bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic Recommendations in the Youth Justice System Cohort Diagnosed with Foetal Alcohol Spectrum Disorder
Authors: Russell Natasha K. , Yee Tan Kuen , Pestell Carmela F. , Connor Sophia , Fitzpatrick James P.
Published: August 2021

Patches Paediatrics is a specialised private multidisciplinary service in Western Australia (WA), offering a range of developmental diagnostic assessments such as foetal alcohol spectrum disorder (FASD). Many FASD assessments occur in children and youth who are engaged with the justice system in WA and the Northern Territory (NT). There are currently no studies outlining the types of clinical recommendations and management strategies made or implemented by clinicians for this clinical population within Australia. This study outlines therapeutic recommendations made as part of the youth justice FASD diagnostic process within Patches Paediatrics to ultimately refine recommendations to inform therapeutic strategies. This was a retrospective cross-sectional descriptive study of those aged 10 years to 17 years 11 months (N = 64) who were diagnosed with FASD within Patches Paediatrics; and referred from the youth justice system in WA and the NT between January 2017 and February 2019. Information on FASD recommendations was gathered by reviewing participants’ source documents, such as FASD diagnostic reports. ‘FASD recommendations’ categories were divided into subdomains: medical, mental health, developmental, lifestyle, future goals and others. In the various categories of recommendations, the most prominent were referral for National Disability Insurance Scheme (NDIS) funding (75%) followed by education support (67.2%), occupational therapy (56.3%), and drug and alcohol services (45.3%). Significant correlations between impaired neurocognitive domains and recommendations were also observed. Similarly, there were significant correlations between comorbidities and recommendations. Our study highlighted gaps in recommendations for those with comorbid attention-deficit/hyperactivity disorder (ADHD), rural communities and access to NDIS, therapeutic rehabilitation programmes as well as community work programmes. Other gaps included making adequate recommendations for speech/language therapy, education support, life skills advice and staff/clinician education. This study was the first to describe therapeutic recommendations for the youth cohort assessed by Patches Paediatrics in WA and the NT. It also showed significant correlations between the neurocognitive/comorbidity profile and clinical recommendations. This highlights areas within the recommendations that can be individualised as well as ways to improve community integration. A discussion of limitations and suggestions for future research is also provided.
Solvent diffusion mechanism of PMMA/ acetone coated glass fiber fabric during curing process
Authors: Zheng Zhenrong , Bi Yuejiao , Tong Lihuan , Liu Yalan
Published: August 2021

Fabric it is not an impermeable substrate because of fiber porosity. To study the solvent diffusion mechanism of coated fabric in the curing process, the drying model of PMMA/acetone coated glass fiber fabric was established. This drying model was verified by confocal Raman spectroscopy. Finally, the impact of fabric structure, thickness and porosity on the solvent diffusion process in coated fabrics was studied by the model. It was shown that the predicted solvent concentrations by the model were consistent with the experimental values. This model can be used to quantitatively calculate the solvent concentration at any position and at any time inside the coating film during the drying process. Moreover, it can also predict the curing time and residual solvent concentration of the coating fabric required to reach drying equilibrium. Compared with coated 3/1 twill, 5/3 satin and 2/1 twill, the solvent diffusion of coated plain fabric was faster during curing. Under the same environmental conditions, the thinner the fabric was and the greater the porosity was, the shorter the curing time was. The fitting equations for fabric thickness, fabric porosity and drying time were obtained, which can provide a theoretical guidance for the preparation, performance research and drying conditions optimization of PMMA coated textile materials.
Polymeric textile-based electromagnetic interference shielding materials, their synthesis, mechanism and applications – A review
Authors: Safdar Faiza , Ashraf Munir , Javid Amjed , Iqbal Kashif
Published: August 2021

The rapid proliferation of electronic devices and their operation at high frequencies has raised the contamination of artificial electromagnetic radiations in the atmosphere to an unprecedented level that is responsible for catastrophe for ecology and electronic devices. Therefore, the lightweight and flexible electromagnetic interference (EMI) shielding materials are of vital importance for controlling the pollution generated by such high-frequency EM radiations for protecting ecology and human health as well as the other nearby devices. In this regard, polymeric textile-based shielding composites have been proved to be the best due to their unique properties such as lightweight, excellent flexibility, low density, ease of processability and ease of handling. Moreover, such composites cover range of applications from everyday use to high-tech applications. Various polymeric textiles such as fibers, yarn, woven, nonwoven, knitted, as well as their hybrid composites have been extensively manipulated physically and/or chemically to act as shielding against such harmful radiations. This review encompasses from basic concept of EMI shielding for beginner to the latest research in polymeric-based textile materials synthesis for experts, covering detailed mechanisms with schematic illustration. The review also covers the gap of materials synthesis and their application on polymeric textiles which could be used for EMI shielding applications. Furthermore, recent research regarding rendering EMI shielding properties at various stages of polymeric textile development is provided for readers with critical analysis. Lastly, the applications along with environmental compliance have also been presented for better understanding.
Hypoxia and the Tumor Microenvironment
Authors: Li Yue , Zhao Long , Li Xiao-Feng
Published: August 2021

Hypoxia is an important feature of the tumor microenvironment, and is closely associated with cell proliferation, angiogenesis, metabolism and the tumor immune response. All these factors can further promote tumor progression, increase tumor aggressiveness, enhance tumor metastatic potential and lead to poor prognosis. In this review, these effects of hypoxia on tumor biology will be discussed, along with their significance for tumor detection and treatment.
Silica-Coated Fe3O4 Nanoparticles as a Bifunctional Agent for Magnetic Resonance Imaging and ZnII Fluorescent Sensing
Authors: Qiu Lin , Zhou Shuwen , Li Ying , Rui Wen , Cui Pengfei , Zhang Changli , Yu Yongsheng , Wang Cheng , Wang Xiang , Wang Jianhao , Jiang Pengju
Published: August 2021

Bifunctional magnetic/fluorescent core-shell silica nanospheres (MNPs) encapsulated with the magnetic Fe3O4 core and a derivate of 8-amimoquinoline (N-(quinolin-8-yl)-2-(3-(triethoxysilyl) propylamino) acetamide) (QTEPA) into the shell were synthesized. These functional MNPs were prepared with a modified stöber method and the formed Fe3O4@SiO2-QTEPA core-shell nanocomposites are biocompatible, water-dispersible, and stable. These prepared nanoparticles were characterized by X-ray power diffraction (XRD), transmission electron microscopy (TEM), thermoelectric plasma Quad II inductively coupled plasma mass spectrometry (ICP-MS), superconducting quantum interference device (SQUID), TG/DTA thermal analyzer (TGA) and Fourier transform infrared spectroscopy (FTIR). Further application of the nanoparticles in detecting Zn2+ was confirmed by the fluorescence experiment: the nanosensor shows high selectivity and sensitivity to Zn2+ with a 22-fold fluorescence emission enhancement in the presence of 10 μM Zn2+. Moreover, the transverse relaxivity measurements show that the core-shell MNPs have T2 relaxivity (r2) of 155.05 mM−1 S−1 based on Fe concentration on the 3.0 T scanner, suggesting that the compound can be used as a negative contrast agent for MRI. Further in vivo experiments showed that these MNPs could be used as MRI contrast agent. Therefore, the new nanosensor provides the dual modality of magnetic resonance imaging and optical imaging.
Searching and Caring for the Sacred: Psychological Perspectives on Caring for People’s Spiritual Needs
Authors: Viftrup Dorte Toudal , Hvidt Niels Christian
Published: August 2021

We present knowledge from the field of psychology of religion for professional clinicians. The model “Search for the Sacred” and other concepts of psychology of religion are introduced: Sacred core and ring, sanctification, spiritual emotions, spiritual relationships, spiritual pathways, and sacred moments. These are discussed in relation to different concepts of theology for broadening the understanding and application of these concepts. Interviews with Danish Christians facing a crisis illustrate the application of the theoretical perspectives.
500 Consecutive Robotic Lobectomies for Non-Small Cell Lung Cancer: Perioperative and Oncologic Outcomes
Authors: Herrera Luis J. , Wherley Eric M. , Agyabeng-Dadzie Kojo , Ramsuchit Bhupaul , Johnston Matthew A. , Escalon Juan C.
Published: August 2021

Objective

Clinical adoption of robotic lobectomy for management of lung cancer is rapidly increasing across the world. Several studies have evaluated the technique with regards to perioperative and cost outcomes, with evidence beginning to grow regarding long-term oncologic outcomes. We report perioperative and oncologic outcomes in our single institution experience with 500 consecutive robotic lobectomies, including a significant portion for locally advanced disease.

Methods

This study is a retrospective review of the first 500 robotic lobectomies performed at our institution from 2010 to 2018. Segmentectomy, pneumonectomy, and lobectomy for other conditions were excluded. Descriptive statistics and Kaplan-Meier survival analysis are presented.

Results

Pathologic stage distribution was IA in 194 (39%), IB in 54 (11%), IIA in 41 (8%), IIB in 109 (22%), IIIA in 83 (17%), IIIB in 11 (2%), and IV in 8 (2%). Elective conversion occurred in 26 cases (5.2%) and emergent conversion occurred in 3 cases (0.6%). Mean length of stay was 3.7 days (1 to 40). The most common complications encountered were atrial fibrillation in 71 (14.2%) and prolonged air leak in 49 (9.8%). Thirty-day mortality occurred in 3 patients (0.6%). Nodal upstaging was 16.6%. Stage specific overall survival outcomes included an 84% survival for stage IA patients, 73% for IB, 68% for IIA, 63% for IIB, and 49% for IIIA disease.

Conclusions

Robotic lobectomy for lung cancer is a feasible technique for treatment of non-small cell lung cancer with low perioperative morbidity and mortality. Furthermore, excellent oncologic outcomes can be achieved with this approach.
Provision of exercise services in patients with peripheral artery disease in the United Kingdom
Authors: Harwood Amy E , Pymer Sean , Ibeggazene Said , Ingle Lee , Caldow Eddie , Birkett Stefan T
Published: August 2021

Objectives

Supervised exercise programmes (SEPs) are a vital treatment for people with intermittent claudication, leading improvements in walking distance and quality of life and are recommended in multiple national and international guidelines. We aimed to evaluate the use and structure of SEPs in the United Kingdom (UK).

Design

We conducted an anonymous online survey using the Jisc platform comprising of 40 questions. The survey was designed to address key areas such as access, provision, uptake and delivery of SEPs in the United Kingdom. Ethical approval was obtained from Coventry University (P108729).

Methods

The list of trusts providing vascular services was obtained from the National Vascular Registry (NVR) report. The survey was disseminated via social media, The Vascular Society of Great Britain and Ireland and the Society for Vascular Technology. Data were exported to a Microsoft Excel document and analysed using simple descriptive statistics.

Results

Of 93 vascular units identified, we received response from 48. Of these, 23 had access to an exercise programme (48%). The majority of SEPs were exclusively for PAD patients (77%), with 21% using integrated services. 67% of respondents were providing a circuit-based programme, and 5 out of 23 were meeting the dose recommendations in the UK National Institute for Health and Care Excellence (NICE) guidelines. Respondents felt that programmes were moderately to extremely important to patients, slightly to very important to clinicians and not at all important to slightly important to commissioning/funding bodies.

Conclusion

SEPs are a well-established first-line treatment for patients with IC and they are recommended by NICE guidelines. Despite this, many patients still do not have access to an exercise programme, and clinicians do not feel that they have support from commissioning/funding bodies to develop them. There is an urgent need for funding, development and delivery of SEPs in the United Kingdom.
Late onset infection of covered and bare metal arterial stents
Authors: Borghese Ottavia , Pisani Angelo , Funaru Dan Andrei , Di Marzo Luca , Di Centa Isabelle
Published: August 2021

Objective

The objective was to present the case of a late covered iliac stent late infection and report a comprehensive literature review on diagnosis and outcomes in this setting.

Methods

A comprehensive review of the literature was performed through MedLine by two independent reviewers from 1990 to 2020 on reported cases of arterial stent late onset infection over arterial stents. The data about on the risk factors, clinical presentation, treatment and outcomes were collected.

Results

Twenty-two studies were selected as pertinent for the analysis, totalling 24 patients including the indexed case. Infection occurred at a median of 22 months postoperatively (range 2–120 months) over a bare metal stent in 66.7% ( n 16) of cases versus 33.3% ( n 8) over a covered stent. Clinical presentation included local symptoms (local pain, oedema, petechiae or skin rash) in 21 (87.5%) cases and non-specific systemic symptoms (fever, sepsis, chills and leucocytosis) in 8 cases (33.3%). In 4 cases (16.7%), patients presented with haemorrhagic shock upon arterial rupture. The bacteria most frequently encountered were S. aureus (54.2% of cases). Several factors were supposed to be responsible for the infection including among which procedure-related (non-aseptic technique, lack of prophylactic antibiotics and repetitive punctures at the access site) or related to pre-existing patient’s clinical conditions (immunosuppression, diabetes and concurrent infection) have been considered responsible for the infection. Treatment consisted in antibiotics alone (2 patients, 8.3%) or in association with surgical explant, both with or and without revascularization ( n 21, 87.5%). In one case, an endovascular coiling was performed. Complications occurred in 29.2% ( n 7) of cases and included the need for amputation, bowel resection, endocarditis, pulmonary failure or pneumonia. Overall, three patients (12.5%) died from a septic shock or multi-organ failure.

Conclusions

Intravascular stent infection is a rare but fearsome condition associated with high morbidity and mortality.
The development and initial validation of the Health and Reproductive Survey (HeRS)
Authors: Duffy Donna , Yourkavitch Jennifer , Bruinvels Georgie , Rinaldi Nicola J , Wideman Laurie
Published: August 2021

Background:

Due to the diversity in profiles associated with the female reproductive cycle and their potential physiological and psychological effects, monitoring the reproductive status of exercising females is important from a practical and research perspective. Moreover, as physical activity can influence menstrual function, the effects of physical activity energy expenditure on reproductive function should also be considered.

Aim:

The aim of this study was to develop and establish initial face and content validity of the Health and Reproductive Survey (HeRS) for physically active females, which is a retrospective assessment of menstrual function from menarche (first menstruation) to menopause (cessation of menstruation).

Methods:

Face validity was evaluated qualitatively, and the initial content validity was established through a principal component analysis. The face validity process was completed by 26 females aged 19–67 years and the content validity was established through a survey sent to a convenience sample of 392 females, of which 230 females (57.9% and aged 18–49 years) completed the survey.

Results:

The revisions made following the face validation improved the understanding, flow, and coherence of the survey. The principal component analysis indicated that, at a minimum, the survey measures these constructs: menstrual cessation and associated moderators, athletic participation and performance levels (as associated with menstruation change and the menstrual cycle), age and menstrual cessation, hormonal contraception (“birth control”), and menarche and associated moderators.

Conclusion:

The Health and Reproductive Survey (HeRS) is a partially validated tool that can be used by researchers to characterize the menstrual status of physically active females relative to their physical activity status.
A biomechanical comparison of different baseball batting training methods
Authors: Chen Wei-Han , Chiu Yu-Cheng , Liu Chiang , Chan Ming-Sheng , Fiolo Nicholas J , Shiang Tzyy-Yuang
Published: August 2021

This study compared the kinematic parameters of swing mechanics under toss batting (TB), motor imagery (MI), video projection (VP), and virtual reality (VR) conditions during baseball batting. Nine college baseball players performed three swings to hit a tossed ball under TB conditions or a virtual ball under MI, VP, and VR conditions. The results revealed that upper trunk backward rotation was smaller in the loading phase under the VP and VR conditions than under the TB and MI conditions and lower under VR than under the VP condition ( p < 0.05) except at the load event. Pelvic backward rotation was smaller under the VR condition than under the TB, MI, and VP conditions ( p < 0.05). In the swing phase, TB demonstrated higher peak velocity at the head of the bat, lead elbow extension, and pelvis and upper trunk rotation than did MI, VP, and VR, whereas VP also demonstrated higher peak velocity in pelvic forward rotation than did VR ( p < 0.05). In summary, VR demonstrates a more realistic response in the loading phase and reduced pelvic backward rotation but lower movement velocities. Coaches should pay attention to movement differences between swing conditions when arranging a swing training plan.
Meaningful interpretation of algebraic inequalities to achieve uncertainty and risk reduction
Authors: Todinov Michael
Published: August 2021

The paper develops an important method related to using algebraic inequalities for uncertainty and risk reduction and enhancing systems performance. The method consists of creating relevant meaning for the variables and different parts of the inequalities and linking them with real physical systems or processes. The paper shows that inequalities based on multivariable sub-additive functions can be interpreted meaningfully and the generated new knowledge used for optimising systems and processes in diverse areas of science and technology. In this respect, an interpretation of the Bergström inequality, which is based on a sub-additive function, has been used to increase the accumulated strain energy in components loaded in tension and bending. The paper also presents an interpretation of the Chebyshev’s sum inequality that can be used to avoid the risk of overestimation of returns from investments and an interpretation of a new algebraic inequality that can be used to construct the most reliable series-parallel system. The meaningful interpretation of other algebraic inequalities yielded a highly counter-intuitive result related to assigning devices of different types to missions composed of identical tasks. In the case where the probabilities of a successful accomplishment of a task, characterising the devices, are unknown, the best strategy for a successful accomplishment of the mission consists of selecting randomly an arrangement including devices of the same type. This strategy is always correct, irrespective of existing uknown interdependencies among the probabilities of successful accomplishment of the tasks characterising the devices.
Muscle relaxants as adjunctive analgesics in the perioperative setting: A review of the literature
Authors: Mattison Ryan , Midkiff Sarah , Reinert Justin P , Veronin Michael A
Published: August 2021

Patients undergoing surgical procedures are one of the few populations that still require substantial doses of opioid medications to provide analgesia, despite the best efforts of clinicians to integrate non-opioid adjunctive analgesics into practice. While many options exist with varying degrees of evidence, one drug class that deserves renewed consideration are muscle relaxants. Although these medications have differing mechanisms of action and require a more thorough evaluation of patient parameters prior to administration as opposed to other adjunctive analgesics, it is readily apparent by the results of this review that these agents may be able to mitigate pain and limit opioid usage. The objective of this review was to determine the efficacy and safety of adjunctive muscle relaxers for the purposes of analgesia in the perioperative setting.
Forensic conflict studies: Making sense of war in the social media age
Authors: Hauter Jakob
Published: August 2021

Online media is a blessing and a curse for academic research on war. On the one hand, the internet provides unprecedented access to information from conflict zones. On the other hand, the prevalence of disinformation can make it difficult to use this information in a transparent way. This article proposes digital forensic process tracing as a methodological innovation to tackle this challenge and make case study research on the causes of war fit for the social media age. It argues that two important features of process-tracing methodology – source criticism and Bayesian updating – are well developed in theory but are rarely applied to the study of armed conflict. Digital forensic process tracing applies these features to online media sources by drawing on the journalistic practice of open source intelligence (OSINT) analysis. This article uses the case of the war in eastern Ukraine’s Donbas region to illustrate the usefulness of the proposed methodology.
Total elbow arthroplasty cases involving orthopaedic residents do not affect short-term postoperative complications
Authors: Gordon Adam M , Malik Azeem Tariq
Published: August 2021

Background

Impact of resident participation on short-term postoperative outcomes after total elbow arthroplasty has not been studied. The aim was to investigate whether resident participation affects postoperative complication rates, operative time, and length of stay.

Methods

The American College of Surgeons National Surgical Quality Improvement Program registry was queried from 2006 to 2012 for patients undergoing total elbow arthroplasty. A 1:1 propensity score match was performed to match resident cases to attending-only cases. Comorbidities, surgical time, and short-term (30-day) postoperative complications were compared between groups. Multivariate Poisson regression was used to compare the rates of postoperative adverse events between groups.

Results

After propensity score match, 124 cases (50% with resident participation) were included. Adverse event rate after surgery was 18.5%. On multivariate analysis, there were no significant differences between attending-only cases and resident involved cases, with regards to short-term major complications, minor complications, or any complications (all p > 0.071). Total operative time was similar between cohorts (149.16 vs. 165.66 min; p = 0.157). No difference was observed in the length of hospital stay (2.95 vs. 2.6 days), p = 0.399.

Discussion

Resident participation during total elbow arthroplasty is not associated with increased risk for short-term medical or surgical postoperative complications or operative efficiency.
Staying Home, Staying Alive: Campus Food Pantry Student Clients’ Experiences During the COVID-19 Pandemic
Authors: Jangjou Elmira
Published: August 2021

In response to students’ food insecurity, a number of colleges and universities have taken action and established campus food pantries as part of their intervention plans. However, many of these pantries ceased operation due to COVID-19 campus shutdowns. The purpose of this study is to illustrate the short-term impacts of the COVID-19 pandemic on postsecondary students, who use a university-provided food pantry. Drawing from semi-structured interviews with 12 participants, the thematic analysis explored the initial coping strategies these students used to endure the pandemic. Findings revealed that many students experienced the immediate effects of the pandemic in the form of income loss, self-isolation, anxiety, and appetite change. Although the pandemic interrupted these students’ journeys to continue their studies and become independent in various ways, the affected students implemented various coping strategies, including seeking help from family or friends, using available resources, cooking at home, and even trying to save money. However, considering that the targeted population in this study was already at risk because of their basic needs insecurity, these postsecondary students require extra attention from their higher education institutions in the case of emergencies, such as a global pandemic. In addition to its timely and relevant findings, this study provides important avenues for future research and intervention efforts.
Silence with caution: The right to silence in police investigations in Belgium
Authors: Beazley Ashlee , Gilleir Fien , Panzavolta Michele , Rozie Joëlle , Vanderhallen Miet
Published: August 2021

This article is about the right to remain silent within Belgium. Although the right has always been considered applicable, both the courts and parliament have historically demonstrated a disinclination to define or engage with this. The right to silence is now formally recognised in the Belgian Code of Criminal Procedure, albeit with the classic distinction between those who are not (yet) accused of a crime and those who are formal suspects: while all enjoy the right not to incriminate themselves, only formal suspects in Belgium enjoy the explicit right to remain silent. Accordingly, whilst no one may be obliged to assist with their own conviction or be forced to co-operate with the authorities, it remains unclear how far the right not to cooperate effectively stretches. The case law seems to be moving, albeit slowly, in the direction of confining this right within narrower borders, particularly by excluding its applicability with regard to the unlocking and decryption of digital devices. This is not, however, the only idiosyncrasy concerning the right to silence in Belgium. Among those also addressed in this article are: the lack of caution on the right to remain silent given to arrested persons immediately following their deprivation of liberty (an absence striking for its apparent breach of Directive 2012/13/EU on the right to information in criminal proceedings); the possible inducement to breach the right to silence via the discretionary powers of the public prosecutor to offer a reduction or mitigation in sentence; the obscurity surrounding the definition of ‘interrogation’ and the consequences of this on both the caution and the obtaining of statements; and the extent to which judges can draw adverse inferences from the right to silence. The question remains: is the right to silence currently protected enough?
Development of economic competence of students at general grammar schools through a non-formal opportunity to learn with experts
Authors: Siegfried Christin , Wuttke Eveline
Published: August 2021

For many years empirical studies have repeatedly pointed to the need to improve the economic competence of adolescent and young adults. This demand is already reflected – at least in part – in the inclusion of economic content in the curriculum of general educational schools. However, the curricular implementation seems to be only partially comprehensive enough to sufficiently support the acquisition of economic competence, so that non-formal and informal learning opportunities do not lose their importance as a supplement to the general curriculum-based framework. The research situation, however, is hardly given with regard to empirical findings on the effectiveness of such learning opportunities for the acquisition of economic competence. Therefore, our intervention study examines the role of non-formal learning opportunities in the economic field as a supplement to normal economic teaching lessons and how these learning opportunities affect the competence development of students in general educational schools. The results show that the intervention group was able to improve its economic competence significantly more than the control group. Furthermore, it becomes clear that over the intervention period the influence of personal factors loses relevance for the prediction of economic competence, but only for the intervention group.
The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings
Authors: Mishra Kundan , Kumar Suman , Ninawe Sandeep , Bahl Rajat , Meshram Ashok , Singh Kanwaljeet , Jandial Aditya , Sahu Kamal Kant , Sandal Rajeev , Khera Sanjeev , Yanamandra Uday , Khurana Harshit , Kumar Rajiv , Kapoor Rajan , Sharma Sanjeevan , Singh Jasjit , Das Satyaranjan , Ahuja Ankur , Somasundaram Venkateshan , Chaterjee Tathagat
Published: August 2021

Introduction:

Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML.

Method:

This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included.

Result:

A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period.

Discussion:

Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections.

Conclusion:

Infections continues to be a major cause of morbidity and mortality among AML patients.
Prevalence of osteoporosis and osteopenia in a cohort of HIV positive women with a history of treated neoplasms
Authors: Rivera-Díaz Cecilia , Volkow-Fernández P , Villalobos José Luis , Cornejo-Juárez P
Published: August 2021

Introduction:

Higher prevalence of osteopenia and osteoporosis in HIV positive patients compared to non-infected population has been recognized. However, cancer patients have a higher risk of bone loss and fractures that is multifactorial. The aim of the study was to describe the prevalence of osteopenia and osteoporosis in HIV positive women with history of treated cancer.

Methods:

Between January 2018 and December 2019, women aged >40 years, HIV+ with a history of cancer diagnosis, who attended the AIDS Cancer Clinic at Instituto Nacional de Cancerología, Mexico City, and who had a dual X-ray absorptiometry performed during the study period were included. Two control groups (CG)—HIV negative women with history of cancer (CG1) and non-HIV, non-cancer women (CG2)—were matched by age 1:1.

Results:

Forty-eight patients in each group were included; the mean age was 51.1 ± 8.1 years. Osteopenia was found in femoral neck in 54.2% (HIV+), 37.5% (CG1), and 27.1% (CG2), p = 0.02; in spine was 35.7%, 47.9%, and 31.2%, respectively, p = 0.442. Osteoporosis in femoral neck was documented in 12.5%, 2.1%, and 0% in HIV+, CG1, and CG2 ( p = 0.03), and in the spine was 47.9%, 16.7%, and 14.6%, respectively ( p = 0.002).

Conclusion:

HIV patients with a history of treated cancer have a much higher prevalence of osteoporosis when compared with same-aged HIV-uninfected women with and without cancer. It is necessary to monitor Bone Mineral Density periodically, and all patients should be encouraged to make lifestyle changes, such as avoid tobacco and alcohol, and to increase exercising.
A survey of technology literacy and use in cancer survivors from the Alberta Cancer Exercise program
Authors: Ester Manuel , McNeely Margaret L , McDonough Meghan H , Culos-Reed S Nicole
Published: August 2021

Background

Supervised physical activity interventions can improve cancer survivor quality of life. However, they are resource intensive and may not support physical activity maintenance. Therefore, most cancer survivors remain inactive. Electronic health is a promising tool to support physical activity maintenance, yet technology-based physical activity interventions in oncology have shown mixed effectiveness. We surveyed cancer participants in the Alberta Cancer Exercise program to better understand their experience with technology.

Methods

Alberta Cancer Exercise participants were invited to complete a survey on technology literacy, usage, and perceived usefulness. Summary statistics were calculated for all variables. Multiple regression examined demographic prediction of technology usage and literacy.

Results

The response rate was 52.6% ( n = 627/1191), with 93.3% survey completion ( n = 585/627). Respondents were 60.6 ± 11.0 years old, 96.2% Caucasian, and of high socioeconomic status (83.3% with post-secondary education, 65.5% with income >$60,000). While electronic health literacy was low (mean 1.73 ± 0.73/4), computer (87.6%) and smartphone (87.5%) use was widespread, with 94.6% of smartphone users reporting daily use. One in two respondents used mobile applications or wearable trackers for physical activity, which were perceived as useful by >80% of users. Age and income were significant predictors of technology use and literacy.

Conclusions

Technology is part of the lives of cancer survivors who engaged in a physical activity program, with mobile devices perceived as useful to support physical activity. However, the present findings highlight a need to increase electronic health literacy via education and tailoring of digital tools. These survey findings are being used to build our patient-centered, technology-supported physical activity interventions.
Rolling resistance of casters increases significantly after two years of simulated use
Authors: Wilson-Jene Holly , Mhatre Anand , Ott Joseph , Krider Benjamin , Smith Clair , Terhorst Lauren , Pearlman Jonathan
Published: August 2021

Introduction

Manual wheelchair propulsion is associated with upper limb pain and injury, and clinical guidelines recommend minimizing propulsive force to lower health risks. One of the strategies to reduce propulsive force is by minimizing rolling resistance (RR). Product testing studies suggest that RR of casters is affected by wear and tear which could have implications on the health risk of wheelchair users. The study will investigate the relationship between caster RR and environmental exposure using standard testing protocols.

Methods

RR of ten casters representing a range of diameters for different models of wheelchairs were measured before and after environmental exposure that includes corrosion, shock and abrasion simulating two years of community use.

Results

Four casters exhibited failures during durability testing, one catastrophically. Increases to RR after corrosion, shock and abrasion exposure were statistically significant using mixed-effects modeling, and four casters had increased RR greater than 20%.

Conclusions

Many of the casters evaluated exhibited increased RR forces and failure after environmental exposure. Improved caster design and use of corrosion resistant materials may reduce these failures. In addition, modification of the provision process could include replacement casters to reduce failures and avoid breakdowns that leave manual wheelchair users stranded or injured.
Beyond Clicktivism: What Makes Digitally Native Activism Effective? An Exploration of the Sleeping Giants Movement
Authors: Li Yevgeniya , Bernard Jean-Grégoire , Luczak-Roesch Markus
Published: August 2021

This article explores how successful digitally native activism generates social change. Digitally native movements are initiated, organized, and coordinated online without any physical presence or pre-existing offline campaign. To do so, we explore the revelatory case of Sleeping Giants (SG)—an online movement that led more than 4,000 organizations to withdraw their programmatic advertising spend from Breitbart, a far-right publisher. Analyzing 3.5 million tweets related to the movement along with qualitative secondary data, we used a mixed method approach to investigate the conditions that favored SG emergence, the organizing and coordinating practices of the movement, and the strategic framing practices involved in the tuning of the movement’s language and rhetoric toward its targets. Overall, we contribute to research on online movements and shed light on the pivotal role of peer production work and of language in leading an impactful online movement that aimed to counter online disinformation and hate speech.
The feasibility of transcatheter arterial chemoembolization following radiation therapy for hepatocellular carcinoma
Authors: Hamada Mostafa , Ueshima Eisuke , Ishihara Takeaki , Koide Yutaka , Okada Takuya , Horinouchi Hiroki , Ishida Jun , Mayahara Hiroshi , Sasaki Koji , Gentsu Tomoyuki , Sofue Keitaro , Yamaguchi Masato , Sasaki Ryohei , Sugimoto Koji , Murakami Takamichi
Published: August 2021

Background

Technological developments have led to an increased usage of external-body radiotherapy (RT) for the treatment of hepatocellular carcinoma (HCC). Transcatheter arterial chemoembolization (TACE) may be required later in patients treated with RT because of the high recurrence rate and multinodular presentation of HCC. However, despite the risk of liver function impairment, the cumulative liver damage correlated with TACE following a hepatic RT has not been adequately assessed.

Purpose

To evaluate the feasibility of TACE following RT for HCC.

Materials and methods

Sixty-seven patients with HCC who underwent TACE after RT were retrospectively evaluated between 2012 and 2018. We assessed increases in Child–Turcotte–Pugh (CTP) by ≥2 points at 1 month, the incidence of major complications, survival duration, and short-term mortality within 6 months after TACE. Furthermore, we evaluated the predictive factors for liver function impairment and short-term mortality.

Results

Eight patients experienced a CTP increase ≥2 points at 1 month. There were no cases of liver abscesses or bilomas. Nine patients died within 6 months following TACE. The mean liver dose (MLD) was a significant predictor of liver function impairment at 1 month ( p = 0.042). Low liver functional reserve, distant metastasis ( p = 0.037), MLD ( p = 0.046), TACE type ( p = 0.025), and TACE within 3 months following RT ( p = 0.007) were significant predictors of short-term mortality.

Conclusions

Despite the feasibility of TACE following RT, clinicians should pay attention to impaired pretreatment liver function, following high dose RT, and the short duration between RT and TACE.
International Organizations Lending Policy, are There Strings Attached? A Case Study From the Latest Wave of Reforms in the Albanian Social Security System
Authors: Qejvanaj Gentian
Published: August 2021

Pension policy reform in post-communist countries received attention from most international organizations since the early 1990s. Accordingly, Albania has implemented comprehensive liberalization and privatization of the state sector since transitioning to a market economy. This study will look at the impact that the European Union (EU), the World Bank, and the International Monetary Fund had in guiding the Albanian state-run social security system toward principles of decentralization, liberalization and privatization. Specifically, social security reforms between 2009 to 2019 will be examined, along with a focus on the side-effect of the conditions imposed by the three organizations. A mixed-method including literature review and secondary data analysis will empirically evidence growing inequality, with senior citizens poverty rate sharply rising due to reforms in social security. Our conclusions will argue that closer ties with the EU will keep social security in its current form, as the EU does not push for a specific pension system, while the World Bank policy influence will lose ground, thus freeing Albania from periodic social security reforms.
Tubulin Folding Cofactor D Deficiency: Missing the Diagnosis With Whole Exome Sequencing
Authors: Quitmann Christina M. , Rust Stephan , Reunert Janine , Biskup Saskia , Fiedler Barbara , Marquardt Thorsten
Published: August 2021

Two siblings with an early onset of a neurodegenerative disease were presented with muscular hypotonia, secondary microcephaly, and severe developmental delay. Seizures were refractory to treatment but could be controlled with a ketogenic diet. Over the course of 5 years, whole exome sequencing (WES) was performed twice in both children. The first time the diagnosis was missed. The next one revealed compound heterozygous mutations in the gene coding for the tubulin folding cofactor D. Technical improvements in WES mandated a new investigation after a few years in children where the diagnosis has not been found.
Patients With Extreme Early Onset Juvenile Huntington Disease Can Have Delays in Diagnosis: A Case Report and Literature Review
Authors: Moeller Ashley A. , Felker Marcia V. , Brault Jennifer A. , Duncan Laura C. , Hamid Rizwan , Golomb Meredith R.
Published: August 2021

Huntington disease (HD) is caused by a pathologic cytosine-adenine-guanine (CAG) trinucleotide repeat expansion in the HTT gene. Typical adult-onset disease occurs with a minimum of 40 repeats. With more than 60 CAG repeats, patients can have juvenile-onset disease (jHD), with symptom onset by the age of 20 years. We report a case of a boy with extreme early onset, paternally inherited jHD, with symptom onset between 18 and 24 months. He was found to have 250 to 350 CAG repeats, one of the largest repeat expansions published to date. At initial presentation, he had an ataxic gait, truncal titubation, and speech delay. Magnetic resonance imaging showed cerebellar atrophy. Over time, he continued to regress and became nonverbal, wheelchair-bound, gastrostomy-tube dependent, and increasingly rigid. His young age at presentation and the ethical concerns regarding HD testing in minors delayed his diagnosis.
The Relationship Between Immigration Enforcement and Educational Attainment: The Role of Sanctuary Policies
Authors: Corral Daniel
Published: August 2021

This study explores the association between sanctuary policies and the high school completion and college enrollment of Hispanic undocumented youth. Sanctuary policies, which city, county, and/or state governments implement, prohibit local political leaders and police officials from cooperating with federal immigration enforcement officers regarding the questioning, detention, and deportation of undocumented immigrants. This study uses data from the American Community Survey and applies a difference-in-differences design. On average, my preferred specification detected no association with high school completion or college enrollment. These findings suggest that although these policies may help counteract immigration enforcement, they may not reduce uncertainty enough to have a significant relationship with educational outcomes.
The effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate: A clinical trial study
Authors: Hakim Ashrafalsadat , Zakizadeh Zahra , Saki Nader , Haghighizadeh Mohammad Hossein
Published: August 2021

Cleft lip and palate is a major problem that disrupts the child’s family life. The present study aimed to investigate the effect of combined education on the knowledge and care and supportive performance of parents with children with cleft lip and palate. This is a clinical trial study was conducted on 40 parents referring to hospitals. The data were collected using the demographic information questionnaire, the questionnaire of parental knowledge and care supportive performance questionnaire and analyzed using descriptive and analytical tests. After education the intervention group, the mean score of parents’ care and supportive knowledge significantly increased in the intervention group as compared to the control group. There was also a significant difference in the mean score of parents’ care-supportive performance between the two groups ( P < 0.001). It is recommended to use the combined education as an effective method to increase knowledge and performance in parents of children with cleft lip and palate.
Milking economies: Multispecies entanglements in the infant formula industry
Authors: Hirtenfelder Claudia Towne , Prouse Carolyn
Published: August 2021

In 2016 the Chinese infant formula company Feihe International signed a deal with the Canadian Dairy Commission (CDC) to process Canadian cows’ and goats’ milk for infant formula export to China. Our purpose in this paper is to understand how this deal – and the new Feihe formula factory located in Kingston, Canada – is underpinned by a series of multispecies entanglements across cow, human and goat mothers in China and Canada. To do so, we analyse official correspondence between the CDC, Feihe and City of Kingston; market reports for the dairy, goat and infant formula industries; and news articles about the Feihe infant formula plant. Conceptually, we develop an anti-colonial, multispecies entanglement framework to chart the violent inclusions, exclusions and typologizations that make milk and formula economies possible. We are specifically interested in how the Feihe–CDC deal (re)configures entanglements across species, nation, race, science and motherhood. To understand these relations, we heuristically imbricate two different sets of entanglements that underpin this deal: milk drinking, empire and genetic purity across race, breed and species; and motherhood, science and technology across humans, goats and cows. We use our threefold entanglement framework to better understand the violence of these imbrications and to work towards a multispecies feminist ethic in the infant formula industry.