bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-traumatic acute myelopathies: Clinical and imaging features in a real world emergency setting
Authors: Stasolla Alessandro , Prosperini Luca , Haggiag Shalom , Pezzella Francesca R , Pingi Alberto , Cozzolino Valeria , Pampana Enrico , Cotroneo Enrico , Tortorella Carla , Menniti Agazio , Gasperini Claudio
Published: May 2022

Objective

The aetiologic diagnosis of non-traumatic acute myelopathies (AMs), and their differentiation from other mimicking conditions (i.e. ‘mimics’), are clinically challenging, especially in the emergency setting. Here, we sought to identify: (i) red flags suggesting diagnoses alternative to AMs and (ii) clinical signs and magnetic resonance imaging (MRI) features differentiating non-compressive from compressive AMs.

Materials and methods

We retrospectively retrieved MRI scans of spinal cord dictated at emergency room from January 2016 to December 2020 in the suspicion of AMs. Patients with traumatic myelopathies and those with subacute/chronic myelopathies (i.e. MRI scans acquired >48 h from symptom onset) were excluded from analysis.

Results

Our search retrieved 105 patients; after excluding 16 cases of traumatic myelopathies and 14 cases of subacute/chronic myelopathies, we identified 30 cases with non-compressive AMs, 30 cases with compressive AMs and 15 mimics. The presence of pyramidal signs ( p = 0.012) and/or pain ( p = 0.048) correctly identified 88% of cases with AMs. We failed to identify clinical indicators for distinguishing non-compressive and compressive AMs, although cases with inflammatory AMs were younger than cases with all the remaining conditions ( p < 0.05). Different MRI patterns could be described according to the final diagnosis: among non-compressive AMs, inflammatory lesions were more often posterior or central; vascular malformation had a fairly widespread distribution; spine ischaemia was more often central. Anterior or lateral compression were more often associated with neoplasms and disc herniation , whereas hemorrhages and infections produced spine compression on all sides.

Conclusion

We propose a simple clinical indicator (i.e. pyramidal signs and/or pain) to distinguish AMs from their mimics in an emergency setting. Urgent spinal cord MRI remains essential to discriminate compressive and non-compressive aetiologies.
More Than Asthma: A Case Report of Eosinophilic Bronchiolitis
Authors: Khoo Sophie Su Hui , Yii Anthony Chau Ang
Published: May 2022

Eosinophilic bronchiolitis (EB) is a rare disease that may mimic or coexist with asthma, but EB typically fails to improve with guideline-based asthma treatments. A 52-year-old man presented with wheezing and shortness of breath for 5 months. He was found to have elevated peripheral blood eosinophils and moderately severe airflow obstruction but did not improve with high-dose inhaled corticosteroids in combination with long-acting beta2-agonist and long-acting muscarinic antagonist. Computed tomography revealed diffuse and widespread “tree-in-bud” changes. Transbronchial lung biopsy demonstrated eosinophilic bronchiolitis. The patient improved with a prolonged course of systemic corticosteroids. EB is distinguished from eosinophilic asthma by the presence of florid bronchiolitis on radiologic imaging or histopathology. The mainstay of treatment is systemic corticosteroids, with a possible role for biologics.
Non-inferiority of 1 month versus longer dual antiplatelet therapy in patients undergoing PCI with drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials
Authors: Bajraktari Gani , Bytyçi Ibadete , Bajraktari Artan , Henein Michael Y.
Published: May 2022

Aim:

The aim of this meta-analysis was to evaluate the safety of 1-month dual antiplatelet therapy (DAPT) followed by aspirin or a P2Y12 receptor inhibitor, after percutaneous coronary intervention (PCI) with drug-eluting stents (DES), based on the available evidence.

Methods:

PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL, and ClinicalTrials.gov database search identified four RCTs of 26,431 patients who underwent PCI with DES and compared 1-month versus >1-month DAPT. The primary endpoint was major bleeding and co-primary endpoint stent thrombosis, and secondary endpoints included all-cause mortality, cardiovascular death, myocardial infarction (MI), stroke, and major adverse clinical events (MACE).

Results:

Compared with >1-month DAPT, the 1-month DAPT was associated with a similar rate of major bleeding (OR = 0.74, 95%CI: 0.51–1.07, p = 0.11, I2 = 67%), stent thrombosis (OR = 1.10, 95%CI: 0.82–1.47, p = 0.53, I2 = 0.0%), similar risk for all-cause mortality (OR = 0.89, 95%CI: 0.77–1.04, p = 0.14, I2 = 0%), CV death (OR = 0.80, 95% CI: 0.55–1.60, p = 0.24, I2 = 0.0%), MI (OR = 1.02, 95% CI: 0.88–1.19, p = 0.78, I2 = 0.0%), and stroke (OR = 0.76, 95% CI: 0.54–1.08, p = 0.13, I2 = 29%). The risk of MACE was lower (OR = 0.84, 95% CI: 0.73–0.98, p = 0.02, I2 = 39%) in the 1-month DAPT compared with the >1-month DAPT. Only patients with stable CAD had lower risk of MACE with 1-month DAPT (OR = 0.81, 95% CI: 0.67–0.98, p = 0.03, I2 = 21%) compared with >1-month DAPT.

Conclusion:

This meta-analysis proved the non-inferiority of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor compared with long-term DAPT in patients undergoing PCI with DES.
Reimaging eLearning technologies to support students: On reducing transactional distance at an open and distance eLearning institution
Authors: Sevnarayan Kershnee
Published: May 2022

Transactional distance continues to be a major issue in Distance Education (DE) as resolutions to guarantee and support it are not wholly contingent on technological affordances, but depend on interactions, communication, and motivational channels embedded in pedagogical practices. While education during the Covid-19 pandemic is supported by DE, discussions around academic achievement during the pandemic have also begun. This paper argues that without reducing the transactional distance between the lecturers and students in DE institutions, effective teaching and learning cannot occur. This is a qualitative, participatory action research study that uses the experiences of first-year students, interviews from lecturers and observations of the online activity of the students in one academic writing module. This paper draws on one DE University as an example, the University of South Africa. The purpose of the paper is to identify and suggest alternative pedagogical practices to reduce the transactional distance between students and lecturers.
The efficacy of antipsychotics in the treatment of physical aggressive behavior in patients with dementia in nursing homes
Authors: Nawzad Sina , Cahn Wiepke , Abdullah-Koolmees Heshu
Published: May 2022

Patients with dementia often suffer from behavioral changes. A common behavioral change is acute physical aggressive behavior which is the most distressing change. This can lead to harm, which is especially problematic in nursing homes. Despite the serious safety concerns, antipsychotics are often prescribed to combat this problem. This article is aimed to review the evidence of the efficacy of utilizing antipsychotics in acutely treating physical aggressive behavior in patients with dementia in nursing homes. Therefore, a systematic literature search was performed. The results demonstrated that a meta-analysis confirmed statistically significant reduction in physical aggression when risperidone was compared to placebo. However, a randomized controlled trial showed no change in physical aggressive behavior between quetiapine and placebo. More research is needed to fully investigate the benefits of physical aggressive behavior and safety concerns of all the antipsychotics in patients with dementia in nursing homes.
Child-sensitive water, sanitation, and hygiene composite score and its association with child nutritional outcomes in St. Martin’s Island, Bangladesh
Authors: Jubayer Ahmed , Islam Md. Hafizul , Nayan Md. Moniruzzaman
Published: May 2022

Objectives:

This study aimed to outline water, sanitation, and hygiene (WASH) practices for children under 5 years of age among the households of St. Martin’s Island as well as examine the role of water, sanitation, and hygiene on child nutritional outcomes.

Methods:

A total of 256 children under 5 years of age were anthropometrically measured, and multiple linear regression was performed to understand the relationship between combined water, sanitation, and hygiene score and child nutritional outcomes: height-for-age, weight-for-age, weight-for-height z-scores.

Results:

The majority of the sampled households had improved drinking water facilities. Over one-third of the participants (36.5%) did not have access to better sanitation, and 12.4% reported defecating in open places. Just over one-third of those surveyed reported washing their hands with soap or detergents after defecation, with more than 22% of people not having access to a handwashing station on their premises. Stunting, wasting, and underweight were found to be prevalent in 34.4%, 17.6%, and 18.9% of the sampled children, respectively. Height-for-age (0.08 SDs) and weight-for-age (0.014 SDs) were greater on average in children from households with improved water, sanitation, and hygiene conditions, but weight-for-height did not significantly differ from those from WASH-unimproved households.

Conclusion:

Certain aspects of WASH, particularly, sanitation facilities and hygiene practices were not up to the mark in St. Martin’s Island, and consistent with findings from other studies, our study findings underlined the potential benefits of improved water, sanitation, and hygiene practices in addressing child undernutrition.
Familiarity with emergency preparedness and its predictors among nurses and physicians working at public hospitals in east Gojjam zone, northwest Ethiopia
Authors: Ayenew Temesgen , Gedfew Mihretie , Afenigus Abebe Dilie , Amha Haile , Mulugeta Henok , Mengist Belayneh , Bewket Bekalu , Melese Yidersal Hune , Teym Abraham , Bishaw Keralem Anteneh , Yitayew Meseret
Published: May 2022

Objective:

Emergency preparedness and response operations for all types of catastrophes rely heavily on healthcare facilities and their staff. On the other hand, hospital employees suffer significant gaps in emergency preparedness knowledge and skills when it comes to treating mass casualties. The objective of this study was to assess the nurses’ and physicians’ familiarity with emergency preparedness and identify the associated factors.

Methods:

A facility-based cross-sectional survey was conducted by census utilizing a self-administered questionnaire among all nurses and physicians working in emergency departments in East Gojjam zone public hospitals. The collected data were entered into Epi-data version 4.2 and exported to SPSS 25.0 for further analysis. Frequency, mean, and standard deviation were computed to describe individual and other characteristics of the sample. A simple and multiple linear regression model was fitted to identify factors associated with familiarity with emergency preparedness. An unstandardized adjusted beta ( β) coefficient with a 95 % confidence level was used to report the result of the association at a p-value of 0.05 statistical significance.

Results:

In this study, a total of 237 individuals completed the questionnaire, yielding a response rate of 94 %. The mean score of familiarity with emergency preparedness was 106.1 ± 31.8 (95% CI: 102, 110.1), with approximately 52.3 % scoring higher than the mean score. Self-regulation (B = 3.8, 95% CI: 2.6, 5), health care climate (B = 1.4, 95% CI: 0.4, 2.43) and participation in actual major disaster event (B = 15.5, 95% CI: 7.8, 23.2) were significant predictors of familiarity.

Conclusion:

According to the findings of this study, nurses’ and physicians’ expertise in emergency and disaster preparedness is inadequate. Previous engagement in actual disaster events, self-regulation, and the healthcare climate were significant predictors of familiarity. As a result, the responsible stakeholders should develop strategy to enhance self-regulation (motivation), job satisfaction of emergency department employees, and drills and hands-on training in mass casualty management.
Patients’ perceptions of nurses’ communication in public hospitals of Harari Regional State, Eastern Ethiopia
Authors: Bekele Yazew , Worku Teshager , Atnafe Genanaw , Debella Adera , Habte Sisay , Goshu Abel Tibebu , Assebe Tesfaye
Published: May 2022

Introduction:

The quality of nursing care has been evaluated using patient perception. Patients’ participation in nursing care and decision-making is regarded as a prerequisite for effective clinical practice; however, poor communication can lead to incorrect diagnosis and delayed, or ineffective medical treatment.

Objectives:

This study sought to assess admitted adult patients’ perceptions of, and factors influencing, nurse communication at public hospitals in Harar, eastern Ethiopia.

Methods:

Facility-based cross-sectional study was conducted among 377 admitted adult patients in Harar Town public Hospitals from 15 April to 30 May 2020. A proportionate stratified sampling technique was used to select the study participants. A pretested and structured questionnaire was used to collect data through a face-to-face interview and which were entered into EpiData and analyzed using SPSS. Bivariate and multivariate logistic regression analyses were conducted, odds ratio and confidence intervals were calculated and statistical significance was declared at p < 0.05.

Results:

This study outlined that the overall prevalence of good perception toward nurses’ communication was 41.9% (95% confidence interval = 37.1%, 46.9%). Patients whose age group were 26–35 years (adjusted odds ratio = 0.46 (95% confidence interval: 0.24, 0.86), Being female patients (adjusted odds ratio = 1.89; 95% confidence interval: 1.20, 2.98), admitted in private room (adjusted odds ratio = 3.25; 95% confidence interval: 1.91, 5.51), patients who have family support (adjusted odds ratio = 2.56; 95% confidence interval: 1.16, 3.64), urban residence (adjusted odds ratio = 0.65; 95% confidence interval: 0.02, 0.66) and language difference (adjusted odds ratio = 0.61; 95% confidence interval: 0.40, 0.94) were statistically significant.

Conclusion:

This study pointed out that less than half of the study participants had good perceptions toward nurses’ communication. As a result, increasing the number of health care providers who speak the same language as the patients and communication and behavioral change training must be prioritized.
Spectrum of thyroid function test among type 2 diabetic patients attending a rural health facility, southwest Nigeria: A hospital-based study
Authors: Jimoh Ahmed Kayode , Ghazali Muritala Segun , Ogundeji Olajumoke Ajele , Adeleke Babajide Adewoyin , Ajani Oladimeji Gbadebo , Gabriel-Alayode Emmanuel Olusegun , Popoola Gbenga Omotade , Adediran Olufemi Sola
Published: May 2022

Objectives:

The thyroid gland produces hormones that have significant influence on carbohydrate metabolism; its disorders may affect carbohydrate metabolism in type 2 diabetic patients (T2DM) more than the non-diabetic (NDM) patients as reported in various studies. We determined the spectrum of thyroid function tests (TFTs) profile among T2DM in our rural health facility.

Methods:

T2DM patients and NDM patients were recruited for the study. The age, educational level, occupation, marital status, and duration of diabetes were extracted from interviewer’s administered questionnaire. The weight, height, body mass indices (BMIs), and the waist and hip circumferences were measured. Waist-hip ratios (WHR) were calculated for all participants. Venous blood was collected and assayed for free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) using a Chemiluminescence Immunoassay (CLIA) 2nd Generation Autoanalyzer. The mean, standard deviation, frequencies, and percentages were calculated for the variables. The student’s t-test and chi-square test were also determined as appropriate.

Results:

Seventy-eight patients made up of 56 T2DM and 22 NDM were evaluated in this study. Fifty-one were males while 27 were females; 67.9% and 59.1% of the female participants were T2DM and NDM, respectively. The WHR was significantly higher in T2DM than NDM (0.92 ± 0.05 versus 0.88 ± 0.06). The TSH was higher in T2DM than the NDM. Forty-four (78.6%) of the T2DM had euthyroid (normal) biochemical pattern; 12 (21.4%) showed abnormal biochemical pattern of euthyroid sick syndrome, subclinical hyperthyroid, and subclinical hypothyroid. Thirty (53.6%) of the T2DM were diagnosed less than five years ago. The value of TSH was increasing with the duration of diabetes but not in a statistically significant way. None of the T2DM showed overt hypothyroid or hyperthyroid test result.

Conclusion:

Thyroid function test may identify diabetics with altered thyroid hormone status that may impact on their metabolic control. Knowledge of the functional state of the thyroid gland can help in achieving a better metabolic control and attenuate the development of complications in T2DM.
Traditional practices during pregnancy and childbirth among mothers in Shey Bench District, South West Ethiopia
Authors: Solomon Nahom , Tesfaye Melkamsew
Published: May 2022

Objective:

Pregnancy and child birth is the most critical period in the health of women and children and the objective of this study was to explore traditional practices among mothers during pregnancy and delivery in Shey Bench District, South West Ethiopia, and we hope the evidence generated could benefit decision-makers and concerned bodies who are interested in this important public health issue.

Methods:

A descriptive qualitative study, which is an ideal approach when an uncomplicated description is desired that focuses on the details of what, where, when, and why of an event or experience, was conducted from March to May 2019 in Shey Bench District and a purposively selected 43 women have participated in the study. In-depth interviews and key informant interviews were conducted and data were analyzed by Open code 4.2 software and summarized following content analysis approach. Findings were narrated based on the major categories and study participants’ words were used as quotes.

Results:

In this study, it was found that mothers have experience of traditional practices mainly of abdominal massage, use of herbs, prohibition of some food types, and strenuous physical exercise during pregnancy and childbirth. As of the reasons; mothers reported as traditional practices help them to make the labor easy and fast, alleviate discomforts, and avoid unwanted big size of the fetus. Experience of health problem following practice of traditional practices like vaginal bleeding and child death were also reported. However, some study participants indicated as community members are changing their mind because of getting advice from health professionals.

Conclusion:

Although traditional practices were found to be exercised by mothers believing to get benefits, there were reports of health side effects on mothers and the fetus from applying abdominal massage, herbal medicine, food prohibition, and strenuous physical exercise during their pregnancy and childbirth. Therefore, concerned working bodies shall design and implement necessary interventions, particularly health education programs to bring a better a change against harmful traditional practices.
Detecting professional interpreter use among patients with limited English proficiency: Derivation and validation study
Authors: Soleimani Jalal , Marquez Alberto , Fathma Sawsan , Weister Timothy J , Barwise Amelia K
Published: May 2022

Objectives:

The objective of this derivation and validation study was to develop and validate a search strategy algorithm to detect patients who used professional interpreter services.

Methods:

We identified all adults who had at least one intensive care unit admission during their hospital stay across the Mayo Clinic Enterprise between 1 January 2015 and 30 June 2020. Three random subsets of 100 patients were extracted from 60,268 patients to develop the search strategy algorithm. Two physician reviewers conducted gold standard manual chart review and any discrepancies were resolved by a third reviewer. These results were compared with the search strategy algorithm each time it was refined. Sensitivity and specificity were calculated during each phase by comparing the search strategy results to the reference gold standard for both derivation cohorts and the final validation cohort.

Results:

The first search strategy resulted in a sensitivity of 100% and a specificity of 89%. The second revised search strategy achieved a sensitivity of 100% and a specificity of 87%. The final version of the search strategy was applied to the validation subset and sensitivity and specificity were 100% and 89%, respectively.

Conclusion:

We derived and validated a search strategy algorithm to assess interpreter use among hospitalized patients. Using a search strategy algorithm with high sensitivity and specificity can reduce the time required to abstract data from the electronic medical records compared with manual data abstraction.
Pediatric diabetic ketoacidosis as type 1 diabetes debut with concurrent SARS-CoV-2 infection: A case report
Authors: Valenzuela-Vallejo Laura , López-Ramírez Sofía A , Morales-Burton Verónica , Aguilera-Martínez Sara , Álvarez-Olmos Martha I , Durán-Ventura Paola
Published: May 2022

Diabetic ketoacidosis is a life-threatening complication associated with type 1 diabetes (T1D). Recent evidence suggests that SARS-CoV-2 could trigger diabetic ketoacidosis in type 1 diabetes susceptibility and previous insulitis; however, the data on SARS-CoV-2-infected patients with diabetic ketoacidosis as their type 1 diabetes are still limited. We report a 13-year-old Latinamerican male with symptoms and laboratory tests diagnostic of diabetic ketoacidosis and positive SARS-CoV-2 reverse transcription polymerase chain reaction, who required mild COVID-19 care management, fluid resuscitation, and insulin infusion at a regular dose, without further complications after the acute infection. Clinical/biochemical improvement allowed outpatient endocrinology follow-up with insulin therapy and continuous glucose monitoring. To our knowledge, we report the first case of diabetic ketoacidosis as the debut of type 1 diabetes in a Colombian pediatric patient with concurrent SARS-CoV-2 infection. Therefore, this report aims to contribute to the global research on SARS-CoV-2 and diabetic ketoacidosis and discuss the approach to these concomitant pathologies.
Gemella haemolysans: Rare case of automatic implantable cardioverter-defibrillator (AICD) lead infection
Authors: Kriege Kevin , Wilson Brycen , Tate Joshua
Published: May 2022

We present a rare case of Gemella haemolysans automated implantable cardioverter defibrillator (AICD) lead infection. Gemella species are catalase-negative, facultative anaerobic, Gram-positive cocci which are found in normal human oral flora. Gemella are often incorrectly identified on routine Gram stain and culture, requiring advanced techniques such as PCR. Gemella has been shown to be a rare cause infective endocarditis in case reports; however, there has not been a report of an isolated AICD lead infection. AICD infections with gram positive organisms other than Staphylococcus species has been associated with more aggressive infections and higher mortality. Standard treatment for Gemella consists of β-lactam inhibitors and aminoglycosides. In this case, we present an alternative antibiotic treatment with vancomycin and ceftriaxone. A case series for Gemella haemolysans endocarditis, without lead infection, reported the use of vancomycin and ceftriaxone with good results. This approach is similar to methicillin-resistant staphylococcus aureus (MRSA) bacteremia salvage therapy. In addition, this case highlights the importance of culture and sensitivity in the selection of antibiotics, particularly avoiding nephrotoxic drugs when possible.
A critical review of drug testing policy in the Philippines
Authors: Dioquino Carissa Paz , Gerona Roy Roberto
Published: May 2022

The drug policy in the Philippines is written as the Comprehensive Dangerous Drugs Act of 2002 or Republic Act 9165. Unlike drug policies in other countries, the law includes policies on drug testing. Aside from mandatory drug testing for specific situations, the law states further that two testing methods should be employed—a screening test, and a confirmatory test to be performed if the former yields a presumptive positive result. Over 1000 drugs of abuse screening laboratories are scattered all over the Philippines, but only seven can perform confirmatory testing using either gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-mass spectrometry (LC-MS) technologies. In the last 30 years, more sophisticated analytical technologies like liquid chromatography-tandem mass spectrometry (LC-MS/MS) and high-resolution mass spectrometry such as liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-QTOF/MS) have been developed not only to confirm what has been detected on screening tests, but also to determine the presence of new psychoactive substances that are not usually detected in drug screening. New matrices are also being utilized for the detection of drugs. The drug testing policy in the Philippines will have to keep up with the changing drug trends and drug testing innovations in the world to truly address the current administration's war on drugs. With the adoption of new drug testing methods using modern analytical platforms, the cut-offs used for drug testing interpretation should be updated.
Fusion versus cognitive MRI-guided prostate biopsies in diagnosing clinically significant prostate cancer
Authors: Lockhart Kathleen , Martin Jarad , White Martin , Raman Avi , Grant Alexander , Chong Peter
Published: May 2022

Objective:

This study assesses whether fusion or cognitive magnetic resonance imaging (MRI)-guided prostate targeted and systematic transperineal biopsies (TPB) increase detection of clinically significant prostate cancer (csPCa).

Materials and Methods:

A retrospective analysis was completed of patients (2018–2020) undergoing 3-Tesla multiparametric prostate MRI informing targeted (either cognitive or MIM software fusion approach) and systematic TPB. ISUP (International Society of Urological Pathology) grade group ⩾ 2 was considered csPCa.

Results:

A total of 355 cases from 4 urologists were included; 131 were fusion and 224 were cognitive MRI-guided biopsies. Of all csPCa found, 86.8% ( n = 171) of cases were confirmed to be at the MRI-indicated location and 11.6% were found as part of active surveillance. In all, 45.0% of the fusion group were found to have csPCa, compared to 62.05% ( n = 139) in the cognitive group ( p = 0.002). csPCa detection rates varied between urologists (41% to 78%, p < 0.001), so a subgroup analysis was performed on Urologist A; 45.0% of fusion and 41.3% of cognitive biopsies had csPCa ( p = 0.644). Multinomial logistic regression analysis showed that biopsy type, being on active surveillance, number of biopsy cores, iPSA (initial Prostate Specific Antigen) value or PIRADS (Prostate Imaging-Reporting and Data System) score made no significant difference in whether csPCa was found.

Conclusion:

Cognitive and fusion targeting had similar csPCa detection rates. Further prospective studies would be beneficial to validate these findings.

Level of evidence:

2b (according to Oxford Centre for Evidence-Based Medicine)
ADXBladder molecular urine testing to risk stratify and prioritise management of suspected and known bladder cancers during the COVID-19 pandemic
Authors: Santiapillai Joseph , Foster Luke , Allchorne Paula , Green James S. A. , Mohamud Haboon , Almushatat Ahmad , Patki Prasad , Nawaz Hussain , Stevens Michael , Rajan Prabhakar
Published: May 2022

Objective:

COVID-19 has challenged diagnostic and surveillance pathways for suspected and known bladder transitional cell cancer (TCC). Exclusion of high-grade/invasive TCC by molecular urine testing could risk stratify patients for priority flexible cystoscopy and transurethral resection (TUR). We evaluated ADXBladder (ArquerDx), which has a high negative predictive value (NPV) for high-grade and ⩾ pT1 TCC.

Patients and methods:

Prospective cohort study of patients referred with haematuria for diagnostics or on TCC surveillance (Dec 2020–Feb 2021). Patients underwent ADXBladder testing, flexible cystoscopy and imaging (for haematuria), followed by TUR/biopsy as necessary. Clinico-radiological/pathology findings were compared with ADXBladder results.

Results:

Of 117 eligible patients, 39 and 78 had positive and negative ADXBladder tests, respectively. Of 15 suspected TCC on cystoscopy, eight were confirmed on TUR/biopsy. Overall ADXBladder NPV was 96.2% (CI: 91.0–98.4). NPV for high-grade and ⩾pT1 TCC was 97.4% (CI: 94.4–98.8) and 98.7% (CI: 95.0–99.7), respectively.

Conclusions:

Our ‘real world’ evaluation confirmed a high NPV for high grade and ⩾pT1 TCC using ADXBladder. Further larger studies are required to determine whether a negative ADXBladder test combined with negative imaging and patient risk factors may justify patient downgrading on timed diagnostic pathways.

Level of evidence:

IV
The ethnic church attendance gap at Christian colleges
Authors: Glanzer Perry L , Dougherty Kevin D , Cockle Theodore F , Davignon Phil
Published: May 2022

While interviewing seniors at our university, we came across a curious and disturbing trend. Students of color were less active in any local church. This finding pushed us to ask: does this gap exist throughout Christian college campuses? We answered this question using survey data from over 800 seniors at Baylor University and a national sample of over 6000 students from 34 Council of Christian Colleges and Universities (CCCU) institutions. As suspected, many students of color on these campuses attend church less often than their white classmates, despite similarities in beliefs. We suggest some possible reasons for this gap.
Palliative care in Norwegian nursing education: A document analysis of the integration of learning outcomes
Authors: Valen Kristin , Jensen Kari Toverud , Holm Anne Lise , Grov Ellen Karine
Published: May 2022

Large variations in palliative care education across and within countries are reported. Nursing students report that they feel unprepared for palliative care. The present study identified and outlined whether universities integrated learning outcomes on palliative care as described in the national regulation into programme descriptions and course plans after implementation of the National Curriculum Regulations for Norwegian Health and Welfare Education (RETHOS) in the 2020 academic year. A qualitative descriptive design with a document analysis approach was used. The findings revealed variation in the terminology used. Palliative care was differently emphasized in selected learning outcome descriptors, related subjects, and presence in the academic trajectory. It is crucial to emphasize palliative care in nursing education to prepare the future workforce to meet patients’ and their families’ individual needs in a multidisciplinary environment across service levels.
Review of China's Online Education Policy, 1999–2022
Authors: Jiang (蒋宇) Yu , Shang (尚俊杰) Junjie , Jiao (焦丽珍) Lizhen
Published: May 2022

Purpose

This study traces the development of China's online education policy over the past 20 years.

Design/Approach/Methods

Employing a textual research method, this study examines online education policymakers, policy content and influence, and related policies and regulations.

Findings

This study identifies the starting point of China's online education policy and divides its development into four stages: namely, the pilot exploration stage (1999–2002), the standard development stage (2002–2012), the transformation stage (2012–2017), and the governance improvement stage (2017–present). Policy development reflects three characteristics: the need to meet the requirements of the times, shifting from a single management to multiple governance approach, and developing from one object for some people to one object for everyone. Current policy focuses on regulating institutions, content, and products, as well as guiding social capital to participate in online education.

Originality/Value

This study systematically analyzes the development of China's online education policies, discerns policy characteristics, and identifies current policy priorities. In doing so, this study enhances our understanding of the current status and potential needs of online education in China so as to promote its development from the perspective of education policy and governance.
Predictors of Depression in Nurses During COVID-19 Health Emergency; the Mediating Role of Resilience: A Cross-Sectional Study
Authors: Chura Sonia , Saintila Jacksaint , Mamani Rut , Ruiz Mamani Percy G. , Morales-García Wilter C.
Published: May 2022

Background:

Nurses are susceptible to several mental problems, such as fear, stress, and depression due to the COVID-19 pandemic, which affects their emotional well-being. However, resilience plays an important role in mitigating the effects of COVID-19.

Objective:

This study was to examine the mediating role of resilience in the relation between fear, stress, and depression of nurses during COVID-19 health emergencies.

Methods:

A cross-sectional—predictive study was carried out. The variables analyzed were fear, resilience, stress, and depression. A total of 286 nurses from 2 hospitals in the cities of Juliaca and Puno, Peru. Data analyses were performed using structural equation modeling (SEM).

Results:

Analyses showed that the variables were significantly related ( P < .01). In addition, a confirmatory analysis of the hypothesized model using structural equation modeling shows that fear and stress are predictors of depression, and that resilience plays a role in mediating the effect of fear on stress ( X2 = 534.69, gl = 372, P = .000; TLI = .902, CFI = .910, RMSEA = .039 [95% CI = 0.032-0.046], and SRMR = .065).

Conclusion:

Nurses tend to develop fear, stress, and depression. Resilience reduces the impact of these psychological variables. Hospital management should provide psychological support and training for nurses in coping strategies.
Sarcopenia and Its Association With Change of Bone Mineral Density and Functional Outcome in Old-Aged Hip Arthroplasty Patients
Authors: Kweon Suc-hyun , Park Jin sung , Park Byung Ha
Published: May 2022

Aim

This study aimed to investigate the relationship between sarcopenia and change in bone mineral density (BMD) and functional outcome in hip arthroplasty patients. Methods: Among the 221 patients who had undergone hip arthroplasty, 147 patients were enrolled. All patients were divided into 2 groups according to presence of sarcopenia. Bone mineral density (BMD) at hospitalization and 1-year after surgery and Barthel index was measured at the time of before injury, hospitalization, 3 months and 1-year after surgery. Results: BMD at hospitalization showed .627 ± .082 (g/cm2) in Sarcopenia and .726 ± .059 (g/cm2) in Non-sarcopenia at femur (total) site ( P < .001), .531 ± .085 (g/cm2) vs .629 ± .057 (g/cm2) at femur neck site (P=.002), .715 ± .084 (g/cm2) vs .807 ± .058 (g/cm2) at lumbar (L1-L4) site ( P < .001). BMD at 1-year follow-up period, Sarcopenia showed .626 ± .082 (g/cm2) and Non-sarcopenia showed .725 ± .060 (g/cm2) at femur (total) site ( P < .001), .530 ± .085 (g/cm2) vs .629 ± .058 (g/cm2) at femur neck site ( P < .001), .715 ± .084 (g/cm2) vs .806 ± .058 (g/cm2) at lumbar (L1-L4) site ( P < .001). Change of BMD showed −.01 ± .25% for Sarcopenia and −.15 ± .47% for Non-sarcopenia in femur (total) site (P=.089), −.08 ± .63% vs −.01 ± 1.01% in femur neck site ( P = .058), .00 ± .09% vs −.12 ± .33% for each group in lumbar (L1-L4) site ( P = .052). Barthel index score showed 79.94 ± 5.66 for Sarcopenia and 84.74 ± 5.36 for Non-sarcopenia at pre-injury status ( P < .001), 33.89 ± 4.94 vs 33.87 ± 5.36 at the time of hospitalization ( P = .977), 57.42 ± 7.19 vs 60.06 ± 5.39 at 3 months follow up ( P = .015), 73.86 ± 5.94 vs 80.71 ± 4.81 for each group at 1-year follow up ( P < .001). Conclusions: Our study found that the sarcopenia showed lower BMD than the non-sarcopenia, but there was no significant difference of BMD change in the follow-up period. In addition, the sarcopenia showed poor functional results at all points except at the time of hospitalization.
Development and Psychometric Evaluation of a Brief Measure of School and Community Mental Health Supports and Services
Authors: Marraccini Marisa E. , Vanderburg Juliana L. , Martinez Robert R. , Knotek Steven E. , Pittleman Cari , Neshkes Rebecca
Published: May 2022

This study evaluated a self-report survey assessing school professionals’ perceptions of school and community mental health supports and services. Based on responses from 560 school professionals, findings provide support for the measure’s internal structure and ability to distinguish low-poverty and high-poverty schools. Practitioners and researchers may consider using this survey to understand perceptions of the quality and availability of mental health services, informing the selection and adaptation of school-based mental health supports and services.
School Counselors’ Perceptions Regarding Importance of and Ability to Implement Transition Services for Students With Disabilities
Authors: Parikh Foxx Sejal , Saunders Rachel , Test David W. , Flowers Claudia
Published: May 2022

The purpose of this study was to investigate school counselors’ perception of and ability to implement the 20 predictors of post-school success for students with disabilities. Results indicated statistical differences between grade levels in their perceived ability to implement transition services. We offer specific recommendations for how school counselors can provide support in alignment with the 20 special education predictors of improved postschool success for students with disabilities.
COVID-19 Onset, Parental Status, and Psychological Distress among Full-time Employed Heterosexual Adults in Dual-earning Relationships: The Explanatory Role of Work-family Conflict and Guilt
Authors: Montazer Shirin , Brumley Krista M. , Pineault Laura , Maguire Katheryn , Baltes Boris
Published: May 2022

We propose that the COVID-19 pandemic and the restrictions to daily life that followed had greater negative impact on the mental health, as measured by psychological distress, of employed parents than nonparents, because of an associated increase in both directions of work-family conflict and work-family guilt among this group of the population. To test this argument, we examined pooled data from two cross-sectional online surveys administered to heterosexual adults in dual-earning relationships living in the United States. The first data set was collected before the onset of the COVID-19 pandemic ( N = 616), and the second data set was collected during the early months of the pandemic ( N = 454). Results of multivariate analyses show that distress increased between the two surveys, but only among parents, as compared with nonparents, irrespective of gender of the respondent, or age of the youngest child. This association is due to a change in work-family conflict and guilt between the two surveys: among parents, the COVID-19 onset was associated with higher family-to-work conflict, work-to-family guilt, and family-to-work guilt; among nonparents the pandemic was associated with lower work-to-family conflict and work-to-family guilt. Our results suggest that the COVID-19 onset had contrasting effects on the lives of employed parents and nonparents.
Applying Problem-Based Approach in Business English Courses for China’s English Majors
Authors: Xie Qing
Published: May 2022

To enhance pedagogical innovation, the study reports on an investigative study using surveys and teacher participant observation of 121 English-major undergraduates about using problem-based approach under active learning framework in business English teaching, learning outcomes, and suggestions for the teaching and learning process to cultivate professional soft skills. Based on quantitative and qualitative data analysis, the study found that the problem-based approach should focus on business English communication skills development. The study also found that participants preferred problems related to recruiting and marketing. The participants commented positively on the effectiveness of the problem-based approach and reported personal gains in soft skills. To refine the problem-based approach, the participants suggested having more diverse problems and activities, more time, and higher-quality group discussion. Follow-up problem-based activities should include more personal reflections, extended practice activities, learning materials, and teacher feedback. The study suggests strategies for implementing problem-based approach applicable for both Chinese and international contexts.
Passion and Flow at Work for the Reduction of Exhaustion at Work in Nursing Staff
Authors: Zito Margherita , Emanuel Federica , Bertola Lara , Russo Vincenzo , Colombo Lara
Published: May 2022

Passion for work is an important individual factor related to the quality of working life. Flow at work is an optimal experience in which the individual is immersed in, loves and enjoys the work. The aim of the study is to investigate the relationship between passion for work (harmonious and obsessive), flow at work (as a mediator) and exhaustion in a sample of Italian nurses. About 270 nurses participated in the study: this profession is characterized by intrinsic motivation but is also subjected to fatigue and distress. The results show that harmonious passion increases flow at work which, in turn, decreases exhaustion; moreover, flow mediates the relationship between harmonious passion and exhaustion. Obsessive passion has no significant effect on flow at work, but directly increases exhaustion. The study shows that harmonious passion and flow at work contribute to alleviate exhaustion, while obsessive passion instead increases feelings of distress.
Social Avoidance and Stigma Among Healthcare Workers Serving COVID-19 Patients in Saudi Arabia
Authors: Alajmi Abduruhman Fahad , Al-Olimat Hmoud Salem , Abu Ghaboush Reham , Al Buniaian Nada A.
Published: May 2022

This study investigated the social impact of COVID-19 on healthcare workers and their relationships with their families and relatives. Data were collected from a sample of 226 healthcare workers (HCWs) using an analytical cross-sectional design. The data extracted three factors: communication impairment, social avoidance, stigma, and personal deprivation and distress, rated as severe, moderate, and moderate, respectively. The results showed that HCWs’ social and personal lives were significantly affected, ranging from predominantly moderate to highly severe. The variability of the three factors coordinated with marital status and working hours showed a mixed pattern. Discontinued workgroups are more affected by communication impairments, social avoidance, and stigma, less emotional and personal deprivation. HCWs with lower levels of education suffer more severe impacts of working with COVID-19 patients than those with higher educational levels. The study highlights the social impact of working with the COVID-19 patients on healthcare workers and the need for more social support and institutional support.
Youth Cohort Size, Structural Socioeconomic Conditions, and Youth Protest Behavior in Democratic Societies (1995–2014)
Authors: Nkansah Godfred Bonnah
Published: May 2022

Conventional literature associates large youth cohort size (YCS) with increased risk of political violence in countries with such demographic profiles. Key questions which remain unanswered, however, are whether YCS is also associated with young people’s proclivities toward more peaceful forms of protests, and whether structural socioeconomic conditions influence such a relationship? Using multilevel binary logistic regression techniques on pooled individual level data for 51 democratic countries purposively sampled from World Values Survey Waves 3 to 6, and country level data from World Bank, and UN Population Division, I show that YCS demonstrates a positive relationship with young people’s participation in peaceful demonstrations. This relationship is, however, moderated by structural factors such as education and unemployment, which end up reducing young people’s likelihood of participation. I argue that resource limitation, as predicted by the Civic Voluntarism Model, better explains the relationship between YCS and individual youth protest behavior in democratic societies, more than socioeconomic grievance, as suggested by grievance theory. An important implication of this finding is that participation in elite-challenging behaviors such as peaceful protests, can be expected to be more common among young people in affluent democratic societies, than their peers elsewhere in the democratic world.
Filmic Depiction of Malay Subjectivity in the Late Yasmin Ahmad’s Films
Authors: Changsong Wang , Kerry Lucyann
Published: May 2022

Besides P. Ramlee, Yasmin Ahmad’s name is synonymous with Malaysian cinema. The award-winning Malaysian filmmaker’s death impacted not only the Malaysian film industry but also those who admired her work. The late legendary filmmaker was a liberal Islamic Malaysian who explored Islam and humanity through interracial love stories. These filmic stories resonated with the ordinary Malaysians as they were compelling and courageous, often challenging the norms and conventions of other Malaysian films by daringly dramatizing and visualizing societal taboos and hypocrisies on the cinematic screen. The employment and integration of cosmopolitan themes of love, humanism, and humor in her films sets her apart from other local filmmakers. Yasmin’s films had attracted international attention and garnered awards at film festivals in Europe, North America, and Asia. This paper attempts to analyze her cinematic approaches of the construction of Malay subjectivity in all of her six films. For example, interracial relationships in Muallaf and Talentime is the dominant leitmotif of each, which connects the films with parallel events occurring in real-life Malaysia. The author interviewed production crew members who worked closely with Yasmin for her six films and tried to have a better understanding of the narrative motifs and themes in her films. These interviewees provided a comprehensive picture which drives her films, even now, to move beyond being focused on multiculturalism and to more socially, culturally and politically issues related to Malaysians.
Interest Rate Liberalization and Commercial Bank Performance: New Evidence From Chinese A-Share Banks
Authors: Rathnayake Dilesha Nawadali , Bai Yang , Louembé Pierre Axel , Qi Li
Published: May 2022

Abundant literature infers the negative incidence of financial liberalization in the banking sector. As interest rate marketization is a reality in China, we empirically investigate the determinants of commercial banks’ financial performance using 10 listed Chinese commercial banks for 1999 to 2019. Our findings suggest that net interest margin (NIM), non-performing loans (NPL), and asset size (LnAsset) are the key drivers of profitability in Chinese banks. Interestingly, for the sample of city banks observed, we find that bank performance is strongly driven by sound management of the assets and the retail interest margins. On the opposite, the joint-stock banks’ strong diversification leads to lower reliance on net interest margins. Our results also suggest that joint-stock banks’ asset size puts strong pressure on their overall performance and exert a diminishing return effect as their assets’ critical size generates proportional administrative expenses that hinder profitability.