bluuebunny/crossref_metadata_2025 huggingface dataset:
Immigration and the Life Course: Contextualizing and Understanding Healthcare Access and Health of Older Adult Immigrants
Authors: Bacong Adrian M. , Đoàn Lan N.
Published: June 2022

Objective

Immigrant health discussions often focus on acculturation and omit discussions on historical events that may underlie health differences among immigrant older adults. This paper provides a historical overview of immigration policy and flows to the U.S. and examines insurance access and health difficulties by sending country.

Methods

We analyzed the “Immigrants Admitted to the United States, Fiscal Years 1972–2000” and 2015–2019 American Community Survey datasets to examine the number of admitted immigrants, sociodemographic profiles for current immigrant older adults, and the predicted probabilities of health insurance access and health difficulties.

Results

Our results highlight alignment of immigration flows with immigration legislation and vast heterogeneity in migration, health, and healthcare access of immigrants by sending country.

Discussion/Implications

Public health practitioners must consider how historical events and social factors contribute to the healthcare access and health of immigrant populations, as demographic shifts will require interventions that promote equitable healthy aging.
Combined Gap and Interpositional Arthroplasty Utilizing Three-Dimensional Printed Model in a Dog with Temporomandibular Joint Ankylosis and Pseudoankylosis
Authors: Renner Emily , Thatcher Graham
Published: June 2022

Objective: To report the surgical treatment of a canine with both ankylosis and pseudoankylosis of temporomandibular joint (TMJ). Methods: The patient presented for inability to open his mouth. Facial asymmetry with normal dental occlusion was appreciated and computed tomography (CT) was performed. CT was used to diagnose ankylsosis and pseudoankylosis of left TMJ secondary to chronic maxillofacial trauma. A gap arthroplasty followed by interpositional arthroplasty using temporalis muscle fascia was performed to remove the site of fusion and prevent re-ankylosis between remaining cut boney surfaces. A three-dimensional (3D) printed skull for surgical planning and intraoperative spatial localization was employed. Results: Following preoperative and intraoperative evaluation of the 3D printed skull, the surgery was performed successfully without major complications. The patient's TMJ range of motion was markedly improved and remains improved as noted by inter-incisal distance measurements, ability to pant, and ease of chewing. Conclusion: A combined Gap and interpositional arthroplasty was assisted with the use of a 3D printed skull and immediately resulted in improved TMJ range of motion and patient quality of life. Three-month postoperative CT revealed stable ostectomies with no complications, with the exception of left-sided disuse masticatory muscle atrophy. Long-term follow-up is warranted. Clinical Significance: Three-dimensional printed skull models may be utilized preoperatively and intraoperatively to determine individual variants and landmarks, especially in cases where anatomical structures are difficult to recognize. Gap arthroplasty with interpositional myofascial transposition is an option for a patient with both anklyosis and pseudoankylosis of the TMJ.
Comparison of the design maps of TPMS based bone scaffolds using a computational modeling framework simultaneously considering various conditions
Authors: Lu Yongtao , Huo Yi , Zou Jia’ao , Li Yanchen , Yang Zhuoyue , Zhu Hanxing , Wu Chengwei
Published: June 2022

In recent years, the triply periodic minimal surface (TPMS)-based scaffolds have been served as one of the crucial types of structures for biological replacements, the energy absorber, etc. Meanwhile, the development of additive manufacturing (AM) has facilitated the production of TPMS scaffolds with complex microstructures. However, the design maps of TPMS scaffolds, especially considering the AM constraints, remain unclear, which has hindered the design and application of TPMS scaffolds. The aims of the present study were to develop an efficient computational modeling framework for investigating the design maps of TPMS scaffolds simultaneously considering the AM constraints, the biological requirements, and the structural anisotropy. To demonstrate the computational framework, five widely-used topologies of the TPMS-based scaffolds (i.e. the Diamond, the Gyroid, the Fischer-Koch S, the F-RD, and the Schwarz P) were used, whose design maps for the surface-to-volume ratio and the effective elastic modulus were also investigated. The results showed that as the porosities increase, the design ranges of the surface-to-volume ratios decreases for all the structures. Compared with the effect of the constraint for the pore size, the minimal structural thickness for AM constraint has a greater effect on the surface-to-volume ratio. Regarding the elastic modulus, in the region of low porosity (approximately 0.5–0.7), the range for the effective elastic modulus of Schwarz P is the widest (approximately 2.24–32.6 GPa), but the Gyroid can achieve both high porosity and low effective elastic modulus (e.g. 0.61 GPa at the porosity of 0.90). These results and the method developed in the present study provided important basis and guidance for the design and application of the TPMS-based porous structures.
Taking a Disagreeing Perspective Improves the Accuracy of People’s Quantitative Estimates
Authors: Van de Calseyde Philippe P. F. M. , Efendić Emir
Published: June 2022

Many decisions rest on people’s ability to make estimates of unknown quantities. In these judgments, the aggregate estimate of a crowd of individuals is often more accurate than most individual estimates. Remarkably, similar principles apply when multiple estimates from the same person are aggregated, and a key challenge is to identify strategies that improve the accuracy of people’s aggregate estimates. Here, we present the following strategy: Combine people’s first estimate with their second estimate, made from the perspective of someone they often disagree with. In five preregistered experiments ( N = 6,425 adults; N = 53,086 estimates) with populations from the United States and United Kingdom, we found that such a strategy produced accurate estimates (compared with situations in which people made a second guess or when second estimates were made from the perspective of someone they often agree with). These results suggest that disagreement, often highlighted for its negative impact, is a powerful tool in producing accurate judgments.
Friends, enemies, and agonists: Politics, morality and media in the COVID-19 conjuncture
Authors: Phelan Sean
Published: June 2022

The radical democratic theorist Chantal Mouffe has long criticized the moralization of politics in its neoliberalized Third Way form. The argument informs her analysis of the rise of the far right, which she suggests has partly been enabled by moralizing antagonisms that inhibit a culture of agonistic political contestation. This paper uses Mouffe to think about the current condition of mediatized public discourse, extending her critique of moralized politics to a wider set of targets. I illuminate the argument through an analysis of a BBC Newsnight report that thematizes the ‘toxic’ nature of public debate about the science of COVID-19. I show how the report internalizes sedimented ‘culture war’ discourses about the polarized nature of today’s public culture and, in the process, offers oblique insights into how far-right discourses are normalized. I end by considering some of the limitations of Mouffe’s work as a resource for thinking about how to counteract the far right.
An analysis of self-other representations in the incelosphere: Between online misogyny and self-contempt
Authors: Scotto di Carlo Giuseppina
Published: June 2022

The present study intends to contribute to the analysis of digital discursive practices of hate speech expressed throughout the so-called ‘Manosphere’, a group of online communities in which men express their considerations about masculinity. Through qualitative and quantitative analysis, it investigates how one of the main Manosphere groups, the Incels, creates its in-group/out-group discourse through its representations of women and of themselves. Driven by Critical Discourse Studies and studies on the ideological function of metaphors, the first part of the analysis reveals a conflation of apparently sarcastic metaphors, dark humour, and misogyny used to talk about women, while the second section of the study focuses on the peculiar self-representations of the men who participate in the forum, which breach Van Dijk’s ‘us vs them’ identity square pattern: rather than emphasising the positive traits of the in-group, incels describe themselves through self-derogative nominations and predications that give way to a spiral of self-pitying and self-contempt, which might be used to create fraternal bonds within the community.
Resilient fixed-time bipartite consensus of multi-agent systems with nonlinear dynamics and directed graphs
Authors: Sharifi Arman , Pourgholi Mahdi
Published: June 2022

This article is concerned with the bipartite fixed-time consensus problem for a class of multi-agent systems with nonlinear dynamics and directed graphs. To achieve the fixed-time consensus, a discontinuous control protocol is proposed. Compared to the protocols with undirected graphs, the control parameters are designed using a new Laplacian matrix based on an underlying undirected graph. Besides, to apply the method to the multi-agent systems with malicious agents, the proposed controller is combined with the Weighted Mean Subsequence Reduced (WMSR) algorithm which is modified for signed graphs. Finally, some simulations are presented to demonstrate the performance of the proposed method.
Fitting joint models of longitudinal observations and time to event by sequential Bayesian updating
Authors: McKeigue Paul
Published: June 2022

Joint modelling of longitudinal measurements and time to event, with longitudinal and event submodels coupled by latent state variables, has wide application in biostatistics. Standard methods for fitting these models require numerical integration to marginalize over the trajectories of the latent states, which is computationally prohibitive for high-dimensional data and for the large data sets that are generated from electronic health records. This paper describes an alternative model-fitting approach based on sequential Bayesian updating, which allows the likelihood to be factorized as the product of the likelihoods of a state-space model and a Poisson regression model. Updates for linear Gaussian state-space models can be efficiently generated with a Kalman filter and the approach can be implemented with existing software. An application to a publicly available data set is demonstrated.
Christianity-science compatibility beliefs increase nonreligious individuals’ perceptions of Christians’ intelligence and scientific ability
Authors: Mackey Cameron D. , Rios Kimberly , Cheng Zhen Hadassah
Published: June 2022

Nonreligious individuals stereotype Christians as unscientific and see Christianity and science as conflicting. The present studies examined how perceptions of incompatibility between Christianity and science influence nonreligious individuals’ stereotypes of Christians in science in the US context. We measured (Study 1) and manipulated (Study 2) participants’ beliefs about the compatibility or incompatibility of Christianity and science. In Study 1 ( N = 365), nonreligious participants ( n = 214), more so than Christian participants ( n = 151), perceived Christianity and science as incompatible, which in turn predicted perceptions of Christians as less intelligent and less scientifically able. In Study 2 ( N = 799; 520 Christians, 279 nonreligious), manipulating perceived Christianity-science compatibility reduced negative perceptions of Christians’ scientific ability and general intellect among nonreligious participants. Implications for mitigating negative stereotypes of Christians in science, increasing Christians’ representation in scientific fields, and improving relations between Christians and nonreligious groups are discussed.
Polyaniline–calcium titanate perovskite hybrid composites: Structural, morphological, dielectric and electric modulus analysis
Authors: Bibi Ariba , Shakoor Abdul , Niaz Niaz Ahmad
Published: June 2022

This paper reports hybrid composites based on polyaniline (PANI) and calcium titanate (CaTiO3) perovskite as a nanofiller synthesized by in-situ polymerization technique. Their structure and morphology were investigated by X-ray diffraction analysis and scanning electron microscopy. The XRD analysis shows that the addition of CaTiO3 in polyaniline reduced the amorphous structure of polyaniline transforming it into semi-crystalline nature, which agrees well with the higher conductivity. Scanning electron microscopy of composites showed a more compact and homogenous structure with uniform distribution of CaTiO3 in the polymer matrix. Dielectric parameters such as dielectric constant, loss factor, and dielectric loss, real and imaginary parts of electric modulus were measured and evaluated as a function of frequency and temperature as well. The variation of dielectric properties and ac conductivity reveals that the dispersion is due to the Maxwell-Wagner type of interfacial polarization. The observed ac conductivity behavior of polyaniline in the presence of calcium titanate was discussed in the framework of Jonscher’s power law. The result showed that ac conductivity increases with the rise of the frequency of applied field and temperature analogous to the semiconducting behavior of composites. Temperature-dependent behavior of frequency exponent seems to obey correlated barrier hopping conduction mechanism. The relaxation behavior of the synthesized samples was analyzed by the electric field modulus and was found to decrease with temperature and CaTiO3 content and increase with frequency.
Sedom’s Subjects: Sodomy and Urban Politics in the Late Medieval Kingdom of Castile
Authors: Solórzano-Telechea Jesús Ángel
Published: June 2022

The aim of this article is to analyse the significance of the legal discourses and the urban practices against female and male sodomy for the governance in the Late Medieval Kingdom of Castile. The motivation for the persecution of sodomy was not solely to judge and punish persons engaging in same sex acts or relations according to moral values, as it might be inferred from a superficial reading of the trials, but rather, the persecution of sodomites, both men and women, took part in the everyday life and political arena in Castilian cities. Firstly, the medieval Castilian laws regarding the crime of sodomy, which entailed the social and political exclusion are analysed. Penal legislation composed a fertile territory to know closely the existing relations between politics and the values of the Castilian medieval society. Secondly, urban rulers deployed the prosecution of sodomy in the Castilian courts of justice to justify their good government and to assert their authority. In conclusion, the changes in the legal and cultural interpretation of sodomy, emphasising the communitarian shame, revealed how the accusation of having committed the crime of sodomy worked as a political instrument of urban governance in Late Medieval Castile.
Accounting in the organisation and life of a religious institution: The Monastery ofSanta Anain the eighteenth century
Authors: Gomes Delfina , Maran Laura , Araújo Domingos
Published: June 2022

Set in the municipal archives of Braga, this article studies the accounting system and practices of the Monastery of Santa Ana, a female monastery located in a small town, Viana do Castelo, in the north of Portugal, during the eighteenth century. This work is a full-scale examination of the interlink between governance and accounting aspects of Benedictine organisations. It sheds light on the extent of management and administration that the female gender was able to exercise pertaining to a monastic order. The use of ‘displacement’ and ‘restraint’ concepts is pivotal to such exploration in the Monastery. The analysis of the accounting practices makes visible that large parts of its governance was embedded in social and internal accounting controls rather than the principal-agent type of relationship between the abbess, her auxiliaries and the monastery. Moreover, accounting practices help to appreciate the level of freedom of nuns that exceeded the actual freedom of a contemporary married woman.
Clinical Experience Is Not a Proxy for Competence: Comparing Fellow and Medical Student Performance in a Breaking Bad News Simulation-Based Mastery Learning Curriculum
Authors: Smith Melanie M. , Secunda Katharine E. , Cohen Elaine R. , Wayne Diane B. , Vermylen Julia H. , Wood Gordon J.
Published: June 2022

Background: It is unknown whether traditional medical education ensures competence among fellows in the key skill of breaking bad news (BBN). While simulation-based mastery learning (SBML) has been used to train fourth-year medical students (M4s) in BBN, it is unclear if it adds similar value for fellows. Objective: We examined the effect of traditional medical training on BBN skills by comparing baseline fellow and M4 skills and confidence and assessed the impact of a BBN SBML curriculum for fellows. Methods: Fellows training in six programs at Northwestern University from November 2018 to May 2019 were eligible for inclusion. Fellows completed a BBN SBML curriculum including a pretest, individualized feedback using a previously published assessment tool, and ongoing deliberate practice until all achieved a minimum passing standard (MPS). The primary outcomes were checklist and scaled item scores on the assessment tool. Fellow performance was compared to a historical M4 cohort. Results: Twenty-eight of 38 eligible fellows completed the curriculum and were included for analysis. Fellows reported significantly more experience and confidence in BBN compared to M4s, yet their pre-training performance was significantly worse on checklist (57.1% vs 65.0%, P = .02) and scaled items; only 4% reached the MPS. After training, fellow performance significantly improved on checklist (57.1% to 92.6%, SD = 5.2%, P < .001) and scaled items; all reached the MPS. Conclusions: Despite higher confidence and BBN clinical experience, fellows performed worse than untrained M4s, confirming that experience is not a proxy for skill. Programs must develop competency-based assessments to ensure entrustment of communication skills.
Microbial Analysis of Obturators During Maxillofacial Prosthodontic Treatment Over an 8-Year Period
Authors: Lyons Karl M , Cannon Richard D , Beumer John , Bakr Mahmoud M , Love Robert M
Published: June 2022

The aim of the study was to investigate the microbial colonization (by Candida species, anaerobic and facultative anaerobic bacteria) of maxillary obturators used for the restoration of maxillary defects, including during radiotherapy.

Retrospective cohort study.

Fifteen patients requiring a maxillary obturator prosthesis had swabs of their obturators and adjacent tissues taken at different stages of their treatment over a period of 8 years.

Identification of microbial species from the swabs was carried out using randomly amplified polymorphic DNA polymerase chain reaction (RAPD PCR) analysis, checkerboard DNA–DNA hybridization, CHROMagar Candida chromogenic agar, and DNA sequencing.

Candida species were detected in all patients and all patients developed mucositis and candidiasis during radiotherapy which was associated with an increase in colonization of surfaces with Candida spp ., particularly C albicans. Microbial colonization increased during radiotherapy and as an obturator aged, and decreased following a reline, delivery of a new prosthesis, or antifungal treatment during radiotherapy.

Microbial colonization of maxillary obturators was related to the stage of treatment, age of the obturator material, radiotherapy and antifungal medications, and antifungal treatment may be recommended if C albicans colonization of palatal tissues is greater than 105 colony-forming units per cm2 following the first week of radiotherapy.
Impact of Syndromes on Sleep-Disordered Breathing in Children After Cleft Palate Repair
Authors: Poupore Nicolas S. , Jungbauer W. Nicholas , Smaily Hussein , Carroll William W. , Pecha Phayvanh P.
Published: June 2022

Objective

Prior research suggests that children with cleft palate (CP) are at increased risk of obstructive sleep-disordered breathing (SDB). However, few studies differentiate the effects of CP repair on SDB based on syndrome status. The goal of this study was to evaluate differences in SDB after palatoplasty among children with nonsyndromic CP, syndromic CP, and isolated Robin sequence (RS).

Design

Retrospective chart review.

Setting

Tertiary academic children's hospital.

Patients/Participants

A total of 145 children who underwent primary CP repair from 2014 to 2021.

Main Outcome Measure

Post-palatoplasty SDB is defined as parent-reported symptoms and/or evidence of obstructive sleep apnea (OSA).

Results

Median age at palatoplasty was 11.1 [IQR 10.2-13.6] months. Most patients (61.4%) had nonsyndromic CP, 26.9% had a syndrome, and 11.7% had RS. Children with syndromic CP and RS had more post-palatoplasty SDB symptoms (56.4% vs 58.8% vs 30.3%, P = .006) and higher rates of OSA (25.6% vs 29.4% vs 5.6%, P = .001) compared to children with nonsyndromic CP after palatoplasty. Children with syndromic CP and RS had nearly 3 to 4 higher odds of post-palatoplasty SDB than children with nonsyndromic CP (adjusted odds ratio [aOR] 2.88, 95% CI 1.29–6.47, P = .010; aOR 3.73, 95% CI 1.19–11.70, P = .024).

Conclusion

This study showed that children with CP experience higher rates of SDB after palatoplasty than the general pediatric population. Within the cohort, children with syndromic CP and isolated RS were more likely to have obstructive sleep disorders than nonsyndromic children after palatoplasty. Clinicians should counsel caregivers accordingly and closely monitor these groups for SDB after palate repair.
DOACs in Mechanical and Bioprosthetic Heart Valves: A Narrative Review of Emerging Data and Future Directions
Authors: Ryu Rachel , Tran Rebecca
Published: June 2022

In the recent years, there has been significant transformation in the management of valvular heart disease (VHD), as a result of new minimally invasive technologies, such as the transcatheter aortic valve implantation (TAVI). Conventionally, mechanical heart valves require anticoagulation with warfarin to prevent thrombogenic events. Lately, there has been an uptrend in the usage of direct-acting oral anticoagulants (DOACs) in both mechanical and bioprosthetic heart valves. In clinical practice, there has shown to be notable heterogeneity in the antithrombotic regimen for patients. Recommendations from clinical guidelines and emerging data on DOAC use in these settings will be critically reviewed here. Future large, randomized-controlled trials are warranted to delineate the role of DOACs in patients receiving a bioprosthetic valve/TAVI or mechanical heart valve, with and without a baseline indication for anticoagulation or antiplatelets. Until clinical trial data from well-designed studies are available, providers must remain vigilant about DOAC use in patients with VHD, especially in patients with a bioprosthetic or mechanical heart valve.
The Association Between Mean Corpuscular Hemoglobin Concentration and Prognosis in Patients with Acute Pulmonary Embolism: A Retrospective Cohort Study
Authors: Ruan Zhishen , Li Dan , Hu Yuanlong , Qiu Zhanjun , Chen Xianhai
Published: June 2022

Introduction

Acute pulmonary embolism (APE) is a typical cardiovascular emergency worldwide. Mean hemoglobin concentration (MCHC) is a standard indicator of anemia. Studies on the association between MCHC and APE are scarce. We aimed to investigate the relationship between MCHC and APE.

Methods

Clinical data were extracted from the Medical Information Bank for Intensive Care (MIMIC)-III. Adult (≥18 years) patients with APE admitted for the first time were included in this study. An analysis was conducted to evaluate the association between MCHC and the prognosis of patients by the Cox regression analysis, generalized additives models and Kaplan–Meier survival curves. The primary outcome was 30-day mortality, and the secondary outcomes were 1-year and 3-year mortality.

Results

A total of 813 patients who met the selection criteria were enrolled, of whom 130 (16.0%) died within 30 days of admission. Univariate Cox regression indicated that MCHC was significantly associated with mortality (30-day: HR = 0.74, 95% CI = 0.66–0.82, P < 0.001; 1-year: HR = 0.80, 95% CI = 0.74–0.86, P < 0.001; 3-year: HR = 0.82, 95% CI = 0.77–0.88, P < 0.001). MCHC remains stable after adjusting multiple models. Kaplan-Meier survival curves showed that patients with lower MCHC had a poorer 30-day prognosis.

Conclusions

Lower MCHC is an independent risk factor for increased mortality in patients with APE. As an inexpensive biomarker, MCHC should receive more attention.
Through a Glass Brightly: Generative Ethical Tensions in Research-Based Theatre
Authors: Michalovich Amir , Mayer Yael , Hershler Laen Avraham Dov , Bulk Laura Yvonne , Cook Christina , Graf Hila , Lee Michael , Belliveau George , Jarus Tal
Published: June 2022

This qualitative case study methodically explores ethical tensions that arose in the Research-based Theatre (RbT) project, Alone in the Ring (AitR), as a case. We borrowed Elliot Eisner’s set of tensions in Arts-Based Research (ABR), exploring the extent to which they manifested as ethical tensions in AitR. Following analysis of in-depth interviews with key project members, we identified five areas of ethical tension in AitR, adapting Eisner’s framework to account for the ethical dimensions of the tensions, their generative quality, and their temporal and social dimensions, as they manifested in AitR. Complicating Eisner’s general tensions for ABR, this article advances an adapted, RbT-specific framework with meta-language to reflect on the ethical terrain of RbT using the richness and specificity afforded by a case study. The framework is particularly useful for RbT practitioners seeking to maximize the benefits of RbT for knowledge translation, arts-based inquiry, and community engagement.
Undisciplined: Research-Creation and What It May Offer (Traditional) Qualitative Research Methods
Authors: Truman Sarah E.
Published: June 2022

As part of the Post Philosophies and the Doing of Inquiry interview series, Sarah E. Truman discusses research-creation at the intersection of arts, theory, and research, and what it may offer traditional qualitative research. Truman gives a theoretical orientation and talks through some research events as exemplifications.
Comparison of different decision support software programs in perspective of potential drug–drug interactions in the oncology clinic
Authors: Bektay Muhammed Yunus , Seker Zehra , Eke Hatice Kubra , Turk Haci Mehmet , Izzettin Fikret Vehbi
Published: June 2022

Introduction

One of the most intriguing situations for healthcare providers is cancer therapy. Drug-drug interactions (DDIs) account for 20–30% of all adverse effects. Cancer patients are more likely to have potential-DDIs since they are taking other drugs with anticancer treatments to prevent the side effects of chemotherapeutic agents. The purpose of this research is to compare various decision support software (CDSS) programs in terms of potential DDIs.

Methods

A cross-sectional study was carried out. A clinical pharmacist assessed the treatment regimens of 231 cancer patients. pDDIs were evaluated using three sources: Lexicomp®, Medscape®, and Micromedex®. The ethical approval was given in November 2017 with decision number 21/286.

Results

A total of 231 participants who were receiving therapy and had a median age of 61.5 ± 9.18 years were assessed. Almost half of the patients (49%) were female, and 155 had at least one comorbidity in addition to cancer. Medscape had a substantial pDDI ratio of 7.09%, Micromedex had a ratio of 11.15%, and Lexicomp had a ratio of 19.50%. The total number of pDDIs for major/X/contraindicated were 363–2716 (1.56–11.7 pDDI/patient) for Medscape®, 60–1723 (0.26–7.4 pDDI/patient) for Micromedex, and 145–984 (0.62–2.24 pDDI/patient) for Lexicomp®. One of the most common pDDI found was diclofenac and dexamethasone. Interactions between escitalopram and granisetron were also common, and different CDSSs made different recommendations.

Conclusions

In this study, significant disparities in the quantity and severity of CDSS across distinct CDSS were discovered. One of the major finding of our study was suboptimal prescribing. To address this issue, regulatory organizations should establish and verify validation and reporting mechanisms.
Pharmacy practitioners’ adherence to safe-handling practices of chemotherapeutic drugs: A cross-sectional study in Saudi Arabia
Authors: Ogbaghebriel Azieb , Alshamrani Majed , Ibrahim Alnada , Al-Masaary Wed , Hakami Sarah , Alrasheed Shahad , Al-Sayed Nada
Published: June 2022

Background

Chemotherapy drug handling and occupational exposure are topics of concern for a variety of oncology health care professionals. Inappropriate handling can pose health risks to practitioners particularly, those who handle them on a daily basis. Therefore, this study aimed to assess chemotherapy handling practices among oncology pharmacists and pharmacy technicians in Saudi Arabia.

Methods

A cross-sectional study was conducted using an online survey with a structured pre-validated questionnaire. Data was collected from pharmacists and pharmacy technicians who handle chemotherapeutic agents in Saudi Arabia, and analyzed using descriptive and inferential statistics.

Results

A total of 79 oncology pharmacy practitioners responded to the survey. The majority (92.4%) had written chemotherapy guidelines at their workplaces. Almost all participants (98.7%) reported the availability of protective gloves and gowns, however, the availability of eye protection was only 57%. Most used chemotherapy-designated gloves (83.6%), and gowns (86.1%). However, 54.4% have reused disposable gowns. The extent of utilization of most protective equipment ranged from 70% (always using closed system transfer device) to 98% (always using shoe cover); while the practice of always using eye protection and face shield was only 30.4% and 38%, respectively. With regard to cleaning practice, the work area was cleaned at least once a day by 35%; monthly decontamination (77%); certification by the biomedical department every 6 months (67%) and at least yearly (95%). Accidental exposure was reported by 28%, and the most common adverse effect was skin irritation (82%). There was no workplace medical surveillance available for 50%. The majority (88.6%) received relevant training, but not periodic updates on their training (38%). The main barriers against the use of personal protective equipment were: that some personal protective equipments were not always available (38%), and personal protective equipments were too uncomfortable to use (30.4%). The demographic variables did not have a statistically significant effect ( p > 0.05) on the responses except for type of institution (workplace) on some of the cleaning practices that showed significant differences namely, the monthly decontamination and certification by the biomedical department.

Conclusions

Most protective equipment and chemotherapy guidelines were available, and the majority of pharmacy practitioners adhered to many aspects of chemotherapy safe-handling practices. Nevertheless, some areas such as medical surveillance programs, use of eye protection and face shields, the practice of re-using disposable gowns, some of the barriers against personal protective equipment use, and the provision of periodic training need improvement for better protection of the health care professionals.
Bacterial isolates and antimicrobial susceptibility pattern of ocular infection at a tertiary referral hospital in the South of Italy
Authors: D’Oria Francesco , Buonamassa Rosa , Rizzo Tiziana , Boscia Francesco , Alessio Giovanni , Guerriero Silvana
Published: June 2022

Purpose

The present study aimed to determine the prevalence of bacterial and fungal infections of the eye and also to assess the antibiotic susceptibility pattern of bacterial isolates at a tertiary referral eye care hospital in Bari, Italy.

Methods

Two hundred seventy three samples collected during a 2-year observation period. Culture, Gram's stain, potassium hydroxide mount and occasionally Giemsa staining was done for the clinical specimens. Antibiotic susceptibility testing was performed for bacterial growth.

Results

Out of 273 samples processed, 236 (86.4%) yielded growth: of them, 183 (77,5%) were bacterial, 26 (11%) fungal, and 23 (9,7%) specimens showed the presence of Acanthamoeba. Among bacterial infections, 99 (54.5%) bacterial isolates were Gram-positives, and 82 (44.8%) were Gram-negatives. Among Gram positives, Tigecycline showed the greatest susceptibility (93.8%), followed by Linezolid (97%) and Daptomycin (95.18%). Gram negative bacteria strains were susceptible to Imipenem (95%), Meropenem (98,5%) and Amikacin (91%) Multidrug in vitro resistance (resistance >3 classes of antibiotics) was found in 45 Gram positive (63%). and 33 Gram negative (44%).

Conclusion

Conjunctival specimens yielded mainly bacterial growth with Staphylococcus species being the predominant isolate followed by Pseudomonas species. Findings from the current analysis evidence a substantial level of in vitro resistance to ≥3 antibiotics.
Outdated or innovative? Examining news practices that have stood the test of time at one of Australia's longest-serving local newspapers
Authors: McAdam Alison , Hess Kristy
Published: June 2022

Researchers studying media innovation and local news tend to emphasise the ‘here and now’, focusing on digital advances as the pathway towards more efficient journalism and viable businesses. This paper argues for the importance of examining media practices that have been preserved and valued over time. It advocates for a temporal reflexivity lens to help inform media innovation strategies and policies for the local news sector in the future. We conduct a fine-grained exploration of one of Australia's oldest family-owned local newspapers, The Buloke Times in the state of Victoria, identifying three main areas of the business that have stood the test of time: respect for tradition and reputations, ‘embeddedness’ in place, and fostering company loyalty and collaboration. Ultimately, we suggest that an appreciation of tradition and continuation may play an important role in understanding the future of digital news in small-town communities.
Normalizing intersex children through genital surgery: the medical perspective and the experience reported by intersex adults
Authors: Cuadra Magali , Baruch Ricardo , Lamas Andrea , Morales María E , Arredondo Armando , Ortega Doris
Published: June 2022

This paper explores the conceptions of specialized physicians regarding intersex child surgery, and contrasts them with the experiences of intersex adults. The gap between the views of health personnel—who affirm that they are “doing their best”—and those of intersex persons—who report the adverse consequences of surgery—highlights the need to stop unnecessary normalization surgeries in children. The findings of this study suggest that bridging the gap between the medical perspective and the experience of intersex people requires opening direct channels of communication among all those involved in the clinical process, incorporating intersex individuals into bioethics committees, encouraging contact with the parents of intersex children, implementing regulations that unambiguously delay or prohibit unnecessary interventions, promoting a debate on relevant ethical principles and human rights to protect the interests of all intersex people, and disseminating the contents of such a debate.
On the grammaticality of passivization in bilingual compound verbs
Authors: Balam Osmer , Stadthagen-González Hans , Rodríguez-González Eva , Parafita Couto María del Carmen
Published: June 2022

Objectives/research questions:

We examined stative and eventive passive bilingual compound verbs (BCVs) in Spanish/English code-switching. Of particular interest to us was the availability of passivization in bilingual eventive passive hacer “do” constructions, purportedly banned in bilingual speech due to a universal syntactic restriction.

Methodology:

A total of 119 bilinguals from Northern Belize and 36 from Southwest United States completed a two-alternative forced-choice acceptability task and a language background questionnaire.

Data and analysis:

The analysis was conducted using Thurstone’s Law of Comparative Judgment.

Conclusion:

For stative passive BCVs, results revealed that Spanish/English bilinguals from both contexts gave the highest ratings to code-switched constructions without the light verb hacer. For eventive passive BCVs, however, Belize bilinguals gave preferential ratings to passive constructions with the light verb hacer. Conversely, US bilinguals rejected them. Notably, among Belize bilinguals, eventive passive BCVs that were rated as most acceptable were constructions with no gender agreement between the light verb and the feminine antecedent noun.

Originality:

This is the first cross-community analysis that investigates stative and eventive passive BCVs in Spanish/English code-switching.

Implications:

Our findings show that the light verb hacer is compatible with both stative and eventive passive BCVs. Crucially, context-specific linguistic norms and social factors rather than a universal syntactic restriction primarily determine the availability of passivization in eventive passive BCVs. Our theorizing of code-switching grammars, thus, necessitates careful consideration of invariant and variable production patterns that are profoundly shaped by historical and sociolinguistic conditions.
Complementary frailty and mortality prediction models on older patients as a tool for assessing palliative care needs
Authors: Blanes-Selva Vicent , Doñate-Martínez Ascensión , Linklater Gordon , García-Gómez Juan M
Published: June 2022

Palliative care (PC) has demonstrated benefits for life-limiting illnesses. Bad survival prognosis and patients' decline are working criteria to guide PC decision-making for older patients. Still, there is not a clear consensus on when to initiate early PC. This work aims to propose machine learning approaches to predict frailty and mortality in older patients in supporting PC decision-making. Predictive models based on Gradient Boosting Machines (GBM) and Deep Neural Networks (DNN) were implemented for binary 1-year mortality classification, survival estimation and 1-year frailty classification. Besides, we tested the similarity between mortality and frailty distributions. The 1-year mortality classifier achieved an Area Under the Curve Receiver Operating Characteristic (AUC ROC) of 0.87 [0.86, 0.87], whereas the mortality regression model achieved an mean absolute error (MAE) of 333.13 [323.10, 342.49] days. Moreover, the 1-year frailty classifier obtained an AUC ROC of 0.89 [0.88, 0.90]. Mortality and frailty criteria were weakly correlated and had different distributions, which can be interpreted as these assessment measurements are complementary for PC decision-making. This study provides new models that can be part of decision-making systems for PC services in older patients after their external validation.
A study on microstructure and recrystallization kinetics on low deformed pure ETP copper
Authors: Harshavardhana N , Sundar Singh Sivam SP , Kumar Gulshan , Saxena Ashish Kumar
Published: June 2022

The kinetics of microstructural changes plays a vital role in designing the material properties. There are various microstructural transformation phenomena such as recovery, recrystallization, and strain-induced boundary migration, which affect the properties of materials. This study aims to investigate the kinetics of low-strain deformed electrolytic tough pitch (ETP) copper (less than 23% reduction in thickness), where an optimum value of hardness and conductivity is obtained after heat treatment when compared with a high strain deformed sample. The activation energy values for the low deformed sample calculated from changes in hardness, conductivity, and microstructure are in the range of 39–99 kJ/mol, 30–90 kJ/mol, and 40–51 kJ/mol, respectively, which is low compared to high deformed values. Careful microstructural investigation of the low-strain deformed copper shows evidence of strain-induced boundary migration, whereas high strain deformed copper shows evidence of recrystallization. The strain-induced boundary migration plays an important role in “cleaning up” some of the deformed grains with a composite microstructure consisting of deformed grains that preserve high hardness, while some grains have low defect density which helps to obtain high conductivity after heat treatment.
Optimizing cranial implant and fixture design using different materials in cranioplasty
Authors: Jindal Prashant , Chaitanya  , Bharadwaja Shreerama Shiva Sai , Rattra Shubham , Pareek Deval , Gupta Vipin , Breedon Philip , Reinwald Yvonne , Juneja Mamta
Published: June 2022

Cranial implants are used to secure intracranial structures, reconstruct the skull contour, normalise cerebral haemodynamic and repair cranial defects. Larger bone defects require intervention for repair from an implant made from autologous bone or other material. To repair such defects using implants, materials necessitate biocompatibility with the natural bone. Patient-specific implants are designed to repair specific cranial defects following standard procedures for implant design, fabrication and cranioplasty. Autologous bone, bone cement comprising hydroxyapatite, polymethyl methacrylate, medical-grade titanium alloy (Ti-6Al-4V) and polyether-ether-ketone, are widely used to fabricate patient-specific implant for repairing different types of bone defects. To optimize a patient-specific implant for shape, size and weight, it is essential to design the implant using 3D modelling and fabrication techniques. Effective attachment of an implant material with a defective skull is also influenced by the joints and fixture arrangements at the interface, these fixtures can be of various types, and materials have different joining procedures. In this study, a comparative analysis of different cranial implant materials (autologous bone, PMMA, polyether-ether-ketone and Ti-6Al-4V) attached to a defective skull with Ti-6Al-4V and polyether-ether-ketone fixture plates has been performed, using finite element analysis. Two types of fixture designs were used as square ‘X’ and linear shapes, which were fixed along with the interface between the implant and the skull. Four fixture plates were fixed symmetrically along the boundary to maximising stability. The findings suggested that all the implant materials were able to sustain extreme boundary conditions such as external loads of 1780 N and intracranial pressure of 15 mmHg without failures. Polyether-ether-ketone implants exhibited 13.5–35% lower von Mises stresses in comparison to autologous bone implants and the square ‘X’ fixture design provided higher stress-relieving results in comparison to Linear fixtures by nearly 18.4% for Ti-6Al-4V fixture material and 10.9% for polyether-ether-ketone fixture material, thereby, encouraging polyether-ether-ketone as an alternative to conventional cranial implant and fixture materials.
Predictors of service utilization among homeless former foster youth: Implications for intervention
Authors: Yoshioka-Maxwell Amanda
Published: June 2022

A high percentage of homeless youth have a history of foster care placement; this population faces high rates of behavioral health problems. No research has focused on the predictors of service use among homeless former foster youth. This analysis seeks to determine what foster care and homeless experiences are associated with service use among this population. Data were collected via convenience sample from 184 homeless former foster youth at a drop-in center in Hollywood, California. A series of logistic regressions were conducted for network engagement behaviors that may be impacted by foster care experiences. Knowledge from prior empirical results form the basis for this analysis.

Findings

Number of foster care placements and age at first foster care placement, overall time spent homeless, age at first homelessness, and being kicked out of housing as a cause of homelessness were associated with decreased service use. Time spent in foster care and homeless experiences during foster care were associated with increased service use.

Application

Results can be used to aid in understanding which foster care and homeless experiences aid or hinder service use. From a policy level, findings from this study can aid child welfare agencies in further understanding which foster care experiences present as risk factors after transition from care.
The Time is Now For Lifestyle Medicine: Lesson From Lifestyle Medicine Leaders
Authors: Collings Cate , Frates Elizabeth Pegg , Shurney Dexter
Published: June 2022

The time is NOW for Lifestyle Medicine. In this review based on a presentation at the American College of Lifestyle Medicine (ACLM) 2021 annual conference, ACLM Current President Cate Collings, MD, Immediate Past-President Dexter Shurney, MD, and President Elect Beth Frates, MD, share insights on the current state of lifestyle medicine (LM). Interest in LM has greatly advanced in the face of disruptions from the COVID-19 pandemic, expanded educational opportunities in the field, and a rapidly changing healthcare landscape. With growing access to virtual care, advancing technologies, growing emphasis on home-based chronic care, continuing corporate healthcare mergers and acquisitions, and widening adoption of personalized, patient-empowered treatments, the time is ripe for LM interventions to move to the mainstream. As health investments and costs skyrocket, and new players enter the scene, traditional models of payments, reimbursements, and incentives are slowly being upended. Companies and healthcare systems are finally recognizing the scientific evidence and powerful but undervalued potential of LM to accelerate healthy outcomes while controlling costs. Taken together, the lessons from the COVID-19 pandemic, the growth in LM educational opportunities, and the evolving “business of medicine landscape” signal that the time for lifestyle medicine is NOW.
A Content Analysis of 100 Qualitative Health Research Articles to Examine Researcher-Participant Relationships and Implications for Data Sharing
Authors: Mozersky Jessica , Friedrich Annie B. , DuBois James M.
Published: June 2022

We conducted a qualitative content analysis of health science literature ( N = 100) involving qualitative interviews or focus groups. Given recent data sharing mandates, our goal was to characterize the nature of relationships between the researchers and participants to inform ethical deliberations regarding qualitative data sharing and secondary analyses. Specifically, some researchers worry that data sharing might harm relationships, while others claim that data cannot be analyzed absent meaningful relationships with participants. We found little evidence of relationship building with participants. The majority of studies involve single encounters (95%), lasting less than 60 min (59%), with less than half of authors involved in primary data collection. Our findings suggest that relationships with participants might not pose a barrier to sharing some qualitative data collected in the health sciences and speak to the feasibility in principle of secondary analyses of these data.