bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of CEO Overconfidence on Capital Structure Decisions: Evidence from S&P BSE 200
Authors: Mundi Hardeep Singh
Published: April 2021

The article presents the impact of CEO overconfidence on capital structure decisions for Indian firms. Using a sample of S&P BSE 200 companies between 2000 and 2015, this study presents results using regression models on the panel data. The findings of this study highlight the significance of behavioural bias of CEO overconfidence to better understand capital structure decisions. This study found that overconfident CEOs prefer debt financing over equity financing and such overconfident CEOs prefer short-term debt over long-term debt. The behavioural features of CEOs are crucial for board of directors, especially in designing the compensation packages. The robustness of results using multiple proxies corroborates previous finding of western nations and shows that CEOs’ overconfidence plays an important role for CEOs of developing nations too.
From green jobs to Green New Deal: What are the questions?
Authors: Stilwell Frank
Published: April 2021

Proposals for development of ‘green jobs’ emerged when environmentalists, labour organisations and political economists recognised the need for economic restructuring to reduce climate change. Current proposals for a Green New Deal go further by putting additional emphasis on fiscal stimulus, ‘just transition’, reducing socio-economic inequalities, and political empowerment. This article analyses the development of this more comprehensive policy approach, its rationale, the constraints it would face and its prospects in the Australian context.

JEL Codes: B50, H12, L78, P18, Q58
Do Disability Policies Shape How People Perceive Work Limitation? An International Perspective
Authors: Yin Na , Heiland Frank
Published: April 2021

This study explored the role that cross-country disability policy differences play in shaping individuals’ work limitation reporting styles. We used anchoring vignettes available in comparable U.S. and European survey data to test and adjust for reporting differences in self-reported work limitation measures. We found that disability policy generosity scores showed statistically significant predictive power for respondents’ work limitation classification scales, with the association stronger and more statistically significant at the lower end and the middle of the scale. That is, respondents under more generous disability regimes tended to apply a more inclusive (i.e., lenient) scale in classifying a mild, moderate, or severe work limitation. Because there is no natural interpretation of the magnitude of the correlation, we conducted counterfactual policy simulations to illustrate the strength of the association; for example, if the United States were to adopt more generous disability policies such as those in Sweden, there might be an associated increase of more than 36 percentage points in the proportion of Americans age 50 years and above reporting work limitation (of any severity). This research contributes to a better understanding of the role of disability policy in reporting heterogeneity in comparative disability research, an area that has been seldom studied.
Effect of microaggregate filter passage on feline whole blood stored for 35 days
Authors: Morse Sophia A , Mooney Erin T
Published: April 2021

Objectives

The aim of this study was to compare the characteristics of fresh and stored feline red blood cells (RBCs) after passage through an 18 μm microaggregate filter.

Methods

Nine cats were recruited for a single blood donation using an open collection system. A simulated transfusion using a syringe driver and microaggregate filter was performed over 2 h with half the blood on the day of donation and the other half after 35 days of storage. Differences in haematological parameters, haemolysis percentage and osmotic fragility (OF) were compared on the day of donation pre-filter passage (D0–) vs day of donation post-filter (D0+) or day 35 storage pre-filter (D35–) and post-filter (D35+). Blood was cultured at D0+ and D35+.

Results

There were no statistically significant differences in the D0– vs D0+ comparisons. There were statistically significant ( P <0.05) increases in haemolysis percentage, red cell distribution width (RDW) percentage and mean OF, and decreases in packed cell volume (PCV), RBC count, haemoglobin and haematocrit for D0– vs D35–. The same was found for D0– vs D35+ with the addition of a significant increase in mean cell haemoglobin (MCH). For D35– vs D35+ only MCH significantly increased. At day 35, 6/9 units had haemolysis percentages that exceeded 1%. This increased to 8/9 of stored units post-filter passage. All blood units cultured negative.

Conclusions and relevance

Fresh RBCs exhibited no in vitro evidence of injury following passage through an 18 μm microaggregate filter. Increased MCH was observed in the stored blood and may represent haemolysis induced by the filter. All other changes can be explained by storage lesion rather than filter passage. The findings highlight the importance of blood banking quality controls and the need for further research to assess the effects of transfusion technique, specifically filter passage, on storage lesion-affected feline blood.
Understanding Teacher Identity as an International Teacher: An Autoethnographic Approach to (Developing) Reflective Practice
Authors: Sahling Julia , De Carvalho Roussel
Published: April 2021

The teaching profession in England and Wales has been experiencing a steady decline in its workforce, with a significant number of teachers making the decision to move abroad and teach in international schools. Teachers cite working conditions, institutional pressures and pay and conditions at home as reasons to seek employment elsewhere. Meanwhile, exploring teachers’ experiences of teaching abroad is a relatively new area of research. The growth of international schools from 1964, when there were only around 50 such schools, to 2017, with over 8,000 international schools and some 420,000 teachers, indicates a need to understand teachers’ personal and professional experiences as they navigate these different contexts. This research presents a small case study of how autoethnography can be used as a methodological tool to support international teachers in revealing changes in their teacher identity, as well as promoting the development of their sense of self-efficacy within different sociocultural school contexts. Through Julia Sahling’s autoethnographic study, this paper explores how teachers may be able to actively engage in critical reflective practice in order better to understand these dynamic transitions, as well as the implications of teaching in multiple international contexts.
A study into wellbeing, student engagement and resilience in early-adolescent international school students
Authors: McKeering Phillipa , Hwang Yoon-Suk , Ng Clarence
Published: April 2021

Growth in the international school sector continues, with significant expansion of the sector in Asia. Whilst substantial research has been conducted on the adjustment experience of tertiary-aged students, limited research attention has been given to school-aged students in international schools. The environment, conditions and challenges experienced by school-aged international students can differ considerably from those of tertiary-aged international students. This can be heightened during early-adolescence with adjustment from school mobility linked to many negative developmental outcomes. The present study investigates wellbeing, engagement and resilience of 178 early-adolescent international school students (aged 10-14) from an international school in Singapore that offers the International Baccalaureate Diploma and the national curriculum of England. Results reported a positive significant association between wellbeing, engagement and resilience constructs. The study also identified demographic and mobility characteristics that were associated with lower levels of wellbeing, behavioural engagement and resilience. Findings of the study highlight a potential cohort of early-adolescent international students who could benefit from additional support.
Patient-Specific 3-Dimensional Model of Smooth Muscle Cell and Extracellular Matrix Dysfunction for the Study of Aortic Aneurysms
Authors: Bogunovic Natalija , Meekel Jorn P. , Majolée Jisca , Hekhuis Marije , Pyszkowski Jakob , Jockenhövel Stefan , Kruse Magnus , Riesebos Elise , Micha Dimitra , Blankensteijn Jan D. , Hordijk Peter L. , Ghazanfari Samaneh , Yeung Kak K.
Published: April 2021

Introduction:

Abdominal aortic aneurysms (AAAs) are associated with overall high mortality in case of rupture. Since the pathophysiology is unclear, no adequate pharmacological therapy exists. Smooth muscle cells (SMCs) dysfunction and extracellular matrix (ECM) degradation have been proposed as underlying causes. We investigated SMC spatial organization and SMC-ECM interactions in our novel 3-dimensional (3D) vascular model. We validated our model for future use by comparing it to existing 2-dimensional (2D) cell culture. Our model can be used for translational studies of SMC and their role in AAA pathophysiology.

Materials and Methods:

SMC isolated from the medial layer of were the aortic wall of controls and AAA patients seeded on electrospun poly-lactide- co-glycolide scaffolds and cultured for 5 weeks, after which endothelial cells (EC) are added. Cell morphology, orientation, mechanical properties and ECM production were quantified for validation and comparison between controls and patients.

Results:

We show that cultured SMC proliferate into multiple layers after 5 weeks in culture and produce ECM proteins, mimicking their behavior in the medial aortic layer. EC attach to multilayered SMC, mimicking layer interactions. The novel SMC model exhibits viscoelastic properties comparable to biological vessels; cytoskeletal organization increases during the 5 weeks in culture; increased cytoskeletal alignment and decreased ECM production indicate different organization of AAA patients’ cells compared with control.

Conclusion:

We present a valuable preclinical model of AAA constructed with patient specific cells with applications in both translational research and therapeutic developments. We observed SMC spatial reorganization in a time course of 5 weeks in our robust, patient-specific model of SMC–EC organization and ECM production.
The Potential Diagnostic Accuracy of Circulating MicroRNAs for Leukemia: A Meta-Analysis
Authors: Zhang Wen-Ting , Zhang Guo-Xun , Gao Shuai-Shuai
Published: April 2021

Background:

Leukemia is a common malignant disease in the human blood system. Many researchers have proposed circulating microRNAs as biomarkers for the diagnosis of leukemia. We conducted a meta-analysis to evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of leukemia.

Methods:

A comprehensive literature search (updated to October 13, 2020) in PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure (CNKI) was performed to identify eligible studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for diagnosing leukemia were pooled for both overall and subgroup analysis. The meta-regression and subgroup analysis were performed to explore heterogeneity and Deeks’ funnel plot was used to assess publication bias.

Results:

49 studies from 22 publications with a total of 3,489 leukemia patients and 2,756 healthy controls were included in this meta-analysis. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve were 0.83, 0.92, 10.8, 0.18, 59 and 0.94, respectively. Subgroup analysis shows that the microRNA clusters of plasma type could carry out a better diagnostic accuracy of leukemia patients. In addition, publication bias was not found.

Conclusions:

Circulating microRNAs can be used as a promising noninvasive biomarker in the early diagnosis of leukemia.
Covered Stents for Endovascular Treatment of Aortoiliac Occlusive Disease: A Systematic Review and Meta-Analysis
Authors: Mallory Austin , Giannopoulos Stefanos , Lee Paul , Kokkinidis Damianos G. , Armstrong Ehrin J.
Published: April 2021

Purpose:

The treatment of aortoiliac occlusive disease (AIOD) has largely shifted to endovascular techniques, with primary stenting constituting the preferred treatment approach. The goal of the current study was to summarize available literature and to determine whether covered stents are superior to bare metal stents for the treatment of AIOD, in terms of both periprocedural and long-term outcomes.

Methods:

A meta-analysis of 47 studies was conducted with the use of random effects modeling. The incidence of adverse events during follow up among the individual included studies was synthesized.

Results:

Most of the lesions were located at the common iliac arteries and were chronic total occlusions. The procedure was technically successful in almost all cases in both groups, with a low rate of periprocedural complications observed in both groups. The reported primary patency rates for the non-covered and covered stent group during an average follow up of 24.3 months among the individual studies, were 84% and 92% respectively, while surgical or endovascular re-intervention was required in 10% of non-covered stent cases and in 6% of covered stent cases. Eight studies comparing covered vs non-covered stents in terms of patency demonstrated superiority of covered stents (OR: 2.47; 95% CI: 1.01-6.01; p = 0.047 Combining TASC C/D lesions together 12 studies reported 92% (95%CI:89%-95%) primary patency in the covered stent group, while 7 studies reported 75% (95%CI: 60%-88%) primary patency for cases treated with non-covered stents.

Conclusion:

This study demonstrated that covered stents are safe and effective when utilized for the treatment of AIOD. Covered stents were associated with a statistically significant higher odds of primary patency in both the overall cohort and in more complex TASC C/D lesions. However, additional high-quality comparative analyses between covered vs bare metal stents and between several types of covered stents are needed to determine the most optimal treatment modality for AIOD.
Traumatic brain injury risk assessment with smart technology
Authors: Huang Chiming , Huang Rosa H , Majid Bani Yaghoub
Published: April 2021

Mild traumatic brain injuries (mTBIs) continue to burden our warfighters. The high-tech industry has delivered wearable Micro-Electro-Mechanical System (MEMS) head-impact sensors to monitor impact forces. So far, these MEMS sensors have categorically failed to detect mTBIs and are therefore of no clinical utility for diagnosis. Our recent studies have shown that human head kinematics is anisotropic with respect to pitch–roll–yaw degrees of freedom of the head and neck. In the present project, we generated head acceleration datasets on non-injurious impacts and mTBI events based on mean values from the literature. We then augmented the simulated data with pitch–roll–yaw information followed by machine learning with a Classification and Regression Tree analysis. Our results revealed that head angular acceleration in pitch is the best predictor. More than 81.3 % of concussive injuries had head angular accelerations in pitch exceeding 3527 rad/s2. Out of 18.6% of concussive injuries with head angular accelerations in pitch under 3527 rad/s2, 75% of these cases had head angular accelerations in roll exceeding 1679 rad/s2. This study shows that artificial intelligence and machine learning should be able to provide accurate identification of subject-specific concussive thresholds in real time and in the field, thereby moving concussion diagnosis toward precision medicine.
A New, Conservative Treatment for Perianal Fistula that May Halve the Need for Surgical Intervention: Case Series
Authors: Pérez Lara Francisco Javier , Hernández González Jose Manuel , Prieto-Puga Arjona Tatiana , Moya Donoso Francisco Javier , Doblas Fernández Juan
Published: April 2021

Purpose. In the last two decades, many sphincter preservation techniques have been proposed for the treatment of anal fistula. Since 2011, our surgical team has treated fistulas by sealing them with platelet-rich fibrin (PRF). This is performed actually as an outpatient process, without anaesthesia. Methods. Patients were treated with PRF sealant, during the period June 2012–March 2017. The fibrin preparation is applied in the fistulous tract, with no need for any type of anaesthesia, and so the patient can go home immediately afterwards, without further observation. Results. After an average follow-up of 26.49 months, the perianal fistula had healed completely in 52.86% of the patients (n = 37), who each received an average of 1.92 sealant operations. In another 10 cases, the sealing was initially successful, but a relapse occurred during the follow-up period. Conclusion. The outpatient treatment of perianal fistula with PRF is totally harmless, is very low cost and achieves very acceptable results. In our opinion, therefore, this could be considered an appropriate initial treatment for perianal fistula, with surgical treatment being reserved if this approach is unsuccessful, thereby avoiding many complications and producing significant economic savings for the health system.
Gamifying Contentious Politics: Gaming Capital and Playful Resistance
Authors: Huang Vincent G. , Liu Tingting
Published: April 2021

This article uses the Bourdieusian tradition to examine the relationship between gameplay elements and contentious politics. When investigating Chinese progressive social movements, this study found that the development of local gaming industries has conditioned three ways in which gameplay elements are employed to organize “playful resistance”: game as an action tactic, game as the mechanism for critical pedagogics, and game as a tool for public education . Gaming capital has become a useful resource for organizing contentious activities and disseminating progressive political views. Two forms of gaming capital are identified: one is the technical competencies needed to design games; the other is the cultural capacity to imagine social movements through game design mechanisms. This article shows how playful resistance challenges both authoritarian governance and the capitalist logic of gaming, offering a glimpse into how the actual process of gamification has taken place in a non-Western context.
Lower Case Truth: Bridging Affect Theory and Arts-Based Education Research to Explore Color as Affect
Authors: Haberl Ellie
Published: April 2021

As education researchers increase our focus on affect as a crucial dimension of school practice and pedagogy, we also have the responsibility of taking up the paradoxical nature of seeking to represent and analyze moments of feeling that, by their very nature, evade our understanding. This article explores the question of attending to affect in education research by drawing on research conducted in a seventh grade classroom in a mid-sized city in the western United States, where students were explicitly invited to ground argumentative writing in lived experiences that were significant to them, including those experiences often deemed difficult and thus saturated with affective intensities. Invited to use visual arts-based methods of representing the felt dimension of the project, participants used both color and abstract design as a method for representing the complexity of these affective intensities. The author makes an argument for this visual method of representation that invites students to illustrate their affective experience in ways that maintain its complex, contrasting and often non-linguistic nature.
Effect of imbalanced interface pre-tightening force on the bearing behavior of carbon fiber reinforced polymer interference-fit lap joint
Authors: Li Jian , Lai Xiaoxu , Zou Peng , Guo Wei , Tang Cuiyong
Published: April 2021

Interference-fit is attracting increasing attention in the aerospace field because of its excellent enhancement of the sealing and fatigue life of carbon fiber reinforced plastic (CFRP). However, it also induces imbalanced pre-tightening forces on the interface, and affects its mechanical behavior. A series of experiments were conducted to assess the imbalanced pre-tightening force of CFRP interference bolted joints and its effects. High-precision washer force sensors were used to measure the pre-tightening force between upper and lower surfaces at various interference-fit and torque. Strain gauges were used to estimate the varying effect on the imbalanced pre-tightening force during tensile tests. The effects of varying interference-fit and torque on pre-loaded transfer, surface strain distribution, tensile strength, and damage mode were identified. The results show that the synergy of interference-fit and torque induces an imbalanced pre-tightening force, which, in turn, changes the stress-strain evolution of the surface, and a special “transition regime” was identified in the evolution curves. Compared with clearance-fit, the ultimate strength and optimal torque of interference-fit joints could be significantly enhanced. In addition, the damage originates from fiber/matrix slipping to the upper surface with a low pre-tightening force and the formation of stack buckling, which then causes delamination fracture.
When Past Group Events and Identities Define the Present: Effect of Perceived Collective Continuity on Defensive Behaviors of the French In-Group
Authors: Maoulida Haifat , Tavani Jean Louis , Urdapilleta Isabel
Published: April 2021

Previous studies have highlighted the benefits of perceived collective continuity. However, to the authors’ knowledge, none have considered the negative effects of such perceptions when they concern a negative past or take the form of a break with a positive past. The authors therefore conducted three studies to examine the influence of perceived continuity (or a break) with positive versus negative events or identities on French in-groups’ defensive behaviors (i.e., perceptions of and attitudes toward refugees and intention to engage in collective actions). They expected to observe the positive impact of a positive (rather than negative) past continuity and a negative (rather than positive) past break. The results of Experiment 1 partially confirmed this hypothesis, as individuals who identified strongly expressed a greater intention to engage in collective actions when they perceived continuity with positive past events. Similarly, participants were more opposed to the reception of refugees when they perceived continuity with a positive past French identity (Experiment 2). Finally, high-identifier participants who perceived a break with a negative past identity expressed greater opposition to the reception of refugees and saw them more as a threat (Experiment 3). The authors discuss the importance of considering the emotional valence of past group memories for the continuity literature and a better comprehension of actual in- and between-group dynamics.
Effects of Jixueteng on Experimental Periodontitis During Orthodontic Tooth Movement in Rats
Authors: Katayama Taira , Sato Takenori , Hamada Nobushiro , Goda Seiji , Yamaguchi Tetsutaro , Tsukinoki Keiichi , Handa Keisuke
Published: April 2021

Recently, natural ingredients have focused on the inhibition of bacteria-induced alveolar bone resorption in orthodontic treatment. Jixueteng (Jix), a Chinese traditional medicine, contains several kinds of flavonoids given their biological properties. We evaluated the effects of Jix on experimental periodontitis during orthodontic tooth movement (OTM) in rats. To this end, 9-week-old male Wistar rats, which were equipped with orthodontic appliance, were orally infected with Porphyromonas gingivalis (Pg), while Jix was administered in their drinking water. A total of 28 days after the beginning of OTM, alveolar bone resorption on the right side of the upper jaws was scanned with micro-computed tomography. These were also used as histological specimens and underwent tartrate-resistant acid phosphatase (TRAP) staining. TRAP-positive multinucleated cells were counted as osteoclasts. As a result, the distance of tooth movement in the OTM and Pg infection with Jix administration (OTM + Pg + Jix) group was the same as that of the sham-infected group. The amount of bone resorption and number of osteoclasts in the OTM + Pg + Jix group was more significantly decreased than that in the OTM and Pg-infected group ( P < 0.05). Hence, Jix had little effect on OTM and inhibited Pg-induced alveolar bone destruction. We suggested that the administration of Jix can support tooth movement and contribute to the prevention of periodontitis during orthodontic treatment.
Prosecuting political dissent: Discussing the relevance of the political offence exception in EU extradition law in light of the Catalan independence crisis
Authors: Top Sibel
Published: April 2021

Most extradition treaties contain a political offence exception clause, which precludes extradition from taking place when the concerned crime is considered to be political by the requested state. This clause has been abolished within the European Union (EU), where mutual trust prevails among Member States, allegedly rendering such safeguards obsolete. This article, however, seeks to question the commonly agreed outdatedness of the political offence exception clause within the EU framework, looking at the context of its abolition, the role Spanish authorities played in it at the time of its abolition, the way they have handled the Catalan crisis since 2017 and the exportation of the latter at the EU level. It argues that the situation in which Catalan exiles are today casts doubt over the obsolescence of safeguards such as the political offence exception and further contends that human and political rights safeguard mechanisms should not be perceived as hampering mutual trust and judicial cooperation in criminal matters in the EU.
Optimizing diabetes mellitus care to improve COVID-19 outcomes in resource-limited settings in Africa
Authors: Kyazze Andrew Peter , Bongomin Felix , Ninsiima Sandra , Nattabi Gloria , Nabakka Winnie , Kukunda Rebecca , Odanga Henry , Ssekamatte Phillip , Baluku Joseph Baruch , Kibirige Davis , Andia-Biraro Irene
Published: April 2021

Diabetes mellitus (DM) is an important risk factor for both severe disease and death due to coronavirus-2019 (COVID-19). About 19 million of the 463 million persons living with DM (PLWD) globally are found in sub-Saharan Africa (SSA). The dual burden of DM and poverty in SSA, coupled with the rising number of cases of COVID-19 in this region, predisposes PLWD to inadequate care and poor glycemic controls due to the disruption to the economy and the healthcare system. The risk of acquisition of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) among PLWD is the same as those in the general population. Therefore, the standard preventive measures outlined by the World Health Organization must be strictly adhered to. In addition, maintaining adequate glycemic control is associated with better outcomes in DM patients with COVID-19. In SSA, adequate supply of DM medication while patients stay at home is crucial to minimize routine hospital visits since DM clinics are usually overcrowded and have longer waiting times, which may maximize risk of SARS-CoV-2 transmission to PLWD across the region. Psychosocial support to improve adherence to anti-hyperglycemic medications may improve COVID-19 outcomes. Trained healthcare professionals should diagnose and evaluate severity comprehensively as well as evaluate the need for in-patient care for PLWD with COVID-19 irrespective of disease severity. Due to the increased risk of severe disease, a multi-disciplinary approach to the management of COVID-19 in PLWD should preferably be in a setting where close monitoring is available, typically a health facility, even for mild disease that may require home management according to local guidelines. In conclusion, DM complicates COVID-19 outcomes and the on-going COVID-19 pandemic adversely affects DM care at individual and global public health levels. PLWD should be prioritized as COVID-19 vaccines are being rolled out.
Case report of an atrial septal defect with negative transthoracic echocardiography, a diagnostic challenge in a middle-aged female with marked dyspnoea
Authors: Liyanapathirana Chathuri , Arthanayake Shashika Mihirani , Widyaratne Sisil , Chandana Saman , Senevirathne Danajani
Published: April 2021

A 39-year-old G3P3 female presented with abrupt onset dyspnoea of one month duration. She was markedly symptomatic when lying supine and resorted to prone sleeping. Chest X-ray reported as cardiomegaly. Transthoracic echocardiography was unremarkable twice. Computed tomography chest showed a dilated pulmonary artery. Transesophageal echocardiography identified a 12-mm ostium secundum atrial septal defect with mild pulmonary hypertension. The defect was closed with a cocoon device and rendered her symptom free. This case highlights the importance of timely organization of transesophageal echocardiography when transthoracic echocardiography is negative. It also illustrates marked dyspnoea could be a presentation of undiagnosed atrial septal defect with mild pulmonary hypertension.
Retrospective analysis of clinical characteristics and laboratory results of COVID-19 patients
Authors: Zhang Liying , Peng Yusheng , Zheng Qiao , Jiang Lanbin , Tang Shijie , Chen Pu
Published: April 2021

The positive detection of SARS-CoV-2 is the “gold standard” for diagnosing COVID-19. However, due to the low detection capacity of SARS-CoV-2 and the high false negative rate at the beginning of the epidemic, and the medical staff did not know much about the condition and treatment of COVID-19 patients. Therefore, our hospital paid more attention to the results of other laboratory indicators in the early stage of the epidemic of COVID-19. The aim of this study was to explore clinical characteristics and laboratory results of COVID-19 patients in Wuhan, China and provide evidence for the prevention and treatment of COVID-19. Retrospective study of 562 COVID-19 patients hospitalized in Wuhan Red Cross Hospital from January 28 to March 12, 2020 was performed. The patients were divided into 2 groups according to the severity of illness: Mild group ( n = 436) and Severe group ( n = 126). The general clinical characteristics of the patients were collected, including age, gender, past medical history, clinical symptoms, etc. All patients underwent blood routine test, biochemical indicators, blood gas analysis and other related laboratory examinations. The clinical data and laboratory results of the two groups were compared. Compared with the patients in the Mild group, the patients in Severe group were older and the proportion of patients suffering from underlying disease (61.11%) was higher ( p < 0.05). In Severe group, WBC, NEUT, NLR, PCT, CRP, IL-6, ESR, CK, CK-MB, Mb, cTnI, D-D, Fib, and PaCO2 of patients had higher values, while the levels of LYMPH, HBG, PLT, PO2, and SaO2 were significantly reduced, and the differences were statistically significant ( p < 0.05). Between Severe group and Mild group, there was no significant difference in other indexes such as ALT, Urea, and Cr ( p > 0.05) or in the positive rate of influenza A, B virus, or other respiratory pathogens by pairwise comparison ( p > 0.05). Viral infection and inflammation were more serious in elderly patients or patients with underlying diseases. They were more likely to progress to severely ill patients. Clinical manifestations and laboratory examinations were important basis for clinical classification and treatment. Therefore, Timely and accurate attention to these indicators is beneficial to prevent the deterioration of the disease.
Leading for Whom? Teaching-Research Officers’ Role Perception and Work Engagement in Chinese Mainland
Authors: Shen (沈伟) Wei , Ma (马红梅) Hongmei
Published: April 2021

Purpose:

The purpose of this article is to analyze both teaching-research officers’ (TROs) role perceptions and work engagement, figuring out how their competing roles are balanced to ensure continued work engagement and which roles have greater benefits to the community and educational reform.

Design/Approach/Methods:

The study employs a questionnaire, which is composed of an inventory of work role requirements and the Utrecht Work Engagement Scale, to investigate TROs’ role perception, work engagement, and their relationship.

Findings:

TROs’ work experience had a complicated relationship with their work engagement. The two strands of the TROs’ role orientation co-existed within their daily work and strengthened each other through exerting effects on the dedication and absorption aspects of work engagement. However, TROs concerned with teacher development displayed higher work engagement than those who put a greater emphasis on policy implementation.

Originality/Value:

The study contributes to current research in three respects. First, it bridges the macro-level trend of education reform with micro-level role internalization of individuals. Second, it broadens our understanding of work engagement by linking it with the subjective perceptions of one’s work role. Finally, this Chinese case is expected to enrich international perspectives on teacher leaders in the context of top-down districtwide instructional reform.
Growth in Self-Regulation Over the Course of Adolescence Mediates the Effects of Foster Care on Psychopathology in Previously Institutionalized Children: A Randomized Clinical Trial
Authors: Mukerji Cora E. , Wade Mark , Fox Nathan A. , Zeanah Charles H. , Nelson Charles A.
Published: April 2021

Children reared in institutions experience severe psychosocial deprivation, resulting in lasting consequences for social and emotional development. This study evaluated growth trajectories of self-regulation from ages 8 to 16 among previously institutionalized children randomized to foster care (foster-care group; FCG) or to remain in institutional care (care-as-usual group; CAUG) compared with a never-institutionalized group (NIG). We then tested a developmental pathway by which growth in self-regulation reduces general psychopathology at age 16 for the FCG relative to the CAUG. The FCG experienced modest growth in self-regulation over adolescence and “caught up” to the NIG by age 16. The beneficial effect of foster care on psychopathology operated through growth in self-regulation; part of this effect was further mediated by reduced peer difficulties for the FCG. Findings reveal that the effects of foster care on self-regulation emerge over adolescence and that growth in self-regulation is a mechanism by which foster care mitigates the impact of institutionalization on psychopathology.
Anterior Cruciate Ligament Length in Pediatric Populations: An MRI Study
Authors: Tran Emily P. , Dingel Aleksei B. , Terhune E. Bailey , Segovia Nicole A. , Vuong Brian , Ganley Theodore J. , Fabricant Peter D. , Green Daniel W. , Stavinoha Tyler J. , Shea Kevin G.
Published: April 2021

Background:

As regards anterior cruciate ligament (ACL) reconstruction (ACLR), graft diameter has been identified as a major predictor of failure in skeletally mature patients; however, this topic has not been well-studied in the higher risk pediatric population. Hamstring tendon autograft configuration can be adjusted to increase graft diameter, but tendon length must be adequate for ACLR. Historical parameters of expected tendon length have been variable, and no study has quantified pediatric ACL morphology with other osseous parameters.

Purpose:

To develop magnetic resonance imaging (MRI)–derived predictors of native ACL graft length in pediatric patients so as to enhance preoperative planning for graft preparation in this skeletally immature patient population.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

MRI scans of 110 patients were included (64 girls, 46 boys; median age, 10 years; range, 1-13 years). Patients with musculoskeletal diseases or prior knee injuries were excluded. The following measurements were taken on MRI: ACL length; sagittal and coronal ACL inclination; intercondylar notch width and inclination; and femoral condyle depth and width. Associations between these measurements and patient sex and age were investigated. Univariate linear regression and multivariable regression models were created for each radiographic ACL measure to compare R 2.

Results:

Female ACL length was most strongly associated with the depth of the lateral femoral condyle as viewed in the sagittal plane ( R 2 = 0.65; P < .001). Other statistically significant covariates of interest included distal femoral condylar width, age, and coronal notch width ( P < .05). For males, the ACL length was most strongly associated with the distal femoral condyle width as viewed in the coronal plane ( R 2 = 0.70; P < .001). Other statistically significant covariates of interest for male ACL lengths were lateral femoral condyle depth, age, and coronal notch width ( P < .05).

Conclusion:

In pediatric populations, femoral condylar depth/width and patient age may be valuable in assessing ACL size and determining appropriate graft dimensions and configuration for ACLRs. The use of this information to optimize graft diameter may lower the rates of ACL graft failure in this high-risk group.
Effectiveness of Isometric Exercise and Counseling on Level of Pain Among Patients With Knee Osteoarthritis
Authors: Kangeswari Ponnu , Murali Kamala , Arulappan Judie
Published: April 2021

Introduction

Osteoarthritis (OA) is one of the emerging health issues in Asian countries in elderly population. Knee osteoarthritis (KOA) is a major age related public health issue characterized by progressive loss of articular cartilage resulting in pain, functional impairment, disability and diminished quality of life. The aim of this study was to assess the effectiveness of Isometric exercise and counseling on level of pain among patients with KOA.

Methods

Quantitative research approach and a quasi-experimental pretest-posttest control group research design was utilized. The study was conducted at MIOT hospital and Devadoss Hospital, Madurai, Tamil Nadu, India. Data was collected from a total of 200 patients with KOA, 100 in the study and 100 in the control group. These patients were clinically diagnosed to have Grade I, II and III KOA. The demographic variables and clinical profile were recorded for both groups. The self-administered WOMAC questionnaire was used to assess the level of pain of KOA patients. Post-test assessment was carried out on Day 15, Day 30, Day 60 and Day 90. The data was analyzed using SPSS windows 16.

Results

The comparison of level of pain between the study and control group has showed a remarkable reduction in level of pain among patients with KOA in the study group. The post-test level of pain in the study group was 14.9% (13.3% -16.5% with 95% CI) and was 2.1% (1.2% -3.0% with 95% CI) in the control group. It showed that the reduction in the level of pain was higher in the study group than the control group.

Conclusion

The study found that a 12-week Isometric exercise and counseling program has significantly reduced pain, stiffness and improved physical function. Therefore, the Isometric exercise and counselling should be adopted as a routine care in the hospitals treating patients with KOA.
Genetic Polymorphism of Tumor Necrosis Factor-Alpha, Interferon-Gamma and Interleukin-10 and Association With Risk of Mycobacterium Tuberculosis Infection
Authors: Adane Gashaw , Lemma Mulualem , Geremew Demeke , Sisay Tekeba , Tessema Mekibib Kassa , Damtie Debasu , Ayelign Birhanu
Published: April 2021

Background.

Mycobacterium tuberculosis has become the leading cause of morbidity and death in humans worldwide. Thus, genetic variability of the host plays a major role in human susceptibility to the pathogen, among others. Therefore, the objective of this finding was to assess the association of genetic polymorphisms of cytokines with tuberculosis infection.

Method.

A cross-sectional study was conducted between January and May 2018. Five ml of whole blood was collected and extracted the genomic DNA through simple salting out method. The patterns of genetic polymorphism were determined by amplification refractory method PCR using specific primers. Finally, the PCR run on electrophoresis of agarose gel and the band was visualized under UV light. A logistical regression model has been adapted to assess the association of genetic polymorphisms with tubercular infection. In order to determine the association between the explanatory and outcome variable, the odds ratio with 95% CI was calculated. P < 0.05 is a statistically significant value.

Result.

In present study, the frequency of TNF-α -308 G allele and GG genotype OR (95% CI)= 0.20 (0.11-0.37), and OR (95% CI)= 0.29 (0.18-0.46)), respectively) and IFN-γ +874 A allele and AA genotype OR (95% CI)= 3.80 (2.11-6.86) and (OR (95% CI)= 1.61(1.13-2.28), respectively) were significantly associated with tuberculosis incidence. In contrast, there is no significant correlation between IL-10 -1082 A and AA of allele and genotype, respectively in tuberculosis patients (p > 0.05) was evident.

Conclusion.

From our finding, the genetic variability of TNF-α -308 A and IFN-γ +874 alleles are the potent host genetic risk factors associated with tuberculosis infection.
Is there a relationship between hematological inflammatory parameters and age-related macular degeneration?
Authors: Karahan Mine , Hazar Leyla , Erdem Seyfettin , Ava Sedat , Dursun Mehmet Emin , Demirtaş Atılım Armağan , Keklikçi Uğur
Published: April 2021

Purpose:

We aimed to analyze blood inflammation parameters in patients with age-related macular degeneration (AMD).

Methods:

In this retrospective study, patients were divided into three groups: wet-type AMD ( n = 60), dry-type AMD ( n = 60), and healthy controls ( n = 71). The laboratory and demographic data of the patients were analyzed. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated manually.

Results:

The mean NLR was 2.26 ± 1.42 in the dry-type AMD group, 3.90 ± 1.65 in the wet-type AMD group, and 1.84 ± 0.61 in the control group ( p < 0.001). The mean MLR was 0.30 ± 0.20 in the dry-type AMD group, 0.47 ± 0.31 in the wet-type AMD group, and 0.28 ± 0.14 in the control group ( p < 0.001). The mean PLR was 129.31 ± 79.82 in the dry-type AMD group, 156.67 ± 83.99 in the wet-type AMD group, and 135.59 ± 58.68 in the control group ( p = 0.101). Receiver operating characteristic (ROC) curve analyses revealed that the area under the curve (AUC) for NLR and MLR was 0.920 and 0.717, respectively, for wet-type AMD. The sensitivity and specificity of NLR for wet-type AMD were 64% and 93%, respectively, whereas MLR was 63% and 75%, respectively.

Conclusion:

Simple blood tests revealed that NLR and MLR were significantly higher in patients with wet-type AMD than in patients with dry-type AMD and healthy controls, which implies low-grade inflammation.
Appropriate intraprocedural initial heparin dosing in patients undergoing catheter ablation for atrial fibrillation receiving uninterrupted non-vitamin-K antagonist oral anticoagulant treatment
Authors: Zhang Rong-feng , Ma Cheng-ming , Wang Na , Yang Ming-hui , Li Wen-wen , Yin Xiao-meng , Dong Ying-xue , Yu Xiao-hong , Xiao Xian-jie , Xia Yun-long , Gao Lian-jun
Published: April 2021

Background

To clarify the appropriate initial dosage of heparin during radiofrequency catheter ablation (RFCA) in patients with atrial fibrillation (AF) receiving uninterrupted nonvitamin K antagonist oral anticoagulant (NOAC) treatment.

Methods

A total of 187 consecutive AF patients who underwent their first RFCA in our center were included. In the warfarin group (WG), an initial heparin dose of 100 U/kg was administered (control group: n = 38). The patients who were on NOACs were randomly divided into 3 NOAC groups (NG: n = 149), NG110, NG120, and NG130, and were administered initial heparin doses of 110 U/kg, 120 U/kg, and 130 U/kg, respectively. During RFCA, the activated clotting time (ACT) was measured every 15 min, and the target ACT was maintained at 250–350 s by intermittent heparin infusion. The baseline ACT and ACTs at each 15-min interval, the average percentage of measurements at the target ACT, and the incidence of periprocedural bleeding and thromboembolic complications were recorded and analyzed.

Results

There was no significant difference in sex, age, weight, or baseline ACT among the four groups. The 15 min-ACT, 30 min-ACT, and 45 min-ACT were significantly longer in the WG than in NG110 and NG120. However, no significant difference in 60 min-ACT or 75 min-ACT was detected. The average percentages of measurements at the target ACT in NG120 (82.2 ± 23.6%) and NG130 (84.8 ± 23.7%) were remarkably higher than those in the WG (63.4 ± 36.2%,p = 0.007, 0.003, respectively). These differences were independent of the type of NOAC. The proportion of ACTs in 300–350 s in NG130 was higher than in WG (32.4 ± 31.8 vs. 34.7 ± 30.6,p = 0.735). Severe periprocedural thromboembolic and bleeding complications were not observed.

Conclusions

For patients with AF receiving uninterrupted NOAC treatment who underwent RFCA, an initial heparin dosage of 120 U/kg or 130 U/kg can provide an adequate intraprocedural anticoagulant effect, and 130 U/kg allowed ACT to reach the target earlier.

Trial registration: Registration number: ChiCTR1800016491, First Registration Date: 04/06/2018 (Chinese Clinical Trial Registryhttp://www.chictr.org.cn/index.aspx).
A systematic review of the quality of conduct and reporting of survival analyses of tuberculosis outcomes in Africa
Authors: Ngari Moses M. , Schmitz Susanne , Maronga Christopher , Mramba Lazarus K. , Vaillant Michel
Published: April 2021

Background

Survival analyses methods (SAMs) are central to analysing time-to-event outcomes. Appropriate application and reporting of such methods are important to ensure correct interpretation of the data. In this study, we systematically review the application and reporting of SAMs in studies of tuberculosis (TB) patients in Africa. It is the first review to assess the application and reporting of SAMs in this context.

Methods

Systematic review of studies involving TB patients from Africa published between January 2010 and April 2020 in English language. Studies were eligible if they reported use of SAMs. Application and reporting of SAMs were evaluated based on seven author-defined criteria.

Results

Seventy-six studies were included with patient numbers ranging from 56 to 182,890. Forty-three (57%) studies involved a statistician/epidemiologist. The number of published papers per year applying SAMs increased from two in 2010 to 18 in 2019 (P = 0.004). Sample size estimation was not reported by 67 (88%) studies. A total of 22 (29%) studies did not report summary follow-up time. The survival function was commonly presented using Kaplan-Meier survival curves (n = 51, (67%) studies) and group comparisons were performed using log-rank tests (n = 44, (58%) studies). Sixty seven (91%), 3 (4.1%) and 4 (5.4%) studies reported Cox proportional hazard, competing risk and parametric survival regression models, respectively. A total of 37 (49%) studies had hierarchical clustering, of which 28 (76%) did not adjust for the clustering in the analysis. Reporting was adequate among 4.0, 1.3 and 6.6% studies for sample size estimation, plotting of survival curves and test of survival regression underlying assumptions, respectively. Forty-five (59%), 52 (68%) and 73 (96%) studies adequately reported comparison of survival curves, follow-up time and measures of effect, respectively.

Conclusion

The quality of reporting survival analyses remains inadequate despite its increasing application. Because similar reporting deficiencies may be common in other diseases in low- and middle-income countries, reporting guidelines, additional training, and more capacity building are needed along with more vigilance by reviewers and journal editors.