bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing Presence in Pediatric Oncology: A Scoping Review
Authors: Mcharo Solomon K. , Bally Jill , Spurr Shelley
Published: September 2021

Background: Nursing presence creates meaningful and trusting relationships that facilitate healing for the patient and enhances the nurse's clinical experience. Although nursing presence has been linked to better health outcomes especially in chronic illnesses and end-of-life, little is known about its contribution in pediatric oncology. Purpose: The purpose of this scoping review was to explore how nursing presence is understood and expressed in pediatric oncology. Methods: Arksey and O’Malley’s (2005) framework was used to guide the review, with Clarke and Braun’s (2013) thematic analysis process used for collating, summarizing, and reporting the results. Key search terms were developed for searches between January 1999 and July 2020 in CINAHL, MEDLINE, and Psych INFO databases. Initially, 4,357 studies were identified with a final sample of nine articles meeting specific inclusion and exclusion criteria. Gray literature retrieved from the search was used to inform the review. Findings: Most notably, there is a limited understanding of nursing presence in pediatric oncology setting. However, findings revealed five themes that can be identified with nursing presence: Being With or Being There, Therapeutic Relationships, Communication, Family-centered Approach, and Perceived Outcomes of Nursing Presence. Nurses in pediatric oncology are in an ideal position to provide nursing presence in order to improve the quality of care in pediatric oncology settings. Discussion: There is a need to establish a comprehensive evidence-based understanding of the construct of nursing presence in pediatric oncology that health care providers can utilize to enhance their clinical practice and health research.
Working With More Creative Coworkers and New Product Development Team Performance
Authors: Chiang Yun-Hwa , Hsu Chu-Chun
Published: September 2021

This study proposes that working with colleagues who have similar levels of open personality can enhance a person’s social exchange relationship with teammates, which then inspires the person’s creativity. This study also draws on the idea-journey model of creativity and innovation to propose that the positive relationship between team members’ aggregated similarity in openness personality with teammates and the performance of the new product that the team develops is stronger when members of the team possess low levels of openness personality in aggregate. Examining data collected from Taiwanese new product development team engineers, we find support for these arguments.
“Painful, yet Beautiful, Moments”: Pathways Through Infant Feeding and Dynamic Conceptions of Breastfeeding Success
Authors: Whipps Mackenzie D. M. , Yoshikawa Hirokazu , Demirci Jill R. , Hill Jennifer
Published: September 2021

What is breastfeeding “success”? In this article, we challenge the traditional biomedical definition, instead centering visions of success described by breastfeeding mothers themselves. Using semi-structured interviews, quantitative surveys, and written narratives of 38 first-time mothers in the United States, we describe five common pathways through the first-year postpartum, a taxonomic distinction far more complex than a success–failure dichotomy: sustained breastfeeding, exclusive pumping, combination feeding, rapid weaning, and grinding back to exclusivity. We also explore the myriad ways in which mothers define and experience breastfeeding success, and in the process uncover the ways that cultural narratives—especially intensive mothering—color those experiences. Finally, we discuss how these experiences are shaped by infant feeding pathway. In doing so, we discover nuance that has gone unexplored in the breastfeeding literature. These findings have implications for supporting, promoting, and protecting breastfeeding in the United States and other high-income countries.
Integrating Word-Meaning Instruction Within Word-Reading Instruction
Authors: Austin Christy R. , Boucher Alexis N.
Published: September 2021

Despite strong theoretical and empirical evidence suggesting that word meaning knowledge plays a critical role in word reading, interventions for students with word reading difficulties and disabilities frequently target word reading instruction in isolation. This article connects reading theory to practice by describing one approach to integrate word-meaning instruction within word-reading instruction to support students who have mastered foundational phonics skills but require additional support to read multisyllabic words with accuracy and fluency. Included are the steps a teacher could use to implement integrated word reading and word meaning instruction utilizing the multisyllabic, academic vocabulary words students must be able to read and understand to comprehend complex science or social studies texts.
Health-Related Stigma, Social Support, Self-Efficacy, and Self-Care Actions Among Adults With Sickle Cell Disease in Oman
Authors: Al Raqaishi Huda , Al Qadire Mohammad , Alzaabi Omar , Al Omari Omar
Published: September 2021

Stigma contributes to the burden of individuals and families affected by Sickle cell disease (SCD) and causes delay in appropriate care seeking. The aim of this study is to examine the levels and associations between stigma, social support, self-efficacy, and self-care actions among adult patients with SCD in Oman using a cross-sectional, correlational design. Of the 264 participants, 56.1% ( n = 148) were males, with mean age of 30.1 years ( SD 7.7). Half of the participants were married, and 88.3% had no other associated diseases. The results demonstrate that patients in Oman suffer from health-related stigma. However, social support, self-efficacy, and self-care actions were reported to be high and correlated with several clinical and demographic variables. Based on the results, effective, low-cost interventions such as psycho-educational groups, individual counseling, or group therapies might be developed. They can promote belief in enhanced efficacy and improved SCD adaptation, thereby increasing patient, and provider satisfaction.
One-Stage Lengthening and Minimally Invasive Distal Metatarsal Metaphyseal Osteotomy (DMMO) for Brachymetatarsia
Authors: Chaparro Felipe , Espinoza Raul , Pellegrini Manuel J. , Carcuro Giovanni , Ortiz Cristian
Published: September 2021

Level of Evidence: Level V.
Construction of a Risk Prediction Model for Hospital-Acquired Pulmonary Embolism in Hospitalized Patients
Authors: Hou Lengchen , Hu Longjun , Gao Wenxue , Sheng Wenbo , Hao Zedong , Chen Yiwei , Li Jiyu
Published: September 2021

The purpose of this study is to establish a novel pulmonary embolism (PE) risk prediction model based on machine learning (ML) methods and to evaluate the predictive performance of the model and the contribution of variables to the predictive performance. We conducted a retrospective study at the Shanghai Tenth People's Hospital and collected the clinical data of in-patients that received pulmonary computed tomography imaging between January 1, 2014 and December 31, 2018. We trained several ML models, including logistic regression (LR), support vector machine (SVM), random forest (RF), and gradient boosting decision tree (GBDT), compared the models with representative baseline algorithms, and investigated their predictability and feature interpretation. A total of 3619 patients were included in the study. We discovered that the GBDT model demonstrated the best prediction with an area under the curve value of 0.799, whereas those of the RF, LR, and SVM models were 0.791, 0.716, and 0.743, respectively. The sensibilities of the GBDT, LR, RF, and SVM models were 63.9%, 68.1%, 71.5%, and 75%, respectively; the specificities were 81.1%, 66.1, 72.7%, and 65.1%, respectively; and the accuracies were 77.8%, 66.5%, 72.5%, and 67%, respectively. We discovered that the maximum D-dimer level contributed the most to the outcome prediction, followed by the extreme growth rate of the plasma fibrinogen level, in-hospital duration, and extreme growth rate of the D-dimer level. The study demonstrates the superiority of the GBDT model in predicting the risk of PE in hospitalized patients. However, in order to be applied in clinical practice and provide support for clinical decision-making, the predictive performance of the model needs to be prospectively verified.
Incidence, Outcomes and Risk Factors of Heparin-Induced Thrombocytopenia After Total Joint Arthroplasty: A National Inpatient Sample Database Study
Authors: Chen Yuhang , Wang Jian , Shi Zhan-jun , Zhang Yang , Yang Qinfeng , Xu Yichuan
Published: September 2021

Backgrounds: Heparin-induced thrombocytopenia (HIT) is a severe immune-mediated complication of heparin exposure, leading to negative consequences after total hip (THA) and knee arthroplasty (TKA). Materials and Methods: A retrospective study was conducted using the National Inpatient Sample (NIS) database from 2005 to 2014. The incidence and outcomes of HIT after THA or TKA were documented. Logistic regression analysis was performed to identify the postoperative HIT risk factors. Results: A total of 59 3045 patients who underwent THA and 1228 707 patients who underwent TKA were identified. The cumulative incidences were 0.02% and 0.01%, respectively. The HIT group presented significantly higher Charlson Comorbidity Index and Elixhauser Comorbidity Index scores, longer hospital stays (LOS), and higher medical costs. HIT led to a significantly higher mortality rate after THA (2.17% vs 0.16%, P = .0091). In THA, the HIT risk factors were racial minority, AIDS, pulmonary circulation disorders (PCD), psychoses, and hypertension. In TKA, the HIT risk factors were racial minority, PCD, and weight loss. Conclusion: The incidence of HIT after THA and TKA is relatively low; however, HIT significantly increases inpatient mortality, LOS, and medical cost.
Method for increasing the speed of an electrodynamic shaker for vibration test of rolling stock equipment
Authors: Wang Peng , Deng Hua , Liu Yue , Wang Yi-ming , Zhang Yi , Tang Zi-di
Published: September 2021

The velocity required in IEC 61373 for long-life random vibration testing of Category-3 rolling stock equipment in the vertical direction is 2.7821 m/s, but the maximum velocity of existing electrodynamic shakers falls in the range of 2–2.5 m/s. In this study, an electrodynamic shaker with a velocity satisfying the requirements for vibration testing of Category-3 rolling stock equipment was developed. First, mechanical and equivalent circuit models of an electrodynamic shaker were developed. On this basis, reducing the impedance of the armature coil was identified as the best option for increasing the velocity of the shaker. However, owing to the impact of the back electromotive force of the armature coil, a decrease in the input impedance of the armature coil at low frequencies leads to an increase in its input impedance at high frequencies. To reduce the input impedance at high frequencies, a shading coil was incorporated into the circuit. The shading coil-incorporated new design was modeled using equivalent circuits and simulated numerically. The results showed that the improvement measures—incorporating a shading coil, increasing the cross-sectional area, and reducing the number of turns of the armature coil—effectively reduced the input impedance of the armature coil, thereby increasing the armature coil current and the velocity of the shaker. Finally, a shaker with a maximum velocity of 3.2 m/s was fabricated based on the new design and was validated to satisfy the high-velocity requirement for the long-life vibration test of Category-3 equipment in the vertical direction as specified in IEC 61373.
Novel agents for myelodysplastic syndromes
Authors: Xu Katie , Hansen Elizabeth
Published: September 2021

Review objective

There have been several advances in the field of myelodysplastic syndromes over the past year, yielding two new US Food and Drug Administration drug approvals. The pharmacology, pharmacokinetics, clinical trials, therapeutic use, adverse effects, clinical use controversies, product description, and upcoming trials for myelodysplastic syndromes novel agents luspatercept-aamt and decitabine/cedazuridine are reviewed.

Data sources

This review article utilized primary information obtained from both the published studies involved in the approval of luspatercept-aamt and decitabine/cedazuridine and package inserts for the respective medications. This review article utilized secondary information obtained from National Comprehensive Cancer Network guidelines using filters and keywords to sustain information relevancy as well as key studies using the keywords, “luspatercept-aamt, myelodysplastic syndromes, decitabine, cedazuridine, hypomethylating agent, ASTX727” from scholarly journal database PubMed.

Data summary

Myelodysplastic syndromes consist of myeloid clonal hemopathies with a diverse range of presentation. Until recently, there have been relatively few new therapies in the myelodysplastic syndromes treatment landscape. On April 3, 2020 the US Food and Drug Administration approved Reblozyl®(luspatercept-aamt), then on July 7, 2020, the US Food and Drug Administration approved INQOVI® (decitabine and cedazuridine). Luspatercept-aamt acts as a erythroid maturation agent through differentiation of late-stage erythroid precursors. The safety and efficacy of luspatercept-aamt was demonstrated in the MEDALIST trial, a phase III trial in patients with very low-intermediate risk refractory myelodysplastic syndromes and ring sideroblasts. Luspatercept-aamt met both primary and secondary endpoints of transfusion independence of 8 weeks or longer and transfusion independence of 12 weeks or longer, respectively. Decitabine/cedazuridine has a unique mechanism of action in which decitabine acts as a nucleoside metabolic inhibitor promoting DNA hypomethylation and cedazuridine then prevents degradation of decitabine. The safety and efficacy of decitabine/cedazuridine was shown in the ASCERTAIN study, a phase III trial in patients with intermediate or high risk myelodysplastic syndromes or chronic myelomonocytic leukemia. The primary outcome evaluated was 5-day cumulative area under the curve between decitabine/cedazuridine and IV decitabine as well as additional outcomes including safety. Decitabine/cedazuridine met primary outcome and had a similar safety profile to IV decitabine.

Conclusion

The novel myelodysplastic syndromes agents luspatercept-aamt and decitabine/cedazuridine provide a clinical benefit in the studied populations.
Effectiveness and safety of eribulin for human epidermal growth factor receptor 2 negative metastatic breast cancer in a real-world population
Authors: Díaz-Acedo Rocío , Artacho Criado Silvia , Jiménez Galán Rocío , Gutiérrez Pizarraya Antonio , Galván Banqueri Mercedes , Rodríguez-de-la-Borbolla-Artacho María , Marcos Rodríguez José Antonio , Márquez Saavedra Esther
Published: September 2021

Background

Eribulin’s clinical benefit remains unclear; so, studies analyzing its effectiveness in routine clinical practice are interesting.

Patients and methods

This is a multicenter, retrospective study including patients with human epidermal growth factor receptor-2-negative metastatic breast cancer which assesses effectiveness and safety of eribulin.

Results

A total of 140 women were included, with a median age of 57 years. The median overall survival and progression-free survival were 8.8 (95% confidence interval: 6.1–11.4) and 2.8 months (95% confidence interval: 2.5–3.1), respectively. For patients with hormonal receptor expression, a significantly longer progression-free survival was observed: 3.4 (95%confidence interval: 2.3–4.5) versus triple negative: 2.0 (95%confidence interval: 1.7–2.3) months, p = 0.003. Also, those who had received capecitabine prior to eribulin had a higher median overall survival than those who had not received it (9.5 months, 95% confidence interval: 6.6–12.5 vs. 4.8 months, 95% confidence interval: 3.4–6.2; p = 0.001). When only triple-negative patients were included, median overall survival was 6.5 (95% confidence interval: 0.1–16.2) for those who had received previous capecitabine versus 4.3 (95% confidence interval: 2.8–5.8) months for patients who had not received it; p =0.006. The safety profile of eribulin was adequate.

Conclusion

Effectiveness of eribulin in a real-life human epidermal growth factor receptor-2--negative population is lower than that observed in clinical trials. Its benefit seems to be higher in patients with hormonal receptor expression and patients who had received capecitabine prior to eribulin. The safety profile of eribulin is adequate.
From Train Station to Night Market: Bangkok’s Talad Rod Fai as Urban Liminoid Space
Authors: Tan Kevin S.Y. , Chan Steve K.L.
Published: September 2021

Drawn from grounded perspectives of a Bangkok night market that is part of a franchise known as “Talad Rod Fai” (or “Train Station Market”), this article argues that the market’s popularity rested originally on its liminoid character, enabling the construction of an alternate public space that can be transgressive of the city’s highly urbanized landscape. Its long-term sustainability, however, appears to be at the cost of its original objectives, due to the onset of global tourism, which has increasingly converted and transformed its spaces into a site of commercialization and formalization. This has impacted the nature of the goods and products sold, and contributed to the growing precarity of many of its tenants, along with significant loss of local interest in the market. Such insights raise implications about the potentially contradictory nature of tourism on local street-level economies, and its impact on the construction and subsequent consumption of public spaces in urban settings.
On the role of input welding parameters on the microstructure and mechanical properties of Al6061-T6 alloy during the friction stir welding: Experimental and numerical investigation
Authors: Bagheri Behrouz , Sharifi Farzaneh , Abbasi Mahmoud , Abdollahzadeh Amin
Published: September 2021

The Taguchi method was employed to find the optimum values of friction stir welding parameters including welding speed, rotating speed, and tilt angle for joining AA6061-T6 aluminum alloys. The combined influences of these parameters were entirely analyzed. Statistical outcomes were investigated by the study of variances and signal-to-noise ratios. A Coupled Eulerian and Lagrangian technique is implemented to simulate and verify the optimal parameters during the friction stir welding. To verify results, a comparison between the welding process under optimized parameters with experimental and non-optimized parameters was simulated for the friction stir welding process. The material flow, strain rate, thermal behaviors, and mechanical properties of samples fabricated with optimal welding parameters are higher than those produced from the non-optimal parameters. It was also concluded that the grain size of the stir zone under optimal welding parameters (6–8 µm) is finer than that of non-optimal welding parameters (11–13 µm). Low uniform distribution of material element and coarse microstructure were some of the results of welding with non-optimized parameters. Based on residual stress analysis, the application of optimal joining conditions can decrease the peak tensile residual stress by about 38.3%. The much desirable results obtained in terms of microstructure and mechanical properties could be of great significance to the welding industry.
Design thinking in responding to disruptive innovation: A case study
Authors: Radnejad Amir Bahman , Sarkar Soumodip , Osiyevskyy Oleksiy
Published: September 2021

How can the design thinking approach assist firms in developing response strategies to momentum-gaining disruptive innovations, along the lines of effectively exploiting established technologies and corresponding products/services? Such exploitative response strategies, implying successfully strengthening and leveraging the disrupted firm's existing technology without embracing the disruptive elements, have been, to a large extent, overlooked in the disruptive innovations literature. Using an inductive analysis of a critical case (a major cork stopper producer), the current study aims at developing a systematic understanding of exploitative strategic options and the role of design thinking in enabling them. The findings shed light on the effectiveness of the design thinking mindset to respond to disruptive innovations. In addition, we present evidence that a design thinking method can be successfully applied to process innovation. Finally, we demonstrate that to achieve a radical innovation based on design thinking principles, the establishment of design discourse is required.
Social inequality in alternative sanctions: A register data study on all adolescent drug offenders in Norway 2005–2015
Authors: Sandøy Thomas Anton , Østhus Ståle , Bretteville-Jensen Anne Line
Published: September 2021

The penal repertoire for young offenders in Europe encompasses an increasing variety of alternative sanctions. Research indicates that the availability and implementation of these sanctions vary within jurisdictions, raising issues of unequal treatment for equal offences. Among possible factors associated with intra-jurisdictional disparities in alternative sentencing outcomes is the socioeconomic status of young offenders. This study investigates the social profile of diverted youth, thereby addressing social inequalities in alternative sanctioning. Register data on all 15- to 17-year olds charged with minor drug offences in Norway between 2005 and 2015 ( N = 3209) were compared to a randomly drawn sample of non-offenders ( N = 69,201). Offenders who were diverted from a fine to a conditional waiver of prosecution, either with or without rehabilitative measures, were classified with an alternative sanction. Socioeconomic status was measured by an indicator combining register data on household income and parental education. Probit regressions with sample selection were used to identify social gradients in alternative sanctioning. By extensive register linkages, we were able to control for a range of well-known confounders such as gender, immigrant status, family composition, parental crime, and geographical centrality. We found that the probability of receiving a conditional waiver of prosecution was around 5% points higher for youth from a medium-high socioeconomic status background and 8% points higher for youth from a high socioeconomic status background compared with their low socioeconomic status counterparts. The positive social gradient pertained to sanctioning with rehabilitative elements and not to minimal interventions. Social inequality in desistance-oriented sanctions, which may consolidate pre-existing inequalities in criminal charges, is likely influenced by the resources parents have at their disposal to get involved in their children’s legal processes.
Investigation of Patients With Eye Closure Sensitive Epilepsy With Magnetic Resonance Spectroscopy
Authors: Yıldırım Feyza , Aydin Zeynep , Sakcı Zakir , Yalçın Ays¸e Destînâ
Published: September 2021

Introduction and aim: A proportion of patients diagnosed with genetic generalized epilepsy (GGE) experience eye-closure sensitivity (ECS), the underlying pathogenesis of which is unknown. In this study, we compare magnetic resonance spectroscopy (MRS) findings of healthy volunteers with patients diagnosed with GGE, with and without ECS, to detect possible explanatory differences between groups. Materials and methods: A total of 33 patients diagnosed with GGE: 17 with ECS and 16 without, and 12 healthy volunteers are included. MRS measurements of N-acetyl-aspartate (NAA), choline (Cho), and creatine (Cr) were made of bilateral occipital lobes and thalamus, and values of patients with GGE were compared with those of normal controls, and within subgroups with different clinical variables, using appropriate statistical tests. Results: Left occipital NAA and NAA/Cr levels were found to be significantly higher in the ECS group than in the control group. In the ECS epilepsy group, a significant moderate positive correlation was noted between left thalamic Cr and duration of drug therapy ( r = .539, P = .047) and left thalamic Cr and age at epilepsy onset ( r = .564, P = .036). Additionally, left thalamic NAA and NAA/Cr levels were observed to be lower in GGE patients compared to healthy subjects, although not to a statistically significant degree. Conclusion:The differences in MRS-measurable metabolites in the left occipital lobe in those with ECS epilepsy suggest an association between the ECS mechanism and the left occipital lobe. Our results also support the multifocal thalamocortical pathway disorder in the pathophysiology of GGE based on the observation of cellular dysfunction in the thalamus.
The Utility of Indocyanine Green Dye Fluorescence Lymphography and Angiography During Wide Excision of Cutaneous Melanoma
Authors: Chu Tzi-Shiang , Tzeng Yuan-Sheng , Wang Chi-Yu , Shih Yu-Jen , Chen Chun-Yu , Wang Chih-Hsin
Published: September 2021

Background and Objectives. Lymph node status is the most important prognostic factor in cutaneous melanoma patients. Recent studies showed that indocyanine green (ICG) fluorescence lymphography helps locating sentinel nodes better. Sometimes, flap reconstruction is needed after wide excision of tumor. Indocyanine green fluorescence also simplifies the intraoperative design of flaps. This study investigates the use of ICG fluorescence in patients with cutaneous melanoma during operation. Methods. We performed a single-center, retrospective study of subjects with cutaneous melanoma using ICG lymphograhy and/or angiography during wide excision of tumor between 2015 and 2019. Patients received a dermal injection of ICG and patent blue (PB) dye. The positive node was excised. Indocyanine green angiography was utilized to visualize better skin paddle during flap reconstruction if needed. Results. A total of 37 sentinel lymph nodes (SLNs) were removed in 12 patients. Indocyanine green successful localization was found in 10 of the 12 patients (83%). Three patients were found with 6 metastatic nodes on final pathology. 100% of these 6 nodes were identified by ICG, while 83% (5/6) were positive PB. Three of the 12 patients received flap reconstruction after operation, and no major complications occurred. Conclusions. ICG dye lymphangiography is a good alternative for locating SLNs in patients with melanoma. It could also visualize well perfusion skin paddle during reconstruction. We reported a reproducible and simple method to utilize ICG fluorescence in cutaneous melanoma patients.
Nursing workplace and its relation to occupational health outcomes and physical activity
Authors: Abd El-Fattah Mohamed Aly Nagah , El-Shanawany Safaa M , Ghanem Maha
Published: September 2021

Background

Working in hospitals entails several risks to nurses. A better nursing workplace can help in improving physical activity and reducing adverse occupational health outcomes among nurses.

Aim

This study aimed to investigate the relationships of the nursing workplace with occupational health outcomes and physical activity.

Methods

A cross-sectional correlation study was conducted with 623 nurses. Data were collected through report self-administered questionnaires that included employment and occupational conditions, hospital workplace environment, and adverse occupational health outcomes as well as physical activity pattern.

Results

The current study showed that the nursing workplace environment and conditions had a negative effect on occupational health outcomes and physical activity among nurses in the study units. Nurses in this study reported a high prevalence of low back pain (82.7%), burnout (78.3%), and occupational injuries (70.5%). They also reported insufficient physical activities (90.6%). High prevalence of burnout and low back pain were associated with low levels of physical activities among nurses.

Conclusion

A fair working environment and conditions have been implicated as a causative factor of negative occupational health outcomes and limitations of physical activity among nurses. Adverse occupational health outcomes also affect the nurses engaging in physical activity.
Experiences of a ‘screen and treat’ cervical cancer prevention programme among brothel-based female sex workers in Bangladesh: A qualitative interview study
Authors: Wilson Emma , Barnard Sharmani , Mahmood Samiya , Nuccio Olivia , Rathod Sujit D , Chowdhury Raveena , Sapkota Sabitri , Tabassum Tanzila , Rashid Shah Halimur , Verde Hashim Catherine
Published: September 2021

Objectives:

Little is known about sex workers’ experiences of cervical cryotherapy. We sought to understand sex workers’ perspectives of ‘screen and treat’ programmes and their management of the World Health Organization post-treatment guidance to abstain from sex or use condoms consistently for 4 weeks. We explored contraceptive preferences and use of menstrual regulation services.

Methods:

We conducted semi-structured interviews with 16 sex workers and six brothel leaders in an urban brothel complex in Bangladesh between October and November 2018. All had undergone cryotherapy. We conducted a thematic analysis using deductive coding, informed by a priori themes, and inductive data-driven coding.

Results:

Most sex workers could not abstain from sex during the healing period. Consistent condom use was challenging due to economic incentives attached to condomless sex and coercive behaviours of clients. The implications of non-adherence among high-risk groups such as sex workers are not known. Use of short-acting methods of contraception was common, and discontinuation was high due to side effects and other perceived health concerns. The majority of sex workers and brothel leaders had utilized menstrual regulation services. Barriers to accessing timely menstrual regulation and other sexual and reproductive health services included limited mobility, economic costs, and discriminatory attitudes of health care workers.

Conclusion:

Service innovations are required to enable sex workers to abstain or use condoms consistently in the post-cryotherapy healing phase and to address sex workers’ broader sexual and reproductive health needs. Further research is required to assess the risk of HIV and other sexually transmitted infection transmission following cryotherapy among high-risk groups.
Concrete Culture: The Planning Hearing as a Stage for Cultural Debates
Authors: Smith Neil Thomas
Published: September 2021

This article is an investigation into how cultural debates are staged within the planning hearing for a new concert hall in Edinburgh. Through an analysis of the hearing and interviews with protagonists, it shows how the material, in this case the proposed concrete cladding, functions within a cultural controversy, providing an excellent example of how materials are socially mediated. The findings suggest that the debates over cultural impact and elitism rehearsed in the hearing are inextricably tied to two opposing ontologies of concrete, one very fixed, the other far more open. It is argued that planning hearings are an under-explored area in which cultural policy is effected, though the entwinement – indeed co-constitution – of material and cultural issues shows that the course and eventual conclusion of these debates are highly complex.
On a Different Page! Perceptions on the Onset, Diagnosis, and Management of Type 2 Diabetes Among Adolescent Patients, Parents, and Physicians
Authors: Xu Jinyu , Pratt Keeley , Chaudhari Monika , Henry Rohan , Hubbard Rebecca A. , Siegel Robert , Eneli Ihuoma
Published: September 2021

To examine perceptions about the diagnostic process and post-diagnosis care of type 2 diabetes (T2D) from adolescent patients, parents, and diabetes care physicians, semi-structured interviews were conducted with 8 individuals from each group. Interview transcripts were coded using content analysis. Emerged categories were compared among 3 groups. Half of adolescent patients and parents were surprised by the T2D diagnosis, despite most reporting that patients experienced common symptoms of T2D prior to diagnosis. Adolescents and parents recognized diet, exercise, and weight gain as risk factors after diagnosis, whereas physicians noted weight gain as a common risk factor pre-diagnosis. All 3 groups noted the importance of maintaining a healthy lifestyle and adherence to T2D management, though physicians noted the challenges from socioeconomic structural inequalities. Adolescent and parents were surprised by the T2D diagnosis, suggesting the need for increasing awareness of risk factors and symptomatology of T2D among at-risk adolescents and parents.
The Family of Jesus (Yehsu Chia-t'ing)
Authors: Romig Theodore P.
Published: September 2021

Information concerning the small christian sects and independent churches in China is very scant. a contribution to our knowledge of one of these groups is most welcome, especially when that group is one which practices communal life based upon the example of the primitive christian community in Jerusalem. It will be very important to observe the fate of a christian communist group under a Marxian communistic regime. It is reported that S. P. Wang has published a book on the group in China, but a copy is not available in the united states.

The Rev. Theodore F. Romig is a missionary of wide experience in China and the son of missionary experience. He is professor-elect of Missions at the Mccormick Theological seminary, Chicago, but during the present year is on loan by the Board of Foreign Missions of the presbyterian church in the U.S.A. to the international Missionary council and the Research committee of the Foreign Missions Conference of North America for executive service in the Study of the Missionary Obligation of the Church.–Editor.
Cochlear Duct Length Measurements in Computed Tomography and Magnetic Resonance Imaging Using Newly Developed Techniques
Authors: Taeger Johannes , Müller‐Graff Franz Tassilo , Ilgen Lukas , Schendzielorz Phillip , Hagen Rudolf , Neun Tilman , Rak Kristen
Published: September 2021

Objective

Growing interest in measuring the cochlear duct length (CDL) has emerged, since it can influence the selection of cochlear implant electrodes. Currently the measurements are performed with ionized radiation imaging. Only a few studies have explored CDL measurements in magnetic resonance imaging (MRI). Therefore, the presented study aims to fill this gap by estimating CDL in MRI and comparing it with multislice computed tomography (CT).

Study Design

Retrospective data analyses of 42 cochleae.

Setting

Tertiary care medical center.

Methods

Diameter (A value) and width (B value) of the cochlea were measured in HOROS software. The CDL and the 2‐turn length were determined by the elliptic circular approximation (ECA). In addition, the CDL, the 2‐turn length, and the angular length were determined via HOROS software by the multiplanar reconstruction (MPR) method.

Results

CDL values were significantly shorter in MRI by MPR (d = 1.38 mm, P <. 001) but not by ECA. Similar 2‐turn length measurements were significantly lower in MRI by MPR (d = 1.67 mm) and ECA (d = 1.19 mm, both P <. 001). In contrast, angular length was significantly higher in MRI (d = 26.79°, P <. 001). When the values were set in relation to the frequencies of the cochlea, no clinically relevant differences were estimated (58 Hz at 28‐mm CDL).

Conclusion

In the presented study, CDL was investigated in CT and MRI by using different approaches. Since no clinically relevant differences were found, diagnostics with radiation may be omitted prior to cochlear implantation; thus, a concept of radiation‐free cochlear implantation could be established.
Putting Psychology to the Test: Rethinking Model Evaluation Through Benchmarking and Prediction
Authors: Rocca Roberta , Yarkoni Tal
Published: September 2021

Consensus on standards for evaluating models and theories is an integral part of every science. Nonetheless, in psychology, relatively little focus has been placed on defining reliable communal metrics to assess model performance. Evaluation practices are often idiosyncratic and are affected by a number of shortcomings (e.g., failure to assess models’ ability to generalize to unseen data) that make it difficult to discriminate between good and bad models. Drawing inspiration from fields such as machine learning and statistical genetics, we argue in favor of introducing common benchmarks as a means of overcoming the lack of reliable model evaluation criteria currently observed in psychology. We discuss a number of principles benchmarks should satisfy to achieve maximal utility, identify concrete steps the community could take to promote the development of such benchmarks, and address a number of potential pitfalls and concerns that may arise in the course of implementation. We argue that reaching consensus on common evaluation benchmarks will foster cumulative progress in psychology and encourage researchers to place heavier emphasis on the practical utility of scientific models.
Protease activity sensors enable real-time treatment response monitoring in lymphangioleiomyomatosis
Authors: Kirkpatrick Jesse D. , Soleimany Ava P. , Dudani Jaideep S. , Liu Heng-Jia , Lam Hilaire C. , Priolo Carmen , Henske Elizabeth P. , Bhatia Sangeeta N.
Published: September 2021

Background

Biomarkers of disease progression and treatment response are urgently needed for patients with lymphangioleiomyomatosis (LAM). Activity-based nanosensors, an emerging biosensor class, detect dysregulated proteasesin vivoand release a reporter to provide a urinary readout of disease. Because proteases are dysregulated in LAM and may directly contribute to lung function decline, activity-based nanosensors may enable quantitative, real-time monitoring of LAM progression and treatment response. We aimed to assess the diagnostic utility of activity-based nanosensors in a pre-clinical model of pulmonary LAM.

Methods

Tsc2-null cells were injected intravenously into female nude mice to establish a mouse model of pulmonary LAM. A library of 14 activity-based nanosensors, designed to detect proteases across multiple catalytic classes, was administered into the lungs of LAM mice and healthy controls, urine was collected, and mass spectrometry was performed to measure nanosensor cleavage products. Mice were then treated with rapamycin and monitored with activity-based nanosensors. Machine learning was performed to distinguish diseased from healthy and treated from untreated mice.

Results

Multiple activity-based nanosensors (PP03 (cleaved by metallo, aspartic and cysteine proteases), padjusted<0.0001; PP10 (cleaved by serine, aspartic and cysteine proteases), padjusted=0.017)) were differentially cleaved in diseased and healthy lungs, enabling strong classification with a machine learning model (area under the curve (AUC) 0.95 from healthy). Within 2 days after rapamycin initiation, we observed normalisation of PP03 and PP10 cleavage, and machine learning enabled accurate classification of treatment response (AUC 0.94 from untreated).

Conclusions

Activity-based nanosensors enable noninvasive, real-time monitoring of disease burden and treatment response in a pre-clinical model of LAM.
Sleep apnoea in the elderly: a great challenge for the future
Authors: Osorio Ricardo S. , Martínez-García Miguel Ángel , Rapoport David M.
Published: September 2021

Due in part to overall improvements in health, the population of elderly individuals is increasing rapidly. Similarly, obstructive sleep apnoea (OSA) is both gaining increased recognition and also increasing due to the worldwide obesity epidemic. The overlap of OSA and ageing is large, but there is strong plausibility for causation in both directions: OSA is associated with pathological processes that may accelerate ageing and ageing-related processes; ageing may cause physical and neurological changes that predispose to obstructive (and central) apnoea. In addition, the common symptoms (e.g.excessive daytime sleepiness, and defects in memory and cognition), possible physiological consequences of OSA (e.g.accelerated cardiovascular and cerebrovascular atherosclerosis), and changes in metabolic and inflammatory markers overlap with the symptoms and associated conditions seen in ageing. There is also the possibility of synergy in the effects of these symptoms and conditions on quality of life, as well as a need to separate treatable consequences of OSA from age-related complaints. Taken together, the aforementioned considerations make it essential to review the interaction of OSA and ageing, both proven and suspected. The present review examines some aspects of what is known and points to the need for further investigation of the relationships, given the large number of potentially affected subjects.
Genome-wide analysis of HSP70 gene superfamily in Pyropia yezoensis (Bangiales, Rhodophyta): identification, characterization and expression profiles in response to dehydration stress
Authors: Yu Xinzi , Mo Zhaolan , Tang Xianghai , Gao Tian , Mao Yunxiang
Published: September 2021

Background

Heat shock proteins (HSPs) perform a fundamental role in protecting plants against abiotic stresses. Individual family members have been analyzed in previous studies, but there has not yet been a comprehensive analysis of the HSP70 gene family in Pyropia yezoensis.

Results

We investigated 15 putative HSP70 genes in Py. yezoensis. These genes were classified into two sub-families, denoted as DnaK and Hsp110. In each sub-family, there was relative conservation of the gene structure and motif. Synteny-based analysis indicated that seven and three PyyHSP70 genes were orthologous to HSP70 genes in Pyropia haitanensis and Porphyra umbilicalis, respectively. Most PyyHSP70s showed up-regulated expression under different degrees of dehydration stress. PyyHSP70-1 and PyyHSP70-3 were expressed in higher degrees compared with other PyyHSP70s in dehydration treatments, and then expression degrees somewhat decreased in rehydration treatment. Subcellular localization showed PyyHSP70-1-GFP and PyyHSP70-3-GFP were in the cytoplasm and nucleus/cytoplasm, respectively. Similar expression patterns of paired orthologs in Py. yezoensis and Py. haitanensis suggest important roles for HSP70s in intertidal environmental adaptation during evolution.

Conclusions

These findings provide insight into the evolution and modification of the PyyHSP70 gene family and will help to determine the functions of the HSP70 genes in Py. yezoensis growth and development.
Maternal and neonatal outcomes in mothers with diabetes mellitus in Qatari population
Authors: Bayoumi Mohammad A. A. , Masri Razan M. , Matani Nada Y. S. , Hendaus Mohamed A. , Masri Manal M. , Chandra Prem , Langtree Lisa J. , D’Souza Sunitha , Olayiwola Noimot O. , Shahbal Saad , Elmalik Einas E. , Bakry Mohamed S. , Gad Ashraf I. , Agarwal Ravi
Published: September 2021

Background

Diabetes Mellitus (DM) is a major cause of maternal, fetal, and neonatal morbidities. Our objective was to estimate the effect of both pre-pregnancy and gestational DM on the growth parameters of newborns in the Qatari population.

Methods

In this population-based cohort study, we compared the data of neonates born to Qatari women with both pre-pregnancy and gestational diabetes mellitus in 2017 with neonates of healthy non-diabetic Qatari women.

Results

Out of a total of 17020 live births in 2017, 5195 newborns were born to Qatari women. Of these, 1260 were born to women with GDM, 152 were born to women with pre-pregnancy DM and 3783 neonates were born to healthy non-diabetic (control) women. The prevalence of GDM in the Qatari population in 2017 was 24.25%. HbA1C% before delivery was significantly higher in women with pre-pregnancy DM (mean 6.19 ± 1.15) compared to those with GDM (mean 5.28 ± 0.43) (P <0.0001). The mean birth weight in grams was 3066.01 ± 603.42 in the control group compared to 3156.73 ± 577.88 in infants born to women with GDM and 3048.78 ± 677.98 in infants born to women with pre-pregnancy DM (P <0.0001). There was no statistically significant difference regarding the mean length (P= 0.080), head circumference (P= 0.514), and rate of major congenital malformations (P= 0.211). Macrosomia (Birth weight > 4000 gm) was observed in 2.7% of the control group compared to 4.8% in infants born to women with GDM, and 4.6% in infants born to women with pre-pregnancy DM (P= 0.001). Multivariate logistic regression analysis demonstrated that higher maternal age (adjusted OR 2.21, 95% CI 1.93, 2.52, P<0.0001), obesity before pregnancy (adjusted OR 1.71, 95% CI 1.30, 2.23, P<0.0001), type of delivery C-section (adjusted OR 1.25, 95% CI 1.09, 1.44, P=0.002), and body weight to gestational age LGA (adjusted OR 2.30, 95% CI 1.64, 2.34, P<0.0001) were significantly associated with increased risk of GDM.

Conclusion

Despite the multi-disciplinary antenatal diabetic care management, there is still an increased birth weight and an increased prevalence of macrosomia among the infants of diabetic mothers. More efforts should be addressed to improve the known modifiable factors such as women's adherence to the diabetic control program. Furthermore, pre-pregnancy BMI was found to be significantly associated with gestational DM, and this is a factor that can be addressed during pre-conceptional counseling.
Frequency and severity of prehospital obstetric events encountered by emergency medical services in the United States
Authors: Cash Rebecca E. , Swor Robert A. , Samuels-Kalow Margaret , Eisenbrey David , Kaimal Anjali J. , Camargo Carlos A.
Published: September 2021

Background

Prehospital obstetric events encountered by emergency medical services (EMS) can be high-risk patient presentations for which suboptimal care can cause substantial morbidity and mortality. The frequency of prehospital obstetric events is unclear because existing descriptions have reported obstetric and gynecological conditions together, without delineating specific patient presentations. Our objective was to identify the types, frequency, and acuity of prehospital obstetric events treated by EMS personnel in the US.

Methods

We conducted a cross-sectional analysis of EMS patient care records in the 2018 National EMS Information System dataset (n=22,532,890). We focused on EMS activations (i.e., calls for service) for an emergency scene response for patients aged 12-50 years with evidence of an obstetric event. Type of obstetric event was determined by examining patient symptoms, the treating EMS provider’s impression (i.e., field diagnosis), and procedures performed. High patient acuity was ascertained by EMS documentation of patient status and application of the modified early obstetric warning system (MEOWS) criteria, with concordance assessed using Cohen’s kappa. Descriptive statistics were calculated to describe the primary symptoms, impressions, and frequency of each type of obstetric event among these activations.

Results

A total of 107,771 (0.6%) of EMS emergency activations were identified as involving an obstetric event. The most common presentation was early or threatened labor (15%). Abdominal complaints, including pain and other digestive/abdomen signs and symptoms, was the most common primary symptom (29%) and primary impression (18%). We identified 3,489 (3%) out-of-hospital deliveries, of which 1,504 were preterm. Overall, EMS providers documented 34% of patients as being high acuity, similar to the MEOWS criteria (35%); however, there were high rates of missing data for EMS documented acuity (19%), poor concordance between the two measures (Cohen’s kappa=0.12), and acuity differences for specific conditions (e.g., high acuity of non-cephalic presentations, 77% in EMS documentation versus 53% identified by MEOWS).

Conclusion

Prehospital obstetric events were infrequently encountered by EMS personnel, and about one-third were high acuity. Additional work to understand the epidemiology and clinical care of these patients by EMS would help to optimize prehospital care and outcomes.