bluuebunny/crossref_metadata_2025 huggingface dataset:
Application and effect evaluation of multidisciplinary team management model: On central venous access device associated skin impairment based on Delphi method
Authors: Li Ji-Yue , Li Jia , Fan Yu-Ying , Lin Xi-Ling , Huang Chun-Li , Qin Hui-Ying
Published: June 2022

Objective:

To establish a multidisciplinary management model based on Delphi method to guide nursing practice and reduce the incidence of CVAD-associated Skin Impairment (CASI) in tumor patients.

Methods:

On the basis of literature review and focus group interview, the initial item pool of CASI management model for cancer patients was determined. The Delphi method was used to conduct two rounds of letter consultation with 36 authoritative and representative experts to determine the content and weight of indicators of CASI multidisciplinary management model for cancer patients.

Results:

Most of the research group were experts with bachelor degree or above. More than 90% of experts have worked for more than 10 years; Areas of expertise include oncology care, venous therapy, wound stomatology, and dermatology. The recovery rate of the two rounds of expert correspondence questionnaire was 100%. The authority coefficient of experts was 0.898, indicating a good degree of authority. Kendall’s harmony coefficients were 0.193 and 0.250, with statistically significant differences ( p < 0.001). After two rounds of expert letter consultation, a multidisciplinary management model of CASI for cancer patients was initially formed, which included 15 first-level prevention indexes and 38 second-level prevention indexes of CASI for cancer patients. There were 9 first-level indexes and 16 second-level indexes of CASI treatment in tumor patients.

Conclusion:

Cancer patients based on Delphi method to construct CASI multidisciplinary management model has high reliability and scientificity, multidisciplinary management model in the management of patients with tumor CASI exploration will provide new methods for central venous catheter nursing and the new way of thinking, will also be intravenous fluids will provide a scientific basis for professional development and quality improvement and practical experience.
Changes in umbilical catheters’ microstructure in vivo: A prospective study
Authors: Sobczak Alina , Kowalik Aleksandra , Homa Marta , Turalska Patrycja , Kwinta Przemko
Published: June 2022

Background:

Umbilical vessels present after birth allow a unique central access for both venous and arterial catheterization, yet the catheterization complications can be misdiagnosed as the complications of prematurity per se.

Methods:

A prospective observational study of 41 used polyurethane umbilical catheters, both venous and arterial was conducted in a tertiary neonatal intensive care unit. The study consisted of bedside ultrasound imaging and post-removal microbiological and microstructural analysis to assess the in vivo catheters’ changes and their clinical significance.

Results:

The study has shown that catheters’ surface thrombosis and bacterial colonization happen more often within umbilical venous than within arterial catheters (31% vs 8% in both cases) and are inversely proportional to the patient’s gestational age (thrombosis: Me: 28 weeks vs no thrombosis: 32 weeks; p = 0.05, bacterial colonization: 27 weeks vs no colonization: 30 weeks; p = 0.013), respectively. The clots formed near the catheter’s tip are correlated with catheter’s bacterial colonization. Chemical analysis with energy dispersive spectroscopy showed a higher calcium composition in used catheters (19.89% vs 0%, p = 0.016) and structure analysis in the scanning electron microscopy proved that within hours catheters become covered with an external coating of a constant thickness, not affected by the catheterization time.

Conclusion:

The following observations give a better insight to the complex in vivo interactions and call for a more intense bedside-monitoring of the indwelling devices.
Investigating the Genomic Background of CRISPR-Cas Genomes for CRISPR-Based Antimicrobials
Authors: Shim Hyunjin
Published: June 2022

CRISPR-Cas systems are an adaptive immunity that protects prokaryotes against foreign genetic elements. Genetic templates acquired during past infection events enable DNA-interacting enzymes to recognize foreign DNA for destruction. Due to the programmability and specificity of these genetic templates, CRISPR-Cas systems are potential alternative antibiotics that can be engineered to self-target antimicrobial resistance genes on the chromosome or plasmid. However, several fundamental questions remain to repurpose these tools against drug-resistant bacteria. For endogenous CRISPR-Cas self-targeting, antimicrobial resistance genes and functional CRISPR-Cas systems have to co-occur in the target cell. Furthermore, these tools have to outplay DNA repair pathways that respond to the nuclease activities of Cas proteins, even for exogenous CRISPR-Cas delivery. Here, we conduct a comprehensive survey of CRISPR-Cas genomes. First, we address the co-occurrence of CRISPR-Cas systems and antimicrobial resistance genes in the CRISPR-Cas genomes. We show that the average number of these genes varies greatly by the CRISPR-Cas type, and some CRISPR-Cas types (IE and IIIA) have over 20 genes per genome. Next, we investigate the DNA repair pathways of these CRISPR-Cas genomes, revealing that the diversity and frequency of these pathways differ by the CRISPR-Cas type. The interplay between CRISPR-Cas systems and DNA repair pathways is essential for the acquisition of new spacers in CRISPR arrays. We conduct simulation studies to demonstrate that the efficiency of these DNA repair pathways may be inferred from the time-series patterns in the RNA structure of CRISPR repeats. This bioinformatic survey of CRISPR-Cas genomes elucidates the necessity to consider multifaceted interactions between different genes and systems, to design effective CRISPR-based antimicrobials that can specifically target drug-resistant bacteria in natural microbial communities.
Optimizing wear analysis of plasma sprayed Linz-Donawitz slag-Al2O3 coatings using experimental design and neural network
Authors: Pati Pravat Ranjan , Satapathy Alok , Gupta Gaurav , Ray Subhrajit
Published: June 2022

The present research investigates the erosion wear performance of plasma-sprayed Linz-Donawitz (LD) slag coatings through combined execution of experimental design and neural network. This effort reveals that LD slag is coatable on aluminum substrate. Different weight proportions of Al2O3 are mixed with LD slag prior to coating deposition. In this investigation, it is observed that the coating thickness and micro-hardness improve with the addition of Al2O3 into LD slag content. Wear characteristics of LD slag coatings in terms of parametric influence have been analyzed using Taguchi approach. Impact velocity is the most substantial for reducing the wear rate. The results are also optimized using artificial neural network (ANN). The experimental and ANN predicted data established a decent agreement keeping the error within 7%. The wear mechanism failures are also examined microscopically. This study demonstrates that these coatings are found appropriate in tribological areas as well.
Lesion size and shape in central vein sign assessment for multiple sclerosis diagnosis: An in vivo and postmortem MRI study
Authors: Al-Louzi Omar , Manukyan Sargis , Donadieu Maxime , Absinta Martina , Letchuman Vijay , Calabresi Brent , Desai Parth , Beck Erin S , Roy Snehashis , Ohayon Joan , Pham Dzung L , Thomas Anish , Jacobson Steven , Cortese Irene , Auluck Pavan K , Nair Govind , Sati Pascal , Reich Daniel S
Published: June 2022

Background:

The “central vein sign” (CVS), a linear hypointensity on T2*-weighted imaging corresponding to a central vein/venule, is associated with multiple sclerosis (MS) lesions. The effect of lesion-size exclusion criteria on MS diagnostic accuracy has not been extensively studied.

Objective:

Investigate the optimal lesion-size exclusion criteria for CVS use in MS diagnosis.

Methods:

Cross-sectional study of 163 MS and 51 non-MS, and radiological/histopathological correlation of 5 MS and 1 control autopsy cases. The effects of lesion-size exclusion on MS diagnosis using the CVS, and intralesional vein detection on histopathology were evaluated.

Results:

CVS+ lesions were larger compared to CVS− lesions, with effect modification by MS diagnosis (mean difference +7.7 mm3, p = 0.004). CVS percentage-based criteria with no lesion-size exclusion showed the highest diagnostic accuracy in differentiating MS cases. However, a simple count of three or more CVS+ lesions greater than 3.5 mm is highly accurate and can be rapidly implemented (sensitivity 93%; specificity 88%). On magnetic resonance imaging (MRI)-histopathological correlation, the CVS had high specificity for identifying intralesional veins (0/7 false positives).

Conclusion:

Lesion-size measures add important information when using CVS+ lesion counts for MS diagnosis. The CVS is a specific biomarker corresponding to intralesional veins on histopathology.
The shadow of sanctions: reputational risk, financial reintegration, and the political economy of sanctions relief
Authors: Raynor Benjamin
Published: June 2022

Financial sanctions have become a major component of American foreign policy. Since 2015, the number of blacklisted actors has nearly tripled, coinciding with US financial campaigns against Iran, North Korea, and Russia. This paper centers an under-examined paradox of this proliferation: the complexity of lifting financial sanctions. Indeed, successful sanctions regimes necessitate both sticks (punitive sanctions) and carrots (economic incentives). Yet financial sanctions often limit the economic benefits promised to target states, as banks and other financial institutions risk hefty material and reputational costs if they are to cooperate with previously sanctioned actors. Thus, while financial sanctions are effective at producing negative market reactions against a target, they can be hugely damaging if market actors do not cooperate with the lifting of sanctions. To capture this dynamic, this paper leverages process-tracing to observe financial market reactions to sanctions relief in three key cases—Iran (2010–2015), North Korea (2002–2007), and Libya (1996–2008). It finds that in each case, the presence or absence of US Treasury blacklisting corresponds to the post-sanction willingness of financial actors to extend sanctions relief to targeted states. In doing so, this study identifies “reputational risk” as the primary causal mechanism limiting a target’s reintegration into the global economy.
Racialization within Antitrafficking Interventions Targeting Migrant Sex Workers: Findings from the SEXHUM Research Project in France
Authors: Giametta Calogero , Mai Nicola , Musto Jennifer , Bennachie Calum , Fehrenbacher Anne E , Hoefinger Heidi , Macioti PG
Published: June 2022

This article draws on the findings of the research project Sexual Humanitarianism: Migration, Sex Work, and Trafficking (SEXHUM), a study investigating migration, sex work, and human trafficking in Australia, France, New Zealand, and the US. In this article, we focus on how racialized categories are mobilized in antitrafficking practices in France. Since April 2016, the French government has enforced a prohibitionist and neo-abolitionist law criminalizing the demand for sexual services. This coincided with the targeting of Chinese and Nigerian cis-women and with the neglect of Latina trans women working in the sex industry according to racialized and sex-gendered understandings of victimhood. Whereas Chinese women tend to be presented by humanitarian rhetoric as silent victims of Chinese male-dominated mafias, Nigerian women have come to embody the ultimate figure of the victim of trafficking by an overpowering Black male criminality. Meanwhile, (sexual) humanitarian actors have neglected Latina trans women’s ongoing experiences of extreme violence and marginalization.
Textbook authors’ perspectives on selecting and instructing Chinese characters and words in beginner and intermediate textbooks
Authors: Wang Jing
Published: June 2022

This article explores how leading textbook authors select and instruct vocabulary in beginner and intermediate Chinese textbooks used in the United States. Leading textbook authors were approached; subsequently; four authors completed interviews with pre-designed questions. Grounded theory methodology was used to analyse the interviews, and their textbooks were surveyed for clarification and additional information. For vocabulary selection, the four participants first decided content according to learners’ communicative needs. Next, the three participants, who provided primary written texts, coordinated the content with sequenced grammar. They then coordinated the content and grammar with frequently and widely used words. For vocabulary instruction, the four participants used the following approaches to teaching the spoken and written forms of characters: integration with facilitation, integration with progression, separation with coordination, or gradation. They also used the following strategies to systematically support the learning of characters: scaffolding, providing an overall framework, teaching more words in the spoken form than the written form and consolidating the written form for high-frequency characters, or gradation and self-controlled learning. They all consistently explained the meanings of radicals for characters and explored the meanings of words and their composite characters. A theoretical vocabulary model is proposed for vocabulary selection and instruction in second language textbooks. For textbooks with primary written texts, this model proposes first deciding content by contextualizing learners in specific situations for real-life communication, and then coordinating the content and sequenced grammar with established wordlists. This model also proposes various approaches to teaching the spoken and written forms of words, systematic strategies to support vocabulary learning, and specific methods to set up form-meaning connections from the paradigm of the target language. For textbooks using audiovisual materials as the primary input, this model proposes the possibility of achieving differentiated results. Pedagogical applications of the study results are discussed.
Do beliefs matter? The relationship between beliefs about peer feedback and peer feedback outcomes on pronunciation
Authors: Martin Ines A. , Sippel Lieselotte
Published: June 2022

This study investigated the relationship between learner beliefs about peer feedback and development of second language (L2) pronunciation skills after peer feedback on pronunciation had been used in the classroom. Seventy-four first-year learners of German were assigned to a peer feedback provider group, a peer feedback receiver group, and a control group. After completing a questionnaire designed to elicit learner beliefs about peer feedback, the provider group and the receiver group received general pronunciation training. Following the training, the provider group gave feedback to peers on their pronunciation and the receiver group listened to this feedback. Participants’ learning gains were measured by means of native speaker comprehensibility ratings of their productions both before and after the intervention. Statistical analyses revealed significant, positive relationships between learner beliefs about peer feedback and their learning gains. These results suggest that learners who held more positive beliefs about peer feedback tended to improve more after peer feedback had been implemented into their classroom. Pedagogical implications of these findings are discussed.
Second language development in face-to-face versus synchronous computer-mediated interactions: Dyadic type and language proficiency
Authors: Ribeiro Angelica , Eslami Zohreh R.
Published: June 2022

Language negotiations facilitate second language acquisition (SLA) in both face-to-face (FTF) and computer-mediated interactions. Research shows that dyadic type can impact the quantity and quality of negotiations. Although both learner (L)-learner and native speaker (NS)-L dyadic type interactions have shown to be beneficial to SLA, it is still unclear which dyadic type is more effective for second language (L2) development in FTF and computer-mediated interactions. To fill this gap, this quantitative study compares FTF versus text-synchronous-computer-mediated communication (SCMC) task-based interactions by examining the following question: Is there a significant difference in the (1) frequency of negotiations and (2) effect of negotiations on subsequent L2 development in FTF interactions compared with text-SCMC in the following three dyadic types: NS-low-proficiency learners (LPL), NS-high-proficiency learners (HPL), and HPL–LPL? The study is grounded in the Interaction Hypothesis, which argues that comprehensible input, opportunities for modified output, and noticing are essential for interactions to facilitate SLA through negotiation episodes. The participants included four NSs, four LPLs, and four HPLs. The participants were paired up to form two of each of the following dyadic types: NS–LPL, NS–HPL, and HPL–LPL. All dyads performed one task in each mode. The learners took a tailor-made posttest, designed to measure their L2 development. The data collection included transcribed FTF interactions, SCMC chats, and posttest scores. The interactions were coded for negotiation episodes and strategies. The posttest responses were coded as correct, partially correct, or incorrect. Chi-square test of independence was used to analyse the quantitative data because of their categorical nature and small sample size. Results found no statistically significant difference in the frequency of negotiation episodes among the three dyadic types or the LPLs’ and HPLs’ language learning outcome in FTF versus SCMC. Pedagogical implications are discussed.
Teachers’ use of reported speech in Korean elementary school classroom interactions
Authors: Park Yujong , Kim Sol
Published: June 2022

Research on reported speech in classrooms has focused on the roles and functions of quoted conversation produced by the teacher; however, there is less information on the responses following this device and its multimodal character. This study draws on a multimodal conversation analysis approach to investigate teachers’ use of reported speech in evaluating students’ performances by examining 83 hours of videotaped elementary school classroom interactions in Korea. The findings suggest that teachers frequently employ reported speech in the evaluative element of the three-turn instructional sequence to create an affiliative atmosphere in the event of a negative assessment. Sequences that contained reported speech were compared with teachers’ evaluations produced by simply repeating students’ answers. The findings suggest that the multimodal production of reported speech might be a tool adapted for the classroom institutional context by creating a positive space for learning compared to other similar devices available in the classroom.
Does differentiated integration weaken parliamentary involvement? Evidence from the European Union's interparliamentary conferences
Authors: Winzen Thomas
Published: June 2022

Does differentiated integration undermine the motivation of parliamentarians from less integrated member states to become involved in European Union affairs? Focusing on the European Union's new interparliamentary conferences in economic governance, and justice and home affairs, this study examines whether voluntary and involuntary as well as comprehensive and partial differentiation influence parliamentary involvement, measured as participation in interparliamentary conferences. Based on new data and Coarsened Exact Matching, the results indicate that the effect of differentiation depends on its political origins and design. Only voluntary and comprehensive differentiation depress parliamentary involvement. The results can be seen as favourable regarding the legitimacy of differentiation and compatible with the European Union's ambition to limit the institutional implications of differentiation. They also indicate a targeted parliamentary response to differentiated integration.
Habitus and personality in the work of Max Weber
Authors: Anderson Elisabeth
Published: June 2022

Weber’s critique of modernity centred on how it shaped the habitus – life-conduct and motivations – of the modern individual. I explicate six habitus-types that appear in Weber’s work: the early-modern Puritan Berufsmensch, the modern specialist, the modern industrial worker, the politician, the civil servant and the citizen voter. In doing so, I identify the main characteristics of each type and the causal mechanisms through which Western modernity’s core features – capitalism and bureaucracy – brought them into being. Further, I discuss two habitus-related problems that concerned Weber: the general failure of the modern habitus to achieve ‘personality’; and the mismatch between habitus and occupational role in the Wilhelmine political sphere. I then explain the practical reforms through which Weber hoped to address these problems. Finally, I show how this analysis helps resolve two apparent contradictions which have long perplexed Weber scholars.
Betwixt and between: A narrative inquiry into Chinese university leaders’ intercultural competence in leadership
Authors: Wei Ge , Xing Xin
Published: June 2022

This narrative inquiry explores three Chinese university leaders’ intercultural competence as a key dimension of their leadership that overseas leadership development programmes enabled them to develop. The leaders visited three different countries – namely, the United States, the United Kingdom and Canada – storied their experiences in the programmes and connected their reflections to leadership in the Chinese higher education system. Our narrative analyses show that the overseas leadership development programmes were mediators in the construction of leadership, for which there were two focal themes: (1) leadership as a personal and contextual construction process and (2) intercultural competence as a key dimension of university leaders’ leadership. Betwixt and between different higher education systems in different cultural contexts, the reconceptualisation of leadership with intercultural competence is unfurled in the liminal space, which goes beyond the functionalist paradigm of leadership and is also of international interest and value in the global communication of higher education.
Case report of fetal liver cirrhosis due to gestational alloimmune liver disease in a primigravida female, in the northeast region of India
Authors: Maheshwari Sandip
Published: June 2022

Introduction:

Fetal liver failure is a major cause of neonatal morbidity and mortality, presenting as acute liver failure and/or congenital cirrhosis. Gestational alloimmune liver disease associated with neonatal haemochromatosis is a rare cause of fetal liver failure.

Case report:

24-year-old primigravida on Level II ultrasound scan showed intrauterine live fetus, with the fetal liver showing nodular architecture and coarse echotexture. Moderate fetal ascites were present. Scalp oedema was present with minimal bilateral pleural effusion. Suspicious fetal liver cirrhosis was raised, and the patient was counseled for a poor prognosis of pregnancy. Surgical termination of pregnancy was performed at 19 weeks through Cesarean section, and postmortem histopathological examination revealed haemochromatosis, hence gestational alloimmune liver disease was confirmed.

Discussion:

The presence of a nodular echotexture of the liver, with ascites, pleural effusion, and scalp oedema suggested chronic liver injury. Gestational alloimmune liver disease-neonatal haemochromatosis is often diagnosed late and patients are therefore referred late to specialized centers, delaying treatment.

Conclusion:

This case highlights the consequences of late diagnosis and treatment of gestational alloimmune liver disease-neonatal haemochromatosis and emphasizes the importance of a high grade of suspicion of this disease. Level II ultrasound scan should include scanning of the liver, as a part of the protocol. A high grade of suspicion is key for the diagnosis of gestational alloimmune liver disease-neonatal haemochromatosis, and early use of intravenous immunoglobulin should not be postponed to allow longer survival of the native liver.
Mindfulness for adults with autism spectrum disorder and intellectual disability: A pilot study
Authors: Gandía-Abellán Helena , Nieto Carmen , García-Rubio Carlos
Published: June 2022

The present study aims to examine the effects of the MindfulTEA program, an Mindfulness-based Interventions (MBIs) specifically designed for adults with Autism Spectrum Disorder (ASD) and Intellectual Disability, to reduce behavioural problems. MBIs are effective in improving well-being in people with high-functioning ASD, but little is known about the impact of the MBIs on people with ASD and intellectual disability associated. Fourteen adults (age 18 to 44) with ASD and intellectual disability participated in the program. Results showed a significant decrease in self-injurious and aggressive/destructive behaviours after the MBI. Stereotyped behaviour did not show significant change. Results suggest that the MindfulTEA program could effectively reduce some types of behaviour problems in people with ASD and intellectual disability. MBIs could be a useful alternative to traditional behaviour management interventions for reducing behaviour problems in this population.
Joint optimization of inspection and maintenance strategy for complex multi-component systems using a quantum-inspired genetic algorithm
Authors: Tang Diyin , Wang Xuan , Di Junwei , Zheng Guofeng , Yu Jinsong
Published: June 2022

Advances in sensor and data technology enable real-time condition monitoring, thus extending the opportunities for condition-based maintenance (CBM) to be applied in practice. In this paper, a joint inspection and maintenance strategy for multi-component systems is proposed. The objective of this strategy is to minimize the long-run expected operational cost by jointly considering the inspection frequency of each health monitor in the system and the threshold for the maintenance initialization. To find the optimal strategy, a dynamic Bayesian network-based maintenance model is developed at first to provide reasoning of the dynamic reliability of degrading components in the multi-component system, in which complex relationship among inspections by different health monitors, different failure modes in the system, and different maintenance actions to system components are considered and quantified. Then, a quantum-inspired genetic algorithm (QGA) is proposed to optimize the strategy. With quantum encoding method, improved rotation gate, and specially designed crossover and mutation operators, the QGA is able to find the optimal strategy for multi-component systems with a general system structure. An example simplified from real practice is presented to demonstrate the effectiveness and advantages of the proposed strategy and the optimization algorithm, with comparison to similar strategies and traditional intelligent optimization algorithms.
The case of Mesut Özil: A symbol of (non-) integration? An analysis of German print media discourses on integration
Authors: Möllering Martina , Schmidt Eva
Published: June 2022

This paper examines how German media discourses reflect debates around integration, based on a newspaper corpus spanning the period 2008–2018. Considering these discourses, our research interest is focussed on how integration is constructed as a responsibility of those who are expected to integrate into society. To analyze how media might play a role in reproducing essentialist constructions of difference, we present a case study that combines methodologies of corpus linguistics and critical discourse analysis, and that examines discursive practices and strategies linked to dominant discourses about integration in Germany. Our findings show that in the German context, certain ethnicities (here: people of Turkish background) are framed as “other” and these groups are constantly being assessed in terms of integration in ways that others are not.
The living past in the lives of victims-/survivors of conflict-related sexual violence: Temporal implications for transitional justice
Authors: Clark Janine Natalya
Published: June 2022

Issues of time and temporality are highly relevant to the field of transitional justice. The very concept of ‘transition’ and transitional justice processes more broadly reflect a linear and teleological understanding of time that moves in a particular direction. While building on existing temporal critiques of transitional justice, this interdisciplinary article makes two original contributions to this corpus of scholarship – empirical and conceptual. First, emphasizing what it refers to as ‘the living past’, it draws on qualitative interviews with victims-/survivors of conflict-related sexual violence in Bosnia-Herzegovina, Colombia and Uganda to explore empirically some of the various ways that the past experientially intruded into the interviewees’ present. Second, it utilizes the analogy of the coagulation cascade, a biological blood-clotting process, to reflect on how transitional justice processes might move beyond linear temporal conceptualizations to recognize lived experiences of time and the multiple ways that individuals – as well as communities and societies – continue to coexist and transition with the living past.
Comparison of Customer Reviews for Local and Chain Restaurants: Multilevel Approach to Google Reviews Data
Authors: Yalcinkaya Beril , Just David R.
Published: June 2022

Online reviews influence customer decisions and present publicly available data to investigate differences between customer evaluations for local and chain businesses. We conduct a text analysis on a sample of 80,728 online customer reviews of quick-service restaurants to examine how the impact of dining experience attributes on customer evaluation differs between the two restaurant types. Estimation of multilevel multinomial models reveals that customer reviews for local restaurants have less polarized sentiment than chain restaurants. This polarization is also evident for sentiment usage related to four dining experience attributes: food, service, ambience, and price. Although food offerings are essential to get high ratings for local restaurants, service quality has a relatively greater impact on customer satisfaction for chains. Although customer reviews favor local restaurants, they need powerful testimonials for differentiation due to high review valence among their local competitors.
Characterization of Musculoskeletal Injuries in Gymnastics Participants From 2013 to 2020
Authors: Albright J. Alex , Meghani Ozair , Lemme Nicholas J. , Owens Brett D. , Tabaddor Ramin
Published: June 2022

Background:

Many studies have analyzed gymnastics-related injuries in collegiate and elite athletes, but there is minimal literature analyzing the epidemiological characteristics of injuries in the greater gymnastics community.

Hypothesis:

A higher incidence of injuries in younger gymnasts between the ages of 6 and 15 years compared with those 16 years and older and a difference in the distribution of injuries between male and female gymnasts.

Study Design:

Retrospective cross-sectional study.

Level of Evidence:

Level 3.

Methods:

The National Electronic Injury Surveillance System (NEISS) was queried for all gymnastics-related musculoskeletal injuries presenting to the emergency department (ED) between 2013 and 2020. Incidence was calculated as per 100,000 person-years using the weighted estimates provided by NEISS and national participation data. Chi-square and column proportion z-testing was used to analyze where appropriate.

Results:

The incidence of gymnastics-related musculoskeletal injuries was 480.7 per 100,000 person-years. Most ED visits were children between the ages of 6 and 15 years (84.0%). Younger gymnasts (ages 6 to 10) were most likely to experience a lower arm fracture, while those over the age of 10 years were most likely to experience an ankle sprain ( P < 0.01). Men and boys presented with a much greater proportion of shoulder injuries (8.0% vs 3.9%), while women and girls presented with a greater proportion of elbow injuries (9.9 % vs 5.9%) and wrist (10.5% vs 8.3%) injuries ( P < 0.01).

Conclusion:

As hypothesized, most gymnastics-related injuries between 2013 and 2020 were athletes between 6 and 15 years old. Many of these athletes are attempting new, more difficult, skills and are at increased risk of more acute injury when attempting skills they may be unfamiliar with.

Clinical Relevance:

With increased pressure to specialize at an early age to maintain competitiveness and learn new, higher-level skills compared with their peers, younger athletes are most susceptible to acute injury. New injury prevention strategies could be implemented to help this high-risk population compete and train safely.
Color Compensatory Mechanism of Chromatic Adaptation at the Cortical Level
Authors: Shimakura Hitomi , Sakata Katsuaki
Published: June 2022

Reportedly, some chromatic adaptations have extremely short temporal properties, while others have rather long ones. We aimed to dynamically measure the transition of a neutral point as an aftereffect during chromatic adaptation to understand the temporal characteristics of chromatic adaptation. The peripheral retina was exposed to a yellow light to progress color adaptation, while the transition of a neutral point was measured at the fovea. In Experiment 1, the aftereffect had initially progressed but subsequently recovered despite ongoing chromatic adaptation and regardless of the retinal exposure size, suggesting that the adaptation mechanism at the cortical level continues to readjust the color appearance based on daylight conditions. Experiment 2 was similar to Experiment 1, except that it included participants of varying ages. Older eyes behaved in a homologous manner with younger eyes in Experiment 2, albeit quantitative differences. Regardless of age, similar recalibration of neutral points shifted by color adaptation suggests the color compensation function in older eyes may not change due to long-term chromatic adaptation by optical yellowing. In conclusion, the chromatic adaptation mechanism at the cortical level readjusts color perception, even in younger eyes, according to the daylight neutral point. This daylight information may be stored in the neural mechanism of color vision.
Survey of knowledge and attitude towards fibromyalgia among physicians in Karachi, Pakistan
Authors: Hyder Zaidi Syed Tafazzul , Ashraf Hira , Javaid Syed Sarmad , Rashid Ahmed Mustafa , -Haque Shajee-Ul , Fatima Syeda Sidra , Ali Nouman Mansoor
Published: June 2022

Objectives

Our study aims to assess knowledge and understanding of FM among doctors employed at a tertiary care hospital in Karachi, Pakistan with a focus on its diagnostic criteria, treatment modalities, and general knowledge of symptoms.

Study Design

Cross-sectional Study.

Methods

Our cross-sectional study recruited participants through convenience sampling. A total of 104 participants responded, which included (a) House Officers, (b) Medical Officers, and (c) Residents. A structured questionnaire was used, and an electronic form was generated which was then emailed to the participants to acquire their responses.

Results

The majority (66.3%) of our respondents were female and the median age was 26 years. A majority (93.3%) accepted FM as a separate and distinct clinical identity, and 79.8% were confident in recognizing its general symptoms. Widespread pain (95.2%) and fatigue (80.8%) were correctly identified as most commonly observed symptoms. Moreover, 68.3% of respondents possessed no knowledge of both ACR 1990 and 2010 diagnostic criteria for FM. Of those aware, majority favored using the most recent ACR 2010 criteria (72.7%). Majority of our respondents (75%) preferred using pharmaceutical and non-pharmaceutical interventions simultaneously in the treatment.

Conclusions

Our study indicates that while physicians have satisfactory knowledge of the symptoms and treatment modalities of FM, a knowledge gap concerning its diagnostic criteria exists. Proper treatment can only be successful when physicians successfully diagnose FM, therefore, future training programs should use this fact as a stepping stone for advances in its healthcare.
The role of telemedicine services in changing users’ intentions for presenting to the emergency departments in Saudi Arabia
Authors: Alfaleh Amjad , Alkattan Abdullah , Alageel Alaa , Salah Mohammed , Almutairi Mona , Sagor Khlood , Alabdulkareem Khaled
Published: June 2022

Background

Emergency department (ED) overcrowding is described as one of the main issues in any hospital. In Saudi Arabia, the ministry of health applied new telemedicine technology to serve patients by using the mobile application, including the Sehha application and 937 medical call center. The main aim of this study is to determine the role of different telemedicine services in changing the intention users’ intentions for visiting the emergency departments in Saudi Arabia.

Methods

A cross-sectional study was conducted during August 2020 to May 2021 among 319 patients using two telemedicine services in Saudi Arabia, including the medical call center and Sehha smartphone application. The primary endpoint of this study was to determine the number of patients intended to visit ER before and after contacting one of the two telemedicine services and the frequency of people who changed their opinion to visit an ED.

Results

This study analyzed the data from 319 patients who completed the survey provided by the Saudi Ministry of Health concerning information related to their health status and ED visits. Among patients that had the intention to visit the ED ( N = 159), 53 of them did not go to EDs after using telemedicine services ( p < 0.01). Regarding the medical call center and Sehha application, 9.6% and 24.4%, respectively, of the patients who used these telemedicine services changed their minds concerning visiting ED after taking the medical advice ( p < 0.01).

Conclusions

The implemented telemedicine services in Saudi Arabia, namely the Sehha application and medical call center, could reduce those intended to visit ED and consequently reduce the overload of EDs by providing medical advice to patients concerning their minor medical issues.
‘Braiding strings’: A qualitative interview study with relatives of older people discharged after an acute admission
Authors: Hoffmann Eva , Andersen Pernille Tanggaard , Mogensen Christian Backer , Prinds Christina , Primdahl Jette
Published: June 2022

Older people’s relatives’ negotiation power potentially influences their access to quality care and treatment after acute hospitalisation. This study aimed to analyse relatives’ purposes and strategies for negotiating with healthcare professionals (HCPs) after older people’s acute hospital admission. Eighteen relatives of older people who were discharged after acute hospital admission in Denmark were interviewed. Qualitative content analysis guided the analysis. We used COREQ as a reporting guideline. Three themes emerged from the analysis: (a) Braiding strings to make a cord, (b) Struggling for responsibility placement, and (c) A twofold agenda. The overall purpose for relatives’ negotiations with HCPs appeared to be a desire to ensure coherence in the older person's life. The strategy relatives used was negotiating the division of responsibility between relatives and HCPs. Relatives’ negotiations proceeded according to a twofold agenda. In the light of the ideas of French philosopher and sociologist Pierre Bourdieu, we conclude that relatives’ negotiation strategies can be understood as a result of their habitus, their social position, and the capital they bring to the specific situation.
Taking Prior Sick Leave Patterns Into Account When Estimating Health Consequences of Violence on the Job
Authors: Andersen Lars H. , Christensen Therese B.
Published: June 2022

Background:

Violence on the job has been shown to harm both physical and psychosocial health, but the results presented in existing studies might be biased because they have not considered prior indicators of such health.

Methods:

Physical violence and threats were pooled into a measure of workplace violence for 77,388 randomly sampled respondents from the working population in Denmark in 2012, 2014, and 2016. Longitudinal analyses of these survey data merged with administrative records on sick leave (exceeding 30 days, implying that the consequences of the violence were more serious) were performed. Separate analyses were conducted by sector, gender, and by gender within sectors.

Findings:

Experiencing violence increased sick leave +36% from before to after the violence relative to the general trend among other respondents that did not experience a violent event.

Conclusions/Application to Practice:

Work-related violence is a serious health issue, especially in health care, even when we meticulously took prior use of sick leave into account to obtain less biased results.
“On the Tour, They’re Always Sticking a Microphone in Your Face”: Mediatization of Professional Tennis From the 1980s to the Early 2010s
Authors: Küpper Lena , Kossing Greta , Birkner Thomas
Published: June 2022

Although the intertwining of sports and media, especially in soccer and from an organization-centered perspective, has been highlighted in communication research, little attention has been paid to the perception and evaluation of the mediatization of professional tennis. The aim of this study was to close this research gap by presenting the athletes’ perspective. Based on the autobiographies of four top international athletes, we systematized their perceptions of the media before the rise of social media, using a qualitative content analysis. We demonstrate a significant influence of the media system and the perceived media logic: Tennis is closely intertwined with the media, and mediatization processes have strong effects on the players, both positive and negative. Players are aware of the importance of public attention for tennis and actively adapt to the perceived media logic. On the other hand, they often feel inhibited by the press and reject adaptations to media affordances. Our study demonstrates once again the research potential of mediatization as a beneficial concept in studies on sports communication, stresses the need to focus also on the dysfunctional influences of media and mediatization, and opens the path for further research on social media influences.
Identifying Inflation Dynamics in India in the Post Reform Period
Authors: Rasool Haroon
Published: June 2022

The present study aims at examining the inflation dynamics in Indian context with a particular focus on its determinants from 1991–1992Q1 to 2017–2018Q4. The purpose of this study is to investigate the role of monetary, fiscal, structural and external variables in explaining inflationary tendencies in India in the post economic reform period. To identify the determinants fuelling the inflationary tendencies, the study employs ARDL bounds testing procedure followed by the VECM Granger causality test. The findings indicate that interest rate shock and output growth mitigates inflation while rupee depreciation, money supply generate inflationary pressures in the economy. Moreover, fiscal deficit has inflationary impact only in the short run. The positive link between inflation and openness refutes the applicability of Romer’s hypothesis in the Indian context. VECM based Granger causality indicates that money supply and interest rate causes both output and inflation, which suggests monetary policy in India has an important role to play in the process of economic growth and price stability.

JEL Classification: E3, E4, F6, E620
Implementing SAFER Responses to Misconduct and Responding to Biased Patient Requests ASAP
Authors: Stevens Sheila K , Houge Benjamin J , Poterucha Jeff M , Preston Heather R , Werneburg Brooke L , Welch Thomas J , Siddiqui Mustaqeem A
Published: June 2022

Background: In response to encounters involving misconduct, discrimination, and harassment toward healthcare workers, the Experience Training, Education, and Coaching (XTEC) team was tasked with empowering staff members to respond to biased requests and misconduct appropriately and consistently. The aim of this article is to discuss communication strategies for how to respond to patient bias and misconduct. Methods: XTEC developed a training program with two focused communication strategies: (1) SAFER, a stepped approach to respond to patient and visitor misconduct and (2) ASAP, an approach for responding to patient bias which we describe as requests related to race, religion, ethnicity, gender, and other personal attributes of staff. Intervention: SAFER ASAP workshops were delivered to 2154 health care professionals through 109 face-to-face training over a 15-month period between January 2019 and March 2020. All trainings were discussion- and scenario-based, ranging in duration from 60 to 90 min. Participants were given pre- and post-training test case scenarios, in which respondents wrote responses to a challenging behavior to assess skill attainment post-training. Results:Seventy-one percent demonstrated higher levels of response ability post-training, and 92% of respondents indicated they would likely recommend this training to others. Conclusions: SAFER ASAP is an effective communication training program for responding to patient and visitor bias and misconduct.
Impact of a Pharmacist-Led Chronic Disease State Management Clinic on Patient Assessment of Chronic Illness Care
Authors: Buatois Emily M , Covington Les P , Lopez Nicole D , Young Rodney B , MacLaughlin Eric J
Published: June 2022

Background: The Patient Assessment of Chronic Illness Care (PACIC) tool measures patient satisfaction with chronic disease care. Objective: A modified PACIC tool (PACIC-RxFM) was used to assess patient satisfaction in a pharmacist-led chronic disease state management clinic. The secondary outcome compared satisfaction with pharmacist-led and physician-led visits. Methods: This cross-sectional study surveyed individuals with ≥ 1 chronic disease who saw a pharmacist (pharmacotherapy) or primary care provider (usual care) in the Texas Tech Physicians Family Medicine Clinic. The PACIC-RxFM survey included 15 items rated on a five-point Likert scale (5 = “always satisfied”). Results: A total of 107 patients with no significant differences in demographics or complexity between groups were surveyed. All mean domain scores indicated a high level of satisfaction in the pharmacotherapy group with statements regarding perceptions of care organization and encouragement to go to group classes yielding statistically significantly higher scores than the usual care group. Conclusion: Patients are satisfied with both providers’ and pharmacists’ involvement in chronic illness care. This involvement leads to significant improvement in patient perception of care organization.