bluuebunny/crossref_metadata_2025 huggingface dataset:
Gonococcal endocarditis: A rare manifestation of a common disease in the COVID-19 era
Authors: Kavalier Meredith , Fiedler Amy , Urban Andrew
Published: May 2021

Gonococcal infections have been increasing worldwide and in the United States. Rarely, Neisseria gonorrhoeae can cause disseminated disease, including endocarditis. We present a case of gonococcal endocarditis, confirmed by blood cultures and 16S rRNA sequencing on excised valvular tissue. Prior to presentation with heart failure, our patient was asymptomatic. Most gonococcal infections are diagnosed through routine screening of individuals at risk. During the COVID-19 pandemic, healthcare contact for nonurgent complaints has decreased, and test kit shortage has been a factor. With increased incidence and decreased opportunities for screening, healthcare providers should be aware of rising gonococcal infections, as well as potential complications.
AGR Challenge for Bharti Airtel and Vodafone Idea
Authors: Anand Manoj , Singh Jagandeep
Published: May 2021

In 2018, India had 1.2 billion subscribers, and it was the second largest telecommunications market in the world. The industry had witnessed the emergence, ascendency, and dominance of private sector players during the last two decades. The telecom sector was characterized by a growing wireless user base and Internet subscriber base. The dwindling average revenue per user (ARPU) in the mobile telephony segment and the declining average cost to subscriber per GB of data were manifestations of the intense rivalry in the sector which had led to price wars among incumbent players. The Supreme Court of India’s judgement on Adjusted Gross Revenue (AGR) in October 2019 obligated the industry players to pay ₹1,470 billion as payment towards their licence fee and spectrum usage charges. Vodafone Idea and Bharti Airtel, two leading players, collectively owed 60% of the aforementioned liability. Declining revenue had already squeezed the profitability and liquidity of these companies. The AGR liability augmented their challenges.
Weight perception and symptoms of depression in rural Australian adolescents
Authors: Skidmore Samuel , Hawke Catherine , Luscombe Georgina , Hazell Philip , Steinbeck Katharine
Published: May 2021

Objective

To investigate associations between measured and perceived weight, and symptoms of depression in rural Australian adolescents.

Method:

At baseline a prospective rural adolescent cohort study collected demographic data, measured weight and height, weight self-perception, and presence of depression (Short Mood and Feelings Questionnaire). Using World Health Organisation’s (WHO) age and gender body mass index (BMI) standardisations, participants were classified into four perceptual groups: PG1 healthy/perceived healthy; PG2 overweight/perceived overweight; PG3 healthy/perceived overweight; and PG4 overweight/perceived healthy. Logistic regression analyses explored relationships between these groups and symptoms of depression.

Results:

Data on adolescents ( n = 339) aged 9–14. PG1 contained 63% of participants, PG2 18%, PG3 4% and PG4 14%. Across the cohort, 32% were overweight and 13% had symptoms of depression. PG2 (overweight/perceived overweight) were more likely to experience symptoms of depression than PG1 (healthy/perceived healthy; Adjusted Odds Ratio [AOR] 3.1, 95% CI 1.5–6.7). Females in PG3 (healthy/perceived overweight) were more likely to experience symptoms of depression (38%) than males (14%) and females in PG1 (10%, AOR 5.4, 95% CI 1.1–28.2).

Conclusions:

Results suggest that perceptions of being overweight may be a greater predictor for symptoms of depression than actual weight. This has public health implications for youth mental health screening and illness prevention.
Reflections on how to approach early career psychiatrist roles and challenges
Authors: Looi Jeffrey C L , Finlay Angus J F , Heard Daniel S
Published: May 2021

Objective:

To reflect upon and provide experiential advice to address the roles of early career psychiatrists. The main roles include leading patient care; working in teams; clinical supervision and governance of trainees, and of the psychiatrist by clinical directors/managers. While these roles vary across public and private sectors, the discussion focuses on common elements.

Conclusions:

The first several years of an early career psychiatrist’s work often involves roles for which formal training cannot provide direct guidance, and which benefit from planning and reflective practice. Learning how to navigate clinical care, clinical supervision and governance, formal/informal mentoring and peer review are necessary to effective practice.
An Evaluation of the Effect of Catheter-Directed Continuous Infusion of Local Anesthetic by Elastomeric Pump on Opioid Usage Following Donor Kidney Nephrectomy
Authors: Goldsby Jessica , Schwarz Kerry , Kim Ike , Lewis Victor , Lyda Clark
Published: May 2021

Background

Postoperative pain management following donor nephrectomy can prove challenging for immediate discharge on postoperative day 1 or 2. Although the standard for pain control is utilization of opioids, this increases the risk of postoperative ileus and, if continued inappropriately, increases excess opioids circulating in the community. One strategy that proposes to limit postoperative opioids in kidney donors is the continuous infusion of local anesthetics (CILA), though the effect on patient outcomes is unclear.

Objective

The purpose of this study was to evaluate the effectiveness of postoperative CILA to decrease opioid usage in kidney donors who undergo laparoscopic nephrectomy.

Methods

A retrospective analysis was conducted of kidney donors who underwent laparoscopic nephrectomy and received CILA (CILA group) compared with kidney donors who received standard-of-care (SOC) postoperative analgesia. The primary outcome was the mean total oral morphine equivalents (OMEs) administered following surgery.

Results

A total of 176 kidney donors were evaluated, 88 in each group. The mean OME administered in the CILA group was significantly higher than in the SOC group: 194.8 versus 133.5 mg ( P = 0.003). Mean total postoperative administration of acetaminophen was also increased in the CILA group: 3736.9 versus 2611.6 mg ( P = 0.0041). Mean length of stay following surgery was higher in the kidney donors who received CILA, whereas return to bowel function, time to ambulation, and pain scores were not significantly different.

Conclusion and Relevance

This report demonstrated that CILA is not an effective modality to reduce opioid utilization or improve recovery in kidney donors following laparoscopic nephrectomy.
Can biosimilar products be interchangeable? Pharmaceutical perspective in the implementation of biosimilars in oncology
Authors: Soares José Cleberson Santos , Cavalcanti Iago Dillion Lima , Vasconcelos Juliana Lúcia de Albuquerque
Published: May 2021

Objective

To evaluate the safety in the interchangeability of biosimilar products approved for cancer treatment from a pharmaceutical perspective.

Methods

A literature review was carried out using the descriptors “Biosimilar”, “Oncology Therapy”, “Interchangeable drugs” and “Biological Products”, in the Sciencedirect, MEDLINE, and CAPLUS databases.

Results

Fifty-one articles were selected, which addressed the importance of establishing standards that prove the efficacy and safety of biosimilars with reference products, as well as the growing interest of the pharmaceutical industry in the development of biosimilars and the impact on costs and changes in the perspective of the treatment of cancer patients.

Conclusions

As they are large and complex molecules, it is impossible to obtain identical copies of their reference products, which generates conflicts and concerns on the part of the pharmaceutical class regarding the safety in the interchangeability of these products, highlighting the importance of pharmacovigilance in this process.
Effects of Automated Messages on Internet Users Attempting to Access “Barely Legal” Pornography
Authors: Prichard Jeremy , Wortley Richard , Watters Paul A. , Spiranovic Caroline , Hunn Charlotte , Krone Tony
Published: May 2021

With the increasing number of individuals accessing online child sexual exploitation material (CSEM), there is an urgent need for primary prevention strategies to supplement the traditional focus on arrest and prosecution. We examined whether online warning messages would dissuade individuals from visiting a honeypot website purporting to contain barely legal pornography. Participants ( n = 419) seeking the site were randomly assigned to one of five conditions; they went straight to the landing page (control; n = 100) or encountered a warning message advising of the potential harm to viewers ( n = 74), potential harm to victims ( n = 65), ability of police to track IP addresses ( n = 81), or possible illegality of such pornography ( n = 99). We measured the attempted click-through to the site. Attrition rates for the warning message conditions were 38% to 52%, compared with 27% for the control group. The most effective messages were those that warned that IP addresses can be traced (odds ratio [OR] = 2.64) and that the pornography may be illegal (OR = 2.99). We argue that warning messages offer a valuable and cost-effective strategy that can be scaled up to help reduce the accessing of CSEM online.
The Prevalence of Sexual Interest in Children and Sexually Harmful Behavior Self-Reported by Men Recruited Through an Online Crowdsourcing Platform
Authors: Ó Ciardha Caoilte , Ildeniz Gaye , Karoğlu Nilda
Published: May 2021

This study examined the feasibility of using crowdsourcing to recruit men who self-report sexual interest in children or sexually problematic behavior involving children. Crowdsourcing refers to the use of the internet to reach a large number of people to complete a specific task. A nonrepresentative sample of men ( N = 997) participated in a brief self-report survey examining age of attraction, sexual interest in children, proclivity toward sexual offenses involving children, and history of sexual offending. Almost a quarter of the sample (23.1%) indicated some degree of sexual interest in children, propensity to sexually offend against children, and/or actual offending behavior. We present our data broken down by type of interest or behavior and examine the frequency of these outcomes. Findings are likely to be of value to those considering the viability of crowdsourcing to overcome the limitations or challenges of face-to-face research on stigmatizing interests and behaviors. Findings also contribute to estimating prevalence of self-reported sexual interest in children, and sexual offending behavior toward children, across different countries.
A GPU-accelerated adaptive FSAI preconditioner for massively parallel simulations
Authors: Isotton Giovanni , Janna Carlo , Bernaschi Massimo
Published: May 2021

The solution of linear systems of equations is a central task in a number of scientific and engineering applications. In many cases the solution of linear systems may take most of the simulation time thus representing a major bottleneck in the further development of scientific and technical software. For large scale simulations, nowadays accounting for several millions or even billions of unknowns, it is quite common to resort to preconditioned iterative solvers for exploiting their low memory requirements and, at least potential, parallelism. Approximate inverses have been shown to be robust and effective preconditioners in various contexts. In this work, we show how adaptive Factored Sparse Approximate Inverse (aFSAI), characterized by a very high degree of parallelism, can be successfully implemented on a distributed memory computer equipped with GPU accelerators. Taking advantage of GPUs in adaptive FSAI set-up is not a trivial task, nevertheless we show through an extensive numerical experimentation how the proposed approach outperforms more traditional preconditioners and results in a close-to-ideal behavior in challenging linear algebra problems.
Proposal for Employing User-Generated Content as a Data Source for Measuring Tourism Destination Image
Authors: Alarcón-Urbistondo Pilar , Rojas-de-Gracia María-Mercedes , Casado-Molina Ana
Published: May 2021

The user-generated content (UGC) published on the internet offers great advantages as a source of data. This study proposes a way to make better use of its potential to measure tourism destination image, based on the recommendations of Echtner and Ritchie. These authors indicate that in order to obtain a comprehensive picture of tourism destinations, it is necessary to carry out a holistic and attribute-based analysis using unstructured and structured data, respectively. Since UGC provides both types of data, here we propose its use to study and compare the images of five tourist cities. Our results demonstrate that UGC is a valid source for the study of tourism destination image, confirming the need to adopt a holistic and attribute-based approach to this concept. They also show that not all attributes influence the overall impression of a destination.
Towards best-practice inclusion of cultural indicators in decision making by Indigenous peoples
Authors: Morgan Te Kīpa Kēpa Brian , Reid John , McMillan Oliver Waiapu Timothy , Kingi Tanira , White Te Taru , Young Bill , Snow Val , Laurenson Seth
Published: May 2021

Acknowledgement that Indigenous Knowledge cannot be assimilated and readily generalised within reductionist scientific paradigms is emerging. The reluctance of Indigenous Peoples to adopt reductionist science-based interpretations is justified. Science that stops at the point where reality is universal excludes consideration of how outcomes are understood and experienced by more holistic epistemologies including those of Indigenous Peoples. Culturally derived ways of knowing are beyond the realm of reductionist science and require approaches to decision-making frameworks that are capable of including culturally specific knowledge. Cultural indicators are a geographically specific means of enabling measurement of a particular culture’s attributes; however, to be appropriately recognised, the method of inclusion is at least as important. Therefore, cultural indicators, their definition and their measurement are the sole prerogative of Indigenous Peoples, and how Indigenous epistemologies are effectively empowered in frameworks is critical, as decisions are no longer being made in purely Indigenous contexts.
Metonyms of destruction: Death, ruination, and the bombing of Rotterdam in the Second World War
Authors: Robben Antonius CGM
Published: May 2021

The German and Allied bombing of Rotterdam in the Second World War caused thousands of dead and hundreds of missing, and severely damaged the Dutch port city. The joint destruction of people and their built environment made the ruins and rubble stand metonymically for the dead when they could not be mentioned in the censored press. The contiguity of ruins, rubble, corpses and human remains was not only semantic but also material because of the intermingling and even amalgamation of organic and inorganic remains into anthropomineral debris. The hybrid matter was dumped in rivers and canals to create broad avenues and a modern city centre. This article argues that Rotterdam’s semantic and material metonyms of destruction were generated by the contiguity, entanglement, and post-mortem and post-ruination agencies of the dead and the destroyed city centre. This analysis provides insight into the interaction and co-constitution of human and material remains in war.
Experimental study on post-fire mechanical performances of high strength steel Q460
Authors: Kang Lan , Wu Bin , Liu Xinpei , Ge Hanbin
Published: May 2021

A series of experimental tests for investigating the post-fire mechanical (PFM) and post-fire fracture (PFF) performances of high strength steel Q460 are reported in this paper. All Q460 coupon specimens are heated up to a designated temperature which is selected from 100 to 900°C and then cooled down naturally to room temperature. Tensile tests are conducted to obtain their completely full-range post-fire stress-strain curves and the corresponding mechanical properties. The obtained experimental results show that with an increase in the heating temperature, the post-fire yield strength and ultimate strength of the Q460 structural steel decrease particularly when the heating temperature is over 650°C, but the post-fire elongation enhances. Ductile fracture behaviour of the coupon specimens under axial tensile loading can also be observed through the tensile coupon tests. The obtained experimental data are compared with the other results found in the open literatures on Grade 460 high strength steel. Based on a wider range of experimental data sets, predictive equations for evaluating the PFM properties of Grade 460 high strength steel are proposed. The experimental results presented in this study will provide benchmark data for the future calibration of complex ductile fracture parameters applied in numerical simulation.
The social uses of the Internet: Introduction to the special section
Authors: Ørmen Jacob , Helles Rasmus , Jensen Klaus Bruhn
Published: May 2021

This Special Section takes stock of a shift toward an integrated and global digital media environment with a set of articles comparing and contrasting the social uses of the Internet in China, Europe, and the United States. Departing from James Lull’s typology of the social uses of television, the articles address both general media use patterns and the specific private and public uses to which the Internet is put in these different social and cultural contexts. A concluding commentary by Lull serves to place current communicative practices in historical perspective and to suggest implications for future research.
The effects of green supply chain management practices on firm performance: Empirical evidence from restaurants in Egypt
Authors: Abbas Tamer M , Hussien Faten M
Published: May 2021

The primary purpose of this study was to investigate the effects of three green supply chain management (GrSCM) dimensions (i.e., green management, green food, green environment, and equipment) on operational performance, competitive advantage, and firm performance, in a convenience sample of international quick-service restaurants (QSRs) in Egypt. The hypotheses of the study were tested empirically by employing a self-administered questionnaire. A total of 600 questionnaires were randomly distributed by hand to QSR managers and supervisors, and 478 usable questionnaires were personally retrieved, representing a usable response rate of 79.7%. The obtained data were analyzed using one-way independent ANOVA and structural equation modeling (SEM). The SEM results revealed that the green management dimension had a significant positive effect on a restaurant's competitive advantage while the green environment and equipment dimension had a significant positive effect on operational performance. Additionally, the operational performance had a significant positive effect on firm performance. The study has significant theoretical and practical implications.
Estimating the Effect of the New York State Nurse Practitioners Modernization Act on Care Received by Medicaid Patients
Authors: Timmons Edward Joseph , Norris Conor , Martsolf Grant , Poghosyan Lusine
Published: May 2021

The demand for primary care services may surpass the supply of primary care providers, exacerbating challenges with access, quality, and cost in the U.S. health care system. Expanding the supply of, and access to, nurse practitioner (NP) care has been proposed as one method to alleviate these challenges. New York State (NYS) changed its regulatory environment for NPs in 2015. We estimate the impact of expanded NP scope of practice (SOP) regulations in NYS on total care days received by Medicaid beneficiaries from 2015 to 2018 using a model derived from national historical data from 1999 to 2011. We used a longitudinal data policy analysis framework and a generalized difference-in-differences model to identify the effect of changes in NP SOP regulations on total care days. The model included controls for state income and unemployment rates. Our results suggest that the policy change increased total care days provided to patients, but that this difference was not statistically significant and became negligible after computing the number of days per beneficiary. In addition, our results suggest that had NYS moved to a full practice environment, more care days could have been provided to Medicaid patients, and this difference was found to be statistically significant. Our results suggest that states should adopt full NP SOP practice environments to realize measurable benefits of expanded NP SOP.
“The Hoist of the Yellow Flag”: Vulnerable Port Cities and Public Health
Authors: Schubert Dirk , Wagenaar Cor , Hein Carola
Published: May 2021

Port cities have long played a key role in the development, discovery, and fight against diseases. They have been laboratories for policies to address public health issues. Diseases reached port cities through maritime exchanges, and the bubonic plague is a key example. Port city residents’ close contact with water further increased the chance for diseases such as cholera. Analyzing three European port cities, this article first explores the relevance of water quality for public health through the lens of the Dutch city of Rotterdam. It then examines plans and projects for London that were shaped by social Darwinism and stressed the moral failings of slum dwellers as a major cause for their misery. It finally explores the case of Hamburg as the perfect example of a city that cultivated ideals of purity and cleanliness by addressing all issues at stake in public health. This article on urban hygiene in three port cities shows how remarkably rich this field of study is; it also demonstrates that the multifaceted aspects of public health in port cities require further attention.
Men and Oral Health: A Review of Sex and Gender Differences
Authors: Lipsky Martin S. , Su Sharon , Crespo Carlos J. , Hung Man
Published: May 2021

Sex and gender related health disparities in oral health remain an underappreciated and often over looked aspect of well-being. The goal of this narrative review is to identify sex and gender related oral health disparities by summarizing the current literature related to differences in oral health between men and women. The review identified that men are more likely to: ignore their oral health, have poorer oral hygiene habits, and experience higher rates of periodontal disease, oral cancer, and dental trauma. Men also visit dentists less frequently and compared to women seek oral treatment more often for an acute problem and less often for disease prevention. Women exhibit more positive attitudes about dental visits, greater oral health literacy, and demonstrate better oral health behaviors than men. Men disproportionately develop periodontal diseases due to a combination of biological and gender related reasons including immune system factors, hormone differences, poorer oral hygiene behaviors, and greater tobacco use. There is a male to female ratio of 2:1 for oral cancer, largely attributable to more tobacco use, heavier use of alcohol, and longer sun exposure. Minority men experience a disproportionate burden of oral health disparities because of both their gender and race/ethnic identities. In conclusion, this review identifies several differences between men and women related to oral health and highlights the need for further research to better understand these disparities and how to incorporate them into developing prevention, education and treatment strategies to improve oral health in men.
Optimization principle and application of forced ventilation in railway tunnels based on improved TOPSIS theory and CFD simulations
Authors: Wu Bo , Chen Huihao , Huang Wei
Published: May 2021

The optimization of forced ventilation in tunnel construction becomes the key problem to improve the construction environment and energy saving. The influence of main factors on the flow field is considered for orthogonal experimental design and optimization, which includes the distance between the air duct outlet and the tunnel face, the bench length, the bench height, and the position of the air duct. Thus, the TOPSIS theory was adopted for the optimization method and improvement, and a series of CFD simulations were applied to analyze optimal solutions. The results show that the improved TOPSIS theory with entropy weight method and analytic hierarchy process could effectively solve the optimization problem of forced ventilation in tunnel construction. Based on this optimization principle, a case was analyzed, and the optimized ventilation parameters are obtained to improve ventilation efficiency and save energy. In the optimization scheme, the flow field in the tunnel is stable and the wind is strong enough to ventilate. Besides, there is none huge vortex, which might disrupt the stable flow field and reduce energy efficiency. It could improve the ventilation efficiency and stability, save time and cost, and bring considerable economic and social benefits to the tunnel construction.
Prior information use and response caution in perceptual decision-making: No evidence for a relationship with autistic-like traits
Authors: Retzler Chris , Boehm Udo , Cai Jing , Cochrane Aimee , Manning Catherine
Published: May 2021

Interpreting the world around us requires integrating incoming sensory signals with prior information. Autistic individuals have been proposed to rely less on prior information and make more cautious responses than non-autistic individuals. Here, we investigated whether these purported features of autistic perception vary as a function of autistic-like traits in the general population. We used a diffusion model framework, whereby decisions are modelled as noisy evidence accumulation processes towards one of two bounds. Within this framework, prior information can bias the starting point of the evidence accumulation process. Our pre-registered hypotheses were that higher autistic-like traits would relate to reduced starting point bias caused by prior information and increased response caution (wider boundary separation). 222 participants discriminated the direction of coherent motion stimuli as quickly and accurately as possible. Stimuli were preceded with a neutral cue (square) or a directional cue (arrow). 80% of the directional cues validly predicted the upcoming motion direction. We modelled accuracy and response time data using a hierarchical Bayesian model in which starting point varied with cue condition. We found no evidence for our hypotheses, with starting point bias and response caution seemingly unrelated to Adult Autism Spectrum Quotient (AQ) scores. Alongside future research applying this paradigm to autistic individuals, our findings will help refine theories regarding the role of prior information and altered decision-making strategies in autistic perception. Our study also has implications for models of bias in perceptual decision-making, as the most plausible model was one that incorporated bias in both decision-making and sensory processing.
Why don’t they do it? Handwashing barriers and influencer study in Faridabad district, India
Authors: Gupta V , Anand S
Published: May 2021

Background:

Handwashing has been widely accepted as the simplest protection against communicable diseases. However, despite proven effectiveness and cost-efficiency, adoption of regular handwashing is still poor in developing countries. As children in school-going age are vulnerable and continue to suffer from preventable illnesses, this study aims to spot barriers to handwashing among children while simultaneously recognizing the influencing factors to aid the solutions narrative for effective water, sanitation and hygiene (WASH) strategies.

Methods:

A school-based cross-sectional, mixed-method study was conducted in Ballabhgarh block, Faridabad district, India. A predesigned, pretested, structured questionnaire was administered to 106 class V students in five randomly selected rural government primary schools. Due permissions, consent and ethical clearances were taken.

Results:

The majority (>91%) of children were found to have low illness threat perception. The inability to visually see germs came out as one of the biggest barriers (46%) that were preventing children from practicing regular handwashing. Family, teachers and peers were found to be the most important sources of information for children and not any particular media channel. In fact, role of peers was found to be critical as 72% children said that they would wash hands if their friends were also washing hands.

Conclusion:

This study suggests children’s need for visible proof of germs and associated casual attitude toward illness threat as a hitherto unexplored potential barrier to practicing regular handwashing. In addition, the human channel of communication seems to be the most relevant regarding public health messaging in rural heartlands. Despite 100% penetration of mobile phones and commonplace presence of television, it is the community ecosystem that is still the most trusted sources of information and influence. The unique role of peers found in this study could have strategic implications for future behaviour change interventions making a case for peer-to-peer behaviour modeling.
The Action Scales Model: A conceptual tool to identify key points for action within complex adaptive systems
Authors: Nobles James D , Radley Duncan , Mytton Oliver T ,   The Whole Systems Obesity programme team
Published: May 2021

Background:

Systems thinking is integral to working effectively within complex systems, such as those which drive the current population levels of overweight and obesity. It is increasingly recognised that a systems approach – which corrals public, private, voluntary and community sector organisations to make their actions and efforts coherent – is necessary to address the complex drivers of obesity. Identifying, implementing and evaluating actions within complex adaptive systems is challenging, and may differ from previous approaches used in public health.

Methods:

Within this conceptual article, we present the Action Scales Model (ASM). The ASM is a simple tool to help policymakers, practitioners and evaluators to conceptualise, identify and appraise actions within complex adaptive systems. We developed this model using our collective expertise and experience in working with local government authority stakeholders on the Public Health England Whole Systems Obesity programme. It aligns with, and expands upon, previous models such as the Intervention Level Framework, the Iceberg Model and Donella Meadows’ 12 places to intervene within a system.

Results:

The ASM describes four levels (synonymous with leverage points) to intervene within a system, with deeper levels providing greater potential for changing how the system functions. Levels include events, structures, goals and beliefs. We also present how the ASM can be used to support practice and policy, and finish by highlighting its utility as an evaluative aid.

Discussion:

This practical tool was designed to support those working at the front line of systems change efforts, and while we use the population prevalence of obesity as an outcome of a complex adaptive system, the ASM and the associated principles can be applied to other issues. We hope that the ASM encourages people to think differently about the systems that they work within and to identify new and potentially more impactful opportunities to leverage change.
Predictors of Change in Skin Intrinsic Fluorescence in Type 1 Diabetes: The Epidemiology of Diabetes Complications Study
Authors: Tomaszewski Erin L. , Orchard Trevor J. , Hawkins Marquis S. , Conway Rebecca B.N. , Buchanich Jeanine M. , Maynard John , Songer Thomas , Costacou Tina
Published: May 2021

Background

Skin intrinsic fluorescent (SIF) scores are indirect measures of advanced glycation end-products (AGEs). SIF scores are cross-sectionally associated with type 1 diabetes (T1D) complications such as increased albumin excretion rate (AER), coronary artery calcification (CAC) and neuropathy. We assessed predictors of SIF score change in those with T1D.

Methods

Data from the 30-year longitudinal Epidemiology of Diabetes Complications (EDC) study of childhood-onset T1D were used to assess AGEs measured with a SIF score produced by the SCOUT DS® device. SIF scores were assessed twice in 83 participants: between 2007-08 and again between 2010-14. Regression analyses were used to assess independent predictors of SIF score change

Results

At baseline, mean age was 47.9 ± 6.9 years, diabetes duration was 36.7 ± 6.4 years, and median glycosylated hemoglobin (HbA1c) was 7.1 (interquartile range: 6.5, 8.5). During a mean follow-up of 5.2 ± 0.9 years, mean change in SIF score was 2.9 ± 2.8 arbitrary units. In multivariable linear regression models, log HbA1c ( P < 0.001), log estimated glomerular filtration rate (eGFR) ( P < 0.001), overt nephropathy (defined as AER ≥ 200 µg/min, P = 0.06), and multiple daily insulin shots/pump use (MDI) exposure years ( P = 0.02) were independent predictors of SIF score change.

Conclusions

Increases in SIF score over 5 years were related to increased glycemic levels and decreased kidney function (eGFR). MDI and glomerular damage were related to a decreased SIF score. This is one of the first studies with repeated SIF assessments in T1D and provides unique, albeit preliminary, insight about these associations.
“Long COVID”: A case report of persistent symptoms in a patient with prolonged SARS-CoV-2 shedding for over 110 days
Authors: Omololu Ayanfe , Ojelade Barakah , Ajayi Oluwatomiwa , Adesomi Tolu , Alade Oreoluwa , Adebisi Segun , Nwadike Victor
Published: May 2021

Coronavirus disease 2019 is a novel disease currently ravaging the world as a pandemic. More emphasis has been focused on the acute disease, with less attention on the detection and management of long-term sequelae which develop in some patients, variously termed “Long COVID,” Post-coronavirus disease 2019 syndrome, or ongoing coronavirus disease. There are also various reports in the literature on the duration of viral shedding, with the longest known recorded being about 70 days, and whether this duration has an effect on prognosis or patients remaining infectious is still unknown. We report the case of a 22-year-old health care worker with prolonged multi-systemic features of coronavirus disease 2019 including cardiovascular, respiratory, central nervous system, and musculoskeletal symptoms lasting about 18 weeks from symptom onset, though never hospitalized, and persistent detection of severe acute respiratory syndrome coronavirus 2 attributed to viral shedding for over 110 days, which is the longest duration recorded to our knowledge.
How hospitalized patients evaluate and report their pain together with nurses: A scoping review
Authors: Malones Bente Dale , Kallmyr Sindre Sylte , Hage Vera , Eines Trude Fløystad
Published: May 2021

Pain assessment tools are often used by patients to report their pain and by health professionals to assess patients’ reported pain. Although valid and reliable assessment of pain is essential for high-quality clinical care, there are still many patients who experience inappropriate pain management. The aim of this scoping review is to examine an overview of how hospitalized patients evaluate and report their pain in collaboration with nurses. Systematic searches were conducted, and ten research articles were included using the PRISMA guidelines for scoping reviews. Content analysis revealed four main themes: 1) the relationship between the patient and nurse is an important factor of how hospitalized patients evaluate and report their post-surgery pain, 2) the patient’s feelings of inconsistency in how pain assessments are administered by nurses, 3) the challenge of hospitalized patients reporting post-surgery pain numerically, and 4) previous experiences and attitudes affect how hospitalized patients report their pain. Pain assessment tools are suitable for nurses to observe and assess pain in patients. Nevertheless, just using pain assessment tools is not sufficient for nurses to obtain a comprehensive clinical picture of each individual patient with pain.
A comparative study of serotonin and norepinephrine as adjuncts to improve cutaneous antinociception of mexiletine in response to skin pinpricks in rats
Authors: Han Mingming , Kang Fang , Yang Chengwei , Zhai Mingyu , Zheng Kesong , Wang Ting , Liu Ziyou , Li Juan
Published: May 2021

As adrenaline, serotonin and norepinephrine are two other vasoconstrictors and both of which have been proved to increase the quality and duration of local anesthetics when added as adjuvants. However, the difference in the improvement of the nociception of local anesthetics between the two adjuvants remains unclear. The purpose of this study was to assess the cutaneous nociception of mexiletine by coadministration with serotonin and norepinephrine. Subcutaneous injection of drugs or combinations includes mexiletine 0.6, 1.8, 6.0 μmol, serotonin 1.6500 μmol, noradrenaline 0.8895 nmol, saline, mexiletine 1.8 and 6.0 μmol, respectively combined with serotonin 0.4125, 0.8250, 1.6500 μmol and noradrenaline 0.0356, 0.1779, 0.8895 nmol, with each injection dose of 0.6 ml. The nociception of mexiletine alone and mexiletine coadministered with serotonin and norepinephrine was assessed after subcutaneous injection. Subcutaneous injections of mexiletine elicited dose-related cutaneous antinociception ( P < 0.05, 0.01, or 0.001). Compared with mexiletine (1.8 μmol), adding norepinephrine (except for lowest dose) and serotonin to mexiletine (1.8 μmol) solutions for skin nociceptive block potentiated and prolonged the action ( P < 0.01 or 0.001). Mexiletine (6.0 μmol) combined with norepinephrine and serotonin extended the duration of cutaneous antinociception when compared with mexiletine (6.0 μmol) alone ( P < 0.05, 0.01, or 0.001). Both serotonin and norepinephrine improve the sensory block and enhances the nociceptive block duration of mexiletine, and serotonin is superior to that of norepinephrine.
Shadow Education Policy in Korea During the COVID-19 Pandemic
Authors: Piao (朴汇燕) Huiyan , Hwang (황현아) Hyuna
Published: May 2021

Purpose:

This study systematically reviews Korea’s shadow education policies during the COVID-19 pandemic and the implications for shadow education policy development in the future.

Design/Approach/Methods:

In terms of approach, this policy review analyzes selected documents using the analytical framework of shadow education policies. Selected documents comprise recently revised decrees, policies, and regulations issued by the Korean Ministry of Education, as well as policy notices issued by the Korea Association of Hagwon. Data are supplemented by triangulation with news media content.

Findings:

This study identifies tutoring policies at the legal level in response to the COVID-19 pandemic. Government debate regarding shadow education largely centers on the closing of tutoring organizations and ensuring that online tuition fees adhere to government regulation. In respect to the expansion of the government-led shadow education partnership, the government’s increasing role in education has served to restrict the shadow education market.

Originality/Value:

The Korean government has adjusted its shadow education policies in response to COVID-19, altering its legal and economic status. An examination of Korea’s recent shadow education policies suggests future trends in the revision and development of shadow education in the country.
The Impact of Human Trafficking Training on Healthcare Professionals’ Knowledge and Attitudes
Authors: Lee Hayoung , Geynisman-Tan Julia , Hofer Sarah , Anderson Emily , Caravan Sahar , Titchen Kanani
Published: May 2021

Objectives:

The objective of this study was to evaluate a CME-accredited human trafficking didactic and discussion-based training for healthcare professionals by comparing participant knowledge and attitudes on human trafficking before and after attending the training.

Methods:

A novel 18-item survey was developed to test the knowledge of and attitudes towards human trafficking. Participants of 17 standardized trainings delivered by 4 physician-trainers over a two-year period were invited to take a pre-test and 2 post-tests at 1-week and 6-months post training. Surveys were anonymously collected and linked to each participant with a de-identified number. Data were analyzed using SPSS software with scores given to the overall and knowledge and attitude subscales. Data are presented as mean ± standard deviation. Comparisons were made using paired t-tests or ANOVA, as appropriate.

Results:

Total of 424 participants submitted the pre-test and were predominantly female (81%) and students in healthcare fields (55%). Of these participants, 237 (56%) submitted the 1-week post-test. Scores increased from pre-test to 1-week post-test in both knowledge (54.7 ± 18.7%-84.5 ± 12.8%, P = .001) and attitude (49.4 ± 14.7%-71.0 ± 12.8%, P < .001) subscales. Forty-seven participants (11%) submitted the 6-month post-test, which demonstrated a decrease in knowledge score from the 1-week post-test (84.5 ± 12.8%-50.0 ± 13.6%, P < .001). However, improvements in attitude scores were sustained across time (71.0 ± 12.8%-68.8 ± 12.4%, P < .001).

Conclusions:

Among health professionals, the CME-accredited LIFT training leads to a short-term improvement in knowledge of human trafficking and a sustained improvement in awareness and attitudes about human trafficking.
Beyond Conspiracy and Coordinated Ascendancy: Revisiting Caste Question in West Bengal under the Left Front Rule (1977–2011)
Authors: Guha Ayan
Published: May 2021

This article has critically engaged with the speculative claim that the disappearance of caste question from public discourse during Left rule in West Bengal was a result of conscious upper-caste ploy to silence articulation of caste interests and tactfully eliminate the possibility of Dalit political assertion. To verify the veracity of this claim, this study has critically scrutinized Left Front’s political mobilization strategy of rural population and also its landmark land reform initiative. The investigation attempted by this article, in this regard, has revealed that there is little to suggest the existence of any organized upper-caste conspiracy. It is, however, true that the articulation and aggregation of political demands along the lines of caste was indeed averted in West Bengal through political tactics and developmental strategies devised by the upper castes. But, the marginalization of the caste question in mainstream politics was an unintended consequence of such political tactics and developmental strategies which were primarily designed with the objective to preserve and enlarge the political support base, rather than to contain the lower castes. Thus, political motives acted as far more important determinants of political and developmental activities rather than any inherent caste bias.
Estimating colocalization probability from limited summary statistics
Authors: King Emily A. , Dunbar Fengjiao , Davis Justin Wade , Degner Jacob F.
Published: May 2021

Background

Colocalization is a statistical method used in genetics to determine whether the same variant is causal for multiple phenotypes, for example, complex traits and gene expression. It provides stronger mechanistic evidence than shared significance, which can be produced through separate causal variants in linkage disequilibrium. Current colocalization methods require full summary statistics for both traits, limiting their use with the majority of reported GWAS associations (e.g. GWAS Catalog). We propose a new approximation to the popular coloc method that can be applied when limited summary statistics are available.

Our method (POint EstiMation of Colocalization, POEMColoc) imputes missing summary statistics for one or both traits using LD structure in a reference panel, and performs colocalization using the imputed summary statistics.

Results

We evaluate the performance of POEMColoc using real (UK Biobank phenotypes and GTEx eQTL) and simulated datasets. We show good correlation between posterior probabilities of colocalization computed from imputed and observed datasets and similar accuracy in simulation. We evaluate scenarios that might reduce performance and show that multiple independent causal variants in a region and imputation from a limited subset of typed variants have a larger effect while mismatched ancestry in the reference panel has a modest effect. Further, we find that POEMColoc is a better approximation of coloc when the imputed association statistics are from a well powered study (e.g., relatively larger sample size or effect size). Applying POEMColoc to estimate colocalization of GWAS Catalog entries and GTEx eQTL, we find evidence for colocalization of 150,000 trait-gene-tissue triplets.

Conclusions

We find that colocalization analysis performed with full summary statistics can be closely approximated when only the summary statistics of the top SNP are available for one or both traits. When applied to the full GWAS Catalog and GTEx eQTL, we find that colocalized trait-gene pairs are enriched in tissues relevant to disease etiology and for matches to approved drug mechanisms. POEMColoc R package is available at https://github.com/AbbVie-ComputationalGenomics/POEMColoc.
Population genetic considerations for using biobanks as international resources in the pandemic era and beyond
Authors: Carress Hannah , Lawson Daniel John , Elhaik Eran
Published: May 2021

The past years have seen the rise of genomic biobanks and mega-scale meta-analysis of genomic data, which promises to reveal the genetic underpinnings of health and disease. However, the over-representation of Europeans in genomic studies not only limits the global understanding of disease risk but also inhibits viable research into the genomic differences between carriers and patients. Whilst the community has agreed that more diverse samples are required, it is not enough to blindly increase diversity; the diversity must be quantified, compared and annotated to lead to insight. Genetic annotations from separate biobanks need to be comparable and computable and to operate without access to raw data due to privacy concerns. Comparability is key both for regular research and to allow international comparison in response to pandemics. Here, we evaluate the appropriateness of the most common genomic tools used to depict population structure in a standardized and comparable manner. The end goal is to reduce the effects of confounding and learn from genuine variation in genetic effects on phenotypes across populations, which will improve the value of biobanks (locally and internationally), increase the accuracy of association analyses and inform developmental efforts.