bluuebunny/crossref_metadata_2025 huggingface dataset:
Social-communicative gestures at baseline predict verbal and nonverbal gains for children with autism receiving the Early Start Denver Model
Authors: Laister Dominik , Stammler Magdalena , Vivanti Giacomo , Holzinger Daniel
Published: March 2021

In children with autism spectrum disorder, atypical gesture use is a core deficit with consequences for social learning, social interaction, and language development. Little is known about the relevance of early gesture use in predicting developmental outcomes of children receiving early interventions targeting social-communicative behaviors such as the Early Start Denver Model. We found that the parent-rated “Gestural Approach Behavior” subscale of the Pervasive Developmental Disorder Behavior Inventory was predictively associated with developmental changes after 1 year of intervention as assessed by the Mullen Scales of Early Learning. This subscale was as strong a predictor as the Mullen nonverbal development quotient before intervention. Our findings suggest that children who use more gestures for social communication might be better equipped to respond to the learning opportunities offered by the Early Start Denver Model.

Lay abstract

Although there is growing evidence of the effectiveness and importance of certain early intervention programs for children with autism spectrum disorders, little is known about predictive information before intervention to search for the most accurate therapeutic approach for the individual child and his family. In children with autism spectrum disorder, atypical gesture use is one core deficit with consequences for the development of social interaction and language, but there is little knowledge about the relevance of early gesture use in predicting developmental outcomes of children receiving early interventions targeting social-communicative behaviors such as the Early Start Denver Model. In this study, we found that the parent-rated “Gestural Approach Behavior” subscale of the Pervasive Developmental Disorder Behavior Inventory was predictively associated with clinically assessed developmental changes after 1 year of intervention. This subscale was as strong a predictor as nonverbal development before intervention. Our findings suggest that children who use more gestures in daily life might be better equipped to respond to learning opportunities offered by early interventions targeting social communication strategies such as the Early Start Denver Model. Furthermore, we conclude that the parent-rated questionnaire might be a valuable and economic set of questions with high relevance for clinical assessments.
‘I guess girls can be more emotional’: Exploring the complexities of sextual consent with young people
Authors: Meehan Claire
Published: March 2021

Often focusing on permission to act or not to act, debates about sexual consent are multifaceted and enduring. The pervasive presence of digital technology in young people’s lives has added new complexities to ‘sextual’ consent. Drawing on qualitative small friendship group interview data with school-aged young people in Aotearoa New Zealand, this article provides insights into their understandings of consent surrounding the creation and sharing of intimate images. Through navigating the nuances of sextual consent, young people are forming their own informal norms and expectations. These informal norms are strengthened by competitive masculinity which disadvantages young women at all stages of the process, resulting in gendered harms and victim blaming. Many young people expressed views that unsafe sexting, in terms of pressure, coercion to produce the image, the image being shared without consent and the resulting fall out, could be avoided with an enhanced programme of digital literacy. While digital literacy has merit, it should not be at the expense of conversations around gender, power and culture, desire, victimisation, or how young people from different socio-cultural backgrounds navigate these relations.
National identity and beliefs about historical linguicide are associated with support for exclusive language policies among the Ukrainian linguistic majority
Authors: Chayinska Maria , Kende Anna , Wohl Michael J. A.
Published: March 2021

We examined the idea that endorsement of state-level restrictive language policies can be understood as an ingroup-preserving behaviour driven by majority group members’ experiences of linguistic-based collective angst (i.e., concern about the future vitality of the ingroup’s language). We did so in the context of legislative reform aimed to enforce monolinguistic public education in Ukraine – a linguistically heterogeneous nation-state with a history of a foreign ethno-political domination. Specifically, we hypothesized that collective angst is most likely to be experienced when majority group members feel higher attachment to Ukraine (vs. glorification) and shared beliefs about historical linguicide of the Ukrainian language. Using data from a public opinion survey ( N = 774), we found support for the mediation model – higher attachment and beliefs about historical linguicide predicted increased support for restrictive policies directly and through collective angst, whereas glorification was found to be a non-significant predictor in this relation. Our results highlight the role of the specific content of protagonists’ social identities in predicting their support for cultural assimilation of ethnic minority groups within heterogeneous societies.
Comparing relations of ethnic-racial public regard, centrality, and intergroup contact attitudes among ethno-racially diverse adolescents
Authors: Wantchekon Kristia A. , Umaña-Taylor Adriana J. , McDermott Elana R. , Sladek Michael R. , Rivas-Drake Deborah , Agi Abunya C. , Satterthwaite-Freiman Megan
Published: March 2021

The current cross-sectional study examined how adolescents’ appraisal of how positively others viewed their ethnic-racial group (i.e., public regard) and how integral their ethnic-racial background was to their self-concept (i.e., centrality) related to their intergroup contact approach and avoidance attitudes. Participants were Black, Latinx, and White high school students ( N = 2,609; Mage = 16.39, SD = 1.16; 52% female) from the U.S. Southwest and Midwest. Utilizing multigroup structural equation modeling, results indicated that across all ethnic-racial backgrounds, and regardless of geographical context, public regard was positively associated with approach attitudes. Conversely, findings for avoidance attitudes varied by ethnic-racial background. Specifically, public regard was negatively associated with avoidance attitudes for White adolescents, whereas this relation was null for Black and Latinx adolescents. Additionally, although centrality was positively associated with avoidance attitudes among all adolescents, the relation was stronger among White adolescents than among Black and Latinx adolescents.
The case of the disappearing bullet: An extraluminal compression of the biliary tree
Authors: Mihalik M , Allopi N
Published: March 2021

Penetrating abdominal injuries, especially from gun shot wounds, are a common occurrence in South African hospitals, and a vast majority of these patient receive surgical intervention for suspected intra-abdominal injuries. Not all bullets are found and removed however, and we detail the case of a gentleman who presented to our institution with obstructive jaundice secondary to an extraluminal compression of his biliary tree by a retained migrated bullet, that spontaneously resolved, without any surgical intervention.
Falls downstairs: The impact on a UK major trauma centre
Authors: Callon Joshua , Thomas Daniel , Mercer Simon J
Published: March 2021

Introduction

Major trauma centres are increasingly managing a significant injury burden in older patients, with falling downstairs being a prevalent mechanism of injury. Literature evaluating the impact of falls on stairs upon UK trauma networks is limited. Gaining a greater understanding of this may allow for more effective planning of services and improvements in training and education. This study evaluates the impact of falls downstairs on a UK major trauma centre.

Methods

A single centre retrospective service evaluation of local major trauma data over a 3-year period from 01/01/2017 to 31/12/2019. Included were patients who activated a trauma call whose mechanism of injury recorded at the time of admission was a fall downstairs. We excluded patients less than 16 years of age.

Results

There were 4480 major trauma patients who presented in the study period and of these, 860 (19.2%) sustained injuries following a fall downstairs. The most common age group presenting was 70–79 years; younger patients (<60 years) made up 43.3% with the majority (56.7%) being older. All but one patient were managed by a consultant-led trauma team, 6.4% of patients were admitted to critical care and 1% received an urgent operation. The overall mortality rate was 8.5%. Older patients made up 85% of those who died and had nearly four times longer average length of stay than younger patients (9.69 v 2.49 days).

Conclusion

Falls downstairs place a significant burden on the major trauma centre. There is a stark contrast in the use of hospital resources and outcomes between older and younger patients.
Familiarity and participation outside home for persons living with dementia
Authors: Margot-Cattin Isabel , Kühne Nicolas , Öhman Annika , Brorsson Anna , Nygard Louise
Published: March 2021

Familiarity is important for persons living with dementia who participate outside home. When familiarity is challenged, such participation may be difficult. This ethnographic study clarifies how familiarity is experienced by persons with dementia in performing activities and visiting places, and how familiarity contributes to maintaining participation outside home. Nine participants were interviewed in their home and while visiting familiar places. Data were content analysed using a constant comparative method. The findings suggest that persons with dementia experience familiarity as continuous and whole, through occurrences that support personal territories. Landmarks and objects enhance the experience of familiarity. Familiarity that is continuously challenged may render participation outside home fragile.
Evaluating quality of life and well-being at the intersection of dementia care and creative engagement
Authors: Kenning Gail , Visser Mandy
Published: March 2021

Increasingly, art and design projects are used in dementia care settings to support the well-being of people living with dementia. However, the way well-being is defined and evaluated varies significantly in reporting. This study briefly examines the development of the concept of well-being and how it is intertwined with concepts of health and quality of life. It presents a scoping review of studies that use art and design to support the well-being of people living with dementia. We examined the characteristics and methodologies of the studies, how well-being is understood and operationalized, and how the outcomes are reported. The aim of this study was to understand whether there is any consistency in how well-being and related terminology are understood, the methodologies used, how projects are evaluated, the assessment tools used, and in what outcomes and implications are discussed. Results showed well-being and related terminology are used to reference the social, physical, states of mind and feelings, and in opposition to identified deficits. There was no consistent approach to how arts engagement for well-being in the dementia care space is carried out and evaluated. However, this study suggests that this is not necessarily problematic across arts engagement activities for well-being, providing the use of terminology and approaches, and means of evaluation are consistent and retain integrity within the design of individual projects. It suggests that well-designed projects provide frameworks that are able to take into account the many variables in relation to art and creativity and dementia care, and can offer transferability.
The 2017 French riots and trust in the police: A quasi-experimental approach
Authors: Nägel Christof , Lutter Mark
Published: March 2021

On 2 February 2017, French police officers brutally abused a young black man, leading to the first wave of 2017 French riots. The present study exploits the coincidence that the focal event occurred during the survey period of the European Social Survey (ESS) 2016 (11 November 2016 – 11 March 2017) in France, thus providing the basis for a natural experiment on the effect of media reporting on police misconduct on trust in the police. Data are analysed by means of a regression discontinuity design (RDD) as well as more conventional regression analyses with heteroscedasticity robust standard errors. In line with procedural justice theory as well as institutional theory, the present study finds support for the notion that this special case of police misconduct did decrease trust in the police. In addition, people reporting a migrant background showed even less trust in the police after the event. Frequency of different media consumption does not appear to explain the deterioration of trust in the police after the event. The results of this study increase the internal and external validity of the assumption that trust in the police can be explained not only by personal experiences but also by the perceived unfair treatment of others. Results are robust to various placebo tests. There is some evidence that the effect seems to be short-lived, although the data basis is limited in this regard. Several fruitful approaches for future studies are discussed.
Icelandic Prevention Model for Rural Youth: A Feasibility Study in Central Appalachia
Authors: Kristjansson Alfgeir L. , Davis Stephen M. , Coffman Jessica , Mills Rosalina
Published: March 2021

The purpose of this study was to assess the feasibility of implementing the Icelandic model for Primary Substance Use Prevention (IPM) in rural Central Appalachia. Guided by the IPM’s theoretical framework, 26 stakeholders from a single county in West Virginia were purposefully recruited during the spring of 2019 and divided into four focus groups. Interviews were recorded and transcribed verbatim and analyzed into themes based on IPM premises. Focus group material produced seven themes: Drug use overall, Drug treatment and other service needs, Poverty, Parenting/Caregiver practices, Transportation, Downtime/Leisure time activities, and Opportunities for solutions. General support was found for the potential of the IPM in the region. Preferably, the implementation of the model should coincide with attention to the adult population as drug use was reported to be plaguing the whole community. Treatment options were few and mostly far away. General poverty and lack of public transportation further stifled progress and potential for change. Organized leisure time activities and programs for youth were scarce and mostly seasonal. Suggested solutions for the adult community included workforce and skill training, coupled with increased opportunities for organized leisure activities for youth, and access to healthy role models via schools and faith-based organizations. We conclude that implementation of the IPM would be feasible to prevent substance use initiation and progression among youth in the rural Central Appalachia. We present several specific recommendations for policy and practice that address factors unique to this environment to initiate the IPM implementation development and suggest initial model application strategies.
Microstructure and physical properties of composite nonwovens produced by incorporating cotton fibers in elastic spunbond and meltblown webs for medical textiles
Authors: Sikdar Partha , S Bhat Gajanan , Hinchliffe Doug , Islam Shafiqul , Condon Brian
Published: March 2021

The objective of this research was to produce elastomeric nonwovens containing cotton by the combination of appropriate process. Such nonwovens are in demand for use in several healthcare, baby care, and adult care products that require stretchability, comfort, and barrier properties. Meltblown fabrics have very high surface area due to microfibers and have good absorbency, permeability, and barrier properties. Spunbonding is the most economical process to produce nonwovens with good strength and physical properties with relatively larger diameter fibers. Incorporating cotton fibers into elastomeric nonwovens can enhance the performance of products, such as absorbency and comfort. There has not been any study yet to use such novel approaches to produce elastomeric cotton fiber nonwovens. A hydroentangling process was used to integrate cotton fibers into produced elastomeric spunbond and meltblown nonwovens. The laminated web structures produced by various combinations were evaluated for their physical properties such as weight, thickness, air permeability, pore size, tensile strength, and especially the stretch recovery. Incorporating cotton into elastic webs resulted in composite structures with improved moisture absorbency (250%-800%) as well as good breathability and elastic properties. The results also show that incorporating cotton can significantly increase tensile strength with improved spontaneous recovery from stretch even after the 5th cycle. Results from the experiments demonstrate that such composite webs with improved performance properties can be produced by commercially used processes.
Children’s Carbon Cultures
Authors: Hickey-Moody Anna , Cutter-Mackenzie-Knowles Amy , Rousell David , Hartley Sophie
Published: March 2021

In this article, we examine the connection between how we imagine carbon, energy and energy futures, and carbon use. We argue that to act on climate change we must reframe our cultural understanding carbon. Where children have often been left out of discussions of carbon use, we bring children into these conversations about carbon consumption and imaginaries through examining contemporary perspectives on posthumanism and energy cultures. We demonstrate that children’s imaginative renderings of possible climate change solutions offer an effectively very different way of connecting with climate change, perhaps a more motivating and inspiring means of relating to the more than human world and reworking our entanglements with energy cultures.
Sounding out the hidden data: A concise review of deep learning in photoacoustic imaging
Authors: DiSpirito Anthony , Vu Tri , Pramanik Manojit , Yao Junjie
Published: March 2021

The rapidly evolving field of photoacoustic tomography utilizes endogenous chromophores to extract both functional and structural information from deep within tissues. It is this power to perform precise quantitative measurements in vivo—with endogenous or exogenous contrast —that makes photoacoustic tomography highly promising for clinical translation in functional brain imaging, early cancer detection, real-time surgical guidance, and the visualization of dynamic drug responses. Considering photoacoustic tomography has benefited from numerous engineering innovations, it is of no surprise that many of photoacoustic tomography’s current cutting-edge developments incorporate advances from the equally novel field of artificial intelligence. More specifically, alongside the growth and prevalence of graphical processing unit capabilities within recent years has emerged an offshoot of artificial intelligence known as deep learning. Rooted in the solid foundation of signal processing, deep learning typically utilizes a method of optimization known as gradient descent to minimize a loss function and update model parameters. There are already a number of innovative efforts in photoacoustic tomography utilizing deep learning techniques for a variety of purposes, including resolution enhancement, reconstruction artifact removal, undersampling correction, and improved quantification. Most of these efforts have proven to be highly promising in addressing long-standing technical obstacles where traditional solutions either completely fail or make only incremental progress. This concise review focuses on the history of applied artificial intelligence in photoacoustic tomography, presents recent advances at this multifaceted intersection of fields, and outlines the most exciting advances that will likely propagate into promising future innovations.
Computational prediction of small molecules with predicted binding to FGFR3 and testing biological effects in bone cells
Authors: Mohan Subburaman , Muthusamy Karthikeyan , Nagamani Selvaraman , Kesavan Chandrasekhar
Published: March 2021

Activating anabolic receptor-mediated signaling is essential for stimulating new bone formation and for promoting bone healing in humans. Fibroblast growth factor receptor (FGFR) 3 is reported to be an important positive regulator of osteogenesis. Presently, recombinant proteins are used to stimulate FGFR3 function but have limitations for therapy due to expense and stability. Therefore, there is a need for identification of novel small molecules binding to FGFR3 that promote biological function. In silico molecular docking and high-throughput virtual screening on zinc database identified seven compounds predicted to bind to an active site within the βCʹ-βE loop, specific to FGFR3. All seven compounds fall within an acceptable range of ADME/T properties. Four compounds showed a 30–65% oral absorption rate. Density functional theory analysis revealed a high HOMO-LUMO gap, reflecting high molecular stability for compounds 14977614 and 13509082. Five compounds exhibited mutagenicity, while the other three compounds presented irritability. Computational mutagenesis predicted that mutating G322 affected compound binding to FGFR3. Molecular dynamics simulation revealed compound 14977614 is stable in binding to FGFR3. Furthermore, compound 14977614, with an oral absorption rate of 60% and high molecular stability, produced significant increases in both proliferation and differentiation of bone marrow stromal cells in vitro. Anti-FGFR3 treatment completely blocked the stimulatory effect of 14977614 on BMSC proliferation. Ex vivo treatment of mouse calvaria in organ culture for seven days with 14977614 increased mineralization and expression levels of bone formation markers. In conclusion, computational analyses identified seven compounds that bind to the FGFR3, and in vitro studies showed that compound 14977614 exerts significant biological effects on osteogenic cells.
Innovation at a Children’s Hospital: Personal Protective Equipment Efforts During the Pandemic
Authors: Opfermann Justin , Dayal Anuradha , Abo Alyssa , Thatcher Emily , Salvador Tyler , Eskandanian Kolaleh , McLeese Raven , Cleary Kevin R
Published: March 2021

The COVID-19 pandemic has affected life for everyone, and hospitals, in particular have been hard hit. In this study, we describe our efforts to develop personal protective equipment at a children’s hospital early in the pandemic. We convened an innovation working group to organize our efforts and respond to the rapidly changing situation. We describe our work in four areas: (1) plexiglass shields for the emergency department, (2) face shields for clinical providers, (3) breath shields for ophthalmology, and (4) flip-up safety glasses for nurses. The hospital’s supply chain is now caught up with addressing many pandemic-related shortages. Nevertheless, through our multidisciplinary approach to reacting to the pandemic’s urgent needs, we demonstrated agility to bring stakeholders together to maximize the use of scarce resources and build resiliency. We believe this method can be rapidly replicated as future needs arise.
Regulatory scenario of pharmaceutical advertisement in India, USA and Australia: A comparative study
Authors: Budhwar Vikas , Hussian Tarif , Choudhary Manjusha , Saini Garima
Published: March 2021

Advertisements are essential for sustaining growth and economic development in a world for all kinds of industries. Drug development is a protracted process and a risky business. For new product entry in the market, advertising has a noteworthy positive impact. But some pharmaceutical products advertising specially branded products is controversial and doubtful to advertisement regulations. Advertising is an important asset for any industry to reach new consumers with faith in existing consumers forms over a decade. As per the regulatory perspective in pharmaceutical advertising which is much more than advertising in the serious sense of words itself. The different county has a different legislative framework for protects consumer and company rights. Administrative bodies and lawmakers limit the possibilities of advertising for better achievements. This study emphasizes the regulatory outline of pharmaceutical advertisements in India, USA and Australia.
Effect of educative reminder telephone calls on human papillomavirus immunization rate: A randomized controlled trial
Authors: Bernard-Genest Marie-Pier , Ruel-Laliberté Jessica , Lapointe-Milot Korine
Published: March 2021

Context:

Human papillomavirus coverage varies widely among women depending on their race, incomes, geographical location and education level.

Objective:

To evaluate whether reminder educative phone calls increase human papillomavirus vaccination rates in adult women aged 18–45 with high-risk factors of cervical cancer.

Design:

We conducted a single-blind randomized controlled trial in patients who consulted at a Canadian tertiary center in October 2019 during National Cervical Cancer Awareness Week.

Interventions:

We randomized women to receive three standardized educative phone calls or standard care.

Main outcome measure:

We assessed the immunization rate at 6 months.

Results:

A total of 130 patients were randomized of which 62 patients were randomized to the intervention. Eight patients (15.4%) got immunized at 6 months in the intervention group as compared to seven (11.7%) in the control group (p = 0.5645). The main barrier to vaccination reported by non-immunized patients at 6 months was the cost of vaccination (42.3%).

Conclusion:

Reminder educative phone calls did not increase human papillomavirus vaccination rates in adult women with risk factors of cervical cancer. ISRCTN registration number: ISRCTN58518971
Continuity in Discontinuity: The Recurrent Motif of Cultural Autonomy in the Development of Czech Sociology of Culture
Authors: Skovajsa Marek
Published: March 2021

This article analyses the development of the sociology of culture in Czechia. Its focus is on the sociology of the arts and cultural sociology, which, it is argued, are connected through the notion of the relative autonomy of cultural structures. While the Czech sociology of culture may have been rendered less dynamic by the lack of a critical mass of sociologists specialising in this area and by the country’s frequent political upheavals and its isolation from the international circulation of ideas, it has experienced moments of considerable vitality. Three periods in the development of the field are identified here, each of them marked by a movement toward a stronger and more sociologically adequate conceptualisation of cultural autonomy: (1) from the diffuse culturalism of the field’s founding figures to the functionalist theory of the interwar sociologist Inocenc Arnošt Bláha, whose view of the relationship between art and society was influenced by the work of the Prague School of Structuralism; (2) from the cultural reductionism of Marxist-Leninist theory after 1948 to the eclectic sociology of culture and the arts of the late socialist period; (3) from the demise of this transitional form of a sociology of culture in the 1990s to the increasingly internationalised but also heterogeneous landscape of the 2010s, which is constituted by a semi-institutionalised centre of cultural sociology at Brno and small groups or individuals in Prague and other academic locales. The thread of continuity in an otherwise discontinuous historical development is found in the recurrent motif of the relative autonomy of culture which the Czech sociology of culture absorbed through its exposure to art and literary theory.
Perioperative and anaesthetic considerations of marijuana use
Authors: Everett Lauren , Foley Adam J , Scholl Adam T , Petrovic Michelle A
Published: March 2021

The psychoactive substance cannabis is the most-commonly used drug around the world, and its use is becoming more prevalent globally. Additionally, it is becoming available in an increasing variety of forms. As such, it is imperative that perioperative practitioners have an understanding of the drug, its effects, and its implications in perioperative care. There is currently a lack of a standardised approach to a patient who uses cannabis, and prospective studies prove difficult given the current legal status of cannabis. This literature review seeks to provide information regarding cannabis and its use. Specifically, we explore the systemic effects of marijuana as well as perioperative and anaesthetic implications so that safer, more effective care may be administered.
Predisposing Factors for 30-Day Complications Following Leg Amputation
Authors: Villarreal Joseph V. , Hussien Doha G. , Panchbhavi Vinod K. , Jupiter Daniel C.
Published: March 2021

Background

Although amputation rates, morbidity, and mortality have been established for select populations, the impact of general demographic factors on postoperative surgical complications remains little studied.

Methods

The American College of Surgeons’ National Surgical Quality Improvement Program database was searched for leg amputations from 2012 to 2017 using CPT codes 27881, 27882, 27884, and 27886, identifying 4162 patients. A total of 29 demographic variables with 4 complications (surgical infection, additional service, and deep-vein thrombosis [DVT], and sepsis) were analyzed.

Results

Preoperative open, contaminated, or dirty/infected wounds; longer intraoperative times; development of sepsis prior to surgery; and admission of patients from home or another hospital influenced postoperative infection rates. Preoperative open, infected, or dirty/infected wounds; height; weight; total length of hospital stay; and ethnicity affected postoperative additional service incidence. Preoperative congestive heart failure, large decreases in body weight, and total length of hospital stay influenced postoperative DVT rates. Preoperative functional heath status, total length of hospital stay, amputations conducted as emergency cases, preoperative acute renal failure, open or infected wounds, sepsis, and contaminated or dirty/infected wounds affected postoperative sepsis rates.

Background

Conclusion. Understanding these risk factors may allow providers to anticipate and address higher rates of complications in certain patient populations.

Level of evidence:

Level III: Prognostic
Patient experiences of integrated care within the United Kingdom: A systematic review
Authors: Davidson Lea , Scott Jason , Forster Natalie
Published: March 2021

Introduction

Integrated care and patient experience are central to the coordination and delivery of high quality health and social care in the UK, but their joint application is poorly understood. This systematic review aimed to gain an understanding of patient experience within current integrated care services in the UK, and specifically, whether they reflect person-centred coordinated care (PCCC).

Methods

Following PRISMA, electronic databases (ProQuest, EBSCO and Cochrane Library) were searched from 2012 to 2019 for primary, peer-reviewed literature. Papers were included where patients’ or carers’ experiences of integrated care were reported. Papers were excluded where they focused on acute integrated care interventions, measured experience via satisfaction scores only, or findings lacked sufficient depth to answer the research question. Quality was assessed using Mixed Methods Appraisal Tool, and findings synthesised using a framework approach, incorporating the Rainbow Model of Integrated Care and Measuring Integrated Care Patient Framework.

Results

Sixteen studies were included. Person-centred and shared responsibility experiences were most often discussed. Experiences were not always described as positive and some patients experienced a lack of PCCC. Clinical, professional/organisational and functional integration processes were associated with experiencing domains of PCCC.

Discussion

People with complex needs experience a lack of coordination across teams and wider community resources, and limited associations were made between integration processes and patient experience. Further research which gives context to individual experience, provides greater detail of integration processes and utilises validated patient experience measures of PCCC is required to understand the association between integration processes and domains of PCCC.
Detecting COVID-19 and other respiratory infections in obstructive sleep apnoea patients through CPAP device telemonitoring
Authors: Pépin Jean-Louis , Bailly Sébastien , Borel Jean-Christian , Logerot Sophie , Sapène Marc , Martinot Jean-Benoît , Lévy Patrick , Tamisier Renaud
Published: March 2021

Objective

The earliest possible detection of individuals with COVID-19 has been essential to curb the spread of infection. Existing digital tools have been scaled up to address this issue. Every night telemonitoring data on continuous positive airway pressure (CPAP) device use, the first-line therapy for obstructive sleep apnoea (OSA), is collected worldwide. We asked whether the changes in CPAP adherence patterns of might constitute an alert for COVID-19.

Methods

We analysed preliminary results of telemonitoring data, recorded between February 1 and April 30, 2020, on OSA patients followed by our sleep clinics and diagnosed with COVID-19.

Results

CPAP telemonitoring data from the first 19 patients diagnosed with COVID-19 showed a clear decrease or halt in adherence in the 20 days immediately preceding COVID-19 diagnosis compared to an earlier period (p < 0.01).

Conclusion

Patterns of continuous positive airway pressure device use by obstructive sleep apnoea patients collected through telemonitoring can indicate the onset of COVID-19 symptoms. Existing telemonitoring platforms could be immediately used to screen for COVID-19, and for other respiratory infections, in this large at-risk population.
CEO Temporal Focus and Corporate Philanthropy: The Moderating Role of Ownership
Authors: Nguyen Luu Thi , Chen Shouming , Kwan Ho Kwong
Published: March 2021

This study examines the association between CEO temporal focus and corporate engagement in philanthropy, and considers the moderating role of ownership. This association is investigated based on upper echelons theory and the conceptual framework of temporal focus. Using a sample of 2,285 observations of Chinese listed firms from 2010 to 2015, our results show that the relationship between CEO past focus and corporate philanthropy is positive in state-owned firms but negative in private firms. In addition, CEO future focus is negatively associated with charitable activities in state-owned firms, but positively associated with such activities in private companies. For present-oriented CEOs, the relationship between temporal focus and philanthropy is negative in both public and private firms, but the negative effect is stronger in private firms. The findings of this study show how CEOs’ time perspectives shape their decisions on company engagement in philanthropic projects.
Engendering Political Labour: Findings from a Kerala Village
Authors: Ajay Anamika
Published: March 2021

Literature on Indian politics has largely under-examined the role of the family in shaping party politics with the exception of the studies on dynasticism. There is a paucity of research that looks at the complex ways in which intimate lives and party politics are intertwined. This article contributes to the existing feminist analyses of Indian party politics by conceptualizing politics and political labour in a way that does not exclude the role of the family. It presents the case study of a village in northern Kerala, which has been witnessing heightened political conflicts to show how personal experiences and family disputes get politicized. As domestic and political spheres bleed into each other, political parties become hugely dependent on feminine ideals and women’s everyday labour, affects and sociality to survive electoral competitions. Yet, the patriarchal family and masculinized local party leadership use gender ideologies to celebrate hypermasculine political participation, undervalue women’s labour and limit their political aspirations.
Plasma D-dimer level is associated with clinical outcomes in patients with atrial fibrillation related acute ischemic stroke after pneumonia
Authors: Yang Xu , Lu Taoli , Qu Zhanli , Zhang Yi , Liu Pingping , Ma Ying
Published: March 2021

Background

Pneumonia is related to poor prognosis in acute ischemic stroke (AIS), and its risk might be higher in atrial fibrillation (AF) related AIS with elevated plasma D-dimer. The aim of our study was to investigate the prognostic value of D-dimer for predicting clinical outcome of AF-related AIS with pneumonia.

Method

AF-related AIS patients with pneumonia were prospectively enrolled. Receiver operating characteristic (ROC) curve was used to determine the optimal D-dimer point for 3-month mortality and death/severe disability. The associations between the D-dimer and 3-month mortality and death/severe disability were assessed by multivariable logistic regression analysis.

Results

A total of 415 patients were enrolled in this study. ROC curve analysis showed that the optimal cut point of D-dimer for 3-month death/severe disability and mortality were D-dimer≥2.35 mg/l and D-dimer≥3.35 mg/l, respectively. Multivariable logistic regression analysis showed that D-dimer≥2.35 mg/l [adjusted odds ratio (aOR) 5.99, 95% confidence interval (CI): 3.04–11.83, P<0.001], higher NIHISS score (aOR:1.53, 95% CI: 1.38–1.69, P<0.001) and larger infarct volume (aOR 1.01, 95% CI: 1.01–1.02, P<0.001) were associated with increased risk of 3-month death/severe disability), and anticoagulant was associated with decreased risk of death/severe disability (aOR:0.21, 95% CI: 0.09–0.47, P<0.001). Higher NIHISS score (aOR:1.64, 95% CI: 1.38–1.94, P<0.001), older age (aOR 1.08, 95% CI: 1.02–1.14, P = 0.007), D-dimer≥3.35 mg/l (OR 8.49, 95% CI: 4.13–17.84,P<0.001), larger infarct volume (aOR 1.02, 95% CI: 1.00–1.03, P = 0.014), and higher CRUB-65 score (aOR 6.43, 95% CI: 3.10–13.34, P<0.001) were associated with increased risk of 3-month mortality.

Conclusions

AF-related AIS patients with concurrent high D-dimer and pneumonia increased risk of 3-month mortality and death/severe disability, plasma D-dimer may have predictive value in outcome after AF-related AIS with pneumonia.
Placental glucose transporter 1 and 3 gene expression in Monochorionic twin pregnancies with selective fetal growth restriction
Authors: Chang Yao-Lung , Chao An-Shine , Chang Shuenn-Dyh , Cheng Po-Jen
Published: March 2021

Background

In monochorionic twin (MC) gestations with selective fetal growth restriction (FGR), the discordant fetal growth usually is due to unequal placental sharing. Glucose, which is essential for oxidative metabolism in the growing placenta and fetus, is transferred from maternal blood by facilitated carrier-mediated diffusion via glucose transporters (GLUTs). How the GLUTs expression varies in the two placenta territories manifests discordant perfusion in MC twin pregnancy with selective FGR is unknown. This study evaluates the human placental GLUT1 and GLUT3 gene expression in MC twin gestations with selective FGR.

Methods

MC twin pregnancy with selective FGR was defined as the presence of inter-twin birth weight discordance of > 25% and the smaller twin with a birth weight less than the 10th percentile in third trimester. Fetal umbilical artery Doppler was checked within 1 week before delivery in the two fetuses. An abnormal umbilical artery Doppler was defined as persistently absent or reverse end-diastolic flow (UA-AREDF). GLUT1, GLUT3 and HIF-1α gene expression were assayed in each twin’s placental territories. The inter-twin placental gene expression ratio was calculated as the placenta GLUTs or HIF-1α expression level of the selective FGR twin divided by expression level of the appropriate-for-gestational-age (AGA) cotwin. Higher gene expression ratio means elevated gene expression in the selective FGR twin’s placenta territory compared to AGA twin’s placenta territory.

Results

15 MC twin gestations with selective FGR including nine with normal (group 1) and six with abnormal selective FGR twin UA Doppler (group 2) were included into this study. The GLUT3 and HIF-1α gene expression are significantly elevated in selective FGR twin’s placenta territory in group 2 twin pregnancies (mean gene expression ratio as 2.23 and 1.65, p values as 0.015 and 0.045, respectively), but not in in group 1 twin pregnancies.

Conclusion

The upregulation of placental GLUT3 gene expression in selective FGR fetus with abnormal UA Doppler may be due to hypo-perfusion which is mediated by up -regulation of HIF-1α gene expression.
Increasing the spectrum of white matter diseases with tigroid pattern on MRI: glutaric aciduria type 1 – case report
Authors: Bekiesinska-Figatowska Monika , Duczkowski Marek , Duczkowska Agnieszka , Taybert Joanna , Krzywdzinska Amanda , Sykut-Cegielska Jolanta
Published: March 2021

Background

Most white matter diseases present on magnetic resonance imaging as focal or diffuse T2-hyperintensities. However, in a few of them, radially oriented stripes of low (relatively normal) signal intensity are observed within diffusely affected T2-hyperintense cerebral white matter and are called “tigroid pattern” in the literature. The fornix is a tiny white matter fibers bundle playing crucial role in cognitive functioning, easily overlooked on magnetic resonance imaging and not described in inborn errors of metabolism.

Case presentation

We present a case of glutaric aciduria type 1 with a follow-up of over nine years. The course of the disease is presented in three magnetic resonance scans at the age of 8 and 21 months, and 10 years, with diffusion restriction in the fornix in scan 1 and 2 and with tigroid pattern in scan 3. Despite appropriate diet and supplementation, injury of white matter progressed achieving diffuse stage with tigroid pattern. Psychological tests revealed deficits in patient’s specific cognitive skills, most likely related to damage to the fornix.

Conclusions

To our knowledge, this is the first report of tigroid pattern of white matter involvement in glutaric aciduria type 1 and the first report of forniceal injury in this disease which seems to be correlated with patient’s low functioning in all kinds of memory skills, previously not reported in glutaric aciduria type 1.
Impacts of injury severity on long-term outcomes following motor vehicle crashes
Authors:   On behalf of the FISH Investigators, Hung Kevin K. C. , Kifley Annette , Brown Katherine , Jagnoor Jagnoor , Craig Ashley , Gabbe Belinda , Derrett Sarah , Dinh Michael , Gopinath Bamini , Cameron Ian D.
Published: March 2021

Background

There is growing evidence that a range of pre-injury, injury related and post-injury factors influence social and health outcomes across the injury severity spectrum. This paper documents health related outcomes for people with mild, moderate and severe injury after motor vehicle crash (MVC) injuries in New South Wales, Australia.

Methods

This inception cohort study followed 2019 people injured in MVCs, for 6 and 12 months post-injury. We categorised moderate injury as hospital length-of-stay (LOS) of 2–6 days and Injury Severity Score (ISS) of 4–11, while severe injury as LOS ≥7 days or ISS ≥ 12. We examined differences in paid work status, 12-Item Short Form Survey (SF12), EQ-5D and World Health Organisation Disability Assessment Schedule II (WHODAS) outcomes longitudinally from baseline to 12 months between levels of injury severity using linear mixed models for repeated measures. We first considered minimally sufficient adjustment factors (age, sex, crash role, perceived danger in crash, pre-injury health, pre-injury EQ-5D, recruitment source), and then more extensive adjustments including post-injury factors. The presence of mediating pathways for SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) via post-injury factors was evaluated.

Results

Based on hospital length of stay (LOS), 25 and 10% of participants sustained moderate and severe injuries, respectively, while 43 and 4% had these injuries based on ISS. Twelve months post-injury LOS ≥7 days versus ≤1 day was associated with an estimated 9 units lower mean SF12 PCS using a minimally sufficient adjustment model, and LOS ≥ 7 days was associated with a 3 units lower mean SF12 MCS score. Mediation analyses (LOS ≥ 7 days vs ≤1 day) found for SF12 MCS outcomes, effects of injury severity were small and mostly indirect (direct effect − 0.03, indirect effect − 0.22). Whereas for SF12 PCS outcomes the effect of having a more severe injury rather than mild were both direct and indirect (direct effect − 0.50, indirect effect − 0.38).

Conclusions

Individuals with severe injuries (those with LOS ≥ 7 days and ISS 12+) had poorer recovery 12 months after the injury. In addition, post-injury mediators have an important role in influencing long-term health outcomes.

Trial registration

Australia New Zealand Clinical trial registry identification number - ACTRN12613000889752.
Modifiable and non-modifiable epidemiological risk factors for acne, acne severity and acne scarring among Malaysian Chinese: a cross-sectional study
Authors: Say Yee-How , Heng Anna Hwee Sing , Reginald Kavita , Wong Yi Ru , Teh Keng Foo , Rawanan Shah Smyrna Moti , Sio Yang Yie , Ng Yu Ting , Matta Sri Anusha , Pang Sze Lei , Chew Fook Tim
Published: March 2021

Background

Acne vulgaris, a highly prevalent multifactorial inflammatory skin disease, can be categorised into different severity and scarring grades based on the type, number, and severity of lesions. While many epidemiology studies have investigated the risk factors for acne presentation, fewer studies have specifically studied the risk factors for acne severity and scarring. Therefore, this study investigated the prevalence of acne, acne severity and scarring grades, and their associated non-modifiable and modifiable epidemiological risk factors among Malaysian Chinese.

Methods

A total of 1840 subjects (1117 cases/723 controls) completed an investigator-administered questionnaire as part of a cross-sectional study, which include socio-demographics, familial history, lifestyle factors, dietary habits, and acne history. Acne cases were further evaluated for their severity (n = 1051) and scarring (n = 1052) grades by a trained personnel.

Results

Majority of the acne cases (up to 69%) had mild acne or Grade 1/2 scarring, while 21.6% had moderate/severe acne and 5.5% had Grade 3/4 scarring. Males had significantly higher risk of presenting with higher grades of acne scarring. Those who had acne, regardless of severity and scarring grades, had strong positive familial history (either in parents and/or sibling). Frequent consumption (most or all days) of foods that are commonly consumed during breakfast (butter, probiotic drinks, cereals and milk) decreased the risk for acne presentation and higher acne scarring, while periodic consumption (once/twice per week) of nuts and burgers/fast food decreased the risk for higher acne severity. Alcohol drinking was significantly associated with increased risk for acne presentation, while paternal, parental and household smoking were associated with reduced risk of more severe acne.

Conclusions

In conclusion, positive familial history is a strong predisposing factor in influencing acne presentation, severity and scarring. Frequent consumption of foods that are commonly consumed during breakfast is protective against acne presentation.