bluuebunny/crossref_metadata_2025 huggingface dataset:
Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019
Authors: van ’t Hof Maarten , Tisseur Chanel , van Berckelear-Onnes Ina , van Nieuwenhuyzen Annemyn , Daniels Amy M , Deen Mathijs , Hoek Hans W , Ester Wietske A
Published: November 2020

Between 1990 and 2012, the global mean age at diagnosis of autism spectrum disorder ranged from 38 to 120 months. Measures have since been introduced to reduce the age at autism spectrum disorder diagnosis, but the current global mean age is unknown. This review and meta-analysis report the average age at diagnosis from studies published between 2012 and 2019. We initially identified 1150 articles, including 56 studies that reported the mean or median age at diagnosis across 40 countries (n = 120,540 individuals with autism spectrum disorder). Meta-analysis results (on 35 studies, including 55 cohorts from 35 countries, n = 66,966 individuals with autism spectrum disorder) found a current mean age at diagnosis of 60.48 months (range: 30.90–234.57 months). The subgroup analysis for studies that only included children aged ⩽10 years (nine studies, including 26 cohorts from 23 countries, n = 18,134 children with autism spectrum disorder) showed a mean age at diagnosis of 43.18 months (range: 30.90–74.70 months). Numerous factors may influence age at diagnosis and were reported by 46 studies, often with conflicting or inconclusive findings. Our study is the first to ascertain the global average age at autism spectrum disorder diagnosis from a meta-analysis. Continued efforts to lower the average age at autism spectrum disorder diagnosis are needed.

Lay abstract

We currently assume that the global mean age at diagnosis of autism spectrum disorder ranges from 38 to 120 months. However, this range is based on studies from 1991 to 2012 and measures have since been introduced to reduce the age at autism spectrum disorder diagnosis. We performed a systematic review and meta-analysis (statistical analysis that combines the results of multiple scientific studies) for studies published between 2012 and 2019 to evaluate the current age at autism spectrum disorder diagnosis. We included 56 studies that reported the age at diagnosis for 40 countries (containing 120,540 individuals with autism spectrum disorder). Results showed the current mean age at diagnosis to be 60.48 months (range: 30.90–234.57 months) and 43.18 months (range: 30.90–74.70 months) for studies that only included children aged ⩽10 years. Numerous factors that may influence age at diagnosis (e.g. type of autism spectrum disorder diagnosis, additional diagnoses and gender) were reported by 46 studies, often with conflicting or inconclusive results. Our study is the first to determine the global average age at autism spectrum disorder diagnosis from a meta-analysis. Although progress is being made in the earlier detection of autism spectrum disorder, it requires our constant attention.
The role of national identification in explaining political and social civic engagement
Authors: Rupar Mirjana , Sekerdej Maciej , Jamróz-Dolińska Katarzyna
Published: November 2020

The present research examines the relationship between distinct forms of national identification—constructive patriotism, conventional patriotism, and glorification—and both political and social engagement. Three correlational studies were conducted in Poland. In Study 1 ( N = 234) and Study 2 ( N = 316), using self-report measures, it was found that constructive patriotism positively predicts both forms of civic engagement. Conventional patriotism positively predicted social engagement (Studies 1 and 3). Glorification negatively predicted political engagement. Study 3 ( N = 969) supported the link between these different forms of national identification and political and social engagement, using both self-report and behavioural measures of civic engagement. The findings suggest that national identification can both promote and deter civic engagement.
Research on wind barrier of canyon bridge-tunnel junction based on wind characteristics
Authors: Wang Lu , Chen Xiaoxin , Chen Hong
Published: November 2020

Due to the acceleration effect of the wind by the special geographical location of the canyon bridge-tunnel junction, the traffic safety and stability of this section are difficult to be guaranteed, resulting in frequent traffic accidents. In order to ensure the safety and comfort of vehicles driving on this section, the numerical simulation method based on CFD is adopted to establish the numerical model of the canyon bridge-tunnel junction. The acceleration of the incoming wind speed in the bridge-tunnel junction with a guardrail that is 0.8 m high is analyzed from different canyon spacings, wind directions and heights from the bridge deck. Based on the characteristics of wind field above the bridge deck, two kinds of gradient wind barriers—trapezoidal and stepped—are proposed, and their wind reduction effects and turbulence intensity changes are analyzed. Then the aerodynamic performances of running vehicle are compared. The results show that the stepped wind barrier with 50% porosity and rectangular section railings has the best wind reduction effects, and can noticeably improve the comfort of driving. The aerodynamic coefficients of vehicle are lower with stepped wind barrier.
Permit checking of overloaded customized transport vehicle based on serviceability limit state reliability of concrete bridges
Authors: Yuan Yangguang , Han Wanshui , Xu Xin , Wang Junfeng , Sun Jianpeng
Published: November 2020

To increase the authorization efficiency of overloaded customized transport vehicle (CTV), a serviceability limit state (SLS) reliability based permit checking method for concrete bridges is proposed through the optimization towards critical load effect ratio. In this procedure, the SLS reliability of crack width and the SLS reliability of concrete stress in tensile region are analyzed for reinforced concrete (RC) and prestressed concrete (PC) structures, respectively. The durability requirements and a unified reliable level can be concentrated reflected by the optimized critical load effect ratio. The results show that it is unreasonable to take a uniform target reliability index for all routes in permit checking of CTV, a stricter authorization criterion should be adopted for a higher expected authorization frequency. For a specific route level, a fluctuant variation of critical load effect ratio can be found with the increasing of bridge span. By introducing an ultimate limit state (ULS) based safety checking procedure, it is found that the SLS based permit checking criterion is crucial and determinative for the authorization of CTV instead of the ULS.
Retrieval Practice: Beneficial for All Students or Moderated by Individual Differences?
Authors: Bertilsson Frida , Stenlund Tova , Wiklund-Hörnqvist Carola , Jonsson Bert
Published: November 2020

Retrieval practice is a learning technique that is known to produce enhanced long-term memory retention when compared to several other techniques. This difference in learning outcome is commonly called “the testing effect”. Yet there is little research on how individual differences in personality traits and working memory capacity moderate the size of the retrieval-practice benefits. The current study is a conceptual replication of a previous study, further investigating whether the testing effect is sensitive to individual differences in the personality traits Grit and Need for Cognition, and working memory capacity. Using a within-subjects design ( N = 151), participants practiced 60 Swahili–Swedish word pairs (e.g., adhama–honor) through retrieval practice and re-studying. Learning was assessed at three time points: five minutes, one week, and four weeks after practice. The results revealed a significant testing effect at all three time points. Further, the results showed no association between the testing effect and the personality traits, or between the testing effect and working memory, at any time point. To conclude, retrieval practice seems to be a learning technique that is not moderated by individual differences in these specific personality traits or with working memory capacity, thus possibly beneficial for all students.
Getting Physical: A Specific Boost for Cognition in Epilepsy?
Authors: Barr William B.
Published: November 2020

[Box: see text]
Targeted Imaging Agent to HSP70 Induced In Vivo
Authors: Ghosh Pradip , O’Neill Brian E. , Li King C.
Published: November 2020

Heat shock protein expression can be induced by heat shock making it possible to artificially modulate their levels noninvasively in vivo in a spatially and temporally controlled manner. Here, we report the use of the major heat shock protein 70 (HSP70) as an inducible target by using the small molecule deoxyspergualin (DSG) conjugated to the near-infrared fluorophore (Cy5.5). We demonstrate that heat induction in the form of localized hyperthermia of normal tissue in living mice results in sufficient HSP70 overexpression for detection with DSG-Cy5.5 conjugate. This effect is dependent on total energy delivered and reaches maximum fluorescence signal in 6 to 8 hours post heat induction and declines over a period of up to 24 hours. These results suggest that DSG-Cy5.5 agent accumulates in tissue with elevated HSP70 by heat.
Build with intrinsic security: Trusted autonomy security system
Authors: He Shen , Huang Jing , Yang Penglin
Published: November 2020

Security of Internet of things network is difficult to manage because Internet of things devices are heterogeneous and always deployed in remote places. Based on these features, attacks against Internet of things network like distributed denial-of-service and system intrusion are easier than traditional network. In order to enhance Internet of things network’s security, in this article we propose the concept of intrinsic security to establish a trusted and autonomy Internet of things network. Intrinsic security emphasizes that network itself must be trusted and security autonomous to address the security problems which are caused by remote and heterogeneous. Based on this thought, we designed the architecture of Trusted Autonomy Security System. Trusted Autonomy Security System maintains a LAN characterized by trusted and security autonomy, in which all Internet of things network gateways formed a decentralized autonomy system to evaluate if other gateways or Internet of things devices are secure. Compared to traditional Internet of things networks, this architecture uses trusted computing technique to build the basic of security, and makes Internet of things network available to manage security automatically. In addition, the decentralized architecture could reduce security risks caused by compromise of single node in Internet of things network. With these advantages, it can be expected that this novel idea will have more development in Internet of things scenarios with high security requirements.
Numerical research on impact performance of bridge columns with aluminum foam protection devices
Authors: Zhang Yuye , Pan Ruiyang , Xiao Feng
Published: November 2020

This article presents a new protection device using aluminum foam to enhance the impact resistance of bridge columns. First, the protection device is designed according to the characteristics of aluminum foam material. The geometric configuration and structure of the device are described. Second, the impact performance of bridge column is analyzed, including impact force analysis, damage analysis, and the influence of axial load. Third, three-dimensional solid element models of columns with and without the protection device are developed in order to verify the effect of the protection device. By comparing dynamic responses of vehicle impact on columns with and without the protection device, it is considered that the protection device has certain protection effect: after installing the protective device, the peak value of impact force reduces by 37.5%, the maximum displacement of column top reduces by 23.7%, the maximum stress at column bottom reduces by 51.6%, the maximum stress at column bottom reduces by 51.6%, the maximum acceleration of the vehicle reduces by 40.6%, and 86.84% of the impact energy is absorbed by the protection device. Finally, the devices with different foam thicknesses and porosities are comparatively analyzed to investigate the influence of these design parameters on impact performance. The results show that the increase in the thickness of aluminum foam has positive effects on the protection capability. The protection capability improves with aluminum foam porosity increasing when the porosity is less than 60%.
Research Ethics in Decolonizing Research With Inuit Communities in Nunavut: The Challenge of Translating Knowledge Into Action
Authors: Held Mirjam B. E.
Published: November 2020

Research failures are not readily disclosed in research representations. This exclusion is a missed opportunity to practice reflexivity, a practice otherwise crucially important to social science inquiry, and share the learning that was inspired by the failure. In this paper I present and reflect on a research failure that occurred during my doctoral research into alternative, Inuit-centered models of fisheries governance in Nunavut. While working on defining the research, I experienced a far-reaching impasse due to the lack of community response and academic guidance. Eventually, despite the best intentions to engage in decolonizing research, I chose to forgo meaningful community consultation before embarking on my fieldwork. Decolonizing research centers collaboration and local research needs from the outset. At the same time, what it means to negotiate a research relationship is in itself negotiable. Further, the negotiating is often challenged by time constraints, institutional restrictions, and limited financial resources. Lessons learned from my case study include a) that a nonideal start does not mean that the entire research project will fail and b) that participating Indigenous communities have the sovereignty, irrespective of existing protocols, to set the terms under which research can take place. Above all, negotiating a research relationship is about relational work which requires commitment and continuous engagement.
Surgical decision-making among patients with uncontrolled epilepsy: “Making important decisions about my brain, which I happen to love”
Authors: Pieters Huibrie C , Dewar Sandra R , Ranit Lizza , Iwaki Tomoko J , Engel Jerome
Published: November 2020

Objective

To explore decision-making from patients’ perceptions of risks and benefits of epilepsy surgery for refractory focal seizures.

Methods

Using constructivist grounded theory, in-person interviews were conducted with 35 adults with refractory focal epilepsy who were undergoing a pre-surgical evaluation or who had consented for surgery.

Results

For this sample of participants decision-making about surgery was complex, centering on the meaning of illness for the self and the impact of epilepsy and its treatment for significant others. Two interrelated categories crystalized from our data: the unique context of brain surgery and how the decisional counterweights of risks and benefits were considered.

Discussion

Exploring components of decision-making from the patients’ perspective afforded an opportunity to describe thought processes intrinsic to how people with drug-resistant epilepsy weighed their treatment options. Tensions were evident in how decisions were made. We use the analogy of an imaginary tightrope-walker to create a visual image of what patients face as they consider the illness experience (past and present), their hopes for the future, and the simultaneous uncertainty centered around balancing the counterweights of treatment risks and benefits.
Maternal death secondary to COVID-19 infection: A case report and review of the literature
Authors: Stout Annabel , Crichton Robert , Tahmasebi Farshad
Published: November 2020

Maternal death secondary to coronavirus disease 19 (COVID-19) infection in a previously well woman is described. The woman presented with an eight-day history of productive cough and shortness of breath. Rapid deterioration of respiratory function was seen following admission, with associated tachycardia, tachypnoea and hypoxia. Emergency caesarean section was performed followed by transfer to the intensive care unit. COVID-19 PCR throat swab from day 0 was positive. Later, she developed hypoxaemia refractory to mechanical ventilation, proning and paralysis. The woman was transferred for veno-venous Extra Corporeal Membrane Oxygenation therapy but unfortunately died despite rigorous management. We review the conflicting information regarding physiological and immunological changes occurring during pregnancy and how these may affect susceptibility to respiratory viral disease. An overview of the current literature concerning ventilation and intensive care support in pregnant women suffering from COVID-19 is given. Further documentation of such cases is called for to progress understanding and management strategies.
What is the most suitable sampling frequency to register accelerometry-based workload? A case study in soccer
Authors: Gómez-Carmona Carlos D , Rojas-Valverde Daniel , Rico-González Markel , Ibáñez Sergio J , Pino-Ortega José
Published: November 2020

The purpose of the present study is to analyze the agreement between different sampling frequencies (SF) to quantify the accelerometer-load in soccer. Eight under-16 male soccer players were registered during an in-season training session. Each player wore four inertial measurement units that registered the accelerometer workload index PlayerLoadRT at different sampling frequencies: (a) 10 Hz, (b) 100 Hz, (c) 500 Hz, and (d) 1000 Hz. Additionally, a down-sampling method was performed: (e) 1000 to 100 Hz and (f) 500 to 100 Hz for comparison purposes. Agreement and correlation analysis were determined using the Pearson correlation coefficient, intraclass correlation, Bland-Altman bias, and t-student of independent samples with Cohen’s d effect size. Very large to nearly perfect correlations were found between all SF ( r  > 0.704). An almost perfect agreement was found between all SF ( ICC>0.864), except regular to substantial agreement between 10 Hz and the rest of the sampling frequencies ( ICC = 0.357–0.658). Comparison analysis showed statistical differences between all sampling frequencies ( p  < 0.01) with the highest differences between 10 Hz and all other sampling frequencies. If trying to compare data collected at different frequencies, researchers should explain their rationale for the chosen sampling frequency to provide greater context for the reader. Accelerometers with greater than 100 Hz frequency should be used to provide more robust data regarding the dynamics in soccer. Based on the goals of the research, a sampling frequency can be selected to register suitable accelerometry-based data.
Patients with locally advanced and metastatic cutaneous squamous cell carcinoma treated with immunotherapy in the era of COVID-19: stop or go? Data from five Italian referral cancer centers
Authors: Saponara Maristella , Pala Laura , Conforti Fabio , Rubatto Marco , De Risi Ivana , Spagnolo Francesco , Guida Michele , Bossi Paolo , Quaglino Pietro , Queirolo Paola
Published: November 2020

Since the end of 2019, global healthcare systems have been dealing with the COVID-19 pandemic.

In oncology, the biggest questions concern interaction of COVID-19 with pre-existing cancer disease and with systemic anticancer treatments. With regards to immunotherapy, there is uncertainty about its effect in the context of COVID-19 in terms of probability and course of viral infection.

Herein, we retrospectively report data of patients with advanced cutaneous squamous cell carcinoma (cSCC) treated with immunotherapy at five Italian referral cancer centers during the pandemic. cSCC is a disease poorly represented in the literature, typically affecting fragile, elderly patients, with multiple comorbidities and often immunosuppressed. Overall, 54 patients were identified, most of them coming from Lombardy and Piedmont, the two regions hit hardest by COVID in Italy. In most cases, our choice was to continue treatment, reserving temporary interruptions only to patients considered particularly at risk for age and comorbidity. A total of 9% of patients developed new-onset symptoms or had chest radiological assessment potentially related to COVID-19. Nasopharyngeal swabs were collected in all suspicious cases and two hospitalized patients were found to be positive. In conclusion, the outbreak of COVID-19 is a major worldwide health concern. Our data indicate that COVID-19 mortality in patients with cancer may be principally driven by advancing age, the presence of other comorbidities, and other cancer-related conditions (i.e. hospitalization). Our data further suggests the safety of continued use of PD-1 blockade during the COVID-19 pandemic (obviously implementing all the safety measures in the hospital environment) also considering the possible negative effects of a prolonged suspension on the course of the tumor evolution. We think it is useful to collect and report case studies coming from reference centers, because they can represent helpful examples for the scientific community of clinical management of patients affected by cancer in this difficult period and guide further research.
Soft-Tissue Reconstruction of Complicated Total Ankle Arthroplasty
Authors: Othman Sammy , Colen David L. , Azoury Saïd C. , Piwnica-Worms William , Fischer John P. , Levin L. Scott , Kovach Stephen J.
Published: November 2020

Background

Total ankle arthroplasty (TAA) is a popular modality to treat end-stage arthritis or internal ankle derangement. Unfortunately, failure rates remain undesirably high, with severe complications, including prosthesis failure, ankle fusion, and amputation. The importance of a stable soft-tissue envelope for coverage of implant compromise has been previously described, but the predictive factors for successful salvage of complicated TAA remain poorly understood.

Methods

A retrospective review was conducted of patients requiring soft-tissue reconstruction following TAA wound complications. Patient demographics, history, microbiological data, reconstructive approach, and outcomes data were collected. Statistical analysis was used to abstract factors associated with unsuccessful prosthetic salvage.

Results

In all, 13 patients met inclusion criteria: 8 (61.5%) achieved prosthetic salvage, and 5 (38.5%) failed. The majority (90.9%) of patients presented with infected joints. Reconstructive techniques included skin grafts, dermal substitutes, locoregional flaps, and free tissue transfer. Successful prosthetic salvage was associated with shorter time intervals between wound diagnosis and index reconstructive surgical intervention (median: 20 days for salvage vs 804 days for failure; P = .014). Additionally, salvage was associated with reduced time from the index orthopaedic/podiatric surgical intervention to the index reconstructive surgery procedure (12 vs 727 days; P = .027).

Conclusion

The prognosis of complicated TAA requiring soft-tissue reconstruction remains poor, especially in patients who present with infected joints. Several reconstructive techniques, ranging from simple skin grafts to complex free tissue transfers, can be used successfully. Early intervention to achieve soft-tissue coverage is crucial in maximizing salvage rates in the setting of complicated and infected TAA.

Level of Evidence

Level IV
Heterotopic Ossification Following Total Ankle Arthroplasty With Fourth-Generation Prostheses
Authors: Rushing Calvin J. , Steriovski James , Hyer Christopher F. , Berlet Gregory C.
Published: November 2020

Background

The purpose of the present study was to assess the radiographic incidence, location, and classification of heterotopic ossification (HO) in patients who underwent total ankle arthroplasty (TAA) with a 4th generation prostheses at a minimum of 1-year follow up. Baseline demographic, radiographic, and operative factors between patents with and without HO were compared.

Methods

Ninety ankles that underwent TAA with a 4th generation protheses, INFINITY (n = 62) or CADENCE (n = 28) were followed for an average of 23.7 (range, 12-49) months. Incidence and location of HO was assessed on weightbearing radiographs, and severity graded according to the modified Brooker classification. Data was compared between patents with and without HO to identity any predisposing factors.

Results

In 90 ankles that underwent 4th generation TAA, HO incidence was 55.6% (n = 50); 56.5% (n = 35) for INFINITY, and 53.6% (n = 15) for CADENCE. Twenty-five cases of HO were observed posteriorly, 16 anteriorly, and 9 combined. Severity was as follows; class I in 19 cases (38%), class II in 20 (40%), class III in 9 (18%) and class IV in 2 (4%). A single ankle required a non-revisional reoperation for HO debridement; reoperation rate of 2%.

Conclusion

The present study suggests a similarly high incidence of HO after TAA with two different 4th generation protheses (INFINITY 56.5%, CADENCE 53.6%). A trend for differences in location and severity between the protheses may also be present. Given the paucity of literature, additional studies with longer follow-up are warranted to discern the significance of HO following TAA with 4th generation protheses.

Level of Evidence

Level III: Retrospective cohort study
Energy Drinks and Their Adverse Health Effects: A Systematic Review and Meta-analysis
Authors: Nadeem Ibrahim M. , Shanmugaraj Ajaykumar , Sakha Seaher , Horner Nolan S. , Ayeni Olufemi R. , Khan Moin
Published: November 2020

Context:

Energy drinks are the fastest growing product in the beverage industry. However, there is concern regarding potential for adverse effects with use.

Objective:

To evaluate the reported adverse effects of energy drink consumption.

Data Sources:

The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from inception to November 2019, and pertinent data were abstracted.

Study Selection:

Only clinical studies reporting adverse events after energy drink consumption were included.

Study Design:

Systematic review.

Level of Evidence:

Level 4.

Data Extraction:

Data regarding sample size characteristics, energy drink characteristics, comparators, and all adverse events were extracted in duplicate and recorded.

Results:

A total of 32 studies and 96,549 individuals were included. Frequently reported adverse events in the pediatric population were insomnia (35.4%), stress (35.4%), and depressive mood (23.1%). Frequently reported adverse events in the adult population were insomnia (24.7%), jitteriness/restlessness/shaking hands (29.8%), and gastrointestinal upset (21.6%). Alcohol mixed with energy drinks significantly reduced the likelihood of sedation effects but increased the likelihood of stimulatory effects. Energy drink consumption significantly increased the odds of insomnia (OR, 5.02; 95% CI, 1.72-14.63) and jitteriness/activeness (OR, 3.52; 95% CI, 1.28-9.67) compared with the control group.

Conclusion:

The authors recommend that individuals avoid frequent energy drink consumption (5-7 energy drinks/week) and avoid co-consumption with alcohol; increased regulatory standards should be placed in the sale of energy drinks, particularly with regard to the pediatric population.
Pregnant women’s satisfaction with antenatal care services and its associated factors at public health facilities in the Harari region, Eastern Ethiopia
Authors: Birhanu Simon , Demena Melake , Baye Yohannes , Desalew Assefa , Dawud Bedru , Egata Gudina
Published: November 2020

Background:

Antenatal care coverage is very low in low-and middle-income countries, including Ethiopia. Self-reported pregnant women’s satisfaction may be important in identifying the demographic, provider-, and facility-related factors that can be improved to increase antenatal care satisfaction. However, there is a paucity of data on pregnant women’s satisfaction in Ethiopia, particularly in the study setting. Therefore, this study aimed to assess antenatal care service satisfaction and associated factors among pregnant women at public health facilities in the Harari region of eastern Ethiopia.

Methods:

A health institution–based cross-sectional study was conducted among women who were attending antenatal care clinics in February 2017. All 531 pregnant women were selected using a systematic random sampling method. Data were collected using an interviewer-administered questionnaire, entered into EpiData version 3.1, and analyzed using SPSS version 22.0 software. A logistic regression model was applied to control for confounders. The level of significance was determined at a p-value of less than 0.05.

Results:

The magnitude of pregnant women’s satisfaction with antenatal care services was 70.3% (95% confidence interval (CI) = 66.4%–74.3%). Receiving antenatal care services from the hospital (adjusted odds ratio (AOR) = 2.44, 95% CI = 1.50–3.98), did not attend formal education (AOR = 2.53, 95% CI = 1.52–4.20) and attended primary education (AOR = 2.17, 95% CI = 1.17–4.04), having a repeated visit to antenatal care (AOR = 4.62, 95% CI = 2.98–7.17), initiating antenatal care services within the first trimester (AOR = 1.74, 95% CI = 1.12–2.71), having no history of stillbirth (AOR = 2.52, 95% CI = 1.37–4.65), and waiting for no more than 30 min in the health facility to get service (AOR = 2.31, 95% CI = 1.28–4.16) were factors associated with pregnant women’s satisfaction with antenatal care services.

Conclusion:

More than two-thirds of pregnant women were satisfied with the antenatal care service. The type of health facility, education status, number and initiation time of antenatal visit, history of stillbirth, and waiting time to get service were factors associated with pregnant women’s satisfaction with antenatal care services.
Oral histiocytic sarcoma in a cat
Authors: Néčová Slavomίra , North Susan , Cahalan Stephen , Das Smita
Published: November 2020

Case summary

A 15-year-old neutered male domestic shorthair cat presented with a 4-week history of dysphonia and reluctance to chew hard food. Oral examination revealed a mass lesion on the caudal soft palate. Biopsy was performed and histopathology with immunohistochemistry was most consistent with histiocytic sarcoma. CT of the head identified a discrete, left-sided, soft tissue mass lesion cranial to the tonsil with bilaterally symmetrical regional lymph nodes. CT of the thorax was unremarkable. Surgical removal achieved cytoreduction but not complete removal. Adjuvant chemotherapy with lomustine 10 mg (30 mg/m2) was initiated. The patient developed suspected pancreatitis 2–3 weeks postoperatively, so further chemotherapy treatment was discontinued, but supportive treatment with pain relief and appetite stimulants was provided. Three months postoperatively, the patient developed recurrent dysphonia, and oral examination revealed a suspicion of local recurrence. Confirmation of diagnosis (cytopathology or histopathology) was not obtained. Supportive treatment to maintain a good quality of life was continued and the patient was euthanased 6 months after diagnosis owing to progressive disease.

Relevance and novel information

Only a few reports have been published describing histiocytic diseases of cats. To our knowledge, this is the first report of a feline histiocytic sarcoma of the oral cavity. Therefore, histiocytic sarcoma should be considered as a differential diagnosis in feline patients with an oral mass, especially if histopathology suggests a pleomorphic and poorly differentiated sarcoma. Immunohistochemistry for the confirmation of cell line origin would be strongly recommended.
Conversational agents and the making of mental health recovery
Authors: Meadows Robert , Hine Christine , Suddaby Eleanor
Published: November 2020

Background

Artificial intelligence (AI) is said to be “transforming mental health”. AI-based technologies and technique are now considered to have uses in almost every domain of mental health care: including decision-making, assessment and healthcare management. What remains underexplored is whether/how mental health recovery is situated within these discussions and practices.

Method

Taking conversational agents as our point of departure, we explore the ways official online materials explain and make sense of chatbots, their imagined functionality and value for (potential) users. We focus on three chatbots for mental health: Woebot, Wysa and Tess.

Findings

“Recovery” is largely missing as an overt focus across materials. However, analysis does reveal themes that speak to the struggles over practice, expertise and evidence that the concept of recovery articulates. We discuss these under the headings “troubled clinical responsibility”, “extended virtue of (technological) self-care” and “altered ontologies and psychopathologies of time”.

Conclusions

Ultimately, we argue that alongside more traditional forms of recovery, chatbots may be shaped by, and shaping, an increasingly individualised form of a “personal recovery imperative”.
Healthcare Workers Exposure Risk Assessment: A Survey among Frontline Workers in Designated COVID-19 Treatment Centers in Ghana
Authors: Ashinyo Mary Eyram , Dubik Stephen Dajaan , Duti Vida , Amegah Kingsley Ebenezer , Ashinyo Anthony , Larsen-Reindorf Rita , Kaba Akoriyea Samuel , Kuma-Aboagye Patrick
Published: November 2020

Background:

Healthcare workers (HCWs) are faced with an elevated risk of exposure to SARS-COV-2 due to the clinical procedures they perform on COVID-19 patients. However, data for frontline HCWs level of exposure and risk of COVID-19 virus infection are limited.

Objective:

We investigated the level of exposure and risk of COVID-19 virus infection among HCWs in COVID-19 treatment centers in Ghana.

Methods:

A cross-sectional study was utilized in this study and HCWs were invited by convenience to participate in the study, 408 HCWs in 4 COVID-19 treatment centers participated in the study. Adherence to infection prevention and control (IPC) measures were used to categorized HCWs as low or high risk of COVID-19 virus infection. The WHO COVID-19 risk assessment tool was used to collect quantitative data from the study participants.

Results:

There was a high (N = 328, 80.4%) level of occupational exposure to the COVID-19 virus. However, only 14.0% of the exposed HCWs were at high risk of COVID-19 virus infection. Healthcare workers who performed or were present during any aerosol-generating procedures (AGP) were 23.8 times more likely to be exposed compared to HCWs who did not perform or were absent during any AGP (AOR 23.83; 95% CI: 18.45, 39.20). High risk of COVID-19 virus infection was less likely among registered nurses (AOR = 0.09; 95% CI: 0.02, 0.60), HCWs who performed or were present during any AGP (AOR = 0.05; 95% CI: 0.01, 0.50) and HCWs with a master’s degree qualification (AOR 0.06; 95% CI: 0.01, 0.63).

Conclusion:

Despite the high level of exposure to the COVID-19 virus among HCWs in the treatment centers, only 14.0% were at high risk of COVID-19 virus infection. To protect this group of HCWs, treatment centers and HCWs should continue to adhere to WHO and national IPC protocols in managing of COVID-19 cases.
Development of a Pediatric Dermatology Screening Tool Based on Two Parent-Reported Skin Symptoms: Comparison of Parental Recognition and Physician Diagnosis of Skin Symptoms of Infants and Toddlers
Authors: Sato Hiroko , Goto Aya , Murakami Michio , Kawabata Yasuhiro
Published: November 2020

Aim

The objective of the present study was to develop a tool for mothers to assess their children’s skin condition with the ultimate goal of its wider use in general health checkups for infants and toddlers.

Methods

This was a single-institution, cross-sectional study in Japan, targeting parents of 200 infants and toddlers who visited a dermatology clinic between December 2018 and March 2019. The parents completed a self-administered survey of the mother’s perception of her child’s dermatological symptoms, itchiness, and sleep status, and a quality-oflife assessment, using a nine-question version of the Quality of life in Primary Caregivers of children with Atopic Dermatitis questionnaire (QP9). The attending physician was asked to complete a form about the child’s dermatological condition and the treatment prescribed. The severity of the dermatological condition noted by the physician was compared with the combined response to the 3 perception items (dermatological condition, itchiness, and sleep) reported by the parents, in order to identify the optimal cutoff score.

Results

Of 200 parent questionnaires distributed, 198 (99% response rate) were returned and analyzed, along with the responses from 198 physician records (100% response rate). The optimal cutoff score was 2/3 for the total score (range 0-6) for 2 items, itchiness and sleep status (sensitivity 73%, specificity 64%). There was a significant difference in QP9 scores between the 2 groups categorized by the cutoff score

Conclusions

A pediatric dermatological screening tool based on 2 symptoms reported by the parents of children with atopic dermatitis was developed, and its precision and criterion-related validity were confirmed. This simple tool could help parents become better aware of their children’s skin condition and allow healthcare workers to provide adequate skin care advice. This practical tool could be widely applicable in primary child care and public health service settings.
Online Clinical Consultation as a Utility Tool for Managing Medical Crisis During a Pandemic: Retrospective Analysis on the Characteristics of Online Clinical Consultations During the COVID-19 Pandemic
Authors: Zhou Fengli , Wang Zhouhan , Mai Xiaojun , Liu Xiaoyun , Reid Christopher , Sandover Sally , Zhang Kouxing , Xu Dan
Published: November 2020

Coronavirus disease 2019 (COVID-19) is a newly-identified infectious diseases that has rapidly spread throughout the world with rising fatalities with declaration by World Health Organization as the pandemic. Online consultations have been shown to alleviate the pandemic with our study aims to demonstrate whether online consultation can be a solution for acute health crisis. Retrospective analysis of the characteristics of online consultations through two primary care online-consultation platforms during COVID-19 pandemic was performed at the Third Affiliated Hospital of Sun Yat-Sen University, which led the assessment of COVID-19-symptoms patients in Guangzhou. The 3473 online consultations were divided into pre-pandemic and pandemic period groups with Chi-square test as statistical analysis method. The number of online consultations has increased with diagnosis of upper respiratory tract infection, psychological conditions, COVID-19-related investigations and interventions. The increased online consultations met the increased demand of the relevant clinical services and reduced the overwhelming hospital presentations, thus decreasing the potential COVID-19 spread inside the major tertiary hospital and sparing the resources for acute crisis management. The epidemiology and disease characteristics of online consultations during the pandemic have been demonstrated with identification of the enabling factors and potential barriers in improving online healthcare in China with online consultation model being a durable solution for pandemic in future.
Thirty-Day Mortality in COVID-19 Positive Patients With Hip Fractures: A Case-Series and Literature Review
Authors: Al Farii Humaid , Al Rawahi Salim , Samaila Elena , Lavini Franco , Magnan Bruno , Al Maskari Sultan
Published: November 2020

Introduction:

The novel coronavirus has spread rapidly around the world with particularly high mortality in the elderly. Care and nursing homes have become the sites of greatest concentration of cases. We intended to review 30-day mortality of COVID-19 patients with hip fractures. This is relevant given the disease impact in this age group.

Methods:

Medline and Embase databases were searched for relevant studies linked to mortality and morbidity in COVID-19 patients who have undergone non-elective hip surgeries using the keywords “COVID-19”OR “SARS-cov-2”OR “Coronavirus Infections”; AND “Surgery”OR “Hip”OR “Fracture”OR “Orthopedics.” We included all patients with hip fractures, but excluded pathological fractures and other non-traumatic hip pathologies. Four-hundred and eighty-one articles were identified for screening, in addition to an unpublished case-series of 67 patients that have 3 cases turned positive for COVID 19, yielding a total of 50patients for the final review.

Results:

The study included 4 articles published until May 9th 2020 and a case-series: 26(52%) patients were females; the median age was 86years; hypertension(53.6%), diabetes mellitus type II(28.6%), and coronary artery heart disease(25%) were the most common comorbidities; 34(68%) patients had intertrochanteric hip fracture and 16(32%) patients had femoral neck fractures; 22(59.5%) patients underwent cephalomedullary nail fixation, 12(32.4%) patients had hemiarthroplasty, and for 3(8.1%) patients, the type of surgery was not documented; 20(40%) patients died(12patients died before the surgery and 8died after surgery at a median time of 3days), 29(76.3%) patients had an unremarkable course throughout hospitalization and were discharged including 1(2.6%) patient managed non-operatively, and 1(2.6%) patient was admitted to the ICU after the surgery but eventually discharged.

Conclusion:

COVID-19 infected elderly patients have a higher 30-days mortality rate compared to non-COVID-19 infected cases. Further studies are warranted to look at the morbidity and mortality rates in COVID-19 positive patients with hip fractures and to investigate how these outcomes can be improved.

Level of evidence:

Level IV
Adult Outcomes of Justice Involved Indigenous Youth
Authors: Sittner Kelley J. , Estes Michelle L.
Published: November 2020

Juvenile arrest serves as a critical turning point in the life-course that disrupts the successful transition to adulthood and carries numerous consequences including diminished socioeconomic status. Despite their disproportionately high rates of contact with the criminal justice system (CJS), Indigenous people’s experiences remain largely invisible in extant research. Further, colonization has left them in an extremely marginalized position in terms of social, economic, and political power, which is compounded by CJS involvement. In the current study, we apply propensity score matching to investigate whether being arrested in adolescence impacts early adult socioeconomic outcomes (i.e., education, employment, and income). Data come from the Healing Pathways project, a longitudinal, community-based participatory study of North American Indigenous young people that includes eight waves of data in adolescence and three waves in early adulthood. We find that being arrested at least once in adolescence is associated with higher rates of unemployment, not completing high school, and low income, and lower rates of full-time employment and post-secondary education in young adulthood (mean age = 26.2 years). Criminal justice system involvement widens existing socioeconomic disparities, and remedying these consequences requires changes in how CJS policies are enacted as well as larger structural changes to address significant inequities in income, education, and employment for Indigenous people.
The Mechanism of Empathy and Relationship Commitment Through Emojis: Path to Perspective Taking, Inner Imitation, Emotional Empathy, and Relationship Commitment
Authors: Jeon Hye-Jin
Published: November 2020

We analyzed empathy and relationship commitment mechanisms through emojis. We defined emojis based on theoretical reviews and neuroscientific studies as a mind reading process. Perspective taking, inner imitation, and emoji cognition were independent variables. Emotional empathy and emotional response was the mediating variable. Relationship commitment and behavioral response was the dependent variable. Analyzing the relationship between variables indicated emotional empathy and relationship commitment through emojis having positive (+) relationships with “perspective taking” and “inner imitation,” the two dimensions of mind reading (cognitive and emotional) and, among them, a stronger positive (+) relationship with inner imitation, which is simulation theory’s (ST) cognitive process. Relationship commitment through emojis was strongly related to emotional empathy as a mediating factor than being directly related to cognitive processes (perspective taking, inner imitation). Moreover, considering inner imitation’s influence being greater than perspective taking, relationship commitment through emojis is mainly caused by emotional empathy with inner imitation as a mediating factor.
Employees’ Perception of CSR Affecting Employer Brand, Brand Image, and Corporate Reputation
Authors: Özcan Fatih , Elçi Meral
Published: November 2020

Employees are one of the most important factors in business. Therefore, enterprises should account for the expectations of employees, particularly their perception of the enterprise, and their behavior. This study investigates the importance of employees’ perceived corporate social responsibility (CSR) and also examines the potential role of predicting employer brand, brand image, and corporate reputation. The study’s participants comprise employees working in different departments of various corporations. A total of 559 surveys were collected from randomly sampled company employees working in small and medium-sized enterprises (SMEs) in Turkey, and the responses were analyzed using component-based least squares modeling. The model was analyzed and validated by Smart partial least squares software. Employee-oriented CSR activities have a positive effect on employer brand and brand image perceptions among employees in SMEs. Perceived corporate reputation mediates this relationship.
Spine Treatment Appraisal Report (STAR): Interbody Fusion Does not Fully Protect Against Rod Failure in Long Posterior Spinal Fusion for Adult Spinal Deformity
Authors: Dettori Joseph R.
Published: November 2020

El Dafrawy M, Bridwell K, Adogwa O, Shlykov M, Koscso J, Lenke LG, Lertudomphonwanit T, Kelly MP, Gupta M. Rod fractures and nonunions after long fusion to the sacrum for primary presentation adult spinal deformity: a comparison with and without interbody fusion in the distal lumbar spine. Spine Deform. 2020. doi: 10.1007/s43390-020-00 174-6. Online ahead of print. PMID: 32  725 494