bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual Theme Collection: Body Politics: Making Black Lives Matter
Authors: Asante Molefi Kete
Published: November 2020

Few journals in the social sciences have published as much over the past twenty years on the reality of racial, cultural, and social inequality in law and practice as the Journal of Black Studies. In this special issue edited in the 50th year of the journal we have initiated a series related to the evolution of human relations that considers where we have been and what we need to arrive at the place where we should be. In this issue we look at the presence of violence against African descended people, the mediations of people, laws, and processes intervening in the nature of our interactions in order to establish a more humane future. This issue should allow teachers, scholars and students to re-evaluate and re-examine their own set of assumptions, actions, and potentialities in regard to humanity.
Sculpting Culture: Early Maternal Responsiveness and Child Emotion Regulation – A UK-Italy Comparison
Authors: Bozicevic Laura , De Pascalis Leonardo , Montirosso Rosario , Ferrari Pier Francesco , Giusti Lorenzo , Cooper Peter Jonathan , Murray Lynne
Published: November 2020

Mother-infant interactions, including culturally specific features, have been found to predict child socio-emotional development (e.g., social communication and emotion regulation (ER)). However, research is lacking on the specific processes involved. We used a cross-cultural, longitudinal design, and a microanalytic coding approach to address this issue. Fifty-two mother-infant dyads were recruited from the UK ( N = 21) and Italy ( N = 31), representing Northern European and Mediterranean cultures, respectively. While these cultures share core features of parent-child relationships, their values about emotional expressiveness differ. We observed face-to-face mother-infant interactions at 2 months (T1), and coded infant socio-emotional behavior and maternal responses. Children were seen again at 2 years (T2), when their ER in the face of frustration, using the Barrier Task, was assessed, and the occurrence of different “mature” strategies (communicative and autonomous) coded. Results revealed common features of interactions at T1 (infant socio-emotional expressions, and maternal positive responses), but also cultural variation in the frequency of different infant cues (more pre-speech in UK infants, more smiles in Italians), and of maternal responses to them. While greater overall maternal responsiveness at T1 predicted more mature ER in general at T2, cultural differences in early responsiveness to specific infant behaviors predicted later group differences in children’s use of particular ER strategies, with UK children using more communicative strategies, and Italians more autonomous. Findings indicate that positive maternal behaviors that are common across cultures (e.g., responsiveness) promote overall successful child emotion regulation, while culturally specific features of interactions are associated with how child socio-emotional outcomes are expressed.
Treatment and Non-Treatment Professionals in Texas: Race, Sex, Age, and Level of Education Influencing Attitudes About Addiction
Authors: Richards Shauna N. , Broadus Angela D. , Yelderman Logan A.
Published: November 2020

Using a two-step process, attitudes about addiction among Texas professionals working primarily with youth were examined. In Step 1, researchers examined attitudes about addiction in Texas ( n = 1,078), across professionals working with youth. In Step 2, researchers selected a subset of treatment and non-treatment professionals ( n = 522) and tested two hypotheses related to differences in attitudes between the two professional groups. Two research questions were also explored. Step 1 analyses revealed stronger endorsement of attitudes related to the psychological and sociological models, and that demographic variables were modest but significant predictors of attitudes about addiction. Step 2 analyses revealed that professional status and demographic variables were significant predictors of attitudes about addiction. Findings have implications for treatment seeking, treatment and non-treatment professional behavior toward adolescents with substance use issues, and the need for continuing education to reduce stigma.
Factors Related to Data-Based Decision-Making: Examining Experience, Professional Development, and the Mediating Effect of Confidence on Teacher Graph Literacy
Authors: Oslund Eric L. , Elleman Amy M. , Wallace Kelli
Published: November 2020

In tiered instructional systems (Response to Intervention [RTI]/Multitier System of Supports [MTSS]) that rely on ongoing assessment of students at risk of experiencing academic difficulties, the ability to make informed decisions using student data is critical for student learning. Prior research has demonstrated that, on average, teachers have difficulty analyzing and interpreting student progress-monitoring (PM) data presented graphically (i.e., graph literacy). This study examines the impact that teacher training, experience, and confidence have on teacher graph literacy, using structural equation modeling. Data were gathered from a nationally representative sample of 309 teachers and included latent variables related to their experience (e.g., years teaching, years working with RTI), training (e.g., hours of data-based decision-making [DBDM] professional development), and confidence (e.g., confidence in interpreting data, confidence in determining student response) as well as data-based decision-making skills on a graph literacy assessment. Findings indicate that latent experience and confidence factors predicted graph literacy but training did not. Furthermore, training increased teacher confidence but experience did not. Finally, confidence did not mediate the effect of experience or training on graph literacy.
Impacts of Leader Humility Between Authority and Trustworthiness on Compliance: Tests of Three-Way Interaction
Authors: Chiu Teng-Chu , Hung Yishuo
Published: November 2020

This study aims to examine how leader humility affects the relationship between authority and trustworthiness, and its effect on subordinate compliance. This study further addresses the reliability and validity issue to advance the measurement of humility; 300 participants consisting of leader-subordinate dyads of 50 leaders and 250 subordinates contributed to the data collections. This study found that both trustworthiness and authority have impact on subordinate compliance. Through three-way moderating analysis, this study further revealed that a leader’s high humility, along with high trustworthiness under high authority results in the highest compliance, whereas a leader’s high humility combined with low trustworthiness under low authority leads to the lowest compliance. Moreover, although a leader’s personal background showed no relationship with the degree of leader humility, divergent combinations of leader-subordinate backgrounds were found to affect the degree of humility. Based on our findings, we propose that to effectively increase compliance, leader humility must be viewed as a strength when combined with high trustworthiness in high authority situations. This study may prompt future research in exploring humility in the context of virtue versus power, and the effects of humility in leadership. The implications of these findings for both theory and practice are also discussed.
Social Factors and the Teaching of Pronunciation: What the Research Tells Us
Authors: Hansen Edwards Jette , Chan Ka Long Roy , Lam Toni , Wang Qian
Published: November 2020

The current article presents a state-of-the-art review of research on the social factors that have been found to impact how learners acquire and use a second language (L2) sound system. These factors include ethnic group identification, gender, and study abroad experience. The research synthesis presents the key findings on each social factor, with examples drawn from the cited research for illustration. The article then presents recommendations for pedagogical practice. These recommendations are aimed at both teachers and learners, and for use both outside and inside the L2 classroom; they include examples and links to free online resources that both teachers and learners can use to enhance meaningful L2 pronunciation teaching and learning.
Migration and Socio-Economic Adaptation: A Study of Tibetans in Rumtek Dharma Chakra Centre, Sikkim
Authors: Choden Sonam , Thapa Sandhya , Surjyajeevan Yumnam
Published: November 2020

The post-1959 migration of Tibetans due to Chinese incursion in Tibet impelled them to seek refuge in many countries. Due to socio-cultural, historical and religious ties between Sikkim and Tibetan for centuries and also due to geographical proximity, Sikkim was one of the most desired destinations. Based on the study of Tibetan settlement of Rumtek Dharma Chakra Centre, the largest monastery of Karma Kagyu Lineage in Sikkim, the article is an attempt to make an exploratory study to enquire the process of migration and socio-economic adaptation faced by the migrant Tibetan communities of Rumtek. By revisiting historical references and comparative evaluation of the field carried out in two phases, the article is a sociological exploration to examine the changes and challenges faced by the community.
Uniportal thoracoscopic surgical management using a suture traction for primary pneumothorax
Authors: Fiorelli Alfonso , Cascone Roberto , Carlucci Annalisa , Natale Giovanni , Freda Chiara , Bove Mary , Messina Gaetana , Liguori Giovanni , Santini Mario
Published: November 2020

Background

We devised a new strategy using suture traction to facilitate the management of primary spontaneous pneumothorax during uniportal thoracoscopy. To test its validity, we compared the outcomes of our modified technique with those of conventional three-port thoracoscopy.

Methods

This retrospective study included all 43 consecutive patients with primary spontaneous pneumothorax undergoing thoracoscopy between January 2017 and December 2019. They were divided within two groups: uniportal thoracoscopy using suture traction ( n = 21) and conventional 3-port thoracoscopy ( n = 22). Postoperative pain, paresthesia, patient satisfaction, and surgical outcomes were compared to test the validity of our technique.

Results

There were no significant differences in operative time (47 ± 4.8 vs. 43 ± 7.9 min), number of staples used (2.5 ± 0.9 vs. 2.3 ± 0.6), postoperative drainage (235 ± 15 vs. 240 ± 19 mL), chest tube drainage time (3.2 ± 0.8 vs. 3.4 ± 1.8 days), and hospital stay (4.2 ± 1.2 vs. 4.3 ± 0.9 days). However, uniportal thoracoscopy was associated with less pain at 24 ( p = 0.01), 48 ( p = 0.02), and 72 h ( p = 0.03) postoperatively, less paresthesia at 24 ( p = 0.03), 48 ( p = 0.02), and 72 h ( p = 0.02) postoperatively, and greater patient satisfaction at 24 ( p = 0.04), 48 ( p = 0.02), and 72 h ( p = 0.02) postoperatively.

Conclusions

Our technique may facilitate the use of uniportal thoracoscopy for treatment of primary spontaneous pneumothorax, reducing neurological sequelae and improving patient satisfaction compared to the traditional three-port thoracoscopy.
Body mass index, time of day and genetics affect perivascular spaces in the white matter
Authors: Barisano Giuseppe , Sheikh-Bahaei Nasim , Law Meng , Toga Arthur W , Sepehrband Farshid
Published: November 2020

The analysis of cerebral perivascular spaces (PVS) using magnetic resonance imaging (MRI) allows to explore in vivo their contributions to neurological disorders. To date the normal amount and distribution of PVS in healthy human brains are not known, thus hampering our ability to define with confidence pathogenic alterations. Furthermore, it is unclear which biological factors can influence the presence and size of PVS on MRI. We performed exploratory data analysis of PVS volume and distribution in a large population of healthy individuals (n = 897, age = 28.8 ± 3.7). Here we describe the global and regional amount of PVS in the white matter, which can be used as a reference for clinicians and researchers investigating PVS and may help the interpretation of the structural changes affecting PVS in pathological states. We found a relatively high inter-subject variability in the PVS amount in this population of healthy adults (range: 1.31–14.49 cm3). The PVS volume was higher in older and male individuals. Moreover, we identified body mass index, time of day, and genetics as new elements significantly affecting PVS in vivo under physiological conditions, offering a valuable foundation to future studies aimed at understanding the physiology of perivascular flow.
Neural activation of different music styles during emotion-evoking
Authors: Liu Ying , Tang Qingting , Zhao Xingcong , Lu Huan , Yuan Guangjie , Wang Gaoyuan , Liu Guangyuan
Published: November 2020

Music style is tightly connected with listeners’ emotional processes and neural activities. However, it remains unclear how the brain works when different music styles are processed emotionally. The current study analyzed the neural activation associated with five music styles during emotion-evoking. Twenty non-musicians participated in the functional magnetic resonance imaging (fMRI) scanning and the emotional ratings of pleasure and arousal evoked by pop, rock, jazz, folk, and classical music. Results showed that classical music was associated with the highest pleasure rating and deactivation of the corpus callosum. Rock music was associated with the highest arousal rating and deactivation of the cingulate gyrus. Pop music activated the bilateral supplementary motor areas (SMA) and the superior temporal gyrus (STG) with moderate pleasure and arousal. As the first fMRI experiment investigating the relationship between the music style and emotion, it provides neural correlates of different music styles during emotion-evoking.
Manufacturing deformation impact on the performance of electrical generator for the wind turbine application
Authors: Singh Gopal , Sundaram Kalpathy
Published: November 2020

The system of systems approach is the representation of several distributed and independent systems, for a larger and complex system. The system can be defined as interacting and interdependent components forming a complex system. System perspective considers every single stator bar as a complex system, made up of several component strands and vent tubes. Strands are interacting and interdependent in orientation, to cancel out unbalanced strand voltage and minimizing circulating current. Visualizing the electrical generator with the system approach, the issue of incorrectly aligned interdependent and interacting components of the system has been noticed. The study presents the effective flux calculation due to strand tilt, and a nondestructive testing technique to measure the strand tilt. This paper first time presents a unique system perspective of the electrical generator; this would open further dimensions of system research, in electrical rotatory machinery and beyond.
Examining Prominent Causes of Traffic Injury Severity in Louisiana with Multinomial Logistic Models
Authors: Lukongo Onyumbe Enumbe B.
Published: November 2020

Accidents rank third among the top 10 leading causes of death in Louisiana, claiming more than 2,000 lives out of a total of almost 33,000 deaths. Drivers’ characteristics (age and gender), the geometry of the roadways, driving on the major roadways, the day of the week, and the wet or dry condition or the road have been associated with crash severity. This study applies unordered multinomial logistic models to investigate causes leading to crash severity in Louisiana. Several models were estimated and the best results were retained for presentation and discussion. Consistent with previous research, findings suggest that drivers’ gender and age matter for traffic safety. Individually, male and older drivers are too risky. Major roads, weekdays, dry surfaces, and road geometry increase the risk of fatal accidents. Male drivers are prone to severe and fatal accidents while old drivers are vulnerable to all types of accidents. Young drivers and female drivers feature among cases of injury and moderate accidents. Evidence suggests that crash severity is not ethnicity specific, contrary to some studies. This study is relevant because it builds a new dataset for safety research, identifies risk factors, and informs the aim of public safety policy to reduce loss of life, injuries, and costs resulting from motor vehicle accidents.
Circulatory support for prolonged electro-mechanical standstill in fulminant pediatric myocarditis
Authors: Deshpande Shriprasad R , Willett Renee C , Ramakrishnan Karthik , Peer Syed Murfad , Sinha Pranava
Published: November 2020

Pediatric patients with fulminant myocarditis can rarely present with complete heart block with severe hemodynamic compromise, cardiac arrest and require circulatory support. Additionally, patients with cardiac dysfunction that require extracorporeal membrane oxygenation (ECMO) support sometimes develop cardiac stun or standstill. These factors are associated with extremely poor survival. We present a case of fulminant myocarditis presenting with dense heart block, no ventricular electrical activity resuscitated with ECMO that developed prolonged cardiac standstill. We present the clinical course, management including ECMO followed by biventricular assist devices, pacing and review supporting literature. We hope that the case will highlight challenges in management and decision making in such patients.
From Metropolitanization to Megaregionalization: Intentionality in the Urban Restructuring of Java’s North Coast, Indonesia
Authors: Hudalah Delik , Octifanny Yustina , Talitha Tessa , Firman Tommy , Phelps Nicholas A.
Published: November 2020

This paper examines the intentionality behind the emergence of megaregion in Indonesia’s reinvented developmentalist state tradition. Illustrated by the case of Java, this paper explores the role of regional planning in facilitating megaregion emergence. It reveals that sectoral and ad hoc national planning policies, although not intentionally aimed to guide spatial development, implicitly promote the emergence of this megaregion. This is particularly registered in the construction of megaprojects aimed at increasing regional competitiveness through the improvement of interregional connectivity and facilitating exurbanization through the building of in-between cities.
Urbanization beyond the Metropolis: Planning for a Large Number of Small Places in the Global South
Authors: Randolph Gregory F. , Deuskar Chandan
Published: November 2020

How are urban population and its growth distributed across urban settlements of different sizes? In the Global South, this is a critical planning question, yet its answer is muddled by contradictory claims in the literature and inconsistent data. Using a new dataset measuring urbanization from 1975 to 2015, we find that urban populations in the South are less concentrated in megacities than in the North—contrary to conventional wisdom. Given an explosion in the number (not simply size) of urban settlements in the South, we suggest reviving the concept of “barefoot planning” as an approach for empowering communities beyond the metropolis to shape the urbanization process.
In-Between: Late-Arriving Teens in Adult Education Programs Navigating Child and Adult Immigrant Narratives
Authors: Birman Dina , Oberoi Ashmeet K. , Garcia Maria Fernanda , Haarlammert Miryam , Leiva Massiel , Lane Alexandra , Culbreth Caroline , Taylor Hanna , Ruiz-Sorrentini Andrea , Trickett Edison J.
Published: November 2020

We report on a grounded theory study of late-arriving immigrant youth (LIY) who arrived in the United States at 16–18 years of age and were referred to daytime General Education Diploma (D-GED) programs. These programs provide an alternate path to a high school diploma for youth with insufficient knowledge of English to complete graduation requirements before turning 19 years. Based on interviews with 38 youth from Latin America, we propose the core category of our grounded theory to be students Navigating Child and Adult Immigrant Narratives while making educational and career decisions. This process begins before immigration when youth imagine ambitious alternate selves—ideal educational and career selves in the United States, consistent with the American Dream and immigrant child narrative. The D-GED programs represent a compromise between a child and adult educational pathway. Students in these programs felt excluded from the regular high school but received social and emotional support while on a faster track to graduation and self-sufficiency as adults. However, students lacked concrete information and roadmaps for how to attain their ambitious goals. The study highlights the unique challenges faced by LIY as they develop ambitious and realistic education and career goals.
An integrated machine learning: Utility theory framework for real-time predictive maintenance in pumping systems
Authors: Khorsheed Raghad M , Beyca Omer Faruk
Published: November 2020

Bearings are the most widely used mechanical parts in rotating machinery under high load and high rotational speeds. Operating continuously under such harsh conditions, wear and failure are imminent. Developing defects give rise to even-higher vibration and temperature levels. In general, mechanical defects in a machine cause high vibration levels. Therefore, bearing fault identification and early detection enables the maintenance team to repair the problem before it triggers catastrophic failure in the bearing. Machine downtime is thus avoided or minimized. This paper explores the use of Machine Learning (ML) integrated with decision-making techniques to predict possible bearing failures and improve the overall manufacturing operations by applying the correct maintenance actions at the right time. The accuracy of the Predictive Maintenance (PdM) module has been tested on real industrial production datasets. The paper proposes an effective PdM methodology using different ML algorithms to detect failures before they happen and reduce pump downtime. The performance of the tested ML algorithms is based on five performance indicators: accuracy, precision, F-score, recall, and an area under curve (AUC). Experimental results revealed that all tested ML algorithms are successful and effective. Furthermore, decision making with utility theory has been employed to exploit the probability of failures and thus help to perform the appropriate maintenance interventions. This provides a logical framework for decision-makers to identify the optimum action with the maximum expected benefit. As a case study, the model is applied on forwarding pumping stations belonging to the Sewerage Treatment Company (STC), one of the largest sewage stations in Qatar.
Analysis of sealing performance of a kind of profiled rubber gasket used in the radial contact seal structure
Authors: Song Xinyi , Huang Song , Hui Hu , Hu Xindan
Published: November 2020

Sealing performance of standard rubber gaskets in the radial contact seal structure are observed through the experiment. A kind of profiled rubber gasket is proposed to replace the standard gasket. Leakage experiment and numerical simulation are carried out to study the sealing performance and failure mode of the profiled gasket. Several equations are presented to help analyze the failure reason. Results show that sealing performance of the profiled rubber gasket is more reliable than that of the standard rubber gasket. The failure reason of the profiled rubber gasket is that the friction force between the gasket external face and tube wall cannot balance the tube internal pressure. Dimension precision of the metal compressive ring has a great effect on the failure pressure.
Effect of longitudinal deformation on wave propagation in truss core sandwich panel
Authors: Liang Sun , Yougang Xiao
Published: November 2020

The longitudinal deformation has been ignored by most previous study on vibroacoustic behaviours of truss core sandwich panels. This paper investigates its effect by developing two theoretical models. One, named as full model, considers both flexural and longitudinal deformation of face sheets while the other, named as flexural model, incorporates only flexural deformation. By comparing free characteristic waves obtained from two models, one find that flexural model ignore two waves, that is, a compressive wave and a global flexural one. The ignored waves cause vibration in transverse direction even at high frequencies, and thus result in vibration peaks under forced vibration. Therefore the flexural model would underestimate the vibration response, and the longitudinal deformation of face sheets cannot be ignored during dynamic analysis of the sandwich panels.
Exploring the Yield Spread Between Sukuk and Conventional Bonds in Malaysia
Authors: Asmuni Nurin Haniah , Tan Ken Seng
Published: November 2020

This article aims to shed light on the differences in yield rate between conventional bond and sukuk in the Malaysian market. We find that the historical yield rates for the government-issued sukuk is significantly higher than the conventional bond. Conversely, there is a slight yield spread discount between the corporate-issued sukuk and bonds for all rating classes. We conclude that liquidity factor can mainly explain the positive yield spread on the government-issued sukuk. We also illustrate the effect of tax and expenses on asset pricing, which may contribute to the yield spread discount for corporate issuance.

JEL Classification: E43, G12, G13
Socio-Economic Progress with Poor Governance: How are Amartya Sen’s Thoughts Relevant for Contemporary Bangladesh?
Authors: Mahmud Wahiduddin
Published: November 2020

The overriding concerns of Amartya Sen’s writings are about how to promote public action towards achieving an equitable and just society, which particularly addresses the needs of the underprivileged. While his ideas are of great relevance for all developing countries, this is more so for India and Bangladesh—the two countries that provide the socio-economic settings for much of his empirical works. Sen has praised the remarkable progress in many social development indicators that Bangladesh has achieved compared to India, despite having a much lower per capita income and suffering from the same, or even much worse, institutional and policy failures. In fact, the contradictions of Bangladesh lie in its impressive socio-economic progress achieved under extremely poor institutions of economic and political governance. By drawing upon Sen’s writings on issues ranging from human development and social inequalities to the concepts of freedom and “public reasoning”, this essay aims at understanding the factors underlying Bangladesh’s achievements and the challenges that lie ahead.
Integration and Interdependence Among Equity Markets in South Asia: Measuring Through ARDL Bounds Approach
Authors: Prakash J. Vineesh , Nauriyal D. K.
Published: November 2020

This article examines the degree of integration among the financial markets in South Asia at regional and extra-regional levels by using monthly data collected for the period 2010–2018. It uses autoregressive distributed lag (ARDL) bounds test approach of cointegration, and short-run causalities are obtained under the error correction framework. The bounds testing procedure finds the existence of long-run relations among the four markets when the equity market of India is taken as the dependent variable. Although the bounds testing procedure finds some evidence of integration at the regional level, evidence suggests that integration at the global level is much higher than the integration at the regional level for this region. Another interesting finding is that Pakistan does not exhibit cointegrating relations with the rest of the equity markets in South Asia, and results are inconclusive when developed countries’ equity markets are introduced to the estimated models, which can be attributed to the political instability that Pakistan is consistently plagued with and also its strained relationship with India, thereby hampering capital inflows.
Navigating the Monetary Sanctions Maze: Understanding and Confusion Among Criminal Legal Debtors
Authors: Spencer-Suarez Kimberly , Martin Karin D.
Published: November 2020

Monetary sanctions in the criminal legal system are legally and procedurally complex. If not paid in a timely manner, a single conviction can result in multiple legal financial obligations, varying in kind, payment procedure, and consequences. This study examines how, and the extent to which, criminal legal debtors understand monetary sanctions. Based on interviews with 60 individuals who owed criminal legal debt in New York, we propose a typology of debtor understanding. Proximal understanding pertains to individual, case-level factors and is instrumentally oriented. Distal understanding concerns system-level matters and is oriented toward normativity and fairness. We examine how debtors develop each type of understanding, how these dimensions interact, and the implications of debtor understanding for compliance behavior.
Considering the Process of Debt Collection in Community Corrections: The Case of the Monetary Compliance Unit
Authors: Link Nathan W. , Powell Kathleen , Hyatt Jordan M. , Ruhland Ebony L.
Published: November 2020

Monetary sanctions levied on individuals on probation and parole may dramatically influence their ability to reintegrate into the community and to complete their community supervision. Yet very little work has empirically assessed how agencies respond to these obligations. This is critical, given that individuals under community supervision occupy a liminal space: free in the community yet often at risk of violation, rearrest, additional fines, or re-incarceration. In this article, we introduce an approach to the collection and management of monetary sanctions by an adult probation and parole agency in one Pennsylvania county. This specialized department focuses solely on repayment of fines, fees, and costs for a subset of probationers and parolees who have completed all other supervision requirements. We complement the conceptual overview by presenting administrative data on this caseload ( N = 5,811) to describe the population under supervision and assess the factors associated with debt amount, having difficulty with repayment, and being the subject of an enforcement action for non-payment. We conclude with a discussion of the advantages and disadvantages of this model compared with historical and other existing models of debt enforcement during community supervision.
Intraoperative Site Vancomycin Powder Application in Infected Diabetic Heel Ulcers With Calcaneal Osteomyelitis
Authors: Brodell James D. , Kozakiewicz Lauren N. , Hoffman Samantha L. , Oh Irvin
Published: November 2020

Background:

Intraoperative site application of vancomycin powder has been found to be beneficial in foot and ankle surgery among diabetic patients undergoing elective procedures. However, there are concerns for risks such as selection of multidrug-resistant bacteria, local tissue irritation, and increased wound complications. The clinical utility of intraoperative site vancomycin powder application in infected diabetic foot ulcer surgery is unknown. We aimed to report the clinical outcomes of partial or total calcanectomy for diabetic heel ulcer (DHU) and determine if intraoperative site application of vancomycin powder placement at the time of wound closure leads to improved clinical outcomes.

Methods:

A current procedural terminology query (CPT 28120: partial excision bone; talus or calcaneus) was run that identified 35 patients representing 38 calcanectomies performed secondary to infected DHU with calcaneal osteomyelitis. An initial group of 25 patients did not receive intraoperative site vancomycin powder, whereas the following 13 cases received intraoperative site vancomycin powder. Demographics, clinical characteristics, comorbidities, operative complications, unexpected return to the operating room (RTOR), and revision amputations were recorded for each patient. Average follow-up was 26.1 (6.5-51.6) months.

Results:

There was a significantly higher rate of RTOR among the vancomycin powder cohort (VANC) relative to the no-vancomycin cohort (No-VANC) (84.6% vs 36.0%, P = .038). Of the 13 VANC patients, 3 healed the wound and did not require RTOR, 2 underwent below-knee amputation (BKA), 2 received irrigation and debridement (I&D), and 6 underwent revision or total calcanectomies. Of the 25 No-VANC patients, 17 healed the wound, 4 underwent BKAs, 1 received an I&D, and 2 required revision or total calcanectomy. There was a trend toward increased rates of revision calcanectomy and BKA among the VANC cohort, but this was not statistically significant (61.5% vs 28.0%, P = .079).

Conclusion:

Partial or total calcanectomies for the management of infected DHU resulted in an overall healing rate of 50.0%, unplanned RTOR and revision calcanectomy rate of 39.5%, and a limb salvage rate of 82.6%. We found no clinical benefit with the intraoperative site application of vancomycin powder.

Level of Evidence:

Level III, retrospective case control study.
Vertical Integration and Physician Practice Labor Composition
Authors: Barnes Hilary , Martsolf Grant R. , McHugh Matthew D. , Richards Michael R.
Published: November 2020

With the growth of vertical integration among physician practices (i.e., hospital–physician integration), there have been many studies of its effects on health care treatments and spending. It is unknown if integration shapes provider configurations, especially against the backdrop of increasing employment of nurse practitioners (NPs) and physician assistants (PAs) across specialties. Using a longitudinal panel of 144,289 practices (2008-2015), we examined the association of vertical integration with NP and PA employment. We find positive associations between vertical integration and newly employing NPs and PAs within physician practices; however, the relationships differ by practice specialty type as well as timing of vertical integration. Supplementary analyses offer supporting evidence for coinciding enhancements to practice productivity, diversification, and provider task allocation. Our results suggest that vertical integration may promote interdisciplinary provider configurations, which has the potential to improve care delivery efficiency.
Mapping the History of Journalism & Mass Communication Educator: 30 Years of Publication (1990–2019)
Authors: Gearhart Sherice , Cho Janice
Published: November 2020

University educators and administrators have used Journalism & Mass Communication Educator as an outlet to share ideas. As the journal enters its 75th year of publication, it is also decades into the transition to peer review. Thus, it is important to review publication trends since this development. This study analyzes 30 years of research articles printed from 1990 to 2019. Aspects of article authorship are examined and reveal trends in the publication history. Results demonstrate the growing amount of diversity across a number of aspects and remains on par with publication trends throughout the discipline.
Reducing chemotherapy administration time on an inpatient oncology unit
Authors: Nguyen Trung V , Ononogbu Onyebuchi J , Egwim Oliver U , Saffari Farnoush , Ferrer Jamie
Published: November 2020

Purpose

Due to the multifaceted chemotherapy workflow within the hospital, many patients often experience delays in receiving their treatment. This study aims to evaluate the causes for chemotherapy administration delays and implement new methods to reduce delays from order release to chemotherapy administration on an inpatient oncology unit at a community-focused academic medical center.

Methods

In this prospective quality improvement study, we developed a process map to track baseline time stamps and utilized performance improvement tools to identify causes for chemotherapy delays. Based on recognized areas for improvement, the Plan-Do-Study-Act (PDSA) model was used to implement one cycle of interventions. Chemotherapy orders were collected, and benchmark time stamps were documented from the electronic medical record.

Results

The primary outcome for the number of chemotherapy delays, based on compliance rate, was reduced from 63/100 (63.0%) to 48/100 (48.0%), a 15% reduction (p = 0.046). Our primary outcome of chemotherapy delays, based on our institutional benchmark of <3 hours, did not show statistical significance. Median time from chemotherapy order release to administration decreased from 7.08 hours at baseline to 6.10 hours post-intervention, a 13.8% reduction (p < 0.0001). Median verification, preparation, and delivery times were all reduced post-intervention by 13.0% (p < 0.0001), 3.9% (p = 0.024), and 14.8% (p < 0.0001) respectively.

Conclusions

This study allowed our institution to evaluate our current practice and reformulate the chemotherapy administration process. With the continuing education on the chemotherapy administration process and additional PDSA cycle interventions, it will help standardize our process and ultimately continue to reduce chemotherapy delays.
Oedipism: An unusual case of auto-enucleation including mechanism of avulsion
Authors: Okafor Linda , Choudry Abid , Mudhar Hardeep S , Sandramouli Soupramanien
Published: November 2020

Introduction:

Self-inflicted enucleation, also known as auto-enucleation (AE) or Oedipism, is an uncommon and severe form of ocular injury which presents as an ophthalmic and psychiatric emergency. Usually known to occur with untreated psychosis, this case is a rare report which demonstrates AE as a result of a subsequently diagnosed drug induced psychosis. We report the clinical presentation, management and for the first time a detailed speculative account about the mechanism of AE, based on our clinicopathologic findings.

Case report:

A 53-year old Afro-Caribbean patient was arrested following an altercation and was incarcerated awaiting arraignment. The patient had no previous psychiatric history but tested positive for cannabis, opiates and cocaine as well as admitting to illicit drug use in the community. Whilst in custody, the patient self-enucleated his right eye. The patient declined consent to eye examination and was subsequently admitted under section 2 of the Mental Health Act. After full work-up including Goldmann visual fields and magnetic resonance imaging, he underwent right orbital exploration under anesthetic where AE was confirmed whilst the left eye showed evidence of attempted enucleation. The residual tenons and conjunctiva was subsequently repaired without placement of an orbital implant in the right orbit. The globe was sent for histology which revealed clues to the potential mechanism of auto-enucleation.

Conclusion:

This case is unique as it offers an alternative presentation to those most commonly reported in the current literature, highlights the sparsity of literature detailing the mechanism of AE and stimulates discussion around various potential systemic etiological differential diagnoses, management strategies and complications of AE.
Iris thickness measurements in patients with diabetic retinopathy
Authors: Demirtas Önder , Pekel Gökhan , Pekel Evre , Cetin Ebru Nevin
Published: November 2020

Purpose:

The aim of the study was to investigate iris alterations in diabetic retinopathy (DR).

Methods:

Sixty-nine eyes of 69 patients were recruited and three groups of patients were examined: proliferative DR ( n = 25), non-proliferative DR ( n = 21) and healthy controls ( n = 23). Macular optical coherence tomography (OCT), anterior segment iris OCT, and slit lamp digital camera photographs were taken. The thicknesses of the iris at a distance of 1 mm, 2 mm, and 3 mm from pupil margin were measured via iris OCT. Iris crypt count, furrow extent, color tone and collarette/diameter ratio were measured by means of anterior segment photography. Visual acuity, refractive error, intraocular pressure, and numbers of intravitreal injections were also recorded.

Results:

The iris thickness measurements at 1 mm from pupil margin were significantly correlated with the macular thickness measurements ( r = 0.32, p = 0.016). In the proliferative DR group, total number of injections were significantly correlated with the iris thickness measurements at 1 mm ( r = 0.25, p = 0.04). The iris thickness measurements at distances 1 mm, 2 mm, and 3 mm from the pupil margin were similar in all of the groups ( p > 0.05). Iris thickness did not correlate with age, intra-ocular pressure and collarette iris ratio in all the participants ( p > 0.05).

Conclusion:

Iris thickness is similar in diabetic patients and healthy controls. Meanwhile, iris thickness near the pupillary margin is positively correlated with macular thickness.
Topical corticosteroids in Acanthamoeba keratitis: Friend or foe?
Authors: Wouters Karlijn A , Verhoekx Jennifer SN , van Rooij Jeroen , Wubbels René , van Goor Arnoud T
Published: November 2020

Background/Aims:

To analyse the effect of topical corticosteroids before start of anti-amoebic therapy (AAT) in Acanthamoeba keratitis (AK) on final visual outcome and to identify factors that affect the outcome.

Methods:

A retrospective case control study of the medical records of patients diagnosed with AK at the Rotterdam Eye Hospital between 2003 and 2017 was performed. Patient demographic and clinical data were collected. The outcomes of patients treated with topical corticosteroids before the start of AAT were compared with those not treated with topical corticosteroids. Univariable and multivariable analyses were conducted.

Results:

A total of 109 patients was diagnosed with AK, with a mean follow-up time of 18 months. The use of corticosteroids was associated with a delay in diagnosis and thereby the start of AAT. In the non-steroids group, mean diagnostic delay was 23 days versus 62 days in the steroids group ( p < 0.001). We found a statistically significant effect of pre-AAT steroid use on disease severity stage ( p < 0.001). Also, a suboptimal visual outcome (⩽20/80) was seen significantly more frequent in the steroids group, as was the need for an urgent penetrating keratoplasty (PK) and for the total need of surgeries.

Conclusion:

Use of corticosteroids before the start of AAT is associated with a suboptimal visual outcome, a significantly higher risk for a PK and a significantly more severe disease stage. It is important to continuously consider a differential diagnosis in a keratitis of unknown cause and to use corticosteroids cautiously before a definite diagnosis.
MRI after successful eyeWatchTM implantation
Authors: Roy Sylvain , Villamarin Adan , Stergiopulos Nikolaos , Mermoud André
Published: November 2020

The eyeWatchTM is a new glaucoma drainage device that includes an adjustable mechanism that can vary the resistance to aqueous humor outflow during the postoperative period to reduce the burden of postoperative intraocular pressure (IOP) management. The mechanism contains a magnetic rotor that can be adjusted using an external magnetic control unit. Adjustments of the position of the rotor are performed mostly in the initial postoperative follow-up period in order to reach the target IOP. However, for some patients, it might be necessary to perform MRI for the sake of medical investigations. As the MRI is creating a strong magnetic field, this magnetic field is likely to interact with the adjustable rotor of the eyeWatchTM, resulting in modification of the IOP. We report the case of an 82-old female patient successfully operated with the implantation of an eyeWatchTM. The patient underwent a cerebral MRI for persistent headache. Shortly after the MRI procedure, the patient was checked at the eye clinic to assess the position of the rotor and to measure the IOP. The eyeWatchTM was readjusted to the former position set before undergoing the MRI. No complications were reported in the follow-up after MRI. This case demonstrates that MRI examinations can be safely performed after glaucoma surgery using an eyeWatchTM without compromising on the quality of the imaging or the stability of the IOP. This is a complication-free procedure that only requires checking the new position of the rotor and re-adjusting the implant, if necessary, to achieve the target IOP.
Safety and efficacy of Mynx vascular closure device for the closure of common femoral artery access after ipsilateral stent placement
Authors: Hwang Jin Ho , Park Sang Woo , Yang Woo Young , Kwon Yong Wonn , Min Jeeyoung , Jang Hyemin , Kim Jun Seok
Published: November 2020

Introduction:

To evaluate the feasibility and safety of the Mynx vascular closure device (VCD) for arteriotomy closure after stent placement near the common femoral artery (CFA) access site.

Methods:

A total of 88 patients (73 men; mean age, 72 ± 9.2 years; 136 procedures) who underwent closure of CFA arteriotomy using the Mynx VCD after stent placement in proximal superficial femoral artery (SFA) with antegrade approach, or in common or external iliac artery with retrograde approach were retrospectively studied. Technical success and access site complication were evaluated. Body mass index (BMI), platelet count, international normalized ratio, prior history of ipsilateral CFA access, access direction, degree of CFA calcification, stent location and diameter, total procedure time, and sheath size were analyzed to evaluate their relationship with technical failure and development of bleeding complications.

Results:

Technical success was achieved in 94.9% (129/136) patients. The mean time to hemostasis was 0.7 ± 1.8 min. Technical failure was significantly associated with low BMI ( p = 0.001). Other variables presented no significant relationship with technical failure and development of complications. Ultrasonography on the day after the procedure revealed that 8 (5.9%) patients had hematoma.

Conclusions:

Mynx VCD for arteriotomy closure is feasible and provides hemostatic safety after stent placement near antegrade or retrograde CFA access. However, Mynx VCD may have a poor technical success rate among patients with low BMI.
Engaging Indigenous peoples in research on commercial tobacco control: a scoping review
Authors: Lee Kelley , Smith Julia , Thompson Sheryl
Published: November 2020

Commercial tobacco products are a leading contributor to health disparities for many Indigenous peoples. Mainstream interventions developed for non-Indigenous peoples have been found less effective at addressing these disparities. Meaningful engagement is needed to develop effective measures but there are limited understandings of what engagement means in practice. We conduct a scoping review of studies self-reporting engagement with Indigenous peoples; assess their engagement against ethics guidelines concerning research involving Indigenous peoples and writings of Indigenous scholars; and draw lessons for advancing practice. We found engagement of Indigenous peoples in tobacco control research is practiced in varied ways—who conducts the research, who is engaged with, for what purpose, at what research steps, and what approaches are applied. Engagement ranges from limited to deeper commitment to research as decolonizing practice. Critical reflection along five questions can advance research practice for this purpose.