bluuebunny/crossref_metadata_2025 huggingface dataset:
Skeletal Maturation in Patients With Cleft Lip and/or Palate: A Systematic Review
Authors: Wu Xiaoyi , Kuang Wenying , Zheng Jie , Yang Zhengkun , Ren Meiqing , Yang Ruicong , Yuan Wenjun
Published: April 2021

Objective:

The objective of this systematic review was to evaluate the evidence regarding skeletal maturation in patients with cleft lip and/or palate (CL/P) and to investigate whether the skeletal maturation is delayed in these patients.

Design:

Systematic review.

Methods:

Electronic and manual searches of scientific literature were conducted in 4 databases (MEDLINE, Embase, Cochrane Library, and Web of Science). Cohort studies that compared the skeletal maturation of patients with CL/P with that of children without CL/P were eligible for inclusion. The quality of included cohort studies was assessed using the Newcastle-Ottawa Scale.

Patients and Participants:

Patients of any sex and ethnicity with CL/P and children without CL/P were included in this systematic review.

Main Outcome Measures:

Difference in skeletal maturation between patients with CL/P and patients without CL/P.

Results:

Thirteen retrospective cohort studies were included in this systematic review. Ten studies were considered of high quality and 3 were considered of general quality. The results of the included studies comparing skeletal maturation of patients with CL/P and children without CL/P were heterogeneous.

Conclusion:

Heterogeneity of skeletal maturation assessment methods, chronological age, sex, cleft type, and race may influence the final results of clinical studies on skeletal maturation in patients with CL/P. Overall, there is limited evidence to determine whether the skeletal maturation level of patients with CL/P is delayed compared to that of normal children. Further studies are needed to determine the skeletal maturation patterns in patients with CL/P.
Russell Body Typhlitis: A Case Report and Literature Review
Authors: Al-Rawaf Sarah , Alowami Salem , Riddell Robert , Naqvi Asghar
Published: April 2021

Russell bodies are accumulation of immunoglobulin in plasma cells forming intracytoplasmic inclusions. Russell body colitis is rare with only 3 cases described in the English literature up to date. We report a 78-year-old male with cirrhosis showing prominent cecal infiltration of Russell body containing plasma cells. Plasma cells showed no nuclear atypia or mitoses, and no evidence of light chain restriction. In this article, we report a fourth case of Russell body colitis, that is unique in being localized to the cecum in contrast to the other 3, 1 of which was in an inflammatory polyp in the sigmoid colon, 1 in a rectal tubulovillous adenoma and 1 as part of diffuse gastrointestinal disease. This is therefore the first report of localized Russell body typhlitis, occurring in a cirrhotic patient in whom an adjacent erosion was likely nonsteroidal anti-inflammatory drug-associated, a combination that may have facilitated the formation of Russell bodies.
Fundic Gland Polyp With Parietal Cell Vacuolation Mimicking Signet Ring Cell Carcinoma
Authors: Coyne John D. , Thampy S.
Published: April 2021

Pseudo-signet ring parietal cell vacuolation has been described as a mimic of invasive signet ring cell carcinoma. Moreover, signet ring cell carcinoma has been described in a fundic gland polyp. This case demonstrates parietal cell vacuolation in a fundic gland polyp in a patient on a long-term proton pump inhibitor.
Therapeutic Approaches With Immune Checkpoint Inhibitors in Head and Neck Cancers and the Role of PD-L1 as a Biomarker
Authors: Oualla Karima , Castelo Branco Luis , Nouiyakh Lamiae , Amaadour Lamiae , Benbrahim Zineb , Arifi Samia , Mellas Nawfel
Published: April 2021

Head and neck squamous cell carcinoma (HNSCC) is a potential curative disease at its localized stage, by the use of multimodal treatment including surgery, radiation, and chemotherapy. While the metastatic stage is considered incurable and is characterized by poor prognosis. Conventional cytotoxic chemotherapy in addition to cetuximab were the only available systemic treatment with limited efficacy and modest median overall survival barely crossing the 1 year limit. Immunotherapy with PD-1 and PD-L1 inhibitors has revolutionized the treatment of multiple cancers. Recently, Immunotherapy is being extensively explored in head and neck cancer and clinical trials have shown impressive results that allowed to immune check point inhibitors to be the new standard of care. In this article we tried to explain the rationale and mechanisms of targeting the immune system in head and neck carcinoma and to report the results from the phase III clinical trials that put the immunotherapy as a new standard of care for head and neck cancer.
The Implementation of Comprehensive Health Education to Improve Household Contacts’ Participation in Early Detection of Tuberculosis
Authors: Artawan Eka Putra I Wayan Gede , Purnama Dewi Ni Putu Eka , Probandari Ari Natalia , Notobroto Hari Basuki , Wahyuni Chatarina
Published: April 2021

Lack of participation of household contacts is the main problem of early detection of tuberculosis (TB) in Indonesia. A comprehensive health education (CHE) program has been developed to encourage the participation of household contacts. This study aimed to assess the implementation of the CHE to improve participation of household contacts in early detection of TB. This was a quasi-experimental study conducted between November 2018 and June 2019 in Badung District, Bali, Indonesia. Twelve public health centers (PHCs) were randomly allocated to six PHCs implementing the CHE and six PHCs implementing standard health education (SHE). The CHE was developed through a pilot study using the health belief model supplemented with perceived stigma and social support to identify the factors that influence participation. The participation was measured using a TB register with a cross-check to the health care officer until 2 months after health education was provided. Four hundred and twenty-eight household contacts enrolled in this study—216 in the CHE group and 212 in the SHE group. The CHE group’s participation was 28.2%, with 10 new TB cases found; in the SHE group, the participation was 15.6%, with 3 new TB cases found. The CHE increased the household contact participation by 1.83-fold (95% confidence interval [1.19, 2.81]) and case findings by 3.13-fold (95% confidence interval [0.85, 11.56]). The CHE implementation should be scaled up to other areas with a high level of TB transmission. The content and technique of the CHE could also be incorporated in contact investigation guidelines and materials for the TB campaign.
Multi-Staged Data-Integrated Multi-Omics Analysis for Symptom Science Research
Authors: Harris Carolyn S. , Miaskowski Christine A. , Dhruva Anand A. , Cataldo Janine , Kober Kord M.
Published: April 2021

The incorporation of omics approaches into symptom science research can provide researchers with information about the molecular mechanisms that underlie symptoms. Most of the omics analyses in symptom science have used a single omics approach. Therefore, these analyses are limited by the information contained within a specific omics domain (e.g., genomics and inherited variations, transcriptomics and gene function). A multi-staged data-integrated multi-omics (MS-DIMO) analysis integrates multiple types of omics data in a single study. With this integration, a MS-DIMO analysis can provide a more comprehensive picture of the complex biological mechanisms that underlie symptoms. The results of a MS-DIMO analysis can be used to refine mechanistic hypotheses and/or discover therapeutic targets for specific symptoms. The purposes of this paper are to: (1) describe a MS-DIMO analysis using “Symptom X” as an example; (2) discuss a number of challenges associated with specific omics analyses and how a MS-DIMO analysis can address them; (3) describe the various orders of omics data that can be used in a MS-DIMO analysis; (4) describe omics analysis tools; and (5) review case exemplars of MS-DIMO analyses in symptom science. This paper provides information on how a MS-DIMO analysis can strengthen symptom science research through the prioritization of functional genes and biological processes associated with a specific symptom.
Nd:YAG laser vitreolysis and health-related quality of life in patients with symptomatic vitreous floaters
Authors: García Begoña Gacimartin , Orduna Magán Carlos , Alvarez-Peregrina Cristina , Villa-Collar César , Sánchez-Tena Miguel Ángel
Published: April 2021

Background:

The treatment of floaters has consisted primarily of monitoring. The therapeutic approach is based on surgical removal or Nd:YAG laser treatment. The objective of this study was the assessment of the quality of life in patients treated with Nd:YAG laser for floaters.

Methods:

Single-center pretest-posttest design in a cohort of subjects treated with Nd-YAG laser with Ultra Q-Reflex technology. Health-related quality of life of the patients was measured before and after the intervention with the Visual Function Questionnaires VFQ-25 and VFQ-39. Anxiety level was measured with the State-Trait Anxiety Inventory. Visual acuity, contrast sensitivity, and safety parameters were also considered.

Results:

Thirty-four patients were included in the study. For the VFQ-25 baseline, the median was 73.05, interquartile range (19.25) versus a final median value of 93.76 (8.73) with p < 0.01. The baseline median for the extended version VFQ-39 was 74.60 (19.01) versus the final median of 95.01 (6.50) with p < 0.001. Regarding the anxiety, according to the STAI questionnaire, there were statistically significant differences between the baseline and the final conditions, with a baseline median of 38 (11) versus a final median of 18 (19); p < 0.001. When the analyses differentiated between patients with and without myopia, there were statistically significant differences for VFQ-25 and VFQ-39.

Conclusions:

This study shows an improvement in the health-related quality of life and a significant decrease in anxiety for patients that have undergone Nd: YAG Ultra-Q Reflex laser vitreolysis for floaters vaporization. The effect found is higher in myopic patients.
Relationship between retinal sensitivities and optical coherence tomographic findings in eyes with myopic chorioretinal atrophy
Authors: Kakisu Masato , Baba Takayuki , Iwase Takehito , Yokouchi Hirotaka , Yamamoto Shuichi
Published: April 2021

Purpose:

To determine whether there is a significant correlation between the retinal sensitivity and the integrity of the ellipsoid zone (EZ) of the photoreceptors in eyes with myopic chorioretinal atrophy (CRA). We also determined the significance of the correlation between the retinal sensitivity and the retinal and choroidal thicknesses.

Methods:

The medical records of 10 eyes of six subjects with myopic CRA were reviewed. The integrity of the EZ was determined in the spectral-domain optical coherence tomographic (OCT) images at 37 points of six scans corresponding to the locations where the retinal sensitivities were measured by MP-3 microperimetry. The mesopic retinal sensitivities were determined within the central 16°. The significance of the correlations between the integrity of the EZ and the mesopic retinal sensitivities was determined. The relationships between the retinal and choroidal thickness and the retinal sensitivity were also determined.

Results:

The average age of the patients was 70.0 ± 6.7 years, and the average axial length of the eye was 29.2 mm. The mesopic sensitivities at the points where the EZ was present were significantly higher than those where the EZ was absent ( p < 0.01). The mesopic sensitivity was significantly correlated with the retinal thickness ( p < 0.01, r = 0.30) and the choroidal thickness ( p < 0.01, r = 0.23).

Conclusions:

The significant correlation between the mesopic retinal sensitivity and the integrity of the EZ indicates that the mesopic sensitivities can be used to assess the integrity of the photoreceptors in eyes with myopic CRA.
Effect of intravitreal dexamethasone implant versus ranibizumab on vessel density in branch retinal vein occlusion
Authors: Kaya Mahmut , Ozturk Taylan , Atas Ferdane , Akbulut Yagci Betul , Oner Hakan
Published: April 2021

Purpose:

This study aimed to compare the effect of intravitreal dexamethasone implant with that of ranibizumab on vessel density (VD) in eyes with branch retinal vein occlusion (BRVO).

Methods:

Sixty-three eyes of 63 patients with superotemporal BRVO treated either with intravitreal dexamethasone implant (DEX group, n = 31) or ranibizumab (RNB group, n = 32) were prospectively enrolled. Swept-source optical coherence tomography angiography 6 × 6 mm scans of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in all eyes were analyzed.

Results:

The mean baseline VD of the SCP and the DCP was similar between groups in all quadrants ( p > 0.05 for all). At 12 months, the VD of the SCP in the parafoveal superior and temporal quadrants was significantly higher in the RNB group than in the DEX group ( p = 0.002 and p = 0.001, respectively). The VD of the DCP in the parafoveal temporal, nasal, and superior quadrants was significantly higher in the RNB group than in the DEX group ( p < 0.05 for all). Further, there was a statistically significant positive correlation between the improvement of visual acuity and increased VD of the SCP and the DCP in the parafoveal temporal quadrant in both groups ( R = 0.589, p = 0.001 and R = 0.455, p = 0 .017, respectively).

Conclusion:

Our findings support that ranibizumab does not inhibit collateral vessel formation in eyes with superotemporal BRVO compared to dexamethasone implant. VD and vessel formation can positively affect the vision prognosis in long-term follow-up.
Evaluation of the labrum on postoperative magnetic resonance images: a predictor of acetabular development in developmental dysplasia of the hip
Authors: Tetsunaga Tomonori , Tetsunaga Tomoko , Akazawa Hirofumi , Yamada Kazuki , Furumatsu Takayuki , Ozaki Toshifumi
Published: April 2021

Introduction:

Residual acetabular dysplasia of the hip after open reduction can complicate the treatment of developmental dysplasia of the hip (DDH) due to the potential need for corrective surgery. This retrospective study aimed to determine the predictive factors for acetabular development using postoperative radiographs and magnetic resonance imaging (MRI).

Methods:

We retrospectively investigated 74 hips of patients with DDH who underwent open reduction after reaching walking age and were followed up radiologically until skeletal maturity. We evaluated the cartilaginous acetabulum and labrum using a new method that measures the cartilaginous and labral landmarks on coronal and axial MR T2*-weighted images in patients aged 5 years. The mean age at the time of surgery was 22 months and that at the final survey was 20 years. Severin classification was determined at the final follow-up. Groups with good (53 hips) and poor (21 hips) outcomes were compared using the postoperative radiographic and MRI parameters recorded at 5 years of age. Factors predicting acetabular development were identified using univariate and multiple logistic analyses.

Results:

There were no significant differences in the bony-acetabular index (AI) and centre-edge (CE) angle between the good and poor outcome groups. However, the poor outcome group had significantly larger cartilaginous- and labral-AIs but significantly smaller cartilaginous- and labral-CE angles than the good outcome group (both p < 0.05). Multiple logistic regression analysis showed that labral-AI and labral-CE angle were predictors of acetabular development after open reduction for DDH, and their optimal cut-offs were 4° (77% sensitivity, 76% specificity) and 37° (68% sensitivity, 85% specificity), respectively.

Discussion:

Normal cartilaginous acetabulum development occurs in childhood, and evaluation using only radiographs is difficult. However, labral-AI ⩾4° and labral-CE angle <37° on MRI at 5 years of age offer useful indications for corrective surgery in patients with DDH.
Driving reaction time following periacetabular osteotomy
Authors: Chitnis Shreyas S , Marsh Andrew G , Gillespie James A , Nisar Aamer , Meek Dominic RM , Patil Sanjeev
Published: April 2021

Introduction:

Periacetabular osteotomy (PAO) is increasingly being used to treat young adults with symptomatic hip dysplasia. Currently there is a lack of evidence to guide return to driving after this procedure. This study aimed to identify the length of time required after a Periacetabular Osteotomy procedure before a patient can safely return to driving.

Methods:

All patients undergoing PAO were assessed for suitability for the study. Inclusion criteria were: currently driving with a valid licence; and being able to attend follow-up assessment. Baseline driving reaction time was assessed using a driving simulator preoperatively. The simulation was repeated 5 times for each patient and reaction times recorded (Thinking time, Action time and Total reaction time for braking at 30 mph). The driving simulation was repeated using the same methods at 6 weeks and 12 weeks postoperatively. Pre- and postoperative times were compared.

Results:

26 patients were included (24 females, 2 males) with a mean age of 32 (range 19–50) years. The mean preoperative times were: Thinking time 0.48, Action time 0.21, Total time 0.69 seconds. At 6 weeks postoperatively, mean Action time increased to 0.26 seconds ( p = 0.012) and mean Total time increased to 0.78 seconds ( p = 0.013). By 12 weeks post procedure, there was no significant difference in reaction times compared to baseline (mean Thinking time 0.47 seconds, Action time 0.23, Total time 0.72; p > 0.05).

Conclusions:

Most patients may not be safe to drive at 6 weeks following PAO procedures but should be safe to drive at 12 weeks postoperatively. Individual patient factors should also be taken into consideration.
A retrospective analysis of the real-time ultrasound-guided supraclavicular approach for the insertion of a tunneled central venous catheter in pediatric patients
Authors: Nakame Kazuhiko , Kaji Tatsuru , Onishi Shun , Murakami Masakazu , Nagano Ayaka , Matsui Mayu , Nagai Taichiro , Yano Keisuke , Harumatsu Toshio , Yamada Koji , Yamada Waka , Masuya Ryuta , Muto Mitsuru , Ieiri Satoshi
Published: April 2021

Purpose:

Tunneled central venous catheter (tCVC) placement plays an important role in the management of pediatric patients. We adopted a real-time ultrasound (US)-guided supraclavicular approach to brachiocephalic vein cannulation. We evaluated the outcomes of tCVC placement via a US-guided supraclavicular approach.

Methods:

A retrospective study was performed for patients who underwent US-guided central venous catheterization of the internal jugular vein (IJV group) and brachiocephalic vein (BCV group) in our institution. The background information and outcomes were reviewed using medical records.

Results:

We evaluated 85 tCVC placements (IJV group: n = 59, BCV group: n = 26). Postoperative complications were recognized in 19 patients in the IJV group (catheter-related bloodstream infection (CRBSI), n = 14 (1.53 per 1000 catheter days); occlusion, n = 1 (1.7%, 1.09 per 1000 catheter days); accidental removal, n = 3 (5.2%, 0.33 per 1000 catheter days); and other, n = 1 (1.7%, 1.09 per 1000 catheter days)) and five patients in the BCV group (CRBSI, n = 2 (0.33 per 1000 catheter days); catheter damage, n = 1 (3.8%, 1.67 per 1000 catheter days); and accidental removal, n = 2 (7.7%, 0.33 per 1000 catheter days)). In the BCV group, despite that, the incidence of postoperative complications was lower ( p = 0.205) and the period of placement was significantly longer in comparison to the IJV group ( p = 0.024).

Conclusion:

US-guided placement of tunneled CVC though the BCV results in a low rate of postoperative complications despite longer CVC indwelling times compared to IJV insertion. Our results suggest that BCV insertion of tunneled CVC in children may offer advantages in terms of device performance and patient safety.
Off label use of PICC as umbilical arterial catheter: Clinical case series
Authors: Giovanni Barone , Miria Natile , Gina Ancora
Published: April 2021

Umbilical arterial catheters are often placed at birth in critical ill neonates. Advantages of umbilical arterial catheterization include continuous blood pressure monitoring, accurate blood gas and frequent blood samplings. We described the off-label use of a third generation polyurethane power injectable 3 Fr single lumen peripheral inserted central catheter as umbilical arterial catheter. This clinical case series opens new scenarios about the off-label use of power PICC in newborns. Prospective studies are needed to evaluate the safety and advantages of PICCs as umbilical catheters over the conventional old generation polyurethane neonatal catheters.
Single center experience with ultrasound guided axillary vein port placement
Authors: Tivnan Patrick , Nannery Micaela , Epelboym Yan , Vilvendhan Rajendran
Published: April 2021

Purpose:

To retrospectively review a single institution experience of ultrasound guided axillary vein port placement.

Methods:

In this retrospective study, a patient list was generated after searching our internal database from 1/1/2012 to 10/1/2018. Patients who had undergone axillary vein port placement were included. Chart review was performed to confirm approach, laterality and to gather demographic data, clinical indications, technical outcomes, and complications. Descriptive statistics were used to analyze this cohort. Chi-square statistics were used to compare outcomes by laterality.

Results:

Three hundred seven patients (51% female) with an average age of 58 years were included. The port was placed via the right axillary vein in 85% (261/307), predominantly for the indication of chemotherapy access (296/307). Technical success was achieved in all 307 cases. Peri procedural complications occurred in 1% (4/307) of cases and included port malpositioning requiring replacement and a case of port pocket hematoma. Post procedural complications including deep vein thrombosis and port malfunction occurred in 17% (52/307) of cases and port removal as a result of complication occurred in 9% (29/307) of cases.

Conclusions:

Ultrasound guided placement of an axillary port is a safe procedure to perform and demonstrates good clinical outcomes.
Use of cyanoacrylate glue for the sutureless securement of epicutaneo-caval catheters in neonates
Authors: D’Andrea Vito , Pezza Lucilla , Barone Giovanni , Prontera Giorgia , Pittiruti Mauro , Vento Giovanni
Published: April 2021

Introduction:

Epicutaneo-caval catheters (ECC) are pivotal for drug and fluid infusion in neonates. Given the intrinsic importance of the catheter for the patients’ health and the need to avoid stressful and painful procedures on premature or critically ill newborns with fragile and poor vein asset, it is clearly necessary an accurate bundle for ECC insertion and management to avoid complications that may lead to non-elective ECC removal. Among others, dislodgment is an acknowledged complication, and conventionally adopted fixing devices seem alone unsatisfying in relation to ECC securement.

Object:

To evaluate the usefulness of medical Cyanoacrylate Glue (CG) as a solution to strengthen conventional ECC securement.

Methods:

Since the use of CG has become part of our ECC insertion bundle in 2018, the present study compares all term and preterm neonates admitted in our NICU in 2018 who required an ECC for any cause (92 cases) with an historical cohort formed by all neonates who required an ECC in 2017 (80 patients).

Results:

CG added to usual securement devices is effective in reducing ECC accidental dislodgment. Moreover, it is easy and safe to apply and remove, limits bleeding and oozing at the puncture site, and may also be an effective antimicrobial mechanical barrier.
Older people’s news dependency and social connectedness
Authors: Fisher Caroline , Park Sora , Lee Jee Young , Holland Kate , John Emma
Published: April 2021

Social isolation has become a growing issue, particularly among older citizens. The ‘digital divide’ has been identified as one of the contributing factors leaving many older citizens behind. While increasing digital literacy among seniors has been identified as one of the remedies, less attention has been paid to the role of news media on the wellbeing and connectedness of older people. Through the lens of the uses and gratifications theory, this article reports on the findings of a survey of 562 news consumers aged 50 years and above who live in Canberra, the capital city of Australia. The analysis highlights the important role of news in reducing feelings of social isolation, particularly for those who spend more time alone and older people with cognitive impairment. Older participants who had difficulty concentrating and learning new tasks were also more dependent on news. We suggest this is due to the habitual, predictable and concise nature of news. These findings contribute to our understanding of the role of news in the wellbeing of older people and point to the need for policymakers and those in the aged care sector to ensure access to news for older citizens to improve the quality of life.
Overcoming hurdles to intervention studies with autistic children with profound communication difficulties and their families
Authors: McKinney Ailbhe , Weisblatt Emma JL , Hotson Kathryn L , Bilal Ahmed Zahra , Dias Claudia , BenShalom Dorit , Foster Juliet , Murphy Suzanne , Villar Sofía S , Belmonte Matthew K
Published: April 2021

Autistic children and adults who are non-verbal/minimally verbal or have an intellectual disability have often been excluded from Autism Spectrum Disorder research. Historical, practical and theoretical reasons for this exclusion continue to deter some researchers from work with this underserved population. We discuss why these reasons are neither convincing nor ethical, and provide strategies for dealing with practical issues. As part of a randomised controlled trial of an intervention for children with profound autism, we reflected as a multi-disciplinary team on what we had learnt from these children, their families and each other. We provide 10 strategies to overcome what appeared initially to be barriers to collecting data with this population. These hurdles and our solutions are organised by theme: interacting physically with children, how to play and test, navigating difficult behaviours, selecting suitable outcome measures, relating with parents, managing siblings, involving stakeholders, timing interactions, the clinician’s role in managing expectations, and recruitment. The aim of this article is to provide researchers with the tools to feel motivated to conduct research with children with profound autism and their families, a difficult but worthwhile endeavour. Many of these lessons also apply to conducting research with non-autistic children with intellectual disabilities.

Lay abstract

Autistic children who speak few or no words or who have an intellectual disability are the most in need of new understandings and treatments, but the most often left out of the research that can bring these benefits. Researchers perceive difficulties around compliance with instructions, testing, challenging behaviours and family stress. Although research with these children can indeed be difficult, their continuing exclusion is unethical and unacceptable. Drawing on our experiences testing a possible treatment for children with profound autism, we provide 10 practical guidelines related to (1) interacting physically, (2) combining play and testing, (3) responding to challenging behaviour, (4) finding suitable tests, (5) relationships with parents, (6) relationships with siblings, (7) involving stakeholders, (8) planning the testing times, (9) the role of the clinical supervisor and (10) recruiting and retaining participants. We hope that these guidelines will prepare and embolden other research teams to work with profoundly autistic children, ending their historical exclusion from research. These guidelines also could be useful for conducting research with children with intellectual disabilities.
“Rural mothers’ feelings of isolation when caring for a child chronic health condition: A phenomenological study”
Authors: Bristow Sally M. , Jackson Debra , Power Tamara , Usher Kim
Published: April 2021

Evidence indicates that people in rural settings may experience difficulties in accessing health services, mainly specialist services. Caring for a child with a chronic health condition in a rural environment can present these mothers’ challenges. This article reports one of four finding themes from a more extensive qualitative study on rural mothers’ experiences of providing care for a child with a chronic health condition. Using hermeneutic phenomenological methods, narrative accounts were collected from 17 rural mothers of children with a chronic health condition in 2018. Analysis revealed that these mothers experienced emotional and physical isolation resulting in an overall theme reported within this article: “ Alone in the Outback” : isolation, capturing rural mother’s feelings of isolation; comprising three subthemes: On the fringe; There is no shelter; and Choosing their own direction . Their experiences of caring highlighted a need for additional local carer support services and resources. Nurses can assist in supporting rural mothers through facilitating local social support networks enabling women to connect with others in similar caregiving situations. This study reports following the consolidated criteria for reporting qualitative research guidelines ( Tong et al., 2007 ).
Hope against hope: COVID-19 and the space for political imagination
Authors: Gross Jonathan
Published: April 2021

COVID-19 has loosened neoliberalism’s hegemonic grip on the future. Amid the enormous suffering experienced internationally, there is much discussion of how to ‘Build Back Better’, and hope for a more caring, just and sustainable world. But competing futures are being imagined and planned. Hope is never politically neutral, and the content of collective hope is a key site of political struggle. This is partly a question of space: who has the literal and discursive space in which to develop visions of the future? The following article considers the role that cultural studies can play in this struggle. ‘Conjunctural analysis’ has a key task, making visible the competing futures contained within the present. But cultural studies should go further: combining conjunctural analysis with methods drawn from a range of scholarly and activist traditions – including critical pedagogy, devised theatre and the interdisciplinary field of futures studies – that deliberately create spaces for imagining new futures.
Till austerity do us part? A survey experiment on support for the euro in Italy
Authors: Baccaro Lucio , Bremer Björn , Neimanns Erik
Published: April 2021

The COVID-19 pandemic worsened Italy’s fiscal outlook by increasing public debt. If interest rates were to rise, it would become more likely that Italy experiences a financial crisis and requires a European bailout. How does making EU funds conditional on austerity and structural reforms affect Italians’ support for the euro? Based on a novel survey experiment, this article shows that a majority of voters chooses to remain in the euro if a bailout does not involve conditionality, but the pro-euro majority turns into a relative majority for ‘Italexit’ if the bailout is contingent on austerity policies. Blaming different actors for the fiscal crisis has little effect on support. These results suggest that conditionality may turn Italian voters against the euro.
Evaluation of ASTM D6424 standard for knock analysis using unleaded fuel candidates on a six cylinder aircraft engine
Authors: Ebrahimi Khashayar , Gordon David , Canteenwalla Pervez , Koch Charles R
Published: April 2021

The ASTM D6424 standard is used for general aviation piston engine knock detection and is tested for unleaded fuel candidates. Issues are discussed regarding the identification of knocking cycles, filtering frequency bands, and the effects of down-sampling for this knock detection technique. The knock tests were performed on the Continental TSIO-520-VB engine at 12,000 ft for take-off and cruise conditions using three different fuels, the standard leaded 100LL avgas and two unleaded fuel candidates. The ASTM D6424 knock detection method has its own particular disadvantages, which are detailed and compared to other knock detection methods including the third derivative of pressure signal and discrete wavelet transform. Updates to the standard include a minimum sampling rate of 0.2 CAD. Additionally, the current standard does not contain recommendations for filtering the cylinder pressure which results in over detection of knocking cycles with the two new aviation fuel candidates tested. Recommendations are provided regarding the pressure signal processing prior to ASTM D6424 knock-characterization.
A novel technology assessment chart for thermal efficiency improvement of IC engines
Authors: Uchida Noboru
Published: April 2021

Analysis of internal combustion (IC) engine measurements for thermal efficiency improvement is a complex endeavor involving a number of competing interrelated factors. To simplify the process, a novel chart and its utilization are introduced. The proposed chart divides a potential indicated thermal efficiency improvement into the contribution factors of cooling system losses and cycle efficiency. Cycle efficiency is an ideal target or goal; how much in-cylinder net heat energy, less cooling losses and unburnt fuel losses from the lower heating value of injected fuel, can be effectively transformed into indicated work? This paper explains the definition and practical usage of this chart. Furthermore, several experimental case studies involving advanced engine technologies using the chart are illustrated to identify improvement pathways and their potential effects on thermal efficiency.
It’s no joke: The critical power of a laughing chorus
Authors: Kravets Olga
Published: April 2021

There is no known time in history, nor known human community without laughter. Laughter imbues our social life. Laughter dominates our daily interactions, perhaps more visibly so on social media, where it is now a weapon wielded frequently against marketers. Yet, marketing theory paid little attention to laughter as a social phenomenon or a collective consumer (re)action. This article begins to address this neglect through an integrative review of theories of laughter and specifically by introducing Mikhail Bakhtin’s notion of a laughing chorus. I engage the notion as a way to understand the internet publics’ rowdy laughter directed at marketing. I show that seemingly nihilistic, irresponsible and discordant laughter is nonetheless an efficacious and notably polyvocal social commentary. To probe further the power of a laughing chorus, I draw on the works of Henri Bergson and Alenka Zupancic and elaborate on laughter as a form of expression that does not depend on reason and argumentation for its effects. I contend that a critical impetus of a laughing chorus may not always be in its content, but in the comic element, centred on repetition. That is, collective, excessive laughter involves a distinct mode of critique, which is not premised on discursive deliberation. I conclude with a reflection on theoretical and methodological opportunities in taking laughter seriously in marketing and consumer culture studies.
Money creation, debt, and justice
Authors: Dietsch Peter
Published: April 2021

Theories of justice rely on a variety of criteria to determine what social arrangements should be considered just. For most theories, the distribution of financial resources matters. However, they take the existence of money as a given and tend to ignore the way in which the creation of money impacts distributive justice. Those with access to collateral are favoured in the creation of credit or debt, which represents the main form of money today. Appealing to the idea that access to credit confers freedom, and that inequalities in this freedom are morally arbitrary, this article shows how the advantage to those with collateral plays out in different ways in today’s economy. The article identifies several forms of bias inherent in money creation, and its subsequent destruction: loans from commercial banks to individuals and corporations, interbank lending, lending from central banks to commercial banks, and selective bail-outs by central banks. These are not mere inequalities: they are unjust since alternative designs of the financial architecture exist that would significantly reduce them. The paper focuses on one possible reform with the potential to address several of the types of bias identified, namely the separation of money creation from private bank credit.
How do we provide good mealtime care for people with dementia living in care homes? A systematic review of carer–resident interactions
Authors: Faraday James , Abley Clare , Beyer Fiona , Exley Catherine , Moynihan Paula , Patterson Joanne M
Published: April 2021

People with dementia who live in care homes often depend on care home staff for help with eating and drinking. It is essential that care home staff have the skills and support they need to provide good care at mealtimes. Good mealtime care may improve quality of life for residents, and reduce hospital admissions. The aim of this systematic review was to identify good practice in mealtime care for people with dementia living in care homes, by focusing on carer-resident interactions at mealtimes. Robust systematic review methods were followed. Seven databases were searched: AgeLine, BNI, CENTRAL, CINAHL, MEDLINE, PsycINFO and Web of Science. Titles, abstracts, and full texts were screened independently by two reviewers, and study quality was assessed with Joanna Briggs Institute tools. Narrative synthesis was used to analyse quantitative and qualitative evidence in parallel. Data were interrogated to identify thematic categories of carer-resident interaction. The synthesis process was undertaken by one reviewer, and discussed throughout with other reviewers for cross-checking. After title/abstract and full-text screening, 18 studies were included. Some studies assessed mealtime care interventions, others investigated factors contributing to oral intake, whilst others explored the mealtime experience. The synthesis identified four categories of carer-resident interaction important to mealtime care: Social connection, Tailored care, Empowering the resident, and Responding to food refusal. Each of the categories has echoes in related literature, and provides promising directions for future research. They merit further consideration, as new interventions are developed to improve mealtime care for this population.
Questioning the rhetoric: A critical analysis of intergovernmental organisations’ entrepreneurship education policy
Authors: Amiel May , Yemini Miri , Kolleck Nina
Published: April 2021

Entrepreneurship education is increasingly prominent in university and school curricula worldwide, following its intensive advocacy by intergovernmental organisations and national governments as a remedy for the urgent pressures to better prepare students for today’s globalised and highly competitive workplace. This study analyses the official policy documents of two of the most influential intergovernmental organisations – the European Union and the Organisation for Economic Co-operation and Development – in a quest to understand how each of these organisations presents and promotes entrepreneurship education. We argue that while the rationales and problems the European Union and the Organisation for Economic Co-operation and Development address regarding entrepreneurship education differ somewhat, the two organisations propose a very similar solution for entrepreneurship education implementation, occasionally even advocated through formal collaboration between the two intergovernmental organisations. We suggest that this collaboration exemplifies how intergovernmental organisations seek to govern in line with a globally dominant logic by providing universal, de-contextualised solutions to various problems. We build on previous studies on other policies these intergovernmental organisations advocated (e.g. quality education and modernisation of higher education) to learn about the nuances of such policy moves. We conclude by suggesting a critical understanding of such policy convergences and outlining recommendations for future research.
Endoscopic Left Central Lymph Node Dissection of Thyroid Cancer: Safe, Feasible, and Relatively Easy
Authors: Sun Peng , Mak Tsz Kin , Li Jinyi , Wang Cunchuan
Published: April 2021

Purpose. The purpose of this study was to explore the feasibility of left central lymph node dissection (CLND) in endoscopic thyroidectomy via chest-breast approach (ETCB). Methods. Retrospective analysis of 57 cases of left CLND (group A) via ETCB, 35 cases of open left CLND (group B), and 90 cases of right CLND via ETCB (Group C) were performed from October 2014 to October 2019. Surgical data, complications, and follow-up data were compared among group A and group B, group A and group C, respectively. Results. There were no significant differences between group A and group B in intraoperative blood loss, tumor size, lymph node (LN) metastasis rate, dissected LN number, metastatic LN number, serum thyroglobulin (sTg), radioactive iodine uptake (RAIU), radioactive technetium uptake (RATU), radionuclide imaging of the residual area (RITRA), and radionuclide imaging of suspicious lymph node metastasis (RISLNM). There were no significant differences between group A and group C in age, operation time, intraoperative blood loss, postoperative hospital stay, tumor size, LN metastasis rate, dissected LN number, metastatic LN number, hypoparathyroidism, sTg, RAIU, RATU, RITRA, and RISLNM. There were 5 cases of temporary recurrent laryngeal nerve (RLN) palsy and 1 case of recurrence in group C. Besides, 1 case of lymphatic leakage was in group A. Conclusion. For selected cases, endoscopic left CLND is safe, feasible, efficient, and more easier than endoscopic right CLND.
The Value of Surgical Data—Impact on the Future of the Surgical Field
Authors: August Auriel T. , Sheth Kunj , Brandt Arthur , deRuijter Vivian , Fuerch Janene H. , Wall James
Published: April 2021

The combination of computing power, connectivity, and big data has been touted as the future of innovation in many fields, including medicine. There has been a groundswell of companies developing tools for improving patient care utilizing healthcare data, but procedural specialties, like surgery, have lagged behind in benefitting from data-based innovations, given the lack of data that is well structured. While many companies are attempting to innovate in the surgical field, some have encountered difficulties around collecting surgical data, given its complex nature. As there is no standardized way in which to interact with healthcare systems to purchase these data, the authors attempt to characterize the various ways in which surgical data are collected and shared. By surveying and conducting interviews with various surgical technology companies, at least 3 different methods to collect surgical data were identified. From this information, the authors conclude that an attempt to outline best practices should be undertaken that benefits all stakeholders.
Technical Performance of Continuous Pressure Insufflators Versus Traditional Insufflators in the Presence of Leaks During Laparoscopic Surgery
Authors: Perretta Silvana , Spota Andrea , Dallemagne Bernard
Published: April 2021

Background. New insufflators have been developed to manage leaks emanating from the working cavity during laparoscopic surgery. Little data have been published to show the performance of these insufflators. This study evaluates the performance of 2 modern continuous pressure insufflators in various leak conditions. Methods. Performance of a new continuous pressure insufflator, EVA15 (Palliare, Galway, Ireland), was compared with that of a continuous pressure insufflator, Airseal intelligent Flow System (iFS) (CONMED, Utica, NY), and a traditional intermittent pressure insufflator, Endoflator 40 (KARL STORZ, Tuttlingen, Germany). Six different leak scenarios were created in a swine model to create different dynamic leak profiles of between 5 and 15 L/min. Pressure deviation from setting was measured for each insufflator tested. The following were calculated: (a) mean absolute difference of measured insufflation pressure vs. the insufflator pressure setting for the 50 second measurement period (MAD) and (b) standard deviation of the absolute differences (SD). Results. The average mean absolute pressure difference between the EVA15 and Airseal is .27 mmHg. However, the average mean absolute pressure difference between the EVA15 and Endoflator 40 is 2.62 mmHg. Conclusions. Continuous pressure insufflators provide superior pressure delivery performance in leak situations when compared against a traditional intermittent pressure insufflator. No clinically significant performance difference was observed when comparing the EVA15 and Airseal iFS insufflators in the tested leak situations.
A Structured Modular Approach: The Answer to Training in Laparoscopic Colorectal Surgery
Authors: Abdel-dayem Mahmoud , Maradi Thippeswamy Kumarswamy , Haray Puthucode
Published: April 2021

Bakground: Laparoscopic techniques are now an integral part of the operative management of colorectal diseases. However, the specialist training that is required for this is not uniformly available. There is, therefore, a need for a structured competency-based training method so that trainees can navigate the learning curve safely. Aim. To develop a modular structured training programme for laparoscopic colorectal surgery (LCS) with the capability of ensuring competency-based progression from a novice level to independent operator. Methodology. Over the past decade, we have developed a structured approach, starting with junior surgical trainees and progressing through to consultant level, with 7 clearly defined levels of progression attending courses to achieving a trainer status. This approach allows trainees to maintain objective records of their progression and trainers to provide targeted learning opportunities. It also allows for several trainees of varying experience to be trained during the same procedure. Conclusion. Our structured training module for junior surgeons has successfully produced several competent laparoscopic colorectal surgeons in the United Kingdom and around the world. This approach may also be adaptable to training in other laparoscopic procedures as the levels of progression are generic and not procedure-specific.