bluuebunny/crossref_metadata_2025 huggingface dataset:
Does State Tightness-Looseness Predict Behavior and Attitudes Early in the COVID-19 Pandemic in the USA?
Authors: Gilliam Ashley , Schwartz Danielle B. , Godoy Ricardo , Boduroglu Aysecan , Gutchess Angela
Published: March 2022

We investigated how tightness-looseness, reflecting strictness of social norms, of state of residence in the USA predicts behaviors and attitudes related to COVID-19. Because individual-level tightness may better capture current attitudes during the pandemic, whereas state-level archival measures reflect historical factors, we assessed the extent to which tightness-looseness at both levels predicted adherence to public health guidelines and biases toward outgroups related to COVID-19. In Spring 2020, 544 mTurk participants, primarily from the 13 tightest and 13 loosest states, completed survey questions about health behaviors in response to COVID-19, endorsement of future policy changes, feeling of responsibility for lives, and attitudes toward groups marginalized during the pandemic (i.e., Asians, older adults). State-level results indicated some associations with attitudes toward Asians and older adults, but effects were not robust. Results based on individuals’ ratings of the tightness of their state indicated that higher levels of perceived tightness were associated with higher levels of protective self-reported public health behaviors (e.g., mask wearing, handwashing) during COVID-19, more endorsement of future policy changes to contain the pandemic, higher reported feelings of responsibility for one’s life, and stronger negative attitudes toward Asians. The relations between tightness and health outcomes persisted after controlling for political attitudes and demographics. Thus, individual, more than state, tightness-looseness accounted for some degree of public health behaviors (unique contribution of individual tightness: R2 = .034) and attitudes toward marginalized groups ( R2 = .020) early during the COVID-19 pandemic. The implications of these findings for interventions to support behavior change or combat anti-Asian bias are discussed.
Influences of Teachers’ Characteristics on Their Gender-Responsive Pedagogy Practices: The Case of General Secondary Schools of North Wollo
Authors: Abraha Mollaw , Dagnew Asrat , Seifu Amera
Published: March 2022

The study assessed the influences of science teachers’ sex and teaching experiences on their gender-responsive pedagogy (GRP) practices of general secondary schools of North Wollo Zone, Ethiopia. It used a case study design and considered science department heads and school principals, and students as data sources comprehensively and purposively, respectively. The researchers collected data via interview and focus group discussion (FGD) and analyzed them thematically. According to the findings, teachers’ sex and teaching experiences did not affect their GRP practicing status. So, it is vital to engage teachers in gender-sensitive teaching that both address students’ different learning styles and preferences.
Death and Other Losses in the COVID-19 Pandemic in Long-Term Care Facilities for Older Adults in the Perception of Occupational Therapists: A Qualitative Study
Authors: Figueiredo Carolina de S. , Giacomin Karla C. , Gual Ramon F. , de Almeida Simone C. , Assis Marcella G.
Published: March 2022

Long-term care facilities for older adults (LTCFs) were directly affected by the COVID-19 pandemic. This study aimed to discuss the perceptions of occupational therapists about deaths and other losses in LTCFs during the pandemic. This qualitative study is anchored in social phenomenology, and conducted in-depth interviews with eight occupational therapists who worked in LTCFs. Thus, two themes were generated after the Thematic Analyses: “The proximity of death” and “Losses associated with living and dying in a LTCF.” In the first theme, the interviewees addressed the feeling of imminent death in the daily life of the LTCF, and feelings related to their own death, that of their family members and other older adults. In the second, the professionals highlighted three groups of losses: social, functional, and psychological/cognitive. These results highlighted the challenges faced by occupational therapists and can contribute to improve behavior and care for institutionalized older adults during the pandemic.
Orchestrating Knowledge Networks: Alter-Oriented Brokering
Authors: Ritala Paavo , De Kort Charlotte , Gailly Benoit
Published: March 2022

In knowledge networks, such as best-practice networks, industry forums, and professional communities, members of different organizations exchange knowledge for mutual and individual benefit. When properly managed, knowledge networks enable time- and resource-constrained individuals to engage across organizational and industry boundaries. Such networks often involve deliberate orchestration by a hub actor (individual, team, or organization), often referred to as the orchestrator. Orchestration in a network of individuals is essentially a form of brokering behavior. While most previous studies of orchestration and brokerage have adopted a broker-centric perspective, the present study advances an alter-oriented account of how brokering behavior influences relationships to create knowledge-related benefits for individual network members. Drawing on interviews with 51 members of a Belgian knowledge network focusing on best practices in research and development, this study explores the orchestrator's brokering behavior and ensuing benefits for network members. Based on these findings, the study describes an integrative model of alter-oriented brokering processes that modify, intermediate, and maintain relationships among alters in orchestrated knowledge networks. The study contributes by conceptualizing alter-orientation as a distinct brokering behavior, by unpacking the microfoundations of brokering in knowledge network orchestration, and by demonstrating the dynamics between knowledge and social dimensions of knowledge network orchestration.
The feelings and coping strategies of children placed in Flemish family foster care
Authors: Van Holen Frank , Van Hove Lisa , Clé Ann , Verheyden Camille , Vanderfaeillie Johan
Published: March 2022

This article describes how 27 foster children aged 12 to 18 years old, placed in Flemish long-term family foster care, experience life in their foster family and how they cope with their feelings. Evidence from a combination of the children's selection of visual images displaying different emotions (emoticons) and semi-structured interviews shows that they mostly express positive feelings, such as happiness and pride, but simultaneously experience difficult emotions like sadness, anger and confusion. Positive feelings are mostly related to being able to feel like an ‘ordinary’ kid and negative ones to strained relationships with birth parents. Investigations into how the children cope with these emotions distinguished two groups: those who talk about their feelings with friends and other supportive figures and those who hide them. The latter group needs to be provided with strategies to better comprehend and express their feelings; among those suggested were activities that offer tranquility, consolation or distraction and having a private place for themselves. More attention to the emotional experiences of foster children and the ways they cope with their emotions is recommended in policy, practice and research if children's well-being is to be enhanced.
New Jersey Pharmacists’ Perceptions on Performing COVID-19 Testing in Community Pharmacy Practice Sites
Authors: Brust-Sisti Lindsay A. , Armanious Mark E. , Ohlinger Kelly , Patel Jainaben , Lodhia Tanvi , Sturgill Marc G. , Volino Lucio R.
Published: March 2022

Background

Point of care testing (POCT) for Coronavirus Disease 2019 (COVID-19) is a major source of its control. On May 13, 2020, NJ pharmacists were authorized to order and perform COVID-19 testing, expanding their role in the response to the COVID-19 pandemic. Objective: The purpose of this study was to evaluate NJ pharmacists’ perceptions on the safety and potential consequences of performing COVID-19 testing within their community pharmacy practice sites. Methods: An electronic survey was distributed to NJ-registered pharmacists approximately 3 months after the administrative order was issued. Results: The survey was completed by 523 recipients (3.39% response rate) and responses from 311 NJ pharmacists practicing in community pharmacy were analyzed. The majority of respondents (83.8%) were not providing testing, while 16.2% were testing at the time of survey distribution. Most testing pharmacists were staff pharmacists with one to five years of experience, working in a pharmacy chain approximately 30-40 hours per week. Those not testing identified lack of a pharmacy drive-through, insufficient staff, and potential workflow disruption as reasons for not testing. Increased workload and fear of spreading the virus to others were concerns noted by both testers and non-testers. Conclusion: Overall, NJ pharmacists reported mixed perceptions regarding performing COVID-19 testing. Challenges and barriers to pharmacist COVID-19 testing, including inadequate staffing and space, and concerns about reimbursement and disruption to workflow were identified. Findings may serve as a guide to design and implement strategies to overcome barriers.
Adaptive super-twisting control for deployment of space-tethered system with unknown boundary disturbances
Authors: Dong Zhe , Zhang Lei , Li Aijun , Wang Changqing , Shi QingSheng
Published: March 2022

This paper proposes an adaptive super-twisting control (ASTC) for the deployment of space-tethered systems with the consideration of uncertainty of external and internal disturbances with unknown boundaries. The main advantage of the ASTC scheme is that it can deal with the unknown bounds of uncertainties and disturbances. The proposed control law consists of two adaptive control gains that ensure the establishment, in a finite time, of a real second-order sliding mode. This, in turn, guarantees a convergence to a small domain and without overestimating the control gains. The stability of the control law is demonstrated theoretically. Compared with the sliding mode control algorithm with power reaching law, the newly proposed adaptive super-twisting control method performs better in the settling time, the maximum in-plane angle, and angular velocity control and suppressing oscillations. Numerical simulations are presented to validate the effectiveness and robustness of the proposed ASTC scheme.
Unraveling EPSDT and Pediatric Hospice Care: An Exploratory Policy Analysis
Authors: Lindley Lisa C , Weaver Meaghann S
Published: March 2022

Background: Medicaid is the most common of health care benefits for children at end of life. Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) presents a complex policy scenario for children enrolled in the Medicaid hospice benefit, and specifically concurrent hospice care. Objective: The study purpose was to identify policy guidance on EPSDT and pediatric hospice care from state Medicaid documents. Methods: We conducted a descriptive exploratory study, using state-level Medicaid hospice documents. Manuals, policy transmittals, provider memos, policy updates, and other related documents were searched from 50 states and the District of Columbia. We created a comprehensive data extraction tool that enabled us to identify EPSDT-specific information. The appraisal of the documents was conducted under 3 main a priori themes: definitions, function, and administration. Results: Eleven states included EPSDT in their hospice documentation. Definitions for concurrent care and palliative care were sparse and inconsistent. Four states defined medically necessary criterion. Several states did not integrate EPSDT into the hospice or concurrent care benefit, while EPSDT functioned as part of the Medicaid hospice benefit in 3 states and another 4 included it in their concurrent hospice care program. Among all the states, procedures for EPSDT program administration varied widely, including care coordination and payment. Conclusion: We found significant variation in state documents on EPSDT and pediatric hospice care. Clear guidelines and consistent standards regarding EPSDT services and how they interface with hospice, concurrent hospice care, and palliative care would improve care for children and families.
Side-to-Side Difference of Metatarsal Rotation in Normal Individuals
Authors: Duff Alexander , Tay Kae Sian , Najefi Ali-Asgar , Cullen Nicholas , Patel Shelain , Welck Matthew , Malhotra Karan
Published: March 2022

Background:

A previous study defined the normal first metatarsal pronation angle (MPA) as <16 degrees and normal α angle as <18 degrees. The primary purpose of this study was to assess the side-to-side variation in first metatarsal pronation between feet in normal individuals.

Methods:

MPA and α angles were measured on standardized coronal weightbearing computed tomography slices. Paired t tests were used to test significance of mean side-to-side differences in a population of 63 normal, asymptomatic individuals.

Results:

The mean side-to-side difference in first metatarsal pronation was 4.3 degrees (95% CI 3.3, 5.2 degrees) for MPA and 4.9 degrees (95% CI 3.8, 6.0 degrees) for α angle. The normative range for side-to-side difference was calculated as 12 degrees for MPA and 14 degrees for α angle, as defined by 2 SDs from the mean.

Conclusion:

In a cohort of normal patients, the mean difference in first metatarsal pronation between sides was approximately 4 to 5 degrees based on MPA and α angle. However, considerable variation in differences was observed. These findings may be considered when assessing first metatarsal pronation using population-based values as it may influence thresholds for identifying pathology in an individual.
Second-Hand Smoking Prevalence in Vietnamese Population Aged 15 and older: A Systematic Review and Meta-Analysis
Authors: Duc Tran Quang , Anh Le Thi Kim , Chi Vu Thi Quynh , Huong Nguyen Thi Thanh , Quang Phan Ngoc
Published: March 2022

Background:

Second-hand smoking (SHS) is associated with many health problems. However, its prevalence in the community population aged 15 years and older in Vietnam is unknown.

Objectives:

To quantify the prevalence of SHS in Vietnamese communities aged 15 and above.

Methods:

This is a meta-analysis that reviewed studies of the prevalence of SHS in Vietnam published in MEDLINE, Scopus, Pubmed and the WHO library database between 1 January 2010 and 31 December 2019. MedCalc was used to perform all the analyses, and publication bias was determined using funnel plots and Egger regression asymmetry tests. Q-test and I2 statistic were used to identify heterogeneity across studies.

Results:

There were 7 articles that met our inclusion criteria 2 surveys at the national level, 3 Cross-sectional studies and 2 Case-control studies) involving 184 921 participants. According to the meta-analysis, the overall random-effects pooled prevalence of SHS was 54.6% (95% CIs: 44.900-64.154) with a high level of heterogeneity ( P = .0001, Q = 2245.60, I2 = 99.73%). It is noteworthy that the pooled prevalence of SHS rose throughout the course of the survey years. Our research found no evidence of publication bias.

Conclusions:

Vietnam has ratified the implementation the WHO Framework Convention on Tobacco Control (FCTC) in 2004, there are still a large number of people who are adversely impacted by SHS. Given the tremendous cost that SHS imposes on health systems, our results underscore the critical need for the Vietnamese government to expedite an implementation of a set of stronger tobacco control practices, thus reducing the incidence of smoking-related illnesses and fatalities.
Study on the integrated structure/control design method of magnetorheological damper for improving vehicle posture
Authors: Deng Zhaoxue , Wei Xinxin , Li Xingquan , Zhao Shuen , Zhu Sunke
Published: March 2022

In order to achieve a good match between magnetorheological (MR) damper and vehicle Noise Vibration and Harshness (NVH) quality and improve vehicle posture while driving, an integrated design method of MR damper structure/control for vehicle vibration suppression was proposed considering the coupling effect between MR damper structure parameters and controller parameters. A controller was designed to control the damping force generated by the tapered channel MR damper. Furthermore, the damping force expression of the tapered flow mode MR damper was derived, and the damping force was introduced into the vehicle dynamics model. In order to improve the vehicle posture, an integrated structure/control platform combining response surface model, current controller and vehicle dynamics model was established. Based on integrated platform, the vehicle dynamics model and Fourier transform were adopted to extract the time-frequency characteristics of the design objective under different working conditions. In the optimization process, the damper structure was optimized by taking the time domain values as the constraints and the frequency domain values as the optimization goals. The results show that the proposed integrated design method of MR damper can obtain its global optimal structural parameters under different driving conditions. The acceleration root mean square (RMS) values and frequency domain values of vehicle were both reduced to varying degrees, achieving the purpose of improving the vehicle posture.
Pandemic journey to prestige at nursing
Authors: Calıskan Nerıman Ozge , Yalın Hayat , Eti Aslan Fatma
Published: March 2022

Respect, which is human virtue by its very nature, is a universal feeling and action. Prestige; it is expressed as being respected, valuable, and reliable. These intertwined concepts draw attention basically for nursing, in which interpersonal interactions stand out compared to other professions. Moreover, while continuing the services in a kind of mobilization environment during the pandemic process that we have been faced with since 11 March 2020 and will obviously be affected for a long time in our country, the most common sense and respectful perspectives and approaches are needed. Respectful actions and respectful practices which are also included in the scope of professional ethics are more strategically important as we experience such a mass and historical human experience in which each of us is responsible for each other's health. The reputation of nursing continues to be formed and differentiated with how this profession is perceived by members of the profession and society, influenced by various processes from past to present. In this article, the change/development of the reputation of the nursing profession during the COVID-19 pandemic period was discussed.
Novel energy absorbent composites for crashworthiness applications
Authors: Abd El-baky Marwa A , Hegazy Dalia A , Hassan Mohamad A
Published: March 2022

Glass reinforced epoxy composite tubes filled with 1, 2, 3, and 4 wt. % of HNC, MC, Al2O3, SiO2, and SiC nanofillers were fabricated using wet-wrapping process by hand lay-up and tested under quasi-static axial loadings. Crashworthiness parameters and failure modes were recorded. Results indicated that EAC and the specimens’ failure modes are dominated by the type and wt. % of the embedded nanofillers. As compared to pristine glass/epoxy tubes, an enhancement of 230.42, 243.30, 286.43, and 336.12% in the absorbed energy ( U) was attained by the addition of 1, 2, 3, and 4 wt. % of HNC, respectively. An improvement of 21.93, 87.35, 225.99, and 318.07% in U was achieved by the inclusion of 1, 2, 3, and 4 wt. % of MC, respectively. An enhancement of 17.66, 51.63, and 71.94% in U was reported by the integration of 1, 2, and 3% of nano-Al2O3. Whilst a reduction of 31.16% was noticed for 4 wt. % of nano-Al2O3. The incorporation of nano-SiO2 and nano-SiC exhibits a reduction in U of the fabricated tubes. Composites filled with 4 wt. % of HNC has the highest load carrying capacity and EAC of 32.75 kN and 1110.84 J, respectively. So, they seem to be the best appropriate choice for energy absorbing elements. Glass/epoxy composite tubes filled with HNC, MC, and Al2O3 show outstanding energy absorption characteristics. However, specimens filled with SiO2 and SiC nanofillers are ineffective in the crashworthiness applications.
Distal Bypass Versus Infrageniculate Endovascular Intervention for Chronic Limb-Threatening Ischemia
Authors: Kim Young , Decarlo Charles S. , Thangappan Karthik , Zacharias Nikolaos , Mohapatra Abhisekh , Dua Anahita
Published: March 2022

Chronic limb-threatening ischemia (CLTI) carries a high risk of amputation and warrants urgent intervention. CLTI involving the infrageniculate vessels, in particular, carries a considerably higher risk of major limb amputation. Open surgical bypass is the historical gold standard for the treatment of tibial arterial disease; however, endovascular therapy provides an attractive alternative in this high-risk patient population. In this article, we review the existing literature regarding distal bypass and infrageniculate endovascular intervention in patients with CLTI.
Improved firefly algorithm–extended Kalman filter–least-square support-vector machine voltage sag monitoring and classification method based on edge computing
Authors: Liu Zhu , Qiu Xuesong , Wang Yonggui , Zhang Shuai , Li Zhi
Published: March 2022

Aiming at the hardware reusability, multi-service carrying capacity, and computing resource limitations of edge devices, a light-weight voltage sag monitoring and classification method based on improved firefly algorithm optimization, extended Kalman filter, and least-square support-vector machine is proposed. The strategy of linearly decreasing inertia weight is introduced to optimize the state error of the extended Kalman filter algorithm and the measurement noise covariance matrix to achieve accurate monitoring of voltage sags. Extract characteristic quantities such as average value, duration of sag, minimum sag dispersion characteristics, number of sag phases, and flow direction of disturbance energy. As a model training data set, the least-square support-vector machine method optimized based on the improved firefly algorithm is used to create a multi-level classification model of voltage sag source to realize the classification of voltage sag sources. This method fully considers the influence of the limited resources of edge computing equipment on the algorithm, and effectively improves the use of computing resources by improving the optimization algorithm. Simulation and experimental results show that this method is suitable for edge computing equipment to monitor and distinguish voltage sags.
Complications Following Endoscopic and Open Trigger Finger Release: A Retrospective Comparative Study
Authors: Mirza Ather , Mirza Justin , Thomas Terence L. , Zappia Luke , Abulencia Jacob
Published: March 2022

Background:

Open trigger finger release (OTFR) and endoscopic trigger finger release (ETFR) are effective methods in treating stenosing tenosynovitis. However, a paucity of literature exists comparing the techniques. This study describes and compares postoperative complications following OTFR and ETFR at a single institution.

Methods:

Patients undergoing trigger finger release between 2018 and 2020 within a single institution were identified. Electronic medical records were reviewed for patient demographics, surgical history, surgical characteristics, and clinical outcomes. Major and minor postoperative complications were assessed. Secondary outcome measures included tourniquet time and procedure time. Statistical analysis evaluated associations between postoperative complications, surgical technique, patient demographics, and surgical characteristics.

Results:

In total, 57 patients (80 digits) were included in the study: 42 digits treated with OTFR and 38 digits treated with ETFR. Mean follow-up time was 57.6 ± 69.0 days (range, 7-307 days) for ETFR and 34.2 ± 26.3 days (range, 6-120 days) for OTFR. Overall, major, and minor complication rates for the cohort were 8.8%, 1.8% and 7.0%, respectively. There were no major complications following ETFR and 1 following OTFR (4%), the isolated case being postoperative Chronic regional pain syndrome. Minor complication rates were similar following OTFR (8%) and ETFR (6%). Persistent digit stiffness and swelling were found to be the most prevalent minor complications (n = 2, respectively), followed by wound dehiscence (n = 1). Female patients were significantly more likely to experience postoperative complications.

Conclusions:

Major complications following trigger finger release are unlikely; however, minor complications are prominent. Patients treated with OTFR and ETFR showed similar postoperative complication rates. Continued investigations into the benefits of ETFR are warranted.
An institutional report of heparin induced thrombocytopenia type II in aneurysmal subarachnoid hemorrhage patients
Authors: Li Boyi , Sursal Tolga , Martinez Erick , Karimov Zafar , Feldstein Eric , Stein Alan , Cooper Jared , Hosein-Woodley Rasheed , Liu Aiden , McIntyre Matthew , Bowers Christian , Hanft Simon , Hafeez Zeeshan , Pisapia Jared , Muh Carrie , Tyagi Rachana , Mayer Stephan A. , Gandhi Chirag D. , Al-Mufti Fawaz
Published: March 2022

Background

Heparin induced thrombocytopenia Type II (HIT-II) is a dangerous thromboembolic complication of heparin therapy. The current literature on incidence and outcomes of HIT-II in aneurysmal subarachnoid hemorrhage (aSAH) patients remains sparse.

Objective

We report our institution's incidence and outcomes of HIT-II in aSAH patients.

Methods

We performed a retrospective cohort study at an academic medical center between June 2014 and July 2018. All patients had aSAH confirmed by digital subtraction angiography. Diagnosis of HIT-II was determined by positive results on both heparin PF4-platelet antibody ELISA (anti-PF4) and serotonin release assay (SRA).

Results

204 patients met inclusion criteria. Seven patients (7/204, 3.5%) underwent laboratory testing, three of whom met clinical criteria. HIT-II incidence was confirmed in two of these seven patients (2/204, 0.98%), who had high BMI and T4 scores.

Conclusion

Our institution's report of HIT-II incidence in aSAH patients is lower than previously reported in this population and more closely parallels HIT-II incidence in the general and surgical ICU setting. Widely-accepted American College of Chest Physicians (ACCP) clinical diagnostic criteria in conjunction with anti-PF4 and SRA testing is the gold standard of clinical diagnosis of HIT-II in aSAH patients.
Post-prognostics decision-making strategy for load allocation on a stochastically deteriorating multi-stack fuel cell system
Authors: Zuo Jian , Cadet Catherine , Li Zhongliang , Berenguer Christophe , Outbib Rachid
Published: March 2022

This work proposes a load allocation decision strategy based on deterioration prognostics information for multi-stack fuel cell systems. The fuel cell deterioration is characterized by the overall resistance value, as it carries the key aging information of a fuel cell. The fuel cell deterioration dynamics is then modeled as an increasing stochastic process whose trend is a function of the fuel cell output power. Combining system deterioration and fuel cell consumption, a multi-objective optimization (MOO) based decision-making strategy is proposed to manage the operation of a multi-stack fuel cell system. Based on this algorithm, the optimal operating power load is computed for each stack. Finally, the performance of the proposed approach is compared to the case without post-prognostics decision for a three-stack fuel cell system. The simulation results show that the proposed post-prognostics decision-making strategy can manage fuel cell system operating in real time by scheduling the optimal load allocation among stacks.
Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study
Authors: Dieckmann Klaus-Peter , Pokrivcak Tomas , Geczi Lajos , Niehaus David , Dralle-Filiz Inken , Matthies Cord , Dienes Tamas , Zschäbitz Stefanie , Paffenholz Pia , Gschliesser Tanja , Pichler Renate , Mego Michal , Bader Pia , Zengerling Friedemann , Heinzelbecker Julia , Krausewitz Philipp , Krege Susanne , Aurilio Gaetano , Aksoy Cem , Hentrich Marcus , Seidel Christoph , Törzsök Péter , Nestler Tim , Majewski Matthaeus , Hiester Andreas , Buchler Tomas , Vallet Sonia , Studentova Hana , Schönburg Sandra , Niedersüß-Beke Dora , Ring Julia , Trenti Emanuela , Heidenreich Axel , Wülfing Christian , Isbarn Hendrik , Pichlmeier Uwe , Pichler Martin
Published: March 2022

Introduction:

Clinical stage 1 (CS1) nonseminomatous (NS) germ cell tumors involve a 30% probability of relapse upon surveillance. Adjuvant chemotherapy with one course of bleomycin, etoposide, and cisplatin (1xBEP) can reduce this risk to <5%. However, 1xBEP results are based solely on five controlled trials from high-volume centers. We analyzed the outcome in a real-life population.

Patients and Methods:

In a multicentric international study, 423 NS CS1 patients receiving 1xBEP were retrospectively evaluated. Median follow-up was 37 (range, 6–89) months. Primary end points were relapse-free and overall survival evaluated after 5 years. We also looked at associations of relapse with clinico-pathological factors using stratified Kaplan–Meier methods and Cox regression models. Treatment modality and outcome of recurrences were analyzed descriptively.

Results:

The 5-year relapse-free survival rate was 96.2%. Thirteen patients (3.1%; 95% confidence interval, 1.65–5.04%) relapsed after a median time of 13 months, of which 10 were salvaged (77%). Relapses were mostly confined to retroperitoneal nodes. Three patients succumbed, two to disease progression and one to toxicity of chemotherapy. Pathological stage >pT2 was significantly associated with relapse rate.

Conclusion:

The relapse rate of 3.1% found in this population of NS CS1 patients treated with 1xBEP at the routine care level was not inferior to the median rate of 2.3% reported from a meta-analysis of controlled trials. Also, the cure rate of relapses of 77% is consistent with the previously reported rate of 80%. This study clearly shows that the 1xBEP regimen represents a safe treatment for NS CS1 patients.
The EU’s mutual defence clause? Article 42(7) of the Treaty on European Union
Authors: Virkkunen Henna
Published: March 2022

The article discusses Article 42(7) of the Treaty on European Union and the principle of mutual defence in general in the EU. Most EU member states base their defence policy around NATO, and thus, there has historically been little appetite to create new overlapping structures for mutual defence. However, during recent years, interest in the further operationalisation and clarification of Article 42(7) has arisen, with the European Parliament and member states such as Finland and France at the forefront of these demands. While the EU’s mutual defence is not going to replace or overtake NATO as the cornerstone of Europe’s security order, further developing the Common Security and Defence Policy and the EU’s mutual defence policy would be beneficial for Europe as a whole.
Berberine Is a Promising Alkaloid to Attenuate Iron Toxicity Efficiently in Iron-Overloaded Mice
Authors: Aalikhani Mahdi , Alikhani Mehrdad , Jahanshahi Mehrdad , Elyasi Leila , Khalili Masoumeh
Published: March 2022

Iron toxicity in iron-overloaded conditions, including high iron diet and blood transfusion, causes deleterious effects on vital organs. There currently are a number of chemical chelators in clinics to reduce iron concentration, for example , deferoxamine and deferiprone, but these produce diverse side effects. Hence, the need for a safe and effective iron chelator is demanded. To evaluate rigorously the potential of berberine on iron chelation and its anti-oxidant effect, 30 mice were divided into 5 groups of 6. Except for the control group, other groups received iron sucrose 5 times a week for 4 successive weeks as an i.p injection. Afterward, either berberine or deferoxamine was injected for 1 month. The mice were then euthanized and liver, kidney and lungs were carefully removed for biochemical and pathological analysis. In comparison with the iron group with an extraordinary amount of iron deposits, berberine (20 mg/kg/day) dramatically reduced iron sedimentation in all tissues ( P < 0.01). Moreover, berberine lowered clinical symptoms of iron overdose, including inflammation, fibrosis and tissue degeneration. In terms of the activity of antioxidant enzymes, catalase and superoxide dismutase, iron overdose greatly reduced their activity compared to the control group. Berberine progressively increased their activity in comparison with the controls by lowering oxidative conditions ( P < 0.05). Iron overdose similarly increased lipid peroxidation by increasing the level of malondialdehyde. Berberine promptly suppressed lipid peroxidation in an efficient manner and reduced the level of malondialdehyde, a marker of lipid peroxidation in the tissues. Accordingly, berberine, as a natural antioxidant compound, could adequately serve as a substitute for chemical chelators with fewer side effects and comparable effectiveness.
Injury Trends for School Rugby Union in Ireland: The Need for Position-specific Injury-prevention Programs
Authors: Leahy Therese M. , Kenny Ian C. , Campbell Mark J. , Warrington Giles D. , Purtill Helen , Cahalan Roisin , Comyns Thomas M. , Harrison Andrew J. , Lyons Mark , Glynn Liam G. , O’Sullivan Kieran
Published: March 2022

Background:

Concern has been raised over the injury risk to school Rugby union (Rugby) players and the potential long-term health consequences. Despite the increase in studies for this cohort, the influence of playing position on injury incidence and presentation is unclear.

Purpose:

To describe the incidence, nature and severity of match injuries for school Rugby in Ireland overall, and as a function of playing position.

Study Design:

Prospective cohort study.

Methods:

Data were collected from 15 male (aged 16-19 years) school Senior Cup teams across 2 seasons. In total, 339 players participated in season 1, whereas 326 players participated in season 2. Injury data were recorded onto a bespoke online platform. Match exposure was also recorded.

Results:

The incidence rate of match injuries (24-hour time loss) was 53.6 per 1000 hours. Across both seasons, 6810 days were lost from play due to injury. Forwards (65.4 per 1000 hours) sustained significantly more ( P < 0.05) injuries than backs (40.5 per 1000 hours). The head, shoulder, knee, and ankle were the most common injured body regions; however, forwards sustained significantly more ( P < 0.05) head and shoulder injuries than backs. The tackle was responsible for the majority of injuries in both groups. The highest proportion of injuries occurred during the third quarter.

Conclusion:

Clear differences in injury presentation and incidence were evident when comparing forwards versus backs. The high rate of head and shoulder injuries in the forwards suggest the need for more targeted injury-prevention strategies and further research on education and laws around the tackle event. The spike of injuries in the third quarter suggests that fatigue or inadequate half-time warm-up may be a contributing factor warranting further exploration.

Clinical Relevance:

This study demonstrates clear differences in injury presentation according to playing position in school Rugby and highlights the need for a more tailored approach to the design and implementation of injury-prevention strategies.

Level of Evidence:

Level 3
Severe Case of Oral Baclofen Withdrawal Resulting in Mechanical Ventilation
Authors: Khanal Resha , Oli Sharad , Chan Gomez Janet , Tahir Sahar , Bhandari Binita , Komanduri Saketram
Published: March 2022

Abrupt baclofen withdrawal may be life-threatening with varied neuropsychiatric manifestations. We present a case of baclofen withdrawal necessitating intubation. A 58-year-old female with a history of undiagnosed muscle spasticity presented with worsening extremities tremors, paresthesia, and weakness for 2 days. Initial vitals included temperature 103 F, tachycardia, hypertension, and tachypnea. Examination revealed coarse tremors of all extremities. Inflammatory markers, blood, and urine culture were negative. Head and spine imaging were non-diagnostic. Meningitis and seizure were ruled out. She continued worsening with hallucinations, hyperpyrexia, ocular clonus, and profound muscle rigidity. The patient was intubated for respiratory distress and transferred to intensive care unit (ICU). Further history revealed running out of oral baclofen 3 days ago. Baclofen was restarted with symptomatic improvement. The patient was extubated after 2 days and discharged to a rehabilitation facility. Oral or intrathecal baclofen is thought to inhibit spinal nerves reducing muscle spasm and pain. Abrupt stoppage causes activation of dopamine and noradrenergic receptors causing muscle spasms, tremors, hyperpyrexia, delusions, hallucination, and delirium. Severe cases can mimic meningoencephalitis, seizure disorder, or neuroleptic malignant syndrome. Symptoms usually develop in 1 to 3 days of cessation and can be life-threatening if unrecognized timely. Treatment includes supportive therapy, re-administration of baclofen, or use of benzodiazepines, propofol, dexmedetomidine; however, no specific guidelines have been established. To the knowledge of the authors, this is the first case of oral baclofen withdrawal requiring intubation. We found only 3 reported cases of intrathecal baclofen withdrawal necessitating intubation.
Is early mobilization necessary in isolated rotator cuff repair? Results of a prospective series of 1,200 cases
Authors: Dufournier Benjamin , Schlur Charles , Collin Philippe
Published: March 2022

Objectives:

Non-healing of rotator cuff tears is estimated to be between 5 and 20%. Rehabilitation protocols vary. Some advocate early rehabilitation. The aim of the study was to verify whether rapid recovery of mobility was not associated with a higher rate of non-healing.

Methods:

We conducted a single-center prospective study. The primary inclusion criterion was first-line arthroscopic repair of an isolated complete cuff tear without retraction (Patte 1) or fatty degeneration (Goutallier - less than 2). It was the same surgeon, the same surgical technique (double row) and the same rehabilitation protocol (self-mobilization, hands together). Patients were seen again by an evaluator other than the surgeon. We analyzed passive elevation and external rotation (ER1) mobility and pain at 6 weeks, 3 months, and 6 months, active mobilities at 3 months and 6 months, and the Constant score at 6 months. Tendon healing was assessed at six months by ultrasound according to Sugaya’s classification (grouping 1/2/3 healed and 4/5 unhealed).

Results:

1,200 patients were included, 101 were excluded (lost to follow-up or missing data at one of the reviews). The healing rate was 85.7%. We noted a statistically significant difference between the healed and unhealed groups for passive elevation at 6 weeks (128° vs 142° p <0.0001), passive ER1 (23°/32°, p <0.0001). As well as at 3 months for passive elevation (149°/155°, p = 0.0005) for ER1 (43°/48°, p = 0.0008). No difference in pain between the 2 groups (at each review) nor in the final Constant score (72.3 vs 70.2)

Conclusion:

Patients with poorer passive joint mobility at 6 weeks and 3 months postoperatively had a better healing rate at 6 months. This clear correlation is an indication that we should reflect on the earliness of rehabilitation after rotator cuff repair.
Speed of recovery after rotator cuff surgery: definition and predictive model
Authors: Billaud Anselme
Published: March 2022

Objectives:

The speed of recovery after rotator cuff surgery is variable, poorly studied and has no precise definition. However, it is one of the questions often asked by our patients. It allows us to plan the postoperative follow-up and to determine whether sick leave is necessary.

Methods:

The objective of the study was to define the speed of recovery after rotator cuff surgery and to analyze the predictive factors. Prospective longitudinal follow-up of 135 rotator cuff surgery patients. Patients who missed one of the 3 scheduled appointments in the first 6 months were excluded. Patients were evaluated by Constant (CS), Quick-Dash (QD), SSV, VAS pain and VAS satisfaction scores. A regression model was used to estimate the speed of recovery (VITESS) for each patient expressed in CS points/month. Predictive factors included demographic, psychological, socio-professional, radiographic and surgical data.

Results:

107 patients were included, 65 men and 42 women with a mean age of 55 years. The mean VITESS was 22 CS points/month (4.61 ± 12) which corresponds to a mean theoretical time of 2.7 months (1.15) to recover 60 CS points. Positive predictive factors were age >65 years, male gender, regular sports and a low preoperative QD score. Negative predictive factors were anxiety, sick leave (SL), a high QD score, suture involving the supraspinatus (SSP) and significant postoperative pain. The final multivariate model included SSP suture, QD, SL, and age >65 years (p <0.0001, R2 = 40).

Conclusion:

Recovery rate can be measured in CS points/month. This intuitive definition reflects the variability in patient recovery time. With a simple 4-parameter model, the consequences of a procedure can be estimated.
Race, Gender, and Networks: How Teachers’ Social Connections Structure Access to Job Opportunities in Districts With School Choice
Authors: Jabbar Huriya , Boggs Rachel , Childs Joshua
Published: March 2022

Research in sociology demonstrates the way social connections shape access to information about job opportunities. In education, we understand less about how social networks impact the job process for marginalized teachers and teachers in nontraditional labor markets. This study examines how teachers in New Orleans and Detroit, cities with high concentrations of charter schools, use their networks to search for jobs, and how their experiences vary by race and gender. We find that in choice-rich environments, there was an extensive reliance on social networks in the hiring process, and teachers had different access to key social networks that can help to land jobs. Hiring decisions and unequal access to job opportunities among teacher candidates, in part due to the reliance on networks, created conditions where teachers who cultivated stronger networks, or with access to the “right” networks, had greater opportunity, with implications for racial and gender equity and diversity.
Agreement in anterior segment measurements between swept-source and Scheimpflug-based optical biometries in keratoconic eyes: a pilot study
Authors: Chalkiadaki Evangelia , Gartaganis Panos S. , Ntravalias Thomas , Giannakis Ioannis , Manousakis Evangelos , Karmiris Efthymios
Published: March 2022

Background:

Cataract surgery in keratoconic patients is challenging because of the corneal distortion, which can lead to inaccurate keratometry readings. This study is a comparison of the accuracy of keratometry readings by two types of devices in a tertiary hospital.

Purpose:

To evaluate the comparability of corneal power measurements, anterior chamber depth (ACD), and white-to-white (WTW) distance between Scheimpflug-based tomography (Pentacam AXL; OCULUS GmbH, Wetzlar, Germany) and swept-source optical biometry (IOLMaster 700; Carl Zeiss Meditec AG, Jena, Germany) in patients with keratoconus.

Methods:

This pilot, prospective, interinstrument reliability study included 30 keratoconic eyes of 15 individuals who had not undergone any kind of corneal surgery. Standard K and total refractive power (TK®) of the flattest and steepest axes of the IOLMaster 700 were compared with the standard keratometry (SimK), true net power (TNP), equivalent keratometer readings (EKR), and total corneal refractive power (TCRP) of the Pentacam. The Bland–Altman analysis was used to evaluate the agreement between the measurements of both devices. The paired-samples t-test and the Wilcoxon signed-rank test were performed to compare the mean values of the variables obtained with the devices.

Results:

The K1 value of the IOLMaster 700 was significantly higher from EKR K1 along the 3-mm (mean difference: 0.79 diopters, p = 0.01), 4-mm (mean difference: 1.01 D, p = 0.01), and 4.5-mm zones (mean difference: 1.20 D, p = 0.01) and TNP K1 along the 3-mm (mean difference: 0.88 D, p < 0.001) and 4-mm zones (mean difference: 0.97 D, p < 0.001). The TK1 value was significantly higher from EKR K1 along the 2-mm (mean difference: 0.42 D, p = 0.04), 3-mm (mean difference: 0.83 D, p = 0.003), 4-mm (mean difference: 1.05 D, p = 0.004), and 4.5-mm zones (mean difference: 1.24 D, p = 0.005) and TNP K1 along the 3-mm (mean difference: 0.92 D, p < 0.001) and 4-mm zones (mean difference: 1.01 D, p < 0.001). The K2 value of the IOLMaster 700 was significantly higher from TK2 (mean difference: 0.11 D, p = 0.04) and all the corresponding variables of the Pentacam device. The TK2 value was significantly higher from all the corresponding variables of the Pentacam device. The Pentacam also yielded significantly lower values for the WTW distance (mean difference: 0.31 mm, p < 0.001) and no significant difference in terms of ACD values ( p = 0.9).

Conclusion:

The IOLMaster measured significantly greater keratometry readings in the steep axis for all the variables studied. The keratometry and WTW measurements of the investigated devices cannot be used interchangeably in keratoconus.
Making Sense of Sustainability: How Institutional Design Can Sustain Informal Savings and Credit Groups
Authors: Tan Sarah , Savani Manu Manthri
Published: March 2022

A majority of people in developing countries lack access to formal finance and rely on community-organised groups. These savings and credit associations (SCAs) face challenges in overcoming well-known collective action problems. SCA financial products can be understood as a common pool resource. Drawing on Ostrom’s (1990) design principles for self-governing local institutions, we investigate the conditions under which SCAs can achieve sustainability. Using a qualitative methodology, data were collected by examining administrative records and interviewing stakeholders from three SCAs in the Philippines. Our results indicate that adherence to the design principles is positively associated with SCA sustainability. We find that pre-existing social connections are not a necessary condition for initial adherence to the design principles but social capital may play an important role in sustainability overall. These findings contribute to our understanding of how governance design can boost the sustainability of informal groups and enhance financial inclusion among the poor.