bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiencing and Learning through Story and Educational Drama: A Workshop Example
Authors: Eriksson Stig A.
Published: February 2022

The article introduces the field of educational drama to new readers by outlining foundational concepts and source literature, and some historical roots. Using the well-known folk tale of Hansel and Gretel (Brothers Grimm) as point of departure, the article describes a practical workshop example – with a rationale of the suggested activities.
Effects of NaOH Pretreatment on the Microbial Community and Its Enzymatic Activities in Anaerobic Digestion of Chicken Manure and Straw
Authors: Zheng Jian , Qi Xingyun , Feng Lei , Wang Yan , Yang Shaohong
Published: February 2022

NaOH pretreatment straw and chicken manure were mixed in different proportions to study the performance of anaerobic fermentation gas production of mixed materials with different proportions. The results showed that the pretreatment with 2% NaOH had the best effect on the gas production
efficiency and cumulative gas production. After the pretreatment with NaOH, at the genus level, the main active flora was unidentified_Spirochaetaceae, unidentified_Prevotellaceae, uniden-tified_Lentimicrobiaceae, Lactobacillus, and Bacteroides. The highest peaks of amylase, protease, and
cellulase activities were 308.73 IU/L, 121.03 IU/L, and 270.18 U/mL, respectively. The number of microbial colonies was positively correlated with the activity of the corresponding enzyme. With the increase of the proportion of straw in the raw materials, the activities of various hydrolases
increased by 2.8%~28%. When the straw amount was 3%, the utilization rate of the raw material increased by optimization of C/N, and the efficiency of anaerobic digestion improved.
Screening and Identification of a Lignocellulose Degrading Strain and the Condition Optimization
Authors: Yang Dongsheng , Li Xuanqi , Yang Chunmiao , Dong Yuhe , Shen Hongbo , Zhong Wenting , Ren Xiaodong , Cao Hui
Published: February 2022

Lignocellulose, the most abundant renewable resource in the world, is not fully utilized due to degradation difficulty. As a result, microbial biodegradation of lignocellulose has become a research hotspot. In this paper, a strain Q7 that degrades lignocellulose efficiently was screened
from soil, and identified as Aspergillus niger by morphology and molecular biology. The enzyme-producing conditions were optimized. SEM, FTIR, XRD and TGA of the degraded lignocellulose were performed. The FPA activity of Q7 reached maximum (23.02 U/mL) with 3% straw powder as the carbon
source of medium, 1.5% peptone as the nitrogen source, pH = 5, 30 °C. SEM, FTIR, XRD and TGA of the degraded cellulose residue were carried out, which found that the structure of straw was obviously destroyed, the characteristic peaks of some functional groups disappeared, the crystallinity
increased, and the decomposition temperature and maximum degradation temperature (Tmax) of the fermented straw increased.
Growing the simulation ecosystem: introducing Mesa Data to provide transparent, accessible, and extensible data pipelines for simulation development
Authors: Pike Thomas D , Golden Samantha , Lowdermilk Daniel , Luong Brandon , Rosado Benjamin
Published: February 2022

The agent-based model (ABM) community has a rich and diverse ecosystem of libraries, platforms, and applications to help modelers develop rigorous simulations. Despite this robust and diverse ecosystem, the complexity of life from microbial communities to the global ecosystem still presents substantial challenges in making reusable code that can optimize the ability of knowledge-sharing and reproducibility. This research seeks to provide new tools to mitigate some of these challenges by offering a vision of a more holistic ecosystem that takes researchers and practitioners from the data collection through validation, with transparent, accessible, and extensible subcomponents. This proposed approach is demonstrated through two data pipelines (crop yield and synthetic population) that take users from data download through cleaning and processing until users have data that can be integrated into an ABM. These pipelines are built to be transparent by walking users step by step through the process, accessible by being skill scalable so users can leverage them without code or with code, and extensible by being freely available on the coding sharing repository GitHub to facilitate community development. Reusing code that simulates complex phenomena is a significant challenge but one that must be consistently addressed to help the community move forward. This research seeks to aid that progress by offering potential new tools extended from the already robust ecosystem to help the community collaborate more effectively internally and across disciplines.
Interactive Learning and Governance Transformation for Securing Blue Justice for Small-Scale Fisheries
Authors: Jentoft Svein , Chuenpagdee Ratana
Published: February 2022

In the “Future We Want,” states and non-state actors are invited to contribute to achieving sustainable development goals through various means and mechanisms. This includes securing justice for the most marginalized and disadvantaged sectors like small-scale fisheries, whose rights and access to resources are threatened by Blue Economy/Growth initiatives. While strong and just institutions are imperative to securing sustainable small-scale fisheries, they are not sufficient conditions for obtaining justice. As illustrated in this paper, justice must be secured in the daily interactions between small-scale fisheries actors and other stakeholders, including governments, by means of interactive learning and involving governance transformation.
The New Mentors
Authors: Evans Thomas W.
Published: February 2022

Although we have a tendency to lay blame on our public schools for the current state of American education, a plausible case can be made for another major contributing factor, as well. Over the past decades, there has been a diminution in the number of caring adults who pay attention to our children. We were once a mentoring society; we are not now. In the past few years, a surge of new mentors has emerged, however, rising from programs sponsored by business, community, and national organizations. This influx may make a difference, but the new mentors, though numbering in the millions, presently fall far short of filling the mentor gap. This article, through in-depth vertical analyses of four case studies, attempts to probe the question of what mentors do to enhance education and the school and career readiness of mentees.
Examining the Role of Critical Inquiry for Transformative Practices: Two Joint Case Studies of Multicultural Teacher Education
Authors: Jennings Louise B. , Smith Cynthia Potter
Published: February 2022

Multicultural teacher education is often conceptualized as a series of courses or in-service programs. However, research suggests that courses may influence teachers’ attitudes but not their practices. By joining two related case studies, we examine how an emphasis on critical inquiry in a multicultural education course influenced one teacher's understandings and practices well beyond the class itself. The first case describes the pedagogy of critical inquiry used in the course and the shift in 14 European American students’ understandings away from traditional “tourist” approaches toward more comprehensive views of multicultural education. These understandings fell short of transformative multicultural approaches that emphasize education for a more democratic, just society. The second case explores one student's evolution in developing transformative multicultural beliefs and practices during the 2 years following the course. We examine how particular processes of critical inquiry supported the teacher's evolving beliefs and practices through dialogue, reflection, and action. We summarize the tools and structures that supported this teacher in creating transformative multicultural practices across classrooms in her school district. These joint case studies suggest that multicultural teacher education needs to include but extend beyond particular courses to more expanded venues that provide opportunities for collaboration and critical reflection in action over time.
Out-of-Field Assignments: Case Studies of Two Beginning Teachers
Authors: Ringstaff Cathy , Sandholtz Judith Haymore
Published: February 2022

Reports profiling America's teachers are drawing increased attention to concerns about teachers’ subject-matter preparation and out-of-field assignments. In this article, we focus on two 1st-year high school teachers who graduated from the same teacher preparation program in the same year. One is credentialed in the subject area, and the other is not. Using comparative case methodology, we investigate and contrast how the teachers taught a unit on Steinbeck's novel Cannery Row. We analyze their teaching using Shulman's (1987) model of pedagogical reasoning, which divides the overall instructional process into components. We initially describe their teaching without clarifying which teacher is credentialed and which is not. After revealing the out-of-field teacher, we examine other factors that contribute to the differences in these two teachers. In a subsequent section, we argue that out-of-field teaching is a more complex issue than it appears and identify factors contributing to the complexity. We propose conceptualizing out-of-field teaching, as well as teaching assignments generally, as a matter of goodness of fit to take into account the relationship among teacher characteristics, contextual characteristics, and teaching placements.
Demystifying Reflection: A Study of Pedagogical Strategies that Encourage Reflective Journal Writing
Authors: Spalding Elizabeth , Wilson Angene
Published: February 2022

Reflection is a mysterious concept to many of the students who enter our graduate-level, secondary teacher education program at a large, Southeastern university. Although all already hold degrees in their subject areas and many have extensive life and work experience, few have written—or perhaps even thought—reflectively during their academic careers (King & Kitchener, 1994). The purpose of this study was to identify pedagogical strategies that helped preservice secondary teachers improve their reflective thinking via journal writing during the 1st semester of a yearlong professional program. A secondary purpose was to study the effectiveness of our own practices as teacher educators. We present brief case studies of four preservice teachers who met our criteria for growth in reflection and report their views of how and why they became more reflective over the course of the semester. We found that no single pedagogical strategy was best and that students responded differently to different strategies. These preservice teachers benefited from spending class time on defining, discussing, and viewing models of reflection. Overall, personalized feedback on their journals and their relationships with their instructors were most important in helping them grow. We must actively teach and model reflective skills in a variety of ways if we are to demystify reflection.
Inquiry at the Crossroads of Policy and Learning: A Study of a District-Wide Literacy Initiative
Authors: Stein Mary Kay , D'Amico Laura
Published: February 2022

The literacy improvement efforts of New York City's Community School District #2 serve as the locus of a study into the relationship between educational policy and practice. Based on 100 observations of classroom literacy instruction, a review of documentation related to the district's Balanced Literacy Program, and interviews with teachers, staff developers, and district leaders the investigators found strong parallels between how the district children learn to read and district teachers learn to teach. These parallels are due in part to the ways in which District #2's professional development system is anchored in the Balanced Literacy Program. They also stem from District #2 leaders’ beliefs in authentic and social forms of learning, beliefs that researchers found to have resonance with sociocultural theories of how individuals develop complex knowledge and skills. The result is a coherent system in which district policy regarding student learning is consistent with that of teacher learning.
Preparing Early Childhood Educators to Work in Diverse Urban Settings
Authors: Horm Diane M.
Published: February 2022

This article focuses on the challenges confronted by early childhood educators as they seek to offer developmentally effective programs and services for all children, especially those who live in urban settings characterized by cultural diversity. To meet the challenges, the programs that prepare these educators must take account of important research findings (e.g., children under age 6 are more likely to be poor than any other age group of Americans). These programs also need to develop practical strategies to ensure that teachers are prepared to work with children from a range of cultural backgrounds (e.g., infuse interdisciplinary perspectives with a focus on cultural diversity throughout professional preparation programs).
Strategies for Enhancing Teachers’ Beliefs in Their Effectiveness: Research on a School Improvement Hypothesis
Authors: Ross John A.
Published: February 2022

Teachers’ beliefs in their effectiveness consistently predict desired student outcomes. This article argues that the achievement impact of Teacher Efficacy (TE) arises from goal-setting and attributional processes. Teachers who anticipate that they will be successful set more challenging goals for themselves and their students, accept responsibility for the outcomes of instruction, and persist through obstacles. These findings suggest that student achievement of cognitive and affective goals can be enhanced by strengthening TE. The hypothesis that school improvement will flow from enhanced TE has been tested in a variety of skill-development projects with mixed results. It is pro -posed that skill-development approaches be augmented by attending to teacher beliefs (particularly about the mutability of intelligence) and to conditions of teacher work.
Becoming Right: Education and the Formation of Conservative Movements
Authors: Apple Michael W. , Oliver Anita
Published: February 2022

Conservative movements are becoming more powerful in the United States. Yet there are few investigations of why people actually “become Right.” We show how people “become Right” through their interactions with unresponsive institutions. We first describe the assemblage of cultural assumptions, fears, and tensions that underpin the cultural and religious Right. We argue that the way the bureaucratic state has developed is ideally suited to confirm these fears and tensions. We then instantiate these arguments by focusing on a specific textbook controversy that led to the formation of Rightist sentiments in a community. Finally, we suggest a number of important theoretical and practical implications of this analysis for the politics of education and for attempts at countering the growth of ultraconservative movements in education.
Changing Classroom Practices through Teacher Networks: Matching Program Features with Teacher Characteristics and Circumstances
Authors: Pennell James R. , Firestone William A.
Published: February 2022

Teacher networks are a recent innovation in professional development that are being used in California and Vermont to support state policy initiatives. Our analysis relies on interviews, observations, and document analysis to identify how teachers’ program experiences are affected by the fit between their backgrounds and program goals and methods. Drawing on insights from symbolic interactionist and social movements theory, we treat the teacher networks in these states as professional-area movement organizations sharing the common goal of changing instruction in a constructivist direction. First, we describe the common goals of the programs in both states. Then we describe key features of the network programs and their different policy environments. Finally, we identify how teachers’ beliefs, background experiences, social influences, and contextual circumstances can color their program experiences and willingness to make changes in classroom instruction.
Comments: NCTM's Curriculum and Evaluation Standards
Authors: Romberg Thomas A.
Published: February 2022

The comments in this article provide a background to the key notions underlying the National Council of Teachers of Mathematics (NCTM) Curriculum and Evaluation Standards for School Mathematics: first, the organization's intent when it decided to prepare this document; second, the anticipated use of the standards by teachers, schools, and states to change how mathematics has been organized and taught in American schools; third, the current process of preparing revisions to the standards by NCTM. The author ends by offering comments about unanticipated reactions to the document.
Conservatism, social isolation and political context: Why East Europeans would leave the EU in Exit referendums
Authors: Gherghina Sergiu , Tap Paul
Published: February 2022

The British decision to leave the European Union after the 2016 referendum raises questions about who could be next. This article analyzes why citizens in East European Member States would vote to leave the European Union in the event of further referendums. It proposes an analytical framework that seeks to explain this strong form of Euroscepticism through four variables that are rarely linked to the European Union: political apathy and alienation, dissatisfaction with domestic democracy and economy, conservative values, and social isolation. We use individual-level data from the 2018 wave of the European Social Survey to show that citizens’ conservative attitudes and social isolation are robust determinants of a potential European Union exit vote in Eastern Europe. We also identify several country-specific causes, which means that the European Union faces particular challenges across political settings.
English language learners with visual impairments: An exploratory literature review
Authors: Schultz Jessica E , Savaiano Mackenzie E
Published: February 2022

English language learners with visual impairments (ELLVIs) are a low incidence population with unique learning needs. The purpose of this review was to identify the existing literature specifically examining ELLVIs. As no literature review examining ELLVIs could be located, this review synthesizes what we know about the population and provides a starting point for future research. The authors reviewed all titles found across four databases ( n = 658 articles) and included only articles addressing English language learners with visual impairments in educational contexts. A total of 24 articles were included in the review. The following four themes emerged: assessment, family perceptions, teacher perceptions, and instructional strategies. Findings are discussed generally and by theme. Assessment reports revealed common accommodations for English language proficiency tests, but decision-making criteria for whether ELLVIs participated in assessments were unclear. Parent/guardian perceptions largely revealed dissatisfaction with school communication. Teacher perception studies revealed a need for more training and support. Common instructional strategies were identified by researchers and teachers in the field, but only one article examined instructional strategies experimentally. Therefore, there is limited evidence of the efficacy of any particular instructional strategy. Analyzing the research, the results show the majority has been conducted by the same research teams. More research needs to be conducted across all themes. Commonly accepted/validated assessment accommodations are discussed, allowing practitioners to identify which accommodations they might be able to implement. In addition, this review alerts practitioners to common parental concerns. This review also uncovers commonly used instructional strategies although these are not necessarily research based within the population. Commonly used instructional strategies are discussed, which, although not evidence-based, identifies potential areas for future research.
Detoxification vs non-detoxification before starting an anti-CGRP monoclonal antibody in medication overuse headache
Authors: Pensato Umberto , Baraldi Carlo , Favoni Valentina , Mascarella Davide , Matteo Eleonora , Andrini Giorgia , Cainazzo Maria Michela , Cortelli Pietro , Pierangeli Giulia , Guerzoni Simona , Cevoli Sabina
Published: February 2022

Background

Medication overuse headache significantly contributes to the chronification process and treatment refractoriness of migraine. Currently, abrupt discontinuation of the overused medication still represents the best management strategy for these patients, challenging public health system resources.

Methods

In this prospective study, chronic migraine and medication overuse headache sufferers with at least 28 days of analgesic consumption per month were included. Assessment of efficacy outcomes at three months were compared among patients who underwent in-hospital abrupt discontinuation of overused acute medication (YES-DETOX group) and patients who did not (NO-DETOX group) before starting an anti-CGRP monoclonal antibody.

Results

Of 401 patients who received either erenumab or galcanezumab, 28% (n = 111) satisfied inclusion criteria (YES-DETOX n = 28; NO-DETOX n = 83). After three months of treatment, 59% (n = 65; 47/83 YES-DETOX; 18/28 NO-DETOX) patients reverted from medication overuse headache and 51% (n = 57; 42/83 YES-DETOX; 15/28 NO-DEOTX) achieved ≥50% reduction in monthly headache days; yet no statistical differences were observed between the two groups (p = 0.4788 and p = 0.8393, respectively). Monthly consumption of pain medication was the only baseline prognostic factor in multivariate analysis in the overall cohort (p = 0.016).

Conclusion

Our results support the emerging evidence that anti-CGRP monoclonal antibodies may be effective in medication overuse headache patients irrespective of detoxification, yet further studies are needed to draw definitive conclusions.
High-throughput Genetically Modified Animal Experiments Achieved by Next-generation Mammalian Genetics
Authors: Minami Yoichi , Yuan Yufei , Ueda Hiroki R.
Published: February 2022

Animal models are essential tools for modern scientists to conduct biological experiments and investigate their hypotheses in vivo. However, for the past decade, raising the throughput of such animal experiments has been a great challenge. Conventionally, in vivo high-throughput assay was achieved through large-scale mutagen-driven forward genetic screening, which took years to find causal genes. In contrast, reverse genetics accelerated the causal gene identification process, but its throughput was also limited by 2 barriers, that is, the genome modification step and the time-consuming crossing step. Defined as genetics without crossing, next-generation genetics is able to produce gene-modified animals that can be analyzed at the founder generation (F0). This method is or can be accomplished through recent technological advances in gene editing and virus-based efficient gene modifications. Notably, next-generation genetics has accelerated the process of cross-species studies, and it will be a useful technique during animal experiments as it can provide genetic perturbation at an individual level without crossing. In this review, we begin by introducing the history of animal-based high-throughput analysis, with a specific focus on chronobiology. We then describe ways that gene modification efficiency during animal experiments was enhanced and why crossing remained a barrier to reaching higher efficiency. Moreover, we mention the Triple CRISPR as a critical technique for achieving next-generation genetics. Finally, we discuss the potential applications and limitations of next-generation mammalian genetics.
Neoliberalism in Decline? New Pluralists Recast Schools in Los Angeles
Authors: Fuller Bruce
Published: February 2022

Neoliberal tenets have colored the past half-century of education reform, marked by top-down accountability, market competition, and regimented learning aims. Federal drift and post-pandemic recovery, along with economic uncertainty, will blur policy priorities going forward. Less noticed, local networks of pro-equity activists have come to challenge urban bureaucracies, while advancing fairness, diverse forms of schooling, respectful and rigorous social relations inside schools. This paper examines the case of Los Angeles, where a coalition of Black and Latina leaders, civil rights attorneys, social-justice nonprofits, and pedagogical reformers succeeded to progressively fund schools, extend college-prep courses, and decriminalize discipline. Student achievement, in turn, climbed steadily upward for nearly two decades, 2002 to 2019. This pluralist network of advocates carved-out a third civic terrain, challenging corporate elites and traditional labor leaders. Rooted in humanist ideals, these colorful activists countered the individualistic and competitive values of neoliberal advocates, while motivating lasting institutional change.
Broadening the spectrum of the neurological complications in systemic lupus erythematosus: A patient with meningoradiculitis
Authors: Matthys Arthur , Megdiche Imen , Bardel Benjamin , Remy Philipe , Limal Nicolas , Planté-Bordeneuve Violaine , Gendre Thierry
Published: February 2022

Background

Neurological complications of systemic lupus erythematosus (SLE) are wide and may rarely involve the peripheral nervous system. However, no case of meningoradiculitis has been well-detailed.

Methods

We report a patient with lupus-associated meningoradiculitis.

Results

A 57-year-old woman had SLE without neurological involvement, treated with hydroxychloroquine, methotrexate, and prednisone for 10 years. Six months after the drug discontinuation for SLE, she acutely developed gait instability, paresthesia, and neuropathic pain of the four limbs. The neurological examination and nerve conduction studies were consistent with radiculopathies. Cerebrospinal fluid (CSF) analysis showed lymphocytic meningitis. The spinal magnetic resonance imaging (MRI) revealed thickening and an enhancement of the lumbosacral roots consistent with meningoradiculitis. The extensive investigations did not argue for a differential diagnosis of SLE. The patient dramatically improved upon corticosteroids. At the last follow-up, the patient still reported mild paresthesia but the clinical examination, the CSF, and the spinal MRI were normal.

Conclusion

This well-detailed case of meningoradiculitis broadens the spectrum of neurological complications in SLE. Early recognition of such complications might lead to efficient immunotherapy.
A competing risks regression model for the association between time-varying opioid exposure and risk of overdose
Authors: Li Xingyuan , Chang Chung-Chou H. , Donohue Julie M. , Krafty Robert T.
Published: February 2022

In the opioid research, predicting the risk of overdose or other adverse outcomes from opioid prescription patterns can help health professionals identify high-risk individuals. Challenges may arise in modeling the exposure-time-response association if the intensity, duration, and timing of exposure vary among subjects, and if exposures have a cumulative or latency effect on the risk. Further challenges may arise when the data involve competing risks, where subjects may fail from one of multiple events and failure from one precludes the risk of experiencing others. In this study, we proposed a competing risks regression model via subdistribution hazards to directly estimate the association between longitudinal patterns of opioid exposure and cumulative incidence of opioid overdose. The model incorporated weighted cumulative effects of the exposure and used penalized splines in the partial likelihood equation to estimate the weights flexibly. The proposed model is able to distinguish different opioid prescription patterns even though these patterns have the same overall intensity during the study period. Performance of the model was evaluated through simulation.
ComPsych communication skills training: Applicability of simulated patients in psychiatry communication skills training
Authors: Ditton-Phare Philippa , Sandhu Harsimrat , Kelly Brian , Loughland Carmel
Published: February 2022

Objective

Communication skills training (CST) programs within postgraduate psychiatry training are rare. ComPsych CST utilises simulated patients (SPs) for trainees to practice communication skills for discussing severe mental illness with patients and their families/carers. This study examined the applicability of using SPs in a psychiatry-specific CST.

Methods

A total of 41 postgraduate psychiatry trainees attended at least one of four modules of training in their cohort year and completed a questionnaire after each module presenting eight questions rating the use of SPs and ratings of course deliverables.

Results

Overall, trainees rated contact with SPs very highly across all modules, with a mean rating of 9.11 out of 10 (SD = 0.97). Trainees agreed that SPs appeared authentic, that their reactions showed they listened to the trainee.

Conclusions

Trainees valued training with SPs, providing evidence that using SPs for psychiatry-specific CST is feasible. Despite subjectivity, this is valuable to course providers as it highlights benefits perceived by trainees to be useful and provides further evidence for the program’s feasibility and utility.
An Opportunity for Improvement: Evaluation of Diabetes Technology Education Among Adult Endocrinology Training Programs
Authors: Fantasia Kathryn L. , Demers Lindsay B. , Steenkamp Devin W. , Modzelewski Katherine L.
Published: February 2022

Background:

Despite increases in continuous glucose monitor (CGM) and insulin pump use in adults with diabetes, there is room for expansion. Technology adoption may be influenced by the training environment and fellowship education. However, little is known about adult endocrinology trainee comfort with, understanding of, or methods by which trainees receive education about diabetes technology.

Methods:

Mixed methods, sequential explanatory evaluation using survey and semi-structured interviews of endocrinology trainees and fellowship leadership in Accreditation Council for Graduate Medical Education (ACGME)-accredited adult endocrinology fellowship programs to assess trainee and leadership comfort with, perceived knowledge of, and current methods for diabetes technology education.

Results:

Seventy-seven respondents completed the survey. The majority of training programs have curricula for training on insulin pumps (74%) and CGM (75.3%); 52% of fellows felt curricula are adequate. First- and second-year fellows were more comfortable with CGM than insulin pump use. Only half of third-year fellows felt comfortable with starting insulin pump therapy or recommending insulin dose adjustments based on CGM rate of change arrows. Qualitative interviews identified the importance of both direct instruction and experiential learning in diabetes technology education.

Conclusions:

Almost half of trainees feel that curricula for learning to use and manage insulin pumps and CGM are inadequate and feel uncomfortable with critical aspects of technology use, demonstrating the need for increased attention to trainee education in the use of diabetes technology. Based on a better understanding of current and preferred methods for instruction, this study provides direction for future development of initiatives to improve fellow education in this field.
Employment Interventions for Youth With Disabilities: A Review of Transition Practices and Partners
Authors: Schutz Michele A. , Carter Erik W.
Published: February 2022

The employment process for youth with disabilities often begins in high school. Although connecting youth to work is a recommended practice, the literature lacks a review of available interventions. This scoping review examined the practices and partners represented in 42 intervention studies addressing employment outcomes for transition-age youth (14–22 years old) with disabilities. These interventions varied widely, with a total of 25 components addressing employment preparation, job placement, other supports for youth, supports for other stakeholders, and collaborative/organizational strategies. Although families and employers participated in these interventions, the most prominent players were school staff and agency providers. We offer recommendations for research and practice around strengthening employment practices and engaging multiple stakeholders in preparing youth with disabilities for work.
Lateral Ulnar Collateral Ligament Reconstruction for Posterolateral Rotatory Instability After Failed Common Extensor Origin Release: Outcomes at Minimum 2-Year Follow-up
Authors: Schneider Marco M. , Müller Konstantin , Hollinger Boris , Nietschke Rainer , Zimmerer Alexander , Ries Christian , Burkhart Klaus J.
Published: February 2022

Background:

In patients with chronic lateral epicondylitis who have failed nonoperative treatment, open or percutaneous release of the common extensor origin (CEO) without subsequent reconstruction tends to result in good clinical outcomes. However, surgery can lead to iatrogenic injuries of the lateral collateral ligamentous complex, causing posterolateral rotatory instability (PLRI).

Purpose:

To determine the clinical outcomes of lateral ulnar collateral ligament (LUCL) reconstruction using a triceps tendon graft after failed open CEO surgery.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 103, patients underwent revision surgery at a single institution because of PLRI after failed open release of the CEO (Hohmann procedure) between January 2007 and October 2016. The primary surgery had been performed at other institutions in all cases. Of these patients, 72 were available for follow-up (49 by clinical examination, 23 by telephone interview). Standardized clinical examination; Mayo Elbow Performance Score (MEPS); 11-item version of the Disabilities of the Arm, Shoulder and Hand Score (QuickDASH); subjective elbow value (SEV); and patient satisfaction were assessed at least 2 years after LUCL reconstruction.

Results:

The mean age of patients in the study was 46.9 years (range, 21-74 years), and the mean follow-up was 2.8 years after revision surgery. The mean MEPS was 78.9, and the mean QuickDASH score reached 20.4. The mean SEV was 78.6%, and 75% of the patients rated the surgery as good to excellent. Complications were detected in 14% of the patients, and 9 needed revision surgery, primarily owing to graft failure with recurrent instability (n = 5).

Conclusion:

LUCL reconstruction in patients with PLRI after release of the CEO can restore elbow stability and achieve high patient satisfaction. However, outcome scores and revision rates in this cohort were inferior to published outcomes of primary LUCL reconstruction for treatment of noniatrogenic or traumatic PLRI.
Patient Adherence to Health Care Provider Recommendations and Medication among Free Clinic Patients
Authors: Panahi Samin , Rathi Naveen , Hurley Jazmine , Sundrud Justine , Lucero Mary , Kamimura Akiko
Published: February 2022

Patient adherence is vital for the quality of health care outcomes and treatment efficacy, and reduces the economic burden on the healthcare system. The purpose of this study was to examine factors associated with levels of general adherence among uninsured free clinic patients. This was a cross-sectional study using a convenience sample of free clinic patients aged 18 years and older who spoke English and/or Spanish. Descriptive statistics and multiple regression were performed to understand sociodemographic characteristics and factors associated with higher levels of general adherence. A higher level of general adherence were significantly associated with younger age ( P < .01), levels of adherence to lifestyle recommendations ( P  < .01), and medication ( P  < .01). Having attended health education classes and having a primary care provider were not associated with levels of general adherence.This study suggested that a lower level of general adherence exists among elderly patients of the free clinic. In this light, providers need to consider unique strategies to enhance the provider-patient relationship by understanding patient's characteristics and providing sufficient information and explanation for treatment and medication.
Diagnosis, course and management of hypersensitivity pneumonitis
Authors: Hamblin Mark , Prosch Helmut , Vašáková Martina
Published: February 2022

Hypersensitivity pneumonitis (HP) is a complex and heterogeneous interstitial lung disease (ILD) that occurs when susceptible individuals develop an exaggerated immune response to an inhaled antigen. In this review, we discuss the latest guidelines for the diagnostic evaluation of patients with suspected HP, the importance of identifying patients with fibrotic and progressive disease, and the evidence supporting the drugs commonly used in the treatment of HP. Differential diagnosis of HP can be challenging and requires a thorough exposure history, multidisciplinary discussion of clinical and radiologic data, and, in some cases, assessment of bronchoalveolar lavage lymphocytosis and histopathologic findings. Patients with HP may be categorised as having non-fibrotic or fibrotic HP. The presence of fibrosis is associated with worse outcomes. A proportion of patients with fibrotic HP develop a progressive phenotype, characterised by worsening fibrosis, decline in lung function and early mortality. There are no established guidelines for the treatment of HP. Antigen avoidance should be implemented wherever possible. Immunosuppressants are commonly used in patients with HP but have not been shown to slow the worsening of fibrotic disease. Nintedanib, a tyrosine kinase inhibitor, has been approved by the US Food and Drug Administration for slowing the progression of chronic fibrosing ILDs with a progressive phenotype, including progressive fibrotic HP. Non-pharmacological interventions, such as oxygen therapy, pulmonary rehabilitation and supportive care, may be important components of the overall care of patients with progressive HP.
Clinical significance and applications of oscillometry
Authors: Kaminsky David A. , Simpson Shannon J. , Berger Kenneth I. , Calverley Peter , de Melo Pedro L. , Dandurand Ronald , Dellacà Raffaele L. , Farah Claude S. , Farré Ramon , Hall Graham L. , Ioan Iulia , Irvin Charles G. , Kaczka David W. , King Gregory G. , Kurosawa Hajime , Lombardi Enrico , Maksym Geoffrey N. , Marchal François , Oostveen Ellie , Oppenheimer Beno W. , Robinson Paul D. , van den Berge Maarten , Thamrin Cindy
Published: February 2022

Recently, “Technical standards for respiratory oscillometry” was published, which reviewed the physiological basis of oscillometric measures and detailed the technical factors related to equipment and test performance, quality assurance and reporting of results. Here we present a review of the clinical significance and applications of oscillometry. We briefly review the physiological principles of oscillometry and the basics of oscillometry interpretation, and then describe what is currently known about oscillometry in its role as a sensitive measure of airway resistance, bronchodilator responsiveness and bronchial challenge testing, and response to medical therapy, particularly in asthma and COPD. The technique may have unique advantages in situations where spirometry and other lung function tests are not suitable, such as in infants, neuromuscular disease, sleep apnoea and critical care. Other potential applications include detection of bronchiolitis obliterans, vocal cord dysfunction and the effects of environmental exposures. However, despite great promise as a useful clinical tool, we identify a number of areas in which more evidence of clinical utility is needed before oscillometry becomes routinely used for diagnosing or monitoring respiratory disease.
A randomized comparison of loss of resistance versus loss of resistance plus electrical stimulation: effect on success of thoracic epidural placement
Authors: Dobson Sean Wayne , Weller Robert Stephen , Edwards Christopher , Turner James David , Jaffe Jonathan Douglas , Reynolds Jon Wellington , Henshaw Daryl Steven
Published: February 2022

Background

Loss of resistance (LOR) for epidural catheter placement has been utilized for almost a century. LOR is a subjective endpoint associated with a high failure rate. Nerve stimulation (NS) has been described as an objective method for confirming placement of an epidural catheter. We hypothesized that the addition of NS to LOR would improve the success of epidural catheter placement.

Methods

One-hundred patients were randomized to thoracic epidural analgesia (TEA) utilizing LOR-alone or loss of resistance plus nerve stimulation (LOR + NS). The primary endpoint was rate of success, defined as loss of sensation following test dose. Secondary endpoints included performance time. An intention-to-treat analysis was planned, but a per-protocol analysis was performed to investigate the success rate when stimulation was achieved.

Results

In the intention-to-treat analysis there was no difference in success rates (90% vs 82% [LOR + NS vs LOR-alone]; P = 0.39). The procedural time increased in the LOR + NS group (33.9 ± 12.8 vs 24.0 ± 8.0 min; P < 0.001). The per-protocol analysis found a statistically higher success rate for the LOR + NS group compared to the LOR-alone group (98% vs. 82%; P = 0.017) when only patients in whom stimulation was achieved were included.

Conclusions

Addition of NS technique did not statistically improve the success rate for epidural placement when analyzed in an intention-to-treat format and was associated with a longer procedural time. In a per-protocol analysis a statistically higher success rate for patients in whom stimulation was obtained highlights the potential benefit of adding NS to LOR.

Trial registration

ClinicalTrials.gov identifier NCT03087604 on 3/22/2017; Institutional Review Board Wake Forest School of Medicine IRB00039522, Food and Drug Administration Investigational Device Exemption: G160273.
Effects of Kinesio taping on forearm supination/pronation performance fatigability
Authors: Hsiao Chih-Kun , Tsai Yi-Jung , Lu Chih-Wei , Hsiung Jen-Chou , Hsiao Hao-Yuan , Chen Yung-Chuan , Tu Yuan-Kun
Published: February 2022

Background

Repetitive exertion in supination/pronation could increase the risk of forearm diseases due to fatigue. Kinesio taping (KT) is a physical therapy technique that decreases muscle tone and musculoskeletal disorders (MSDs) risk. Many assumptions about taping have been made and several studies have considered the taping applications; however, the effect of KT on strength and fatigue of the forearm supination/pronation remains unclear. The purpose of this study was to evaluate the effect of KT on forearm performance fatigability.

Methods

A screwing test was constructed to measure the forearm force loss and screwing efficiency during repetitive supination/pronation. Data from 18 healthy adults who underwent both KT and no taping (NT) sessions were used to investigate the forearm strength change in terms of grip force (GF), driving torque (DT), and push force (PF). The maximal isometric forces before and after the screwing test and force decreasing rate (efficiency) during screwing were evaluated to assess the performance fatigability in KT and NT conditions.

Results

A statistically significant force loss (FL) in maximal isometric GF (p = 0.039) and maximal isometric DT (p = 0.044); however, no significant difference was observed in maximal isometric PF (p = 0.426) between NT and KT. KT provides greater screwing efficiency than NT.

Conclusions

KT could not improve FL in the maximal muscle strength of the forearm in healthy subjects. KT on the forearm was associated with a lesser decline in DT efficiency than NT, implying that KT could decrease the loss rate of muscle strength and delay the development of fatigue; however, the KT did not yield improvements in PF while performing screwing tasks.
Humility in medical practice: a qualitative study of peer-nominated excellent clinicians
Authors: Wadhwa Anupma , Mahant Sanjay
Published: February 2022

Background

Humility has recently been conceptualized as a positive, multifaceted attribute in fields outside of medicine, such as psychology and philosophy. In medicine, there has been limited study into the nature of humility and its role in clinical practice. We sought to develop a deeper understanding of humility in medical practice through the lived-experiences of peer-nominated excellent clinicians.

Methods

We conducted a qualitative study with secondary analysis of transcripts from individual open ended, semi-structured interviews of 13 peer nominated physicians [7 (54%) female] at an academic centre. Using constant comparative analysis, the transcripts were analyzed for instances where humility was discussed as it related to clinical practice.

Results

Participants perceived humility to be an important driver for excellence in clinical practice. This was further explained using two overarching themes: an inward, intellectual perspective and an outward, social perspective. The physician’s inward perspective was their view of their abilities and limits, their self-confidence, and their intellectual openness and adaptability to the limitations and evolving nature of knowledge in medicine. Their outward perspective was an understanding and appreciation for the larger system in which they worked, an openness to others, and valuing patients’ experience. Through these perspectives, humility positively influenced clinical care, learning and curiosity, motivation in the care of others, and relationships with team members and patients.

Conclusions

Humility in medicine is a rich, multifaceted construct that was perceived to be a driver for excellence in medical practice by peer-nominated excellent clinicians. Humility was seen as an active force in formulating and calibrating a clinician’s perspective of self and of others, and as such, positively influencing clinical practice. These findings will help inform a discourse in medical education and faculty development about the important role of humility in medical practice.
Synthesis of aromatic lactone analogues of Lipoxin A4
Authors: Ismael Aya , Zeeshan Muhammad , Hansen Jørn H.
Published: February 2022

Objective

Synthesis of novel aromatic Lipoxin A4 lactone analogues.

Results

Novelpara-substituted aromatic lactone analogues of Lipoxin A4 have been synthesized in a convergent manner with six steps in the longest linear sequence in 12–13% yields, employing 2-deoxy-d-ribose as a chiral pool starting material and the classicalE-selective Wittig olefination.