bluuebunny/crossref_metadata_2025 huggingface dataset:
Tunisian High School Students and Digital Media Literacy: A Quantitative Study
Authors: Dridi Tarak
Published: July 2021

Digital media literacy has become an intrinsic component in shaping high school students’ knowledge acquisition and critical thoughts. Over the last two decades, internet and computers have been the implemented tools to reach such goals and promote the students’ learning. This article looks for the impact of Information and Communication Technology (ICT) on Tunisian secondary school students by detecting their technical skills as well as their critical understanding. This quantitative study relies on a self-reporting approach and targets 150 Tunisian secondary students. It proves the necessary consideration of technological and social variables in helping sort out major digital handicaps related to secondary students and displays the interconnectedness between the different dimensions of digital media literacy. It also displays that Tunisian high school students cannot be referred to as digital-media literate people. The study contributes to the field of digital media literacy as it offers a solid empirical background to build on and indicates the necessity of integrating digital media literacy into the school-based initiatives.
Winning, Losing, and the Quality of Democracy
Authors: Nadeau Richard , Daoust Jean-François , Dassonneville Ruth
Published: July 2021

Citizens who voted for a party that won the election are more satisfied with democracy than those who did not. This winner–loser gap has recently been found to vary with the quality of electoral democracy: the higher the quality of democracy, the smaller the gap. However, we do not know what drives this relationship. Is it driven by losers, winners, or both? And Why? Linking our work to the literature on motivated reasoning and macro salience and benefiting from the Comparative Study of Electoral Systems project—covering 163 elections in 51 countries between 1996 and 2018, our results show that the narrower winner–loser gap in well-established electoral democracies is not only a result of losers being more satisfied with democracy, but also of winners being less satisfied with their victory. Our findings carry important implications since a narrow winner–loser gap appears as a key feature of healthy democratic systems.
Data Analysis and Presentation in Integrative Reviews: A Narrative Review
Authors: Younas Ahtisham , Shahzad Sharoon , Inayat Shahzad
Published: July 2021

Integrative reviews are invaluable for synthesizing literature to guide practice. This review examined the nature and range of data analysis approaches and the methods used for data presentation in integrative reviews. We reviewed 151 integrative reviews published from January to December 2019 in nursing journals listed in Journal Citation Report 2020. Summary tables were used for data extraction and researcher-developed questions-based process for synthesis. Data analysis and synthesis methods were categorized as non-specific, inductive, deductive, and framework-based. Majority of reviews did not explicitly delineate data analysis and synthesis methods (n = 67) or used inductive methods (n = 55). Limited reviews used deductive (n = 13) and framework-based methods (n = 13). Most of the reviews used narrative descriptions for presentations of findings, but some reviews also used innovative tables, concept maps, frameworks, and word clouds to enhance data presentation. The findings provide a comprehensive overview of the diversity of methods for data analysis and presentation in integrative reviews.
Development of a wind turbine using 3D printing: A prospection of electric power generation from daily commute by car
Authors: Monzamodeth Román-Sedano A. , Nicolás Iván Román-Roldán , Oscar Xosocotla , Bernardo Hernández-Morales , Osvaldo Flores , Fermín Castillo , Bernardo Campillo
Published: July 2021

The design, construction, and development of micro-turbines using 3D printing has been an important advance in the wind energy field to explore the possibility of offering viable alternative for the electric power generation, reducing the pollution caused by fossil fuels. In this work, a five blade vertical axis wind turbine prototype was tested. The components were designed using CAD and the turbine was manufactured by additive technology in a 3D printer. The material employed for 3D printing was commercial polylactic acid. The mechanical properties of the material used were obtained by tensile tests under the ASTM D-638 standard. On the other hand, a static structural simulation was performed by finite element method. Maximum tensile stress safety factor, maximum principal stresses, and fatigue analyses of the main turbine components were computed. The turbine performance as function of rotational velocity and relative wind velocity was analyzed implementing an experimental set-up.
Estimation of Path Travel Time Distributions in Stochastic Time-Varying Networks with Correlations
Authors: Filipovska Monika , Mahmassani Hani S. , Mittal Archak
Published: July 2021

Transportation research has increasingly focused on the modeling of travel time uncertainty in transportation networks. From a user’s perspective, the performance of the network is experienced at the level of a path, and, as such, knowledge of variability of travel times along paths contemplated by the user is necessary. This paper focuses on developing approaches for the estimation of path travel time distributions in stochastic time-varying networks so as to capture generalized correlations between link travel times. Specifically, the goal is to develop methods to estimate path travel time distributions for any path in the networks by synthesizing available trajectory data from various portions of the path, and this paper addresses that problem in a two-fold manner. Firstly, a Monte Carlo simulation (MCS)-based approach is presented for the convolution of time-varying random variables with general correlation structures and distribution shapes. Secondly, a combinatorial data-mining approach is developed, which aims to utilize sparse trajectory data for the estimation of path travel time distributions by implicitly capturing the complex correlation structure in the network travel times. Numerical results indicate that the MCS approach allowing for time-dependence and a time-varying correlation structure outperforms other approaches, and that its performance is robust with respect to different path travel time distributions. Additionally, using the path segmentations from the segment search approach with a MCS approach with time-dependence also produces accurate and robust estimates of the path travel time distributions with the added benefit of shorter computation times.
Machining of titanium alloys for medical application - a review
Authors: Festas António , Ramos António , Davim João Paulo
Published: July 2021

Titanium alloys for their characteristics have acquired a prominent position in numerous industrial applications. Due to its properties, such as high resistance to corrosion, reduced density, high specific strength, and low Young’s modulus, titanium alloys became indispensable as a biomaterial with high use in medical devices, with special emphasis in the area of orthopedics. Problems associated with its manufacturing by conventional machining processes, such as milling, turning, and drilling are well known and studied. Its low thermal conductivity, high chemical reactivity, high hardness at high temperatures make it classified as difficult to machine material. Despite the already extensive knowledge about machining titanium alloys problems, and the constant technological development to overcome them, it is not yet possible to machine this material like other metals. This work is based on research and review papers from Scopus and Scholar from 2010 to 2020 and addresses the main issues related to the machining of titanium alloys used in medical devices manufacturing and current solutions adopted to solve them. From the research consulted it was possible to conclude that it is consensual that for milling, turning, and helical milling cutting speed can reach up to 100 m/min and up to 40 m/min in drilling. As for feed rate, up to 0.1 mm/tooth for milling and helical milling and up to 0.3 mm/rev for turning and 0.1 mm/rev for drilling. Also, that Minimum Quantity Lubrication is a valid and efficient solution to mitigate titanium alloys machining problems.
Learning Laboratory: An Integrative Learning Design for International Business in a Complex Dynamic World
Authors: Zettinig Peter , Aleem Majid , Majdenic Danijela , Berry Michael
Published: July 2021

Graduates of international business (IB) programs are facing a complex dynamic world in which they need both specific and generalist knowledge they can activate in socially negotiated situations. Their competencies must go beyond narrowly applying knowledge, which requires open minds, transferable social competencies, and skills for crossing multiple boundaries to serve their organizations to deal with global challenges. In order to facilitate the development of such professional and personal competencies, we established a learning laboratory, a space providing simulated opportunities in real multinational organizational structures, where students experiment with intercultural encounters while solving business challenges and reflect on their experiences to develop their managerial practices. This article introduces our instructional innovation by discussing the underlying learning framework and providing an illustration of the approach. The lab has three main learning outcomes: building conceptual knowledge, developing sociocultural practices in multinational organizations, and enhancing self-awareness and reflective competencies. At the core of the lab are a series of IB strategy challenges which students solve by organizing, managing, and leading global virtual teams (GVTs) that are formed with members from five overseas universities. We detail the alignment of our framework, review the actions and interactions that facilitate learning, and discuss learning effectiveness and implementation of the lab.
IPV and Health Consequences Among CPS-Involved Caregivers: A Fixed Effects Analysis Stratified by Race and Ethnicity
Authors: Termos Mirvat , Murugan Vithya , Helton Jesse J.
Published: July 2021

Intimate partner violence (IPV) is a public health dilemma that disproportionately affects minority women in the United States. The present study utilized data from the National Survey of Child and Adolescent Well-Being (NSCAW II) to examine the longitudinal course of IPV outcomes reported by minority women involved with Child Protective Services (CPS). Our findings highlight the heterogeneity of the relationship between IPV and mental or physical health based on race/ethnicity. Nonetheless, additional research is necessary to investigate the impact of IPV severity on physical and mental health outcomes to ultimately facilitate race-specific interventions for women involved with CPS.
Emerging Adulthood in the Time of Pandemic: The COVID-19 Crisis in the Lives of Rural Young Adults in Finland
Authors: Vehkalahti Kaisa , Armila Päivi , Sivenius Ari
Published: July 2021

This article discusses changes introduced into the everyday life and lifecourse dispositions of young adults in two sparsely populated regions in Finland during the COVID-19 lockdown period of spring 2020. By the age of 20, many of them had already spent some years living independently during their school years. Due to the pandemic, many had to move back to their rural home regions. This article shows that the sudden advent of the pandemic as a global risk and the restriction measures that followed affected these young, emerging adults in many ways, even though there were no infections in their immediate environments. Special attention is paid to their relationships with their remote home regions, which suddenly gained new, positive meanings in comparison to the global and national COVID-19 hotspots. The analysis is based on interviews conducted with 30 young adults in May 2020 and pre-existing longitudinal data from the same participants.
Shaping the future of retirement: Aspects of sustainability
Authors: van Meerten Hans , van Zanden Jorik
Published: July 2021

As of 2021, the world is facing several crises that will greatly impact on the ways in which our societies are shaped. This article provides a brief overview of the trends and opportunities that we think are crucial for the area of pensions in the years to come.
The relationship between guilt feelings, conflicts with staff and satisfaction with care in relatives of nursing home residents with dementia: A longitudinal analysis
Authors: Gallego-Alberto Laura , Smaling Hanneke JA , Francke Anneke L , van de Brug Tim , van der Steen Jenny T , Joling Karlijn J
Published: July 2021

Introduction

Family caregivers often experience guilt after nursing home placement. The aim of the present study was to describe family caregivers’ guilt over time and assess the impact of conflicts with staff and satisfaction with care on guilt.

Method

Data of 222 family caregivers at three assessments during one-year follow-up were used. In addition to caregivers’ guilt and the variables conflicts with staff and satisfaction with the care, potential confounders were measured: sociodemographic data, clinical characteristics of the person with dementia, and caregiver burden. Linear mixed model analyses were performed to examine the longitudinal relationships between variables.

Results

Guilt remained stable over time. Unadjusted models showed that conflicts with staff were positively associated with guilt ( β = 0.11; p < 0.001; 95% CI: 0.06 to 0.16) and satisfaction with care showed a negative association with guilt ( β = −0.10; p< 0.05; 95% CI: −0.18 to −0.01). After adjusting for the confounders, only the positive association of guilt with conflicts with staff was similar as in the unadjusted analysis ( β = 0.11; p < 0.001; 95% CI: 0.05 to 0.16), whereas satisfaction with care was not significantly associated with guilt in the adjusted analyses ( β = −0.07; p = 0.10; 95% CI: −0.16 to 0.01).

Discussion

More conflicts with staff are associated with stronger guilt feelings. Guilt feelings are experienced by caregivers even after the admission of the person with dementia, and they remain stable over time. Further studies should focus on how to address guilt in family caregivers of people with dementia living in nursing homes.
Redundancy optimization for multi-state series-parallel systems using ordinal optimization-based-genetic algorithm
Authors: Hu Yishuang , Ding Yi , Zeng Zhiguo
Published: July 2021

Multi-state series-parallel systems (MSSPSs) are widely-used for representing engineering systems. In real-life cases, engineers need to design an optimal MSSPS structure by combining different versions and number of redundant components. The objective of the design is to ensure reliability requirements using the least costs, which could be formulated as a redundancy optimization problem under reliability constraints. The genetic algorithm is one of the most frequently used method for solving redundancy optimization problems. In traditional genetic algorithms, the population size needs to be determined based on the experience of the modeler. Often, this ends up creating a large number of unnecessary samples. As a result, the computational burden can be huge, especially for large-scale MSSPS structures. To solve these problems, this paper proposes an optimal structure designing method named as redundancy ordinal optimization. The universal generating function technique is applied to evaluate the reliabilities of the MSSPSs. Based on the reliabilities, an ordinal optimization algorithm is adapted to update the parent populations and the stopping criterion of genetic algorithm, so that the unnecessary structure designs can be eliminated. Numerical examples show that the proposed method improves the computational efficiency while remaining satisfactorily accurate.
Validity and Reliability of a New Radiological Method to Estimate Medial Column Internal Rotation in Hallux Valgus Using Foot Weight-Bearing X-Ray
Authors: Wagner Pablo , Lescure Nicole , Siddiqui Noman , Fink Jessica , Wagner Emilio
Published: July 2021

Background

Medial column internal rotation in hallux valgus (HV) can be measured using weight-bearing computed tomography (WBCT). Anteroposterior weight-bearing foot radiographs’ (WBXR) ability to estimate medial column internal rotation in HV was evaluated comparing these measurements with those obtained from WBCT.

Methods

Three observers evaluated WBCT and WBXR of 33 HV feet twice. Medial column internal rotation was measured with WBCT and classified into 3 levels according to WBXR findings. Intra- and interobserver reliability were obtained for WBXR and WBCT, in addition to WBXR-WBCT correlation.

Results

WBXR and WBCT intraobserver agreement was substantial and near perfect, respectively (κ 0.79 and 0.84). Their interobserver agreement was excellent (intraclass correlation 0.85 and 0.9, respectively). The WBXR-WBCT correlation was substantial (κ 0.68). WBXR diagnostic accuracy to predict the WBCT results was 85%.

Conclusions

The proposed method for medial column internal rotation measurement using WBXR is reliable and has a substantial agreement with WBCT measurements.

Levels of Evidence

Level III
The Construction of (Non-)Responsibility in Governance Networks
Authors: Willmes Rolien , van Wessel Margit
Published: July 2021

The notion of governance networks urges study of complex interaction processes rather than formal institutions. We argue that the study of interaction in governance networks should be widened to include different ways in which interaction shapes network outcomes. Here, we focus on a dimension of governance networks that is understood as fundamental and problematic, but that as yet has not been researched through the study of interaction: the construction of responsibility in such networks. We propose a model for the analysis of responsibility construction through (implicit) negotiation on the three proposed elements of responsibility and their links: stakeholder identities, contributions to reform, and norms. This model called “the triangle of responsibility in network governance” is the main result of our research. In addition, we offer an empirical case that illustrates both the problem of responsibility construction in network governance and the usefulness of our model, thereby providing proof of concept.
Preoperative PROMIS Physical Function Scores Predict Postoperative Outcomes Following Total Ankle Replacement
Authors: Conti Matthew S. , Caolo Kristin C. , Cororaton Agnes D. , Deland Jonathan T. , Demetracopoulos Constantine A. , Ellis Scott J.
Published: July 2021

Background:

Despite good evidence that supports significant improvements in pain and physical function following a total ankle replacement (TAR) for end-stage ankle arthritis, there is a subset of patients who do not significantly benefit from surgery. The purpose of this study was to perform a preliminary analysis to determine if preoperative Patient-Reported Outcome Measurement Information System (PROMIS) scores could be used to predict which patients were at risk of not meaningfully improving following a TAR.

Methods:

Prospectively collected preoperative and ≥2-year postoperative PROMIS physical function, pain interference, pain intensity, and depression scores for 111 feet in 105 patients were included in the study. Significant postoperative improvement was defined using minimal clinically important differences (MCIDs). Logistic regression models and area under the curve (AUC) analyses were used to determine whether preoperative PROMIS scores were predictive of postoperative outcomes.

Results:

Receiver operating characteristic curves found statistically significant AUCs for the PROMIS physical function (AUC = 0.728, P = .004), pain intensity (AUC = 0.720, P = .018), and depression (AUC = 0.761, P < .001) domains. The preoperative PROMIS pain interference domain did not achieve a statistically significant AUC.

Conclusion:

Preoperative PROMIS physical function and pain intensity t scores may be used to predict postoperative improvement in patients following a fixed-bearing TAR; however, preoperative PROMIS pain interference scores were not good predictors. The results of this study may be used to guide research regarding patient-reported outcomes following TAR.

Level of Evidence:

Level III, retrospective comparative series.
Functional capacity and dual-task cost in the institutionalized older adults, both affected and unaffected by mild cognitive impairment
Authors: Zak Marek , Krupnik Szymon , Brola Waldemar , Rebak Dorota , Sikorski Tomasz , Dutheil Frederic , Andrychowski Jaroslaw , Courteix Daniel
Published: July 2021

Background

Mild cognitive impairment (MCI) affects 10–20% of the individuals over the age of 65; this proportion being higher in the institutional care facilities than within a general population.

Aim

To assess whether dual-task cost in the individuals affected by MCI depends exclusively on gait, or possibly some other functional capacity components might also come into play, as compared to the healthy controls also remaining in the institutional care.

Methods

The study was conducted in five nursing facilities, involving 88 subjects in total, i.e. 44 subjects affected by MCI (mean age of 83.8 years; 34 women (77.3%) and 10 men (22.7%), and 44 healthy controls (mean age 81.67 years; 38 women (84.4%) and 7 men (15.6%). Cognitive functions were assessed through Mini–Mental State Examination (MMSE), while gait by Timed Up and Go Test (TUGT). Gait speed was calculated by the 10 Meter Walk Test, and the fear of falling with the Falls Efficacy Scale International. Dual tasks were assessed by TUGTMAN (Timed Up and Go Test Manual) and TUGCOG (Timed Up and Go Test Cognitive). Dual Task Cost (DTC) of TUGTMAN and TUGTCOG was established. Statistical analyses were completed with STATISTICA Package v. 10.

Results

Individuals affected by MCI differed significantly from the unaffected ones with regard to their gait test results, when assigned a single-task activity, and dual-task activities, as well as in the gait speed. Dual Task Cost Manual (DTCMAN) in the MCI group was significantly higher, as compared to the subjects unaffected by MCI.

Around 25% of the variance of DTCMAN result regarding the MCI group was accounted for by gait performance in the single-task conditions (TUGT). In the case of Dual Task Cost Cognitive (DTCCOG), this value equalled to approx. 10%. A 1% change in DTCMAN corresponded to approx. 0.5 s change in TUGT, whereas a 1% change in DTCCOG entailed approx. 0.35 s change in TUGT walking time.

Conclusion

Individual functional capacity affected the dual-task performance, especially the motor-motor tasks. Dual-task cost in the subjects affected by MCI was significantly reduced, being more dependent on the gait speed in the motor-motor tasks, which entailed visual memory, than in the motor-cognitive tasks.
Downregulation of NKG2DLs by TGF-β in human lung cancer cells
Authors: Lee Young Shin , Choi Hojung , Cho Hae-Ryung , Son Woo-Chang , Park You-Soo , Kang Chi-Dug , Bae Jaeho
Published: July 2021

Background

Transforming growth factor beta (TGF-β) is a typical immuno-inhibitory cytokine and highly secreted by lung cancer cells. It was supposed that its immunosuppressive effects to NK cell might be related with the altered expression of activating and inhibitory molecules in lung cancer cells. In this study, we examined the expression of NKG2DLs, PD-L1 and PD-L2 in lung cancer cells after treatment of TGF-β and a TGF-β inhibitor, Galunisertib (LY2157299).

Results

TGF-β reduced the level of surface proteins of five NKG2DLs without altered transcription levels in lung cancer cells. Galunisertib reversed the effect of TGF-β on the expression of NKG2DLs. Since MMP inhibitors, MMPi III and MMP2 inhibitor I, restored the reduced expression of NKG2DLs after treatment of TGF-β, it was thought that TGF-β induced the expression of MMP2 which facilitated the shedding of the NKG2DLs in cancer cells. However, the expression of PD-L1, L2 were not changed by treatment with TGF-β or Galunisertib.

Conclusions

Therefore, inhibition of TGF-β might reverse the immunosuppressive status on immune cells and restore NK cell mediated anticancer immune responses by upregulation of NKG2DLs in cancer cells.
Discrete terminal ileal ulcers in patients diagnosed with ulcerative colitis: clinical significance and natural course
Authors: Lim Hyo-Jin , Do Kim Hyun , Soh Jae Seung , Kim Sung-Yeun , Jung Ye-Ji , Lim Hyun , Kang Ho Suk , Kim Jong Hyeok
Published: July 2021

Background

Terminal ileal (TI) ulcers are occasionally detected in asymptomatic individuals and mostly resolve without any treatment. In patients with ulcerative colitis (UC), TI ulcers are infrequently observed without evidence of backwash ileitis. However, the clinical significance and natural course of the lesions are unclear. The aim of our study was to evaluate the frequency and clinical implications of TI ulcers in patients with UC.

Methods

We retrospectively reviewed 397 patients with UC via successful TI intubation during colonoscopy. We compared the clinical characteristics of patients manifesting TI ulcers with those who did not. The natural course of TI lesions was also investigated during the follow-up periods.

Results

Forty-one patients (10.3%) showed TI ulcers without evidence of inflammation in the right colon. The patients with and without TI ulcers were not different in terms of baseline characteristics, disease activity and extent at the time of the UC diagnosis, proximal extension, Mayo endoscopic score at the last endoscopic examination, medication history, UC-related hospitalization, and relapse during follow-up periods. Of the 30 patients who underwent follow-up colonoscopy in patients with TI ulcers, 23 (76.7%) showed resolution of TI ulcer. In addition, patients with remaining TI ulcers did not differ in disease activity and biopsy results compared with those with resolving TI ulcers.

Conclusions

Discrete TI ulcers are more common in patients with UC, compared with the healthy cohort. No significant clinical impact on disease extension and severity is found.
Cultural malpractices during labor/delivery and associated factors among women who had at least one history of delivery in selected Zones of Amhara region, North West Ethiopia: community based cross-sectional study
Authors: Melesse Misganaw Fikrie , Bitewa Yibelu Bazezew , Dessie Kumneger Nigussie , Wondim Demeke Binalf , Bereka Tefera Marie
Published: July 2021

Background

Every day, at least 810 women die worldwide from the complications of pregnancy and childbirth, 86% of which occurring in Southern Asia and Sub-Saharan Africa. One of the contributing factors for these problems is cultural malpractices during pregnancy and childbirth. The actual incidence of cultural malpractices in developing countries accounts for about 5–15% of maternal deaths. Thus, understanding the link between cultural affairs and maternal health is critical to saving the lives of women and their babies. Therefore, this research was aimed to assess cultural malpractices during labor and delivery and associated factors among women who had at least one history of delivery in selected Zones of the Amhara region, North West Ethiopia.

Method

Community based cross-sectional study was conducted on women who had at least one delivery history in Awi, West, and East Gojjam Zones from January 1 to May 30, 2020. The multistage cluster sampling technique was used to select 845 study participants. Data was collected through a pre-tested and structured interview questionnaire, entered and cleaned using EPI info version 7.2, and exported to SPSS version 23 for analysis. Bivariable and multivariable logistic regression was employed to assess the association of the variables and a P-value less than 0.05 was declared as statistically significant.

Result

Out of 845 women 162(19.2%) practiced nutritional taboo, 77(9.1%) women practiced abdominal massage and 273(32.3%) delivered their babies at home. Educational status of the respondents being un able to read and write (AOR = 14.35,95% CI: 3.12,65.96), husband's educational status (AOR = 3.80,95% CI: 1.24,11.64), residence (AOR = 2.93,95% CI: 1.41: 6.06), ethnicity (AOR = 2.20,95% CI:1.32, 3.67), pregnancy complications (AOR = 1.61,95% CI:1.02, 2.53), gravidity (AOR = 3.54,95% CI:1.38,9.08) and antenatal care follow up (AOR = 2.24, 95% CI:1.18,4.25) had statistically significant association with cultural malpractices during labor and delivery.

Conclusion

This study showed that cultural malpractices during childbirth were high in Awi, West, and East Gojjam Zones relative to the country's maternal health service utilization plan. Working on antenatal care follow-up and women and husband education in a culturally acceptable manner may reduce cultural malpractices during labor and delivery.
Corona virus disease 2019-associated Stevens-Johnson syndrome: a case report
Authors: Shahraki Toktam , Hassanpour Kiana , Arabi Amir , Ansari Iman , Sadoughi Mohammad-Mehdi
Published: July 2021

Background

To report Stevens-Johnson syndrome (SJS) in a patient with acute pneumonia secondary to SARS-CoV-2 infection.

Case presentation

A 45-years-old woman with a diagnosis of acute pneumonia secondary to SARS-CoV-2 infection who had received azithromycin and naproxen. Three days after starting the medication, she appeared ill and developed ocular discomfort, photophobia, dysuria, and macular rashes on the trunk and the extremities. On ophthalmological examination, a total epithelial defect was seen in both eyes. According to the examination, Stevens-Johnson syndrome was diagnosed and the patient was admitted to receive systemic and ocular support and medical care. The patient’s condition improved during the 3 weeks and recovered from both COVID-19 and SJS life-threatening complications but ocular complications, including the destruction of the meibomian glands, irregularity of the eyelid margin, and corneal scarring remained for the patient.

Conclusions

Although, it is not clear whether the cause of Stevens-Johnson syndrome in COVID-19 patients is the virus itself or whether the use of medication, but patients with COVID-19, especially patients receiving medication, should be screened for symptoms of Stevens-Johnson syndrome.
A qualitative study to investigate Swiss hospital personnel’s perceived importance of and experiences with patient’s mental–somatic multimorbidities
Authors: Aebi Nicola Julia , Caviezel Seraina , Schaefert Rainer , Meinlschmidt Gunther , Schwenkglenks Matthias , Fink Günther , Riedo Lara , Leyhe Thomas , Wyss Kaspar ,   SomPsyNet Consortium
Published: July 2021

Background

Mental–somatic multimorbidity in general hospital settings is associated with long hospital stays, frequent rehospitalization, and a deterioration of disease course, thus, highlighting the need for treating hospital patients more holistically. However, there are several challenges to overcome to address mental health conditions in these settings. This study investigated hospital personnel’s perceived importance of and experiences with mental–somatic multimorbidities of patients in hospital settings in Basel, Switzerland, with special consideration of the differences between physicians and nurses.

Methods

Eighteen semi-structured interviews were conducted with nurses (n = 10) and physicians (n = 8) in different hospitals located in Basel, Switzerland. An inductive approach of the framework analysis was used to develop the themes.

Results

Four themes emerged from the data analysis: 1) the relevance of mental–somatic multimorbidity within general hospitals, 2) health professionals managing their emotions towards mental health, 3) knowledge and competencies in treating patients with mental–somatic multimorbidity, and 4) interprofessional collaboration for handling mental–somatic multimorbidity in hospital settings.The mental–somatic multimorbidities in general hospital patients was found to be relevant among all hospital professionals, although the priority of mental health was higher for nurses than for physicians. This might have resulted from different working environments or in efficient interprofessional collaboration in general hospitals. Physicians and nurses both highlighted the difficulties of dealing with stigma, a lack of knowledge of mental disorders, the emphasis place on treating somatic disorders, and competing priorities and work availability, which all hindered the adequate handling of mental–somatic multimorbidity in general hospitals.

Conclusion

To support health professionals to integrate mental health into their work, proper environments within general hospitals are needed, such as private rooms in which to communicate with patients. In addition, changes in curriculums and continuing training are needed to improve the understanding of mental–somatic multimorbidities and reduce negative stereotypes. Similarly, interprofessional collaboration between health professionals needs to be strengthened to adequately identify and treat mentally multimorbid patients. A stronger focus should be placed on physicians to improve their competencies in considering patient mental health in their daily somatic treatment care.
Switching antifibrotics in patients with idiopathic pulmonary fibrosis: a multi-center retrospective cohort study
Authors: Suzuki Yuzo , Mori Kazutaka , Aono Yuya , Kono Masato , Hasegawa Hirotsugu , Yokomura Koshi , Naoi Hyogo , Hozumi Hironao , Karayama Masato , Furuhashi Kazuki , Enomoto Noriyuki , Fujisawa Tomoyuki , Nakamura Yutaro , Inui Naoki , Nakamura Hidenori , Suda Takafumi
Published: July 2021

Background

Currently, there are two antifibrotics used to treat idiopathic pulmonary fibrosis (IPF): pirfenidone and nintedanib. Antifibrotics slow disease progression by reducing the annual decline of forced vital capacity (FVC), which possibly improves outcomes in IPF patients. During treatment, patients occasionally switch antifibrotic treatments. However, prognostic implication of changing antifibrotics has not yet been evaluated.

Methods

This multi-center retrospective cohort study examined 262 consecutive IPF patients who received antifibrotic therapy. Antifibrotic agents were switched in 37 patients (14.1%). The prognoses were compared between the patient cohort that switched antifibrotics (Switch-IPF) and those without (Non-Switch-IPF) using propensity-score matched analyses.

Results

The median period between the initiation of antifibrotic therapy and the drug switch was 25.8 (12.7–35.3) months. The most common reasons for the switch were disease progression (n = 17) followed by gastrointestinal disorders (n = 12). Of the 37 patients that switched antifibrotics, only eight patients disrupted switched antifibrotics by their adverse reactions. The overall prognosis of the Switch-IPF cohort was significantly better than the Non-Switch-IPF cohort (median periods: 67.2 vs. 27.1 months, p < 0.0001). In propensity-score matched analyses that were adjusted to age, sex, FVC (%), history of acute exacerbation, and usage of long-term oxygen therapy, the Switch-IPF cohort had significantly longer survival times than the Non-Switch-IPF group (median 67.2 vs. 41.3 months, p = 0.0219). The second-line antifibrotic therapy showed similar survival probabilities than those in first-line antifibrotic therapy in multistate model analyses.

Conclusion

Switching antifibrotics is feasible and may improve prognosis in patients with IPF. A further prospective study will be required to confirm clinical implication of switching the antifibrotics.
Cattle connection: molecular epidemiology of BVDV outbreaks via rapid nanopore whole-genome sequencing of clinical samples
Authors: King Jacqueline , Pohlmann Anne , Dziadek Kamila , Beer Martin , Wernike Kerstin
Published: July 2021

Background

As a global ruminant pathogen, bovine viral diarrhea virus (BVDV) is responsible for the disease Bovine Viral Diarrhea with a variety of clinical presentations and severe economic losses worldwide. Classified within the Pestivirus genus, the species Pestivirus A and B (syn. BVDV-1, BVDV-2) are genetically differentiated into 21 BVDV-1 and four BVDV-2 subtypes. Commonly, the 5’ untranslated region and the Npro protein are utilized for subtyping. However, the genetic variability of BVDV leads to limitations in former studies analyzing genome fragments in comparison to a full-genome evaluation.

Results

To enable rapid and accessible whole-genome sequencing of both BVDV-1 and BVDV-2 strains, nanopore sequencing of twelve representative BVDV samples was performed on amplicons derived through a tiling PCR procedure. Covering a multitude of subtypes (1b, 1d, 1f, 2a, 2c), sample matrices (plasma, EDTA blood and ear notch), viral loads (Cq-values 19–32) and species (cattle and sheep), ten of the twelve samples produced whole genomes, with two low titre samples presenting 96 % genome coverage.

Conclusions

Further phylogenetic analysis of the novel sequences emphasizes the necessity of whole-genome sequencing to identify novel strains and supplement lacking sequence information in public repositories. The proposed amplicon-based sequencing protocol allows rapid, inexpensive and accessible obtainment of complete BVDV genomes.
The effect of fear of progression on quality of life among breast cancer patients: the mediating role of social support
Authors: Ban Yue , Li Mengyao , Yu Mingli , Wu Hui
Published: July 2021

Background

Women with breast cancer are prone to have mental stress and be stimulated by the fear of progression (FOP), then giving rise to a lower quality of life (QOL). The study aimed to examine the relationships between FOP, social support and QOL, and further explore whether social support mediates the association between FOP and QOL among Chinese patients with breast cancer.

Methods

The cross-sectional study was conducted from October 2019 to May 2020 at Anshan Cancer Hospital in Liaoning, China. 244 female breast cancer patients completed questionnaires including the Functional Assessment of Cancer Therapy for Breast (FACT-B), Multi-Dimensional Scale of Perceived Social Support (MSPSS), and Fear of Progression (FOP). Hierarchical multiple regression analysis was performed to assess the associations between FOP, social support and QOL. Asymptotic and resampling strategies were used to explore the mediating role of social support.

Results

The mean QOL score was 90.6 ± 17.0 among the patients with breast cancer. FOP was negatively correlated with QOL, while social support was positively related to QOL. Social support partly mediated the association between FOP and QOL, and the proportion of the mediating effect accounted for by social support was 25%.

Conclusions

Chinese breast cancer patients expressed low QOL. Social support could mediate the association between FOP and QOL. Medical staffs and cancer caregivers should alleviate patients’ FOP to improve their QOL by facilitating social support.
Weekly chemotherapy as first line treatment in frail head and neck cancer patients in the immunotherapy era
Authors: Botticelli Andrea , Pomati Giulia , Cirillo Alessio , Mammone Giulia , Ciurluini Fabio , Cerbelli Bruna , Sciattella Paolo , Ralli Massimo , Romeo Umberto , De Felice Francesca , Catalano Carlo , Vullo Francesco , Della Monaca Marco , Amirhassankhani Sasan , Tomao Silverio , Valentini Valentino , De Vincentiis Marco , Tombolini Vincenzo , Della Rocca Carlo , Polimeni Antonella , di Gioia Cira , Corsi Alessandro , D’Amati Giulia , Mezi Silvia , Marchetti Paolo
Published: July 2021

Objective

First-line therapy for metastatic squamous cell carcinoma of the head and neck (R/M HNSCC) has been revolutionized by the introduction of anti-checkpoint monoclonal antibodies, which have shown a significant improvement in overall survival (OS) gaining approval in a first line setting. Efficacy and safety of first-line weekly chemotherapy, compared to 3-weeks treatment, was retrospectively evaluated in a frail patient population with R/M HNSCC with the aim to evaluate its role as part of a personalized first-line approach.

Methods

A total of 124 patients with locally incurable R/M HNSCC receiving weekly (21) or three-weekly (103) chemotherapy plus cetuximab in a first line setting from December 2010 to September 2020 were retrospectively reviewed. Treatment outcomes in terms of objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and toxicities were analysed.

Results

Patients in the three-week subgroup were ECOG PS 0 (39) and 1 (64) while patients in weekly group (21) were all PS 2. No significant differences were reported in terms of age, sex, smoking and previous alcohol abuse considering the two distinct subgroups. Moreover, no statistically significant difference was found in PFS and OS between the two treatment subgroups. The response rate was 35% (36 patients) and 34% (7 patients) in three-week and weekly treatment group, respectively. Seventy patients (68%) in the three-week group experienced chemotherapy-related toxicities, predominantly G3. In the weekly group a predominantly low-grade toxicity was found in a lower number of patients (52%).

Conclusion

The weekly schedule appears to be an active and safe strategy in frail patients with R/M HNSCC. Based on these data, a weekly schedule could be considered as a first line treatment in all frail patients excluded from pembrolizumab treatment and a study on the combination of weekly chemotherapy and immunotherapy should be performed.
Prevalence and clinical correlation of hepatitis E virus antibody in the patients’ serum samples from a tertiary care hospital in Thailand during 2015–2018
Authors: Boonyai Atiporn , Thongput Anchalee , Sisaeng Thidarat , Phumchan Parisut , Horthongkham Navin , Kantakamalakul Wannee , Chaimayo Chutikarn
Published: July 2021

Background

Prevalence and incidence of hepatitis caused by HEV infection are usually higher in developing countries. This study demonstrated the HEV seroprevalence and incidence of HEV infection in patients with clinical hepatitis in a tertiary hospital in Thailand.

Methods

A laboratory-based cross-sectional study was conducted using 1106 serum samples from patients suspected of HEV infection sent to the Serology laboratory, Siriraj Hospital, for detecting HEV antibodies during 2015–2018. Prevalence of anti-HEV IgG and IgM antibodies in general patients, including organ transplant recipients and pregnant women in a hospital setting, were determined using indirect enzyme-linked immunosorbent assay (ELISA) kits. Comparison of laboratory data between groups with different HEV serological statuses was performed.

Results

HEV IgG antibodies were detected in 40.82% of 904 serum samples, while HEV IgM antibodies were detected in 11.75% of 1081 serum samples. Similar IgG and IgM antibody detection rates were found in pregnant women. Interestingly, anti-HEV IgM antibodies were detected in 38.5% of patients who underwent organ transplantation. Patients who tested positive for anti-HEV IgM antibodies had higher alanine aminotransferase levels than those who had not. In contrast, patients who tested positive for anti-HEV IgG had more elevated levels of total bilirubin than those who tested negative.

Conclusions

HEV seroprevalence and incidence in patients with clinical hepatitis were relatively high in the Thai population, including the pregnancy and organ transplant subgroups. The results potentially benefit the clinicians in decision-making to investigate HEV antibodies and facilitating proper management for patients.
A rare case of chest wall lipoma growing into the pleural cavity: a case report
Authors: Jang Hyo Joon , Choi Bu Hyeon , Park Seong Oh.
Published: July 2021

Background

Several cases of lipoma in unusual locations in the thorax have been reported. Appropriate surgical treatment depending on the location and shape is often required.

Case presentation

We herein report an extremely rare case of a chest wall lipoma growing into the pleural cavity. The tumor was successfully removed without damaging the capsule by a combination of direct and thoracoscopic approaches.

Conclusions

Chest wall lipomas growing into pleural cavity can be successfully treated by a combination of direct and thoracoscopic approaches.
Co-producing a multi-stakeholder Core Outcome Set for distal Tibia and Ankle fractures (COSTA): a study protocol
Authors: Pearson Nathan A. , Tutton Elizabeth , Joeris Alexander , Gwilym Stephen , Grant Richard , Keene David J. , Haywood Kirstie L.
Published: July 2021

Background

Ankle fracture is a common injury with a strong evidence base focused on effectiveness of treatments. However, there are no reporting guidelines on distal tibia and ankle fractures. This has led to heterogeneity in outcome reporting and consequently, restricted the contribution of evidence syntheses. Over the past decade, core outcome sets have been developed to address this issue and are available for several common fractures, including those of the hip, distal radius, and open tibial fractures. This protocol describes the process to co-produce—with patient partners and other key stakeholders—a multi-stakeholder derived Core Outcome Set for distal Tibia and Ankle fractures (COSTA). The scope of COSTA will be for clinical trials.

Methods

The study will have five-stages which will include the following: (i) systematic reviews of existing qualitative studies and outcome reporting in randomised controlled trial studies to inform a developing list of potential outcome domains; (ii) qualitative interviews (including secondary data) and focus groups with patients and healthcare professionals to explore the impact of ankle fracture and the outcomes that really matter; (iii) generation of meaningful outcome statements with the study team, international advisory group and patient partners; (iv) a multi-round, international e-Delphi study to achieve consensus on the core domain set; and (v) an evidence-based consensus on a core measurement set will be achieved through a structured group consensus meeting, recommending best assessment approaches for each of the domains in the core domain set.

Discussion

Development of COSTA will provide internationally endorsed outcome assessment guidance for clinical trials for distal tibia and ankle fractures. This will enhance comparative reviews of interventions, potentially reducing reporting bias and research waste.
Survey on serverless computing
Authors: Hassan Hassan B. , Barakat Saman A. , Sarhan Qusay I.
Published: July 2021

Serverless computing has gained importance over the last decade as an exciting new field, owing to its large influence in reducing costs, decreasing latency, improving scalability, and eliminating server-side management, to name a few. However, to date there is a lack of in-depth survey that would help developers and researchers better understand the significance of serverless computing in different contexts. Thus, it is essential to present research evidence that has been published in this area. In this systematic survey, 275 research papers that examined serverless computing from well-known literature databases were extensively reviewed to extract useful data. Then, the obtained data were analyzed to answer several research questions regarding state-of-the-art contributions of serverless computing, its concepts, its platforms, its usage, etc. We moreover discuss the challenges that serverless computing faces nowadays and how future research could enable its implementation and usage.