bluuebunny/crossref_metadata_2025 huggingface dataset:
Harm Reduction for Adolescents and Young Adults During the COVID-19 Pandemic: A Case Study of Community Care in Reach
Authors: Noyes Elizabeth , Yeo Ellis , Yerton Megan , Plakas Isabel , Keyes Susan , Obando Aura , Gaeta Jessie M. , Taveras Elsie M. , Chatterjee Avik
Published: March 2021

The coronavirus disease 2019 (COVID-19) pandemic has challenged the ability of harm reduction programs to provide vital services to adolescents, young adults, and people who use drugs, thereby increasing the risk of overdose, infection, withdrawal, and other complications of drug use. To evaluate the effect of the COVID-19 pandemic on harm reduction services for adolescents and young adults in Boston, we conducted a quantitative assessment of the Community Care in Reach (CCIR) youth pilot program to determine gaps in services created by its closure during the peak of the pandemic (March 19–June 21, 2020). We also conducted semistructured interviews with staff members at 6 harm reduction programs in Boston from April 27 through May 4, 2020, to identify gaps in harm reduction services, changes in substance use practices and patterns of engagement with people who use drugs, and how harm reduction programs adapted to pandemic conditions. During the pandemic, harm reduction programs struggled to maintain staffing, supplies, infection control measures, and regular connection with their participants. During the 3-month suspension of CCIR mobile van services, CCIR missed an estimated 363 contacts, 169 units of naloxone distributed, and 402 syringes distributed. Based on our findings, we propose the following recommendations for sustaining harm reduction services during times of crisis: pursuing high-level policy changes to eliminate political barriers to care and fund harm reduction efforts; enabling and empowering harm reduction programs to innovatively and safely distribute vital resources and build community during a crisis; and providing comprehensive support to people to minimize drug-related harms.
Highly conductive poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate)/nylon 6 nanofiber web treated with repetitive coating cycles and dimethyl sulfoxide multi-step treatment for electronic textiles
Authors: Shin Sungeun , Lee Eugene , Cho Gilsoo
Published: March 2021

Highly conductive nylon 6 nanofiber web was fabricated with poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) and dimethyl sulfoxide (DMSO) for electronic textiles. To improve electrical conductivity, repeated coating with PEDOT:PSS and multi-step treatment of DMSO was performed. The effects of these treatments on electrical conductivity, surface properties, and chemical structures were investigated. For repetitive coating cycles, pristine PEDOT:PSS dispersion was dropped onto a nylon 6 nanofiber web for between one and four times of coating. For DMSO multi-step treatment, in the one-step treatment, the nanofiber web was repeatedly treated using PEDOT:PSS doped with DMSO. In the two-step treatment, the nanofiber web was repeatedly treated with doped PEDOT:PSS at first and, then, it was immersed in a DMSO bath. As a result, the sheet resistance decreased dramatically as the number of coating cycles increased. When the two-step treatment was applied, the sheet resistance was much lower compared to that of the one-step treatment, and thereby sample PD4-D with the lowest resistance showed 6.56 Ω/sq. As a result, the surface of the nanofiber web was covered with more PEDOT:PSS as the coating cycle was repeated. The PEDOT particles became large and long shapes after the two-step treatment of DMSO. This inferred that the contact area among conducting PEDOT particles increased because insulating PSS was removed by DMSO. In addition, the presence of PEDOT:PSS and nylon 6 was confirmed. This study proved that the simultaneous treatments of repeated coating with PEDOT:PSS and multi-step treatment of DMSO can improve electrical conductivity, and it developed the highly conductive PEDOT:PSS/nylon 6 nanofiber web.
The disputed letters of Paul and the ethics of the art trade
Authors: Laird Stephen
Published: March 2021

Opinions about the authenticity/inauthenticity of the disputed canonical letters of Paul are framed within some of the basic ethical codes associated with the upper echelons of the London art trade, where careful consideration is given to the descriptions of objects of uncertain origin and status when they are put on sale. Acting responsibly when conclusions are inconclusive; having regard for the importance of maintaining an honest reputation; and valuing the opinions of experts are as important for Bible teachers as they are for the trade.
From Kindness and Diversity to Justice and Action: White Parents’ Ethnic–Racial Socialization Goals
Authors: Gillen-O’Neel Cari , Huynh Virginia W. , Hazelbaker Taylor , Harrison Asya
Published: March 2021

Ethnic–racial socialization (ERS) is the collection of practices by which individuals learn about norms, values, and customs regarding ethnicity and race (Hughes et al., 2006). In contrast to research with families of color, few studies have examined ERS among White families (Umaña-Taylor & Hill, 2020). In this study, we used the Consensual Qualitative Research procedure (Hill et al., 2005) to analyze the ERS goals expressed by 35 White parents of White children during semi-structured interviews. We identified 11 domains (privilege awareness, take action, racism, value diversity, egalitarianism, children lead the way, informed, embracing the difficulty of being anti-racist, empathy, protection, and racial–ethnic identity) that generally map onto Hughes et al.’s (2006) existing ERS framework. Our results suggest that some White parents have ERS goals that move beyond kindness and diversity to delve into issues of equity and justice in order to support children in their own anti-racist journies.
Semi-quantitative scoring of imaging modalities in detecting soft tissue foreign bodies: an in vitro study
Authors: Alfuraih Abdulrahman M , Almutairi Faisal N , Alotaibi Sultan B , Alshmrani Abdullah A
Published: March 2021

Background

Accurate identification of foreign bodies (FB) using medical imaging is essential for diagnosis and determining the suitable retrieval technique.

Purpose

To compare the sensitivity of different imaging modalities for detecting various FB materials in soft tissue and assess the reproducibility of a scoring system for grading the conspicuity of FBs.

Material and Methods

Five FB materials (plastic, wood, glass, aluminum, and copper) were embedded in a tissue-mimicking phantom. Computed radiography (CR), ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) were compared using a semi-quantitative 5-point Likert scale scoring system. The intra- and inter-reader reproducibility of four independent readers was analyzed using Kendall’s coefficient of concordance (W).

Results

Glass was visible on all imaging modalities. Plastic was only visible in excellent detail using ultrasound. Wood was detected in excellent resolution using ultrasound and CT using the default window while plain X-ray failed to detect it. Ultrasound was the only modality that showed aluminum in excellent quality while CT showed it with good demarcation from the surroundings. Copper was detectable in excellent detail using CR, ultrasound, and CT. MRI performance was suboptimal, especially with the plastic FB. The scoring system showed excellent intra-reader (W = 0.91, P = 0.001) and inter-reader (W = 0.88, P < 0.001) reproducibility.

Conclusion

Ultrasound can be used as the first line of investigation for wood, plastic, glass, and metallic FBs impacted at superficial depths in soft tissue. The semi-quantitative FB scoring system showed excellent within- and between-reader reliability, which can be used to score and compare the detection performance of new imaging techniques.
COVID-19 and the Risk for Increased Intimate Partner Violence Among Gay, Bisexual and Other Men Who Have Sex With Men in the United States
Authors: Stephenson Rob , Chavanduka Tanaka M.D. , Rosso Matthew T. , Sullivan Stephen P. , Pitter Renée A. , Hunter Alexis S. , Rogers Erin
Published: March 2021

Stay at home orders–intended to reduce the spread of COVID-19 by limiting social contact–have forced people to remain in their homes. The additional stressors created by the need to stay home and socially isolate may act as triggers to intimate partner violence (IPV). In this article, we present data from a recent online cross-sectional survey with gay, bisexual and other men who have sex with men (GBMSM) in the United States to illustrate changes in IPV risks that have occurred during the U.S. COVID-19 epidemic. The Love and Sex in the Time of COVID-19 survey was conducted online from April to May 2020. GBMSM were recruited through paid banner advertisements featured on social networking platforms, recruiting a sample size of 696 GBMSM. Analysis considers changes in victimization and perpetration of IPV during the 3 months prior to the survey (March-May 2020) that represents the first 3 months of lockdown during the COVID-19 epidemic. During the period March-May 2020, 12.6% of participants reported experiencing any IPV with higher rates of emotional IPV (10.3%) than sexual (2.2%) or physical (1.8%) IPV. Of those who reported IPV victimization during lockdown, for almost half this was their first time experience: 5.3% reported the IPV they experienced happened for the first time during the past 3 months (0.8% physical, 2.13% sexual, and 3.3% emotional). Reporting of perpetration of IPV during lockdown was lower: only 6% reported perpetrating any IPV, with perpetration rates of 1.5% for physical, 0.5% for sexual, and 5.3% for emotional IPV. Of those who reported perpetration of IPV during lockdown, very small percentages reported that this was the first time they had perpetrated IPV: 0.9% for any IPV (0.2% physical, 0.2% sexual, and 0.6% emotional). The results illustrate an increased need for IPV resources for GBMSM during these times of increased stress and uncertainty, and the need to find models of resource and service delivery that can work inside of social distancing guidelines while protecting the confidentiality and safety of those who are experiencing IPV.
The Effects of Intensive Postrelease Correctional Supervision on Recidivism: A Natural Experiment
Authors: Duwe Grant , McNeeley Susan
Published: March 2021

In July 2018, the Minnesota Department of Corrections revised the criteria it uses to place soon-to-be-released prisoners on intensive supervision by shifting from mostly offense-based conditions to those based exclusively on risk. In doing so, this policy change provided a unique opportunity to evaluate not only the impact of intensive supervision on recidivism but also whether risk-based policies lead to better outcomes. Using Cox regression and negative binomial regression on a sample of 1,818 persons released in 2018, we found that intensive supervised release (ISR) significantly reduced the hazard for general, felony, and violent reoffending. We also found, however, that ISR significantly increased the risk of a technical violation revocation. The findings from our cost–benefit analysis showed that, despite the relatively high costs it incurred, ISR was a cost-effective intervention because it reduced reoffending for those with a higher risk of committing serious, violent crimes.
Towards robotizing the processes of testing lithium-ion batteries
Authors: Rastegarpanah Alireza , Ahmeid Mohamed , Marturi Naresh , Attidekou Pierrot S , Musbahu Muhammad , Ner Rohit , Lambert Simon , Stolkin Rustam
Published: March 2021

To boost the circular economy of the electric vehicle battery industry, an accurate assessment of the state of health of retired batteries is essential to assign them an appropriate value in the post automotive market and material degradation before recycling. In practice, the advanced battery testing techniques are usually limited to laboratory benches at the battery cell level and hardly used in the industrial environment at the battery module or pack level. This necessitates developing battery recycling facilities that can handle the assessment and testing undertakings for many batteries with different form factors. Towards this goal, for the first time, this article proposes proof of concept to automate the process of collecting the impedance data from a retired 24kWh Nissan LEAF battery module. The procedure entails the development of robot end-of-arm tooling that was connected to a Potentiostat. In this study, the robot was guided towards a fixed battery module using visual servoing technique, and then impedance control system was applied to create compliance between the end-of-arm tooling and the battery terminals. Moreover, an alarm system was designed and mounted on the robot’s wrist to check the connectivity between a Potentiostat and the battery terminals. Subsequently, the electrochemical impedance spectroscopy test was run over a wide range of frequencies at a 5% state of charge. The electrochemical impedance spectroscopy data obtained from the automated test is validated by means of the three criteria (linearity, causality and stability) and compared with manually collected measurements under the same conditions. Results suggested the proposed automated configuration can accurately accomplish the electrochemical impedance spectroscopy test at the battery module level with no human intervention, which ensures safety and allows this advanced testing technique to be adopted in grading retired battery modules.
Enablers of Lean for Manufacturing Excellence: An Interpretive Structural Modelling and Analysis
Authors: Ojha Ravindra
Published: March 2021

In the current competitive business world, the importance of lean systems has significantly improved. The purpose of the research paper is to identify key enablers of lean and understand their relationship dynamics using the interpretive structural modelling (ISM) approach with a goal to accelerate the pace of manufacturing excellence in industries. Literature review and focused interaction with domain experts facilitated in identifying 24 significant enablers. The analysis from the ISM has highlighted the strong need to focus on two clusters of four enablers each in the driving and dependent enablers quadrants in manufacturing. People-excellence-related cluster had leadership standard work, quality of people, functional expertise and lean training as the key driving enablers. While, the customer-driven cluster had supermarket pull system, demand management, process quality and value flow as the key dependent enablers. The research paper has provided useful insights and recommendations to industry leaders for accelerating their manufacturing excellence journey.
Customer Incivility and Service Recovery Performance: Job Crafting as a Buffer
Authors: Zahoor Adil , Siddiqi Mushtaq Ahmad
Published: March 2021

This study explores the impact of customer incivility (CI) on service recovery performance (SRP) of Indian frontline banking employees with emotional exhaustion (EE) as a mediator. Whether job crafting behaviour of the employees would assuage the effect of uncivil customer interactions and, thereby, help in maintaining superior recovery performance is further investigated. Data from 428 dyads of employees were gathered to test the hypothesized relationships using structural equation modelling in AMOS 23. The results indicated that CI negatively influences SRP, and EE significantly mediates this relationship. Increasing social and structural resources significantly alleviate the negative effect of (a) CI on EE, (b) CI on SRP and (c) EE on SRP. On the other hand, increasing challenge job demands and decreasing hindrance job demands do not moderate the relationship between (a) CI and EE and (b) CI and SRP. However, decreasing hindrance job demands significantly moderate the negative effect of EE on SRP while, surprisingly, increasing challenge job demands strengthens the relationship between EE and SRP.
Use of a VBX balloon expandable stent-graft for management of right brachiocephalic vein stenosis
Authors: Jones Robert G , Willis Andrew P
Published: March 2021

Here we describe the use of a VBX balloon expandable stent-graft (WL Gore, Flagstaff, AZ, USA) to treat a right brachiocephalic vein stenosis in a haemodialysis patient prior to ipsilateral upper limb arterio-venous (AV) fistula formation. Balloon expandable stent-grafts are unsuitable for treating peripheral fistula stenoses due to their susceptibility of being crushed. The right brachiocephalic vein is both relatively short in comparison to the left and is less susceptible to extrinsic compression and the use of such a device to treat stenosis here allows for very accurate placement and restoration of luminal diameter. The advantages and disadvantages of using these devices in haemodialysis access circuits are also discussed herein, in what we believe to be the first report of the application of a dedicated commercially available balloon expandable stent graft in a haemodialysis patient.
Psychological factors as the risk factor of mouth ulcers: A two-sample Mendelian randomization study
Authors: Shi Yueqi , Wang Shaoyi , Yu Shunying , Lin Guan Ning , Song Weichen
Published: March 2021

To examine whether psychological traits (PT) had causal effects on Mouth Ulcers (MU), we applied two-sample Mendelian randomization (MR) to genetics association summary statistics of eleven PT and MU. After the adjustment of outlier variants, genetic correlations and multiple testing, well-being (WB) spectrum PT like life satisfactory (odds ratio [OR] = 0.638 per one standard deviation increment of PT score) had protective effects on MU. Reverse WB traits like neuroticism (OR = 1.60) increased the risk of MU. The lack of well-being characteristics may increase the risk of MU, which highlighted the value of preventive oral care for people who have a reverse mental condition.
Islamic heritage versus orthodoxy: Figural painting, musical instruments and wine bowls at the Dutch National Museum of World Cultures
Authors: Tamimi Arab Pooyan
Published: March 2021

Shahab Ahmed’s What Is Islam? The Importance of Being Islamic (2016) challenges anthropologists, Islamic Studies scholars, art historians and museum practitioners to question the theological assumptions underlying conceptions of Islamic art and material culture. This article analyses three object types key to Ahmed’s analysis – Islamic figural painting, musical instruments and wine bowls – from the vantage point of the collection of the Dutch National Museum of World Cultures. Based on the author’s experience as Assistant Curator for West Asia and North Africa in 2015–2016 and on exhibition developments up until 2019, Ahmed’s framework is demonstrated as a guide for critical interpretations of exhibitions of Islamic art and material culture. This perspective lays bare a tension that contemporary museums struggle with in response to nationalist pressures to integrate Muslim citizens in Western Europe: between a diverse Islamic heritage, on the one hand, and orthodox desires to materially purify the very idea of Islam, on the other.
Closed Reduction and Percutaneous Pinning for Treatment of Proximal Interphalangeal Joint Pilon Fractures
Authors: Mazhar Farid Najd , Motaghi Paniz
Published: March 2021

Background:

Proximal interphalangeal (PIP) joint pilon fractures are among the challenging hand injuries, which are often associated with a wide range of complications. This study aimed to report the clinical and radiological outcomes of closed reduction and percutaneous Kirschner wire (KW) insertion with or without bone cement application (for the fabrication of an external fixator) in the treatment of PIP joint pilon fractures.

Methods:

Twenty pilon fractures underwent closed reduction and percutaneous KW fixation through a modified technique. At the end of the follow-up period, 3 questionnaires—Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH), Visual Analogue Scale for pain, and Patient-Rated Wrist Evaluation—were completed. The radiological outcome was assessed by radiography. Range of motion, and grip and pinch strength were measured.

Results:

The mean follow-up period was 14.57 ± 4.03 months (range, 12-20 months). The mean range of motion of PIP at the end of the follow-up period was 89.64° ± 10.82° (range, 65°-100°). The mean difference in the range of motion in the contralateral side was 21.4° ± 13°. The mean of the Quick DASH score was 13.50 ± 2.92 (range, 11-21). Two patients had residual articular malalignment, and 3 patients had angular or rotational malunion.

Conclusion:

By treating pilon fractures with the proposed technique, we achieved a satisfactory outcome. The acceptable articular and axial alignment was achieved in 75% of patients, and complications were low. The flexibility of percutaneous KW insertion and handmade external fixators makes these approaches convenient for treating PIP joint pilon fractures.
Fitzpatrick and the Feminine Law
Authors: Ramshaw Sara
Published: March 2021

This short commentary on the legacy and significance of Peter Fitzpatrick’s scholarship tells of the divergent approaches he and I take in relation to the “feminine” in the writings of French poet, playwright, fictional author, and theorist, Hélène Cixous. Peter, on his side, is ever reminding us of the constituent connection between law and its origin and the impossibility of the “feminine law” escaping a scheme fixated on a specific patriarchal content. I, on my side, am optimistically yearning for a Cixousian “feminine” who eludes a return to the origin and who fearlessly transgresses the law(s) of the patriarchal. Herein, I theorize the essential difference between Fitzpatrick’s “feminine law” and my reading of the law of the Cixousian “feminine” as relating back to our (differing?) approaches to creativity and originality. To my mind, on the question of law’s creativity, Peter aligns less with Cixous and more with Jacques Derrida, who many have accused of positing a negative conception of creation. Applied to Peter, while ever endeavoring to situate law in relation to creative undertakings, such as literature and poetry, following his determinate/responsiveness model, the persistence of the negative is inescapable and the “feminine” is always already integral to law.
Vision for menopause care in the UK
Authors: Currie Heather , Abernethy Kathy , Hamoda Haitham
Published: March 2021

Menopause is a major life event affecting all women in a variety of ways, both short and long term. All women should have access to accurate information, available in all forms and through all recognised sources. All healthcare professionals should have a basic understanding of the menopause and know where to signpost women for advice, support and treatment whenever appropriate. Every primary care team should have at least one nominated healthcare professional with a special interest and knowledge in menopause. All healthcare professionals with a special interest in menopause should have access to British Menopause Society Menopause Specialists for advice, support, onward referral and leadership of multidisciplinary education. With the introduction of the comprehensive British Menopause Society Principles and Practice of Menopause Care programme, the society is recognised throughout the UK as the leading provider of certificated menopause and post reproductive health education and training for healthcare professionals. Restrictions imposed by the coronavirus pandemic have been a springboard for the British Menopause Society to bring innovations to the services provided for our membership and for healthcare professionals throughout the UK.
Gendering Products Through Advertisements: A Review (1973–2019) of Various Cues Employed by Advertisers
Authors: Sandhu Namrata
Published: March 2021

Throughout history, people have used consumption props to adorn their gender. The products that individuals own and use are noticeable markers of their gender identity. This explains the sustained interest of advertisers in gender-typing products. Advertisers’ gender work is instrumental in establishing a gender order among products. By virtue of the gender meanings assigned by advertisers, products occupy spaces on the gender map. Advertisers employ various cues to operationalize the gender direction of the advertised products. A review of over four decades of research (1973–2019) on gender and advertising reveals that there are at least 22 different ways in which advertisers achieve gender polarization of products. This explanatory synthesis convenes these cues in the context of television and multimedia web-based and print advertisements. The methodology used also allows for classification of these cues. This review has definite theoretical and practical implications that justify the need for this research. The final output of this article displays the research landscape of the present topic and contributes to the existing advertising literature by offering a repository of objective tools used to shape the gender content of advertisements. It is the author’s belief that this article will help researchers conceptualize different product gendering techniques employed by advertisers and encourage further research in this area. From a practical perspective, advertisers looking to activate the gender schema in advertisements with a view to selectively target a particular gender may benefit from the results of this study.
Disease prevalence and number of health care visits among members of a nationwide sports organization compared to matched controls
Authors: Lindblom Hanna , Lowén Mats , Faresjö Tomas , Hedman Kristofer , Sandström Per
Published: March 2021

Background

Physical activity has positive effects on several diseases and may reduce the risk of morbidity and the mortality rate. Whether the prevalence of disease and health care consumption differ between the members of sports organizations and the general population has not been established. Hence, this pilot study aimed to compare the prevalence of diseases known to be associated with physical inactivity and health care consumption in members of a large non-profit sports organization and an age-, sex- and geographically matched random sample from the general population.

Methods

Subjects in two Swedish cities who exercised at least once a week and had been members for at least two years in the non-profit sports organization Friskis&Svettis were invited. A randomized age-, sex- and geographically matched sample was drawn from the general population. Data on disease prevalence (by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes) and health care consumption were retrieved using the members’ personal identification numbers through a regional health care database. Between-group differences in the prevalence of disease were compared using chi2-tests and logistic regression between members and controls. Health care consumption was defined as the number of visits, stratified by primary and hospital care, and was compared using chi2-tests and Mann-Whitney U-tests.

Results

In total, 3015 subjects were included in each group (response rate 11%). Controls had higher prevalence rates of musculoskeletal diseases (13.3% vs. 11.6%, p = 0.047), metabolic disease (10.4% vs. 5.4%, p < 0.001), hypertension (16.6% vs. 11.7%, p < 0.001), psychiatric diseases (8.9% vs. 7.1%, p = 0.012) and lung cancer (0.4% vs. 0%, p = 0.001) than the members. The total number of health care contacts was 22% higher in the controls than in the members, whereas the proportion of subjects with at least one health care visit was larger in the members (89% vs. 79%, p < 0.001).

Conclusions

The prevalence rates of lifestyle diseases related to musculoskeletal, metabolic and psychiatric diseases, hypertension and lung cancer, and the overall health care consumption, were lower among members of a sports organization than among controls. However, longitudinal studies are needed to establish a cause-effect relationship between membership and disease development.
Socioeconomic determinants of unmet need for outpatient healthcare services in Iran: a national cross-sectional study
Authors: Vahedi Sajad , Torabipour Amin , Takian Amirhossein , Mohammadpur Saeed , Olyaeemanesh Alireza , Kiani Mohammad Mehdi , Mohamadi Efat
Published: March 2021

Background

Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran.

Methods

We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons.

Results

About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN.

Conclusion

It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.
Knowledge and attitudes of U.S. medical students regarding the care of Asian American patients: a cross-sectional survey study
Authors: Pang Sharon , Vongsachang Hursuong , Le Thomas K. , Zhang George Q. , Li Taibo , Lee Jason T. C. , Lawson Shari M.
Published: March 2021

Background

Asian Americans (AsAm) are a rapidly growing population in the U.S. With this growing population, U.S. healthcare providers must be equipped to provide culturally competent care for AsAm patients. This project surveyed U.S. medical students on their knowledge of and attitudes towards AsAm to assess predictors of readiness to care for AsAm patients.

Method

This cross-sectional study surveyed medical students who had completed at least one clinical rotation. The survey was distributed online to nine medical schools throughout the U.S. The survey measured self-rated knowledge of, comfort with, cultural competency (CC) towards, and explicit biases towards AsAm patients. The first three domains were analyzed in a multivariate regression model including sociodemographic characteristics and past clinical, curricular, and social experiences with AsAm. Explicit bias questions were reported descriptively.

Results

There were 688 respondents. Asian race, AsAm-prevalent hometown, AsAm-related extracurricular activities, Asian language knowledge, and having taken a population health course predicted increased AsAm knowledge. Social interactions with AsAm increased comfort with AsAm patients. Increasing year in medical school, more frequent exposure to AsAm patients on rotations, and prior travel to an Asian country were predictors of increased CC toward AsAm. Importantly, having completed a CC course was a significant predictor in all domains. In terms of explicit bias, students felt that AsAm patients were more compliant than Caucasian patients. Students also believed that Caucasian patients were generally more likely to receive self-perceived “preferred” versus “acceptable” care, but that in their own clinical experiences neither group received preferred care.

Conclusion

Experience with and exposure to AsAm prior to and during medical school and CC courses may increase medical student knowledge, comfort, and CC with AsAm patients. Standardized and longitudinal CC training, increased simulations with AsAm patients, diverse student recruitment, and support for students to engage in AsAm-related activities and interact with AsAm may improve CC of future physicians towards AsAm patients and possibly other minority populations.
Human neural stem cell-derived extracellular vesicles mitigate hallmarks of Alzheimer’s disease
Authors: Apodaca Lauren A. , Baddour Al Anoud D. , Garcia Camilo , Alikhani Leila , Giedzinski Erich , Ru Ning , Agrawal Anshu , Acharya Munjal M. , Baulch Janet E.
Published: March 2021

Background

Regenerative therapies to mitigate Alzheimer’s disease (AD) neuropathology have shown very limited success. In the recent era, extracellular vesicles (EVs) derived from multipotent and pluripotent stem cells have shown considerable promise for the treatment of dementia and many neurodegenerative conditions.

Methods

Using the 5xFAD accelerated transgenic mouse model of AD, we now show the regenerative potential of human neural stem cell (hNSC)-derived EVs on the neurocognitive and neuropathologic hallmarks in the AD brain. Two- or 6-month-old 5xFAD mice received single or two intra-venous (retro-orbital vein, RO) injections of hNSC-derived EVs, respectively.

Results

RO treatment using hNSC-derived EVs restored fear extinction memory consolidation and reduced anxiety-related behaviors 4–6 weeks post-injection. EV treatment also significantly reduced dense core amyloid-beta plaque accumulation and microglial activation in both age groups. These results correlated with partial restoration of homeostatic levels of circulating pro-inflammatory cytokines in the AD mice. Importantly, EV treatment protected against synaptic loss in the AD brain that paralleled improved cognition. MiRNA analysis of the EV cargo revealed promising candidates targeting neuroinflammation and synaptic function.

Conclusions

Collectively, these data demonstrate the neuroprotective effects of systemic administration of stem cell-derived EVs for remediation of behavioral and molecular AD neuropathologies.
Using light-level geolocations to monitor incubation behaviour of a cavity-nesting bird Apus apus pekinensis
Authors: Huang Xiao , Zhao Yanyan , Liu Yang
Published: March 2021

The Beijing Swift (Apus apus pekinensis) is a typical cavity-nesting bird that often nests inside holes and crevices in old architectures. Direct observation of their breeding behaviour is challenging and their breeding ecology is thus poorly studied. In this study, we analysed light-level geolocation data collected from six Beijing Swifts for the first time. Our results showed that geolocators can make comprehensive inference of their incubation period and behaviour. As a cost-effective and non-invasive method, geolocators can not only facilitate discovering migration routes, but also can be widely applied in the study of avian reproductive behaviour, especially in cavity-nesting bird species. We further discussed the characteristics and merits of this method and compared with other conventional nest-monitoring methods in recording birds.
Cosmetic outcome of femtosecond laser-assisted pterygium surgery
Authors: Ting Darren Shu Jeng , Liu Yu-Chi , Lee Yi Fang , Ji Angel Jung Se , Tan Tien-En , Htoon Hla M. , Mehta Jodhbir S.
Published: March 2021

Background

To examine the cosmetic outcome of femtosecond laser-assisted pterygium surgery (FLAPS) with conjunctival autograft (CAG) and its potential predictive factors.

Methods

This was a prospective interventional case series (NCT02866968). We included 29 patients (29 eyes) with primary pterygium who underwent FLAPS. Cosmetic outcome was graded by two graders (an ophthalmology resident and an experienced ophthalmologist) using Hirst classification system (1–4 = excellent–poor). Weighted Cohen’s kappa analysis was performed to examine the intra- and inter-rater reliability. The relationship between cosmetic outcome and various factors were determined by Spearman’s correlation coefficients (r).

Results

The preoperative severity of pterygium (Tan grading system) was mild/atrophic (7%), moderate/intermediate (62%), and severe/fleshy (31%). An ultrathin CAG (mean thickness of 74.5 ± 9.8 μm) was fashioned intraoperatively. An excellent cosmetic outcome of FLAPS (median ± IQR) was observed at 3 months (1.0 ± 1.0) and remained similar at 6 months (1.0 ± 0.0) and 12 months (1.0 ± 0.0) postoperatively. At final follow-up, 27 (93%) patients achieved good-to-excellent cosmetic outcome, with 1 (3%) patient having a poor outcome due to incomplete pterygium removal. Weighted kappa analysis of Hirst grading system showed excellent intra-rater (κ = 0.86–0.95) and inter-rater reliability (κ = 0.84–0.88). There was a weak and borderline significant correlation between good cosmetic outcome and reduced postoperative CAG thickness (r = 0.38, P = 0.06) but not with age, gender, preoperative pterygium severity, or intraoperative CAG thickness.

Conclusions

FLAPS can result in an excellent cosmetic outcome, which may be attributed to the beneficial effect of an ultrathin CAG.

Trial registration

ClinicalTrials.gov, NCT02866968. Registered in July 2016,
Study on clinical application of susceptibility weighted imaging ombined with diffusion weighted imaging in patients with Liver Cirrhosis complicated with small Hepatocellular Carcinoma
Authors: Hou Zhi-bo , Zhao Fei , Zhang Bin , Zhang Chun-zhu
Published: March 2021

Objectives: To evaluate the clinical value of susceptibility weighted imaging (SWI) combined with diffusion weighted imaging (DWI) in patients with liver cirrhosis complicated with small hepatocellular carcinoma (SHCC).

Methods: A total of 40 patients with liver cirrhosis and 44 nodules were treated with conventional nuclear magnetic scanning (T1WI, T2WI) and SWI combined with DWI; the results were judged by two senior physicians; the t test, χ2 test, rank sum test, and other methods were used for contrastive analysis of the pathological results of different scanning methods after operation or puncture.

Results: Contrast analysis of the different MRI scanning methods and pathological results showed that among the 32 nodules of small hepatocellular carcinoma, 24 cases were diagnosed by conventional MRI, with the coincidence rate being 75%, 30 cases were diagnosed by SWI DWI, with the coincidence rate being 96%; significant difference was found between the two groups (p=0. 04). Significant differences were found in the specificity, sensitivity and accuracy of different scanning methods in the diagnosis of small hepatocellular carcinoma (specificity, accuracy, p=0.04; sensitivity p=0.01). The SWI of small hepatocellular carcinoma nodules showed hyperintensity, and the degree of iron deposition was low. Significant difference was found between small hepatocellular carcinoma nodules and other nodules (comparison of SWI signal degree, p=0.01; comparison of iron deposition degree, p=0.00).

Conclusion: The SWI of small hepatocellular carcinoma nodules showed hyperintensity, and the degree of iron deposition was low. The coincidence rate of SWI+DWI scanning is higher than that of conventional scanning methods in the diagnosis of small hepatocellular carcinoma, and the difference in specificity, sensitivity and accuracy has obvious advantages. SWI+DWI scanning can improve the detection rate of liver cirrhosis complicated with small hepatocellular carcinoma.

doi: https://doi.org/10.12669/pjms.37.3.3822

How to cite this:Hou ZB, Zhao F, Zhang B, Zhang CZ. Study on clinical application of susceptibility weighted imaging combined with diffusion weighted imaging in patients with Liver Cirrhosis complicated with small Hepatocellular Carcinoma. Pak J Med Sci. 2021;37(3):800-804. doi: https://doi.org/10.12669/pjms.37.3.3822

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Evaluation of the clinical efficacy of 3D Printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in the treatment of Senile Intertrochanteric Fractures
Authors: Zhao Ye , Liu Yong-hui , Mao Shu-ge , Zhang Xin-xin
Published: March 2021

Objectives: To observe the clinical value of 3D printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in elderly patients with intertrochanteric fractures.

Methods: Sixty elderly patients with intertrochanteric fractures of the femur who were treated in our hospital from January 2018 to January 2020 were selected and randomly divided into two groups. In the experimental group, 3D printing technology assisted surgery combined with early postoperative comprehensive rehabilitation was used for treatment. While in the control group, traditional open reduction and dynamic hip screw internal fixation combined with postoperative conventional treatment was utilized. The duration of surgery, intraoperative blood loss, postoperative hospital stay, weight bearing time, fracture healing time and other surgical indicators were recorded respectively, and hip joint function recovery was evaluated prior to and 2 weeks after surgery. All patients were followed up for six months to observe the occurrence of complications within half a year, including deep vein thrombosis, incision infection, avascular necrosis of femoral head, hip joint stiffness, delayed fracture healing, etc. Subsequently, the differences in postoperative complications between the two groups were compared and analyzed.

Results: The operation time, blood loss, postoperative hospital stay, weight bearing time and fracture healing time of the experimental group were better than those of the control group, and the difference was statistically significant (p<0.05). After treatment, the hip joint function of the experimental group was significantly improved compared with the control group, with a statistically significant difference(p=0.03). The incidence of operative complications in the experimental group was 10% (3/30) within six months postoperatively, significantly lower than the 33% (10/30) in the control group, with statistical significance (p=0.03).

Conclusion: 3D printing with early rehab proved to be effective treatment in our study. Such a combined treatment has the advantages of precise operative reduction, fast postoperative recovery, and certain safety and effectiveness.

doi: https://doi.org/10.12669/pjms.37.3.3988

How to cite this:Zhao Y, Liu YH, Mao SG, Zhang XX. Evaluation of the clinical efficacy of 3D Printing technology assisted surgery combined with early postoperative comprehensive rehabilitation in the treatment of Senile Intertrochanteric Fractures. Pak J Med Sci. 2021;37(3):740-745. doi: https://doi.org/10.12669/pjms.37.3.3988

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Plume control in medical and cosmetic laser clinics: a practical guide
Authors: Town Godfrey , Murphy Mike
Published: March 2021

In this article, Godfrey Town and Mike Murphy review risk assessments that aim to control the dangers of plume and make recommendations that laser specialists can use to make their practice safe and secure
Nanometric SiC influence on tribological properties of phenolic composite materials
Authors: PELIN George
Published: March 2021

This paper presents an experimental study of the influence of nano metric silicon carbide in the composition of phenolic composites on the coefficient of friction. The paper is divided into three distinct parts investigating from a tribological point of view three different types of composite materials based on phenolic resin with three concentrations of nSiC (0.5; 1 and 2% by mass). In the first part, a comparative study of the behavior of phenolic resin was performed, representing the basis for the development of composite materials. In the second part, a study was performed on laminated materials reinforced with two-dimensional fabrics (glass fiber and carbon fiber, respectively). The last part studied two types of ablative phenolic materials based on micronic cork, on one hand, and on carbon felt on the other hand.
Mean corrective maintenance time for a medium courier turboprop aircraft
Authors: VOICU Marius-Alexandru , FUIOREA Ion
Published: March 2021

Logistics can be seen as the compound of all the considerations needed to ensure the efficient and economical support of a system throughout its life cycle. The unscheduled actions, performed as a result of a failure or a perceived failure, that are necessary to restore a system to its required level of performance is corrective maintenance. Such activities may include troubleshooting, disassembly to gain access to the faulty item, repair, remove and replace, reassembly, alignment and adjustment and checkout. The frequency of maintenance for a given item is highly dependent on the reliability of that item. In general, as the reliability of a system increases, the frequency of maintenance will decrease and, conversely, the frequency of maintenance will increase as system reliability is degraded.
Offenheit in der IT: Herausforderung und Chance zu Veränderungen
Authors: Knoll Matthias
Published: March 2021

Wer offene Lösungen einsetzen möchte, sieht sich einer Reihe von Fragen und Herausforderungen gegenüber. Nicht nur technische Aspekte, sondern vor allem zwischenmenschliche Faktoren und passende Regelungen sind dabei zu berücksichtigen. Das richtige „Mindset“ spielt eine zentrale Rolle. Mit ihm einher geht eine lebendige Umsetzung des Community-Gedankens. Er ermöglicht, die Idee der Offenheit über Open Source und Open Hardware hinaus auch auf Fragen des Identity Managements, der Entwicklung von Innovationen oder die Nutzung von Open Data auszudehnen. Hierzu bedarf es neben technischem Verständnis vor allem auch Akzeptanzkriterien und einem Bewusstsein für Risiken. Der Beitrag verfolgt daher das Ziel, einen Überblick über die Themen und Fragestellungen zu geben und eine Empfehlung für den Umgang mit Offenheit in der IT zu formulieren.