bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and Predictors of Outcomes in a Psychiatric Day Treatment Program for Elementary-Age
Authors: Balvardi Sahar , Rahbari Noriyeh , Jolicoeur-Martineau Alexia , Rudy Lauren , Arnovitz Mitchell , Laplante David P. , Brown Maria , Habib Paola , Zelkowitz Phyllis , Guzder Jaswant , Wazana Ashley D.
Published: March 2021

Objective:

In this study, we aimed to (1) assess the effectiveness of an intensive multimodal day treatment program in improving externalizing problems and function in elementary-age children and (2) examine 3 predictors of the treatment outcome (i.e., family functioning, baseline severity, and comorbid disorders).

Methods:

The sample included 261 children (80.9% boys) between ages of 5 and 12. A retrospective chart review, from 2013 to 2018, and a prospective chart review, from 2018 to 2019, were conducted to extract all relevant data for the present study. Parents and teachers provided reports on children’s externalizing problems (i.e., aggressive behavior, attention problems, and rule-breaking behavior) and their level of function across different domains. The level of family functioning was also reported by parents, while clinicians assessed children’s severity of disturbance and their diagnoses at intake.

Results:

Based on both parents’ and teachers’ reports, children showed significant improvement in their externalizing problems. Moreover, children showed functional improvement at home, at school, with peers, and in hobbies by the end of the program. Based on teacher’s reports, children with lower level of severity showed less improvement in their attention problems, and those with comorbid developmental problems showed less improvement in their aggressive and rule-breaking behaviors. Family functioning did not predict any treatment outcome.

Conclusion:

An intensive multimodal day treatment program was effective in reducing the symptoms of externalizing problems in elementary-age children. However, children with less severe difficulties and comorbid developmental problems showed less improvement in their externalizing problems.
Diagnosis and Management of an Oronasal Fistula Secondary to Nasal Transmissible Venereal Tumor in a Dog
Authors: Thatcher Graham , Robat Cecilia , Bell Cynthia
Published: March 2021

Canine transmissible venereal tumor (CTVT) is a contagious tumor commonly seen in populations of sexually intact dogs that have close contact with each other. CTVT is one of only 3 known naturally transmissible, contagious tumors in which the mutated tumor cell is thought to have originated in an individual canid about 11000 years ago. Clinical history, signalment, cytological and histologic evaluation are typically sufficient for reaching a diagnosis, although immunohistochemistry(IHC) may be necessary for unique presentations of this neoplasm. This case report describes the diagnosis of an oronasal CTVT using histopathology and IHC, followed by treatment of the tumor with chemotherapy and surgical correction of a defect caused by the tumor.
Institutional betrayal in nursing: A concept analysis
Authors: Brewer Katherine C
Published: March 2021

Background:

Ethical relationships are important among many participants in healthcare, including the ethical relationship between nurse and employer. One aspect of organizational behavior that can impact ethical culture and moral well-being is institutional betrayal.

Research aim:

The purpose of this concept analysis is to develop a conceptual understanding of institutional betrayal in nursing by defining the concept and differentiating it from other forms of betrayal.

Design:

This analysis uses the method developed by Walker and Avant.

Research context:

Studies were reviewed using health literature databases with no date restrictions.

Ethical considerations:

Analysis was conducted using established guidelines for ethical research.

Findings:

Although institutional betrayal is a concept applied in the literature, there was a paucity of studies exploring the concept within nursing. Examples of the concept in the literature include violation of trust between organization (i.e. employer) and nurse, such as provision of inadequate workplace protections, ineffective or hostile management, and gaslighting of those who experience negative events. Examples of institutional betrayal have become more visible during the COVID-19 pandemic.

Discussion:

A conceptual definition of institutional betrayal is a deep violation of trust or confidence or violation of moral standards committed by an institution toward a nurse. This definition incorporates experiences and issues suggested by the literature. Outcomes are likely negative, including impacts on nurse psychological and workplace well-being. This concept likely fits within a framework of ethical workplaces and has conceptual relationships with moral distress and moral resilience. Further studies can help qualitatively explore and empirically measure this concept.

Conclusion:

In the pursuit of improving the ethical culture of healthcare workplaces, this concept can provide meaningful insight into organizational behavior and its consequences. Naming and describing the concept can promote conceptual clarity and equip researchers, nurses, and leaders to identify and mitigate the issue.
Rapid Environmental Planning Methodology: Developing Strategies for the Planners’ Education
Authors: Vasconcelos Vitor Vieira , Momm Sandra
Published: March 2021

Rapid assessments are useful methods for engaging stakeholders, standardizing monitoring activities and supporting later planning stages. This article proposes to extend rapid assessment methods into ‘rapid environmental planning’ and to use it for the education of planning professionals. For the assessment stage, the pressure–state–response model is used, with a participatory valuation of the ecosystem services through supply and demand profile and future trends. The stage of scenario building includes the XLRM methodology (externalities, actions, metrics and relationships), the trends and evaluation of proposals and uncertainties, as well as the formulation of timelines and narratives. The propositional stage included intervention projects, zoning of land use and occupation guidelines. The methodology was evaluated as a didactic resource for undergraduate teaching in a watershed in São Bernardo do Campo, São Paulo (Brazil). The results indicated a high educational potential for the students as well as the potential effectiveness of this planning method.
Land Pattern of Highly Urbanizing Cities: Change in Built-up Area, Population Density and Spatial Development of the Sprawling Dar es Salaam City
Authors: Msuya Ibrahim , Moshi Irene , Levira Francis
Published: March 2021

Dar es Salaam is one of the most diverse cities in Tanzania in terms of its physical, social, economic, environmental and spatial features. This diversity has contributed to differences in built-up area, population density, as well as the pace of spatial development across different parts of the city. This study aims to examine the relationship between physical built-up area changes in Dar es Salaam, population density change and spatial development using remote sensing images and census data. The study finds that the city population has grown tremendously, with peri-urban wards in particular having experienced positive growth. Dar es Salam’s built-up area change and urban sprawl emerging at the city’s edges distinctly follows the pattern of demographic change. This is accompanied by substantial compact growth in the inner parts of the city. A number of factors such as transport, residential development, migration, high natural growth rates, public policies and land speculation are found to have contributed to these changes. Overall, the study aims to aid planning authorities in effectively responding to the rapid spatial development taking place in the city, for which a holistic approach that combines an understanding of physical and demographic changes is needed. By investigating the changing patterns in land use within this highly urbanizing city, it aims to generate insights into urban development control machineries and identify their underlying dynamics.
SARS-CoV-2 as Enteric Virus in Wastewater: Which Risk on the Environment and Human Behavior?
Authors: Sbaoui Yousra , Bennis Faïza , Chegdani Fatima
Published: March 2021

Microorganisms such as viruses, bacteria, and protozoa are the cause of many waterborne human infections. These microbes are either naturally present in aquatic environments or transferred within them by fecal sources. They remain in these environments for varying lengths of time before contaminating a new host. With the emergence of the COVID-19 pandemic, some studies have reported the presence of viral nucleic acids in stool samples from COVID-19 patients, suggesting the possibility of fecal-oral transmission. The SARS-CoV-2 RNA was thereby detected in the wastewater of symptomatic and asymptomatic people with a risk to human and environmental health. In this work, we try to discuss the different potential sources of this contamination, the forms of persistence in the environment, the techniques of partial elimination, and the possibility of creating new reservoirs.
Prioritizing progressive MS rehabilitation research: A call from the International Progressive MS Alliance
Authors: Zackowski Kathleen M , Freeman Jennifer , Brichetto Giampaolo , Centonze Diego , Dalgas Ulrik , DeLuca John , Ehde Dawn , Elgott Sara , Fanning Vanessa , Feys Peter , Finlayson Marcia , Gold Stefan M , Inglese Matilde , Marrie Ruth Ann , Ploughman Michelle , Sang Christine N , Sastre-Garriga Jaume , Sincock Caroline , Strum Jonathan , van Beek Johan , Feinstein Anthony
Published: March 2021

Background:

People with multiple sclerosis (MS) experience myriad symptoms that negatively affect their quality of life. Despite significant progress in rehabilitation strategies for people living with relapsing-remitting MS (RRMS), the development of similar strategies for people with progressive MS has received little attention.

Objective:

To highlight key symptoms of importance to people with progressive MS and stimulate the design and implementation of high-quality studies focused on symptom management and rehabilitation.

Methods:

A group of international research experts, representatives from industry, and people affected by progressive MS was convened by the International Progressive MS Alliance to devise research priorities for addressing symptoms in progressive MS.

Results:

Based on information from the MS community, we outline a rationale for highlighting four symptoms of particular interest: fatigue, mobility and upper extremity impairment, pain, and cognitive impairment. Factors such as depression, resilience, comorbidities, and psychosocial support are described, as they affect treatment efficacy.

Conclusions:

This coordinated call to action—to the research community to prioritize investigation of effective symptom management strategies, and to funders to support them—is an important step in addressing gaps in rehabilitation research for people affected by progressive MS.
Testing for COVID-19 regulates behavior in the general population: A qualitative study of experiences of awaiting test result for COVID-19
Authors: Christensen Signe Westh , Dagyaran Ilkay , Bernild Camilla , Missel Malene , Berg Selina Kikkenborg
Published: March 2021

Aim: This study aimed to explore experiences of awaiting a test result for COVID-19 among individuals from the general population. Methods: Fifteen participants were recruited from COVID-19 testing tents in the Capital Region of Denmark in March and April 2020. A phenomenological–hermeneutic approach inspired by Ricoeur’s theory of interpretation was used. Results: The analysis revealed five themes. (1) The participants’ experiences of awaiting a COVID-19 test result illuminated concerns related to infecting others rather than their own health. Experiences of guilt for not taking all possible precautions to avoid the spread of COVID-19 were described and thoughts of potentially having exposed others bothered the participants. (2) The test result would guide their precautions and therefore regulate behaviour at home and in society. (3) Even though the participants did not take all possible precautions they made some changes in their everyday lives. (4) Leaving the individual with the responsibility for taking precautions based on their subjective experiences created feelings of insecurity and uncertainty. (5) Being met by health professionals was an experience that meant for the particpants that behaviour towards limiting the infection became very clear. The seriousness experienced around the test situation facilitated this attitude and behaviour in the participants. Conclusion: This study illuminated how testing for COVID-19 regulates behavior in the general population. The testing was both important for the individual’s cautious behavior towards other people, work and in getting around in society but also a way to regulate behavior from a societal perspective to quicken suppression and avoid transmission of COVID-19.
Party group collapse and strategic switching in the European Parliament
Authors: Martin Aaron R
Published: March 2021

The literature on party group switching in the European Parliament contends that members re-affiliate primarily for strategic reasons. This article advances the discussion by also considering the occurrence of non-strategic switches which follow the collapse of weakly institutionalized groups. Using an original dataset which includes DW-Nominate scores (1979–2009), I operationalize policy-seeking behavior among strategic switchers by deriving member- and delegation-to-group policy distance variables. The pooled logistic regression models using a penalized maximum likelihood estimator make it possible to address quasicomplete separation, and the results show that members from large groups and delegations have significantly lower odds of switching. Further, as members or delegations become incongruent with their group, the odds of switching increase. The study has important implications for research investigating the relationship between weak party institutionalization and parliamentary behavior.
Towards a typology of prisoners’ awareness of and familiarity with prison inspection and monitoring bodies
Authors: van der Valk Sophie , Aizpurua Eva , Rogan Mary
Published: March 2021

Inspection and monitoring bodies have an important role in the protection of prisoners’ rights. Although these bodies are seen as widely beneficial, there is limited research examining their operations in practice. This study addresses this gap in the existing literature by identifying unique profiles of prisoners based on their familiarity with prison oversight bodies. In addition, the relationship between profiles and key factors (personal characteristics, sentence-related variables and those related to life in prison) was examined using multinomial regression. Participants were 508 males randomly selected from three prisons in Ireland. Data were collected between November 2018 and February 2019, using self-administered surveys. Latent class analysis revealed four subgroups of prisoners characterized by distinct patterns of awareness and contact with prison oversight bodies: (1) Low familiarity (44.1 percent); (2) High awareness with low contact (26.4 percent); (3) High familiarity with the Visiting Committees but low with other oversight bodies (14.2 percent); and (4) High familiarity (15.4 percent). Notably, the largest group was the low familiarity group, and few prisoners belonged to the high familiarity group. Nationality, sentence length, confidence in staff and complaint usage were linked to class membership. The results of this study point to the importance of increasing awareness of inspection and monitoring bodies among prisoners in general, and among certain groups in particular.
Learning From Practice and Politics: The Rise and Fall of Social Marketing in Aotearoa New Zealand (1984–2017)
Authors: Antric Tim , Toledano Margalit , McKie David
Published: March 2021

Background:

This article is the first to explore the emergence and evolution of social marketing as a professional practice in Aotearoa New Zealand [1] (NZ).

Focus of the Article:

The article identifies key political factors enabling the emergence, and causing the decline, of social marketing in NZ.

Research Question:

What are the factors that practitioners of social marketing identify as most influential on its development in NZ?

Importance to the Social Marketing Field:

The article makes a unique contribution to the growing literature on the history of social marketing in different jurisdictions by providing the first account of how social marketing evolved in NZ and by identifying the crucial role of political factors.

Methods:

The research is based on appreciative inquiry-based interviews with 20 experienced social marketers and a review of key documents. Because the field in NZ is small, it was possible to interview almost all of the leading figures.

Results:

This study constructs a timeline of significant political impacts on social marketing in NZ and identifies neoliberal approaches as key. Initially, neoliberalism enabled the growth of social marketing due to its emphasis on individual responsibility for health. Later, a neoliberal agenda helped disestablish the discipline due to social marketing shifting focus from downstream to upstream economic, political and social factors.

Recommendations for Research or Practice:

This research concludes that to sustain the legitimacy of their field, social marketers need to produce ongoing evidence-based communication of their effectiveness and responsibility and be less dependent on government funding. It also suggests the continuing enlargement of specifically situated studies of the different evolutions of social marketing in different places to better map commonalities and contrasts.

Limitations:

The study is limited to social marketing in NZ and would be strengthened by comparative studies of social marketing within other cultures and political systems during particular historical periods. While mainly exploring NZ social marketers’ experience from their own point of view, it could be broadened to include other perspectives.
The Impact and Implications of The COVID-19 Pandemic on Organ Procurement Outside of an Epicenter
Authors: Hudgins Janice Jene , Boyer Allison Jo , Orr Kristen Danielle , Hostetler Clint Allen , Orlowski Jeffrey Paul , Squires Ronald A.
Published: March 2021

The COVID-19 pandemic has been well-documented to have a variable impact on individual communities and health care systems. We describe the experience of a single organ procurement organization (OPO), located in an area without a large cluster of cases during the initial phase of the COVID-19 pandemic. A review of community health data describing the impact of COVID-19 nationally and in Oklahoma was conducted. Additionally, a retrospective review of available OPO data from March 2019-May 2020 was performed. While the amount of donor referrals received and organs recovered by the OPO remained stable in the initial months of the pandemic, the observed organs transplanted vs. expected organs transplanted (O:E) decreased to the lowest number in the 15-month period and organs transplanted decreased as well. Fewer organs from Oklahoma donors were accepted for transplant despite staff spending more time allocating organs.
A Dynamic Model of Employees’ Transition to Entrepreneur: A Cognitive Mapping Approach
Authors: Lee Jin
Published: March 2021

Employees’ transition to an entrepreneurial career has been explained by two major driving forces: push and pull factors. The push-pull dichotomy, however, has been the center of debate on whether the classification is incomplete and ambiguous. Until this debate is resolved, the dynamic and fluid nature of the influencing factors and their relationships remains unclear. The purpose of this research is to discuss the legitimacy of the push-pull dichotomy in explaining the motivations and processes of employees’ transition to an entrepreneurial career. To achieve this, a cognitive mapping approach to synthesize the factors from the extant empirical studies was employed. Analysis of 26 articles revealed that categories of push and pull factors in prior research are neither mutually exclusive nor clearly separate. Our dynamic model of employees’ transition to an entrepreneurial career illustrates the reciprocal, compounding, and counter-effective influence of factors. This research sheds light on the dynamic interrelationship among factors affecting employees’ transition to an entrepreneurial career.
Novel indoor positioning algorithm based on Lidar/inertial measurement unit integrated system
Authors: Jiang Ping , Chen Liang , Guo Hang , Yu Min , Xiong Jian
Published: March 2021

As an important research field of mobile robot, simultaneous localization and mapping technology is the core technology to realize intelligent autonomous mobile robot. Aiming at the problems of low positioning accuracy of Lidar (light detection and ranging) simultaneous localization and mapping with nonlinear and non-Gaussian noise characteristics, this article presents a mobile robot simultaneous localization and mapping method that combines Lidar and inertial measurement unit to set up a multi-sensor integrated system and uses a rank Kalman filtering to estimate the robot motion trajectory through inertial measurement unit and Lidar observations. Rank Kalman filtering is similar to the Gaussian deterministic point sampling filtering algorithm in structure, but it does not need to meet the assumptions of Gaussian distribution. It completely calculates the sampling points and the sampling points weights based on the correlation principle of rank statistics. It is suitable for nonlinear and non-Gaussian systems. With multiple experimental tests of small-scale arc trajectories, we can see that compared with the alone Lidar simultaneous localization and mapping algorithm, the new algorithm reduces the mean error of the indoor mobile robot in the X direction from 0.0928 m to 0.0451 m, with an improved accuracy rate of 46.39%, and the mean error in the Y direction from 0.0772 m to 0.0405 m, which improves the accuracy rate of 48.40%. Compared with the extended Kalman filter fusion algorithm, the new algorithm reduces the mean error of the indoor mobile robot in the X direction from 0.0597 m to 0.0451 m, with an improved accuracy rate of 24.46%, and the mean error in the Y direction from 0.0537 m to 0.0405 m, which improves the accuracy rate of 24.58%. Finally, we also tested on a large-scale rectangular trajectory, compared with the extended Kalman filter algorithm, rank Kalman filtering improves the accuracy of 23.84% and 25.26% in the X and Y directions, respectively, it is verified that the accuracy of the algorithm proposed in this article has been improved.
Neural correlates of cricopharyngeal dysfunction after supratentorial stroke: A voxel-based lesion-symptom mapping with propensity score matched case–control
Authors: Kim Jun Yup , Yoon Seo Yeon , Kim Jinna , Wook Kim Yong
Published: March 2021

Background

Poststroke cricopharyngeal dysfunction has been reported to occur in 50% of brainstem strokes; however, cricopharyngeal dysfunction also occurs commonly in patients with supratentorial stroke. The hemispheric neuroanatomical location of this dysfunction has not been clearly identified.

Aim

We aimed to analyze the relationship between cricopharyngeal dysfunction and supratentorial lesion location in poststroke patients through this retrospective case–control voxel-based lesion-symptom mapping study.

Methods

Cricopharyngeal dysfunction was diagnosed when the residue after swallowing (pyriform sinus) accounted for more than 25% of volume of pyriform sinus. Medical records and the video fluoroscopic swallowing studies of first-ever stroke patients who were admitted to our hospital during acute to subacute phase from 2009 to 2019 were reviewed. After propensity score matching to reduce the likelihood of selection bias, 50 patients per group were included in the cricopharyngeal dysfunction and control groups. We used a P threshold of 0.01 corrected for multiple comparisons with permutation thresholding (5000 permutations). Dichotomized diagnosis of cricopharyngeal dysfunction and the magnitude of pyriform sinus were used as dependent variables.

Results

Analysis using the Liebermeister statistics indicated that lesions of the right lentiform nucleus were associated with the development of cricopharyngeal dysfunction. After adjustment for age and total lesion volume, which are known effectors for the development of dysphagia, statistically significant correlations were found between pyriform sinus and lesions of the right lentiform nucleus and anterior corona radiata beneath the right middle frontal gyrus.

Conclusion

Thus, our study demonstrated for the first time that damages to the right lentiform nucleus, especially globus pallidus externa, and anterior corona radiata beneath the right middle frontal gyrus are associated with the development and severity of cricopharyngeal dysfunction.
Cost-effectiveness of an enhanced Paramedic Acute Stroke Treatment Assessment (PASTA) during emergency stroke care: Economic results from a pragmatic cluster randomized trial
Authors: Bhattarai Nawaraj , Price Christopher I , McMeekin Peter , Javanbakht Mehdi , Vale Luke , Ford Gary A , Shaw Lisa
Published: March 2021

Background

The Paramedic Acute Stroke Treatment Assessment (PASTA) trial evaluated an enhanced emergency care pathway which aimed to facilitate thrombolysis in hospital. A pre-planned health economic evaluation was included. The main results showed no statistical evidence of a difference in either thrombolysis volume (primary outcome) or 90-day dependency. However, counter-intuitive findings were observed with the intervention group showing fewer thrombolysis treatments but less dependency.

Aims

Cost-effectiveness of the PASTA intervention was examined relative to standard care.

Methods

A within trial cost-utility analysis estimated mean costs and quality-adjusted life years over 90 days’ time horizon. Costs were derived from resource utilization data for individual trial participants. Quality-adjusted life years were calculated by mapping modified Rankin scale scores to EQ-5D-3L utility tariffs. A post-hoc subgroup analysis examined cost-effectiveness when trial hospitals were divided into compliant and non-compliant with recommendations for a stroke specialist thrombolysis rota.

Results

The trial enrolled 1214 patients: 500 PASTA and 714 standard care. There was no evidence of a quality-adjusted life year difference between groups [0·007 (95% CI: −0·003 to 0·018)] but costs were lower in the PASTA group [−£1473 (95% CI: −£2736 to −£219)]. There was over 97.5% chance that the PASTA pathway would be considered cost-effective. There was no evidence of a difference in costs at seven thrombolysis rota compliant hospitals but costs at eight non-complaint hospitals costs were lower in PASTA with more dominant cost-effectiveness.

Conclusions

Analyses indicate that the PASTA pathway may be considered cost-effective, particularly if deployed in areas where stroke specialist availability is limited. Trial Registration: ISRCTN12418919 www.isrctn.com/ISRCTN12418919
Age-based salaries of judges, discrimination, and time limitations
Authors: Kullmann Miriam
Published: March 2021

While a two-month limitation period applicable for claims on back payments, the regulation of which is left to the Member States following the principle of national procedural autonomy, is in accordance with EU law, there is clearly a risk that the civil servants and judges concerned may not be in a position to establish whether, and the extent to which, they have been discriminated against, within such a short period of time.

Case: Joined Cases C-773/18 to 775/18 TK, UL, VM/Land Sachsen-Anhalt ECLI: EU: C:2020:125
Systemic low-dose erythropoietin administration improves the vascularization of collagen-glycosaminoglycan matrices seeded with adipose tissue-derived microvascular fragments
Authors: Später Thomas , Worringer Denise MS , Menger Maximilian M , Menger Michael D , Laschke Matthias W
Published: March 2021

Adipose tissue-derived microvascular fragments (MVF) are used as vascularization units in tissue engineering. In this study, we investigated whether the vascularization capacity of MVF can be improved by systemic low-dose erythropoietin (EPO) administration. MVF were isolated from the epididymal fat of donor mice and seeded onto collagen-glycosaminoglycan matrices, which were implanted into full-thickness skin defects within dorsal skinfold chambers of recipient mice. Both donor and recipient mice were treated daily with either EPO (500 IU/kg) or vehicle (0.9% NaCl). The implants were analyzed by stereomicroscopy, intravital fluorescence microscopy, histology, and immunohistochemistry. EPO-treated MVF contained a comparable number of proliferating Ki67+ but less apoptotic cleaved caspase-3+ endothelial cells when compared to vehicle-treated controls. Moreover, EPO treatment accelerated and improved the in vivo vascularization, blood vessel maturation, and epithelialization of MVF-seeded matrices. These findings indicate that systemic low-dose EPO treatment is suitable to enhance the viability and network-forming capacity of MVF.
Body composition and cardiometabolic health of pediatric patients with X-linked hypophosphatemia (XLH) under burosumab therapy
Authors: Brener Avivit , Lebenthal Yael , Cleper Roxana , Kapusta Livia , Zeitlin Leonid
Published: March 2021

Background:

Burosumab, a recombinant anti-FGF23 monoclonal antibody, was recently introduced as a treatment for X-linked hypophosphatemia (XLH). Burosumab normalizes blood phosphate levels, thereby healing rickets, decreasing leg bowing, and reducing pain. We aimed to explore the body composition and cardiometabolic health of pediatric patients with XLH treated with burosumab.

Methods:

This observational real-life study was conducted on growing children and adolescents. The outcome measures included changes in sex- and age-adjusted anthropometric and body composition parameters [fat mass (FM), fat-free mass (FFM), appendicular skeletal muscle mass (ASMM), muscle-to-fat ratio (MFR)], blood pressure, laboratory evaluation, and radiographic rickets severity [Thacher Rickets Severity Score (TRSS)]. Body composition was assessed by bioelectrical impedance analysis (BIA). Percentiles for FFM% and ASMM% were calculated according to BIA pediatric reference curves. The delta variable was calculated as the variable at 12 months minus the variable at baseline.

Results:

A total of 15 pediatric patients with XLH are treated in our clinic; included in the analyses were 7 children and adolescents (3 males, mean age 8.7 ± 3.2 years) with XLH without comorbidities. Baseline BIA revealed an unfavorable physique, with increased body fat percentage in five patients and decreased muscle mass in six. Indices of lean body mass significantly increased after 6 and 12 months of treatment: FFM(kg) ( p = 0.001, p = 0.046, respectively) and ASMM(kg) ( p = 0.012, p = 0.034, respectively), without any significant change in FM(kg). The percentile of ASMM% increased significantly after 6 months of treatment ( p = 0.006) and stabilized thereafter. TRSS improved significantly after 12 months of therapy ( p = 0.005). Age was positively correlated with delta TRSS ( r = 0.814, p = 0.026), and delta TRSS was negatively correlated with delta MFR ( r = −0.826, p = 0.022).

Conclusions:

There was a heretofore unrecognized improvement in body composition of growing children and adolescents with XLH who were treated with burosumab. These findings highlight the need to initiate burosumab treatment at a younger age when rickets is less severe.
Referrals to Urgent Dental Centres During the COVID-19 Pandemic: A Multi-Site Analysis Research Project
Authors: Shathur Adam , Reeves Samuel , Sameja Faizal , Patel Vishal , Jones Allan
Published: March 2021

Introduction:

The COVID-19 pandemic enforced the cessation of routine dentistry and the creation of local urgent dental care systems in the UK. General dental practices are obligated by NHS guidance to remain open and provide remote consultation and referral where appropriate to patients having pain or problems.

Aims:

To compare two urgent dental centres with different triage and referral systems with regard to quality and appropriateness of referrals, and patient management outcomes.

Methods:

110 consecutive referrals received by a primary care urgent dental centre and a secondary care urgent dental centre were assessed. It was considered whether the patients referred had access to remote primary care dental services, fulfilled the criteria required to be deemed a dental emergency as mandated by NHS guidance, and what the outcomes of referrals were.

Results:

At the primary care centre, 100% of patients were referred by general dental practitioners and had access to remote primary care dental services. 95.5% of referrals were deemed appropriate and were seen for treatment. At the secondary care site, 94.5% of referrals were direct from the patient by contacting NHS 111. 40% had received triaging to include ‘advice, analgesia and antimicrobial’ from a general dental practitioner, and 25.5% were deemed appropriate and resulted in treatment.

Conclusion:

Urgent dental centres face many issues, and it would seem that easy access to primary care services, collaboration between primary care clinicians and urgent dental centres, and training of triaging staff are important in operating a successful system.
Interprofessional Clinical Education in Dentistry
Authors: Rajadurai Susha
Published: March 2021

Interprofessional education within a team is a concept that is readily occurring within clinical dental practice, however, the theoretical underpinnings are rarely understood. Now more than ever, dental healthcare professionals are required to deliver holistic care planning for patients working collaboratively and synchronously with other healthcare professionals. This paper highlights the importance of understanding other team members’ ethics, values and beliefs as well as their remit to effectively communicate and collaborate to elevate a positive experience for both the patient and the clinician.
Risk of Hospital Encounters With Kidney Stones in Autosomal Dominant Polycystic Kidney Disease: A Cohort Study
Authors: Kalatharan Vinusha , Welk Blayne , Nash Danielle M. , Dixon Stephanie N. , Slater Justin , Pei York , Sarma Sisira , Garg Amit X.
Published: March 2021

Background:

There is a perception that patients with autosomal dominant polycystic kidney disease (ADPKD) are more likely to develop kidney stones than the general population.

Objective:

To compare the rate of hospital encounter with kidney stones and the rate of stone interventions between patients with and without ADPKD.

Design:

Retrospective cohort study.

Setting:

Ontario, Canada.

Patients:

Patients with and without ADPKD who had a prior hospital encounter between 2002 and 2016.

Measurements:

Rate of hospital encounter with kidney stones and rate of stone intervention.

Methods:

We used inverse probability exposure weighting based on propensity scores to balance baseline indicators of health between patients with and without ADPKD. We followed each patient until death, emigration, outcomes, or March 31, 2017. We used a Cox proportional hazards model to compare event rates between the two groups.

Results:

Patients with ADPKD were at higher risk of hospital encounter with stones compared with patients without ADPKD (81 patients of 2094 with ADPKD [3.8%] vs 60 patients of 1902 without ADPKD [3.2%]; 8.9 vs 5.1 events per 1000 person-years; hazard ratio 1.6 [95% CI, 1.3-2.1]). ADPKD was not associated with a higher risk of stone intervention (49 of 2094 [2.3%] vs 47 of 1902 [2.4%]; 5.3 vs 3.9 events per 1000 person-years; hazard ratio 1.2 [95% CI = 0.9-1.3]).

Limitations:

We did not have information on kidney stone events outside of the hospital. There is a possibility of residual confounding.

Conclusion:

ADPKD was a significant risk factor for hospital encounters with kidney stones.
Decreasing Stress Through a Spatial Audio and Immersive 3D Environment: A Pilot Study With Implications for Clinical and Medical Settings
Authors: Greenberg David M. , Bodner Ehud , Shrira Amit , Fricke Kai R.
Published: March 2021

There is evidence that music-based interventions can be effective in treating clinical and non-clinical populations. With the emergence of audio-visual technologies, there are new opportunities for developing web-based applications that have therapeutic effects in mental health and medical settings. Here we conducted a pilot study ( N = 100) to test if an immersive web-based spatial audio application can decrease stress and negative mood states. Results showed that the application was effective for both clinical ( n = 40) and non-clinical ( n = 60) groups, and that the effect was most profound for individuals diagnosed with depression and anxiety disorders. Though the present study needs to be replicated with physiological methods, the findings provide initial evidence that web-based spatial audio applications can be effective for short-term stress reduction and have the potential to be a supplement to clinical music interventions, but not a replacement or substitute for such interventions.
“Detrimental to the Team Dynamic”: Exploring College Student-Athlete Dissent
Authors: Rey Rikishi T. , Johnson Zac D.
Published: March 2021

To properly manage college student-athlete dissent, stakeholders (e.g., coaches, teammates, administration, athletic trainers, etc.) must first recognize the situations that cause athletes to dissent. Although athletic dissent is not a new concept, to date, it has only been examined at the high school level. To fill this gap, this study begins to explore this issue at the college level by examining the triggering agents that cause college student-athletes to communicate dissent. Participants ( N = 72) from 11 different sports were asked to complete multiple narratives in response to open ended questions after reflecting on a time where they communicated dissent. Results of a thematic analysis indicate that there are eight triggering agents of dissent, demonstrating distinct differences between high school and college student-athlete dissent due to various contextual factors. These findings highlight the needs and desires of college student-athletes which can help coaches, administration, and other stakeholders to promote positive college student-athlete experiences.
Earnings Management and IPO Anomalies—Evidence from Indian Stock Market
Authors: Pandey Aprajita , Pattanayak J. K.
Published: March 2021

This study examines the relationship between the extent of earnings management in a firm, the level of underpricing during an initial public offering (IPO), and their long-term performance. Earnings management has been acknowledged as a matter of concern during IPOs since long; however, its relationship with underpricing and long-term returns remained inconclusive in emerging markets like India. Using a sample of Indian IPO firms, this study finds that firms that manage accruals aggressively in the pre-IPO period have high initial returns and subsequently low stock returns in the post-IPO period. This study also observed that firms that have used abnormal accruals more conservatively while reporting earnings have better returns in the third year after IPO compared to the firms that reported more aggressively. The results are in consonance with the theory of information asymmetry and suggest that valuation of an IPO firm becomes ambiguous with high level of earnings management, which leads to higher underpricing.
Effectiveness of Chitosan Nanohydrogel as a Bone Regenerative Material in Intrabony Defects in Patients With Chronic Periodontitis: A Randomized Clinical Trial
Authors: Meenakshi S. Swarna , Sankari M.
Published: March 2021

Aim:

Different procedures have been attempted to regenerate intrabony defects in periodontitis but complete regeneration is still a herculean feat. Nanoparticles could prove to be advantageous because of their small size and increased surface area. The aim was to evaluate the effectiveness of a chitosan nanohydrogel as a periodontal regenerative material in the management of intrabony defects.

Materials and Methods:

Twenty patients within the age group of 30 to 60 years with intrabony defects >3 mm and clinical attachment levels >5 mm were selected. They were divided randomly into two groups: group-1, which received only open flap debridement with bone graft and acted as control, and group-2, which received open flap debridement, bone graft mixed with a chitosan nanohydrogel, and acted as the test site. Clinical and radiographic measurements were recorded at baseline, three months, and six months. Intragroup comparison was done using a paired t-test and intergroup comparison was done using an unpaired t-test with the statistical value set at P < .05.

Results:

Chitosan hydrogel incorporated bone grafts showed improved bone regenerative potential. The mean reduction in clinical attachment level in group-2 (8.7 ± 0.6 to 1.6 ± 0.8) was significantly higher than that of group-1 (8.6 ± 0.5 to 2.4 ± 0.7). The mean reduction in probing depths in group-2 (test group) was significantly higher (8.3 ± 0.9 to 1.6 ± 0.8) when compared to group-1 (8 ± 0.8 to 2.3 ± 0.7). Significant amount of defect fill was obtained in both the groups from baseline to six-month period.

Conclusion:

Organic materials such as chitosan could have potential bone regenerative capacity.
Sanitary governmentalities: Producing and naturalizing social differentiation in Maputo City, Mozambique (1887–2017)
Authors: Biza Adriano , Kooy Michelle , Manuel Sandra , Zwarteveen Margreet
Published: March 2021

Maputo, Mozambique’s capital city, is marked by clear socio-spatial divisions in access to sanitation services and distributions of environmental risks. Current development plans tend to reproduce these inequalities and suggest that some residents’ sanitary needs are more important than others. We contest this logic of differentiation underpinning current interventions in Maputo, revealing how the assumption of different sanitary needs has become normalized and naturalized in the urban environment. We use a genealogy of sanitation in Maputo and the former colonial city of Lourenço Marques to trace how colonial power relations worked to normatively distinguish urban spaces and the people who live in them, making some residents and places more deserving of public protection and investments than others. Drawing on Foucauldian theorizations of governmentality, we analyse colonial authorities’ sanitary plans and interventions to show how differences and separations between spaces and bodies were and are produced. Projects of drainage and land reclamation created clean, dry and sanitary habitats for the privileged white few, the existence of which simultaneously created the wet, unhealthy and muddy spaces deemed good enough for the non-white majority. Such manufactured spatial distinctions, in turn, worked to strengthen the perception of differences in cleanliness between people. These differences were consequently mobilized by the Lourenço Marques health service to further mark and legitimize racial segregation. This is how social and spatial inequalities became naturalized in the urban environment over time, culminating in the stark sanitary divides that continue to mark the contemporary city.
PCR-reverse blot hybridization assay in respiratory specimens for rapid detection and differentiation of mycobacteria in HIV-negative population
Authors: Zhang Qing , Xiao Heping , Yan Liping
Published: March 2021

Background

Rapid identification of pathogenic Mycobacterium species is critical for a successful treatment. However, traditional method is time-consuming and cannot discriminate isolated non-tuberculosis mycobacteria (NTM) at species level. In the retrospective study, we evaluated the clinical applicability of PCR-reverse blot hybridization assay (PCR-REBA Myco-ID) with clinical specimens for rapid detection and differentiation of mycobacterial species.

Methods

A total of 334 sputum and 362 bronchial alveolar lavage fluids (BALF) from 696 patients with mycobacterium pulmonary disease (MPD) and 210 patients with non-mycobacterium pulmonary disease used as controls were analyzed. Sputum or BALF were obtained for MGIT 960-TBc ID test and PCR-REBA Myco-ID assay. High resolution melt analysis (HRM) was used to resolve inconsistent results of MGIT 960-TBc ID test and PCR-REBA Myco-ID assay.

Results

A total of 334 sputum and 362 BALF specimens from 696 MPD patients (292 MTB and 404 NTM) were eventually analyzed. In total, 292 MTBC and 436 NTM isolates (mixed infection of two species in 32 specimens) across 10 Mycobacterium species were identified. The most frequently isolated NTM species were M. intracellulare (n = 236, 54.1%), followed by M. abscessus (n = 106, 24.3%), M. kansasii (n = 46, 10.6%), M. avium (n = 36, 8.3%). Twenty-two cases had M. intracellulare and M. abscessus mixed infection and ten cases had M. avium and M. abscessus mixed infection. A high level of agreement (n = 696; 94.5%) was found between MGIT 960-TBc ID and PCR-REBA Myco-ID (k = 0.845, P = 0.000). PCR-REBA Myco-ID assay had higher AUC for both MTBC and NTM than MGIT 960-TBc ID test.

Conclusion

PCR-REBA Myco-ID has the advantages of rapid, comparatively easy to perform, relatively low cost and superior accuracy in mycobacterial species identification compared with MGIT 960-TBc ID. We recommend it into workflow of mycobacterial laboratories especially in source-limited countries.
Hemodialysis patients perceived exercise benefits and barriers: the association with health-related quality of life
Authors: Ghafourifard Mansour , Mehrizade Banafshe , Hassankhani Hadi , Heidari Mohammad
Published: March 2021

Background

Patients on hemodialysis have less exercise capacity and lower health-related quality of life than healthy individuals without chronic kidney disease (CKD). One of the factors that may influence exercise behavior among these patients is their perception of exercise benefits and barriers. The present study aimed to assess the perception of hemodialysis patients about exercise benefits and barriers and its association with patients’ health-related quality of life.

Methods

In this cross-sectional study, 227 patients undergoing hemodialysis were randomly selected from two dialysis centers. Data collection was carried out using dialysis patient-perceived exercise benefits and barriers scale (DPEBBS) and kidney disease quality of life short form (KDQOL-SF). Data were analyzed using SPSS software ver. 21.

Results

The mean score of DPEBBS was 68.2 ± 7.4 (range: 24 to 96) and the mean KDQOL score was 48.9 ± 23.3 (range: 0 to 100). Data analysis by Pearson correlation coefficient showed a positive and significant relationship between the mean scores of DPEBBS and the total score of KDQOL (r = 0.55, p < 0.001). Moreover, there was a positive relationship between the mean scores of DPEBBS and the mean score of all domains of KDQOL.

Conclusion

Although most of the patients undergoing hemodialysis had a positive perception of the exercise, the majority of them do not engage in exercise; it could be contributed to the barriers of exercise such as tiredness, muscle fatigue, and fear of arteriovenous fistula injury. Providing exercise facilities, encouraging the patients by the health care provider to engage in exercise programs, and incorporation of exercise professionals into hemodialysis centers could help the patients to engage in regular exercise.