bluuebunny/crossref_metadata_2025 huggingface dataset:
Your phone ruins our lunch: Attitudes, norms, and valuing the interaction predict phone use and phubbing in dyadic social interactions
Authors: Büttner Christiane M. , Gloster Andrew T. , Greifeneder Rainer
Published: December 2021

Phubbing—ignoring another person in order to use a smartphone instead—is an increasingly common behavior that disrupts interactions and harms relationships. Using the frameworks of the theory of planned behavior and an interaction value approach, we examined the driving factors of phubbing frequency. Four preregistered predictors were tested: attitudes toward phubbing, subjective norms of phubbing, interaction value, that is, the extent of valuing a social interaction, and the perceived interaction value of the partner. After having had lunch together, a total of 128 participants in 64 dyads filled out a survey assessing the four predictors. Dyadic linear mixed model analyses confirmed that a more positive attitude toward phubbing increases phubbing, as well as being phubbed. Moreover, we disentangled screen-sharing time (i.e., using a phone together), phone use, co-present phone use (i.e., using a phone alone), and phubbing: we found that valuing the social interaction more decreased phone use, but not phubbing, and holding more accepting subjective norms on phubbing increased co-present phone use, but not phone use in general. We further found that the person that used their phone first, phubbed more. Overall, this research extends our understanding of the factors driving phubbing and may be fruitfully harnessed to reduce phubbing.
Incidence and distribution of pulp stones among Southern Saudi Arabian sub-population
Authors: Alaajam Wafa H , Saleh Ahmed A , Alghamdi Nuha S , Ain Tasneem Sakinatul , Algarni Youssef A , Abubaker Muna
Published: December 2021

Purpose:

To assess the incidence of pulp stones in molar and premolar teeth of Southern Saudi Arabian adult sub-population.

Materials and Methods:

Six hundred patient files were randomly selected from the database (records) of the College of Dentistry outpatient department screened by Oral Medicine and Radiology division. Orthopantomogram and bitewing radiographs using radiovisiographs of first and second maxillary and mandibular molars and premolars were interpreted by three examiners. Pulp stones were identified as definite radiopaque masses and scored as present or absent. Data were subjected to statistical analysis using SPSS version 19.

Results:

Out of total 600 patients, pulp stones were found in 88 (14.7%) patients. Females showed statistically significant higher presence of pulp stones in mandibular molars than males. The patients belonging to middle age group (31–40 years) showed statistically significant higher presence of pulp stones than the other two groups in all first and second molar teeth in both arches. The presence of pulp stones was observed to be higher in maxillary arch than mandibular arch with left side having more frequency than the right side of the arch.

Conclusion:

The prevalence of pulp stones in the study population was found to be 14.7%, and it was higher in molars than premolars. It is quite significant to know the frequency distribution of pulp stones especially for an endodontist or a dentist to plan the root canal treatment of such teeth accordingly.
Prevalence and associated factors of depression among diabetic outpatients attending diabetic clinic at public hospitals in Eastern Ethiopia: A cross-sectional study
Authors: Ebrahim Mohamed , Tamiru Dawit , Hawulte Behailu , Misgana Tadesse
Published: December 2021

Introduction:

Depression is one of the most common comorbid psychiatric disorders among diabetic patients. Depression among diabetic people has led to poor treatment adherence, defective treatment outcomes, and consequently worsened quality of life. However, there is a limited study conducted to assess the magnitude and factors associated with depression among diabetic patients in Ethiopia including this study area.

Objective:

This study aimed to assess the prevalence and factors associated with depression among adult diabetic outpatients attending diabetic clinic in Eastern Ethiopia.

Methods:

An institution-based cross-sectional study was conducted among 407 adult diabetic outpatients on treatment in Ethiopia in 2020. Patient Health Questionnaire-9 was used to assess depression among randomly selected samples. Bivariate and multivariate logistic regression was fitted to identify factors associated with depression among diabetic outpatients. A p value less than 0.05 with a 95% confidence interval was considered statistically significant.

Results:

The overall prevalence of depression among diabetic outpatients was found to be 48.9% (95% confidence interval: 44.2%, 53.4%). Being female (adjusted odds ratio = 1.50, 95% confidence interval: 1.39, 2.73), Khat chewing (adjusted odds ratio = 1.88, 95% confidence interval: 1.22, 2.93), having poor and moderate social support (adjusted odds ratio = 1.79, 95% confidence interval: 1.07, 2.98 and adjusted odds ratio = 1.90, 95% confidence interval: 1.14, 3.17, respectively), taking both oral hypoglycemic agents and insulin medication (adjusted odds ratio = 1.33, 95% confidence interval: 1.13, 2.80) and duration of diabetes mellitus for more than 6 years (adjusted odds ratio = 5.40, 95% confidence interval: 3.42, 8.14) were significantly associated with depression.

Conclusion:

This study revealed a relatively high prevalence of depression in diabetic outpatients. A lesser level of social support, taking oral and insulin treatment regimes, longer duration of illness, using Khat, and being female were associated with depression among diabetic outpatients. Therefore, early screening and identification of such factors could help ameliorate some of the deleterious effects of depression in diabetic outpatients.
A case of Kaposi’s sarcoma of tonsil with profuse bleeding in an HIV-positive patient
Authors: Penjor Dorji , Chong Aun Wee
Published: December 2021

Kaposi’s sarcoma is the most common AIDS-associated malignancy. Kaposi’s sarcoma in the oral cavity and oropharynx present as a macular, papular, or nodular lesion on the palate, gingiva, or tongue which may look pink, reddish, or purplish. Kaposi’s sarcoma of the tonsils is relatively less common compared with other sites in the oral cavity and oropharynx. We report a case of Kaposi’s sarcoma of tonsil with profuse bleeding requiring emergency tracheostomy to protect the airway followed by tonsillectomy to control the bleeding. Our initial diagnosis was hemangioma or a pyogenic granuloma. The patient tested positive for a retroviral infection and the histopathology report was compatible with Kaposi’s sarcoma. Antiretroviral therapy and radiotherapy were given after stabilizing the patient. Kaposi’s sarcoma of tonsils is relatively uncommon and it is unusual to cause profuse bleeding. Various treatment options are available but there are no standard treatment protocols. Treatments options depend on the site, size, stage, and immune status of the patient.
Unexpected tendency to bleeding in COVID-19 patients: A case of spontaneous retroperitoneal hematoma
Authors: Tanal Mert , Celayir Mustafa Fevzi , Kale Zulfiye Sumeyye
Published: December 2021

While COVID-19 pandemic has become an enormous and devastating pandemic for today’s world, studies on the morbidity of the disease mainly show the disease’s progress with pneumonia and thromboembolic pathologies. In this disease with a predisposition to thromboembolism, findings of nontraumatic focused hemorrhages are unexpected. As spontaneous retroperitoneal hematoma is a serious condition with the absence of symptoms, creating a challenge for diagnosis, it should also be considered in COVID-19 which is thought to be predisposed to thromboembolism. Here, a 47-year-old woman with COVID-19 pneumonia diagnosis (diagnosed by computed tomography (CT) scan and approved by nasopharyngeal swab test) is presented with spontaneous retroperitoneal hematoma, and its management is reported. This case highlights the importance of considering both thromboembolic events and bleeding in cases with COVID-19 positivity. The balance between two sides of clotting mechanisms needs to be understood with novel research.
Digital/computational phenotyping: What are the differences in the science and the ethics?
Authors: Lucivero Federica , Hallowell Nina
Published: December 2021

The concept of ‘digital phenotyping’ was originally developed by researchers in the mental health field, but it has travelled to other disciplines and areas. This commentary draws upon our experiences of working in two scientific projects that are based at the University of Oxford’s Big Data Institute – The RADAR-AD project and The Minerva Initiative – which are developing algorithmic phenotyping technologies. We describe and analyse the concepts of digital biomarkers and computational phenotyping that underlie these projects, explain how they are linked to other research in digital phenotyping and compare and contrast some of their epistemological and ethical implications. In particular, we argue that the phenotyping paradigm in both projects is grounded on an assumption of ‘objectivity’ that is articulated in different ways depending on the role that is given to the computational/digital tools. Using the concept of ‘affordance’, we show how specific functionalities relate to potential uses and social implications of these technologies and argue that it is important to distinguish among them as the concept of digital phenotyping is increasingly being used with a variety of meanings.
Hyponatremia in Coronavirus Disease-19 Patients: A Retrospective Analysis
Authors: Machiraju Phani Krishna , Alex Neetu Mariam , Safinaaz  , Vadamalai Vivek
Published: December 2021

Background:

Hyponatremia (serum Na+ < 135 mmol/L) is the most common electrolyte abnormality detected in clinical practice and an important cause of mortality and morbidity in hospital settings. Hyponatremia in patients with pneumonia is usually mild but is associated with increased risk of intensive care unit (ICU) admission, prolonged hospital stays, and increased mortality rates. The purpose of this study is to understand the impact of varying degrees of hyponatremia and various other inflammatory markers on the severity and outcome of coronavirus disease-19 (COVID-19).

Objective:

The main objective of this study is to evaluate the prevalence of hyponatremia in COVID-19 patients and to assess the correlation between hyponatremia and severity and outcome of COVID-19. The other objective is to evaluate the correlation between various inflammatory markers and outcome (ICU vs non-ICU admission, discharged vs deceased) in patients with COVID-19 pneumonia.

Methods:

A total of 113 participants who have been diagnosed with COVID-19 infection by reverse transcriptase-polymerase chain reaction test were included in the study. Epidemiological, demographic, clinical, investigative work-up, and outcome data were extracted from electronic health records using a standard data collection form. Based on serum sodium levels, patients were divided into two groups: normonatremic (serum Na+ ≥ 135 mEq/L) and hyponatremic (serum Na+ < 135 mEq/L). Various clinical, laboratory, and outcome parameters were compared between the two groups.

Results:

Hyponatremia was present in 50 out of 113 (44%) patients in our study, and it was generally mild. There were more male patients in hyponatremia group ( P = .006), and hyponatremic patients were older than normonatremic patients ( P = .001). Forty (35%) of the 113 patients were transferred to the ICU, and 17 (15%) needed mechanical ventilation during their hospitalization. Interleukin-6 (IL-6) levels were higher in the hyponatremic group ( P = .022). Intensive care unit admissions and oxygen requirement were significantly higher in hyponatremic patients ( P = .001 and .016, respectively). Ferritin, lactate dehydrogenase (LDH), IL-6, total leucocyte count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were significantly elevated in those patients requiring ICU admission and those who died due to COVID-19.

Conclusions:

Our study revealed that demography, clinical features, radiographic findings, complications like renal insufficiency, and inflammatory markers like IL-6 play a considerable role in hyponatremic COVID-19 patients. Hyponatremia patients required significantly higher rates of ICU admissions and oxygen support. Our results suggest that monitoring inflammatory markers such as ESR, CRP, total white blood cell (WBC) count, ferritin, LDH, and IL-6 may serve as an early warning system for progression to severe COVID-19.
#iamhere: Collective Counterspeech and the Quest to Improve Online Discourse
Authors: Buerger Catherine
Published: December 2021

This article examines the Facebook group #jagärhär, a Sweden-based collective of thousands of people who have made a regular practice of responding en masse to what they regard as hateful comments online. #jagärhar is one of the largest and best-organized collective efforts to respond directly to hatred online anywhere in the world. Drawing on data collected through ethnographic observation and interviews, the article explores two primary research questions: (1) how do the external counterspeech actions of group members work to counter hatred (and, sometimes, misinformation)? and (2) how do the internal practices of the group keep members engaged? I argue that instead of focusing their work on preventing future hateful speech (presumably by changing the minds or incentives of those who post it), #jagärhär members fight against its effects—attempting to lessen the impact of the hateful speech by hiding it in the comment threads, speaking to the “movable middle” rather than those posting hatred, and encouraging more counterspeech against it.
MRI diffusion-weighted imaging detects a fresh portal vein thrombus as a high intensity lesion in a patient with a liver transplant: A case report
Authors: Kuroiwa Yasuyoshi , Kusumoto Kazunori , Shimata Keita , Yamashita Atsushi , Hibi Taizo , Asada Yujiro , Imamura Takuroh
Published: December 2021

Portal vein thrombosis is one of the most serious complications after liver transplantation. It is important to determine the age of the thrombus for management of portal vein thrombosis. We present a case report of histologically confirmed heterogenous fresh portal vein thrombus which was depicted heterogenous high signal intensity on magnetic resonance diffusion weighted imaging. The sequence may be a useful imaging tool for detecting fresh thrombus components in the portal vein thrombosis.
Liquiritigenin enhances cyclic adenosine monophosphate production to mitigate inflammation in dendritic cells
Authors: Qin Mingming , Guo Aili , Li Feng , Zhang Fuxiang , Bi Meirong , Zhang Yamin , Zhu Weiwei
Published: December 2021

Objective: This study aims to dissect the mechanism of traditional Chinese medicinal herbs against asthma; we chose to first focus on the main chemical components of licorice to investigate their contribution to asthmatic inflammation inhibition. Methods: Production of cellular nucleotide molecules such as cAMP, cGMP, and cGAMP was examined by using enzyme-linked immunosorbent assay (ELISA). Enzyme-encoding genes were tested in vitro using quantitative real-time PCR and protein level was detected by Western blotting analysis. In addition, co-culturing of murine dendritic cells together with T cells was conducted to examine the expression of cytokine genes and host immune response. Results: We found that one of the components within licorice, named liquiritigenin (LR), could efficiently enhance cAMP production in different cell lines. The augmentation of such molecules was linked to the high expression of cAMP synthesis genes and repressed expression of cAMP breaking down genes. In addition, the downstream immune response was also alleviated by the increase in cAMP levels by LR, suggesting the great potential of this molecule against inflammation. Subsequent immunological tests showed that LR could efficiently inhibit the expression of several cytokines and alter the NF-κB pathway and T cell polarization. Conclusion: Altogether, we have identified a promising antiasthmatic agent LR that could exhibit immunosuppressive function by elevating the cAMP level.
An Evaluation of How Students Use Blackboard and the Possible Link to Their Grades
Authors: Darko Charles
Published: December 2021

Blackboard is an important Learning Management System (LMS) employed at most higher education institutions to engage and interact with students during their studies. Students within Material Science and Engineering (MSE) often use these LMS’s to absorb mathematical derivations, scientific information and submit coursework tasks. In this work, statistical analysis of the average times the MSE students spent on Blackboard during their entire Bachelor’s program period were compared to their final examination grades. Results show a positive linear correlation between the time students spent on Blackboard and their final grades. Another interesting observation was the fact that the students engage and interact more with LMS at certain periods within the week rather than performing unintentional activities. Similar to the constructivism learning theory, the results gave evidence to the fact that the more students actively engage with the LMS’s, the more they construct knowledge for themselves.
Training Perception and Innovative Behavior of SME Employees: Examining the Mediating Effects of Firm Commitment
Authors: Jalil Muhammad Farhan , Ullah Wasim , Ahmed Zeeshan
Published: December 2021

Many critical decisions about an employee’s innovative performance are significantly based on the training results, as they are accountable for a variety of behavioral-related consequences. Training is among the most important human resource management strategies. The aim of this study is to examine the relationship between employees’ perceptions of training and their innovative behavior in the Malaysian SME sector, as well as the mediating effect of affective and calculative commitment on this relationship. Structured questionnaires were used to collect the data. A total of 635 employees from 200 SMEs were selected through a stratified random sampling method, and structural equation modeling was applied to test the relationship. The findings of the study supported the hypothesized relationships, as training in Malaysia significantly engaged SME employees in innovative behavior. Furthermore, the study discovered that affective and calculative commitment have partial mediating effects on the association between training and innovative behavior. In the context of the SME sector, theoretical and managerial implications have been addressed. The originality of the study is that it examines the relationship between employees’ perceptions of training and their innovative behavior in SMEs. The relationship was measured using a multidimensional approach in the study. The research also adds to the body of knowledge by identifying the mediating effect of affective and calculative commitment.
A Systematic Literature Review of Organizational Factors Influencing 21st-Century Skills
Authors: Koehorst Mirjam M. , van Deursen Alexander J. A. M. , van Dijk Jan A. G. M. , de Haan Jos
Published: December 2021

Skills, such as critical thinking, creativity, communication, problem solving, collaboration, operational skills, and information management, have become increasingly important for 21st-century employees. These skills are often referred to as 21st-century skills and influence how employees handle novel situations. They are indispensable in an economy where the knowledge and skills of employees are seen as a measure for economic potential. This systematic literature review summarizes the current academic knowledge about organizational factors that influence 21st-century skills on an individual level. A search was performed in three databases. The factors found can be sub-divided into three main categories, namely leader characteristics, job characteristics, and organizational characteristics. Transformational leadership was the factor most mentioned in the literature found. Most research found during the search was done on the level of organizational output, exposing a clear gap concerning organizational factors that influence the skill-level of individual employees. These findings can have substantive implications when looking to improve employee skills by altering organizational determinants, by enabling targeted actions to improve these skills for the individual employee.
Graves Disease Following the SARS-CoV-2 Vaccine: Case Series
Authors: Weintraub Michael A. , Ameer Barbara , Sinha Gregory Naina
Published: December 2021

Widespread vaccination is a principal strategy to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and lessen the global burden of coronavirus disease 2019 (COVID-19). Information is rapidly evolving about the impact of SARS-CoV-2 vaccines on the immune and endocrine systems. This case series heightens clinical awareness of possible thyroid effects and conveys knowledge of what to monitor, which are fundamental components of public health and pharmacovigilance. We present a case series of Graves disease following mRNA SARS-CoV-2 vaccination, with symptoms and altered thyroid function tests developing within 7 days of the first dose in 2 women aged 38 and 63 years, and 28 days after the second dose in a 30-year-old man. New-onset Graves disease occurred following administration of mRNA vaccines against SARS-CoV-2. Based on the timing of signs and symptoms relative to administration of the vaccine and the absence of other probable causes, we consider the vaccine as a potential contributor to the diagnosis. The viral spike protein, delivered indirectly through an encoded mRNA vaccine, may be capable of triggering an inflammatory cascade and immune response triggering thyroid dysfunction.
Mycobacterium bovis Bacillus Calmette-Guérin Cross-Contamination in the Operating Room: A Case Report
Authors: Aqua Jasmine Ko , Holdsworth Jill , Burd Eileen , Jacob Jesse T. , Ray Susan M. , Schechter Marcos C.
Published: December 2021

Mycobacterium tuberculosis complex (MTBC) false-positive cultures are commonly attributed to laboratory cross-contamination, but cross-contamination in the operating room (OR) is seldom reported. We report an investigation of cross-contamination in the OR for our case patient, who underwent surgical intervention for a chronic, left-sided breast lesion. Although the case patient had never received Mycobacterium bovis bacillus Calmette-Guérin (BCG) vaccine or chemotherapy, a subsequent surgical sample culture was identified as MTBC by high-performance liquid chromatography and M. bovis BCG-type by genotyping. A collaborative false-positive investigation was initiated, and we discovered a cross-contamination event in the OR from a source case who received BCG intravesical instillation. Clinicians, public health, and infection control staff should be aware that MTBC cross-contamination in the OR is rare, but possible, and should recognize the importance of conducting thorough false-positive investigations.
Identification and Discrimination of Sound Textures in Hearing-Impaired and Older Listeners
Authors: Scheuregger Oliver , Hjortkjær Jens , Dau Torsten
Published: December 2021

Sound textures are a broad class of sounds defined by their homogeneous temporal structure. It has been suggested that sound texture perception is mediated by time-averaged summary statistics measured from early stages of the auditory system. The ability of young normal-hearing (NH) listeners to identify synthetic sound textures increases as the statistics of the synthetic texture approach those of its real-world counterpart. In sound texture discrimination, young NH listeners utilize the fine temporal stimulus information for short-duration stimuli, whereas they switch to a time-averaged statistical representation as the stimulus’ duration increases. The present study investigated how younger and older listeners with a sensorineural hearing impairment perform in the corresponding texture identification and discrimination tasks in which the stimuli were amplified to compensate for the individual listeners’ loss of audibility. In both hearing impaired (HI) listeners and NH controls, sound texture identification performance increased as the number of statistics imposed during the synthesis stage increased, but hearing impairment was accompanied by a significant reduction in overall identification accuracy. Sound texture discrimination performance was measured across listener groups categorized by age and hearing loss. Sound texture discrimination performance was unaffected by hearing loss at all excerpt durations. The older listeners’ sound texture and exemplar discrimination performance decreased for signals of short excerpt duration, with older HI listeners performing better than older NH listeners. The results suggest that the time-averaged statistic representations of sound textures provide listeners with cues which are robust to the effects of age and sensorineural hearing loss.
Curriculum Vitae Workshops: Promoting Transparency in Alpha Omega Alpha While Serving Student Needs
Authors: Dorismond Christina , Ellis Joshua S. , Rosen Maureen D. , Bhatia Shweta , Searcy Ryan , Leeper Lauren K. , Jordan Sheryl G.
Published: December 2021

OBJECTIVE

To promote equity in the Alpha Omega Alpha Honor Medical Society (AOA) selection process, clear and timely communication of eligibility criteria is needed. Herein, the authors describe and assess the effectiveness of a novel method for improving transparency in the AOA selection process while also teaching students key professional development skills.

METHODS

The authors hosted curriculum vitae (CV) workshops for interested medical students. One part of each session was dedicated to sharing information about AOA and its selection process, while the rest focused on teaching students how to build effective CVs. After the most recent session, students were asked to complete a survey about the effectiveness of the workshop.

RESULTS

Between 2019 and 2020, three CV workshops were hosted. Interest in the events was high, with approximately 15 to 30 first- and second-year medical students participating in each. Based on survey results, participants found the workshop helped them gain a better understanding of AOA eligibility and selection (100%, n = 10) and taught them key CV development skills (100%, n = 10).

CONCLUSION

These workshops are a novel approach to disseminating AOA eligibility criteria and can be employed by medical schools to promote transparency in the AOA selection process. They also give students the skills to craft CVs that will better prepare them for applying to residency and other academic opportunities. As such medical schools and AOA chapters should consider implementing a similar model at their institutions.
World Christianity and Religions 2022: A Complicated Relationship
Authors: Zurlo Gina A. , Johnson Todd M. , Crossing Peter F.
Published: December 2021

This article marks the thirty-eighth year of including statistical information on World Christianity and mission in the International Bulletin of Mission Research. This year it includes details on the growth of world religions, increasing religious diversity, and personal contact between Christians and people of other religions. The world is becoming more religious, and the world’s countries have become more religiously diverse, yet Christians have inadequate personal contact with members of other religions. Solidarity, including friendship, love, and hospitality, is posited as the way forward in addressing these trends.
Global Catholicism: Diverse, Troubled, Holding Steady
Authors: Carney J. J.
Published: December 2021

The World Christian Encyclopedia, third edition, contributes significantly to our understanding of the contemporary Catholic Church, the world’s largest single Christian community. Although the percentage of Catholics has held steady over the past century, the church’s demographic center has shifted markedly from the Global North to the Global South. The encyclopedia’s rich country profiles reveal multiple key trends in current global Catholicism, including the challenge of secularization, the continued rise of the charismatic movement, the importance of migration to Catholic growth, and the critical if controversial intertwining of the Catholic Church with national identity, public life, and social services.
The Legacy of Anna E. Hall, African American Missionary to Liberia
Authors: McGill Jenny
Published: December 2021

This article, which tells the life story of Anna E. Hall, highlights the significant role that this African American missionary played in Liberia for the US Methodist Episcopal Church in the early twentieth century. The latter half of the nineteenth century saw increased migration of free African Americans as ministers . . . and missionaries overseas, especially to Africa. Standing as a paragon in missionary ventures, Anna E. Hall represents one of many who were responsible for the resurgence of Christianity in Africa and provides an exemplar for missionary service.
National implementation of reperfusion for acute ischaemic stroke in England: How should services be configured? A modelling study
Authors: Allen Michael , Pearn Kerry , Ford Gary A , White Phil , Rudd Anthony G , McMeekin Peter , Stein Ken , James Martin
Published: December 2021

Objectives

To guide policy when planning thrombolysis (IVT) and thrombectomy (MT) services for acute stroke in England, focussing on the choice between ‘mothership’ (direct conveyance to an MT centre) and ‘drip-and-ship’ (secondary transfer) provision and the impact of bypassing local acute stroke centres.

Design

Outcome-based modelling study.

Setting

107 acute stroke centres in England, 24 of which provide IVT and MT (IVT/MT centres) and 83 provide only IVT (IVT-only units).

Participants

242,874 emergency admissions with acute stroke over 3 years (2015–2017).

Intervention

Reperfusion delivered by drip-and-ship, mothership or ‘hybrid’ models; impact of additional travel time to directly access an IVT/MT centre by bypassing a more local IVT-only unit; effect of pre-hospital selection for large artery occlusion (LAO).

Main outcome measures

Population benefit from reperfusion, time to IVT and MT, admission numbers to IVT-only units and IVT/MT centres.

Results

Without pre-hospital selection for LAO, 94% of the population of England live in areas where the greatest clinical benefit, assuming unknown patient status, accrues from direct conveyance to an IVT/MT centre. However, this policy produces unsustainable admission numbers at these centres, with 78 out of 83 IVT-only units receiving fewer than 300 admissions per year (compared to 3 with drip-and-ship). Implementing a maximum permitted additional travel time to bypass an IVT-only unit, using a pre-hospital test for LAO, and selecting patients based on stroke onset time, all help to mitigate the destabilising effect but there is still some significant disruption to admission numbers, and improved selection of patients suitable for MT selectively reduces the number of patients who would receive IVT at IVT-only centres, challenging the sustainability of IVT expertise in IVT-only centres.

Conclusions

Implementation of reperfusion for acute stroke based solely on achieving the maximum population benefit potentially leads to destabilisation of the emergency stroke care system. Careful planning is required to create a sustainable system, and modelling may be used to help planners maximise benefit from reperfusion while creating a sustainable emergency stroke care system.
Debating animal agriculture in contemporary India: Ethics, politics, ecologies
Authors: Srinivasan Krithika
Published: December 2021

This paper investigates social science literatures and public discourse on animal-based food systems in India to examine how social, ecological, and animal justice concerns are addressed (or not). The Indian livestock sector is estimated to be the largest in the world, with significant implications for local and planetary natures and the individual animals that compose the sector. The intensification of livestock production in India has unfolded alongside serious, often violent, sectarian conflicts around meat and cow protection. In this paper, I discuss how scholarly and public debates have been centred on the cultural roots of vegetarianism, the right-wing contours of political bans on cow slaughter, beef, and eggs, while issues relating to the more-than-human impacts of animal agriculture have remained marginal. The paper brings these analyses together with an examination of the intensification of animal agriculture in the country, and the consequent animal, ecological, and social vulnerabilities. Through this multi-optic account of animalbased food systems in India, I argue that the single-optic focus on cows, consumption (of meat) and related identity politics has produced serious lacunae in scholarship and public debate in the form of the overlooking of the multiple, intersecting impacts of commercial livestock farming on social, ecological, and animal wellbeing. In the backdrop of global worry about animal agriculture, the paper inspects the role of the social sciences in creating possibilities for considered engagement with the plural justice implications of India’s rapidly intensifying livestock landscapes.
Conserving inequality: How private conservation and property developers ‘fix’ spatial injustice in South Africa
Authors: Thakholi Lerato , Büscher Bram
Published: December 2021

In 2016, South Africa launched its National Biodiversity Economy Strategy. This strategy aims to facilitate the development of a ‘wildlife economy’ as a solution to unemployment, loss of biodiversity and rural development. Central to the strategy is the role of private conservation actors, who keenly posit their commercial model as the best way to achieve these objectives. This stands in sharp contrast to recent critiques that suggest that private conservation reinforces structural inequality by denying access to land and perpetuating unjust labour conditions. Using ethnographic data from the South African Lowveld region that includes the Kruger National Park, the paper takes these points further by arguing that a rapidly growing alliance between private conservation and property developers actively conserve inequality by maintaining and even extending spatial injustice in the region. Two popular recent manifestations of this alliance in particular, share block systems that distribute ownership of access to real estate in private reserves and wildlife housing estates, have established new conservation-property linkages that entrench capitalist socioecological fixes. Not only do these initiatives lead to further engrained spatial injustice, we conclude that this conservation-property alliance at the centre of the ‘wildlife economy’ also willingly sacrifices environmental sustainability on the altar of white conservation imaginations and private profit.
Use of biomaterials in corneal endothelial repair
Authors: Hussain Noor Ahmed , Figueiredo Francisco C. , Connon Che J.
Published: December 2021

Human corneal endothelium (HCE) is a single layer of hexagonal cells that lines the posterior surface of the cornea. It forms the barrier that separates the aqueous humor from the rest of the corneal layers (stroma and epithelium layer). This layer plays a fundamental role in maintaining the hydration and transparency of the cornea, which in turn ensures a clear vision. In vivo, human corneal endothelial cells (HCECs) are generally believed to be nonproliferating. In many cases, due to their nonproliferative nature, any damage to these cells can lead to further issues with Descemet’s membrane (DM), stroma and epithelium which may ultimately lead to hazy vision and blindness. Endothelial keratoplasties such as Descemet’s stripping automated endothelial keratoplasty (DSAEK) and Descemet’s membrane endothelial keratoplasty (DEK) are the standard surgeries routinely used to restore vision following endothelial failure. Basically, these two similar surgical techniques involve the replacement of the diseased endothelial layer in the center of the cornea by a healthy layer taken from a donor cornea. Globally, eye banks are facing an increased demand to provide corneas that have suitable features for transplantation. Consequently, it can be stated that there is a significant shortage of corneal grafting tissue; for every 70 corneas required, only 1 is available. Nowadays, eye banks face long waiting lists due to shortage of donors, seriously aggravated when compared with previous years, due to the global COVID-19 pandemic. Thus, there is an urgent need to find alternative and more sustainable sources for treating endothelial diseases, such as utilizing bioengineering to use of biomaterials as a remedy. The current review focuses on the use of biomaterials to repair the corneal endothelium. A range of biomaterials have been considered based on their promising results and outstanding features, including previous studies and their key findings in the context of each biomaterial.
Safety of different electrocautery modes for endoscopic sphincterotomy: a Bayesian network meta-analysis
Authors: Hedjoudje Abdellah , Cheurfa Chérifa , Farha Jad , Jaïs Bénédicte , Aubert Alain , Lorenzo Diane , Maire Frédérique , Badurdeen Dilhana , Kumbhari Vivek , Prat Frédéric
Published: December 2021

Background and aims:

Post-endoscopic retrograde cholangiopancreatography acute pancreatitis (PAP) and post-sphincterotomy hemorrhage are known adverse events of post-endoscopic retrograde cholangiopancreatography. Various electrosurgical currents can be used for endoscopic sphincterotomy. The extent to which this influences adverse events remains unclear. We assessed the comparative safety of different electrosurgical currents, through a Bayesian network meta-analysis of published studies merging direct and indirect comparison of trials.

Methods:

We performed a Bayesian random-effects network meta-analysis of randomized controlled trials that compared the safety of different electrocautery modes for endoscopic sphincterotomy.

Results:

Nine studies comparing four electrocautery modes (blended cut, pure cut, endocut, and pure cut followed by blended cut) with a combined enrollment of 1615 patients were included. The pooled results of the network meta-analysis did not show a significant difference in preventing post-sphincterotomy pancreatitis when comparing electrocautery modes. However, pure cut was associated with a statistically significant increased risk of bleeding compared with endocut [relative risk = 4.30; 95% confidence interval (1.53–12.87)]. On the other hand, the pooled results of the network meta-analysis showed no significant difference in prevention of bleeding when comparing blended cut versus endocut, pure cut followed by blended cut versus endocut, pure cut followed by blended cut versus blended cut, pure cut versus blended cut, and pure cut versus pure cut followed by blended cut. The results of rank probability found that endocut was most likely to be ranked the best.

Conclusion:

No electrocautery mode was superior to another with regard to preventing PAP. Endocut was superior with respect to preventing bleeding. Therefore, we suggest performing endoscopic sphincterotomy with endocut.
Contextual Characteristics in Relation to Student Intervention in Bullying
Authors: Jenkins Lyndsay N. , Bogart Stone , Miskimon Kayla
Published: December 2021

The goal of the current study was to examine whether contextual characteristics of a school are related to student interventions in bullying. Specifically, participants reported their perceptions of how teachers responded to bullying, school climate, and the promotion of social emotional wellness. The study included 390 eighth to twelfth grade students from the Southeastern region of the United States. The confirmatory factor analysis revealed good model fit and measurement invariance across sex was established. Structural models indicated that for boys, perceptions of social emotional learning (SEL) promotion were positively and significantly related to their intervention in bullying. For girls, both teacher interventions and perceptions of SEL promotion were positively related to their intervention in bullying. Results suggest that characteristics of the school are important for promoting interventions in bullying among high school students.
A randomised controlled trial of intrapleural balloon intercostal chest drains to prevent drain displacement
Authors: Mercer Rachel M. , Mishra Eleanor , Banka Radhika , Corcoran John P. , Daneshvar Cyrus , Panchal Rakesh K. , Saba Tarek , Caswell Melanie , Johnstone Sarah , Menzies Daniel , Ahmer Sana , Shahidi Mitra , Clive Amelia O. , Gautam Manish , Cox Giles , Orton Chris , Lyons Judith , Maddekar Nadeem , De Fonseka Duneesha , Prior Kathryn , Barnes Simon , Robinson Grace , Brown Louise , Munavvar Mohammed , Shah Palav L. , Hallifax Robert J. , Blyth Kevin G. , Hedley Emma , Maskell Nick A. , Gerry Stephen , Miller Robert F. , Rahman Najib M. , Kemp Samuel V.
Published: December 2021

Background

Chest drain displacement is a common clinical problem that occurs in 9–42% of cases and results in treatment failure or additional pleural procedures conferring unnecessary risk. A novel chest drain with an integrated intrapleural balloon may reduce the risk of displacement.

Methods

A prospective randomised controlled trial comparing the balloon drain to standard care (12 F chest drain with no balloon) with the primary outcome of objectively defined unintentional or accidental chest drain displacement.

Results

267 patients were randomised (primary outcome data available in 257, 96.2%). Displacement occurred less frequently using the balloon drain (displacement 5 of 128, 3.9%; standard care displacement 13 of 129, 10.1%) but this was not statistically significant (OR for drain displacement 0.36, 95% CI 0.13–1.0, Chi-squared 1 degree of freedom (df)=2.87, p=0.09). Adjusted analysis to account for minimisation factors and use of drain sutures demonstrated balloon drains were independently associated with reduced drain fall-out rate (adjusted OR 0.27, 95% CI 0.08–0.87, p=0.028). Adverse events were higher in the balloon arm than the standard care arm (balloon drain 59 of 131, 45.0%; standard care 18 of 132, 13.6%; Chi-squared 1 df=31.3, p<0.0001).

Conclusion

Balloon drains reduce displacement compared with standard drains independent of the use of sutures but are associated with increased adverse events specifically during drain removal. The potential benefits of the novel drain should be weighed against the risks, but may be considered in practices where sutures are not routinely used.
Comparison of different sets of immunological tests to identify treatable immunodeficiencies in adult bronchiectasis patients
Authors: Aliberti Stefano , Amati Francesco , Gramegna Andrea , Vigone Barbara , Oriano Martina , Sotgiu Giovanni , Mantero Marco , Simonetta Edoardo , Saderi Laura , Stainer Anna , Tammaro Serena , Marchisio Paola , Polverino Eva , Chalmers James D. , Blasi Francesco
Published: December 2021

Background

The reported prevalence of immunodeficiencies in bronchiectasis patients is variable depending on the frequency and extent of immunological tests performed. European Respiratory Society guidelines recommend a minimum bundle of tests. Broadening the spectrum of immunological tests could increase the number of patients diagnosed with an immunodeficiency and those who could receive specific therapy. The primary objective of the present study was to assess the performance of different sets of immunological tests in diagnosing any, primary, secondary or treatable immunodeficiencies in adults with bronchiectasis.

Methods

An observational, cross-sectional study was conducted at the Bronchiectasis Program of the Policlinico University Hospital in Milan, Italy, from September 2016 to June 2019. Adult outpatients with a clinical and radiological diagnosis of bronchiectasis underwent the same immunological screening during the first visit when clinically stable consisting of: complete blood count; immunoglobulin (Ig) subclass tests for IgA, IgG, IgM and IgG; total IgE; lymphocyte subsets; and HIV antibodies. The primary endpoint was the prevalence of patients with any immunodeficiencies using five different sets of immunological tests.

Results

A total of 401 bronchiectasis patients underwent the immunological screening. A significantly different prevalence of bronchiectasis patients diagnosed with any, primary or secondary immunodeficiencies was found across different bundles. 44.6% of bronchiectasis patients had a diagnosis of immunodeficiency when IgG subclasses and lymphocyte subsets were added to the minimum bundle suggested by the guidelines.

Conclusion

A four-fold increase in the diagnosis of immunodeficiencies can be found in adults with bronchiectasis when IgG subclasses and lymphocyte subsets are added to the bundle of tests recommended by guidelines.
Inhaled anti-asthma therapies following hormone therapy in women: a nationwide cohort study
Authors: Hansen Erik Soeren Halvard , Aasbjerg Kristian , Moeller Amalie Lykkemark , Meaidi Amani , Gade Elisabeth Juul , Torp-Pedersen Christian , Backer Vibeke
Published: December 2021

Research question

Does menopausal hormone therapy (HT) with exogenous oestrogens and progestogens change the use of inhaled anti-asthma medications in women with asthma?

Methods

In a population-based matched cohort study using the Danish registries, we included women with asthma aged 45–65 years from 1 June 1995 to 30 June 2018. We investigated whether HT with oestrogen and/or progestogens was associated with changes in use of inhaled anti-asthma therapies in the 12 months following initiation. We used exposure density matching to match exposed subjects with unexposed subjects on age, household income and level of education. An exposed subject was defined as receiving HT. We calculated mean dose of medications and odds ratios of increases in the 12 months following HT initiation.

Results

We included 139 483 women with asthma, of whom 116 014 (83.2%) were unexposed subjects and 23 469 (16.8%) exposed subjects. Mean±sdage was 53.0±5.2 years. Initiation of HT was not consistently associated with increased mean doses of inhaled corticosteroids (ICS), or long- and short-acting β2-agonists. Women receiving systemic oestrogens had increased odds ratios of large increases (>100 µg) in ICS at 6 months (OR 1.09; 95% CI 1.04–1.13; p<0.001) and 9 months (OR 1.07; 95% CI 1.03–1.12; p<0.001). Progestogens were protective against increases in ICS at 6 and 9 months (OR 0.87; 95% CI 0.82–0.93; p<0.001; and OR 0.86; 95% CI 0.81–0.91; p<0.001).

Conclusion

Initiation of HT did not change the use of inhaled medications in asthma. However, detrimental effects of oestrogen, as well as beneficial effects of progestogens, cannot be excluded.