bluuebunny/crossref_metadata_2025 huggingface dataset:
Climate Change Adaptation in Akropong, Ghana: Experiences of Female Smallholder Farmers
Authors: Addaney Michael , Sarpong George Effah , Akudugu Jonas Ayaribilla
Published: May 2021

This article examines smallholder women farmers’ awareness of climatic factors and the adaptation strategies to climate change events and how they influence their farming methods. A household survey was conducted on 50 smallholder women farmers at Akropong in the Nkoranza South Municipality in the forest-savannah transition zone of Ghana. The survey was complemented with in-depth and semi-structured interviews. The findings revealed that women farmers use multiple adaptation strategies such as creating fire belts to prevent fire outbreak in the dry season, creating channels on their farmland to prevent erosion, planting crops that can withstand excessive rain and drought and mixed cropping to overcome livelihood challenges resulting from climatic factors. The article therefore argues for an in-depth research and intensive education as a targeted intervention in understanding climate change and training women smallholder farmers on adaptation strategies to overcome climatic elements affecting farming and food production which serve as their main livelihood.
Severe Liver Injury Associated With High-Dose Atorvastatin Therapy
Authors: Saha Amit , Garg Abhimanyu
Published: May 2021

Statins are recommended for first-line management of elevated cholesterol in the primary and secondary prevention of atherosclerotic cardiovascular disease. Statins may occasionally be associated with mild transaminase elevations but can also result in life-threatening liver injury. Atorvastatin is the most common cause of clinically significant liver injury in this drug class. We report a case of severe, asymptomatic liver injury in a hepatocellular pattern in a 71-year-old man occurring within 3 months of switching from simvastatin to high-intensity atorvastatin therapy. Hepatitis improved rapidly with cessation of atorvastatin and did not recur after resuming simvastatin.
A Novel Intronic Pathogenic Variant in STAR With a Dominant Negative Mechanism Causes Attenuated Lipoid Congenital Adrenal Hyperplasia
Authors: Finn Erin , Kripps Kimberly , Chambers Christina , Rapp Michele , Meeks Naomi J. L. , Xu Fang , Chen Wuyan , Larson Austin A. , Nokoff Natalie J.
Published: May 2021

Lipoid congenital adrenal hyperplasia (LCAH) is typically inherited as an autosomal recessive condition. There are 3 reports of individuals with a dominantly acting heterozygous variant leading to a clinically significant phenotype. We report a 46,XY child with a novel heterozygous intronic variant in STAR resulting in LCAH with an attenuated genital phenotype. The patient presented with neonatal hypoglycemia and had descended testes with a fused scrotum and small phallus. Evaluation revealed primary adrenal insufficiency with deficiencies of cortisol, aldosterone, and androgens. He was found to have a de novo heterozygous novel variant in STAR: c.65-2A>C. We report a case of a novel variant and review of other dominant mutations at the same position in the literature. Clinicians should be aware of the possibility of attenuated genital phenotypes of LCAH and the contribution of de novo variants in STAR at c.65-2 to the pathogenesis of that phenotype.
Failure Rate After Superior Capsular Reconstruction With Achilles Tendon–Bone Allograft for Irreparable Rotator Cuff Tears
Authors: Kholinne Erica , Sun Yucheng , Kwak Jae-Man , Kim Hyojune , Koh Kyoung Hwan , Jeon In-Ho
Published: May 2021

Background:

Superior capsular reconstruction (SCR) is an alternative to reverse shoulder arthroplasty for irreparable rotator cuff tears (IRCTs). The reconstructed capsule acts as a static restraint to prevent superior migration of the humeral head. Traditional SCR uses a fascia lata autograft, which has shown failure at the greater tuberosity. An Achilles tendon–bone allograft has been proposed to improve the failure rate.

Purpose:

To evaluate the surgical outcomes of SCR using an Achilles tendon–bone allograft for the treatment of IRCTs.

Study Design:

Case series; Level of evidence, 4.

Methods:

We retrospectively evaluated 6 patients with massive IRCTs who underwent SCR using an Achilles tendon–bone allograft between January 2017 and January 2018. Clinical outcomes were assessed using range of motion, the American Shoulder and Elbow Surgeons score, and the visual analog scale for pain. The acromiohumeral distance and the status of graft integrity were evaluated using serial magnetic resonance imaging. Second-look arthroscopy surgery was performed to evaluate graft integrity at the mean of 7.5 months postoperative.

Results:

The mean ± SD clinical follow-up period was 14.5 months (range, 12-17 months). The American Shoulder and Elbow Surgeons and visual analog scale scores improved from 42.8 ± 11.9 and 4.0 ± 1.2 to 62.1 ± 14.7 and 2.8 ± 1.4, respectively. Forward flexion and external rotation improved from 98° ± 36° and 58° ± 4° to 123° ± 20° and 39° ± 8°, respectively. The acromiohumeral distance improved from 3.9 ± 0.8 mm to 6.4 ± 2.2 mm at final follow-up. However, second-look arthroscopy at a mean of 7.6 months postoperatively confirmed a graft failure rate of 83.3%.

Conclusion:

SCR using an Achilles tendon–bone allograft for the treatment of IRCTs had a high graft failure rate among patients in this case series.
Incidence and Risk Factors for Residual High-Grade Pivot Shift After ACL Reconstruction With or Without a Lateral Extra-articular Tenodesis
Authors: Jacquet Christophe , Pioger Charles , Seil Romain , Khakha Raghbir , Parratte Sebastien , Steltzlen Camille , Argenson Jean-Noel , Pujol Nicolas , Ollivier Matthieu
Published: May 2021

Background:

Residual rotatory knee laxity at midterm follow-up after isolated anterior cruciate ligament reconstruction (ACLR) versus ACLR with lateral extra-articular tenodesis (LET) remains an issue.

Purpose/Hypothesis:

To evaluate the outcomes of ACLR with or without additional LET at a minimum 2-year follow-up in patients with preoperative high-grade pivot shift (PS). Our hypothesis was that the addition of LET would decrease the risk of secondary meniscal injury and the presence of residual high-grade PS at follow-up.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective analysis performed at 3 sports medicine centers identified 266 study patients; all had a high-grade PS (grade 2 or 3) preoperatively and underwent isolated ACLR with or without LET. Four different ACLR techniques were used: single-strand quadrupled semitendinosus (ST4) ACLR without LET (ST4 group; n = 55), ST4 with anatomic LET (ST4+LET group; n = 77), bone–patellar tendon and modified Lemaire LET (BTB+LET group; n = 43), and quadriceps tendon and modified Lemaire LET (QT+LET group; n = 91). At follow-up, we evaluated for the presence of high-grade (grade ≥2) PS. Preoperative meniscal tears and their treatment were recorded.

Results:

Overall, 185 (69.5%) patients had at least 1 meniscal tear at index surgery. The mean follow-up period was 44.3 months; 47 (17.7%) patients had a new meniscal tear and 64 (24%) patients had a high-grade PS at follow-up. Compared with meniscal repair, significant predictors for high-grade PS at follow-up were meniscectomy (odds ratio [OR] = 2.65 [95% CI, 1.19-5.63]; P = .02) and nonrepair of preoperative meniscal tear (OR = 3.26 [95% CI, 1.27-9.43]; P = .007). The appearance of a new symptomatic meniscal tear was the strongest significant predictor of high-grade PS at follow-up (OR = 4.31 [95% CI, 2.31-8.06]; P < .001). No significant correlation was observed between the addition of LET and the presence of high-grade PS at follow-up.

Conclusion:

In the current study, 1 in 4 patients with high-grade PS before ACLR with or without LET was at risk of residual rotatory knee laxity at mean 44-month follow-up, regardless of the technique used. Repairing a pre-existing meniscal lesion was more effective than performing LET to decrease the presence of a high-grade PS at follow-up.
Systematic Review of Outcome Measures Used After Proximal Hamstring Repair
Authors: Reza Tara , Hinkle Andrew J. , Perez-Chaumont Andre , Brown Symone M. , Mulcahey Mary K.
Published: May 2021

Background:

Patient-reported outcome measures are important to determine outcomes after orthopaedic procedures. There is currently no standard for outcome measures in the evaluation of patient outcomes after proximal hamstring repair.

Purpose:

To identify and evaluate outcome measures used after proximal hamstring repair.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review was performed to identify all English-language articles assessing outcomes after proximal hamstring repair in PubMed, Embase, CINAHL via EBSCOhost, MEDLINE via OvidSP, and Web of Science between 2000 and 2019. After duplicates were removed, studies were selected using eligibility criteria established by the authors. Image reviews, anatomic/histology studies, literature reviews, surgical technique reports, systematic reviews, narrative reviews, case studies, and studies with <5 patients were excluded. Extraction, synthesis, and analysis of outcome measure data were performed using Microsoft Excel. Quality assessment of included studies was performed using Methodological Index for Non-Randomized Studies criteria.

Results:

After duplicate articles were removed, a total of 304 unique articles were identified and 27 met the inclusion criteria. The mean number of patients with proximal hamstring repairs per study was 40. The most frequently reported outcome measures were return to sport (14/27; 51.9%), custom survey/questionnaire (13/27; 48.1%), and isokinetic hamstring strength testing (13/27; 48.1%). Six of the 10 most commonly used outcome measures were validated and included Lower Extremity Functional Scale, 12-Item Short Form Health Survey, visual analog scale for pain, Perth Hamstring Assessment Tool (PHAT), Single Assessment Numeric Evaluation, and Tegner Activity Scale. Of those, PHAT was the only validated outcome measure designed for proximal hamstring repair.

Conclusion:

There is currently no consensus on the best outcome measurements for the evaluation of patients after proximal hamstring repair. We recommend an increased commitment to the use of return to sport, isokinetic strength testing, Lower Extremity Functional Scale, and PHAT when assessing such injuries. Future studies should aim to define the most reliable methods of outcome measurement in this patient population through consistent use of tools that are clinically relevant and important to patients and can easily be employed in a variety of clinical scenarios.
Computed Tomography Imaging of BioComposite Interference Screw After ACL Reconstruction With Bone–Patellar Tendon–Bone Graft
Authors: Scrivens Brian , Kluczynski Melissa A. , Fineberg Marc S. , Bisson Leslie J.
Published: May 2021

Background:

Bioabsorbable interference screws tend to have high resorption rates after anterior cruciate ligament (ACL) reconstruction; however, no studies have examined screws composed of 30% biphasic calcium phosphate and 70% poly-d-lactide (30% BCP/70% PLDLA).

Purpose:

To evaluate femoral and tibial tunnel widening and resorption of 30% BCP/70% PLDLA interference screws and replacement with bone at 2 to 5 years after ACL reconstruction using bone–patellar tendon–bone (BTB) autograft.

Study Design:

Case series; Level of evidence, 4.

Methods:

Included were 20 patients who had undergone ACL reconstruction using BTB autograft and were reevaluated 2 to 5 years after surgery using computed tomography scans. Tunnel measurements were obtained from computed tomography scans in the sagittal and coronal planes and were compared with known tunnel measurements based on operative reports. These images and measurements were used to assess tunnel widening, resorption of the 30% BCP/70% PLDLA screw, its replacement with bone, and possible cyst formation. Paired t tests were used to compare initial and final femoral and tibial tunnel measurements.

Results:

The cross-sectional area of the femoral tunnel decreased at the aperture ( P = .03), middle ( P = .0002), and exit ( P < .0001) of the tunnel compared with the initial femoral tunnel size, and the tibial tunnel cross-sectional area decreased at the aperture ( P < .0001) and exit ( P = .01) of the tunnel compared with the initial tibial tunnel size. Bone formation was observed in 100% of femoral tunnels and 94.7% of tibial tunnels. Screw resorption was 100% in the femur and 94.7% in the tibia at the final follow-up. Cysts were noted around the femoral tunnel in 2 patients (5.1%).

Conclusion:

The 30% BCP/70% PLDLA interference screws used for ACL reconstruction using BTB autograft had high rates of resorption and replacement with bone, and there were no increases in tunnel size at 2 to 5 years postoperatively. The authors observed a low rate of cyst formation and no other adverse events stemming from the use of this specific biointerference screw, suggesting that this type of screw is a reasonable option for graft fixation with minimal unfavorable events and a reliable resorption profile.
Factors Associated With Clinical Recovery After Concussion in Youth Ice Hockey Players
Authors: Emery Carolyn A. , Warriyar KV Vineetha , Black Amanda M. , Palacios-Derflingher Luz , Sick Stacy , Debert Chantel , Brooks Brian L. , Yeates Keith Owen , Mrazik Martin , Lebrun Constance , Hagel Brent E. , Dukelow Sean , Schneider Kathryn J.
Published: May 2021

Background:

The identification of factors associated with clinical recovery in youth after sports-related concussion could improve prognostication regarding return to play (RTP).

Purpose:

To assess factors associated with clinical recovery after concussion in youth ice hockey players.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Participants were part of a larger longitudinal cohort study (the Safe to Play study; N = 3353). Included were 376 ice hockey players (age range, 11-17 years) from teams in Calgary and Edmonton, Canada, with 425 physician-diagnosed ice hockey–related concussions over 5 seasons (2013-2018). Any player with a suspected concussion was referred to a sports medicine physician for diagnosis, and a Sport Concussion Assessment Tool (SCAT) form was completed. Time to clinical recovery was based on time between concussion and physician clearance to RTP. Two accelerated failure time models were used to estimate days to RTP clearance: model 1 considered symptom severity according to the SCAT3/SCAT5 symptom evaluation score (range, 0-132 points), and model 2 considered responses to individual symptom evaluation items (eg, headache, neck pain, dizziness) of none/mild (0-2 points) versus moderate/severe (3-6 points). Other covariates were time to physician first visit (≤7 and >7 days), age group (11-12, 13-14, and 15-17 years), sex, league type (body checking and no body checking), tandem stance (modified Balance Error Scoring System result ≥4 errors out of 10), and number of previous concussions (0, 1, 2, and ≥3).

Results:

The complete case analysis (including players without missing covariates) included 329 players (366 diagnosed concussions). The median time to clinical recovery was 18 days. In model 1, longer time to first physician visit (>7 days) (time ratio [TR], 1.637 [95% confidence interval (CI), 1.331-1.996]) and greater symptom severity (TR, 1.016 [95% CI, 1.012-1.020]) were significant predictors of longer clinical recovery. In model 2, longer time to first physician visit (TR, 1.698 [95% CI, 1.399-2.062]), headache (moderate/severe) (TR, 1.319 [95% CI, 1.110-1.568]), and poorer tandem stance (TR, 1.249 [95% CI, 1.052-1.484]) were significant predictors of longer clinical recovery.

Conclusion:

Medical clearance to RTP was longer for players with >7 days to physician assessment, poorer tandem stance, greater symptom severity, and moderate/severe headache at first visit.
A Pilot One Group Feasibility, Acceptability, and Initial Efficacy Trial of LISTEN for Loneliness in Lonely Stroke Survivors
Authors: Theeke Laurie A. , Mallow Jennifer A. , Theeke Elliott
Published: May 2021

Introduction

Loneliness is a prevalent problem for adult stroke survivors, and a known contributor to hypertension, secondary stroke, functional decline, poorer quality of life, and mortality in older adults. LISTEN (Loneliness Intervention using Story Theory to Enhance Nursing-sensitive outcomes), a theoretically based behavioral health intervention designed to target loneliness, in a sample of lonely survivors of ischemic stroke. Objectives: To assess the feasibility and acceptability of LISTEN (Loneliness Intervention using Story Theory to Enhance Nursing-sensitive outcomes) in lonely stroke survivors and to evaluate the initial efficacy of LISTEN for loneliness, depressive symptoms, neurological quality of life, and blood pressure in a sample of lonely survivors of ischemic stroke. Methods: The study design was framed using the psychoneuroimmunology paradigm and employed a prospective non-randomized one group design. Six adult stroke survivors were recruited from a Neurology outpatient clinic. Once consented and enrolled, participants attended 5 sequential weekly group sessions of LISTEN. Evaluations, field notes, and video recordings of each session were used to assess feasibility and acceptability of LISTEN. Quantitative data was collected at enrollment and at 1, 6, and 12 weeks post last LISTEN session to assess initial efficacy on loneliness (revised UCLA loneliness scale), depressive symptoms (PHQ-9), neurological quality of life (NeuroQoL), and blood pressure. SPSS was used for descriptive and comparative data analysis to examine within subject changes. Results: LISTEN was feasible to deliver in the selected clinical setting and participants rated LISTEN as highly useful, organized, and clear with an overall rating as excellent for loneliness. Participants reported significant decline in loneliness and improved scores on three subscales of the NeuroQoL; executive function, positive affect and well-being, and satisfaction with social roles. Recruiting stroke survivors for the trial was time intensive for the study team. Conclusions: Larger randomized trials of LISTEN in stroke survivors are needed to build evidence for the longer term effectiveness of LISTEN on loneliness, depressive symptoms, and quality of life. Future study designs will include planning to diminish barriers to recruitment.
Visualizing Shifts in Gendered Parenting Attitudes during COVID-19
Authors: Mize Trenton D. , Kaufman Gayle , Petts Richard J.
Published: May 2021

Many scholars have expressed fears that the 2019 coronavirus pandemic may exacerbate gender inequalities. Indeed, studies have suggested that women, and mothers in particular, have been particularly affected by reducing their participation in the paid labor market to meet increased caregiving needs. What is less clear is whether the pandemic has also shifted attitudes about mothers’ and fathers’ roles. We collected data on gendered parenting attitudes both before and during the pandemic and report shifts in attitudes in this data visualization. Consistent with fears of exacerbated gender inequality, we find a shift toward more conventional gender parenting attitudes. We also find an increase in the importance placed on mothers’ and fathers’ earning money and a decrease in the role mothers and fathers play in child development, both of which may be due to the pandemic’s effects on the economy and schooling.
Design and Evaluation of Scholarship and Research Orientation Sessions in Academic Pharmacy Practice Experiences
Authors: Sumanasekera Wasana , Zhao Yuan , Lozier Samantha , Veldhi Alekya
Published: May 2021

Objective:

Evaluate the efficacy of educating academic Advance Pharmacy Practice Experiential (APPE) students on scholarship and research (S&R). We hypothesized that academic APPE students gain more knowledge in scholarship and research in comparison to non-academic APPE students.

Methods:

As a component of academic APPE rotation, all academic APPE students assigned by the office of experiential education per year (the intervention group) (n = 11) attended S&R sessions during the first week of their academic APPE rotation. Student volunteers from the same graduating class were recruited as the control group (n = 12). However, 1 student from the intervention group and 2 students from the control group were excluded from the analysis, leaving 10 students from each group. These sessions were taken in small groups of 1 to 3 once in their assigned rotation. S&R sessions included many topics that were based on a S&R manual. Upon completion of the sessions, a hard copy of a 10-question knowledge-based quiz was given to both groups at the same time. APPE students’ knowledge about S&R were assessed via grading the quiz. The anonymity of the quiz was maintained by requesting students only to mention whether they are from intervention group or controlled group.

Results:

While control group averaged 49% ± 4.58 on the quiz, the intervention group averaged 71.5% ± 5.77. Statistical analysis was performed using SPSS software. Based on independent sample t-test, students who took the S&R session show significant increase in their quiz score.

Conclusion:

Compared to the control group, S&R sessions helped academic APPE students to gain knowledge on S&R. The students also perceived that S&R sessions increased their interest in S&R.
The Role of Collaboration in Innovation and Value Creation in the Aviation Industry
Authors: Pereira Bruno , Lohmann Gui , Houghton Luke
Published: May 2021

Collaboration plays a critical role in fostering innovation and value creation in the aviation sector. However, how factors and connections relate to the achievement of innovative outcomes in aviation require further investigation. This study investigates the key factors that create a conceptual framework by conducting a literature review and an archival analysis of news articles. The model proposed involves factors such as strategic decision-making; networking and partner choice; cultural context, values, behaviour and compatibilities; collaboration configuration; issues and risks shared; skills, capacities and experience; infrastructure and resources available; engagement activities; knowledge transfer, absorption and appropriation; collaboration management; communication flows; external environment and demand; and expectations and outcomes. Promising collaborations are also indicated in areas where the framework could be adopted to increase partnerships and outcomes. Also, we highlight best practice examples from leading organizations, such as International Airlines Group (IAG), Emirates Airline, Singapore Airlines, Boeing and JetBlue, to provide insights into existing collaborations that have led to innovation and value creation in this sector.
How the Creative Class Co-creates a City’s Brand Identity: A Qualitative Study
Authors: Rodrigues Clarinda , Schmidt Holger J.
Published: May 2021

Purpose:

Place branding is a discipline with high relevance for a city's policymakers and for hospitality and tourism management, and this is even more true in the context of creative cities. This article explores how the creative class contributes to a city’s brand identity and, by doing so, delivers valuable advice for marketing representatives of creative cities.

Design/methodology/approach:

Our study builds on a qualitative study, interviewing 18 members of the creative class in 3 diverse European cities. Our methodology was based on grounded theory: We simultaneously collected and analysed data and created analytic codes and categories.

Findings:

This article suggests that the creative class is an important enactment stakeholder in the identity formation process of a place, as well as destination marketing organizations (DMOs) and other stakeholders. Additionally, it is demonstrated that the creative class co-creates a city’s brand identity by bringing new rhythms and forms of expression to the cityscape.

Originality:

This article contributes to the fast-growing place brand identity literature by exploring the role of the creative class in the context of cities. It also intends to provide a better understanding of how the creative class co-creates and contributes to their city’s brand identity. Since similar studies do not exist, our article fills an important research gap.

Research limitations/implications:

Our study shares the limitations of qualitative studies, but the resulting conceptual model of brand management in the context of a creative city offers a springboard for future research in this regard.

Practical implications:

City representatives and tourist managers need to understand what is the value-in-use generated by the creative class in the brand identity process and must be aware that the creative class plays a key role in delivering the brand message.
Varied layer thickness improves structural properties of YSZ thin film
Authors: Mohd Rahimi Nur Fathirah , Thirugnana Sathiabama T. , Ghoshal Sib Krishna , Muhammad Rosnita
Published: May 2021

In this study, the Yttrium Stabilized Zirconia (YSZ) thin films were deposited on the sapphire substrate (Al2O3) by dip-coating method using simple ethanol-based YSZ suspension. The layer thickness of YSZ films were varied by sintering at 1300°C. Phase change and structural evolution in YSZ films were observed by conducting X-ray diffraction (XRD) analyses. The microstructures and the surface morphology of the deposited films were examined using Atomic Force Microscope (AFM) and Field Emission Scanning Electron Microscope (FESEM). The XRD pattern revealed a phase change from cubic to monoclinic with an increase in YSZ layer thickness. The crystallite size was varied in the range of 9.68–42.98 nm with the changes in the layer thickness. Meanwhile, the AFM image analyses showed a layer thickness-dependent variation in the grain size (205.83–373.77 nm) and the RMS surface roughness (16.72–36.44 nm). The FESEM images of the achieved film exhibited the occurrence of a dense morphology. It was concluded that by controlling the layer thickness of the deposited films, their improved structure and morphology can be achieved.
Relationship between neighborhood land use structure and the spatiotemporal pattern of PM2.5 at the microscale: Evidence from the central area of Guangzhou, China
Authors: Song Jie , Zhou Suhong , Peng Yinong , Xu Jianbin , Lin Rongping
Published: May 2021

Fine particulate matter (PM2.5) is harmful to human health. Although the relationship between urban land use and PM2.5 has been studied in recent years, there has been little consideration of the relationship between land use structure and PM2.5 spatiotemporal patterns at the microscale. Based on mobile monitoring PM2.5 data and point of interest data, this paper explored their relationship with a classification and regression tree model. The results showed that PM2.5 exhibits spatiotemporal heterogeneity at the microscale. The neighborhoods’ land use structure can explain 60.4% of the PM2.5 spatiotemporal patterns. Transportation and ecology are the two most significant land use types that correlated with PM2.5 spatiotemporal patterns. Fourteen rules of neighborhood land use structures with different land use types are identified land use structure which leads to different spatiotemporal patterns of PM2.5. The higher the PM2.5 risk, the stronger the correlation with neighborhood land use structure is. The classification and regression tree model can be effectively used to judge the relationship between neighborhood land use structure and PM2.5 spatiotemporal patterns. The results provide a basis for developing appropriate measures, based on local conditions, to predict PM2.5 pollution levels at the microscale, and reduce the risk of neighborhood exposure to PM2.5.
Evaluating the impact of partial driving restrictions on local air quality in Chongqing using regression discontinuity design
Authors: Li Xin , Jiang Shuhan , Wang Tianqi , Hu Jia , Yuan Yun
Published: May 2021

Driving restriction is used to mitigate traffic congestion and improve air quality. A partial bridge restriction policy is created in Chongqing, China since the bridges are natural network bottlenecks due to the local river system. Is such a strategy really capable of reducing air pollution and further improving local air quality? Employing an integration of principal component analysis and a regression-discontinuity design approach, this study examines the short-run effect of the partial driving restrictions on the local air quality index in Chongqing, China. The examination is first conducted to the city level, and then its eight administrative districts are tested separately. The findings reveal that the air quality index of the whole city area has experienced deterioration after the introduction of restrictions in Chongqing. Among eight districts, Yuzhong is the only one experiencing an improvement of air quality index.
Modelled impacts of a potential light emitting diode lighting system conversion and the influence of an extremely polluted atmosphere in Mexico City
Authors: Lamphar H , Wallner S , Kocifaj M
Published: May 2021

Currently, many cities worldwide are changing current existing and mostly outdated lighting situation systems from inefficient lamps to light emitting diodes (LEDs). Providing the opportunity of energy savings, they can help in preventing influences to the night sky and furthermore issues for human health, wildlife and environment. This work simulates a potential LED conversion for the megacity of Mexico City and investigates impacts to conservation areas. Modelled for the whole visible spectrum, the analysis places special focus on the effects of applying various colour temperatures. Additionally, a highly polluted atmosphere was included as theoretical model, something applying to megacities in particular, to see impacts on skyglow of such an environmental contingency. In general, results show that the night sky brightness increases significantly with increasing colour temperature of LEDs if the lumen output is kept constant. It is shown that a potential conversion requires a thorough adjustment, otherwise negative impacts on environment and health might rise. Furthermore, an increased aerosol optical thickness ends in producing more diffuse light, identifying a major concern for the environment. The results obtained in this paper may be a strong motivation to ascertain measurements conducted in other large urban areas correlated to the computational results presented here.
Political Movements and Forgotten Women of Telangana
Authors: Pathak Keyoor , Subudhi Chittaranjan
Published: May 2021

Telangana became a separate state in 2014 with a lot of sacrifices from women The article provides a brief histography and revolves around those women of Telangana, who actively participated in different political and social movements of Telangana or India as a whole.
Cytotoxic Effects of N,N‐Diethyl‐Meta‐Toluamide (DEET) on Sinonasal Epithelia
Authors: Lee Jivianne T. , Basak Saroj
Published: May 2021

Although the etiology of chronic rhinosinusitis remains unknown, environmental factors including airborne pollutants and toxicants are postulated to contribute to its pathogenesis. However, the precise pathomechanisms with which environmental toxicants may contribute to chronic rhinosinusitis are not fully understood. The purpose of this pilot study is to examine the cytotoxic effects of N,N‐diethyl‐meta‐toluamide (DEET), a commonly used pesticide, on sinonasal epithelial cells (SNECs). Sinus mucosa was obtained from 3 subjects without a history of chronic rhinosinusitis. Cultured SNECs were exposed to various concentrations of DEET (0‐5 mM) for 6 days. Cell viability, proliferation, and morphologic changes were assessed using the MTT colorimetric dye assay and the Incucyte Live Cell Monitoring System. Statistically significant dose‐dependent reduction in cell viability and proliferation was observed between exposure and control groups (P <. 05) at all concentrations tested. Dose‐dependent cellular morphological changes were also seen. These findings indicate that DEET exposure induces dose‐dependent cytotoxicity in sinonasal epithelia.
Development and Assessment of an Otolaryngology‐Specific Surgical Priority Scoring System
Authors: Sharma Arun , Matos Sophia , Ettema Sandra L. , Gregory Stacie R. , Javadi Pardis , Johnson Matthew D. , Stack Brendan C. , Crosby Dana L.
Published: May 2021

Objective

To develop and assess an otolaryngology‐specific surgical priority scoring system that incorporates varying levels of mucosal involvement.

Study Design

Retrospective cohort.

Setting

Academic medical center.

Methods

A novel mucosal score was developed based on best available evidence. This mucosal score was incorporated into the Medically Necessary, Time‐Sensitive (MeNTS) score to generate a MeNTS‐Mucosal (MeNTS‐M) score. A retrospective cohort of patients was identified to assess the surgical priority scoring systems. Inclusion criteria included all scheduled surgical procedures between March 23, 2020, and April 17, 2020. Decisions about whether to proceed or cancel were made based on best clinical judgment by surgeons, without use of any surgical priority scores. The predictive value of the surgical priority scoring systems was assessed in this retrospective cohort.

Results

The median MeNTS score was significantly lower in adult patients whose surgery proceeded compared to those for whom the surgery was cancelled (48 vs 56; P =. 004). Mucosal and MeNTS‐M scores were not statistically different based on whether surgery proceeded. Among adult patients, the highest area under the curve (AUC) was for the MeNTS scoring system (0.794); both the mucosal and MeNTS‐M systems had lower AUC values (which were significantly lower than the AUC for the MeNTS scoring system).

Conclusion

This study represents development and assessment of the first otolaryngology‐specific surgical priority score and incorporates varying levels of mucosal disruption. The combined MeNTS‐M scoring system could be a valuable tool in appropriately triaging otolaryngology–head and neck surgery procedures.
Management of Large Subretinal Gas Bubble After Pneumatic Retinopexy With Head-Positioning Maneuver
Authors: Wang Jay C. , Tang William M. , Eliott Dean
Published: May 2021

Purpose:

This work reports on the management of a large subretinal gas bubble after pneumatic retinopexy.

Methods:

A case report is discussed.

Results:

We report a case of subretinal gas after pneumatic retinopexy for rhegmatogenous retinal detachment that was managed with a series of head-positioning maneuvers to allow the subretinal gas to migrate into the vitreous cavity through the retinal break. Despite the subretinal bubbles being larger than the retinal break, this approach eliminated the subretinal gas and averted surgical intervention.

Conclusions:

Subretinal gas after pneumatic retinopexy can be successfully managed by head-positioning maneuvers in some cases, even if the subretinal gas bubble is larger than the retinal break.
Rapid, Spontaneous Resolution of Prominent Subretinal Infiltrate in Vitreoretinal Lymphoma
Authors: Gong Dan , Aronow Mary E. , Eliott Dean
Published: May 2021

Purpose:

This case report describes a patient with vitreoretinal lymphoma who subacutely developed a large, peripapillary subretinal infiltrate that rapidly and spontaneously resolved.

Methods:

A case report is presented.

Results:

A 65-year-old Asian-American woman was referred for evaluation of a dense, peripapillary subretinal infiltrate in the left eye. A diagnostic vitrectomy revealed large, atypical lymphocytes with irregularly shaped nuclei, and mutational testing was positive for myeloid differentiation primary response 88 ( MYD88). Prior to surgery, the patient’s subretinal infiltrate had begun to resolve spontaneously, a process that continued after surgery without initiation of systemic or local ocular therapy.

Conclusions:

Patients with vitreoretinal lymphoma may present with transient, subretinal infiltrates that can resolve without treatment.
What the VAP: The Expanded VAP Family of Proteins Interacting With FFAT and FFAT-Related Motifs for Interorganellar Contact
Authors: Neefjes Jacques , Cabukusta Birol
Published: May 2021

Membrane contact sites are formed by tether proteins that have the ability to bring two organellar membranes together. VAP proteins are a family of endoplasmic reticulum (ER)-resident tether proteins specialized in interacting with FFAT (two phenylalanines in an acidic tract) peptide motifs in other proteins. If the FFAT-motif-containing proteins reside on other organelles, VAP proteins form contact sites between these organelles and the ER. The role of VAPA and VAPB, the two founding members of the VAP family in recruiting proteins to the ER and forming membrane contact sites is well appreciated as numerous interaction partners of VAPA and VAPB at different intracellular contact sites have been characterized. Recently, three new proteins -MOSPD1, MOSPD2 and MOSPD3- have been added to the VAP family. While MOSPD2 has a motif preference similar to VAPA and VAPB, MOSPD1 and MOSPD3 prefer to interact with proteins containing FFNT (two phenylalanines in a neutral tract) motifs. In this review, we discuss the recent advances in motif binding by VAP proteins along with the other biological processes VAP proteins are involved in.
Medical device error and failure reporting: Learning from the car industry
Authors: Tase Arkeliana , Buckle Peter , Ni Melody Z , Hanna George B
Published: May 2021

Background

Improving the design of technology relies in part, on the reporting of performance failures in existing devices. Healthcare has low levels of formal reporting of performance and failure of medical equipment. This paper examines methods of reporting in the car industry and healthcare and aims to understand differences and identify opportunities for improvement within healthcare.

Methods

A literature search was carried out in Pubmed, Medline, Embase, Engineering Village, Scopus. NHS England and MHRA publications and guidelines were also reviewed. Focus was placed on the current system of reporting in both industries, known degree of patient harm, initiating factors, barriers, quality and methods of incident investigation and their validity. The findings were used to compare error reporting system in the two industries.

Results

Derivation of healthcare incident data from different sources means the full extent of patient harm is not known. For example, in 2012 there were 13,549 and 38,395 incidents reported by MHRA and NRLS (National Reporting and Learning System) respectively leading to uncertainties on the extent of the problem. The car industry emphasises the role of reporting source in ensuring data quality. Utilising some aspects of this approach might benefit healthcare reporting. These include a specific reporting system that stresses the importance of organisational learning in improving safety and recognises the limitations of root cause analysis.

Conclusions

Learning from reporting systems within the car industry may help the healthcare sector improve its own reporting, aiding healthcare performance.
Structured well-being assessments in public child welfare: Observations across two states
Authors: Collins-Camargo Crystal , Strolin-Goltzman Jessica , Verbist A. Nathan , Krompf Alison , Antle Becky F.
Published: May 2021

Children entering custody within the child welfare system have been found to have high levels of trauma and significant behavioral health needs. In this paper, authors demonstrate how a structured functional well-being assessment can be used with the custody population to promote an understanding of behavioral health needs, inform case planning, and measure functional improvement over time. Specifically, this paper will: (a) briefly describe how two states implemented a common standardized assessment of functioning to inform case planning and measure well-being progress of children in the custody of a public child welfare system (b) examine what this common assessment tool reveals about the strengths and needs of children entering custody across two sites and (c) describe the magnitude of change in functional improvement measured across 6 months. This paper will contribute to the existing knowledge by sharing possible themes in functioning related to children entering custody while examining changes in functioning over time. Implications for practice, policy, and future research will be discussed.
How do foster children placed in long-term family foster care experience school?
Authors: Van Holen Frank , Van Hove Lisa , Clé Ann , Verheyden Camille , Vanderfaeillie Johan
Published: May 2021

Background:

Foster children often experience school problems and perform less well than average. This may result in failed school careers and compromised future career paths. Nonetheless, few studies have focused on the perspective of foster children regarding education.

Method:

Semi-structured interviews were conducted with 27 foster children (M = 14 years, range = 12–18 years) placed in long-term family foster care about their experiences regarding “school.”

Results:

A thematic analysis distinguished four main themes: (1) the importance of school for foster children; (2) the impact of the foster care placement on the school performance (3) support foster children receive with regard to their functioning and performance at school; and (4) the fear of stigmatization.

Discussion:

Foster children attach a great importance to school and receive support from different persons. Yet, many foster children are confronted with school difficulties, such as bullying, hindered concentration, and negative reactions to being placed in foster care. Interventions should be developed to support this group and improve their performances. Furthermore, actors who get in touch with foster children should be better acquainted with foster care.
Feeling ‘like you’re on … a prison ship’ – Understanding the caregiving and attachment narratives of parents of autistic children
Authors: Grey Ben , Dallos Rudi , Stancer Rebecca
Published: May 2021

This study explored the caregiving and attachment relationships of parents of autistic children, analysing 16 Parent Development Interviews conducted as part of a larger project. The interviews were analysed using attachment theory–driven discourse analysis, namely, the Adult Attachment Interview and Meaning of the Child Interview methods of evaluating relational discourse for transformations of meaning with a self-protective function. A multiple case-study approach was used to build an explanatory model of the caregiving and parent–child relationships of the whole sample. The study found a high level of trauma in the parents’ early childhood that shaped the way they interpreted their child and the parent–child relationship, often undermining these parents’ intentions to form more positive relationships with their own children. An interpersonal understanding of the problems of these families is suggested, seeing difficulties as residing in relationships, maintained by a circular process of ruptures, as parent and child seek to protect themselves from the pain and shame inherent in the experience of ‘disconnection’, and the apparent failure of the parents’ hope for a better relationship with their children than they experienced as children. This may be exacerbated by commonly available autism narratives, which tend to essentialise problems, mechanise parental understanding of their children and encourage parents to experience their child as fundamentally separate, challenging the caregiving system. Clinicians supporting families with autistic children may be assisted by attending to this meaning-making process, seeking creative alternatives to help these parents realise their positive intentions that do not support a shame-based cycle.
Distant viewing and multimodality theory: Prospects and challenges
Authors: Hiippala Tuomo
Published: May 2021

This article discusses the prospects and challenges of combining multimodality theory with distant viewing, a recent framework proposed in the field of digital humanities. This framework advocates the use of computational methods to enable large-scale analysis of visual and multimodal materials, which must be nevertheless supported by theories that explain how these materials are structured. Multimodality theory is well-positioned to support this effort by providing descriptive schemas that impose structure on the materials under analysis. The field of multimodality research can also benefit from adopting computational methods, which help to achieve the long-term goal of building large multimodal corpora for empirical research. However, despite their immense potential for multimodality research, the use of computational methods warrants caution, because they involve a number of potentially cascading risks that arise from biases inherent to the underlying data and different approaches to the phenomenon of multimodality.
Graft Preparation for Combined ACL and ALL Reconstruction With a Single Femoral Tunnel
Authors: Helito Camilo Partezani , Guimarães Tales Mollica , Sobrado Marcel Faraco
Published: May 2021

Background:

Combined reconstruction of the anterolateral ligament (ALL) and anterior cruciate ligament (ACL) has shown excellent results. It could potentially reduce graft failure and improve outcomes in high-risk patients. There are several surgical techniques described. Hamstrings are the most frequently used graft for ALL reconstruction. The distal portion of the iliotibial band is used for the modified Lemaire procedure.

Indications:

Anterior cruciate ligament reconstructions associated with the following risk factors: pivoting sports, high-demand athletes, high-grade pivot-shift, chronic ACL injury, lateral femoral condyle notch, Segond fractures, young patients (<20 years), ACL revision, generalized hyperlaxity, and Lachman >7 mm.

Technique Description:

Semitendinosus and gracilis tendons are harvested and their extremities are prepared with continuous suture. The semitendinosus graft is folded in 3 parts leaving the ends of the graft internalized. The triple semitendinosus will be the main component of the ACL and the single gracilis will be used for both ACL and ALL. Anterolateral ligament anatomical landmarks are proximal and posterior to the lateral epicondyle in the femur, and in the mid distance from the fibular head and the Gerdy tubercle in the tibia. The ALL is fixed in knee extension with interference screws. This video also includes a brief demonstration of graft preparation for the modified Lemaire procedure.

Results:

Results from our group using this technique have shown excellent clinical outcomes, minimal complications, and low failure rates in high-risk populations. This graft preparation shows excellent diameter and length for combined ACL and ALL reconstruction.

Conclusion:

This technique is easy to perform, with minimal complications, and should be considered in high-risk patients undergoing ACL reconstruction.