bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract WP288: A Portable and Rapid Stroke Imaging and Classification Device
Authors: Shahrestani Shane , Chou Tzu Chieh , Tai Yu-Chong
Published: June 2021

Introduction:
In stroke management, time to treatment is directly proportional to morbidity and mortality. The time lapse between arriving at a hospital and receiving treatment can easily exceed one hour, with most of this time being spent waiting for and operating the CT machine. Imaging is necessary prior to treatment to differentiate between ischemic and hemorrhagic stroke, which boast vastly different treatments. Here, we describe a novel portable sensor that can classify stroke and produce images in minutes.

Objective:
To create of a compact, noninvasive device that can classify stroke and produce an image to localize hemorrhages in minutes.

Methods:
Multiple inductive-damping sensors with varying magnetic field strengths were built in house, with the largest sensor 11cm in diameter. Sixteen gelatin brain models with identical electrical properties to live brain tissue were developed and placed within plastic skull replicas. Saline was diluted to the conductivity of blood and placed within the brain by a third party to simulate a hemorrhage. Bleed sizes ranged from 20-200mL. Individuals scanning were blinded to bleed location, and sensors were tangentially rotated around the skull models to localize blood. Data was also used to create MRI-style images using MATLAB.

Results:
Our novel sensor accurately predicted the location of bleeds in all 16 experiments. The lower limit of volume detection was found to be 25mL. The maximal blood detection range of the sensors was found to be 5cm from the skull, and hemorrhage detection and image processing took 2.43 minutes on average (attached figure, bottom images are actual bleed location, top images are predicted bleed location from sensor).

Conclusion:
We demonstrate the feasibility of a device that may reduce the high morbidity and mortality associated with stroke by providing rapid bedside diagnostics and reduced time to treatment. Further animal and human experiments are necessary to fully establish the efficacy of this device.
Abstract WP355: Recurrent Stroke is an Independent Risk Factor for Ischemic Stroke Prognosis
Authors: Qin Haiqiang , Liu Gaifeng , Wang Penglian , Zhang Runhua , Yu Miaoxin , Zhao Xiangquan , Wang Yongjun
Published: June 2021

Introduction:
Recurrent ischemic stroke is more likely to have a worse prognosis. However, it is little known whether recurrent stroke is an independent risk factor for poor prognosis. We aim to investigate the difference of mortality and recurrent rate of first ever and recurrent ischemic strokes, as well as to explore the potential reasons.

Method:
We analyzed patients with ischemic stroke enrolled in the China National Stroke Registry which was a nationwide, multicenter, and prospective registry of consecutive patients with acute cerebrovascular events from 2007 to 2008. Date including hypertension, diabetes mellitus, hyperlipidemia, heart disease, etc. were obtained from paper-based registry forms. Multivariable analysis using logistic regression was performed to assess the risk of worse prognosis of recurrent ischemic stroke compared to first-ever stroke.

Result:
A total of 8 181 patients with first-ever stroke and 4 234 patients with recurrent stroke were enrolled in the study. For patients with first-ever stroke, the mortality, recurrence, composite Events(modified Rankin Scale=3-6, which means death or disability) rate is 7.2%, 10.3%, 22.6%, respectively at 3-month; and 9.0%, 13.0%, 29.0% at 6-month; as well as 11.4%, 14.7%, 28.5% at 1 year, respectively. For patients with recurrent stroke, the mortality, recurrence, composite events rate is 10.5%, 16.1%, 30.8% respectively at 3-month, and 13.9%, 20.3%, 41.7% at 6-month, as well as 17.3%, 23.6%, 42.1% at 1 year, respectively. Multivariable analysis showed that patients with recurrent stroke had a higher risk of death, recurrence and disability at 3-month, 6 month and 1 year (table 1).

Conclusion:
After adjusting for multiple risk factors, recurrent stroke is still an independent risk factor for poor prognosis of ischemic stroke, which further emphasizes the importance of secondary prevention of ischemic stroke, and the specific causes need to be furtherly investigated.
Abstract WP90: Voxel-Based Lesion Symptom Mapping (VLSM) of NIH Stroke Scale Subscore Deficits
Authors: McCullough-Hicks Margy E , Christensen Soren , Yu Yannan , Albers Gregory W
Published: June 2021

Background:
Studies identifying brain regions required to preserve specific neurologic functions after stroke typically analyze infarct volume or location. Lesion topography studies have found that, independent of volume, involvement of specific regions have greater impact on clinical outcome than others, suggesting location-determined differences in eloquence. However, most anatomy-based studies define location broadly. VLSM is an imaging analysis technique that establishes a relationship between precise lesion location and clinical deficit. A group of patients with a symptom (e.g. aphasia) is analyzed; every voxel on each patient’s MRI is evaluated for lesion presence or absence. Each voxel is assigned a t-statistic, and a statistical map of all lesioned voxels is generated to pinpoint regions most strongly associated with the deficit; a high t-score indicates a lesion in that voxel has a significant effect on the specified symptom. We generated VLSM maps for 6 NIHSS subscores (aphasia, right- and left-limb weakness, and sensory loss) in a novel characterization to be used in future research.

Methods:
172 acute ischemic stroke (AIS) patients with large vessel occlusions (LVOs) were analyzed. Binary masks of infarcts on D5 FLAIR sequences were created. Lesions were coregistered to standard MNI atlas space. VLSM V2.55 was used to generate statistical maps of lesion contribution to clinical deficit. Maps were thresholded to p<0.001 on basis of cluster size and permutation method. A symptom reference area was defined as a region on which voxels had a t-score >3.14.

Results:
VLSM maps with voxelwise thresholds of p<0.001 were generated for 6 NIHSS categories (examples in figure).

Conclusions:
VLSM successfully generated unique maps of 6 NIHSS subscore deficits. These maps will be used to study patients presenting with perfusion/diffusion mismatch to predict the potential for resolution of specific deficits with reperfusion therapy and aid in prognostication.
Working on my own: Measuring the challenges of gig work
Authors: Caza Brianna B , Reid Erin M , Ashford Susan J , Granger Steve
Published: June 2021

Gig workers commonly face challenges that differ in nature or intensity from those experienced by traditional organizational workers. To better understand and support gig workers, we sought to develop a measure that reliably and validly assesses these challenges. We first define gig work and specify its core characteristics. We then provide an integrated conceptual framework for a measure of six challenges commonly faced by gig workers—viability, organizational, identity, relational, emotional, and career-path uncertainty. We then present five studies: item generation in Study 1; item reduction, exploratory assessment of the factor structure of these items, and initial tests of convergent validity in Study 2; and in the remaining three studies, we draw from different gig worker populations to accumulate evidence for the convergent, discriminant, and criterion validity of our Gig Work Challenges Inventory (GWCI), and present initial tests of the universality of the gig challenges inventory across a range of socio-demographic, job type, and regional factors. Our findings establish the reliability and validity of a GWCI that can aid researchers seeking to better understand the types and impact of stressors gig workers face, which in turn can help to inform theory, practice, and public policy.
Agile work practices and employee proactivity: A multilevel study
Authors: Junker Tom L , Bakker Arnold B , Gorgievski Marjan J , Derks Daantje
Published: June 2021

Several large organizations underwent agile transformation processes over the past few years, despite limited theory and empirical research on agile working. The present study draws from the taskwork–teamwork distinction and the proactivity literature to develop a new multilevel model of agile working. We tested this model in a sample of 114 teams ( N = 476 individuals) undergoing an agile transformation at a large German transport and logistics organization. Teams at the end of the agile transformation scored significantly higher on agile work practices, proactivity norms, and team performance than teams at the beginning of the transformation. Results of multigroup structural equation modeling indicated that agile taskwork related indirectly to team performance through a positive relationship with proactivity norms. The positive relationship of agile teamwork with team performance was not mediated by proactivity norms, unlike hypothesized. Finally, we found that agile taskwork increased the likelihood that individual employees benefited from engaging in proactive behavior (specifically, employee intrapreneurship) in terms of in-role performance (i.e., cross-level interaction). This was presumably because of the favorable proactivity norms of teams practicing agile taskwork (i.e., mediated moderation). We discuss the implications of our findings for the literature on proactive behavior in teams.
Neuropsychological Comparison of Guilt and Grief: A Review of Guilt Aspects in Prolonged Grief Disorder
Authors: Joa Brandon , Newberg Andrew B.
Published: June 2021

Taking an integrative approach toward developmental psychology and neurophysiology, this review selects findings from the psychological and medical literature on guilt and bereavement that are relevant to considering whether and how guilt contributes to the development of prolonged grief disorder (PGD) in bereaved persons. Mention of guilt is ubiquitous in literature on general grief and PGD, including 54 articles related to the neuropsychological development and manifestations of guilt and grief, as well as their neuroimaging correlates, that met scoping review criteria. However, mechanisms connecting guilt to development of PGD are scarce. Aspects of guilt are conceptually connected to many PGD criteria, opening avenues to explore treatment of PGD by targeting guilt. Positive and prosocial aspects of guilt are especially neglected in the treatment of psychiatric disorders, and consideration of these aspects may improve interventions for PGD such as complicated grief treatment.
Accessibility Planning for Postsecondary Entrance and Placement Exams for Deaf Students
Authors: Cawthon Stephanie W. , Goldstone Linda , Higgins Jennifer , Thurlow Martha
Published: June 2021

Postsecondary entrance and placement tests provide critical information that shapes the trajectory of the transition from secondary to postsecondary education. Test accommodations can play an important role in reducing barriers that deaf students face during high-stakes testing. For deaf students, decisions about access and accommodations for standardized assessment typically involve an Individualized Education Program (IEP) team. Deaf students’ access needs are not homogeneous, and decisions include a variety of factors including student characteristics, the content of the test, and test accommodations policies. In this article we share information about challenges that deaf students face and suggestions for ways to help to ensure that deaf students receive the accommodations that better allow them to show what they know and can do. These steps to improve accessibility can support equity in postsecondary pathways for deaf students.
Robust attitude control of a 3-DOF helicopter prototype subject to wind disturbance and communication delay
Authors: Xu Wei , Peng Huachao , Yang Liu , Zhu Xiaoyuan
Published: June 2021

In this paper, a robust control strategy is developed for unmanned helicopter prototype to simultaneously deal with random wind disturbances and remote communication delays. First, in the helicopter system modeling, the wind gust is not only treated as bounded external load disturbance, but propeller force-thrust coefficient variation that is caused by wind disturbance is also considered. Then, by equivalently treating the remote communication delays as random input delays, a robust attitude controller with energy-to-energy performance is developed for the helicopter system. Lyapunov-Krasovskii functions are utilized to analyze the stability of the proposed robust attitude controller. The gains of controller are calculated by solving linear matrix inequalities. Finally, by selecting Quanser’s three degrees of freedom(3-DOF) helicopter prototype as the test bench, three groups of comparative tests are carried out respectively, in which electric fan is utilized to generate external wind gusts while random delays are added to the feedback loop. Compared with conventional H-infinity controller, the effectiveness as well as superiority of proposed control approach is well verified.
Precise variable spraying system based on improved genetic proportional-integral-derivative control algorithm
Authors: Xu Yanlei , Wang Xindong , Zhai Yuting , Li ChenXiao , Gao Zongmei
Published: June 2021

Currently, the most efficient method of resolving the pollution problem of weed management is by using variable spraying technology. In this study, an improved genetic proportional-integral-derivative control algorithm (IGA-PID) was developed for this technology. It used a trimmed mean operator to optimize the selection operator for an improved searching rate and accuracy. An adaptive crossover operator and mutation operator were constructed for a rapid convergence speed. The weed density detection was performed through an image acquisition and processing subsystem which was capable of determining the spraying quantity. The variable spraying control sub-system completed variable spraying operation. The performance of the system was evaluated by simulations and field tests, and compared with conventional methods. The simulation results indicated that the parameters of the overshoot (1.25%), steady-state error (1.21%) and the adjustment time (0.157s) of IGA-PID were the lowest when compared with the standard algorithms. Furthermore, the field validation results showed that the system with the proposed algorithm achieved the optimal performance with spraying quantity error being 2.59% and the respond time being 3.84s. Overall, the variable spraying system based on an IGA-PID meets the real-time and accuracy requirements for field applications which could be helpful for weed management in precise agriculture.
Simultaneous Non-Hodgkin Lymphoma of the External Auditory Canal and Thyroid Gland: A Case Report
Authors: Khaw BeeLian , Sivalingam Shailendra , Pathamanathan Sitra Siri , Tan Teck S. , Naicker Manimalar
Published: June 2021

Approximately 25% of all cases of extranodal non-Hodgkin lymphoma (NHL) occur in the head and neck region; NHL of the external auditory canal (EAC) and thyroid gland are rare. Specific immunohistochemical staining of the excised tissue is required to confirm the final pathologic diagnosis. We report the case of a 53-year-old woman with underlying systemic lupus erythematosus and autoimmune hemolytic anemia that were in remission. She presented with chronic left ear pain, a mass in the left EAC, and rapid growth of an anterior neck swelling that had led to left vocal fold palsy. High-resolution computed tomography (CT) of the temporal bone and CT of the neck detected a mass lateral to the left tympanic membrane and another mass in the anterior neck that had infiltrated the thyroid gland. The patient was diagnosed with simultaneous B-cell lymphoma of the left EAC and thyroid gland. She was treated with chemotherapy. She responded well to treatment and was lost to follow-up after 1 year. To the best of our knowledge, the simultaneous occurrence of a lymphoma in the EAC and the thyroid has not been previously described in the literature.
Granulomatous Mucormycosis of the Temporal Bone extending Into Temporomandibular Joint and Infratemporal Fossa: A Case Report
Authors: Chi Zhangcai , Zhang Chen , Wang Wuqing
Published: June 2021

Mucormycosis of temporal bone is extremely rare. They are usually associated with host immunodeficiency, are difficult to diagnose, and many cases are fatal. We performed a literature review and found only 10 reported cases of temporal bone mucormycosis. We present a case of temporal bone mucormycosis involving the temporomandibular joint and infratemporal fossa in a 53-year-old woman with diabetes mellitus who presented with unbearable otalgia. Computed tomography and magnetic resonance imaging demonstrate inhomogeneous density mass in the parapharyngeal and retropharyngeal space accompanied with lytic bone destruction on the temporomandibular joint. After undergoing a biopsy of the left infratemporal fossa, the patient’s pathology exhibited fungal hyphae consistent with mucormycosis. To our knowledge, this is the first report of temporal bone mucormycosis with extensive involvement of temporomandibular joint and its adjacent structures, which exhibited no otologic or rhinologic signs. A definitive diagnosis is made by biopsy.
Why so quiet? Exploring inhibition in digital public spaces
Authors: Sakariassen Hilde , Meijer Irene Costera
Published: June 2021

Social network sites have been considered as important arenas for public debate, but as a large proportion of users do not actively participate, there is a need to further our understanding of a phenomenon as hidden, unnoticed and invisible as non-participation. We argue that inhibition is a valuable socio-psychological lens to study non-participation, usefully extending the conceptual framework of political communication regarding non-participation, and offering a more precise way of theorising the intent behind this apparent passivity. Using representative survey data collected in Norway in 2017 ( N = 2064), we first sensitise the multi-layered concept of inhibition through combining different dominant approaches: the spiral-of-silence theory, the harsh debate climate, political efficacy, and specific properties of social network sites related to identity and impression management. Second, we show that inhibition functions as an in-between concept balancing participation and non-participation in social network sites. Through factor analysis principal component factor (PCF), we integrate established theories that allow us to define overarching dimensions of inhibition, demonstrating that it is a complex phenomenon not easily understood through one specific theoretical perspective.
Multi-vocal voices of refugees: A case study of Rohingya refugees in Bangladesh
Authors: Chowdhury Suban Kumar , Keary Anne , Reupert Andrea , Saito Eisuke
Published: June 2021

The inflow of Rohingya refugees from Myanmar experiencing trauma and torture is a major global issue. This article explores relationships with local communities as they are represented in the multi-vocal voices of Rohingya refugees. Interviews and focus groups were conducted with a group of Rohingya refugees based in the Kutupalong refugee camp in Bangladesh along with observations of camp life. Twenty participants were interviewed. The observations provide insights into the feelings of anxiety among the Rohingya refugees. Yet, the findings also suggest that the refugees hold out hope that in Bangladesh they will find a sense of belonging. The study draws on Bakhtin’s notion of heteroglossia as positioned through sociological discourse, to reflect the social experiences of refugee young people and their families. The intent of the article is to open up, rather than to close off engagement with the issue – furthering awareness and possible actions to be taken.
Connectivity and growth: Financial centres in investment banking networks
Authors: Pažitka Vladimír , Urban Michael , Wójcik Dariusz
Published: June 2021

We investigate the effect of urban network connectivity on the growth of financial centres. While existing research recognises the importance of network connectivity to firms, clusters as well as city regions, large-sample empirical evidence is currently scarce, particularly in the context of financial services. We contribute to this debate by studying underwriting of equity and debt securities, which represent some of the core activities of financial centres. We operationalise our analysis using a proprietary dataset collated from Dealogic Equity Capital Market and Debt Capital Market databases covering over 1.7 million interactions of investment banks with issuers across 540 cities globally during the 1993–2016 period. We estimate our regression equations using the system generalised method of moments estimator, which allows us to obtain consistent coefficient estimates on potentially endogenous regressors, including network connectivity variables. We identify a clear pattern of a positive association between network centrality of financial centres and their growth. We distinguish between intracity and intercity network connectivity and find that financial centres with a larger number of intercity network ties and assortative intracity networks grow faster, while intracity network density does not appear to affect financial centre growth. Our results on intercity network ties are broadly consistent with established knowledge of cluster networks. In contrast, our findings on financial centres' intracity networks contradict previous research that suggests that dense and disassortative intracluster networks aid economic performance of clusters.
Bridging Feminist Psychology and Open Science: Feminist Tools and Shared Values Inform Best Practices for Science Reform
Authors: Matsick Jes L. , Kruk Mary , Oswald Flora , Palmer Lindsay
Published: June 2021

Feminist researchers have long embraced the challenging, dismantling, and reimagining of psychology, though their contributions to transforming psychological science remain largely overlooked in the mainstream open science movement. In this article, we reconcile feminist psychology and open science. We propose that feminist theory can be leveraged to address central questions of the open science movement, and the potential for methodological synergy is promising. We signal the availability of feminist scholarship that can augment aspects of open science discourse. We also review the most compelling strategies for open science that can be harnessed by academic feminist psychologists. Drawing upon best practices in feminist psychology and open science, we address the following: generalizability (what are the contextual boundaries of results?), representation (who is included in research?), reflexivity (how can researchers reflect on who they are?), collaboration (are collaborative goals met within feminist psychology?), and dissemination (how should we give science away?). Throughout each section, we recommend using feminist tools when engaging with open science, and we recommend some open science practices for conducting research with feminist goals.
The ship in the shop: An art history of late medieval ship models
Authors: Timmermann Achim
Published: June 2021

This contribution represents an attempt at a first outline of an art history of late medieval ship models and their contexts of use. Focusing on the mid-thirteenth through early sixteenth centuries, an age of rapidly expanding horizons, this study examines the design and role of miniature vessels at the intersection between devotional practices, courtly culture, modes of patronage and technological change. It explores three categories of ship models in particular: ex-voto ships that were presented to a specific shrine after a miraculous rescue at sea or naval victory; nefs, which served as princely table decorations and containers of commodities such as salt and spices; and nefs that, subsequent to their use as banqueting props, were repurposed as devotional vessels that either contained relics or possibly functioned as ex-votos.
Transportation efficiency in eighteenth-century merchant vessels
Authors: Riggs David
Published: June 2021

A key ingredient in New England’s shipping successes was the speed with which its vessels completed their voyages. The principle research on this subject was completed by Gary Walton and published in its first form in 1967. Walton was ahead of his time in identifying the importance of a detailed study of colonial shipping and linking it to a broader Atlantic World. He draws several conclusions. First, that technological change between 1675 and 1775 was minimal in the industry. Second, costs and crew sizes declined due to increases in security after the Royal Navy eliminated piracy. Third, idle time in port decreased, leading to more efficiencies in acquiring cargo. Fourth, and finally, vessel speeds were stagnant throughout the period and were 1.6 to 1.97 knots for the voyage south between New England and the West Indies and 1.31 to 2.09 knots for the return trip. Averages calculated by Walton indicate speeds of between 1.6 and 1.8 knots, with the southbound legs slightly faster. I agree with Walton on all of his conclusions except for the last. Careful study of 145 logbooks chronicling the voyages of Massachusetts’s vessels in the West Indies trade indicates that the median vessel speed over the approximately 1,500 nautical miles from Boston to the islands was 2.71 knots and the mean speed approached 2.84 knots. In fact, the median southbound speed was five per cent slower than the trip home. In practical terms, this meant that according to Walton the time it took to travel 1,500 nautical miles averaged a minimum of almost 35 days. According to the logbooks, however, merchant mariners completed voyages between New England and the West Indies in slightly more than 25 days on average, 28 per cent faster than Walton figured.
Exploring Herding Behaviour in Indian Equity Market during COVID-19 Pandemic: Impact of Volatility and Government Response
Authors: Bharti  , Kumar Ashish
Published: June 2021

This study investigates the behavioural bias of market-wide herding in the Indian equity market during the spread of COVID-19 pandemic. The study also examines the impact of market volatility and government response on herding during the sample period. We use the measure of cross-sectional absolute deviation and semi-parametric estimator of quantile regression for the period 1 January 2020 till 15 June 2020 for S&P CNX Nifty Index and its 50 constituent companies. The results obtained reveal significant herding in the Indian equity market that is aggravated by market volatility. Further, we find that the government response and control measures implemented are successful in reducing herd behaviour. The research calls for better information disclosure guidelines to promote market efficiency. We further suggest that during exogenous events, investors need to realign their portfolios and formulate trading strategies for better risk-return management.
Quantifying damage evolution within olivine basalt based on crack propagation behavior under microwave irradiation
Authors: Yuan Yuan , Shao Zhushan , Qiao Rujia , Fei Xinshuang , Wu Dandan
Published: June 2021

Application of microwave heating technique is highly promising in assisting rocks breakage and recycling coarse aggregate in waste concrete. This work focus on crack propagation behavior and hence damage of hard rocks subjected to microwave irradiation. Heating effects of basalt and its main mineral components are investigated experimentally using a multimode industrial microwave system. Crack characterization of basalt after irradiating are observed using scanning electron micrograph (SEM). A theoretical model based on heating effects of mineral components is established to deduce crack propagation within basalt under microwave irradiation. Temperature rise of magnetite is drastic while that of other mineral components are tardy. Fracture of basalt is induced by predominant radial crack propagation around the rapidly heated mineral particle. Cracks can be divided into short cracks and long cracks by a characteristic length during extending. Microwave energy required for extension of cracks with characteristic length is minimum. Propagation of initial short cracks results in greater extent of damage evolution instantaneously. Moreover, damage increases with the mineral content of magnetite and decreases with crack density.
Unexpected pancytopenia: Dasatinib induced aplastic anemia in chronic myeloid leukemia
Authors: Feld Jonathan , Steinberg Amir , El Jamal Siraj M , Shapira Ilan
Published: June 2021

Introduction

The use of TKIs in CML has dramatically altered the natural course of the disease and improved outcomes for patients. TKIs overall have a very favorable safety profile. Dasatinib, a second generation TKI, is commonly used as a first-line treatment option in CML.

Case report

We describe the first two reported cases of first-line dasatinib induced aplastic anemia in CML. In both patients, pancytopenia occurred within one year of diagnosis/starting dasatinib. Both bone marrow biopsies showed hypocellularity with mild fibrosis and persistent BCR-Abl1 positivity.

Management & outcome

Dose reduction was attempted without success in both patients. In one patient, multiple TKIs were trialed, while in the other, growth factor support was attempted; neither regimen was effective. Ultimately, the cytopenias associated with dasatinib were only resolved after immunosuppression in one patient and allogeneic stem cell transplant in the other patient.

Discussion

Prior reports have shown that aplasia/aplastic anemia can rarely be associated with imatinib and nilotinib. Here we show that dasatinib can lead to this phenomenon as well. This diagnosis should be considered in patients with CML who unexpectedly develop cytopenias.
The burden of central line-associated bloodstream infections in children with medical complexity
Authors: Scarselli Alessia , Smarrazzo Andrea , De Sanctis Francesco , Ravà Lucilla , Carletti Michaela , Ciofi Degli Atti Marta , Aversa Marcella , Drago Riccardo , Crocoli Alessandro , Geremia Caterina , Guerricchio Andrea , Lucignano Barbara , Campana Andrea , De Ioris Maria Antonietta , Perrotta Daniela
Published: June 2021

Background:

Central line-associated bloodstream infections (CLABSI) are significant cause of complications in pediatric intensive care units (PICUs). An emerging challenge are CLABSIs in children with medical complexity (CMC) admitted to PICU. CMC are patients with chronic conditions with or without neurological impairment needing for tracheostomy and/or home mechanical or non-invasive ventilation and/or gastrostomy/jejunostomy. We evaluate CLABSI incidence in a PICU with high prevalence of CMC.

Methods:

This was a retrospective study in the PICU of the Bambino Gesù Children Hospital from January 2017 to December 2020. The medical records were reviewed and demographic, clinical and microbiological data were extracted. CLABSI were defined according to the Center for Disease Control and Prevention’s National Healthcare Safety Networks (NHSN) surveillance.

Results:

A total of 101 children with 125 central lines (CLs) were included; 79/101 (78%) patients were CMC and 50/101 (50%) had a thracheostomy. CLABSI incidence was 2.75/1000 CL-days (9 cases/3269 CL-days); incidence was 0 in patients without underling conditions and 3.14/1000 in CMC ( p < 0.001). CLABSI were due to gram negative bacteria in five patients, Candida spp in three and Staphylococcus hominis in one. CLs were removed in eight cases while in the later one, with CLABSI due to Pseudomonas aeruginosa, a conservative strategy was adopted cause of unavailable alternative venous access and removed at discharge with negative culture. All patients recovered.

Conclusions:

A target 0% CLABSI was possible in critically ill children without underling condition while a high incidence was reported in CMC and sustained by a peculiar CLABSI ecology. This ecology should be considered when a CLABSI was suspected in CMC for prompt antibiotics stewardship.
Telehealth outpatient coronavirus disease 2019 case management at a tertiary hospital in Sydney
Authors: Micallef Milton , Hurley Siobhan , Brell Nadiya , Cook Rebekah , Post Jeffrey , Overton Kristen
Published: June 2021

Introduction

Coronavirus disease 2019 is an acute respiratory illness caused by severe acute respiratory syndrome coronavirus 2. The coronavirus disease 2019 pandemic upended the traditional paradigm of face-to-face provision of healthcare in the Australian context; as such, a telehealth model of active case management was implemented in our public health system, even though there was little supporting data for the safety of delivering patient care remotely to home-isolation patients in the setting of a highly infectious and potentially fatal illness.

Methods

A retrospective, single-centre, observational cohort study was performed over 6 weeks commencing 12 March 2020, including patients with coronavirus disease 2019 undergoing home isolation and being actively monitored by a coronavirus disease 2019 telephone assessment clinic. Outcomes assessed comprised: duration of active case follow-up, average number of telephone calls per patient, average number of hours managing each patient, treatment required including presentation to the emergency department or admission to hospital, patient characteristics and utilisation of other health services.

Results

Of 5223 severe acute respiratory syndrome coronavirus 2 tests performed, 170 individuals (3.25%) tested positive. A total of 158 were included: 76 (47.5%) male and median age 31 years (range 18-94). Median symptom duration was 13 days (interquartile range 6, range 2-34). Median length of coronavirus disease 2019 telephone assessment clinic admission was 10 days (interquartile range 7, range 3-32). A total of 1151 telephone patient encounters were undertaken, with a median of six phone calls made to each patient (interquartile range 5, range 1-20). Ten patients required repeat clinic review; all but one returned home. Six presented to emergency department, with three of these being admitted. In total, there were six admissions: one from the clinic, three from the emergency department and two direct from home (bypassing emergency department). Only four of the six admissions (or 2.5% of all patients) required low-flow oxygen therapy; none required high-flow oxygen or assisted ventilation. The remaining 140 patients (88.6%) were safely managed at home without complications.

Discussion

A telehealth model of care is safe, efficient and cost-effective for the management of mild-to-moderate coronavirus disease-19 and facilitates home isolation, especially of a low-risk population, thus providing reassurance that this model is sound and suitable for ongoing use.
Psychosocial treatment preferences of persons living with young-onset dementia and their partners
Authors: Grunberg Victoria A , Bannon Sarah M , Reichman Mira , Popok Paula J , Vranceanu Ana-Maria
Published: June 2021

Persons living with young-onset dementia and their partners often experience elevated emotional distress as they cope with an unexpected progressive illness during an active life stage (typically ages 45–64 years). Despite their heightened emotional distress, psychosocial resources are both limited and lack the specificity to meet the unique needs of both partners. Our aim was to gain an in-depth understanding of the psychosocial treatment preferences of persons with young-onset dementia and their partners—an important first step in developing a tailored intervention. We conducted semi-structured dyadic interviews with persons with young-onset dementia and their partners ( N = 23) and used a hybrid deductive–inductive approach to thematic analysis. We identified 12 themes across four domains: (1) perceptions of available and lacking resources, (2) preferences for program content, (3) preferences for program format, and (4) barriers and facilitators to participation. Couples indicated there is a lack of specific and family-oriented resources, which can create more stress and relationship strain. Couples endorsed support for a virtual, dyadic intervention delivered shortly after diagnosis focused on providing tools to cope with difficult emotions and symptom progression and enhance communication and meaningful daily living. They also identified potential barriers to program participation and offered suggestions to promote engagement. By using a qualitative approach, we were able to gather nuanced information that can be used to directly inform a feasible, accepted, and person-centered psychosocial intervention for persons with young-onset dementia and their partners.
Culinary Medicine Training in Core Medical School Curriculum Improved Medical Student Nutrition Knowledge and Confidence in Providing Nutrition Counseling
Authors: D’Adamo Christopher R. , Workman Kayli , Barnabic Christine , Retener Norman , Siaton Bernadette , Piedrahita Gabriela , Bowden Brandin , Norman Nicola , Berman Brian M.
Published: June 2021

Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t-tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved ( P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling.
Body composition in patients with rheumatoid arthritis: a narrative literature review
Authors: Letarouilly Jean-Guillaume , Flipo René-Marc , Cortet Bernard , Tournadre Anne , Paccou Julien
Published: June 2021

There is growing interest in the alterations in body composition (BC) that accompany rheumatoid arthritis (RA). The purpose of this review is to (i) investigate how BC is currently measured in RA patients, (ii) describe alterations in body composition in RA patients and (iii) evaluate the effect on nutrition, physical training, and treatments; that is, corticosteroids and biologic Disease Modifying Anti-Rheumatic Disease (bDMARDs), on BC in RA patients.

The primary-source literature for this review was acquired using PubMed, Scopus and Cochrane database searches for articles published up to March 2021. The Medical Subject Headings (MeSH) terms used were ‘Arthritis, Rheumatoid’, ‘body composition’, ‘sarcopenia’, ‘obesity’, ‘cachexia’, ‘Absorptiometry, Photon’ and ‘Electric Impedance’. The titles and abstracts of all articles were reviewed for relevant subjects.

Whole-BC measurements were usually performed using dual energy x-ray absorptiometry (DXA) to quantify lean- and fat-mass parameters. In RA patients, lean mass is lower and adiposity is higher than in healthy controls, both in men and women. The prevalence of abnormal BC conditions such as overfat, sarcopenia and sarcopenic obesity is significantly higher in RA patients than in healthy controls; these alterations in BC are observed even at an early stage of the disease. Data on the effect treatments on BC in RA patients are scarce. In the few studies published, (a) creatine supplementation and progressive resistance training induce a slight and temporary increase in lean mass, (b) exposure to corticosteroids induces a gain in fat mass and (c) tumour necrosis factor alpha (TNFα) inhibitors might be associated with a gain in fat mass, while tocilizumab might be associated with a gain in lean mass.

The available data clearly demonstrate that alterations in BC occur in RA patients, but data on the effect of treatments, especially bDMARDs, are inconsistent and further studies are needed in this area.
Factors Associated with Clinician Adherence to USPSTF Diabetes Screening Recommendations
Authors: Banerjee Elaine Seaton , Shaak Kyle , Burgess Nicole , Johnson Melanie , Careyva Beth
Published: June 2021

Introduction/Objectives:

Diabetes and prediabetes impact nearly half of the US adult population and are associated with significant health risks but may be underdiagnosed. Effective screening may improve diagnosis and give patients opportunity to manage their disease. The purpose of this study was to determine screening rates, identify characteristics predictive of screening, and evaluate correct diagnosis of diabetes and prediabetes.

Methods:

Retrospective chart review of 71 433 patients eligible for diabetes screening, defined by completing A1c test within the 3-year study period.

Results:

A total of 31.3% of eligible patients received diabetes screening. Factors associated with screening include older age, female sex, non-white race, Hispanic ethnicity, Medicare or Medicaid insurance, higher BMI, and having a medical comorbidity. History of prediabetes or gestational diabetes were the strongest predictors for diabetes screening, but history of gestational diabetes was under-documented. Of those screened, 10.4% had a result consistent with diabetes and 51.8% had a result consistent with prediabetes. However, 52.9% of these patients had a missed diagnosis.

Conclusions:

Findings of this study indicate the need for uniform coverage for diabetes screening for all insurances, increased documentation of gestational diabetes to improve screening for patients with this history, and improving accurate diagnosis after screening is completed.
Social Enterprises of Immigrants: A Panacea for the Finnish Labour Market?
Authors: Yeasmin Nafisa , Koivurova Timo
Published: June 2021

Research questions:

The objectives of this study are to identify the need for Social Enterprises (SEs) as an alternative form of working in the Finnish labour market, what alternative forms of co-operation between such types of SEs could be and how larger local companies can support the sustainable operation of these small SEs by employing immigrants and the long-term unemployed.

Theory:

This article draws on the corporate social responsibility CSR theory of traditional enterprises to better explain the factors that can facilitate co-operation between SEs and private enterprises, thereby reaching the sustainable operation of SEs that are run by socially disadvantaged groups of people in Lapland.

Phenomenon studied:

SE is a new phenomenon in Lapland. There are a few SEs in the region that are struggling to maintain their existence in a sustainable manner. It is harder for the members of such SEs to run businesses or to work and to become successful in Lapland; however, obtaining employment or running a proprietorship is not an alternative (Yeasmin, 2016) for these disadvantaged people.

Case context:

The article contributes to the studies on the economic integration and labour market sustainability of immigrants and long-term job seekers, and particularly to the socio-economic integration of the long-term unemployed by focusing on the necessity-driven social entrepreneurship networking model in a sparsely populated region, that being the region of Lapland in Northern Finland.

Findings:

The disadvantaged groups need access to the labour market in Lapland, and social alliances between various partners (e.g., private, public and SE) under different social circumstances (e.g., CSR) can generate alternative options for co-operation to sustain the existence of such SEs in Lapland. An analysis explores future recommendations for co-operation that might sustain SE’s existence and development and might also increase long-term prospects for targeted SEs.

Discussion:

Lapland-based SEs operated by immigrants or the long-term unemployed are issues and themes that do not fall within the responsibility of any single authority or any single sector. Successfully running SEs demands positive interaction and social innovation strategies among many social partners. Networking with a variety of public stakeholder groups alongside the private sector needs to see an investment of social resources for mapping the phenomena on the topic of social economy, which is a social innovation process that might enable such SEs to have successful outcomes in Lapland.
The employer’s commitment: Conceptualization, development, and validation of a scale
Authors: García-Cruz Joaquín , Valle-Cabrera Ramón
Published: June 2021

This research aimed to achieve two sequential objectives: (1) to provide conceptual support for the idea of organizational commitment toward employees (the employer’s commitment), showing differences in concepts such as perceived organizational support, high commitment work systems, human resource (HR) philosophy, and psychological contracts, and (2) to develop a scale to measure employer’s commitment. To define the construct, we extrapolated the three-component model (TCM) dimensions (affective, continuance, and normative) from the individual to the organizational levels. To develop the new scale, we first used the Delphi method to determine the items in the questionnaire. Second, to verify the validity and reliability of the new scale, data collected from two sample populations (financial and hospitality sectors) were examined. The results suggest that the three dimensions of TCM in the final construct are independent and autonomous.

JEL CLASSIFICATION: M12
Transitioning to Teaching Online During the COVID-19 Pandemic
Authors: Wilson Jessica L. , Hensley Angie , Culp-Roche Amanda , Hampton Debra , Hardin-Fanning Fran , Thaxton-Wiggins Amanda
Published: June 2021

Background

During the COVID-19 pandemic many nursing educators have been required to abruptly convert to an online delivery model. Faculty need resources and support to transition face to face courses into an online format.

Purpose

The purpose of this article is to highlight nursing faculty perceptions of the effectiveness of resources, support, and methodologies for online teaching during the COVID-19 Pandemic.

Methods

A cross-sectional descriptive survey design was used to collect data about nursing faculty resources, support and methodologies used to transition at least one undergraduate or graduate degree nursing course to an online format during the COVID-19 pandemic.

Results

Eighty-four faculty who taught in ten university colleges of nursing used varied teaching methodologies in online courses, but included some consistent methods such as websites and web based tools. The student engagement strategies that faculty were most satisfied with were journal writing and projects. Most faculty reported having information technology support and access to instructional design resources.

Conclusion

Nursing faculty were resourceful, adaptive, and willing to use both novel and existing resources and methodologies to meet their teaching objectives and engage students. They were also, overall, satisfied with the administrative support they received from their respective institutions. Many of these resources, methodologies, and supports will continue to be used by faculty as likely more programs and courses will continue to be managed online.