bluuebunny/crossref_metadata_2025 huggingface dataset:
University and Future-Oriented Cultures: Reflections on Cultivating Communities of Practice in the Basque Country
Authors: Mateo José Luis Granados , Casado da Rocha Antonio
Published: December 2020

There are currently a number of preconceived ideas about the university and its possible fates within our socially latent future. Some of these assumptions can restrict our capacity to imagine much of the actual potential scenarios at present. Following the Integral Futures perspective, here we stress the relevance of its interior cultural development as a key factor when thinking about the futures of and for the university. Instead of defining specific foresight strategies, however, this paper suggests how some current university extension activities can facilitate a productive cultural basis to enhance their forethought capabilities. It specifically addresses the potential of cultivating Communities of Practice (CoPs), through which institutions are able to connect with wide-ranging cultural domains, from both the inner and outer worlds, and making organizational culture more prone to unbiased imagination. Such features are illustrated with recent action-research conducted at the University of the Basque Country, which will finally provide some guidance on how to seed future-oriented cultures in corresponding universities.
What Will a PhD Look Like in the Future? Perspectives on Emerging Trends in Sustainability Doctoral Programs in a Time of Disruption
Authors: Lazurko Anita , Alamenciak Tim , Hill Lowine Stella , Muhl Ella-Kari , Osei Augustine Kwame , Pomezanski Dorian , Schang Kyle , Sharmin Dilruba Fatima
Published: December 2020

In this perspective paper, we aim to provide insights that can help academic institutions and transdisciplinary doctoral programs position themselves within a changing research landscape and prepare for future disruption. We are a group of eight first-year, transdisciplinary doctoral students at the University of Waterloo, representing diverse disciplinary perspectives and gender and cultural experiences. In the process of orienting ourselves as sustainability researchers, we conducted collaborative workshops to critically examine our intellectual and disciplinary positionality by reflecting on the question: What will a PhD look like in the future? Amid this process, the coronavirus pandemic happened, causing a major disruption to our research activity and personal lives. What began as a reflective process on doctoral research shifted toward a more substantive and far reaching discussion about disruption and academia. Through our workshops we identified four emerging trends in the domain of sustainability scholarship that are shaping the future of the academic experience: shifts from disciplinarity to transdisciplinarity; researchers as knowledge holders to knowledge brokers; researcher competencies as bounded to boundary-less; and metrics of success as citation impact to societal impact. We also identified three broad trends in the context of academia that were accelerated by the coronavirus pandemic and may be exacerbated by future disruptions: (1) increasing virtualization of research and teaching; (2) increasing need for flexibility of academic structures and processes; and (3) growing economic and socio-political uncertainty. We offer concrete recommendations that encourage doctoral students and programs to play a more fundamental role in solving complex challenges in a disrupted academic and social landscape. We conclude with our vision of the PhD student of the future as one who thrives in transdisciplinary settings, links society and science through knowledge brokering, spans boundaries between multiple epistemologies to communicate and collaborate through uncertainty, and prioritizes societal impact.
Tears of the Popliteomeniscal Fascicles of the Lateral Meniscus: An Arthroscopic Classification
Authors: Zheng Jiapeng , Xiao Qi , Wu Qingquan , Deng Huiyun , Zhai Wenliang , Lin Dasheng
Published: December 2020

Objective

To bring forward an arthroscopic classification of the popliteomeniscal fascicles of the lateral meniscus (PFLM) tears.

Design

Six fresh frozen knee joint samples of adult males were chosen, and the lateral meniscus at the popliteal hiatus region were measured to analyze their anatomic relationship. Patients who had received magnetic resonance imaging scan at knee joint before the surgery and diagnosed as PFLM tears by arthroscopy from April 2014 to October 2017 were selected. Data regarding the integrity of PFLM were prospectively recorded in a data registry. Tear morphology and treatment received were subsequently extracted by 2 independent reviewers from operative notes and arthroscopic surgical photos.

Results

The average length and thickness of the popliteal hiatus of the lateral meniscus were 2.09 ± 0.21 cm and 0.43 ± 0.08 cm, respectively. The average length of anterosuperior popliteomeniscal fascicle (APF) was 0.87 ± 0.18 cm, and the posterosuperior popliteomeniscal fascicle (PPF) was 0.72 ± 0.15 cm. A total of 36 PFLM tears in 36 patients were divided as type I (APF tear; n = 5, 13.9%), type II (PPF tear; n = 20, 55.6%), and type III (both APF and PPF tears; n = 11, 30.6%). All patients were treated with arthroscopic all-inside repair using a suture hook for the PFLM tears and follow-up for 21.1 months. All patients have done well with significantly improved Lysholm and International Knee Documentation Committee scores at the last follow-up relative to preoperative scores ( P < 0.01).

Conclusion

This study suggests to possibly classify the PFLM tears for clinical practice.
A pictorial review of brain arterial spin labelling artefacts and their potential remedies in clinical studies
Authors: Jaganmohan Deepasree , Pan Somnath , Kesavadas Chandrasekharan , Thomas Bejoy
Published: December 2020

Arterial spin labelling is an emerging non-invasive magnetic resonance imaging technique for estimating the cerebral perfusion without the requirement for gadolinium-based intravenous contrast agents. Despite the wide range of applications in epilepsy, dementia, brain tumours, vascular malformations and stroke imaging, obtaining clinically useful arterial spin labelling data is technically challenging and prone to numerous artefacts. The objective of this review is to provide a comprehensive pictorial overview of the various artefacts associated with arterial spin labelling, particularly three-dimensional fast spin echo pseudocontinuous arterial spin labelling with spiral readout. These artefacts could be broadly classified as those occurring during the magnetic labelling, arterial transit or image acquisition. Arterial spin labelling artefacts of clinical diagnostic utility are also elaborated. A thorough knowledge of the basis of these artefacts will avoid diagnostic pitfalls while interpreting arterial spin labelling images. Important tips to reduce or overcome these artefacts are also discussed.
Contrast-induced acute kidney injury in acute ischaemic stroke patients
Authors: Brito Catarina , Falcão Luís , Raimundo Mário , Fernandes Sara , Fernandes Adriana , Silva Sónia , Vilela Pedro , Almeida Edgar de
Published: December 2020

Purpose

The potential nephrotoxicity of intravenous iodinated contrast media is a major concern for acute ischaemic stroke imaging evaluation. This study aimed to assess the incidence of acute kidney injury after intravenous iodinated contrast media exposure in acute ischaemic stroke patients.

Methods

We conducted a retrospective cohort analysis between January 2012 and July 2018 to select adult patients admitted to the emergency department with acute ischaemic stroke. The exposed patients received a uniform intravenous dose of low osmolar non-ionic iodinated contrast media, as part of the imaging protocol for acute ischaemic stroke. The unexposed patients underwent a non-enhanced cranial computed tomography scan. Acute kidney injury was defined according to the Kidney Disease Improving Global Outcomes criteria, limited to the first 72 hours.

Results

A total of 161 and 105 patients were included in the exposed and unexposed groups, respectively. The median age was 72.8 years (interquartile range 20), 53% were men and 97% were white. Demographic and baseline characteristics were similar between the groups. The incidence of acute kidney injury between exposed ( n = 10, 6.2%) and unexposed ( n = 1, 1%) groups ( P = 0.073) was similar and contrast exposure was not a significant predictor of acute kidney injury.

Conclusion

Intravenous iodinated contrast media exposure during acute ischaemic stroke imaging protocols is not an independent predictor of acute kidney injury in patients with normal or near-normal renal function. Studies with larger sample sizes would help to clarify if patients with both cardiovascular risk factors and impaired renal function could benefit from prophylactic measures.
Impact of transiting from fluorescent polarisation immunoassay to high-performance liquid chromatography–tandem mass spectrometry for immunosuppressant levels analysis in kidney transplant patients
Authors: Goh Li Fang , Khoo Sher Ri , Tung Yu-Tzu , Lee Puay Hoon , Kee Terence
Published: December 2020

Background:

High-performance liquid chromatography–tandem mass spectrometry (HPLC-TMS) is preferred to fluorescent polarisation immunoassay (FPIA) in therapeutic drug monitoring (TDM), as it only measures active drug. Our hospital replaced FPIA with HPLC-TMS for analysis of calcineurin inhibitor (CNI) levels. Preliminary studies demonstrated significantly lower CNI levels with HPLC-TMS versus FPIA in kidney transplant recipients (KTRs). Most studies evaluating CNI exposure in KTRs used FPIA, posing challenges in interpreting HPLC-TMS levels. This study aimed to compare the effectiveness and safety outcomes in the one-year period before (FPIA period) and after (HPLC-TMS period) the switch.

Methods:

A retrospective cohort study was conducted on KTRs receiving ciclosporin (CsA) or tacrolimus (FK). Primary effectiveness end points were biopsy-proven acute rejection (BPAR) rate and estimated glomerular filtration rate (eGFR); safety end points were viral infections and hospitalisation for infection. The secondary end point was change in CNI levels during the FPIA versus HPLC-TMS periods.

Results:

A total of 307 patients were analysed (CsA n=182, FK n=125). BPAR only occurred in two patients in the HPLC-TMS period among the CsA cohort ( p=0.50), but it occurred in six patients in the FPIA period and one patient in the HPLC-TMS period ( p=0.13) among the FK cohort. Median eGFR were similar in both periods (CsA: 52.2 mL/min/1.73 m2 (interquartile range (IQR) 39.8–67.6) vs. 52.5 mL/min/1.73 m2 (IQR 37.1–68.0), p=0.65; FK: 57.7 mL/min/1.73 m2 (IQR 39.1–80.0) vs. 56.4 mL/min/1.73 m2 (IQR 33.5–76.7), p=0.08). There were no significant differences in safety outcomes. The median change in CNI levels from the FPIA period to the HPLC-TMS period was –20.5% (IQR –32.5 to –3.9) and –6.9% (IQR –17.7 to 8.0) among CsA and FK cohorts, respectively ( p<0.01).

Conclusion:

The switch from FPIA to HPLC-TMS for CNI TDM in KTRs did not yield significant changes in clinical end points.
Prevalence of diabetic peripheral neuropathy in patients with type 2 diabetes mellitus at a tertiary referral centre in Singapore
Authors: Hu Hanquan Arnold , Teo Li Wen Melissa-Raye
Published: December 2020

Background:

There is a lack of data regarding prevalence estimates of diabetic peripheral neuropathy (DPN) in Singapore. This study aimed to investigate the prevalence of DPN and risk factors in patients who present to a diabetic foot screening clinic and are considered low to medium risk in developing foot complications due to their type 2 diabetes mellitus.

Methods:

A one-year retrospective analysis was conducted at Ng Teng Fong General Hospital. Patients who underwent diabetic foot screening and endocrinologist review in the Diabetes and Endocrinology Specialist Outpatient Clinic during the period January 2019–December 2019 were included in this study. DPN was defined by the patient’s inability to detect ⩾1 out of 10 sites using the 10 g monofilament. Significantly associated risk factors with DPN were analysed using a multivariable logistic regression model.

Results:

Data from 479 patients were analysed. Prevalence of DPN was 28% (95% confidence interval (CI) 24.0–32.2). DPN was significantly associated with age >65 years (odds ratio (OR)=5.44, 95% CI 2.87–10.32), Indian ethnicity (OR=1.99, 95% CI 1.04–3.80), insulin use (OR=1.65, 95% CI 1.03– 2.64), diabetic retinopathy (OR=2.36, 95% CI 1.47–3.78) and stroke (OR=2.44, 95% CI 1.03–5.77).

Conclusion:

Prevalence of DPN in this study’s population sample was 28%, and the significant risk factors are age, Indian ethnicity, insulin use, diabetic retinopathy and stroke.
Serum ferritin and ECOG performance status predict the response and improve the prognostic value of IPSS or IPSS-R in patients with high-risk myelodysplastic syndromes and oligoblastic acute myeloid leukemia treated with 5-azacytidine: a retrospective analysis of the Hellenic national registry of myelodysplastic and hypoplastic syndromes
Authors: Papageorgiou Sotirios G. , Kotsianidis Ioannis , Bouchla Anthi , Symeonidis Argyris , Galanopoulos Athanasios , Viniou Nora-Athina , Hatzimichael Eleftheria , Vassilakopoulos Theodoros P. , Gogos Dimitrios , Megalakaki Aikaterini , Zikos Panagiotis , Diamantopoulos Panagiotis , Kourakli Alexandra , Giannoulia Panagiota , Papoutselis Menelaos , Poulakidas Elias , Arapaki Maria , Vardi Anna , Anagnostopoulos Achilles , Mparmparousi Despoina , Papaioannou Maria , Bouronikou Eleni , Dimou Maria , Papadaki Helen , Panayiotidis Panayiotis , Pappa Vasiliki
Published: December 2020

Background:

5-azacytidine (5-AZA) improves survival of patients with higher-risk myelodysplastic syndromes (MDSs) and oligoblastic acute myeloid leukemia (AML); however, predictive factors for response and outcome have not been consistently studied.

Methods:

This study of the Hellenic MDS Study Group included 687 consecutive patients with higher-risk MDS and oligoblastic AML treated with 5-AZA.

Results:

The International Prognostic Scoring System (IPSS) revised version (IPSS-R), Eastern Cooperative Oncology Group Performance Status (ECOG PS) (0 or 1 versus ⩾2) and baseline serum ferritin (SF) levels > 520 ng/ml were shown to independently predict response to 5-AZA. In the survival analysis, the IPSS and IPSS-R risk classification systems along with the ECOG PS and SF levels > 520 ng/ml proved to be independent prognosticators for overall survival (OS), as well as for leukemia-free survival (LFS). Next, we built new multivariate models for OS and LFS, incorporating only ECOG PS and SF levels besides IPSS or IPSS-R risk classification systems. Thereby, the new modified IPSS and IPSS-R risk classification systems (H-PSS, H-PSS-R) could each discriminate a low, an intermediate and a high-risk patient group regarding OS and LFS. The H-PSS and H-PSS-R proved to be better predictors of OS than their previous counterparts as well as the French prognostic score, while the most powerful OS predictor was the new, H-PSS-R system.

Conclusions:

ECOG PS and SF levels > 520 ng/ml independently predict response to 5-AZA, OS and LFS. Their incorporation in the IPSS and IPSS-R scores enhances these scores’ predictive power in 5-AZA-treated higher-risk MDS and oligoblastic AML patients.
Adverse events in second- and third-line treatments for acute and chronic graft-versus-host disease: systematic review
Authors: Velickovic Vladica M. , McIlwaine Emily , Zhang Rongrong , Spelman Tim
Published: December 2020

Background:

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is associated with an increased risk of graft- versus-host disease (GvHD), a strong prognostic predictor of early mortality within the first 2 years following allo-HSCT. The objective of this study was to describe the harm outcomes reported among patients receiving second- and third-line treatment as part of the management for GvHD via a systematic literature review.

Methods:

A total of 34 studies met the systematic review inclusion criteria, reporting adverse events (AEs) across 12 different second- and third-line therapies.

Results:

A total of 14 studies reported AEs across nine different therapies used in the treatment of acute GvHD (aGvHD), 17 studies reported AEs of eight different treatments for chronic GvHD (cGvHD) and 3 reported a mixed population. Infections were the AE reported most widely, followed by haematologic events and laboratory abnormalities. Reported infections per patient were lower under extracorporeal photopheresis (ECP) for aGvHD (0.267 infections per patient over 6 months) relative to any of the therapies studied (ranging from 0.853 infections per patient per 6 months under etanercept up to 1.998 infections per patient on inolimomab).

Conclusion:

The reported incidence of infectious AEs in aGvHD and grade 3–5 AEs in cGvHD was lower on ECP compared with pharmaceutical management.
Understanding kindergarten teachers’ perceptions of the use of touchscreen technologies: An exploratory study in mainland China
Authors: Yang Tian , Gunn Cathy
Published: December 2020

Touchscreen technologies have become an important part of many young children’s lives. While kindergarten teachers’ perceptions of the use of touchscreen devices have been investigated across many countries, empirical research on the topic remains scant in mainland China. In an exploratory study, the lead researcher interviewed six teachers from an exemplary kindergarten in Nanjing and analyzed relevant documents to further explore the teachers’ beliefs around children’s use of touchscreen technologies. The Technological Pedagogical and Content Knowledge (TPACK) model was used to understand the rationale behind teachers’ perceptions and self-reported practices. Findings showed that participants generally perceived touchscreen devices as useful tools for catering to children’s interests, believing they could provide active learning experiences. Teachers made decisions about children’s use of touchscreen technologies based on their understandings of learning, pedagogy, subject content, and the affordances of these technologies. Implications for future research on kindergarten teachers’ use of touchscreen technologies are also presented.
Every rose has its thorns: Domesticity and care beyond the dyad in ECEC
Authors: Aslanian Teresa K
Published: December 2020

Care is traditionally researched in ECEC as a dyadic, human phenomenon that relies heavily of tropes of females as care providers. The assumption that care is produced in dyadic relationships occludes material care practices that occur beyond the dyad. Drawing on Bernice Fisher and Joan Tronto’s care ethics and Karen Barad’s focus on the agency of materiality, I have sought to explore how care is produced outside of dyadic relations in ECEC and how that care relates to domestic practices and flourishing in ECEC.
An experimental test of the habit-goal framework: Depressive rumination is associated with heightened habitual characteristics of negative thinking but not habit-directed behavior control
Authors: Hjartarson Kristján Helgi , Snorrason Ivar , Friðriksdóttir Ágústa , Þórsdóttir Brynja B. , Arnarsdóttir Nína B. , Ólafsson Ragnar P.
Published: December 2020

Habitual thinking may underpin a heightened disposition to engage in rumination in response to negative mood, a widely held notion that has rarely been directly tested. The purpose of the current study was to investigate whether rumination is associated with habitual attributes and whether it is related to an imbalance in habit relative to goal-directed behavior control. University students (N=115) completed self-report questionnaires, a rumination induction paradigm and an outcome devaluation task that measures habitual vs goal-directed behavior control. Greater habitual characteristics of negative thinking (e.g., automaticity, lack of conscious awareness, control, and intent) were associated with ruminative brooding but not ruminative reflection and predicted more persistent dysphoric mood following rumination induction. Rumination was not, however, consistently associated with an imbalance in habit versus goal-directed behavior control. These findings indicate that depression vulnerability may be in the form of rumination being habitually triggered (without awareness or intent) with deleterious effects on mood. Although habitual, rumination may not be related to an imbalance in habit relative to goal-directed behavior control. These findings provide support for current theoretical accounts of rumination and set important boundary conditions in the search for specific factors that contribute to rumination as a habit.
Bacterial co-infections and antibiotic prescribing practice in adults with COVID-19: experience from a single hospital cluster
Authors: Cheng Lily Shui-kuen , Chau Sandy Ka-yee , Tso Eugene Yuk-keung , Tsang Steven Woon-choy , Li Issac Yuk-fai , Wong Barry Kin-chung , Fung Kitty Sau-chun
Published: December 2020

Background: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected millions of individuals since December 2019, resulting in significant morbidity and mortality globally. During the 1918 Influenza Pandemic, it was observed that influenza was associated with bacterial co-infections. However, empirical or prophylactic antibiotic use during viral pandemics should be balanced against the associated adverse drug events. Methods: In this retrospective cohort study, we investigated bacterial co-infections in adults with COVID-19 in Hong Kong. Notably, at the time of writing this report, patients with varying disease severities were isolated in hospitals until confirmatory evidence of virological clearance or immunity was available. The study included adults with laboratory-confirmed COVID-19 admitted to a single hospital cluster between 8 January 2020 and 1 May 2020. We obtained data regarding patient demographics, clinical presentations, blood test results, treatment, and outcomes. Bacteriological profiles and risk factors for co-infections were investigated. Antibiotic prescription practices were also reviewed. Results: Of the 147 patients recruited, clinical disease was suspected in 42% ( n = 62) of patients who underwent testing for other respiratory infections. Notably, 35% ( n = 52) of the patients were prescribed empirical antibiotics, predominantly penicillins or cephalosporins. Of these, 35% ( n = 18) received more than one class of antibiotics and 37% ( n = 19) received empirical antibiotics for over 1 week. Overall, 8.2% ( n = 12) of patients developed bacterial co-infections since the detection of COVID-19 until discharge. Methicillin-susceptible Staphylococcus aureus was the most common causative pathogen identified. Although 8.2% ( n = 12) of patients developed hypoxia and required oxygen therapy, no mortality was observed. Multivariate analysis showed that pneumonic changes on chest radiography at the time of admission predicted bacterial co-infections. Conclusion: These findings emphasise the importance of judicious administration of antibiotics throughout the disease course of COVID-19 and highlight the role of antimicrobial stewardship during a pandemic.
Factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda Northwest Ethiopia: A cross-sectional study
Authors: Asrat Damtew , Alle Atsede , Kebede Bekalu , Dessie Bekalu
Published: December 2020

Background:

Over the last 100 years, the development and mass production of chemically synthesized drugs have revolutionized health care in most parts of the world. However, large sections of the population in developing countries still depend on traditional medicines for their primary health care needs. More than 88% of Ethiopian parents use different forms of traditional medicine for their children. Therefore, this study aimed to determine factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda.

Method:

Community-based cross-sectional study was conducted from 1 to 30 March 2019 in Fagita Lekoma Woreda. Data collection tool was a structured interviewer-administered questionnaire. Both descriptive and inferential statistics were used to present the data. Odds ratio and binary and multiple logistic regression analysis were used to measure the relationship between dependent and independent variables.

Results:

Among 858 participants, 71% of parents had used traditional medicine for their children within the last 12 months. Parents who cannot read and write (adjusted odds ratio = 6.42, 95% confidence interval = 2.1–19.7), parents with low monthly income (adjusted odds ratio = 4.38, 95% confidence interval = 1.58–12.1), and those who had accesses to traditional medicine (adjusted odds ratio = 2.21, 95% confidence interval = 1.23–3.98) were more likely to use traditional medicine for their children. Urban residents (adjusted odds ratio = 0.20, 95% confidence interval = 0.11–0.38) and members of community-based health insurance (adjusted odds ratio = 0.421, 95% confidence interval = 0.211–0.84) were less likely to use traditional medicine for their children.

Conclusions:

Our study revealed that the prevalence of traditional medicine remains high. Educational status, monthly income, residence, accessibility to traditional medicine, and being a member of community-based health insurance were predictors of potential traditional medicine use. Therefore, the integration of traditional medicine with modern medicine should be strengthened. Community education and further study on efficacy and safety of traditional medicines should be also given great attention.
An Environmental Scan of Canadian Quality Metrics for Patients on In-Center Hemodialysis
Authors: Blum Daniel , Thomas Alison , Harris Claire , Hingwala Jay , Beaubien-Souligny William , Silver Samuel A.
Published: December 2020

Background:

Quality metrics or indicators help guide quality improvement work by reporting on measurable aspects of health care upon which improvement efforts can focus. For recipients of in-center hemodialysis (ICHD) in Canada, it is unclear what ICHD quality indicators exist and whether they adequately cover different domains of health care quality.

Objectives:

To identify and evaluate current Canadian ICHD quality metrics to document a starting point for future collaborations and standardization of quality improvement in Canada.

Design:

Environmental scan of quality metrics in ICHD, and subsequent indicator evaluation using a modified Delphi approach.

Setting:

Canadian ICHD units.

Participants:

Sixteen-member pan-Canadian working group with expertise in ICHD and quality improvement.

Measurements:

We classified the existing indicators based on the Institute of Medicine (IOM) and Donabedian frameworks.

Methods:

Each metric was rated by a 5-person subcommittee using a modified Delphi approach based on the American College of Physicians/Agency for Healthcare Research and Quality criteria. We shared these consensus ratings with the entire 16-member panel for additional comments.

Results:

We identified 27 metrics that are tracked across 8 provinces, with only 9 (33%) tracked by multiple provinces (ie, more than 1 province). We rated 9 metrics (33%) as “necessary” to distinguish high-quality from low-quality care, of which only 2 were tracked by multiple provinces (proportion of patients by primary access and rate of vascular access-related bloodstream infections). Most (16/27, 59%) indicators assessed the IOM domains of safe or effective care, and none of the “necessary” indicators measured the IOM domains of timely, patient-centered, or equitable care.

Limitations:

The environmental scan is a nonexhaustive list of quality indicators in Canada. The panel also lacked representation from patients, administrators, and allied health professionals, with more representation from academic sites.

Conclusions:

Quality indicators in Canada mainly focus on safe and effective care, with little provincial overlap. These results highlight current gaps in quality of care measurement for ICHD, and this initial work should provide programs with a starting point to combine highly rated indicators with newly developed indicators into a concise balanced scorecard that supports quality improvement initiatives across all aspects of ICHD care.

Trial Registration:

not applicable.
The experience of living with a chronic disease in pediatrics from the mothers’ narratives: The Clinical Interview on Parental Sense of Grip on the Disease
Authors: Savarese Livia , Freda Maria Francesca , De Luca Picione Raffaele , Dolce Pasquale , De Falco Raffaella , Alessio Maria , Cancian Mauro , Franzese Adriana , Guarino Maria Domenica , Perricone Roberto , Petraroli Angelica , Senter Riccardo , Traverso Claudia , Zanichelli Andrea , Zito Eugenio , Bova Maria
Published: December 2020

The Clinical Interview on the Sense of Grip on Chronic Disease has been administered to 68 mothers of children affected by Hereditary Angioedema (C1-Inh HAE), Type 1 Diabetes (T1D), Juvenile Rheumatoid Arthritis (JRA). The objectives are to detect general features of the experience of parenting children with chronic illness as well as the specificities of this experience related to the different conditions. Four Profiles of Sense of Grip were identified: Adempitive, Controlling, Reactive, Dynamic. The Sense of Grip Interview is an effective clinical tool for understanding the characteristics of the disease in daily life, which can help clinicians to encourage family adjustment to disease.
Patients’ Perception Towards Health Education Services Received at the Enhanced Primary Healthcare Facilities: A Qualitative Exploration
Authors: Jaafar Norrafizah , Perialathan Komathi , Zulkepli Mohamad Zaidan , Mohd Zin Zaikiah , Jonoi Patricia Elisha , Johari Mohammad Zabri
Published: December 2020

Background:

The present Malaysian healthcare system is burdened with increasing cases of non-communicable diseases (NCDs) and its risk factors. Health care providers (HCPs) have to provide both treatment and health education to ensure optimal outcome. Health education is a vital component in addressing and managing chronic diseases. This study intends to explore patient’s perspective on health education services received from HCPs, focusing at the secondary triage in government primary healthcare facilities.

Methods:

This qualitative exploratory study focused on the health education component derived from a complex enhanced primary health care intervention. Participants were purposively selected from patients who attended regular NCD treatment at 8 primary healthcare facilities in rural and urban areas of Johor and Selangor. Data collection was conducted between April 2017 and April 2018. Individual semi-structured interviews were conducted on 4 to 5 patients at each intervention clinic. Interviews were transcribed verbatim, coded and analyzed using a thematic analysis approach.

Results:

A total of 35 patients participated. Through thematic analysis, 2 main themes emerged; Perceived Suitability and Preferred HCPs. Under Perceived Suitability theme, increased waiting time and unsuitable location emerged as sub-themes. Under Preferred HCPs, emerging sub-themes were professional credibility, continuity of care, message fatigue, and interpersonal relationship. There are both positive and adverse acceptances toward health education delivered by HCPs. It should be noted that acceptance level for health information received from doctors are much more positively accepted compared to other HCPs.

Conclusion:

Patients are willing to engage with health educators when their needs are addressed. Revision of current location, process and policy of health education delivery is needed to capture patients’ attention and increase awareness of healthy living with NCDs. HCPs should continuously enhance knowledge and skills, which are essential to improve development and progressively becoming the expert educator in their respective specialized field.
Whom Should We Test for COVID-19? Performance of a Symptom and Risk Factor Questionnaire on COVID-19 Test Results and Patient Outcomes in an Immediate Care Setting
Authors: Oshman Lauren , Caplan Amanda , Ali Raabiah , Singh Lavisha , Khalid Rabeeya , Jameel Mohammed , David Sean P.
Published: December 2020

Introduction:

The CDC and Illinois Department of Public Health disseminated risk factor criteria for COVID-19 testing early in the pandemic. The objective of this study is to assess the effectiveness of risk stratifying patients for COVID-19 testing and to identify which risk factors and which other clinical variables were associated with SARS-CoV-2 PCR test positivity.

Methods:

We conducted an observational cohort study on a sample of symptomatic patients evaluated at an immediate care setting. A risk assessment questionnaire was administered to every patient before clinician evaluation. High-risk patients received SARS-CoV-2 test and low-risk patients were evaluated by a clinician and selectively tested based on clinician judgment. Multivariate analyses tested whether risk factors and additional variables were associated with test positivity.

Results:

The adjusted odds ratio of testing positive was associated with COVID-19-positive or suspect close contact (aOR 1.56, 95% CI 1.15-2.10), large gathering attendance with a COVID-19-positive individual (aOR 1.92, 95% CI 1.10-3.34), and, with the largest effect size, decreased taste/smell (aOR 2.83, 95% CI 2.01-3.99). Testing positive was associated with ages 45-64 and ≥65 (aOR 1.75, 95% CI 1.25-2.44, and aOR 2.78, 95% CI 1.49-5.16), systolic blood pressures ≤120 (aOR 1.64, 95% CI 1.20-2.24), and, with the largest effect size, temperatures ≥99.0°F (aOR 3.06, 95% CI 2.23-4.20). The rate of positive SARS-CoV-2 test was similar between high-risk and low risk patients (225 [22.2%] vs 50 [19.8%]; P = .41).

Discussion:

The risk assessment questionnaire was not effective at stratifying patients for testing. Although individual risk factors were associated with SARS-CoV-2 test positivity, the low-risk group had similar positivity rates to the high-risk group. Our observations underscore the need for clinicians to develop clinical experience and share best practices and for systems and payors to support policies, funding, and resources to test all symptomatic patients.
An Analysis of Haydn Wood’s Mannin Veen as It Relates to Manx Folk Songs and Legends From the Isle of Man
Authors: Armstrong Haley
Published: December 2020

Haydn Wood (1882–1959) was an English composer raised on the Isle of Man. His compositional strengths lay in melodic writing and scoring, and he is best remembered as a composer of British light music. Haydn Wood has also been credited with composing works for wind band, most notably, Mannin Veen: A Manx Tone Poem. Given the lack of research on Haydn Wood, his compositions and his homeland, this article focuses on the transcribed wind work Mannin Veen as it relates to Manx folksongs and legends from the Isle of Man. In this article, comprehensive research on Haydn Wood, The Isle of Man, and Mannin Veen is provided. For the analysis, original source materials are provided that can be used by conductors to better prepare and perform these works.
Management for lumbar spinal stenosis: Protocol for a network meta-analysis and systematic review
Authors: Wei Fei-Long , Liu Ya , Zhou Cheng-Pei , Sun Si-Guo , Zhu Kai-Long , Du Ming-Rui , Gao Hao-Ran , Yuan Yi-Fang , Song Yang , Qian Shu , An Bo , Wang Huan , Li Xiao-Xiang , Guo Shi-Kong , Gao Quan-You , Wu Sheng-Da , Yan Xiao-Dong , Sun Li-Li , Qian Ji-Xian
Published: December 2020

Introduction:

Lumbar spinal stenosis (LSS) is caused by structural changes of the spine, which lead to several severe symptoms, including back pain, leg pain, numbness and tingling in the legs, as well as reduced physical function. However, there is little evidence suggesting whether a patient with LSS should be treated with surgery. If surgery is recommended, which type of surgery benefits the patient most? To answer these questions, we will conduct a network meta-analysis and a systematic review to compare surgical and nonsurgical interventions in terms of efficacy as well as safety in adult patients with LSS.

Methods and analysis:

We will search the PubMed, Cochrane library, and EMBASE databases for articles published prior to October 10, 2019. We will search for randomized controlled trials assessing surgical and nonsurgical interventions for adult patients with degenerative LSS without any language restrictions. The primary outcome measures will be pain and disability. The secondary outcomes will include adverse events (number of events or number of people with each type of adverse event), reoperations, complications, blood loss and operation time. We will obtain the full texts of the potentially relevant studies and independently assess them. The quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development and Evaluation framework. A random-effects network meta-analysis will be performed to analyze all the evidence under the frequentist framework, and the ranking results will be presented. We will generate plots depicting the network geometry using Stata. The network meta-analysis will be performed according to the Bayesian framework. Ethics and dissemination Ethics approval is not required. The research will be published in a peer-reviewed journal.
Book review: Gautam Bhatia, Offend, Shock, or Disturb: Free Speech Under the Indian Constitution, Abhinav Chandrachud, Republic of Rhetoric: Free Speech and the Constitution of India and Anushka Singh, Sedition in Liberal Democracies
Authors: Lokaneeta Jinee
Published: December 2020

Gautam Bhatia, Offend, Shock, or Disturb: Free Speech Under the Indian Constitution. New Delhi: Oxford University Press. 2016. 347 pp. ₹750. ISBN: 9780199488643

Abhinav Chandrachud, Republic of Rhetoric: Free Speech and the Constitution of India. Gurgaon: Penguin Viking. 2017. 383 pp. ₹599. ISBN: 9780670090013

Anushka Singh, Sedition in Liberal Democracies. New Delhi: Oxford University Press. 2018. 331 pp. ₹995. ISBN: 9780199481699
Predictors of Under Nutrition and Its Implication toward HIV Continuum Care among Adult People Living with HIV in Jimma Zone Public Hospitals, Southwest Ethiopia: A Mixed Method Study
Authors: Tekelehaimanot Aderajew Nigusse , Lemma Tefera Belachew , Gudina Esayas Kebede , Getnet Masrie , Amdisa Demuma , Dadi Lelisa Sena
Published: December 2020

Objectives:

The study aimed to see predictors of undernourished and its implication towards HIV continuum care.

Study Design:

unmatched case-control study was conducted among 678 individuals in Jimma zone, southwest Ethiopia.

Methods:

Randomly selected data of 339 PLWHA who had poor nutritional outcomes (cases) and 339 without undernourished (controls) were analyzed. Logistic regression was used to identify forecasters of undernutrition. The quantitative results were supplemented from key informants who work closely on HIV care, then data were coded and analyzed thematically.

Results:

Rural residence (AOR:1.8; 95% CI: 1.2, 6.4), female (AOR: 2.9; 95% CI: 1.1, 4.3), unstable livelihood (AOR: 5.1; 95% CI: 4.2, 19.6), low meal frequency (AOR: 6.6; 95% CI: 5.2, 21.1), less diversified foods (AOR: 3.5; 95% CI: 1.2, 14.3), and advanced WHO clinical stage (AOR: 4.3; 95% CI: 3.6, 13.7) and were found to be independent predictors of undernourishment. No social support advanced clinical stage, and unstable livelihood adversely affect nutritional status of PLWHA from the qualitative data.

Conclusions:

The socio-cultural, economic, and health-system factors inhibit ideal patient nutritional status. Better tracking, enhanced livelihood and social support along with drug therapy, food aid needs to consider for PLWHA.
VEGFA Promoter Polymorphisms rs699947 and rs35569394 Are Associated With the Risk of Anterior Cruciate Ligament Ruptures Among Indian Athletes: A Cross-sectional Study
Authors: Shukla Manish , Gupta Rahul , Pandey Vivek , Rochette Jacques , Dhandapany Perundurai S. , Tiwari Pramod Kumar , Amrathlal Rabbind Singh
Published: December 2020

Background:

Associations of genetic variants within certain fibril-forming genes have previously been observed with anterior cruciate ligament (ACL) injuries. Evidence suggests a significant role of angiogenesis-associated cytokines in remodeling the ligament fibril matrix after mechanical loading and maintaining structural and functional integrity of the ligament. Functional polymorphisms within the vascular endothelial growth factor A (VEGFA) gene have emerged as plausible candidates owing to their role in the regulation of angiogenic responses.

Hypothesis:

VEGFA promoter polymorphisms rs699947 and rs35569394 are associated with ACL injury risk among athletes.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 90 Indian athletes with radiologically confirmed or surgically proven isolated ACL tears and 76 matched-control athletes were selected for the present cross-sectional genetic association study. Oral mouthwash samples were collected from all the case and control athletes and genotyped for VEGFA rs699947 and rs35569394 using the polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) method.

Results:

The A allele (rs699947) was significantly overrepresented in the ACL group (C vs A allele: odds ratio [OR], 1.68 [95% CI, 1.08-2.60]; P = .021) (CC vs CA + AA: OR, 2.69 [95% CI, 1.37-5.26]; P = .004). There was a greater frequency of the AA genotype in the ACL group in comparison with the control group (OR, 3.38 [95% CI, 1.23-9.28]; P = .016) when only male athletes were compared. Likewise, there was a greater frequency of the I allele (rs35569394) in the ACL group (D vs I allele: OR, 1.64 [95% CI, 1.06-2.55]; P = .025) (DD vs ID + II: OR, 2.61 [95% CI, 1.31-5.21]; P = .006). The A-I haplotype was overrepresented in the ACL group compared with the control group (OR, 1.68 [95% CI, 1.08-2.60]; χ2 = 5.320; P = .021), and both the polymorphisms were found to be in complete linkage disequilibrium ( r 2 = 0.929; logarithm of the odds score = 63.74; D′ = 1.0). Female athletes did not show any difference in genotype or allele frequency.

Conclusion:

This is the first study to investigate the association of VEGFA promoter polymorphisms in ACL tears among Indian athletes. Increased frequencies of the A allele (rs699947) and I allele (rs35569394) were observed in the ACL group. These results suggest that sequence variants in the VEGF gene are associated with ACL injury risk among athletes. Further research with long-term follow-ups measuring VEGF expression levels during recovery is warranted to establish its role in ACL injuries and healing.
Knee Kinematics During Landing: Is It Really a Predictor of Acute Noncontact Knee Injuries in Athletes? A Systematic Review and Meta-analysis
Authors: Romero-Franco Natalia , Ortego-Mate María del Carmen , Molina-Mula Jesús
Published: December 2020

Background:

Although knee kinematics during landing tasks has traditionally been considered to predict noncontact knee injuries, the predictive association between noncontact knee injuries and kinematic and kinetic variables remains unclear.

Purpose:

To systematically review the association between kinematic and kinetic variables from biomechanical evaluation during landing tasks and subsequent acute noncontact knee injuries in athletes.

Study Design:

Systematic review; Level of evidence, 2.

Methods:

Databases used for searches were MEDLINE, LILACS, IBECS, CINAHL, SPORTDiscus, SCIELO, IME, ScienceDirect, and Cochrane from database inception to May 2020. Manual reference checks, articles published online ahead of print, and citation tracking were also considered. Eligibility criteria included prospective studies evaluating frontal and sagittal plane kinematics and kinetics of landing tasks and their association with subsequent acute noncontact knee injuries in athletes.

Results:

A total of 13 studies met the eligibility criteria, capturing 333 acute noncontact knee injuries in 8689 participants. A meta-analysis revealed no significant effects for any kinematic and kinetic variable with regard to subsequent noncontact knee injuries.

Conclusion:

No kinetic or kinematic variables from landing tasks had a significant association with acute noncontact knee injuries. Therefore, the role and application of the landing assessment for predicting acute noncontact knee injuries are limited and unclear, particularly given the heterogeneity and risk of bias of studies to date.
The Fictional World of Ali Al-Muqri as Seen in The Handsome Jew
Authors: Rashed Redhwan Qasem Ghaleb
Published: December 2020

This study aims at highlighting the artistic and intellectual vision of Ali Al-Muqri, a prominent contemporary Yemeni novelist, in The Handsome Jew, a narrative that marks a sharp departure from the works of his contemporaries in terms of its themes, technical devices, and discursive strategies. Much has been written about the relation between Muslims and Jews in the world literature. However, most, if not all, have a masculine stamp. The norm has been reversed here, Fatima, an educated Muslim woman, loves Salem, the Jew, and marries him. In contrast to the derogatory image of the Jew in literature, Salem seems open-minded and very humane. It is hypothesized that all religions are subject to interpretation according to human needs and that all religions are a source of union, not separation. Building on an eclectic theoretical framework with the analytical method, this study analyzes The Handsome Jew that is still incarcerated within the local Yemeni linguistic and cultural barrier and aims to locate the Yemeni narrative in the realm of Arabic and world literature. The conclusions of the study are as follows: despite different religions and cultures, there is a possibility for coexistence and establishing social relationships, as it happened with Fatima and Salem, who introduce a kind of sublime human reconciliation that has not touched the sacred belief of both. Learning the other’s culture and reading freely, away from the preceding and inherited views, is essential for a healthy society. It would make Muslims love the Jews and would make the Jews love the Muslims. Love is a natural humanistic energy that challenges human-made cultural barriers.
Exploring the Sustainable Behavior and Practices for Public Tourism Organizations: A Case of Jordan
Authors: Allan Mamoon , Allahham Saif
Published: December 2020

This article explores sustainable practices for tourism organizations in the public sector in Jordan by assessing sustainable tourism behaviors from a sample of managers in the public sector and provides recommendations for the development of practices and sustainable behavior in the tourism industry. The key findings of this study are that Jordan’s public sector managers show a better understanding of the concept of sustainability and have tried to apply it in accordance with the specific field of their organization and limits of their management. The study also found that there is always room for improvement and to raise awareness of Jordan’s sustainability.