bluuebunny/crossref_metadata_2025 huggingface dataset:
Simple technique of distal leg perfusion during heart transplant in patients with preoperative veno-arterial extracorporeal membrane oxygenation support
Authors: Ohira Suguru , Pan Stephen , Levine Avi , Aggarwal-Gupta Chhaya , Lanier Gregg M , Gass Alan L , Spielvogel David , Kai Masashi
Published: December 2021

Direct heart transplant from veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support is challenging. Continuation of postoperative VA-ECMO support may be required in the setting of primary graft dysfunction or severe vasoplegia. We describe a simple technique to perfuse the ipsilateral leg of an arterial ECMO cannula during heart transplant while the ECMO circuit is turned off but maintaining the arterial cannula and distal perfusion catheter in place. This technique minimizes the number of intraoperative procedures with a minimal risk of leg ischemia, and provides a smooth transition to postoperative VA-ECMO support if necessary.
Experimental Investigation into Cyclic Shear Behaviors in the Interface Between Steel and Crushed Mudstone Particles
Authors: Liang Yue , Xia Rifeng , Liu Zeyu , Ma Chen , Zhang Hongjie , Sun Zhiwei
Published: December 2021

In the waterway construction projects of the upper streams of the Yangtze River, crushed mudstone particles are widely used to backfill the foundations of the rock-socketed concrete-filled steel tube (RSCFST) pile. The mudstone particles are prone to being crushed, which influences the mechanical properties of the soil and the interface between the soil and the steel cased on the RSCFST pile. The crushing of the particles will be aggravated by reciprocating shear of the interface when the pile experiences repeating lateral loads. The reciprocating shear of the interface may, therefore, weaken the bearing capacity of the pile. In this study, we develop a new apparatus to study the mechanical properties of the steel–soil interface under a reciprocating shear condition. With this apparatus, a set of large-scale direct shear experiments are carried out with two different boundary conditions, that is, a constant stress boundary and a constant stiffness boundary, respectively. Comparative experiments and parallel experiments are carried out to study the physical properties of steel–mudstone particle interface and the stability of the apparatus. Parallel experiments show that the instrument has good stability. The comparative experiment results also reveal the differences of the shear behaviors of the interface under two conditions. Analysis of the experiment results shows that the normal stiffness condition is closer to the real boundary condition when the soil–steel interface is cyclically sheared. The particle crushing and the attenuation of normal stress is the main reason causing the degrading of the interface.
Mobility Dynamics amid COVID-19 with a Case Study in Tennessee
Authors: Hoseinzadeh Nima , Gu Yangsong , Zhang Hairuilong , Han Lee D. , Kim Hyun , Freeze Phillip Brad
Published: December 2021

The year 2020 has marked the spread of a global pandemic, COVID-19, challenging many aspects of our daily lives. Different organizations have been involved in controlling this outbreak. The social distancing intervention is deemed to be the most effective policy in reducing face-to-face contact and slowing down the rate of infections. Stay-at-home and shelter-in-place orders have been implemented in different states and cities, affecting daily traffic patterns. Social distancing interventions and fear of the disease resulted in a traffic decline in cities and counties. However, after stay-at-home orders ended and some public places reopened, traffic gradually started to revert to pre-pandemic levels. It can be shown that counties have diverse patterns in the decline and recovery phases. This study analyzes county-level mobility change after the pandemic, explores the contributing factors, and identifies possible spatial heterogeneity. To this end, 95 counties in Tennessee have been selected as the study area to perform geographically weighted regressions (GWR) models. The results show that density on non-freeway roads, median household income, percent of unemployment, population density, percent of people over age 65, percent of people under age 18, percent of work from home, and mean time to work are significantly correlated with vehicle miles traveled change magnitude in both decline and recovery phases. Also, the GWR estimation captures the spatial heterogeneity and local variation in coefficients among counties. Finally, the results imply that the recovery phase could be estimated depending on the identified spatial attributes. The proposed model can help agencies and researchers estimate and manage decline and recovery based on spatial factors in similar events in the future.
Mapping Unmanned Aerial System Data onto Building Information Modeling Parameters for Highway Construction Progress Monitoring
Authors: Samsami Reihaneh , Mukherjee Amlan , Brooks Colin N.
Published: December 2021

The transportation infrastructure management sector lacks automated procedures that can help it find and resolve the performance deviations. The objective of this research is to illustrate the mapping of Unmanned Aerial System (UAS) collected photogrammetric data to building information modeling (BIM) parameters, and their application for automated construction progress monitoring and the generation of as-built models. The goal is to support project managers to estimate project progress during highway construction. As a part of ongoing work, this paper takes into account 4D (3D + time) data that is acquired from 3D surface digital elevation models, point clouds, LiDAR data, and orthographic photos. It maps these 4D data onto BIM parameters to create as-built models of the project at different intervals. A comparison between as-planned and as-built models using the earned value management method is employed to develop metrics that can be used for indicating cost and schedule deviations during construction. The mapping methodology introduced in this paper is illustrated using an ongoing highway construction project case study. The main contribution of this paper is the organization, processing, and integration of UAS data with BIM data structures and project management workflows. The research outcomes will assist project managers in an easy and quick identification of potential performance problems and support the project management decision-making process.
Enriching Existing 3D Pavement Condition Survey Datasets to Support Paving Project Cost Estimates, Project Planning, Designs, and Automated Machine Guidance
Authors: Fox-Ivey Richard , Laurent John , Petitclerc Benoit
Published: December 2021

State departments of transportation (DOTs) typically perform annual pavement condition inspections, which serve as an important input into pavement management systems (PMS) software. Road surface defects (cracking, rutting, smoothness, etc.) are analyzed by PMS software to model the deterioration of pavements and to make budget and performance-based recommendations about which roads to maintain and how and when to maintain them. Increasingly at the state DOT level, these data are captured using high-speed 3D lasers (laser triangulation systems) that acquire the 3D shape of the road surface to evaluate its condition. Traditionally the capture of road elevation data relied entirely on the use of survey crews. Although accuracy can be quite high, the process of capturing elevations can require a lot of manpower, is time-consuming, requires lane closures, and results in a relatively small number of points per kilometer of road with which to perform all of the tasks from early project planning through construction. This paper explores an alternate approach that leverages existing 3D laser technology utilized by DOTs to measure the condition of in-service pavements. Typically, these laser systems capture “relatively referenced” 3D profiles of the roadway to evaluate pavement condition based on surface distortion. However, there is often no connection between these “relative” 3D profiles and real-world locations. This new approach involves the addition of high-accuracy blended global navigation satellite system + inertial navigation system positioning systems, as well as specialized software, to map the absolute position of 3D profiles in real-world coordinates.
Gender, sexism, and war
Authors: Reiter Dan , Wolford Scott
Published: December 2021

We analyze a model of leader gender and crisis bargaining under asymmetric information. There are no essential differences between the sexes in their willingness to use force, but sexist leaders receive a subjective boost for defeating female leaders in war and pay a subjective cost for defeat. We show that this hostile sexism can lead to war for two reasons, first by offering sufficient private benefits to make peace impossible and second by influencing an uninformed leader’s willingness to risk war. We also show that (a) the effect of leader sex on disputes and war depends on the distribution of power, (b) sexist leaders may initiate disputes at less favorable distributions of power than non-sexist leaders, and (c) sexist leaders adopt bargaining strategies that make it difficult for women to cultivate and benefit from reputations for resolve, even in the absence of sex differences in the willingness to use force.
Transparency in Spanish archive and library websites: A comparative study
Authors: Pacios Ana R. , Martínez-Cardama Sara
Published: December 2021

Transparency is a principle that has attracted a good deal of international attention in recent years, especially in connection with combatting corruption and building open, participatory governments accountable to their citizens. Public libraries and archives are not only information suppliers, but also public bodies obliged to provide the citizenry with information about their own governance and activities. Those obligations are laid down in Spanish Act 19/2013 of 29 December on Transparency, Access to Public Information and Good Governance (Spanish initials LTAIPBG). This article describes the results of applying a transparency measuring tool, TransPa_BA, to 106 regionally administered national historic archives and national public libraries. The tool, in turn the result of a research project, includes 20 indicators to measure active public disclosure by public libraries and 22 by archives in keeping with the provisions of the aforementioned Act. The indicators and their respective parameters (visibility, content, form, accessibility, reusability, dating and currency) provide guidelines to enable these institutions to comply with transparency and accountability requirements by furnishing society in general and their stakeholders in particular with information on their activities and performance in key areas. Further to the findings, the target institutions have made hesitant attempts to enhance transparency with respect to earlier inquiries. Public libraries are observed to be more active than archives, although the transparency scores obtained are low due to the failure to provide information on some indicators as well as on parameters such as dating and reusability. Both types of institution have a long road ahead in the pursuit of greater transparency.
Variation of Political Skill Dimensions Across Different Industries
Authors: Tiwari Shivani , Jain Vikas , Anis Shafiullah
Published: December 2021

The purpose of this study to ascertain if there is any variation in political skill dimensions ((a) social astuteness, (b) interpersonal influence, (c) networking ability and (d) apparent sincerity) exhibited by employees in India’s seven industry sectors. In this study, the Political Skill Inventory (PSI) is used to examine such variations. Five hundred fifty survey respondents are employed in seven sectors viz. automobile, education, finance, fast moving consumer goods, health, information technology and telecom. The results exemplify that statistically significant differences are exhibited in these political skill dimensions by the employees in different industry sectors chosen for this research. Since these differences are reflected on four dimensions of the political skill, this study makes a unique contribution by developing an understanding of individual dimensions of political skill, thus, enabling greater insight into skill enhancement at various levels. Further, this study contributes by furnishing insights on skills useful for practitioners to understand dominance and lack of industry-specific skills within PSI inventory. The implications of this study could be in the areas such as personnel selection, framing skill development tools and programmes, enhancing job performance, achieving organizational goals and improvising organizational culture.
Financial Capability and Asset Building With a Racial- and Gender-Equity Lens: Advances From the Field
Authors: Finsel Christy , Watson Grote Mae , Libby Margaret , Mahon Cathie , Sherraden Margaret S.
Published: December 2021

This essay explores the enormous potential of social service organizations to contribute to people’s financial well-being. It is informed by the work of four pioneering organizations that use a racial- and gender-equity lens to advance financial well-being. It explores five strategies: (a) embedding financial development into social services; (b) focusing on youth transitioning to adulthood; (c) partnering with asset coalitions to expand financial opportunities; (d) partnering with financial institutions; and (e) developing fintech with equity. These approaches hold promise to help address the racial wealth gap and improve financial security.
Partisanship, Policy, and Americans’ Evaluations of State-Level COVID-19 Policies Prior to the 2020 Election
Authors: VanDusky-Allen Julie A. , Utych Stephen M. , Catalano Michael
Published: December 2021

The COVID-19 pandemic was a key policy issue during the 2020 election in the United States. As such, it is important to analyze how voters evaluated government responses to the pandemic. To this end, in this article, we examine factors that influenced Americans’ evaluations of state-level COVID-19 policy responses. We find that during the pandemic onset period, Americans typically rated their state governments’ responses more favorably if their governor was a co-partisan. In contrast, during the re-opening period, we find that Democrats relied on both partisanship and policy to evaluate their state-level responses, while Republicans continued to rely solely on partisanship. We contend that given the complex policy environment surrounding COVID-19, Americans may have not been fully aware of the policies their state governments adopted, so they relied on partisan cues to help them evaluate their state-level policy responses. But by the re-opening period, Americans likely had enough time to better understand state-level policy responses; this allowed Democrats to also evaluate their state-level responses based on policy. These findings shed light on how Americans evaluated COVID-19 responses just prior to the 2020 election.
Chromosome 8 Polysomy Accounting for MYC Over-Expression in Angiosarcoma Arising as Somatic-Type Malignancy in Metastatic Teratoma. Case Report
Authors: Vargas A. Cristina , Grimison Peter , Joy Christopher , Garrone Bernadette , Bonar Fiona , Ghahan Raha Madadi , Davidson Trent , Maclean Fiona M.
Published: December 2021

MYC over-expression by immunohistochemistry (IHC) is utilised in routine pathology practice as a surrogate marker for MYC amplification, which plays a key oncogenic role in post-irradiation and chronic lymphedema-associated angiosarcoma. We present the case of a 32-year old male, who presented with high-grade angiosarcoma arising in a background of metastatic testicular teratoma. IHC for MYC showed strong nuclear expression in the angiosarcoma cells prompting the consideration of post-irradiation-induced angiosarcoma but our patient did not undergo radiotherapy. Fluorescence in-situ hybridization (FISH) excluded MYC amplification and instead showed Chromosome 8 polysomy, which accounted for the strong MYC IHC expression present, not previously described in the context of germ cell tumours. The occurrence of MYC over-expression due to polysomy illustrates a novel clinical scenario (angiosarcoma arising as somatic malignancy) where strong MYC IHC expression can be found in the absence of underlying amplification or prior radiotherapy exposure.
Dynamic Characterization of Additively Manufactured Polylactide (PLA)
Authors: Priyanka GTL , Saideep Ch. , Tadepalli T.
Published: December 2021

Additively manufactured materials have excellent properties with wide applications in many industries. For designing components exposed to extreme loading situations, it is essential to characterize the high strain rate response of 3D printed (fused deposition modelling) materials. In this study, uniaxial quasi-static and dynamic compressive tests were carried out at various strain rates (10−2 s−1 and 200 s−1 to 1800 s−1) for 3D printed PLA. Strain rate dependent compressive response of Polylactide acid (PLA) disk specimens 3D printed at 0°, 45° and 90° orientations was obtained using the Split Hopkinson bar technique. The results show that the compressive strength increases with corresponding strain rates for 0° and 45° print orientations. PLA printed at 0° has higher compressive strength compared to 45° and 90° orientations under quasi-static as well as high strain rate loading. Toughness was observed to increase with strain rate in all three orientations. A simple modification to the Johnson-Cook model is proposed, which accounts for the effects of print orientation, porosity and strain softening behavior.
Strength of three-sheet spot welds with critical nugget sizes in tensile shear, cross tension, peel and fatigue tests
Authors: Siimut K , Zwicker MFR , Nielsen CV
Published: December 2021

Plug failures have been observed in three-sheet spot welds, where the weld nugget did not penetrate into the outer sheet. Such solid-state bonds were found to be formed as a result of high contact pressure and temperature during welding. The strength of single spot welds was studied in a three-sheet combination (0.61 mm DX54 on two 1.21 mm DP600) with nugget penetrations into the thin sheet below 40%. The static strength was evaluated by tensile shear, cross tension and mechanized peel testing, and fatigue tests were carried out in tensile shear configuration at 30 Hz and mean load of 2 kN. It was found that loading of the specimens in tensile shear, mechanized peel and cross tension tests leads to a plug failure and a ductile fracture of the thin sheet. The weld strength is not correlated with the nugget penetration into the thin sheet but is determined by the area of the bonded interface, instead, as shown by peel and cross tension tests. Fatigue tests revealed that the specimens break by a plug failure. The failure mechanism was found to be ductile for the highest load range after approximately 33 000 cycles. At lower load ranges, evidence of a crack was found in the DX54 sheet, leading to higher stress concentration and subsequent ductile fracture. It was estimated that a load range of 940 N leads to failure after approximately 106 cycles.
Calling in to cut back: Settlers learning to listen for a decolonial future
Authors: Beausoleil Emily
Published: December 2021

Clearing the gorse, a particularly aggressive invasive plant, so that native plants can flourish has been used as a potent metaphor for decolonization ( Came, 2014 ), and described as labour appropriate for settlers to perform in the interest of just relations with Indigenous peoples. Yet, this labour is not simply one of negation, for it involves learning to bring one’s group difference alongside that of others rather than continuing to mistake that difference for the unmarked context of Indigenous-settler relations. Clearing the gorse is thus also connected to the labour of “gathering at the gate”: the requirement according to Māori protocols of encounter that visitors develop a sense of collective identity and purpose before any meeting can take place. Settler societies, as a rule, operate without a collective sense of the specific identity and history of being a settler people. How would these two forms of labour appropriate for tauiwi Pākehā to perform be connected, and how would performing them together serve broader projects of decolonization and honouring settler commitments in Te Tiriti o Waitangi? I reflect upon this question in light of insights from Tauiwi Tautoko, a recent nationwide anti-racism programme wherein tauiwi (non-Māori settlers) addressed anti-Māori racism online. Core to the programme’s novel anti-racism approach were listening strategies that both invited and modelled acknowledgment of the particular ground from which tauiwi Pākehā see and speak. These strategies have proven effective in creating openings and shifts regarding racist views in otherwise adversarial and toxic spaces. They offer innovative practical resources for the work settlers can and must do with our own people, if we are to contribute to a decolonial future.
Subdomain integration method of electrical resistance tomography for multiple flaws detection in cementitious materials
Authors: Zhou Xiaoyong , Tu Fubin , Wang Jiahui , Li Qinggang
Published: December 2021

Electrical Resistance Tomography (ERT) has been widely used for detecting cementitious materials with one type of flaw. To extend the ERT for multi-flaws detection in a larger concrete plate, this paper develops a subdomain integration method. The adjacent driver pattern and absolute imaging scheme of ERT are adopted to reconstruct the inner electrical conductivity field of a concrete specimen which contains three different inclusions, namely, a copper bar, a piece of plexiglass, and a drop of saline solution. The feasibility of subdomain integration method for multiple flaws detection in cementitious materials is analyzed by theoretical analyses of the equipotential line density and the image quality evaluation indicator. The concrete specimen is divided into four, nine, and 16 subdomains for detection. The image reconstruction results obtained by the subdomain detection method are compared with each other, and with the results of a global detection method. Results indicate that the effective area of subdomain largely relies on the density of equipotential lines, as well as the measurement errors. Subdomain integration method is effective in detecting a relatively large cementitious component with multi-flaws.
Bell v Tavistock: Rethinking informed decision-making as the practical device of consent for medical treatment
Authors: Sarela Abeezar I.
Published: December 2021

The decision of the High Court in Bell v Tavistock has excited considerable discussion about lawful consent for puberty-blocking drug treatment for children with gender dysphoria. The present paper draws attention to a wider question that surfaces through this case: is informed decision-making an adequate practical tool for seeking and obtaining patients’ consent for medical treatment? Informed decision-making engages the premises of the rational choice theory: that people will have well-crystallised health goals; and, if they are provided with sufficient information about medical treatments, then they will be able to choose the treatment that satisfies their goals. Whilst appealing, the informed decision-making paradigm is assailed by various fallacies, which apply not only to children but also to adults. In Bell v Tavistock, the High Court seems to have recognised such fallacies, and it rejected informed decision-making as an adequate tool for consent from children with gender dysphoria. Similar considerations apply to adults in various situations. Thus, Bell v Tavistock can be seen as an attempt to refine the views on the consent that were expressed by the Supreme Court in Montgomery. It can be inferred that the Supreme Court did recognise the limitations of informed decision-making, but it did not develop this point. Further work is required to formulate an adequate model of decision-making, and Bell v Tavistock serves as a useful reminder to rethink informed decision-making as the device for consent.
A model study on the impact of metal ions on pre-vulcanization of concentrated natural rubber latex and dipped-products
Authors: Rojruthai Porntip , Payungwong Narueporn , Sakdapipanich Jitladda T
Published: December 2021

A model study on the influence of some heavy metal ions on the stability and vulcanization efficiency of uncompounded and compounded high-ammonia natural rubber (HANR) latex was carried out by an exogenous addition and then determined by Brookfield viscometer, mechanical stability time (MST) tester, and tensile testing machine. The case of pre-vulcanized HANR latex with different aging times was determined by the change in the volatile fatty acid (VFA) number, MST, and viscosity. The compounded HANR latex was coagulated by adding Mn2+and Mg2+ while it was unaltered by adding Zn2+, Fe2+, and Cu2+ ions, leading to their colloidal stability. Therefore, these metal ions were chosen further to study the pre-vulcanization of compounded HANR latex. The presence of Zn2+, Fe2+, and Cu2+ in the latex is responsible for the delay in the vulcanization process and changes the appearance of compounded latex. Before compounding, the addition of such metal ions led to the reduction in tensile strength of the obtained gloves. At the same time, there was no effect on the tensile properties of the gloves made from the compounded HANR latex containing the metal ions.
Addressing Black Infant Mortality Through Harnessing the Power of Community
Authors: Knox-Kazimierczuk Francoise , Andavarapu Deepika , Shockley-Smith Meredith
Published: December 2021

In Hamilton County, Ohio, the infant mortality rate is above the national average and the Black infant mortality rate is more than 3 times the white infant mortality rate. These racial disparities in infant mortality cannot be explained through other socio-economic characteristics like education, income, housing, or medical insurance. Research has shown that racism, not race itself, is the driving force behind the high disparity in infant mortality rates in Hamilton County and the nation as well. The World Health Organization (WHO) and the Institute of Medicine have long cited institutional/structural racism and cultural racism as a key factor in health disparity. A paradigm shift needed to occur to address the consequences of racism within the lives of Black women, namely disempowerment and agency. The Commission on Social Determinants of Health (CSDH) model was which engaged Black women and positioned them as an asset, to share in the process of strategizing, creating, and implementing a plan. Queens Village was founded to implement the CSDH model and address the upstream determinants of infant mortality through cultivating a sense of community.
COVID-19 Diffusion Before Awareness: The Role of Football Match Attendance in Italy
Authors: Alfano Vincenzo
Published: December 2021

Anecdotal evidence suggests that football matches may have played a role in the spread of COVID-19 all over Europe. Nevertheless, from a scientific point of view, the impact of football matches on the spread of COVID-19 remains unclear. In this paper we study, via a quantitative analysis, the case of Italy, a country badly affected by COVID, and one where attending football matches is very popular. We consider the impact of matches played in January and February 2020 on the dynamic of the pandemic in March and April the same year. Our results, which consider all levels of Italian professional football, and the highest level of amateur football, show that matches played in January and February had an impact on the evolution of the pandemic in March and April. These results suggest that great care must be taken before considering re-opening stadia.
The role of the officers’ mess in inclusive military leader social identity construction
Authors: Gosling Edward
Published: December 2021

Leadership is fundamentally a social phenomenon, and a leader’s legitimacy in personal and social terms is determined partly by how effectively they incorporate the prototypical leader identity. Using the historical British officers’ mess as a case study, this article presents a conceptual examination of the function place can perform in the construction of collective leader identities and the interconnected influence shared history, materiality and social interaction can have in encouraging inclusivity in leadership. Leadership identity is an integral feature of military life which has historically drawn on complex cultural and legal traditions to underwrite the individual’s right to command. This article will argue that social places such as the officers’ mess have been utilised as a means of cultivating cohesion in the past and that they may have an application in furthering inclusive collective leader identities in the future.
The current state of the surgical care team in the United Kingdom: Shall we ‘do a time out’?
Authors: Krishnamoorthy Bhuvaneswari , Britton Carolina Relvas
Published: December 2021

The reduction of junior doctors’ working hours over the last two decades paved the way to non-medical practitioners providing care traditionally discharged by surgeons and other medics. These registered practitioners play a vital role in the care of patients in surgery and work within multi-disciplinary teams comprising surgical care practitioners, advanced clinical practitioners in surgery, and physician associates, with significant experience in nursing or allied health care professional practice. Health Education England and the Royal Colleges of Surgeons have invested considerably in developing the relevant educational frameworks to support and quality assure the training of non-medical practitioners. Notwithstanding, to ascertain whether advanced and extended practice have been developed appropriately, a wide critical stance is needed. This article aims to begin to analyse the status quo of the extended surgical team and of the associated pitfalls and challenges, making conservative comparisons between the roles with the international scene. The objective is to help students, trainees and all involved in surgical care to adopt an informed and critical viewpoint about the extended surgical team in the United Kingdom, in the hope that this can lead to improvement and forward planning in workforce design for the benefit of patients and their communities.
Back to Westminster: A new transatlantic agenda to defend democracy
Authors: Merheim-Eyre Igor
Published: December 2021

Across the transatlantic area and, indeed, across the democratic world, democracy is under strain from domestic and external factors, while throughout the world, authoritarian and totalitarian forces continue to quash people’s desire for freedom and human dignity. In this context, this article takes stock of the ongoing challenges, and argues for a renewed transatlantic agenda that returns to the spirit of President Ronald Reagan’s 1982 Westminster Speech. It should achieve this by developing an ambitious programme that defends democracy within the transatlantic area and supports people’s desire for freedom globally, while avoiding the dogmatic approaches and ossification that have characterised democracy promotion over the past two decades.
The Effectiveness of Telemedicine Solutions for the Management of Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression
Authors: Hangaard Stine , Laursen Sisse H. , Andersen Jonas D. , Kronborg Thomas , Vestergaard Peter , Hejlesen Ole , Udsen Flemming W.
Published: December 2021

Background:

Previous systematic reviews have aimed to clarify the effect of telemedicine on diabetes. However, such reviews often have a narrow focus, which calls for a more comprehensive systematic review within the field. Hence, the objective of the present systematic review, meta-analysis, and meta-regression is to evaluate the effectiveness of telemedicine solutions versus any comparator without the use of telemedicine on diabetes-related outcomes among adult patients with type 2 diabetes (T2D).

Methods:

This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We considered telemedicine randomized controlled trials (RCT) including adults (≥18 years) diagnosed with T2D. Change in glycated hemoglobin (HbA1c, %) was the primary outcome. PubMed, EMBASE, and the Cochrane Library Central Register of Controlled Trials (CENTRAL) were searched on October 14, 2020. An overall treatment effect was estimated using a meta-analysis performed on the pool of included studies based on the mean difference (MD). The revised Cochrane risk-of-bias tool was applied and the certainty of evidence was graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Results:

The final sample of papers included a total of 246, of which 168 had sufficient information to calculate the effect of HbA1c%. The results favored telemedicine, with an MD of −0.415% (95% confidence interval [CI] = −0.482% to −0.348%). The heterogeneity was great (I2 = 93.05%). A monitoring component gave rise to the higher effects of telemedicine.

Conclusions:

In conclusion, telemedicine may serve as a valuable supplement to usual care for patients with T2D. The inclusion of a telemonitoring component seems to increase the effect of telemedicine.
Clinical Practice Experiences Using a Professional Diabetes Management Ecosystem During COVID
Authors: Merino Torres Juan Francisco , Grady Mike , Lopez Alba Alfonso , Nattero Chavez Lía , Justel Enriquez Alicia , Gaspar Ruth , Aizpeolea San Miguel Lourdes , Menendez Alvarez Flor , Nunes Pinto Elsa , Petry Friedrich Wilhelm , Jorn Rose , Weyland Maria , Scherer Barbara , Birkemeyer Doreen , Scorsone Alessandro , Petrizzo Michela , Lai Alessio , Gravina Giuseppe , Verhaegen Ann , Smet Marleen , Verhaegen Lieve , Van den Bulck Ilde , De Bie Ann , Holt Elizabeth
Published: December 2021

Background:

Challenges of patient care in diabetes were exacerbated by COVID, undermining the ability of patients to engage in-person with health care professionals (HCPs). To combat this, there has been accelerated adoption of telemedicine to support patient and provider connectivity.

Methods:

We collated survey information regarding telemedicine from 21 European clinical institutions. Health care professionals joined virtual meetings focusing on the OneTouch Reveal (OTR) ecosystem and its utility for conducting telemedicine. Selected HCPs provided clinical case studies to explain how the OTR ecosystem supported patient care.

Results:

Remote consultations increased by nearly 50% in 21 European clinics during the pandemic (Belgium [24%], Iberia [65%], Germany [34%], Italy [54%]). In all, 52% of people with diabetes using OTR app to connect remotely with HCPs had type 1 diabetes and 48% had type 2 diabetes. Remote connection methods included telephone (60%), email (19%), video chat (10%), text only (3%), or a mix of these methods (8%). Health care professionals usually reviewed patient data during consultations (45%) rather than before consultations (25%). Fifty-five percent of HCPs indicated digital ecosystems like OTR ecosystem would become their standard of care for diabetes management. In-depth conversations with HCPs provided a deeper understanding of how a digital ecosystem integrated into clinical practice and population management. In addition, five patient case studies using OTR ecosystem were provided by a selection of our HCPs.

Conclusion:

Diabetes management solutions, such as OTR ecosystem, supported telemedicine during the pandemic and will continue to play a valuable role in patient care beyond the pandemic.
Trusting in the online ‘community’: An interview study exploring internet use in young people with chronic pain
Authors: Hurley-Wallace Anna , Kirby Sarah , Bishop Felicity
Published: December 2021

Background

Chronic pain in young people is prevalent in the UK. Young people are digital natives, yet there has not been any online intervention developed in a UK context to help them manage chronic pain. Key to understanding the context in which young people engage with online interventions is better understanding their internet use for chronic pain management. The overarching aim of this study was to explore young peoples’ experiences of searching for information about chronic pain using the internet. This included experiences of using search engines (e.g. Google), health information websites (e.g. the National Health Service [NHS] website) and social media (e.g. Facebook and Instagram).

Methods

Semi-structured interviews were conducted with young people aged 16–24-years ( n = 24), online, via Microsoft (MS) Teams. The study was advertised online and via patient partner charities. Interview data was analysed using reflexive thematic analysis.

Results

Participants presented with a variety of chronic pain conditions, including joint hypermobility syndrome ( n = 6), chronic headache and/or migraine ( n = 4) and fibromyalgia ( n = 3). Four themes were generated: ‘Trustworthy information, or experiences?’, ‘Diagnostic labels in a digital world’, ‘The online chronic pain community’ and ‘A mind and body approach to self-management’. Young people trust advice from others in their online community and having a diagnostic label help them find relevant pain management strategies and support networks online.

Conclusions

This study is the first qualitative exploration of internet use in UK-based young people with chronic pain. Findings highlight the importance of considering internet use when developing new online interventions for young people with pain and that internet use, particularly social media use, is an important psychosocial consideration in pain management. Young people should be encouraged to verify practical pain management techniques found online with their doctor and be empowered in the safe use of appropriate psychology-based self-management resources.
Changes in College Student Anxiety and Depression From Pre- to During-COVID-19: Perceived Stress, Academic Challenges, Loneliness, and Positive Perceptions
Authors: Haikalis Michelle , Doucette Hannah , Meisel Matthew K. , Birch Kelli , Barnett Nancy P.
Published: December 2021

The COVID-19 pandemic is a major stressor that has negatively impacted global mental health. Many U.S. college students faced an abrupt transition to remote learning in March 2020 that significantly disrupted their routines, likely causing changes in mental health. The current study examined changes in anxiety and depressive symptoms among 990 college students, from before COVID-19 had reached U.S. community spread to 5 months into the pandemic. Results indicate overall increases in anxiety and depressive symptoms; this effect was amplified as more COVID-related challenges with academic impact and loneliness were reported. Increases in anxiety and depression were buffered as a function of greater perceived positive changes attributed to COVID-19; the differences in anxiety and depressive symptoms over time were also lessened when greater perceived stress prior to COVID-19 was reported. Findings reveal an unexpected effect involving pre-pandemic stress, and highlight potential targets to promote resilience, which should be examined long-term.
SOD2 V16A amplifies vascular dysfunction in sickle cell patients by curtailing mitochondria complex IV activity
Authors: Dosunmu-Ogunbi Atinuke , Yuan Shuai , Reynolds Michael , Giordano Luca , Sanker Subramaniam , Sullivan Mara , Stolz Donna Beer , Kaufman Brett A. , Wood Katherine C. , Zhang Yingze , Shiva Sruti , Nouraie Seyed Mehdi , Straub Adam C.
Published: December 2021

Superoxide dismutase 2 (SOD2) catalyzes the dismutation of superoxide to hydrogen peroxide in mitochondria, limiting mitochondrial damage. The SOD2 amino acid valine-to-alanine substitution at position 16 (V16A) in the mitochondrial leader sequence is a common genetic variant among patients with sickle cell disease (SCD). However, little is known about the cardiovascular consequences of SOD2V16A in SCD patients or its impact on endothelial cell function. Here, we show SOD2V16A associates with increased tricuspid regurgitant velocity (TRV), systolic blood pressure, right ventricle area at systole, and declined 6-minute walk distance in 410 SCD patients. Plasma lactate dehydrogenase, a marker of oxidative stress and hemolysis, significantly associated with higher TRV. To define the impact of SOD2V16A in the endothelium, we introduced the SOD2V16A variant into endothelial cells. SOD2V16A increases hydrogen peroxide and mitochondrial reactive oxygen species (ROS) production compared with controls. Unexpectedly, the increased ROS was not due to SOD2V16A mislocalization but was associated with mitochondrial complex IV and a concomitant decrease in basal respiration and complex IV activity. In sum, SOD2V16A is a novel clinical biomarker of cardiovascular dysfunction in SCD patients through its ability to decrease mitochondrial complex IV activity and amplify ROS production in the endothelium.
Occasional long-distance dispersal may not prevent inbreeding in a threatened butterfly
Authors: De Ro Annelore , Vanden Broeck An , Verschaeve Leen , Jacobs Ilf , T’Jollyn Filiep , Van Dyck Hans , Maes Dirk
Published: December 2021

Background

To set up successful conservation measures, detailed knowledge on the dispersal and colonization capacities of the focal species and connectivity between populations is of high relevance. We developed species-specific nuclear microsatellite molecular markers for the grayling (Hipparchia semele), a butterfly endemic to Europe and of growing conservation concern in North-West Europe, and report on its population genetics, in a fragmented, anthropogenic landscape in Belgium. Our study included samples from 23 different locations nested in two regions and additional historical samples from two locations. We assessed contemporary, long-distance dispersal based on genetic assignment tests and investigated the effect of habitat loss and fragmentation on the population genetic structure and genetic variation using data of nine microsatellite loci.

Results

Detected dispersal events covered remarkably long distances, which were up to ten times larger than previously reported colonisation distances, with the longest movement recorded in this study even exceeding 100 km. However, observed frequencies of long-distance dispersal were low. Our results point to the consequences of the strong population decline of the last decades, with evidence of inbreeding for several of the recently sampled populations and low estimates of effective population sizes (Ne) (ranging from 20 to 54 individuals).

Conclusions

Our study shows low frequencies of long-distance dispersal, which is unable to prevent inbreeding in most of the local populations. We discuss the significance for species conservation including future translocation events and discuss appropriate conservation strategies to maintain viable grayling (meta) populations in highly fragmented, anthropogenic landscapes.
Analysis of a two-year independent screening effort for retinopathy of prematurity in rural Egypt
Authors: Tawfik Sara , Mansour Ahmed , Selim Norhan Lotfy , Habib Ahmed M. , Fouad Yousef A. , Tawfik Mohamed A. , Al-Feky Mariam
Published: December 2021

Background

The third epidemic of retinopathy of prematurity (ROP) has majorly involved middle income countries in which tailored screening and local guidelines require development. The data regarding ROP prevalence and cutoff numbers for screening in Egypt are lacking.

Methods

Retrospective analysis of an independent screening effort spanning 2 years (February 2019 to February 2021) and involving 32 neonatal care units within Sharkia governorate, Egypt. Infants of gestational age (GA) ≤ 34 weeks and/or birth weight (BW) ≤ 2000 g were included, as well as those with unstable clinical course. Two eyecare centers located in Sharkia and Cairo governorates served as referral centers for any required interventions.

Results

Of the 276 screened infants, 133 (48.2%) had some form of ROP that was bilateral in 127 (95.5%) of them. Aggressive posterior ROP (AP-ROP) was detected in both eyes of 24 infants (8.7%). The median (IQR) GA of infants with ROP was 32 (30–34) weeks, and the median (IQR) BW was 1600 (1350–2000) g. Sixty-three infants (47.4%) required treatment. Of the total 84 eyes that primarily were treated, 73 (86.9%) received intravitreal ranibizumab, 8 (9.5%) underwent laser ablation therapy, and 3 eyes (3.6%) underwent surgery. Recurrence rate was 16.7% (14 eyes). Final outcome was favorable in 83 eyes (98.8%). Applying the American Academy criteria would have led to the missing of 36.8% of infants with ROP and 28.6% of those requiring treatment in our sample.

Conclusion

The incidence of both ROP and AP-ROP in the Egyptian rural setting appears to be in the high end of global reported rates. Prevention measures should urgently be planned and implemented.
Implantable collamer lens versus small incision lenticule extraction for high myopia correction: A systematic review and meta-analysis
Authors: Cao Kai , Zhang Jingshang , Wang Jinda , Yusufu Mayinuer , Jin Shanshan , Chen Shuying , Wang Ningli , Jin Zi-Bing , Wan Xiu Hua
Published: December 2021

Purpose

To compare the efficacy, safety, predictability and visual quality between implantable collamer lens (ICL) implantation and small incision lenticule extraction (SMILE) for high myopia correction in adults.

Methods

A systematic review and meta-analysis was conducted. A comprehensive literature search was done based on databases including PubMed, Science Direct, Embase, and the Cochrane Central Register of Controlled Trials. The efficacy index, safety index, changes in Snellen lines of corrected distance visual acuity (CDVA), predictability (difference between post-operative and attempted spherical equivalent error, SER), incidence of halos, and change in higher-order aberrations (HOAs) were compared. Mean difference (MD) and 95% confidence interval (CI) was used to estimate continuous outcomes, risk ratio (RR) and 95%CI was used to estimate categorical outcomes.

Results

Five observational studies involving 555 eyes were included in this review. Studies’ sample sizes (eyes) ranged from 76 to 197. Subjects’ refraction ranged from -6 diopter (D) to -12D. Study duration of most researches were 6 months or 12 months. Compared to SMILE, ICL implantation showed better efficacy index (MD=0.09, 95%CI:0.01 to 0.16) and better safety index (MD=0.08, 95%CI: 0.00 to 0.16). Compared with SMILE, more ICL-treated eyes gained one or more Snellen lines of CDVA (RR=1.54, 95%CI:1.28 to 1.86), more gained two or more lines (RR=2.09, 95%CI:1.40 to 3.13), less lost one or more lines (RR=0.17, 95%CI:0.05 to 0.63). There was no difference in predictability between two treatments, RRs of predictability of within ±0.5D and ±1D were 1.13 (95%CI: 0.94 to 1.36) and 1.00 (95%CI: 0.98 to 1.02). Compared with SMILE, ICL implantation came with a higher risk of halos [RR=1.79, 95%CI: 1.48 to 2.16] and less increase in total HOAs (MD=-0.23, 95%CI: -0.42 to -0.03).

Conclusion

Compared with SMILE, ICL implantation showed a higher risk of halos, but equal performance on SER control, and better performance on efficacy index, safety index, CDVA improvement and HOAs control. Overall, ICL implantation might be a better choice for high myopia correction in adults.