bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of ring-shaped electrostatic coupled capacitance sensor for the parameter measurement of gas-solid flow
Authors: Ding Hui , Li Jian , Wang Haoran , Xu Chuanlong
Published: April 2021

This paper develops a novel non-intrusive ring-shaped electrostatic coupled capacitance sensor (ECCS) for the parameter measurement of gas-solid flow to eliminate the temperature drift of traditional capacitance sensor and to improve the reliability of velocity measurement. In ECCS, one source electrode and two detection electrodes are housed in a sensing head to simultaneously derive two pairs of capacitance and electrostatic signals, which can achieve the simultaneous measurement of the particle velocity, concentration and mass flow rate within the same sensing space of gas-solid flow system. The effects of the isolation electrodes on the capacitance sensitivity and the temperature drift of the sensor standing capacitance are further investigated. Then, a weighted velocity is determined by fusing the capacitance correlation velocity and the electrostatic correlation velocity based on the correlation coefficients, which are useful for the reliable measurement of gas-solid flow. Finally, experiments are carried out to test the performance of the developed ring-shaped ECCS. Results demonstrate that the developed ECCS triples the capacitance sensitivity for the radial position from -15 mm ∼15 mm. The temperature drift of the capacitance signal is less than 0.075 mV/oC from the room temperature to 65 oC, and thus the sensor standing capacitance is almost impervious to the temperature. After calibrating the relationship between the particle concentration and the capacitance signal, the developed ECCS can measure the particle mass flow rate with a relative error less than ±8%.
Black Lives Matter and the politics of redemption
Authors: Olney Charles
Published: April 2021

This article explores the role of practical political theory in the Black Lives Matter (BLM) movement. I argue that BLM represents a multifaceted engagement with the complicated politics of redemption that lies at the heart of American democracy. In one sense, BLM stands for the integration of black life into the framework of political value, and thus for a redemption of the promise of ‘justice for all’. In another, it is a challenge to the principles themselves, viewing justice as a threat to be managed, rather than as a principle to be redeemed. Exploring the praxis of this movement, organized both against and within the possibility of redemption, will enable us to more effectively characterize the limitations of a politics grounded in the theorization of justice and generate a richer understanding of the possibility for practical political theory to simultaneously employ and critique the politics of redemption.
Clinical Decision Support Systems in Otolaryngology–Head and Neck Surgery: A State of the Art Review
Authors: Standiford Taylor C. , Farlow Janice L. , Brenner Michael J. , Conte Marisa L. , Terrell Jeffrey E.
Published: April 2021

Objective

To offer practical, evidence‐informed knowledge on clinical decision support systems (CDSSs) and their utility in improving care and reducing costs in otolaryngology–head and neck surgery. This primer on CDSSs introduces clinicians to both the capabilities and the limitations of this technology, reviews the literature on current state, and seeks to spur further progress in this area.

Data Sources

PubMed/MEDLINE, Embase, and Web of Science.

Review Methods

Scoping review of CDSS literature applicable to otolaryngology clinical practice. Investigators identified articles that incorporated knowledge‐based computerized CDSSs to aid clinicians in decision making and workflow. Data extraction included level of evidence, Osheroff classification of CDSS intervention type, otolaryngology subspecialty or domain, and impact on provider performance or patient outcomes.

Conclusions

Of 3191 studies retrieved, 11 articles met formal inclusion criteria. CDSS interventions included guideline or protocols support (n = 8), forms and templates (n = 5), data presentation aids (n = 2), and reactive alerts, reference information, or order sets (all n = 1); 4 studies had multiple interventions. CDSS studies demonstrated effectiveness across diverse domains, including antibiotic stewardship, cancer survivorship, guideline adherence, data capture, cost reduction, and workflow. Implementing CDSSs often involved collaboration with health information technologists.

Implications for Practice

While the published literature on CDSSs in otolaryngology is finite, CDSS interventions are proliferating in clinical practice, with roles in preventing medical errors, streamlining workflows, and improving adherence to best practices for head and neck disorders. Clinicians may collaborate with information technologists and health systems scientists to develop, implement, and investigate the impact of CDSSs in otolaryngology.
Immigrant Women’s Economic Outcomes in Europe: The Importance of Religion and Traditional Gender Roles
Authors: Kanas Agnieszka , Müller Katrin
Published: April 2021

This article contributes to previous research on immigrant integration by examining how religiosity and gender roles in European countries influence immigrant women’s labor market outcomes. Moreover, we extend theoretical work on the importance of the receiving country’s norms and values by hypothesizing and testing whether receiving countries’ influence varies with immigrant women’s religiosity and gender-role attitudes. Using the European Social Survey data and multilevel regression models, we find that religious immigrant women participate less in the labor market and work fewer hours than nonreligious immigrant women. Immigrant women’s traditional gender-role attitudes partly explain the negative relationship between individual religiosity and labor market outcomes. While the receiving country’s religiosity is negatively related to immigrant women’s labor market outcomes, this negative relationship is significantly weaker for religious and gender-traditional immigrant women than for nonreligious and gender-egalitarian women. These findings suggest that the economic benefits of residing in countries that support female employment are limited to immigrant women who are ready and positioned to embrace gender-egalitarian norms and values.
Effect of dual-task training on balance in patients with multiple sclerosis: A systematic review and meta-analysis
Authors: Martino Cinnera Alex , Bisirri Alessio , Leone Enza , Morone Giovanni , Gaeta Angela
Published: April 2021

Objective:

To evaluate the effects of dual-task training on static and dynamic balance in patients with multiple sclerosis.

Data sources:

PubMed/MEDLINE, EMBASE, Scopus, and PEDro databases were searched from inception to March 1, 2021.

Methods:

This study was conducted in agreement with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers assessed studies for inclusion and extracted data. We used the Physiotherapy Evidence Database scale to evaluate the methodological quality and the risk-of-bias. Randomized clinical trial data were pooled for the meta-analysis. The effect sizes and 95% confidence interval (CI) were calculated by random-effect models. Egger regression and Begg-Mazumdar rank correlation test were used for publication bias.

Results:

A total of 13 studies involving 584 patients (42.3 ± 9 years mean ± SD; 377 females) met the inclusion criteria for the systematic review, while nine were included in the meta-analysis. People who received dual-task training interventions showed significant improvements in the Timed Up & Go test 0.44 [(95% CI = 0.22; 0.65), P-value<0.001], and in the Berg Balance scale 0.46 [(95% CI = 0.07; 0.85), P-value = 0.02]. Low and moderate heterogeneity between the studies was found for the Timed Up & Go test and the Berg Balance scale, respectively.

Conclusion:

The findings from the current meta-analysis support dual-task training as a beneficial therapy for improving dynamic balance and functional mobility in patients with multiple sclerosis. The limited number of studies that investigated static balance performance after dual-task training do not currently allow us to draw a conclusion about any possible improvements in this ability.
Sexual function in patients with endometriosis: a prospective case–control study in China
Authors: Yang Xiaochun , Xu Xinfen , Lin Lili , Xu Kaihong , Xu Min , Ye Jinying , Shen Xiaoli
Published: April 2021

Objective

Endometriosis is a common disease in women of childbearing age, leading to sexual dysfunction or loss of libido. We aimed to evaluated the effect of endometriosis on women’s sexual function.

Methods

We performed a prospective case–control study to determine the effect of endometriosis on women’s sexual function using a self-administered questionnaire from September 2017 to August 2018. The simplified Chinese version of the Female Sexual Function Index (FSFI) was used to assess sexual function.

Results

We found that sexual function of women in the endometriosis group (n=77) in all dimensions was significantly lower compared with that in the control group (n=63). The total FSFI score in patients was 25.5, which tended to be lower than that in the control group (26.7). Sexual arousal, sexual pain, and satisfaction were significantly different between the two groups. Sexual arousal and sexual pain scores were significantly lower in the endometriosis group than in the control group at the ages of 31 to 40 years.

Conclusion

Women with endometriosis suffer from sexual dysfunction, especially those aged 31 to 40 years. Our findings suggest that the quality of sexual life in this subpopulation needs to be improved.
Primary central nervous system Hodgkin's lymphoma: a case report
Authors: Fu Haiying , Shi Songsheng , Chen Lusan , Xu Benhua , Huang Wanling , Chen Yi , Wu Xuejing , Shen Jianzhen , Liu Tingbo
Published: April 2021

Primary central nervous system Hodgkin's lymphoma (CNS-HL) is extremely rare. This current case report describes a 60-year-old male patient that presented with numbness of the left lower extremity and worsening headache. After a full range of investigations and a partial resection of the right cerebellum, external ventricular drainage reservoir placement and cranioplasty, he was diagnosed with primary CNS-HL. The patient was treated with 3 g/m2 methotrexate (intravenous [i.v.], once a day, day 1) and 1 g/m2 cytarabine (i.v., every 12 h, days 2 + 3), followed by anti-programmed cell death protein 1 antibodies (200 mg sintilimab, i.v., once a day, day 1, every 3 weeks). After six courses of treatment with intrathecal injections of 50 mg cytarabine (once a day, day 1) and 5 mg dexamethasone (once a day, day 1), there was no residual lesion on cranial magnetic resonance imaging. No significant drug-related adverse events were observed. The patient has been followed up every 3 months and no relapse has occurred.
Car Following and Microscopic Traffic Simulation Under Distracted Driving
Authors: Zatmeh-Kanj Sunbola , Toledo Tomer
Published: April 2021

Microscopic simulation models have been widely used as tools to investigate the operation of traffic systems and different intelligent transportation systems applications. The fidelity of microscopic simulation tools depends on the driving behavior models that they implement. However, current models commonly do not consider human-related factors, such as distraction. The potential for distraction while driving has increased rapidly with the availability of smartphones and other connected and infotainment devices. Thus, an understanding of the impact of distraction on driving behavior is essential to improve the realism of microscopic traffic tools and support safety and other applications that are sensitive to it. This study focuses on car-following behavior in the context of distracting activities. The parameters of the well-known GM and intelligent driver models are estimated under various distraction scenarios using data collected with an experiment conducted in a driving simulator. The estimation results show that drivers are less sensitive to their leaders while talking on the phone and especially while texting. The estimated models are implemented in a microscopic traffic simulation model. The average speed, coefficient of variation of speed, acceleration noise and acceleration and deceleration time fractions were used as measures of performance indicating traffic flow and safety implications. The simulation results show deterioration of traffic flow with texting and to some extent talking on the phone: average speeds are lower and the coefficient of variation of speeds are higher. Further experimentation with varying fractions of texting drivers showed similar trends.
Considerations, benefits and unintended consequences of banning plastic shopping bags for environmental sustainability: A systematic literature review
Authors: Muposhi Asphat , Mpinganjira Mercy , Wait Marius
Published: April 2021

Although the ban on plastic bags is gaining in prominence as a policy option to manage plastic bag litter, there are mixed views on its rationale and effectiveness. This study employs a systematic literature review to understand considerations, benefits and unintended consequences of banning plastic bags. The review’s results pointed to the limited success of a plastic bag ban owing to lack of suitable alternatives, limited state capacity to monitor and enforce the ban, thriving black market, structural and instrumental power of the plastic industry. The power of the industry was manifested by the covert practice of deflecting accountability to consumers by focusing on business-oriented solutions, including an inclination towards self-regulation. The findings of this study underscored the need for a global treaty to address the transient nature of plastic bag litter and moving away from the symbolic gesture of targeting only plastic shopping bags but considering the environmental impact of all forms of plastic such as straws, foamed plastics, plastic bottles and caps. There is a general consensus in literature that the end of plastic shopping bags is not nigh due to their utilitarian benefits. This study therefore recommends the promotion of a circular economy focusing on ecological modernisation, sustainable plastic bag manufacturing and recovery strategies such as recycling as a long-term strategy. A significant strand of literature reviewed also recommends the adoption of community-driven approaches such as voluntary initiatives as opposed to a plastic bag ban as they proved to be effective in promoting environmental citizenship behaviours in countries such as Finland.
Analysis of the Theory of Integrative Nurse Coaching
Authors: Moore Amy K. , Avino Karen , McElligott Deborah
Published: April 2021

The Theory of Integrative Nurse Coaching (TINC) has been analyzed according to the method of Walker and Avant. We have found that TINC is a well-constructed mid-range theory in the discipline of nursing. Within the domain of holistic nursing, it is focused on the goal of healing the whole person, synthesizing a large amount of theoretical material related to the concept of healing and placing it within the context of nursing as a discipline. With underpinnings in holistic nursing, it aligns with numerous grand nursing theories via the metaparadigm, healing, and patterns of knowing. It is easily translated into holistic nursing practice, actualized in the role of the nurse coach. It describes a method of holistic nursing practice that is suitable for use in numerous settings, including lifestyle, chronic disease, and end of life, among others. Although there is little published research using the theory, there is potential for application in holistic nursing practice, education, research, policy, and administration. We have identified numerous potential research questions that would test the theory. In this time of global nursing shortage and burnout, it is notable that this mid-range theory explicitly describes how self-care of the nurse enhances client care.
Home and Neighborhood Context of Falls Among Black and White Older Americans
Authors: Okoye Safiyyah M. , Samuel Laura J. , Fabius Chanee , Mulcahy John , Reider Lisa M. , Szanton Sarah L. , Wolff Jennifer L.
Published: April 2021

Objectives: To examine social and physical environmental fall-risk factors in a nationally representative sample of community-living older adults overall and by racial group. Methods: We used data from the 2015 and 2016 rounds of the National Health and Aging Trends Study ( n = 5581) linked to census tract measures from the American Community Survey. Recurrent falls are defined as 2+ self-reported falls over 12 months. Results: Older adults with recurrent falls were more likely to have lower education, lower income, financial hardship, live in homes with disorder and disrepair and in neighborhoods without sidewalks, with high social deprivation, and in nonmetropolitan counties. Home disrepair, lack of sidewalks, and residence in a nonmetropolitan county were important fall-risk factors among White older adults only. Financial hardship was an important risk factor among Black older adults. Discussion: Environmental factors are associated with recurrent falls among older Americans and should be incorporated into fall-risk profiles and prevention efforts.
Joint space–time Bayesian disease mapping via quantification of disease risk association
Authors: Baer Daniel R , Lawson Andrew B , Joseph Jane E
Published: April 2021

Alzheimer’s disease is an increasingly prevalent neurological disorder with no effective therapies. Thus, there is a need to characterize the progression of Alzheimer’s disease risk in order to preclude its inception in patients. Characterizing Alzheimer’s disease risk can be accomplished at the population-level by the space–time modeling of Alzheimer’s disease incidence data. In this paper, we develop flexible Bayesian hierarchical models which can borrow risk information from conditions antecedent to Alzheimer’s disease, such as mild cognitive impairment, in an effort to better characterize Alzheimer’s disease risk over space and time. From an application of these models to real-world Alzheimer’s disease and mild cognitive impairment spatiotemporal incidence data, we found that our novel models provided improved model goodness of fit, and via a simulation study, we demonstrated the importance of diagnosing the label-switching problem for our models as well as the importance of model specification in order to best capture the contribution of time in modeling Alzheimer’s disease risk.
Dealing with risk discontinuities to estimate cancer mortality risks when the number of small areas is large
Authors: Santafé Guzman , Adin Aritz , Lee Duncan , Ugarte Maŕıa Dolores
Published: April 2021

Many statistical models have been developed during the last years to smooth risks in disease mapping. However, most of these modeling approaches do not take possible local discontinuities into consideration or if they do, they are computationally prohibitive or simply do not work when the number of small areas is large. In this paper, we propose a two-step method to deal with discontinuities and to smooth noisy risks in small areas. In a first stage, a novel density-based clustering algorithm is used. In contrast to previous proposals, this algorithm is able to automatically detect the number of spatial clusters, thus providing a single cluster structure. In the second stage, a Bayesian hierarchical spatial model that takes the cluster configuration into account is fitted, which accounts for the discontinuities in disease risk. To evaluate the performance of this new procedure in comparison to previous proposals, a simulation study has been conducted. Results show competitive risk estimates at a much better computational cost. The new methodology is used to analyze stomach cancer mortality data in Spanish municipalities.
Aging of polypropylene probed by near infrared spectroscopy
Authors: Shinzawa Hideyuki , Watanabe Ryota , Yamane Shogo , Koga Maito , Hagihara Hideaki , Mizukado Junji
Published: April 2021

This paper describes the first in-depth attempt to characterize thermally induced aging of polypropylene (PP) samples by near infrared (NIR) spectroscopy. Significant levels of variation in NIR bands associated with short (amorphous-dominated) and long (crystalline-dominated) helices was readily captured when PP samples were subjected to thermal aging treatment. Partial least squares (PLS) regression models derived from the NIR spectra indicated significant level of correlation between the actual and predicted elongations of the samples. Analysis of PLS scores and two-dimensional (2D) correlation spectra derived from the aged PP samples revealed inner working mechanism of the regression model. Namely, the aging treatment essentially induces compositional change in crystalline and amorphous structures of the PP samples, which eventually affect the variation of the PLS scores. Thus, by utilizing the scores, it becomes possible to predict the change in the elongation property of the aged PP sample.
Emerging Markets Redefined: Comprehensive Measurement and Future Prospects
Authors: Hu Biliang , Tang Xing , Yin Lin , Liu Qian
Published: April 2021

The twenty-first century saw the emerging market countries rise as a cluster, becoming a major force driving the global economic growth and playing an increasingly important role in global governance. The existing definition of emerging market countries is vague and quite one-sided, far from capturing the reality. Based on historical experiences and actual circumstances of developing countries and the basic theories of development economics, this article builds a comprehensive index system comprising the five dimensions of nation-state size, institutional environment, economic growth, socio-economic structure, and development impetus to study 30 countries selected from among the 183 countries (regions) around the world. This provides a new analysis framework and theoretical support for in-depth study of the emerging markets.
Breast cancer prediction using an optimal machine learning technique for next generation sequences
Authors: Kurian Babymol , Jyothi VL
Published: April 2021

A wide reach on cancer prediction and detection using Next Generation Sequencing (NGS) by the application of artificial intelligence is highly appreciated in the current scenario of the medical field. Next generation sequences were extracted from NCBI (National Centre for Biotechnology Information) gene repository. Sequences of normal Homo sapiens (Class 1), BRCA1 (Class 2) and BRCA2 (Class 3) were extracted for Machine Learning (ML) purpose. The total volume of datasets extracted for the process were 1580 in number under four categories of 50, 100, 150 and 200 sequences. The breast cancer prediction process was carried out in three major steps such as feature extraction, machine learning classification and performance evaluation. The features were extracted with sequences as input. Ten features of DNA sequences such as ORF (Open Reading Frame) count, individual nucleobase average count of A, T, C, G, AT and GC-content, AT/GC composition, G-quadruplex occurrence, MR (Mutation Rate) were extracted from three types of sequences for the classification process. The sequence type was also included as a target variable to the feature set with values 0, 1 and 2 for classes 1, 2 and 3 respectively. Nine various supervised machine learning techniques like LR (Logistic Regression statistical model), LDA (Linear Discriminant analysis model), k-NN (k nearest neighbours’ algorithm), DT (Decision tree technique), NB (Naive Bayes classifier), SVM (Support-Vector Machine algorithm), RF (Random Forest learning algorithm), AdaBoost (AB) and Gradient Boosting (GB) were employed on four various categories of datasets. Of all supervised models, decision tree machine learning technique performed most with maximum accuracy in classification of 94.03%. Classification model performance was evaluated using precision, recall, F1-score and support values wherein F1-score was most similar to the classification accuracy.
How to conduct integrated pharmaceutical care for patients with hand-foot syndrome associated with chemotherapeutic agents and targeted drugs
Authors: Chen Jiexiu , Wang Zhuo
Published: April 2021

Objective

The objective of this article was to offer practical operational process for pharmacists to successfully conduct integrated pharmaceutical care for patients with hand-foot syndrome associated with chemotherapeutic agents and targeted drugs which may facilitate the work of first-line clinical pharmacist. Data sources: A literature review was conducted in March 2020 of Pubmed, Medline, and EMBASE (2010-2020) using terms such as: hand-foot syndrome, hand-foot skin reaction, palmar-plantar erythrodysesthesia, chemotherapeutic agent, and multikinase inhibitor. Appropriate references from selected articles were also used. Data summary: This paper involves 81 articles including review articles, meta-analysis, and clinical trials which focused on every aspect of hand-foot syndrome, such as manifestation, mechanism, occurrence rate, onset time, patient education, self-monitor scale, and management. Studies were thematically divided into four parts (clinical presentation of HFS, risk stratification, initiation of pharmaceutic care, and management of the adverse reaction).

Conclusion

HFS is one of the common adverse events which was associated with many chemotherapeutic agents and multikinase inhibitor drugs. Although the mechanisms and histopathology may be different, they due share some common clinical manifestations. As part of integrated pharmaceutical care for cancer patients, it is important to conduct patient education about the risk of hand-foot syndrome and basic knowledge about hand-foot syndrome management before initiating anticancer therapy. Once hand-foot syndrome happens, evidence-based management could try. If the hand-foot syndrome is intolerable, dose reduction or discontinuation of the anticancer therapy should be considered.
Optimal depth selection of composite tubular-floor trusses based on cost estimation
Authors: AlHendi Hashem , Mahmoud Mohammad , Celikag Murude
Published: April 2021

The significance of this study initiates from the need to produce a selection guidance on the span range, span-to-depth ratio and scheme of the composite floor truss system to provide optimum performance and cost effectiveness for a particular application area. With this objective a parametric study was designed, based on three parallel chord trusses (Pratt, Howe, and Warren) using Rectangular Hollow Structural Shapes, a constant panel size of 2.5 m, four composite floor European-profiles and a range of load intensities. Hence, the span-to-depth ratios, RS/D, and dead-to-live load ratios, RDL/LL, were ranged from 3 to 27 and 0.84 to 3.22, respectively, for each truss type. The optimization was performed by using the design results of RFEM (2018) software for approximately 675 composite floor trusses with the objective of selecting optimal depth for each truss model. In addition, this paper attempts to introduce a cost function by considering the material, fabrication and painting costs and comparative figures allowing the design to be tailored with a focus on cost reduction. Accordingly, for all truss types, span-to-depth ratio of 9 to 12 with a span range of 7 to 23 m provides the most cost effective solution. Structural steel and the welding process are the two parameters that are found to have the highest impact on total cost.
Eliminating the gap between the use of assistive technologies and the inclusion of people with intellectual disabilities in leisure activities
Authors: Dratsiou Ioanna , Metaxa Maria , Romanopoulou Evangelia , Dolianiti Foteini , Spachos Dimitris , Bamidis Panagiotis D
Published: April 2021

Information and Communication Technology (ICT) tools and Assistive Technologies (AT) can support people with Down Syndrome (PDS) and Intellectual Disabilities (PID) in increasing their self-confidence and independence, enhancing skills, and competences, participating in leisure activities. For families of PDS/PID, professionals, non-formal caregivers and volunteers, the challenge is to appreciate the benefits of ICT Tools in promoting inclusion. The aim of this study is to present the interdisciplinary and multidimensional scope of the DS Leisure project aiming at promoting the inclusion of PDS/PID through innovative ICT tools and their participation in inclusive leisure activities. Particularly, 24 individuals were asked to assess the global satisfaction and performance of PDS/PID, as well as the exploitation of ICT tools. Findings suggested that PDS/PID specific social, decision-making, and communication skills were significantly improved after their participation in the Experiential Activity and the e-Training platform was positively rated and considered a constructive learning experience.
Assessment of ice impact load threshold exceedance in the propulsion shaft of an ice-faring vessel via Bayesian inversion
Authors: De Koker Nico , Bekker Anriëtte
Published: April 2021

Ice-induced impact loads on the propeller blades of vessels operating in polar waters represent a notable hazard to ship propulsion systems. Industry guidelines determine the maximum allowable ice-induced propeller moments, but these loads are not practical to measure directly. Recent studies have implemented deterministic inversion methods to determine these impact-induced moments from torque measurements on the propulsion shaft. This study considers this inversion problem from a stochastic perspective. Bayesian inversion is used, first, as a means of determining the optimal regularisation parameters, and second, as an avenue to explore the contributions to uncertainty in the inverted ice loading values due to the linear inversion model. The method is implemented for two sets of shaft-line measurements recorded on the SA Agulhas II, a polar class PC-5 research and supply vessel, via a lumped-mass model for the forward response signal. Using more sophisticated simulation results as prior information for the model uncertainty, it is shown that inverted ice-induced propeller moments around 20% below the industry guideline maximum loading of 1009.9 kN m correspond to a 1% probability of ice-induced moments exceeding this limit. This finding is significant, given the number of propeller impact events for the SA Agulhas II that approached this limit during recent voyages, and highlights the need for considering design specifications for propulsion systems in ice-faring vessels from a risk perspective.
Involvement of Male Partners of Pregnant Women in the Prevention of Mother-to-Child Transmission (PMTCT) of HIV in Haiti: A Mixed-Methods Study
Authors: Ngangue Patrice , Fleurantin Middle , Adekpedjou Rheda , Philibert Leonel , Gagnon Marie-Pierre
Published: April 2021

This mixed-methods study aimed to determine the level of male involvement in the prevention of mother-to-child transmission (PMTCT) services in Haiti and identify barriers and associated factors. From May to June 2018, a questionnaire was used to measure the level of male involvement. Semistructured interviews with pregnant women were also conducted. Multivariate linear regression and qualitative content analyses were performed to explore factors associated and barriers to male partners’ involvement in PMTCT services. One hundred and two pregnant women living with HIV completed the questionnaire. About 47% of male partners had a high level of involvement. Specifically, 90% financially supported their spouse, and 82% knew her appointment date at the antenatal clinic (ANC). Only 25% of male partners accompanied their spouse to the ANC, and 19% routinely used a condom during sexual intercourse. Factors associated with male involvement in PMTCT were being married and sharing HIV status with the male partner. Male partners with a positive HIV status were more likely to be involved in PMTCT. Qualitative findings revealed that barriers to male involvement included the conflict between opening hours of the ANC and the male partner’s schedule, waiting time at the ANC, and the perception of antenatal care as being women’s business. Overall male partners’ involvement in PMTCT services is moderate. Gender relations, sociocultural beliefs, and care organization are likely to hinder this involvement. Developing and implementing contextually and culturally accepted strategies for male partners of pregnant women could contribute to strengthening their involvement in the PMTCT program.
Cognitive impact of cerebral microbleeds in patients with symptomatic small vessel disease
Authors: Nannoni Stefania , Ohlmeier Laura , Brown Robin B , Morris Robin G , MacKinnon Andrew D , Markus Hugh S ,   for the DNA Lacunar 2 investigators
Published: April 2021

Background and aim

Whether cerebral microbleeds cause cognitive impairment remains uncertain. We analyzed whether cerebral microbleeds are associated with cognitive dysfunction in patients with symptomatic cerebral small vessel disease, and whether this association is independent of other neuroimaging markers of cerebral small vessel disease.

Methods

We analyzed consecutive patients with MRI-confirmed lacunar stroke included in DNA-Lacunar-2 multicenter study. Cerebral microbleeds were graded using the Brain Observer Microbleed Rating Scale (BOMBS). Neuropsychological assessment was performed using the Brief Memory and Executive Test (BMET). We analyzed the association between cerebral microbleeds, BMET, and the following subdomains: executive function/processing speed and orientation/memory. We also searched for an independent association between cerebral microbleeds and vascular cognitive impairment, defined as BMET ≤ 13.

Results

Out of 688 included patients, cerebral microbleeds were detected in 192 (27.9%). After adjusting for white matter hyperintensities severity, lacune count, and other confounders, both the presence and the number of cerebral microbleeds were significantly associated with impaired cognitive performance [β = −13.0; 95% CI = (−25.3, −0.6) and β = −13.1; 95% CI = (−19.8, −6.4), respectively]. On analysis of specific cognitive domains, associations were present for executive function/processing speed [β = −5.8; 95% CI = (−9.3, −2.2) and β = −4.3; 95% CI = (−6.2, −2.4), respectively] but not for orientation/memory [β = −0.4; 95% CI = (−4.0, 3.2) and β = −2.1; 95% CI = (−4.0, 0.1), respectively]. We also found an independent association between the presence and the number of cerebral microbleeds and vascular cognitive impairment [adjusted OR = 1.48; 95% CI = (1.01, 2.18) and OR = 1.43; 95% CI = (1.15, 1.79), respectively].

Conclusion

In a large cohort of symptomatic cerebral small vessel disease patients, after controlling for other neuroimaging markers of cerebral small vessel disease severity, cerebral microbleeds were associated with cognitive dysfunction. Executive function and processing speed were predominantly impaired. This might suggest a causal role of cerebral microbleeds in determining vascular cognitive impairment.
Rationale and design of a phase 3b, prospective, randomized, open label, blinded-endpoint, multicenter trial of the efficacy and safety of urokinase thrombolysis comparing with antiplatelet agents for patients with minor stroke
Authors: Zhao Lu , Jiang Chenyang , Tao Yongli , Gao Yuan , Xu Yafang , Zhang Rui , Liu Kai , Gu Hongqiu , Wang Yilong , Xu Yuming , Song Bo
Published: April 2021

Rationale

Minor ischemic stroke attack has taken a significant part of cerebrovascular disease burden. Benefits of thrombolysis in minor stroke is under debates and the use of urokinase in developing countries needs to be further explored.

Aim

TRUST (ThRombolysis of Urokinase for minor STroke) trial was designed to evaluate the efficacy and safety of intravenous urokinase for the treatment of acute minor ischemic stroke.

Sample size estimates

To reach a double-sided type I error rate of 0.05 to test our hypothesis, with β = 0.80, sample size of 1002 subjects were determined after further adjustment to account for up to 5% nonadherence.

Methods and design

TRUST trial was developed with PROBE design, as a multicenter, randomized, open label, single-blind clinical trial with the stage of phase 3b.

Study outcomes

The proportion of patients retaining full ability of independent living, which is defined as patients scoring 0–1 on modified Rankin Scale score at 90 days.

Discussion

TRUST trial may potentially provide promising and affordable thrombolysis for acute minor ischemic stroke in the developing parts of the world.
Rounding the base: A lower extremity biomechanical analysis in softball players
Authors: Schroeder Lauren E , Valenzuela Kevin A , Zhang Songning , Orme John G , Weinhandl Joshua T
Published: April 2021

Contacting the base is a common injury mechanism for base runners in softball, with ankle sprains being the most common type of injury, but it is not known how the base affects lower extremity mechanics. The purpose of this study was to analyze lower extremity biomechanics while rounding a base. Sixteen recreationally active females with previous softball experience completed two base rounding conditions. A base was securely placed on the force place for the with base (WB) condition, and an outline of the base was taped on the force plate for the no base (NB) condition. Three-dimensional right-leg hip, knee, and ankle kinematics and kinetics were measured during the stance phase of the base rounding and analyzed using statistical parametric mapping (SPM). The WB condition resulted in decreased hip abduction ( p = 0.034), increased dorsiflexion ( p = 0.012), and decreased inversion ( p < 0.001) angles. Increased hip extension ( p < 0.001) and hip abduction ( p = 0.016) moments were exhibited during the WB condition. Decreased hip abduction ( p = 0.026), ankle plantarflexor ( p < 0.001), and ankle eversion ( p < 0.001) moments were also exhibited in the WB condition. The base acts as a lateral banking surface, reducing variables associated with ankle sprains, and likely assists in propelling base runners to the next base without injury.
Application of high-flow nasal oxygenation as a rescue therapy in difficult videolaryngoscopic intubation
Authors: Lee Min Ho , Kim Hyun Joo
Published: April 2021

In difficult airway situations, the next step of the airway management method is selected according to the prior presence of difficulties in mask ventilation and endotracheal intubation. It is important for the practitioner to be calm, quick in judgment, and take action in cases of difficult intubation. Recently, high-flow nasal oxygenation has been rapidly introduced into the anesthesiology field. This technique could extend the safe apnea time to desaturation. Especially, it maintains adequate oxygenation even in apnea and allows time for intubation or alternative airway management. We report two cases in which high-flow nasal oxygenation was implemented in the middle of the induction process after quick judgment by clinicians. High-flow nasal oxygenation was successfully used to assist in prolonging the safe apnea time during delicate airway securing attempts.
The role of eHealth, telehealth, and telemedicine for chronic disease patients during COVID-19 pandemic: A rapid systematic review
Authors: Bitar Hind , Alismail Sarah
Published: April 2021

Objective

To summarize the current status of, and the current expert opinions, recommendation and evidence associated with the use and implementation of electronic health (eHealth), telemedicine, and/or telehealth to provide healthcare services for chronic disease patients during the COVID-19 pandemic.

Materials and methods

We searched four electronic databases (PubMed, Google Scholar, Science Direct, and Web of Science Core Collection) to identify relevant articles published between 2019 and 2020. Searches were restricted to English language articles only. Two independent reviewers screened the titles, abstracts, and keywords for relevance. The potential eligible articles, papers with no abstract, and those that fall into the uncertain category were read in full text independently. The reviewers met and discussed which articles to include in the final review and reached a consensus.

Results

We identified 51 articles of which 25 articles met the inclusion criteria. All included articles indicated the promising potential of eHealth, telehealth, and/or telemedicine solutions in delivering healthcare services to patients living with chronic diseases/conditions during the COVID-19 pandemic. We synthesized the main findings into ten usages and eight recommendations concerning the different activities for delivering healthcare services remotely for those living with chronic diseases/conditions in the era of COVID-19.

Discussion and conclusions

There is limited evidence available about the effectiveness of such solutions. Further research is required during this pandemic to improve the credibility of evidence on telemedicine, telehealth, and/or eHealth-related outcomes for those living with chronic diseases.
What are the implications for patient safety and experience of a major healthcare IT breakdown? A qualitative study
Authors: Scantlebury Arabella , Sheard L , Fedell Cindy , Wright J
Published: April 2021

Introduction

To explore the impact of a three-week downtime to an electronic pathology system on patient safety and experience.

Methods

Qualitative study consisting of semi-structured interviews and a focus group at a large NHS teaching hospital in England. Participants included NHS staff ( n = 16) who represented a variety of staff groups (doctors, nurses, healthcare assistants) and board members. Data were collected 2–5 months after the outage and were analysed thematically.

Results

We present the implications which the IT breakdown had for both patient safety and patient experience. Whilst there was no actual recorded harm to patients during the crisis, there was strong and divided opinion regarding the potential for a major safety incident to have occurred. Formal guidance existed to assist staff to navigate the outage but there was predominantly a reliance on informal workarounds. Junior clinicians seemed to struggle without access to routine blood test results whilst senior clinicians seemed largely unperturbed. Patient experience was negatively affected due to the extensive wait time for manually processed diagnostic tests, increasing logistical problems for patients.

Conclusion

The potential negative consequences on patient safety and experience relating to IT failures cannot be underestimated. To minimise risks during times of crisis, clear communication involving all relevant stakeholders, and guidance and management strategies that are agreed upon and communicated to all staff are recommended. To improve patient experience flexible approaches to patient management are suggested.
Limited implementation of the Nordic hamstring exercise in professional and semi-professional soccer
Authors: Al Attar Wesam Saleh A , Komir Ramy , Alzubeadi Ali , Bukhari Ibrahim , Ghulam Hussain
Published: April 2021

Background/Purpose:

In soccer players, non-contact injuries are most common, especially hamstring muscle injuries, which can be prevented by the Nordic hamstring exercise (NHE). This study assessed the professional and semi-professional soccer players and coaches’ awareness, implementation, and opinion of the NHE efficacy in reducing hamstring injuries.

Methods:

A questionnaire regarding the awareness, implementation, and opinions of the NHE’s efficacy in reducing hamstring muscle injuries was distributed.

Results:

The survey was completed by 812 (88.3% male and 11.7% female) players and coaches. Of these, 395 (48.6%) were aware of the NHE, and 355 (43.7%) implemented it in their current practice. Those implementing NHE had a positive opinion about its efficacy in reducing hamstring injuries.

Conclusion:

Further efforts and research are warranted to increase the international awareness and implementation of the NHE and educate soccer players and coaches about the importance of its implementation and effectiveness in preventing hamstring injury.
Securing Insecure Livelihoods Through Group Synergies: The Case of Violent Namatala Transboundary Wetlandin Rural Eastern Uganda
Authors: Mudondo Constance , Kabumbuli Robert , Batega Dauda Waiswa
Published: April 2021

This article uses evidence from Namatala wetland in Eastern Uganda to examine the livelihood insecurity associated with wetland conflicts and highlights the implications of group synergies in securing the related insecurities affecting access and use of the violent wetlands and livelihoods. Adopting a qualitative approach, data was generated using eight focus group discussions and 12 key informant interviews in Namatala conflict area, in Eastern Uganda. The findings reveal that the unpredictable brutal conflict actions in Namatala wetland compelled people to construct groups as informal mechanisms of navigating the insecure environments to secure livelihoods. The groups acted as a pool of labour, a means of maintaining employment, buffers against attack, financial safety valves and sources of predictive information gathering and sharing. Invoking the theory of practice, the article demonstrates that people experiencing conflicts make sense of their violent environments and devise informal group synergies as adaptive mechanisms of securing and sustaining their livelihoods.
Revision Rotator Cuff Repair Versus Primary Repair for Large to Massive Tears Involving the Posterosuperior Cuff: Comparison of Clinical and Radiological Outcomes
Authors: Meshram Prashant , Liu Bei , Kim Sang Woo , Heo Kang , Oh Joo Han
Published: April 2021

Background:

The retear rate after revision rotator cuff repair (rRCR) ranges from 50% to 90%. Patients who undergo primary RCR (pRCR) for large to massive rotator cuff tear (mRCT) also have unpredictable outcomes.

Purpose:

To compare the clinical outcomes after rRCR for a posterosuperior rotator cuff tear of any size with those after pRCR for mRCT and to identify the risk factors for poor outcomes and retear after rRCR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Among patients with posterosuperior cuff tear treated between 2010 and 2017, the clinical outcomes of 46 patients who underwent rRCR were compared with 106 patients who underwent pRCR for mRCT. Between-group differences in patient-reported outcomes (visual analog scale [VAS] for pain, VAS for satisfaction and American Shoulder and Elbow Surgeons [ASES] and Constant scores) at final follow-up were evaluated and compared with previously published minimal clinically important difference (MCID) values. Radiological outcomes were evaluated using magnetic resonance imaging or ultrasonography at a minimum 1-year follow-up. Multivariate linear regression analysis was performed to identify the risk factors for poor ASES score, and multivariate logistic regression analysis was used to assess the risk factors for retear after rRCR.

Results:

The mean follow-up was 26.4 months (range, 24-81 months). Although final VAS for pain, VAS for satisfaction, and ASES scores in the rRCR group were significantly worse than those in the pRCR group, the Constant score was similar between the groups. These differences in outcomes did not exceed the MCID threshold. The retear rate in the rRCR group was 50% compared with 39% for the pRCR group ( P = .194). In the rRCR group, risk factors for worse ASES score were retear ( P = .043; r = –11.3), lower body mass index ( P = .032; r = 1.9), and lower preoperative VAS for pain ( P = .038; r = 2.3), and risk factors for retear were preoperative high-grade fatty degeneration (Goutallier grades 3 and 4) of the supraspinatus muscle ( P = .026; odds ratio, 5.2) and serum hyperlipidemia ( P = .035; odds ratio, 11.8).

Conclusion:

Both study groups had similar clinical and radiological outcomes. Patients with symptomatic failed rotator cuff repairs having high-grade fatty degeneration of the supraspinatus muscle and/or serum hyperlipidemia had a greater likelihood of retear after rRCR.