bluuebunny/crossref_metadata_2025 huggingface dataset:
Observational study on medication administration errors at a University Hospital in Brazil: incidence, nature and associated factors
Authors: Assunção-Costa Lindemberg , de Sousa Ivellise Costa , Silva Renata Kelly Rodrigues , do Vale Ana Carla , Pinto Charleston Ribeiro , Machado Juliana Ferreira Fernandes , Valli Cleidenete Gomes , de Souza Luis Eugenio Portela Fernandes
Published: August 2022

Background

Medication administration errors are frequent and cause significant harm globally. However, only a few data are available on their prevalence, nature, and severity in developing countries, particularly in Brazil. This study attempts to determine the incidence, nature, and factors associated with medication administration errors observed in a university hospital.

Methods

This was a prospective observational study, conducted in a clinical and surgical unit of a University Hospital in Brazil. Two previously trained professionals directly observed medication preparation and administration for 15 days, 24 h a day, in February 2020. The type of error, the category of the medication involved, according to the anatomical therapeutic chemical classification system, and associated risk factors were analyzed. Multivariate logistic regression was adopted to identify factors associated with errors.

Results

The administration of 561 drug doses was observed. The mean total medication administration error rate was 36.2% (95% confidence interval 32.3–40.2). The main factors associated with time errors were interruptions. Regarding technique errors, the primary factors observed were the route of administration, interruptions, and workload.

Conclusions

Here, we identified a high total medication administration error rate, the most frequent being technique, wrong time, dose, and omission errors. The factors associated with errors were interruptions, route of administration and workload, which agrees well with the results of other national and international studies.
The prevalence and socio-demographic risk factors of coexistence of stunting, wasting, and underweight among children under five years in Bangladesh: a cross-sectional study
Authors: Chowdhury Mohammad Rocky Khan , Rahman Md Shafiur , Billah Baki , Kabir Russell , Perera Nirmala K. P. , Kader Manzur
Published: August 2022

Background

Childhood stunting, wasting and underweight are significant public health challenges. There is a gap in knowledge of the coexistence of stunting, wasting, and underweight among children under five years (under-5) in Bangladesh. This study aims to (i) describe the prevalence of the coexistence of stunting, wasting, and underweight and ii) examine the risk factors for the coexistence of stunting, wasting, and underweight among children under-5 in Bangladesh.

Methods

This study included 6,610 and 7,357 under-5 children from Bangladesh Demographic Health Surveys (BDHS) 2014 and 2017/18, respectively. The associations between the coexistence of stunting, wasting, and underweight and independent variables were assessed using the Chi-square test of independence. The effects of associated independent variables were examined using negative binomial regression.

Results

The prevalence of coexistence of stunting, wasting, and underweight gradually declined from 5.2% in 2014 to 2.7% in 2017/18. Children born with low birth weight ((adjusted incidence rate ratios, aIRR) 2.31, 95% CI 1.64, 3.24)); children of age group 36–47 months (aIRR 2.26, 95% CI 1.67, 3.08); children from socio-economically poorest families (aIRR 2.02, 95% CI 1.36, 2.98); children of mothers with no formal education (aIRR 1.98, 95% CI 1.25, 3.15); and children of underweight mothers (aIRR 1.73, 95% CI 1.44, 2.08) were the most important risk factors. Further, lower incidence among children with the coexistence of stunting, wasting, and underweight was observed in the 2017–18 survey (aIRR 0.59, 95% CI 0.49, 0.70) compared to children in the 2014 survey.

Conclusions

One out of thirty-five under-5 children was identified to have coexistence of stunting, wasting, and underweight in Bangladesh. The burden of coexistence of stunting, wasting, and underweight was disproportionate among children born with low birth weight, socio-economically poorest, a mother with no formal education, and underweight mothers, indicating the need for individual, household, and societal-level interventions to reduce the consequences of coexistence of stunting, wasting, and underweight.
Correlation between tumor to liver SUV ratio and molecular subtypes of invasive breast carcinoma in PET CT
Authors: El Kiki Nada Adel Awad , Mohamed Fatma Salah Eldeen , Abu ElMaati Amal Amin , Keriakos Nermeen Nasry
Published: August 2022

Background

Breast cancer is known to be one of the most cancer affecting women around the globe and the second most common cancer in general. In third worlds countries, breast cancer is the most cause of cancer death. Early diagnosis and accurate follow-up of these patients affect the management. There are multiple prognostic factors most important one is the immunohistochemical molecular markers in the specimens including human epidermal growth factor, progesterone, and estrogen receptors (HER2, PR, ER). In breast cancer, the HER2 positive molecular subtype is associated with a bad prognosis and aggressive histological features, yet while following neoadjuvant chemotherapy, it achieves an increased pathological complete response rate. 18F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) has proved to be an effective and accurate imaging technique for lymph node and distant metastasis assessment, tumor staging, restaging of recurrence, treatment response, and follow-up. In breast cancer, tumor molecular subtype, tumor size, proliferation index, and histological grade correlated with 18F-fluoro-2-deoxy-d-glucose (FDG) uptake. This study evaluates the possible correlation between tumor to liver and tumor to spleen (standardized uptake value) SUV max ratio and the four different molecular subtypes in patients with pathologically proven primary breast cancer.

Results

Tumor to liver and tumor to spleen SUV max ratio (TLR, TSR) was a significant parameter for HER2 molecular subtype identification (P value = 0.0005 and 0.014 respectively) and luminal A molecular subtype identification (P value = 0.016 and 0.037 respectively). The specificity, sensitivity, and area under the receiver operating-characteristic curve (AUC) of TLR parameters for HER2-positive subtype identification were 89.4%, 83.3%, and 0.89, respectively. The specificity, sensitivity, and AUC of the TSR parameter for HER2-positive subtype identification were 57.9%, 100%, and 0.83, respectively.

Conclusions

TLR and TSR appeared to be valuable for HER2- and luminal A molecular subtype detection. thus, 18F-FDG PET/CT could be a beneficial tool for prediction of tumor biological characteristics that help in management of breast cancer patients.
Evaluation of a Culturally Responsive Mentorship Education Program for the Advisers of Howard Hughes Medical Institute Gilliam Program Graduate Students
Authors: Pfund Christine , Sancheznieto Fátima , Byars-Winston Angela , Zárate Sonia , Black Sherilynn , Birren Bruce , Rogers Jenna , Asai David J.
Published: August 2022

Culturally responsive mentorship education, like the Mentorship Skills Development course implemented as part of the Howard Hughes Medical Institute’s Gilliam Fellows Program, can increase knowledge and efficacy in effective mentorship practices and improve mentorship experiences of both mentors and mentees.
Psychological Evaluation of Patients With Cancer Presenting to the Emergency Department With Pain: Independent Predictors of Worse Pain Severity, Interference, and Higher Hourly Opioid Administration
Authors: Azizoddin Desiree R. , Beck Meghan , Flowers K. Mikayla , Wilson Jenna M. , Chai Peter , Johnsky Lily , Cremone Gabrielle , Edwards Robert , Hasdianda Adriana , Boyer Edward , Schreiber Kristin L.
Published: August 2022

PURPOSE:

Pain is a common complaint in patients with cancer presenting to the emergency department (ED). This prospective study evaluated whether biopsychosocial factors could help predict cancer patients with risk of higher pain severity, pain interference, and opioid consumption.

METHODS:

Patients with cancer presenting to the ED with a complaint of moderate-severe pain (≥ 4/10-numeric rating scale) completed validated self-report measures assessing sociodemographics, cancer-related treatments, pain severity and interference, medication use, and psychological symptoms (depression, anxiety, pain catastrophizing, and sleep disturbance). Opioids administered and subsequent hospitalization were abstracted. Univariable and multivariable regression analyses assessed factors associated with pain-related outcomes.

RESULTS:

Participants (n = 175) presented with a variety of cancer types, with 76% having metastatic disease and 42% reporting current outpatient opioid use. Higher pain catastrophizing, lower depressive symptoms, lower income, outpatient opioid use, and historical chronic pain were independently associated with worse pain ( P ≤ .05). Higher pain catastrophizing, anxiety, sleep disturbance, outpatient opioid use, and education were independently associated with worse pain interference ( P ≤ .05). The sole independent predictor of ED opioid administration was outpatient opioid use. Patients taking outpatient opioids were younger, had lower health literacy, worse pain catastrophizing, sleep disturbance, depression/anxiety, and greater rates of metastatic cancer and cancer-related surgery ( P ≤ .05).

CONCLUSION:

Biopsychosocial factors, particularly pain catastrophizing, remained significantly associated with worse pain outcomes for patients with cancer in the ED even after controlling for demographic and clinical variables. Patient outpatient opioid use was independently associated with worse pain, interference, and greater opioid administration, identifying this as a marker for who may benefit most from adjuvant pharmacologic and behavioral interventions.
Markets of Civilization
Authors: Davis Muriam Haleh
Published: August 2022

In Markets of Civilization Muriam Haleh Davis provides a history of racial capitalism, showing how Islam became a racial category that shaped economic development in colonial and postcolonial Algeria. French officials in Paris and Algiers introduced what Davis terms “a racial regime of religion” that subjected Algerian Muslims to discriminatory political and economic structures. These experts believed that introducing a market economy would modernize society and discourage anticolonial nationalism. Planners, politicians, and economists implemented reforms that both sought to transform Algerians into modern economic subjects and drew on racial assumptions despite the formally color-blind policies of the French state. Following independence, convictions about the inherent link between religious beliefs and economic behavior continued to influence development policies. Algerian president Ahmed Ben Bella embraced a specifically Algerian socialism founded on Islamic principles, while French technocrats saw Algeria as a testing ground for development projects elsewhere in the Global South. Highlighting the entanglements of race and religion, Davis demonstrates that economic orthodoxies helped fashion understandings of national identity on both sides of the Mediterranean during decolonization.
Dragging Away
Authors: Lancaster Lex Morgan
Published: August 2022

In Dragging Away Lex Morgan Lancaster traces the formal and material innovations of contemporary queer and feminist artists, showing how they use abstraction as a queering tactic for social and political ends. Through a process Lancaster theorizes as a drag—dragging past aesthetics into the present and reworking them while pulling their work away from direct representation—these artists reimagine midcentury forms of abstraction and expose the violence of the tendency to reduce abstract form to a bodily sign or biographical symbolism. Lancaster outlines how the geometric enamel objects, grid paintings, vibrant color, and expansive installations of artists ranging from Ulrike Müller, Nancy Brooks Brody, and Lorna Simpson to Linda Besemer, Sheila Pepe, and Shinique Smith offer direct challenges to representational and categorical legibility. In so doing, Lancaster demonstrates that abstraction is not apolitical, neutral, or universal; it is a form of social praxis that actively contributes to queer, feminist, critical race, trans, and crip politics.
Phototunable Golden Luster Microcrystalline Film of Photochromic Diarylethene
Authors: Nakagawa Yuma , Nishimura Ryo , Morimoto Masakazu , Yokojima Satoshi , Nakamura Shinichiro , Uchida Kingo
Published: August 2022

This study presents phototunable organic golden luster material. We adopted photochromic diarylethene to produce this material. Through recrystallization, the compound formed plate-like microcrystals, which were then laminated to form a film. The yellowish gold-colored textured film was achieved by a combination of diarylethene absorption and specular reflection from the surface of the stacked microcrystals. The produced films showed a change in color to deep gold upon UV light irradiation due to the change in the absorption band caused by the photocyclization of diarylethene. The film reverted to its original color upon exposure to visible light due to the photocycloreversion of the diarylethene. Such photoresponsive metallic luster in a material could have a significant impact on applications in the decoration and ink industries by avoiding the use of actual precious metals.
A Guide to the Assessment of Function and Fitness in Older Adults
Authors: Thompson Christian J.
Published: August 2022

Apply It!

After finishing this article, the reader will:

• Understand the components of an integrated assessment to be used with older adults.

• Understand the screening process and interpret the data to reveal health risks.

• Learn the procedures for functional fitness assessments including the Senior Fitness, Gait Speed, Functional Reach, Timed Up-and-Go, and Dual-Task Testing.
A Agência Nacional de Águas e a coordenação federativa no Novo Marco do Saneamento Básico
Authors: Ribas Lídia Maria , Savioli Anna Beatriz , Pinheiro Hendrick
Published: August 2022

Este artigo científico busca analisar a especificação dos campos de competência da União, dos estados, do Distrito Federal e dos municípios e o papel da Agência Nacional de Águas e Saneamento Básico (ANA) como instituição de coordenação federativa no novo marco legal de saneamento. Apresenta-se uma pesquisa qualitativa, de viés pós-positivista e caráter hipotético-dedutivo, conduzida por meio de revisão bibliográfica dogmática realizada a partir de textos do direito positivo brasileiro e da doutrina nacional. Conclui-se pela confirmação da hipótese inicial, segundo a qual o novo marco legal do saneamento contribuiu para uma definição mais precisa sobre as atribuições dos entes federados em relação ao saneamento básico e atribuiu à Agência Nacional de Águas e Saneamento Básico o papel de agente de coordenação federativa. O trabalho propõe uma análise, sob o prisma do federalismo cooperativo ambiental, da recente alteração legislativa introduzida pela Lei nº 14.026, de 15 de julho de 2020, e contribui para a técnica interpretativa das competências de cada ente estatal em matéria de saneamento básico.
Instrumentos processuais de controle dos regulamentos à luz dos ordenamentos jurídicos brasileiro e português
Authors: Lima Lucas Asfor Rocha
Published: August 2022

O tema central deste estudo é a análise dos instrumentos processuais de controle jurisdicional dos regulamentos de uma perspectiva comparada entre os ordenamentos jurídicos brasileiro e português, tema reconhecidamente atrativo e ainda de grande utilização prática. A metodologia aqui empregada consiste em um cotejo analítico entre os dois sistemas jurídicos acerca das ações judiciais com vistas a exercer o devido controle sobre os atos regulatórios, como forma de consolidação do estado democrático de direito.
Em busca de uma regra geral para a realização de autocomposição na administração pública: a insuficiência da Lei nº 13.140/2015
Authors: Spengler Fabiana Marion , Eidt Elisa Berton
Published: August 2022

O texto visa examinar a existência, no ordenamento jurídico brasileiro, de uma legislação geral que autorize a administração pública a adotar métodos alternativos de solução de conflitos, à semelhança do que ocorre nos Estados Unidos (Administrative Dispute Resolution Act — Adra). Faz-se uma reflexão acerca dos dispositivos da Lei nº 13.140/2015, no que diz respeito aos entes públicos, em que se percebe sua insuficiência para que a autocomposição seja efetivamente incorporada pela administração. O objetivo do presente artigo é identificar se os dispositivos legais da referida legislação se prestam para que a administração adote a mediação e a negociação como formas de solucionar seus conflitos. Para cumprir tal objetivo, o método utilizado será o hipotético-dedutivo. A partir de uma análise da experiência dos Estados Unidos, são traçados alguns requisitos mínimos que merecem ser observados, a fim de que os métodos alternativos sejam utilizados de forma adequada. Diferentemente do que vem ocorrendo com a arbitragem, conclui-se que, no Brasil, a mediação e a negociação extrajudiciais ainda se encontram em zona de incerteza quando se trata de conflito envolvendo a administração pública.
A study to evaluate the impact of COVID-19 on Lifestyle of Medical students
Authors: Tahir Sania , Imran Nazish , Haider Imran Ijaz , Mustafa Ali Burhan , Rehman Aqeeb-ur , Azeem Muhammad Waqar , Javed Afzal
Published: August 2022

Background: Stressful situations are often linked with poor health and lifestyle behaviors (e.g., unhealthy diet, limited physical activity, poor sleep quality etc.). Subsequent to the nationwide lockdown in Pakistan due to COVID-19 pandemic, medical students experienced substantial lifestyle changes along with academic stresses. The goal of this study was to measure the impact that the COVID-19 lockdown had on lifestyle like sleep, physical activity and nutrition, substance abuse, dealing with finances, spirituality and family life, with respect to a sample of Pakistani medical students.

Methods: This cross- sectional online study involving 1100 medical students (68.7% females) from five medical colleges in Pakistan, used self-administered questionnaire to evaluate the impact of pandemic related restrictions on lifestyle of medical students in Pakistan from August- September 2020. Parameters such as physical activity, sleep, nutrition, smoking and substance abuse, family life, finances, internet use and spirituality were studied.

Results: Fifty-nine percent of medical students reported a significant effect of lockdown on their physical activity. Only 5.8% people clearly followed or adhered to a routine during the pandemic. About 54.6% students have found that physical activity and exercise significantly reduced their anxiety. More than half of respondents reported increase in screen time, weight gain and poor sleep with 3.1% of students stating an increased use of sleeping pills to fall asleep Another 18.3% students had an increased worry regarding COVID19 based on the information they received on internet. No significant increase in substance uses and alcohol use or family conflicts among students post pandemic was noted.

Conclusion: Our findings underscore that COVID-19 pandemic has led to undesired changes in health and lifestyle habits of medical students, which may, to some extent, be responsible for higher negative impact. Hence it is important for medical colleges to start awareness campaigns to tackle challenges for medical students physical and emotional well-being.

doi: https://doi.org/10.12669/pjms.38.7.6031

How to cite this:Tahir SM, Imran N, Haider II, Mustafa AB, Aqeeb-ur-Rehman, Azeem MW, et al. A study to evaluate the impact of COVID-19 on Lifestyle of Medical students. Pak J Med Sci. 2022;38(7):1730-1737. doi: https://doi.org/10.12669/pjms.38.7.6031

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Η Ηθική και η Επιρροή της Βιομηχανίας Φαρμάκων στην Ιατρική
Authors: Ψαρομμάτης Μιχαήλ
Published: August 2022

Οι μελέτες περίπτωσης αυτού του βιβλίου αναλύουν συγκρούσεις συμφερόντων που προκύπτουν στον χώρο της ιατρικής και την επίδρασή τους στην λήψη αποφάσεων στο περιβάλλον της φαρμακευτικής βιομηχανίας. Μέσα από την μελέτη πραγματικών και υποθετικών περιστατικών γίνεται αξιολόγηση καταστάσεων στις οποίες παρουσιάζονται συγκρούσεις και ηθικά διλήμματα κυρίως ανάμεσα σε δύο βασικούς άξονες: το εκάστοτε προσωπικό συμφέρον από τη μία και το ιατρικό όφελος του κοινού από την άλλη. Χωρίς να δίνονται απόλυτες, κατηγορηματικές απαντήσεις σε αυτά τα ηθικά και κλινικά διλήμματα, γίνεται ολιστική αξιολόγηση των περιστατικών αυτών, με χρήση μεθόδων ανάλυσης που λαμβάνουν υπόψη τις συγκεκριμένες συνθήκες. Ως αποτέλεσμα το βιβλίο αυτό αποτελεί έναν χάρτη ο οποίος, συνυπολογίζοντας τα εκάστοτε μοτίβα δεδομένων και τα διαφορετικά ηθικά μοντέλα που μπορούν να εφαρμοστούν σε κάθε περίπτωση, θα βοηθήσει τον αναγνώστη να δράσει αποτελεσματικά όταν βρεθεί αντιμέτωπος με ένα παρόμοιο ηθικό δίλημμα.
Διδάσκοντας Ηθική της Μεταμόσχευσης Οργάνων και της Δωρεάς Ιστών
Authors: Τσιακίρη Λυδία
Published: August 2022

Η μεταμόσχευση οργάνων είναι μια εξαιρετική νέα επιλογή της σύγχρονης χειρουργικής, ικανή να προσφέρει ελπίδα σε χρόνιους ασθενείς, αλλά, ταυτόχρονα, και να γεννήσει αμφιλεγόμενα ηθικά ερωτήματα σχετικά με την ανθρώπινη ταυτότητα και τη σημασία του ανθρώπινου σώματος. Αποτελώντας μια παγκόσμια και διεθνική προσπάθεια, η μεταμόσχευση οργάνων εγείρει πανανθρώπινες ηθικές ανησυχίες, ενώ, ακόμα, οφείλει να συμμορφωθεί με πολιτισμικά καθορισμένες πεποιθήσεις. Σε αυτό το βιβλίο, 30 μελέτες περίπτωσης προερχόμενες από όλο των κόσμο αποσαφηνίζουν το εύρος παγκόσμιων και τοπικών, ηθικών, κοινωνικών, και πολιτισμικών προβλημάτων που απορρέουν από τη νέα αυτή μορφή θεραπείας. Συνοδευόμενη από μία λίστα σχετικών ταινιών, η συλλογή παρέχει μια μοναδική πηγή για τη διδασκαλία της ηθικής στους κόλπους της ιατρικής, της ιατρικής περίθαλψης, της φιλοσοφίας, και των θρησκευτικών σπουδών. Οι συγγραφείς συμπληρώνουν αυτό το υλικό διδασκαλίας παρέχοντας μια συστηματική εισαγωγή στο πεδίο της ηθικής της μεταμόσχευσης.
Το επίθετο στον Απόστολο Παύλο
Authors: Γεωργιάδου Ροδή
Published: August 2022

H διδακτορική διατριβή επιχειρεί να μελετήσει τη λειτουργία του επίθετου μέσα στο παύλειο corpus της Καινής Διαθήκης με ερμηνευτικό εργαλείο έναν από τους κλάδους της Γλωσσολογίας, αυτόν της Μορφολογίας. Αρχικά, επιχειρείται η μορφολογική εξέταση των κατασκευασμένων επιθέτων του corpus. Καταγράφονται όλα τα επίθετα και ταξινομούνται με κριτήριο την μορφολογική τους κατασκευή. Από το σύνολο των κατασκευασμένων επιθέτων αναζητούνται οι νεολογισμοί του corpus και περιγράφεται ειδικώς η μορφολογία και η σημασιολογία κάθε νεολογισμού. Η ανάλυση αυτή αξιοποιείται στην ερμηνεία των νεολογισμών με σκοπό να φωτίσει ερμηνευτικά ζητήματα μέσω της γλωσσικής τους φύσης. Το συμπέρασμα που προκύπτει από την εν λόγω μελέτη σχετίζεται με την πολυποίκιλη χρήση των επιθέτων ως γλωσσικών μέσων έκφρασης της θεολογικής σκέψης του αποστόλου. Αναλύονται παραδείγματα επιθέτων που είναι προσδιοριστικά προσώπων (του Χριστού, του αποστόλου, των επισκόπων, των ανθρώπων των έσχατων χρόνων, των πιστών, κάποιων ομάδων με δράση αντίθετη των αποστόλων, των ανθρώπων γενικά), πραγμάτων (της Γραφής, των χαρισμάτων, κάποιων εννοιών) και επίθετα που είναι δηλωτικά σχέσεων. Επιχειρείται η ποσοτική και ποιοτική ανάλυση των επιθέτων με εργαλείο τις μεθόδους της Υπολογιστικής Γλωσσολογίας. Παρουσιάζεται ο κατάλογος συχνότητας και με βάση τα δεδομένα που προσφέρει επιχειρείται μία ερμηνεία και μελέτη των επιθέτων, ενώ παράλληλα επιχειρείται η συνολική εξέτασή τους με κριτήριο τα σημασιολογικά χαρακτηριστικά τους (μεταφορά, επίταση, νεολογία). Με την ανάλυση αυτή κατανοείται ο τρόπος με τον οποίο το επίθετο συνέβαλε στη διαμόρφωση του θεολογικού λόγου του αποστόλου. Τέλος, παρουσιάζεται ο τρόπος δημιουργίας του ηλεκτρονικού λεξικού των παύλειων επιθέτων και περιγράφονται οι λεξικογραφικές αρχές του.
Η Ελλάδα στο έργο του Βασίλη Αλεξάκη
Authors: Απανωμεριτάκης Κωνσταντίνος
Published: August 2022

Στην παρούσα διδακτορική διατριβή εξετάζεται η ελληνικότητα στο έργο του Βασίλη Αλεξάκη. Η ελληνικότητα πραγματώνεται μέσα από τη σχέση που κατασκευάζει ο συγγραφέας με τη νεότερη Ελλάδα και το παρελθόν της (αρχαία και βυζαντινή). Η νεότερη Ελλάδα αποκτά υπόσταση μέσα από το ιδιαίτερα κριτικό βλέμμα του συγγραφέα σε πολιτικά και πολιτισμικά μεταίχμια και σταθμούς. Μέσα από αυτά αναδεικνύεται μια λιγότερο εξιδανικευμένη και συμβατική εκδοχή της ελληνικότητας, η οποία παρουσιάζεται ισάξια των τυπικών ιστορικών ορόσημων. Έτσι συνδέεται η νεότερη Ελλάδα με την αρχαία ελληνική και τη βυζαντινή παράδοση δημιουργώντας ένα ιστορικό συνεχές μέσα στο οποίο ο ίδιος ο συγγραφέας αισθάνεται ασφαλής στην μεταναστευτική εξορία αλλά και δημιουργεί μια σχέση εμπιστοσύνης με τους αναγνώστες - συνοδοιπόρους στο λογοτεχνικό του ταξίδι. Στην πραγμάτευση της Ελληνικής, η βιωματική αξία της μητρικής του γλώσσας του προσφέρει το έδαφος πάνω στο οποίο ο συγγραφέας επιβιώνει αποκαθιστώντας το αίσθημα τού ανήκειν. Ο αναστοχασμός της ελληνικής μετανάστευσης διαχρονικά του επιτρέπει να δεχτεί την ταυτότητά του ως μετανάστη, το οποίο τον ευαισθητοποιεί σε σχέση τόσο με τη μετανάστευση των ίδιων των Ελλήνων όσο και τη εισδοχή μεταναστών στην Ελλάδα. Επαναλαμβανόμενα μοτίβα, λογοτεχνικές καταβολές και χαρακτήρες είναι σταθμοί συμπύκνωσης δεσμών με τη δική του ελληνικότητα, η οποία γίνεται παράγοντας προέκτασής της.
Programmatic mapping and estimating the population size of female sex workers, men who have sex with men, people who inject drugs and transgender populations in Kenya
Authors: Musimbi Janet , Musyoki Helgar , Mugambi Mary , Kaosa Shem , Kioko Japheth , Aluko Diane , Wanjiru Waruiru , Wambua Solomon , Prakash Ravi , Isac Shajy , Bhattacharjee Parinita , Emmanuel Faran
Published: August 2022

Introduction: Effective coverage of Human Immunodeficiency Virus prevention services for Key Populations (KPs) including female sex workers (FSWs), men who have sex with men (MSM), people who inject drugs (PWID) and transgender (TG) people necessitates periodic validation of physical venues and size estimates. Kenya conducted a robust size estimation of KPs in 2012 and a repeat mapping and size estimation exercise was conducted in 2018 to update KP Size Estimates and sub-typologies within each County for calculation of realistic program indicators. 

Methods: A prospective mixed methods programmatic mapping approach adopted comprised two steps. The first step involved consolidating and documenting all known venues where KPs congregate while the second step included visiting and validating these venues confirming their active status. Data were collected in 34 out of 47 Counties in Kenya between January and March 2018. Data collected included estimated number of KPs (range), venue typology and timing of operation of each venue.  

Results: We estimated a total number of 167,940 (129,271 to 206,609) FSWs; 32,580 (24,704 to 40,455) MSM; 16,063 (12,426 to 19,691) PWIDs; 10,951 (8,160 to 13,742) and 4,305 (2,826 to 5,783) transgender people congregating at 10,250, 1,729, 401 and 1,202 venues respectively. Majority of the venues for FSW (81%), MSM (64%) and transgender people (67%) were bars with and without lodging, PWIDs were mostly found on streets and injecting dens (70%).  Around 9% of FSW and MSM and11% of PWIDs were below the age of 18 years. 

Conclusion: This study provided information on young KPs, female PWIDs, MSWs and for the first time, TG people in Kenya. The exercise updated size estimates of KPs by typology and provided new evidence for resource allocation, planning of interventions and targets. Programmatic mapping continues to be a useful approach supporting programs to achieve high levels of coverage and prioritize resources.
Concept maps as a novel assessment tool in medical education
Authors: LOIZOU STELLA , Nicolaou Nicoletta , Pincus Bridget Anne , Papageorgiou Alexia , McCrorie Peter
Published: August 2022

Background: We conducted a pilot study to investigate the use of Concept Maps (CMs) in a Problem-Based Learning (PBL) setting as a complementary tool to current educational techniques for enhancing medical student knowledge and critical thinking. The main focus of the pilot was to introduce a measure from the field of graph theory and investigate its usefulness as a means of CM quantitative quality assessment.

Methods: Participants were first-year medical students with no or minor prior CM experience. All participants completed questionnaires (demographic information and assessment of learning style) to establish a baseline measure against which the change in clinical and critical thinking was assessed. They were asked to prepare CMs for three PBL cases, and following the submission of the CMs they completed semi-structured critical and clinical thinking questionnaires. A clinical expert also created corresponding “benchmark” CMs for comparison. Qualitative (Wordclouds) and quantitative (graph theory) analysis provided a summary of the key concepts and quantified the CM quality respectively, compared to the “benchmark” CMs.

Results: Questionnaires revealed that CMs helped students recall information, organize material in a concise manner, prepare better for their PBL session and provided a good revision tool. It was also found that graph-theoretical measures (graph density, modularity) were suitable for distinguishing between CMs that captured more in-depth knowledge, compared to CMs that contained simpler associations.

Conclusions: We have shown that it is possible to quantify CM quality using graph-theoretical measures, such as graph density and modularity.
A biopsychosocial approach to death, dying, and bereavement: a course on end-of-life education for medical students
Authors: Kripalani Simran , Joy Sandra , Raizada Shivani , Cerceo Elizabeth
Published: August 2022

Background: Despite the inevitable nature of death and dying, the conversations surrounding this subject are still uncomfortable for many physicians and medical students.

Methods: A six-week humanities-based course, “A Biopsychosocial Approach to Death, Dying, & Bereavement,” at Cooper Medical School of Rowan University, United States, which covers definitions of death and dying, the process of dying, ethical dilemmas, and new concepts of the grieving process. Through development of a curriculum using various academic and medical literature and resources, we sought to bring attention to the necessity of having a medical education curriculum on death and dying to prepare medical students for the difficult conversations and patient experiences that lie ahead of them. Qualitative data in the form of surveys and reflection papers submitted by students and quantitative data (Likert scores on course satisfaction) were collected and analyzed both pre- and post-course.

Results: 90.7% (49/54) of the respondents answered that they agree or strongly agree with the statement that this selective course was useful in the student’s medical education experience. The top three qualitative themes brought up the most in reflection papers (n=54) were: the utility and instruction of the course (21 times), the importance of hospice and palliative care (20 times), avoidance around topics of death (15 times).

Conclusions: Medical students are often not prepared to cope with the realities of patient loss and of caring for the patient and their families throughout the dying process. We created this course to familiarize medical students with an aspect of the medical experience that is frequently neglected in traditional medical curricula. We learned that integrating such a course can help educate medical students facilitate important conversations, teach them to act with kindness and dignity in a physician-patient setting, and enhance their personal understanding of death and dying.
Making pre-screening for Alzheimer's disease (AD) and Postoperative delirium among post-acute COVID-19 syndrome - (PACS) a national priority: The Deep Neuro Study
Authors: Tarnanas Ioannis , Tsolaki Magda
Published: August 2022

SARS-CoV-2 effects on cognition is a vibrant area of active research. Many researchers suggest that COVID-19 patients with severe symptoms leading to hospitalization, sustain significant neurodegenerative injury, such as encephalopathy and poor discharge disposition. However, despite some post-acute COVID-19 syndrome (PACS) case series that have described elevated neurodegenerative biomarkers, no studies have been identified that directly compared levels to those in mild cognitive impairment, non-PACS postoperative delirium patients after major non-emergent surgery or preclinical Alzheimer’s Disease (AD) patients, that have clinical evidence of Alzheimer's without symptoms. According to recent estimates, there may be 416 million people globally on the AD continuum, which include approximately 315 million people with preclinical AD. In light of all the above, a more effective application of digital biomarker and explainable artificial intelligence methodologies that explored amyloid beta, neuronal, axonal, and glial markers in relation to neurological complications in-hospital or later outcomes could significantly assist progress in the field. Easy and scalable subjects’ risk stratification is of utmost importance, yet current international collaboration initiatives are still challenging due to the limited explainability and accuracy to identify individuals at risk or in the earliest stages that might be candidates for future clinical trials. In this open letter, we propose the administration of selected digital biomarkers previously discovered and validated in other EU funded studies to become a routine assessment for non-PACS preoperative cognitive impairment, PACS neurological complications in-hospital or later PACS and non-PACS improvement in cognition after surgery. The open letter also includes an economic analysis of the implications for such national level initiatives. Similar collaboration initiatives could have existing prediagnostic detection and progression prediction solutions pre-screen the stage before and around diagnosis, enabling new disease manifestation mapping and pushing the field into unchartered territory.
Protocol for a pregnancy registry of maternal and infant outcomes in Uganda –The PREPARE Study
Authors: Davies Hannah , Afrika Simon , Olema Ruth , Rukundo Gordon , Ouma Joseph , Greenland Melanie , Voysey Merryn , Mboizi Robert , Sekikubo Musa , Le Doare Kirsty
Published: August 2022

Background: Pregnancy is associated with complications which must be differentiated from adverse events associated with the administration of vaccines during pregnancy both in clinical trials and post licensure surveillance. The frequency of pregnancy related complications varies significantly by geographical location and the prevalence of pregnancy and neonatal outcomes are poorly documented in most low-resource settings. In preparation for Group B Streptococcus maternal vaccination trials, we describe a protocol for a pregnancy register at Kawempe National Referral Hospital, Kampala, Uganda to describe pregnancy maternal and infant outcomes.

Methods: The study has two components. Firstly, an active, prospective surveillance cohort consisting of pregnant women in their first or second trimester recruited and followed up through their hospital scheduled antenatal visits, delivery and their infants through their extended programme of immunisation visits until 14 weeks of age. Data on obstetric and neonatal outcomes defined by the Brighton Collaboration Global Alliance of Immunisation Safety Assessment in Pregnancy criteria will be collected. Secondly, a passive surveillance cohort collecting data through routine electronic health records on all women and infants attending care at KNRH.  Data will be collected on vaccinations and medications including antiretroviral therapy received in antenatal clinic and prior to hospital discharge.

Discussion:  Conducting vaccine research in resource-limited settings is essential for equity and to answer priority safety questions specific to these settings. It requires improved vaccine safety monitoring, which is especially pertinent in maternal vaccine research. During a trial, understanding the epidemiology and background rates of adverse events in the study population is essential to establish thresholds which indicate a safety signal. These data need to be systematically and reliably collected. This study will describe rates of adverse pregnancy outcomes in a cohort of 4,000 women and infants and any associated medications or vaccines received at a new vaccine trial site in Uganda.
Case Report: Acute isoniazid intoxication after intentional ingestion
Authors: Thapa Astha , Dahal Agnimshwor , Yadav Saroj , Sigdel Keshav Raj , Adhikari Sudeep , Khanal Sulav , Basnyat Buddha , Dhital Roman
Published: August 2022

Isoniazid is an anti-tuberculosis medication that is extensively used for treatment and prevention of tuberculosis. Acute isoniazid poisoning is characterized by a clinical triad of recurrent seizures, raised anion gap metabolic acidosis and coma. The seizures are unresponsive to standard anticonvulsant drugs, instead requiring pyridoxine administered in a dose equal to the amount of isoniazid consumed. Due to the high incidence of tuberculosis in low-income countries like Nepal, isoniazid intoxication should be considered in any patient who present with such unresponsive seizures and coma. We report a case of a 31 years old woman from Nepal, who intentionally ingested 12 grams of isoniazid and presented with generalized tonic-clonic seizures. She was successfully managed with 10 grams of pyridoxine along with other supportive management, including sodium bicarbonate for metabolic acidosis and mechanical ventilation. Doctors working in low-income countries, like Nepal, where tuberculosis is endemic, should be well acquainted with presentations and management of isoniazid intoxication.
Chodźcie z nami! Marzec ’68 w Krakowie
Authors: Czyż Waldemar
Published: August 2022

Wśród profesjonalnych historyków często spotykana jest opinia, że nie należy opisywać – a zwłaszcza oceniać – wydarzeń, w których samemu się uczestniczyło. Zgadzam się z ich zdaniem. Ale niniejsza publikacja nie ma ambicji opracowania historycznego; jest raczej pracą popularyzatorską przeznaczoną dla dwóch przeciwstawnych wiekowo kręgów czytelników: ludzi młodych, znających temat Marca ’68 jedynie z opowiadań starszego pokolenia (a niektórzy z licznych, już ściśle historycznych opracowań), oraz dla uczestników studenckiej rewolty, czyli dla „pokolenia czapki studenckiej”, jak ich niegdyś określano. Dla tych pierwszych może być okazją do zapoznania się z nieznaną dotychczas tematyką i możliwością doszukania się analogii z czasami, w których przyszło im żyć obecnie; dla tych drugich – już coraz mniej licznych – zachętą do wspomnień z czasów młodości i konfrontacji swoich dawnych i obecnych opinii i poglądów. Jeśliby jednak czytelnik odnalazł jakieś elementy podobieństwa z obecną rzeczywistością, to wówczas – cytuję tu słowa Heinricha Bölla – „nie będzie to ani zamierzone, ani przypadkowe, lecz nieuniknione”. A więc – CHODŹCIE Z NAMI!
The Power and Limits of Predictive Approaches to Observational Data-Driven Optimization: The Case of Pricing
Authors: Bertsimas Dimitris , Kallus Nathan
Published: August 2022

We consider data-driven decision making in which data on historical decisions and outcomes are endogenous and lack the necessary features for causal identification (e.g., unconfoundedness or instruments), focusing on data-driven pricing. We study approaches that, for lack of better alternative, optimize the prediction of objective (revenue) given decision (price). Whereas data-driven decision making is transforming modern operations, most large-scale data are observational, with which confounding is inevitable and the strong assumptions necessary for causal identification are dubious. Nonetheless, the inevitable statistical biases may be irrelevant if impact on downstream optimization performance is limited. This paper seeks to formalize and empirically study this question. First, to study the power of decision making with confounded data, by leveraging a special optimization structure, we develop bounds on the suboptimality of pricing using the (noncausal) prediction of historical demand given price. Second, to study the limits of decision making with confounded data, we develop a new hypothesis test for optimality with respect to the true average causal effect on the objective and apply it to interest rate–setting data to assesses whether performance can be distinguished from optimal to statistical significance in practice. Our empirical study demonstrates that predictive approaches can generally be powerful in practice with some limitations.

Funding: This work was supported by the National Science Foundation [Grant 1846210].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/ijoo.2022.0077 .
Direct and Indirect Spillovers from Content Providers’ Switching: Evidence from Online Livestreaming
Authors: Zhao Keran , Lu Yingda , Hu Yuheng , Hong Yili
Published: August 2022

Content providers in online social media platforms, particularly livestreaming, often switch content categories. We propose a theory-based framework to study the direct and indirect spillover effects of content switching for livestreamers—individuals who broadcast content through livestreaming platforms. Contrary to conventional wisdom, we propose two positive spillover effects that are unique to the social media platform setting: (a) the entrant streamers do not just increase competition among streamers, but they also bring their own viewers to the new category (direct spillover), and (b) the entrant streamers influence incumbent streamers’ viewer size by boosting category visibility through indirect network effects (indirect spillover). We also propose that the two spillover effects are contingent on the size of the entrant streamers’ follower base. Our findings show that average content switching is associated with a 1.3% net increase in direct net viewer flow and a 2.6% net increase in indirect net viewer flow. Our results provide managerial implications for livestreaming platforms on how to maintain a healthy and fair community among streamers, such as encouraging popular streamers to switch to a category with many promising small streamers.
Tax-Favored Stock Donations by Corporate Insiders and Consequences for Equity Markets
Authors: Arya Anil , Mittendorf Brian , Ramanan Ram N. V.
Published: August 2022

Although corporate insiders face substantial restrictions on stock sales, securing tax deductions through charitable donations of stock is viewed as an attractive alternative. Recent press coverage and growing empirical evidence confirm that insider donations occur frequently and often precede stock price drops. Securities regulators have also taken note, with a recent push for new rules to require rapid disclosure as with insider trades. This paper develops a model of informed stock trading when disposal of stock by insiders takes the form of tax-favored charitable donations rather than direct trading. We demonstrate that charitable gifts by insiders can reflect nonpublic information about firm value and that they do so in a manner that promotes greater market efficiency. Relative to informed trading, insider donations yield greater market liquidity, more efficient equity prices, and superior investor protection. The results suggest that although insider donations deserve scrutiny, they are not equivalent to insider trades. The results also provide a general framework to examine implications of insider donations for tax policy governing philanthropic behavior.

This paper was accepted by Ranjani Krishnan, accounting.

Supplemental Material: The e-companion is available at https://doi.org/10.1287/mnsc.2022.4514 .
Pharmacist prescribers
Authors: Robertson Deborah
Published: August 2022

Deborah Robertson provides an overview of recently published articles that may be of interest to non-medical prescribers. Should you wish to look at any of the papers in more detail, a full reference is provided
Challenges prescribing antiarrhythmic medications for infants and children
Authors: Renwick Catherine
Published: August 2022

Antiarrhythmic medications are the first-line treatment for most tachyarrhythmias occurring during infancy and childhood. However, there are fewer antiarrhythmic medications available to treat infants and children compared to the adult population because of licensing restrictions and the manufacture of preparations infants and children can swallow. Specially prepared antiarrhythmic medications supplied in liquid form suitable for small children are manufactured on an individual basis at a greater cost than tablet equivalents. Safety of therapy when prescribing antiarrhythmic medication includes the need for therapeutic drug monitoring and close observation to reduce adverse reactions. In addition, access to antiarrhythmic medication can be a challenge as many are deemed specialist medications and general practitioners will not assume responsibility for prescribing medications outside their product licence. These limitations and considerations can prove challenging when deciding the most suitable medication to prescribe.
Utilization of ‘Quizizz’ a Game-based Assessment: An Instructional Strategy in Secondary Education Science 10
Authors: Capinding Andie Tangonan
Published: August 2022

The primary goal of this study was to explore the effectiveness of Quizizz in enhancing students' motivation, interest, and achievement in physics. This study was conducted at the Nueva Ecija University of Science and Technology (NEUST) – Gabaldon campus during the second semester of the academic year 2021-2022. This study used both a descriptive and a quasi-experimental one-group pretest-posttest design. The descriptive design was used to describe the student's motivation and interest in learning waves and optics before and after the intervention of Quizizz. The quasi-experimental one-group pretest-posttest design was used to determine the effectiveness of Quizizz in increasing students' motivation, interest, and achievement in physics. The study included 20 students pursuing a bachelor's degree in secondary education with a major in science. According to the findings, before the intervention of Quizizz, students agreed that they are motivated and interested in learning physics, and their performance was average. Following the intervention, students unanimously agreed that they are more motivated and interested in learning physics, and their scores in a specific unit increased. According to the t-test, the intervention of Quizizz significantly increases student motivation, interest, and achievement in physics. It demonstrates that using Quizizz in physics instruction improved students' motivation, interest, and achievement in physics.