers in Eurasia. Their total population comprised almost half of the world’s population. And the GNP of premodern China was half of the combined GNP of the world. Before circa 1600 CE, most of the textiles and iron in the world were manufactured in these two countries. China and India suffered a temporary eclipse during the age of colonialism. However, with the rise of the economic and military power of China and India from the late 20th century, it seems that these two countries are bound to reclaim their traditional positions as big powers in the international system. However, there is a caveat. In the premodern era, the Himalayas prevented any intimate contact between the ‘dragon’ and the ‘elephant’. But, from the mid-20th century, advances in technology, economic competition and the annexation of Tibet by the People’s Republic of China (PRC) among other factors resulted in China and India coming into direct contact with each other. The result has been cooperation–competition–conflict. And this has had consequences not only for these two countries but for the whole world. The present article attempts to trace the troubled trajectory of India’s China policy from the late 1940s (when these two countries became independent) up to the present day.
“That’s Only for Women”: The Importance of Educating HIV-Positive Sexual Minority Men on HPV and High Resolution Anoscopy (HRA)
Authors: Finneran Catherine , Johnson Peretz Jason , Blemur Danielle , Palefsky Joel , Flowers Lisa
Published: May 2021

Gay, bisexual, and other men who have sex with men (MSM) experience disproportionately high burdens of Human Papilloma Virus (HPV)-associated anal cancers. Recent focus has shifted to anorectal cancer prevention through high-resolution anoscopy (HRA); however, little is known about sexual minority men’s perceptions, attitudes, or beliefs regarding HRA. We conducted 4 qualitative Focus Group Discussions (FGDs) (n = 15) with sexual minority men, focusing on their beliefs, attitudes, and perceptions of undergoing HRA. Participants discussed their experiences of HPV/HRA as influenced by both their gender and sexuality, including unawareness of HPV disease as a male health issue, challenges relating to female-oriented HPV/HRA language, conception of HPV/HRA as related to prostate health, and connecting their sexual behavior identification as “bottoms” to their need for HRA. As efforts to improve HRA knowledge, access, and uptake among sexual and gender minority communities increase, special attention should be paid to language and messaging choices around HRA.
Real-World Medication Treatment Patterns for Long-Term Care Residents with Dementia-Related Psychosis
Authors: Rashid Nazia , Abler Victor , Andes Sherry , Citrome Leslie
Published: May 2021

Objectives: This study evaluated treatment patterns and factors associated with medication treatment changes in residents with dementia-related psychosis in a long-term care (LTC) setting. Methods: A retrospective database cohort study was conducted using the national PharMerica® database and included dementia residents with or without incident psychosis. Treatment patterns were assessed and a multivariate logistic regression model was used to identify factors associated with any treatment change (discontinuation, switch, or sporadic use) in dementia-related psychosis therapy. Results: Among 11,921 residents with incident dementia-related psychosis, 11,246 (94.3%) were prescribed ≥1 index medication to treat psychosis, including 77.3% who received ≥1 typical or atypical antipsychotic. Treatment change was evaluated during the post-index period: 38.7% of residents with dementia-related psychosis discontinued treatment, 13.9% switched treatments, and 7.9% had sporadic use. Factors associated with treatment change were age ≥65 years, Medicare insurance, and comorbid conditions (anemia, coronary heart disease, diabetes, falls, depression, hypertension, or hyperlipidemia) during the pre-index period. Discussion: Approximately 60% of dementia-related psychosis LTC residents experienced a medication treatment change. This treatment change was associated with higher age and higher comorbidities. Medications that treat symptoms of dementia-related psychosis without adding to safety concerns are needed to facilitate long-term, consistent treatment.
Impact of COVID-19 on the Health and Well-being of Informal Caregivers of People with Dementia: A Rapid Systematic Review
Authors: Hughes M. Courtney , Liu Yujun , Baumbach Abby
Published: May 2021

Background: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or COVID-19, raised worldwide concern. Since then, the COVID-19 pandemic has negatively influenced health and wellness across the globe and caused nearly three million deaths. This study focuses on informal caregivers of people with dementia, a disease that affects about 50 million older adults worldwide and requires much caregiving support. Objective: Examine the current literature on the impact of COVID-19 on the health and well-being of informal caregivers for people with dementia. Method: This rapid review was conducted across five electronic databases for quantitative and qualitative articles published through March 15, 2021. Results: The 10 studies included in this review reported quantitative descriptive data from across the globe; however, no studies existed from the U.S. or East Asia countries. All of the studies examined the psychological rather than physical impact of COVID-19 and highlighted risk and protective factors in the areas of psychosocial (resilience, neuropsychiatric, and social isolation), sociodemographic (gender and education), and environmental (home confinement, living arrangement, and dementia stage). Conclusion: COVID-19 has had a considerable negative impact on the psychological well-being of informal caregivers of people with dementia, namely causing more depression and anxiety than pre-pandemic.
Potential Role of Vitamins and Zinc on Acute Respiratory Infections Including Covid-19
Authors: Murni Indah K. , Prawirohartono Endy P. , Triasih Rina
Published: May 2021

Background. Vitamin C, E, D, A, zinc are considered to be essential in preventing and treating of acute respiratory infections (ARI) including COVID-19. Methods. We reviewed published studies evaluating the potential roles of these vitamin and zinc for ARIs and COVID-19 using Medline database, medRxiv, and bibliographic references. Results. Vitamins C, D, and E did not reduce incidence of common cold in general, but vitamin C reduced by half in population with physical and environment stresses. Vitamins C and E shortened duration and reduced severity of common cold. A large-dose vitamin A had no effect on recovery from pneumonia. Zinc improved clinical deterioration and pneumonia duration in under five. The effect on preventing COVID-19 morbidity and related-death was lacking. Conclusions. Although the effects of vitamins and zinc on ARIs including COVID-19 were inconclusive, taking these for a short period during pandemic may be beneficial when there is risks of deficiency.
COVID-19 among Minority Children in Detroit, Michigan during the Early National Surge of the Pandemic
Authors: Ang Jocelyn Y. , Kannikeswaran Nirupama , Parker Katherine , McGrath Eric , Abdel-Haq Nahed , Arora Harbir , Lua Jorge L. , Thomas Ronald , Salimnia Hossein , Chopra Teena , Tran Tommy , Asmar Basim
Published: May 2021

Background. The COVID-19 pandemic has shed light on communities of racial/ethnic minority groups in the US where long-standing health issues and structural inequities are now known to have resulted in increased risk for infection, severe illness, and death from the virus. The objective of our study was to describe demographic characteristics, clinical presentations, medical interventions and outcomes of pediatric patients with COVID-19 treated at Children’s Hospital of Michigan (CHM), a tertiary care center in urban Detroit, an early hotspot during the initial surge of the SARS-CoV-2 pandemic. Methods. A retrospective chart review was performed of children ≤18 years of age who had polymerase chain reaction (RT-PCR) testing via NP swab or serum IgG antibody testing for SARS-CoV-2 during March 1, 2020–June 30, 2020. Results. Seventy-eight COVID-19 infected children were identified of whom 85.8% (67/78) were from minority populations (African American, Hispanic). Hospitalization rate was 82% (64/78). About 44% (34/78) had an associated comorbidity with asthma and obesity being most common. Although all ages were affected, infants <1 year of age had the highest hospitalization rate (19/64, 30%). In all disease severity categories, dichotomized non-whites had more severe disease by percentage within race/ethnicity than Whites, and also within percent disease severity ( P-value = .197). Overall, 37% of hospitalized patients required intensive care. Conclusions. Extremely high rates of COVID-19 hospitalization and requirement of ICU care were identified in our patient population. Further studies are needed to better understand the contributing factors to this health disparity in disadvantaged communities.
Hospitable Non-verbal Staff Behaviour as a Means to Create Value to Customers
Authors: Pijls R. , Groen B. H. , Termaat W. A.
Published: May 2021

Background and aim:

Service providers need to be competent in the provision of hospitality. However, the question is, how to operationalize the experience of hospitality? Existing literature shows limited concrete service characteristics that lead to a hospitable experience in service environments. This article presents user-centred research into human-related aspects that influence the hospitality experience of guests.

Methods/methodology:

Four case studies were performed in a public swimming pool and a catering setting. Due to COVID-19 restrictions, in three of the four cases, regular customers of the organizations were approached by email and asked to rate the importance of behaviours related to hospitable service. In the case of the public swimming pool, part of the data was collected prior to closing of the pool, allowing data collection via survey, on site or via email, depending on visitors’ preferences.

Results:

The results show which non-verbal employee characteristics contribute to the distinctive factors of hospitality, especially observable behaviour. The factors ‘modest appearance’ and ‘representative appearance’ seem to be of medium importance, and the factor ‘paralanguage’ seems to be the least important factor.

Practical implications:

This article shows that it is possible to identify concrete characteristics of employee behaviour that people associate with hospitality.
Not so ‘Eco’ Service Ecosystems: Value Co-destruction Practices Affecting Vulnerable Patients in Special Transport
Authors: Echeverri Per
Published: May 2021

This study elaborates on the notion of value co-destruction when applied to complex service ecosystems of interconnected transport and healthcare services. By using a practice-theory perspective in a rich multiple-participant interview and observation study, the article shows that value creation is difficult to achieve, and that vulnerable travellers and patients can experience several problematic situations. It is argued that many crucial situations are linked to ecosystem gaps, in relation to typical practices such as booking, waiting, pick up and drop off, travelling and connecting. This article contributes by uncovering and explaining relatively non-harmonious aspects of service ecosystems, typically not imagined in contemporary value-creating service ecosystem research.
Superficial Temporal Artery Fistula Secondary to Temporomandibular Joint Arthroscopy
Authors: Saucedo Jose , Cox Mougnyan , Granquist Eric , Pukenas Bryan , Hurst Robert , Sedora-Roman Neda I.
Published: May 2021

Temporomandibular joint (TMJ) arthroscopy is considered a safe, minimally invasive procedure for the treatment of certain TMJ derangements. However, as TMJ arthroscopy is being popularized, more complications are being reported. Though exceedingly rare, arteriovenous fistula (AVF) can occur. We describe a case of superficial temporal artery (STA) fistula formation successfully treated with coil embolization.
Generating CAR T cells from tumor-infiltrating lymphocytes
Authors: Mills Jane K. , Henderson Melissa A. , Giuffrida Lauren , Petrone Pasquale , Westwood Jennifer A. , Darcy Phillip K. , Neeson Paul J. , Kershaw Michael H. , Gyorki David E.
Published: May 2021

Background: Tumor-infiltrating lymphocytes (TILs) and chimeric antigen receptor (CAR) T-cell therapies have demonstrated promising, though limited, efficacy against melanoma. Methods: We designed a model system to explore the efficacy of dual specific T cells derived from melanoma patient TILs by transduction with a Her2-specific CAR. Results: Metastatic melanoma cells in our biobank constitutively expressed Her2 antigen. CAR-TIL produced greater amounts of IFN compared with parental TIL, when co-cultured with Her2 expressing tumor lines, including autologous melanoma tumor lines, although no consistent increase in cytotoxicity by TIL was afforded by expression of a CAR. Results of an in vivo study in NSG mice demonstrated tumor shrinkage when CAR-TILs were used in an adoptive cell therapy protocol. Conclusion: Potential limitations of transduced TIL in our study included limited proliferative potential and a terminally differentiated phenotype, which would need addressing in further work before consideration of clinical translation.
Proton Pump Inhibitors in 2021: Pros, Cons, and Everything in Between
Authors: Sloan Joshua A. , Katz Philip O.
Published: May 2021

The medical and lay literature has exploded with reports of adverse events associated with proton pump inhibitors over the last 10 to 15 years. The dissemination of these reports to patients and clinicians have created substantial concerns regarding what has been an exceptionally valuable drug class, dramatically improving patient quality of life, and in many cases preventing life threatening side effects of other medication. Patients are more frequently seeking to avoid these medications, and practitioners are reducing or discontinuing them to the patient’s detriment due to a misunderstanding of the data. This review will discuss the data regarding the most commonly publicized adverse events and attempt to put them in perspective.