bluuebunny/crossref_metadata_2025 huggingface dataset:
Dwarfism in Tibetan Terrier dogs with an LHX3 mutation
Authors: Thaiwong Tuddow , Corner Sarah , Forge Stacey La , Kiupel Matti
Published: April 2021

Canine pituitary dwarfism in German Shepherd and related dog breeds has been reported to be associated with a 7-bp deletion mutation in intron 5 of the LHX3 gene. This mutation is transmitted as an autosomal recessive trait that results in dwarf dogs with significantly smaller stature and abnormal haircoat, and potentially early death. Phenotypically, affected adult dogs are proportionally dwarfs. These dwarfs also have a soft, woolly puppy coat that fails to transition into the typical adult hair coat, and marked hair loss occurs in some dogs. We report a similar manifestation of dwarfism in Tibetan Terriers with the same LHX3 mutation. Dwarf Tibetan Terrier puppies were born physically normal but failed to gain weight or to grow at the same rate as their normal littermates. The 7-bp deletion mutation of the LHX3 gene was identified in both alleles of 3 Tibetan Terrier dwarfs from 3 litters, which were biologically related. All parents of these dogs are carriers, confirming transmission of dwarfism in an autosomal recessive manner. Recognition and detection of this mutation will help in guiding future breeding plans to eventually eliminate this trait from Tibetan Terriers.
Mother-Son Rejection and Triangulation in Polygamous Families: Probing the Spillover Effect and the Compensatory Hypothesis
Authors: Gadban Faten , Goldner Limor
Published: April 2021

The current study examined the applicability of the spillover effect and the compensatory hypothesis in a sample of 80 Israeli Arab mothers living in polygamous families. It was posited that the marital dissatisfaction reflected in mothers’ romantic jealousy and their desire for revenge against their husbands would be transformed into feelings of rejection toward their own eldest sons and would involve the parental practice of triangulation. The results indicated that mothers’ desire for revenge mediated the association between romantic jealousy and mother–child rejection. Furthermore, mothers’ desire for revenge also mediated the association between romantic jealousy and mother-child triangulation. These findings point to the complexity of mother-child relationships in polygamous families.
Opioids and the Workplace Prevention and Response Awareness Training: Mixed Methods Follow-Up Evaluation
Authors: Persaud Eric , Afable Aimee , Geer Laura A. , Landsbergis Paul
Published: April 2021

The National Institute of Environmental Health Sciences Worker Training Program piloted an Opioids and the Workplace: Prevention and Response training tool and program in 2019. The pilot trainees ( N = 97) were surveyed ( n = 27) and interviewed ( n = 6) six months posttraining, and those who downloaded the training tool from the Worker Training Program website ( n = 87) were surveyed ( n = 19) and interviewed ( n = 1) two to six months postdownload, to evaluate the impact of the training program. Workplace policy and program-level actions were reported less frequently than individual-level actions by trainees, except for planning and conducting training and education. Barriers to taking actions included not being able to make changes on their own without supervisor support and lack of upper management support and approval. We found some evidence that the Opioids in the Workplace training program and materials contributed to helping workers introduce policies and programs related to opioids within their workplace or union.
Transforming Impossible into Possible (TIP) for Fatherhood: An Empowerment-Based Social Work Intervention
Authors: Hong Philip Young P. , Lewis Dara , Park Jang Ho , Hong Rana , Davies Ed
Published: April 2021

The purpose of this study is to examine the psychological self-sufficiency (PSS) process among low-income men participating in the Transforming Impossible into Possible (TIP) program and explore the implications of TIP as a fatherhood intervention. Sample from 324 men participating in a community-based fatherhood initiative and four local job training programs in a large Midwestern city was used to examine the group differences in PSS as it relates to economic self-sufficiency (ESS). Men in the fatherhood TIP program and those in the general TIP program had significantly greater relationships between PSS and ESS than those in the non-TIP comparison group. Results provide implications for social work practice with African American fathers in programs that address fatherhood. While traditional fatherhood programs approach mending fathers’ deficiencies, TIP allowed them to discover strengths from being broken and beaten up to authentically invest in their own lives and their children’s.
African American Parents With Children With Disabilities: Gathering Home–School Reflections
Authors: Brandon Regina R. , Higgins Kyle , Jones Vita L. , Dobbins Nicole
Published: April 2021

African American families are multidimensional entities that change over time. This is particularly true when there is a child with a disability in the family. The communication and interaction of the family and parents with the teachers and school in which their child receives special education services are of crucial importance. The goal for all is a relationship based on equity and parity, but research indicates that often this is not the case for African American parents who have a child with a disability. Based on a review of the literature focused on African American parents with a child with a disability and their sense of alienation from their child’s school, a questionnaire is presented in which parents reflect on the barriers in five categories identified in the literature (e.g., personal concerns, work concerns, lack of interest, logistical concerns, teacher/parent relationships) that may impede the development of a professional partnership with the individuals who provide special education services to their child. The questionnaire is presented and suggestions for its usage are provided.
Use of Small-Pin Distraction and Low-Speed, High-Torque Burring for Talar Osteochondral Allografts: Technique Tip
Authors: O’Leary Ryan , Foran Ian M. , Dalstrom David J.
Published: April 2021

Level of Evidence: Level V, expert opinion.
Living With Both a Total Ankle Replacement and an Ankle Fusion: A Qualitative Study From the Patients’ Perspective
Authors: Conlin Catherine , Khan Ryan M. , Wilson Ian , Daniels Timothy R. , Halai Mansur , Pinsker Ellie B.
Published: April 2021

Background:

Total ankle replacement (TAR) and ankle fusion are effective treatments for end-stage ankle arthritis. Comparative studies elucidate differences in treatment outcomes; however, the literature lacks evidence demonstrating what outcomes are important to patients. The purpose of this study was to investigate patients’ experiences of living with both a TAR and ankle fusion.

Methods:

This research study used qualitative description. Individuals were selected from a cohort of patients with TAR and/or ankle fusion (n = 1254). Eligible patients were English speaking with a TAR and contralateral ankle fusion, and a minimum of 1 year since their most recent ankle reconstruction. Surgeries were performed by a single experienced surgeon, and semistructured interviews were conducted by a single researcher in a private hospital setting or by telephone. Ankle Osteoarthritis Scale (AOS) scores, radiographs, and ancillary surgical procedures were collected to characterize patients. Themes were derived through qualitative data analysis.

Results:

Ten adults (8 men, 2 women), ages 59 to 90 years, were included. Average AOS pain and disability scores were similar for both surgeries for most patients. Participants discussed perceptions of each reconstructed ankle. Ankle fusions were considered stable and strong, but also stiff and compromising balance. TARs were considered flexible and more like a “normal ankle,” though patients expressed concerns about their TAR “turning” on uneven ground. Individuals applied this knowledge to facilitate movement, particularly during a first step and transitioning between positions. They described the need for careful foot placement and attention to the environment to avoid potential challenges.

Conclusion:

This study provides insight into the experiences of individuals living with a TAR and ankle fusion. In this unusual but limited group of patients, we found that each ankle reconstruction was generally perceived to have different characteristics, advantages, and disadvantages. Most participants articulated a preference for their TAR. These findings can help clinicians better counsel patients on expectations after TAR and ankle fusion, and improve patient-reported outcome measures by better capturing meaningful outcomes for patients.

Level of Evidence:

Level IV, case series.
Assessment of Dasatinib Versus Nilotinib as Upfront Therapy for Chronic Phase of Chronic Myeloid Leukemia in Qatar: A Cost-Effectiveness Analysis
Authors: Adel Ahmad , Abushanab Dina , Hamad Anas , Abdulla Mohammad , Izham Mohamed , Yassin Mohamed
Published: April 2021

Background:

The economic outcome research of approved tyrosine kinase inhibitors for treating the chronic phase of chronic myeloid leukemia in developing is scarce. The aim of this study was to assess the cost-effectiveness of dasatinib and nilotinib for newly diagnosed chronic myeloid leukemia patients.

Methods:

A decision tree model was developed linking clinical effectiveness (defined as major molecular response) and/or complete cytogenetic response, utility, and cost data over a 12-month period. Patients are recruited from Qatar Cancer Registry. The probability of primary clinical outcome is calculated from DASISION (dasatinib) and ENESTnd (nilotinib) trials. Direct healthcare costs were derived from the national healthcare payer system, whereas adverse effects data were derived from local incident reporting system.

Results:

In the first-line treatments of chronic myeloid leukemia patients, nilotinib has greater major molecular response (39% nilotinib vs 12% dasatinib) and complete cytogenetic response (24% nilotinib vs 16% dastinib) response outcomes, and more adverse effects than dasatinib (13.3% vs 4%). Moreover, nilotinib is more cost-effective with annual costs (USD63,589.59) and after 12 months of follow-up. Despite the lower acquisition annual cost of dasatinib (USD59,486.30), the incremental cost-effectiveness ratio of nilotinib (vs dasatinib) per major molecular response/complete cytogenetic response achieved was USD15,481.10 per year. There were no cases in both arms that progressed to accelerated or blast phase. At a threshold of 3 times gross domestic product per capita of Qatar and according to World Health Organization recommendation, the nilotinib use is still cost-effective.

Conclusion:

Upfront therapy of chronic myeloid leukemia–chronic phase patients by nilotinib plan appears to be more cost-effective than dasatinib.
Numerical and experimental studies on the thermal and static characteristics of multi-leaf foil thrust bearing
Authors: Guo Yu , Hou Yu , Zhao Qi , Ren Xionghao , Chen Shuangtao , Lai Tianwei
Published: April 2021

Foil bearing is considered to be a promising supporting technology in high-speed centrifugal machinery. Due to the high-speed shearing effect in the viscous lubricant film, heat generation could not be ignored. In this paper, a thermo-elastic model of the multi-leaf foil thrust bearing is proposed to predict its thermal and static characteristics. In the model, modified Reynolds equation, energy equation, and Kirchhoff equation are solved in a coupling way. The contact area between the foil and welding plate is taken into account. Besides, the effect of cooling air on the bearing temperature is investigated. The ultimate load capacity and transient overload failure process of the bearing is analyzed and discussed. The effect of rotation speed on the bearing temperature is more obvious than that of the bearing load. The bearing temperature drops obviously by introducing the cooling air, and the cooling effect is improved with the supply pressure. The transient overload failure of the bearing occurs when the bearing load exceeds the ultimate value.
Serum contactin-1 as a biomarker of long-term disease progression in natalizumab-treated multiple sclerosis
Authors: van Lierop Zoë YGJ , Wieske Luuk , Koel-Simmelink Marleen JA , Chatterjee Madhurima , Dekker Iris , Leurs Cyra E , Willemse Eline AJ , Moraal Bastiaan , Barkhof Frederik , Eftimov Filip , Uitdehaag Bernhard MJ , Killestein Joep , Teunissen Charlotte E
Published: April 2021

Background:

Natalizumab treatment provides a model for non-inflammation-induced disease progression in multiple sclerosis (MS).

Objective:

To study serum contactin-1 (sCNTN1) as a novel biomarker for disease progression in natalizumab-treated relapsing-remitting MS (RRMS) patients.

Methods:

Eighty-nine natalizumab-treated RRMS patients with minimum follow-up of 3 years were included. sCNTN1 was analyzed at baseline (before natalizumab initiation), 3, 12, 24 months (M) and last follow-up (median 5.2 years) and compared to 222 healthy controls (HC) and 15 primary progressive MS patients (PPMS). Results were compared between patients with progressive, stable, or improved disability according to EDSS-plus criteria.

Results:

Median sCNTN1 levels (ng/mL,) in RRMS (baseline: 10.7, 3M: 9.7, 12M: 10.4, 24M: 10.8; last follow-up: 9.7) were significantly lower compared to HC (12.5; p ⩽ 0.001). It was observed that 48% of patients showed progression during follow-up, 11% improved, and 40% remained stable. sCNTN1 levels were significantly lower in progressors both at baseline and at 12M compared to non-progressors. A 1 ng/mL decrease in baseline sCNTN1 was consistent with an odds ratio of 1.23 (95% confidence interval 1.04–1.45) ( p = 0.017) for progression during follow-up.

Conclusion:

Lower baseline sCNTN1 concentrations were associated with long-term disability progression during natalizumab treatment, making it a possible blood-based prognostic biomarker for RRMS.
Effect of continuous positive airway pressure treatment of obstructive sleep apnea-hypopnea in multiple sclerosis: A randomized, double-blind, placebo-controlled trial (SAMS-PAP study)
Authors: Khadadah Sulaiman , Kimoff R John , Duquette Pierre , Jobin Vincent , Lapierre Yves , Benedetti Andrea , Johara Fatema T , Robinson Ann , Roger Elaine , Bar-Or Amit , Leonard Gabriel , Kaminska Marta , Trojan Daria A
Published: April 2021

Objective:

The aim of this study was to evaluate the effect of continuous positive airway pressure (CPAP) treatment on the Fatigue Severity Scale (FSS, preplanned primary outcome), another fatigue measure, sleep quality, somnolence, pain, disability, and quality of life in multiple sclerosis (MS) patients with obstructive sleep apnea-hypopnea (OSAH).

Methods:

In a randomized, double-blind trial (NCT01746342), MS patients with fatigue, poor subjective sleep quality, and OSAH (apnea-hypopnea index of ⩾ 15 events per hour/sleep), but without severe OSAH (apnea-hypopnea index > 30, and 4% oxygen desaturation index > 15 events/hour or severe somnolence), were randomized to fixed CPAP or sham CPAP for 6 months. Outcome assessments were performed at 3 and 6 months.

Results:

Of 49 randomized patients, 34 completed the protocol. Among completers, FSS did not improve with CPAP compared to sham at 6 months. FSS tended to improve ( p = 0.09), and sleepiness (Epworth Sleepiness Scale) improved significantly ( p = 0.03) at 3 months with CPAP compared to sham, but there were no other improvements with CPAP at either study evaluation.

Conclusion:

In non-severe OSAH patients, CPAP did not significantly improve the primary outcome of FSS change at 6 months. In secondary analyses, we found a trend to improved FSS, and a significant reduction in somnolence with CPAP at 3 months.
Baseline behaviour moderates movement skill intervention outcomes among young children with autism spectrum disorder
Authors: Bremer Emily , Lloyd Meghann
Published: April 2021

This study examined whether adaptive behaviour, emotional and behavioural challenges, and social skills, respectively, moderated the effect of a movement skill intervention on movement skills among preschool aged children with autism spectrum disorder. Twenty-seven participants with autism spectrum disorder ( N = 13 experimental) between 3 and 5 years of age participated in a 12-week fundamental movement skill intervention. Movement skills were assessed at baseline and post-test. Adaptive behaviour, emotional and behavioural challenges, and social skills were assessed at baseline. A repeated-measures analysis of variance tested the group by time effect on movement skills. Three separate moderation analyses were then run to test the moderating effect of adaptive behaviour, emotional and behavioural challenges, and social skills, respectively, on the relationship between group assignment and movement skills at the post-test. The experimental group significantly improved their movement skills following the intervention ( p = 0.02, ηp2=.19). The moderation analyses showed that adaptive behaviour ( b( SE) = 0.86 (0.41), p < 0.05) and emotional and behavioural challenges ( b( SE) = −1.5 (0.8), p = 0.06) at baseline moderated the association between group and post-test movement skills, when controlling for baseline movement skills. These findings may help caregivers and clinicians individualize treatment plans in regard to movement skill interventions for preschool-aged children with autism spectrum disorder.

Lay abstract

It is common for children with autism spectrum disorder to experience delays in their movement skills. These skills are important for participation in play and physical activity. Previous research has found that movement skills can be improved with movement skill interventions. This study explored the behavioural factors of young children with autism spectrum disorder that make them most likely to improve their movement skills following a 12-week intervention. The study found that children with higher levels of adaptive behaviour and lower levels of emotional and behavioural challenges at the start of the intervention were more likely to have greater improvements in their movement skills following the intervention. These findings may help clinicians and caregivers plan which types of interventions are best suited for individual children with autism spectrum disorder.
Exploring Flemish Muslim children’s experiences and negotiation of offline and online group privacy
Authors: De Wolf Ralf , Van Hove Stephanie , Robaeyst Ben
Published: April 2021

In privacy research, much attention has been devoted to the online privacy practices of adolescents and college youth. Less is known about the privacy management of children and Muslim children in particular. In this study, we gave a voice to Muslim children in the northern Dutch-speaking region of Belgium, and how they negotiate information about their Muslim culture and identity using focus groups and interviews. The empirical studies clarify how different privacy management strategies are used to manage and hide Islam-related information. Overall, our results illustrate how besides managing boundaries around the self, Muslim children take into account the minority group they belong to as well as the representation of that particular group when sharing information. Building further on Petronio’s communication privacy management theory and Cohen’s perspective on privacy as critical and playful subjectivity, we argue to move beyond individual-centric conceptualizations to understand privacy of minority groups.
Patient, clinician and independent observer perspectives of shared decision making in adult orthodontics
Authors: Keshtgar Asma , Cunningham Susan J , Jones Elinor , Ryan Fiona S
Published: April 2021

Objectives:

To investigate and compare the extent of shared decision making (SDM) in orthodontics from the perspective of patients, clinicians and independent observers.

Design:

A cross-sectional, observational study.

Setting:

NHS teaching hospital.

Participants:

A total of 31 adult patients and their treating clinicians were included in the study.

Methods:

The extent of SDM in new patient orthodontic consultations was measured using three versions of a validated instrument: the self-administered patient dyadic-OPTION scale; the self-administered clinician dyadic-OPTION scale; and an independent observer-rated OPTION12 scale. Patients and clinicians completed the 12-item dyadic-OPTION questionnaire independently at the end of the consultation to rate their perceived levels of SDM. The consultations were also audio-recorded and two calibrated raters independently rated the extent of SDM in these consultations using the OPTION12 scale.

Results:

There was excellent inter-rater reliability between the two independent raters using the OPTION12 scale (intraclass correlation coefficient (ICC) = 0.909). The mean patient, clinician and independent observer OPTION scores for SDM were 90.4% (SD 9.1%, range 70.8% to 100%), 76.2% (SD 8.95%, range 62.5% to 95.8%) and 42.6% (SD 17.4%, range 13.5% to 68.8%), respectively. There was no significant correlation between the OPTION scores for the three groups (ICC = −0.323).

Conclusions:

The results showed that generally high levels of SDM were perceived by patients and clinicians but lower levels of SDM were scored by the independent observers. However, it could be argued that the patient’s perception of SDM is the most important measure as it is their care that is affected by their involvement.
Service user violence against social workers in Italy: Prevalence and characteristics of the phenomenon
Authors: Sicora Alessandro , Nothdurfter Urban , Rosina Barbara , Sanfelici Mara
Published: April 2021

Client violence in social services is perceived as constantly increasing in Italy, raising deep concern. This article presents the results of the first online survey on the phenomenon. Involving 20,112 social workers, the aim was to determine the prevalence and forms of client violence towards social workers and to identify key factors associated with such events.

Findings

The results suggest that the vast majority of Italian social workers experience client violence during their careers. Verbal aggression and threats were most common forms of violence, followed by physical attacks and property damage. Young and less experienced social workers appeared more likely to be victims of violence, as well as those who more frequently work in isolation or without their colleagues’ support. Social workers in child protection services, services for adults and municipality services accessible to the entire population were found to be at higher risk of client violence. The social workers considered the quality of the client/professional relationship and communication skills to be critical in preventing and dealing with aggression by users. Unfulfilled clients’ expectation was considered to be one of the main factors contributing to frustration and the consequent hostile behaviour.

Applications

Violence against social workers is a ‘wake-up call’ that makes the weakening of welfare services, and therefore of professional social work, more visible. The first nationwide study on service user violence reported by this paper may significantly contribute to raising awareness about the phenomenon in Italy and to the devising of effective prevention programmes.
Exploring the politicisation and territorialisation of adult social care in the United Kingdom: Electoral discourse analysis of state-wide and meso elections 1998–2019
Authors: Chaney Paul
Published: April 2021

In the face of a global demographic shift, an aging population and a ‘crisis’ in adult social care (ASC), this study analyses over 3000 pledges on ASC in political parties’ manifesto discourse following the United Kingdom’s move to a multi-level electoral politics in 1998/1999. Although often overlooked, attention to this formative phase of social policy-making reveals the discursive political antecedents of welfare interventions. The analysis shows a major increase in issue-salience and party politicisation of ASC policy. The discourse reveals political cleavages on welfare mixes and policy framing, and sub-state resistance to central government policies. Against the backdrop of the international rise of devolved governance, the present case is of wider international significance because it illustrates how the transition from state-wide to (quasi-)federal electoral practices gives rise to new territorial dynamics in the electoral discourse of welfare provision; in turn, promoting territorialisation, pressure for welfare state expansion and the rise of ‘sub-state’ welfare regimes.
Structural damage monitoring for metallic panels based on acoustic emission and adaptive improvement variational mode decomposition–wavelet packet transform
Authors: Li Yang , Xu Feiyun
Published: April 2021

The metallic panel acoustic emission signal with strong non-stationary properties is normally composed of multiple components (e.g. impulses, background noise, and other external signal), where impulses relevant to metallic panel are easily contaminated by background noise and other external signal, making it difficult to excavate the inherent acoustic emission signal features. To address this issue and achieve the damage monitoring of metallic panels based on acoustic emission technology, a new scheme based on adaptive improvement variational mode decomposition–wavelet packet transform is developed for extracting acoustic emission signal features of metallic panels. Specifically, three different dimensions of Q235B steel plates are utilized to collect acoustic emission signal during three-point bending experiments, to evaluate the effectiveness of the proposed approach and to investigate the influence of size effect on the acoustic emission signal characteristics. In addition, the transient process and centroid frequency distribution of each damage stage are investigated, and the internal structure variations in the bending damage process are detected by scanning electron microscopy inspection. Moreover, the generalization of the proposed damage monitoring method is evaluated for plate-like structures that have complex geometric features, such as welds. The results demonstrate the effectiveness of the proposed method for acoustic emission–based structural health monitoring of metallic plate-like structures.
Ethical pause as a framework for high-value care of hospitalized COVID-19 patients
Authors: Martin Benjamin J , Plews-Ogan Margaret , Parsons Andrew S
Published: April 2021

Caring for hospitalized patients with COVID-19 raises ethical dilemmas in which clinicians must weigh the unknown value of an intervention against the unknown risk of viral transmission. Current guidelines for delivering high-value care in the time of the COVID-19 pandemic do not directly address ethical dilemmas that arise from the unique concerns of individual patients. We propose an “ethical pause” in which clinicians address ethical dilemmas by taking time to ask three questions that invoke the major bioethical principles of beneficence, nonmaleficence, and distributive justice: will this intervention help my patient? Could this intervention harm my patient? Could this intervention harm or help others? Using two exemplar cases, we demonstrate how the process of deliberately asking and answering structured ethical questions is a mindful problem-solving strategy that facilitates delivery of high-value care.
A Contribution to Measure Partnership Trust in Community-Based Participatory Research and Interventions With Latinx Communities in the United States
Authors: Moore de Peralta Arelis , Prieto Rosas Victoria , Smithwick Julie , Timmons Shirley M. , Torres Myriam E.
Published: April 2021

Given the growing diversity in the United States, responsiveness to the needs of diverse communities is paramount. Latinx communities in the United States often state mistrust in outside institutions because of adverse experiences. Community-based participatory research (CBPR) is considered a trust-building process and is one approach to understand disparities. However, the conceptualization and evaluation of trust as a CBPR outcome are understudied. This article summarizes a community-engaged research process conducted for the cultural and linguistic refinement of a partnership trust survey tool to assess partnership trust as an outcome of CBPR (CBPR-PTS), by using Perinatal Awareness for Successful Outcomes (PASOs) as a case study and cross-cultural cognitive interviewing (CCCI) methodology. The participants were 21 diverse stakeholders of PASOs, a community-based health organization that serves the Latinx population in South Carolina. A modified version of the multidimensional measure of trust model informed instrument development. The team analyzed the CCCI data using compiling informal analysis to identify which survey items’ wordings must be changed or adapted based on the participants’ accounts. Sixteen of 28 questions subjected to CCCI required modifications due to translation errors, culturally specific errors, or general cognitive problems. The new survey instrument has 19 scales and 195 items categorized into nine dimensions of the modified multidimensional measure of trust model. CCCI was a useful tool to address the cross-cultural understanding issues of the CBPR-PTS. Measurement instruments should be able to capture the socioeconomic, cultural, and geographic/environmental variability of community stakeholders to help understand the diversity of the comprehension and views of the communities involved in disparities’ reduction efforts.
School Nurses as Vital Members of 504 and Individualized Educational Program Teams: Do District-Level Policies Make a Difference in School Nurses’ Involvement?
Authors: McCabe Ellen M. , Kaskoun Jeannine R. , Strauss Shiela M.
Published: April 2021

In 2019, 10 to 20 million school-aged youth were identified as having a chronic health condition or disability. However, little is known about U.S. school district policies on school nurses’ participation in Individualized Educational Program (IEP) and Section 504 teams to support these youth. Using nationally representative district-level data from the 2016 School Health Policies and Practices Study, we examined whether U.S. school districts have policies on school nurse participation in IEP and 504 development. In addition, we examined the relationship between having such policies and policies on (a) creating and maintaining school teams to assist students with disabilities and (b) the participation of other essential school staff in IEP and 504 development. Among districts with policies regarding school nurse participation in IEP development versus those that did not, a significantly greater proportion had policies on student support teams and counselors’ participation on IEP teams (79.2% vs. 44.4%, p <  .001, and 98.7% vs. 56.2%, p <  .001, respectively). In addition, among districts with policies on school nurse participation in 504 development versus those that did not, a significantly greater proportion also had policies on support teams and counselors’ participation on 504 teams (77.5% vs. 43.1%, p <  .001, and 97.2% vs. 50.7%, p <  .001, respectively). We also examine regional and locale differences in these policies. Findings encourage discussion on student support teams’ role in school districts for students with chronic health conditions and disabilities, how school nurses can be essential team members, and better coordination of student care to promote children who are engaged, healthy, and supported within the school community.
Commodifying Diversity in the Marketing of a Digital Hearing Start-Up
Authors: Matthews Nicole
Published: April 2021

This article will unpack the consequences of the convergence between hearing aids and mobile phones. It deploys an analysis of the marketing of two hearing and communication apps from one start-up: a smartphone-based hearing test and a music app which tweaks users’ audio to accommodate their hearing profile. This article argues that both apps and the marketing for them can be seen as examples of biomediation. Rather than marketing hearing apps through biomedical categories to people who recognize themselves as disabled or “hearing impaired,” these apps are framed as personalizing music to fit a unique “earprint.” The article draws on two concepts used to understand this “disruption of the non-disabled/disabled binary” (Puar 2017, xvii, xviii): debility and diversity. Finally, the article offers a critical perspective on the political meanings of the term “diversity” and argues that the categorization of apps has important political consequences.
Expression Profiles Reveal Involvement of VEGF, IGF1, BIRC5, and MMP1 in Vulvar Carcinogenesis
Authors: Zhang Tao , Liu Qin , Yu Minghua , Lan Yibing , Zhou Jianghong
Published: April 2021

Objective:

The objective of this study was to identify key genes and shed light on the underlying molecular mechanisms of vulvar squamous cell carcinoma (VSCC).

Methods:

Bioinformatic software was utilized for the identification and characterization of key differentially expressed genes (DEGs) from microarrays GSE63678 and GSE38228, which contain VSCC and normal vulvar tissue data. These microarrays were obtained from Gene Expression Omnibus (GEO). Immunohistochemical assays (55 VSCC and 50 normal vulvar tissues) were utilized to validate the expression of VEGF, IGF1, BIRC5, and MMP1 screened from the identified DEGs. SPSS 18.0 software was used for statistical analyses of the relationships between IGF1, BIRC5, VEGF, MMP1 expression levels and patient clinicopathological characteristics.

Results:

A total of 141 DEGs were identified, among which 18 genes were closely correlated with the biological characteristics of VSCC. Four of the 18 genes ( VEGF, IGF1, BIRC5, and MMP1) screened from the GEO database were markedly enriched in pathways in cancer ( P < 0.05), and could be considered key genes in VSCC based on KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway analysis in DAVID (Database for Annotation, Visualization and Integrated Discovery).The expression levels of these 4 hub genes, determined by immunohistochemical assays, were consistent with the bioinformatics results. Higher expression of IGF1 showed significant association with well-differentiated carcinomas ( P = 0.017). BIRC5 expression levels showed a positive correlation with clinical stage ( P = 0.039); compared with those in menopause for over 10 years, patients in menopause for less than 10 years at the time of diagnosis tended to have significantly higher expression of BIRC5 ( P = 0.003). VEGF and MMP1 expression levels were not correlated with any of the tested clinicopathological characteristics.

Conclusion:

VEGF, IGF1, BIRC5, and MMP1 were identified as being associated with VSCC using integrated bioinformatic methods, which may provide important insights into the pathogenesis of this disease and help to identify new biomarkers.
A Very Rare Case of Necrotizing Fasciitis Caused by Metallosis
Authors: Huang Dun-Wei , Liu Nien-Tzu , Liu Hung-Hui , Dai Niann-Tzyy , Chen Shyi-Gen , Tzeng Yuan-Sheng
Published: April 2021

Necrotizing fasciitis is a surgically diagnosed infection of the deep soft tissues that results in high mortality. It is usually caused by aerobic and anaerobic bacteria and group A Streptococcus. Metallosis is characterized by the deposition of metal debris in the blood that causes metal poisoning and tissue damage. The abrasion of metal components that occurs after joint replacements causes metallosis, which may lead to severe complications. We report a rare case of metallosis-induced necrotizing fasciitis of the right thigh. Metallosis should be considered as a cause of necrotizing fasciitis if the patient has had a joint replacement surgery.
Onychomycosis and Tinea Pedis in the Feet of Patients With Diabetes
Authors: Aragón-Sánchez Javier , López-Valverde María E. , Víquez-Molina Gerardo , Milagro-Beamonte Ana , Torres-Sopena Luis
Published: April 2021

This study aimed to determine the prevalence of onychomycosis and interdigital tinea pedis in a cohort of Spanish patients with diabetes in whom onychomycosis was clinically suspected (n = 101). Samples from a first toenail scraping and the fourth toe clefts were subjected to potassium hydroxide direct vision and incubated in Sabouraud and dermatophyte test medium. Fifty-eight samples were also analyzed by a pathologist using periodic acid-Schiff staining and Calcofluor white direct fluorescence microscopy. Onychomycosis was only confirmed in 41 patients (40.6%). The most frequent aetiological agent was Trichophyton rubrum, isolated in 10 patients (36%), followed by Candida parapsilosis in 7 patients (25%). Tests on the fourth toe cleft samples were only positive in 11 patients (10.9%), and in all cases, onychomycosis was also diagnosed. Neuroischemic foot was the only significant variable associated with onychomycosis in the univariate analysis ( P < .01). A positive result for mycosis in the fourth toe cleft was found in 11 cases (10.9%) and was associated with a history of myocardial infarction ( P< .01; odds ratio [OR]: 84.2, confidence interval [CI]: 6.8-1036.4) and neuroischemic foot ( P< .01; OR: 13.7, CI: 12.6-71.6) in the multivariate model. In conclusion, the prevalence of onychomycosis and tinea pedis in patients with diabetes in whom onychomycosis was clinically suspected was 40.6% and 10.9%, respectively. In addition, onychomycosis was not always associated with tinea pedis. These results show that clinical diagnosis has low accuracy in people with diabetes mellitus, and that diagnosis should not be based on clinical toenail characteristics alone.
Leading and Working From Home in Times of COVID-19: On the Perceived Changes in Leadership Behaviors
Authors: Stoker Janka I. , Garretsen Harry , Lammers Joris
Published: April 2021

Due to the COVID-19 crisis, managers and employees in many organizations suddenly are forced to work from home. Although working from home (WFH) is not a new phenomenon, it is new in its current scale and scope because of COVID-19. Against this background, we investigate the effect of WFH during the COVID-19 crisis on changes in leadership behaviors, and associated changes in perceived manager quality and productivity, at different hierarchical levels in organizations. Based on the literature, we develop two predictions in opposite directions. On the one hand, implementing WFH may force managers to show less direction and control and especially more delegation. On the other hand, research into the effects of exogenous shocks such as COVID-19, suggests that managers may become more controlling and delegate less. Consistent with the first prediction, we find that managers perceive they execute significantly less control and delegate more. Employees also perceive a significant decrease in control, however they perceive on average no change in delegation. Furthermore, and in line with the second prediction, employees of lower-level managers even report a significant decrease in delegation. Finally, our results show that increased delegation is associated with increased perceived productivity and higher manager quality. Together, these results suggest that in the context of the COVID-19 crisis, the effectiveness of WFH might be hampered by the fact that required changes in leadership behaviors, in particular in delegation, are difficult to realize in times of crisis.
Developing a Group Program for Older Males to Participate in Social Activities in Japan: A Mixed-Methods Study
Authors: Nomura Kenta , Kobayashi Norikazu
Published: April 2021

This study analyzes the effect of social participation in a program that encourages participation in social activities as an approach to counteract the social isolation of elderly males in Japan. The design of this study was an open-label, before-and-after trial for a single group using the convergent design of the mixed-methods study. This program led to significant improvement in independent living and interest in society, but it did not help increase satisfaction with social activities. Additionally, a qualitative data identify that this program encouraged subjects to proactivity participate in social activities. While it has been identified that this program may have had a considerable effect by integrating quantitative and qualitative data, it is necessary to improve the program to further promote change in the subjects’ social behavior.
Hand Surgeons Are Tackling Tougher Scaphoids: A Study of ABOS Candidate Data
Authors: Nicholson Tyler , Dunn John C. , Nesti Leon J.
Published: April 2021

Background

This study will evaluate whether those who have completed a hand fellowship treat a disproportionate number of scaphoid fractures based on recent American Board of Orthopaedic Surgery (ABOS) data. We hypothesize that surgeons who have completed a fellowship in hand surgery will address most surgically treated scaphoid fractures, particularly those with fracture nonunions or requiring graft.

Methods

We queried the ABOS database for case log information submitted for part II of the ABOS examination. This search included all cases with Current Procedural Terminology codes for procedures related to scaphoid fixation. Demographic information, case volume, type of case, and complication rate were compared for hand fellowship–trained surgeons and those who had completed other fellowships as well as non-fellowship-trained surgeons.

Results

During the study period, 1686 surgeons reported treating 4244 scaphoid fractures. Of these surgeons, 1180 had completed a hand surgery fellowship. Hand fellowship–trained surgeons were shown to have operatively treated more scaphoid fractures both in total volume and on a per-surgeon basis. Hand fellowship–trained surgeons were also found to have performed a significantly higher proportion of difficult cases, which were those listed as being a malunion/nonunion or those incorporating a pedicle graft. There was no difference in the complication rate between the 2 groups.

Conclusion

Among those orthopedic surgeons reporting case information for part II of the ABOS certification examination, statistically significant differences exist in case volume and case difficulty among surgeons with different areas of fellowship training. Complication rates increase with patient age and examination year.
Structural analysis and improvement for a new form traveler in long-span cantilever-casting arch bridge
Authors: Li Xiujun , Zhou Jianting , Wu Yuexing , Wang Zhen , Li Xiaogang
Published: April 2021

A form traveler used in bridge construction has a great influence on the safety of the performance and alignment of bridges. As a cantilever casting segment of a bridge becomes longer and heavier, the traditional form traveler may not meet the strength and stiffness requirements, and there is a risk of collapse. This study has devised a new triangle truss form traveler and investigated the performance based on the Ye-Lang Lake arch bridge in China. Firstly, the numerical models of the form traveler were established to get the strength and stiffness index of the form traveler used for the arch Segment 2. Subsequently, the improvement scheme of the mechanical properties of the form traveler has been proposed. Then the partial refined numerical analysis model of the C-type hook has been established, a finite element model, and a design scheme for improving partial structures of the C-type hook was proposed. Finally, the field load test was carried out to verify the reliability of the new form traveler. The test results show that the improvement of the new form traveler is effective.
Effects of first-order chemical reaction and melting heat on hybrid nanoliquid flow over a nonlinear stretched curved surface with shape factors
Authors: Hussain Zakir , Muhammad Saima , Anwar Muhammad Shoaib
Published: April 2021

The aim of the current study is to disclose the results of shape factor analysis of the flow of a hybrid nanofluid over a curved sheet. The flow is caused by a stretchable curved sheet. Mathematical modeling and analyses have been performed in the presence of curvature, melting heat and heterogeneous-homogeneous reactions. Autocatalysis and the coefficients of the reactant are dealt with in a similar manner. The physical properties of the fluid, including the fluid velocity, the heat and mass transfer properties, the skin friction and the Nusselt number have been acquired and analyzed under the influences of the dimensionless curvature, melting and heterogeneous–homogeneous reaction variables. Boundary layer approximations are used in the mathematical formulation. Suitable transformations have been used to transform differential equations into nonlinear ordinary differential equations. The resulting nonlinear system of equations has been analyzed via the matlab bvp4c solver. Comparisons of nanoliquids with the hybrid nanoliquid are presented through graphs and tables. The results of this analysis show that the skin friction and the heat transfer rate in the hybrid nanofluid are seen more prominently than those of the nanofluid for larger values of the curvature parameter [Formula: see text].
Variation and appropriateness of antipsychotic use in long-term care facilities across Newfoundland and Labrador
Authors: Giovannini-Green Zachary E. M. , Gamble John-Michael , Barrett Brendan , Gao Zhiwei , Stuckless Susan , Parfrey Patrick S.
Published: April 2021

Objective:

The use of antipsychotics to treat seniors in long-term care facilities (LTCFs) has raised concern because of health consequences (i.e., increased risk of falls, stroke, death) in this vulnerable population. This study measured geographic patterns of antipsychotic utilization among seniors living in LTCFs in Newfoundland and Labrador (NL) and assessed potential inappropriateness.

Method:

We analyzed prescription records among adults 66 years and older with provincial prescription drug coverage admitted to LTCFs in NL between April 1, 2011, and March 31, 2014. Patterns of use were analyzed across the 4 regional health authorities (RHAs) in NL and LTCFs. Logistic, Poisson and linear regression models were used to test variations in prevalence, rate and volume of antipsychotic utilization. To assess potential inappropriateness of antipsychotic use, we analyzed data from Resident Assessment Instrument–Minimum Data Set (RAI-MDS) 2.0 forms from NL LTCFs between January 1, 2016, and December 31, 2018. Pearson chi-squared analysis was performed at the RHA and LTCF levels to determine changes in percentage of total prescriptions or antipsychotic prescriptions without psychosis.

Results:

Between 2011 and 2014, 2843 seniors were admitted to LTCFs across NL; of these, 1323 residents were prescribed 1 or more antipsychotics. Within the 3-year period, the percentage of antipsychotic use across facilities ranged from 35% to 78%. Using data from 27,260 RAI-MDS 2.0 assessments between 2016 and 2018, 71% (6995/9851) of antipsychotic prescriptions were potentially inappropriate.

Discussion:

There is substantial variation across NL regions concerning the utilization of antipsychotics for senior in LTCFs. Facility size and management styles may be reasons for this.

Conclusion:

With nearly three-quarters of antipsychotic prescriptions shown to be potentially inappropriate, systematic interventions to assess indications for antipsychotic use are warranted. Can Pharm J (Ott) 2021;154:xx-xx.