bluuebunny/crossref_metadata_2025 huggingface dataset:
Death Attitudes Among Middle-Aged and Older Adults in Japan: A Qualitative Study Based on Erikson’s Theory of Generativity
Authors: Tomoi Kazumi
Published: June 2022

There are few opportunities for ordinary people not familiar with death to think about it, whereas basic research on death attitudes is insufficient. This study thus examined the attitudes toward death among ordinary people through a qualitative analysis using Erikson’s theory of generativity. Semi-structured interviews were conducted with 13 middle-aged and older Japanese individuals. The results showed that death attitudes were individualized and consisted of seven components, mainly those related to agency and communion. The change in death attitudes manifested as a change in weight from agency to communion, a change in meaning and perspective, and an orientation toward well-being. In conclusion, the change in death attitudes is to become more generative by balancing agency and communion through the function of narration. This change might be termed “the maturity of death attitudes” because it is oriented toward eudaimonic well-being.
Synthesis, characterization, and properties of a new polyurethane elastomer based on tragacanth gum polysaccharide
Authors: Badakhshanian Elham , Ghaemy Mousa
Published: June 2022

This study prepared a type of bio-based elastomeric polyurethane from tragacanth gum (TG). TG is a natural polysaccharide with many hydroxyl groups that can be used as a chain extender and a crosslinker to react with the isocyanate groups in polyurethane prepolymer to form a highly branched and crosslinked polyurethane with high molecular weight and good mechanical properties. The chemical structure of the prepolymer and the thermal and mechanical properties of the prepared polyurethane were studied by Fourier transform infrared, nuclear magnetic resonance, scanning electron microscopy, thermal gravimetric analysis, dynamic mechanical thermal analysis, and tensile strength tester. The properties of the polyurethane-based on TG (TG-PU) were compared with the properties of the PU based on only polyethylene glycol. The TG-PU sample with 0.5 g TG showed a tensile strength of 288% and the glass transition temperature (Tg) of 33% higher than the tensile strength and Tg of PU without TG. We expect these findings to widen the range of preparation and applications of bio-based polyurethane materials.
Street-Level Bureaucrats in a Catch-All Bureaucracy
Authors: Trappenburg Margo , Kampen Thomas , Tonkens Evelien
Published: June 2022

Since 2015 Dutch street-level bureaucrats have ample discretionary space to determine how to help clients. Simultaneously, resources were reduced. According to Zacka SLBs should avoid three pathological positions: indifference, caregiving, and enforcing. At the individual level SLBs supposedly accomplish that by a gymnastics of the self. We observed SLBs. They avoided the pathological positions by (1) reframing the reigning policy for clients (enforcing caringly) and (2) managing clients’ self-image, bolstering their confidence, or tempering their expectations (caring forcefully). SLBs practice a gymnastics of the client alongside a gymnastics of the self. SLBs thus make the reigning policy palatable for clients.
Testing the Effects of a Utility Value Intervention in an Online Research Methods Course: A Conceptual Replication of Hulleman et al. (2017, Study 2)
Authors: Price Paul C. , Crisosto Kiana , Carvalho Anthony , Jones Constance J. , McCready Meaghan , Shaver Amber , Wiemann Andrea N.
Published: June 2022

Background

Utility-value (UV) classroom interventions typically involve students completing assignments that involve writing about the usefulness of the course material. They are widely recommended and have received some empirical support.

Objective

This study tested the effectiveness of a UV intervention in an online research methods course. It was a conceptual replication of a study by Hulleman et al. (2017, Study 2).

Method

Students ( N = 264) were randomly assigned to complete three assignments that required them to write about the usefulness of course material or three assignments that required them to summarize course material. The groups were compared in terms of their scores on a research methods knowledge test, their final papers, their final exams, and their final point totals, along with measures of the interestingness and usefulness of the course material.

Results

There were no differences between conditions on any of the outcome variables.

Conclusion

The UV intervention was ineffective. Further research is needed to establish the conditions under which such interventions are and are not effective.

Teaching Implications

UV interventions do not necessarily improve student performance. Instructors who use them should consider doing so in a way that allows for an assessment of their effect in their local context.
The potential for ELLECCT to support language development in the early years: A commentary on Weadman, Serry and Snow (2022)
Authors: Reeves Louisa
Published: June 2022

This commentary focuses on the English Early Years Education context and how the Emergent Literacy and Language Early Childhood Checklist for Teachers (ELLECCT Weadman, 2022) could be used in this context to emphasise the centrality of oral language in emergent literacy development. The English Early Years Foundation Stage curriculum and initiatives such as the Early Reading guide, the English Hubs and the Education Endowment Fund all contain a focus on early language and literacy. There is the potential for the ELLECCT to bring these two elements together. Consideration is given to opportunities for using this tool in training, including Early Years Teachers, speech and language therapists and parents, to highlight everyone’s role in supporting early language and literacy. Finally, the ELLECCT’s potential for identifying and supporting children with Speech, Language and Communication Needs in Early Years classrooms, particularly in areas of disadvantage, is highlighted.
Bilateral auriclar and external ear canal cartilage calcification
Authors: Lee Dong Hoon , Lim Sang Chul
Published: June 2022

Calcification of auricular cartilage is a rare condition. This phenomenon might be associated with frostbite, local trauma, inflammation, or systemic diseases. Calcification that progresses to the external ear canal cartilage is even rarer. We present an extremely rare case of bilateral auricular and external ear canal cartilage calcification in a patient with acromegaly. Clinicians should be aware that auricular and external ear canal cartilage calcification can occur in a patient with acromegaly.
Distribution of canine distemper virus and nectin-4 in raccoon (Procyon lotor) skin
Authors: Garcia Pedro A. Triana , Cartoceti Andrew , Affolter Verena K. , Jackson Kenneth , Keel M. Kevin , Agnew Dalen , Cooley Thomas , Melotti Julie , Fitzgerald Scott D. , Pesavento Patricia A.
Published: June 2022

Raccoons ( Procyon lotor) are abundant in urban/wildland interfaces and are key sources of canine distemper virus (CDV) outbreaks in domestic, zoo, and free-ranging wildlife species. CDV is pantropic, which provides multiple potential routes of transmission (urine, respiratory secretions, feces), but the specific role of skin as a target of infection, as a diagnostic sample, or as a potential source of environmental persistence and transmission is unknown. We have characterized the distribution of CDV and its known receptor, nectin-4, in skin samples of 36 raccoons. Even with skin samples that were grossly and histologically normal, immunohistochemistry of skin was useful in the diagnosis of CDV infection, which was found in both epithelium and endothelium. Nectin-4 was codistributed with cellular targets of viral infection. Skin secretions, shed keratinocytes, and hair of CDV infected raccoons are all potential environmental fomites.
‘Never think doing a job is easy’: The lived experience of work for people who have an intellectual and developmental disability
Authors: Ramsey Diana , Cameron Josh , Harrison Rebecca , Young Sharon
Published: June 2022

Introduction

The proportion of people with an intellectual or developmental disability (IDD) in paid employment is low internationally despite policy efforts. Evidence suggests multiple and varied explanations for this, including organisational, social and personal barriers. That evidence has not focused on first-person experiences which may provide a depth of understanding and explanation of the work-related experiences of people with IDD.

Method

A hermeneutic phenomenological approach and an exploratory research method of a ‘creative collaborative partnership’ was adopted to illuminate the work-related experiences of six people with a mild IDD.

Findings

Six work stories composed of narratives and visual images were collaboratively created revealing a complex range of positive and negative experiences and perspectives of paid work. Five collective narrative frames emerged: the quest ‘to do’, navigating bureaucratic seas, finding a good fit, forging of identity and finding both friend and foe.

Conclusion

The collaborators’ stories highlighted that individuals supporting people with IDD towards or in work, including occupational therapists, need to adopt a nuanced systemic perspective of the context surrounding the person. This includes identifying allies and allowing people with IDD to decide how (if at all) they describe their IDD status to others as they establish their worker identity.
Electronic waste control and management in Ghana: A critical assessment of the law, perceptions and practices
Authors: Owusu-Twum Maxwell Y , Kumi-Amoah Gifty , Heve William K , Lente Ishmael , Owusu Seth Anim , Larbi Lloyd , Amfo-Otu Richard
Published: June 2022

The aim of the study was to assess the impact of Ghana’s hazardous and e-waste control and management Act 917 of 2016 on current e-waste management practices and the level of awareness among key stakeholders (general public, repairers, wholesalers/retailers, recyclers and importers of electronic items) in the Greater Accra Region of Ghana. Both quantitative and qualitative data were collected and examined in this study. Results showed a low level (12%) of awareness among stakeholders on the e-waste legislation. Almost 13% of respondents had been educated on e-waste management. Community engagement and the mass media were the main sources of information on e-waste. Significant associations between background information of respondents and awareness level on ‘Ghana’s Act 917’ were observed. Relative to general e-waste issues, only education and stakeholder showed significant associations with e-waste legislation and management. The main e-waste disposal methods adopted by respondents were disposal at dumpsites (22.7%), repair and reuse (21.1%) and reselling (20.1%). Almost 10% of respondents made changes to their e-waste disposal practices over the past 5 years. These changes were mainly due to the economic benefits derived from reselling e-waste (37.6%) and the perceived adverse impacts of e-waste on the environment (23.9%). Overall, there is the need to intensify awareness on ‘Ghana’s Act 917’, especially issues regarding sustainable e-waste management practices.
Experimental investigations on flexural performance of polymer composites with non-uniform out-of-plane waviness defect
Authors: Kulkarni Pritam , Mali Kiran D , Singh Sandeep
Published: June 2022

Fibre waviness is frequently observed manufacturing defect which leads to a reduction of mechanical performance of the fibre reinforced polymer (FRP) composites. The current study investigates the effect of out-of-plane fibre waviness as a manufacturing defect on the flexural performance of carbon fibre reinforced polymer (CFRP) composites. Specimens with the non-uniform hump and non-uniform indentation waviness were fabricated using the transverse strip method. Experimental tests were conducted in the three-point flexural configuration using specimens with and without fibre waviness to investigate the flexural behaviour. Each of the above type of non-uniform waviness was investigated to evaluate the effect of the extent of the wave for three severity levels. Load-displacement response and digital optical microscopy were used to identify typical failure modes and damage initiation and progression in flexural specimens under test. Fibre kinking leading to delamination and fibre fracture were observed as prominent failure modes in hump as well as indentation waviness. Experimental investigation revels 12–30% reduction in flexural strength with increase in wave severity for the range considered in this study.
A new higher-order shear deformation theory for frequency analysis of functionally graded porous plates
Authors: Seyfi Ali , Maleki Mohammadreza , Chen Zengtao , Ebrahimi Farzad
Published: June 2022

The current investigation aims to account for the influence of porosity modeling while studying the dynamic response of functionally graded material (FGM) plates within the framework of a new, higher-order shear deformation theory for the first time. In the newly developed porosity modeling, the reciprocal effect of mass density and Young’s modulus is considered. Furthermore, silicon carbide in the ceramic phase and nickel in the metallic phase are selected as the constituent materials of the functionally graded plate. Based upon the new higher-order theory, the kinetic and kinematic relations are derived. This theory does not need any shear correction factor. The dynamic form of the principle of virtual work is employed to achieve governing equations of structure. Afterward, Galerkin’s method is implemented to solve obtained governing equations of porous, functionally graded plates. In order to verify the accuracy of the method, the obtained results were compared with the results reported in the literature, and good agreement was found. At last, the influences of some parameters such as porosity coefficient, length to thickness ratio, and aspect ratio of the porous, FGM plate on the dimensionless frequency are studied and the results are illustrated in detail.
Family Caregiver Reports of Their Own and Patient Symptoms in Cancer Home Hospice Approaching End-of-Life
Authors: Reblin Maija , Iacob Eli , Tay Djin L. , Li Hui , Thomas Hebdon Megan C. , Beck Anna , Donaldson Gary , Cloyes Kristin G. , Ellington Lee
Published: June 2022

Context: Family caregivers assume the primary responsibility of assessing and managing hospice cancer patient symptoms while simultaneously managing their own wellbeing and symptoms. Objectives: Describe caregivers’ assessment of hospice cancer patient and their own symptoms during the last 60 days of patient life, and assess the relationship between patient and caregiver symptoms over time. Methods: Caregiver symptom report of self and cancer home hospice patient symptom data were collected via telephone in the final 60 days of patient life. Descriptive data on symptom severity and prevalence were summarized. Exploratory Factor Analysis was used to group individual symptoms. Factors representing patient symptoms, caregiver symptoms, and caregiver outlook were analyzed using mixed-effects analysis to determine relationships between factors and change in relationship between factors over time. Results: Data from 61 patient-caregiver dyads are presented. At least 1 day of moderate-to-severe symptoms were reported in the majority of dyads. Significant auto-regressive associations were found, namely previous factor scores for an individual positively predicted the next factor scores for that individual. Previous caregiver report of patient symptoms was also positively associated with the next report of caregiver symptoms; previous caregiver report of their own symptoms were negatively associated with their next report of patient symptoms. Patient and caregiver symptoms and caregiver outlook worsened over time and the relationship between patient and caregiver symptoms strengthened closer to death. Conclusion: Our findings may guide hospice care team responses to caregiver and patient symptoms to promote individual level and unit level functioning.
The Social Subcontract: Business Ethics as Democratic Theory
Authors: Singer Abraham , Ron Amit
Published: June 2022

What does democracy demand of business? We argue that an answer to this question requires an understanding of the sorts of ethical obligations businesses have more generally. Against approaches that understand the duties of business in terms of citizenship or fiduciary obligation, we propose and develop the notion of subcontractor duties. We conceive of commercial activity as a social subcontract, in which businesses are empowered to exercise their judgment in pursuit of parochial interests, but for broader social reasons. Such license, however, puts businesses in a position to use this judgment in ways that unduly influence broader political processes. Given this, business ethics should be seen as indispensable for normative democratic theory, as it offers a conception of how business leaders should discharge their discretionary power in a manner least offensive to democratic principles. Drawing on a pragmatist understanding of democracy, we contend that businesses must respect, and avoid undermining, the formal and informal processes that characterize democratic politics. We conclude with rough sketch of what this looks like in practice, listing three broad sets of desiderata that a social subcontract seems to demand of businesses vis-à-vis democracy.
Artificial Intelligence and Machine Learning in Cancer Research: A Systematic and Thematic Analysis of the Top 100 Cited Articles Indexed in Scopus Database
Authors: Musa Ibrahim H. , Afolabi Lukman O. , Zamit Ibrahim , Musa Taha H. , Musa Hassan H. , Tassang Andrew , Akintunde Tosin Y. , Li Wei
Published: June 2022

Introduction

Cancer is a major public health problem and a global leading cause of death where the screening, diagnosis, prediction, survival estimation, and treatment of cancer and control measures are still a major challenge. The rise of Artificial Intelligence (AI) and Machine Learning (ML) techniques and their applications in various fields have brought immense value in providing insights into advancement in support of cancer control.

Methods

A systematic and thematic analysis was performed on the Scopus database to identify the top 100 cited articles in cancer research. Data were analyzed using RStudio and VOSviewer.Var1.6.6.

Results

The top 100 articles in AI and ML in cancer received a 33 920 citation score with a range of 108 to 5758 times. Doi Kunio from the USA was the most cited author with total number of citations (TNC = 663). Out of 43 contributed countries, 30% of the top 100 cited articles originated from the USA, and 10% originated from China. Among the 57 peer-reviewed journals, the “Expert Systems with Application” published 8% of the total articles. The results were presented in highlight technological advancement through AI and ML via the widespread use of Artificial Neural Network (ANNs), Deep Learning or machine learning techniques, Mammography-based Model, Convolutional Neural Networks (SC-CNN), and text mining techniques in the prediction, diagnosis, and prevention of various types of cancers towards cancer control.

Conclusions

This bibliometric study provides detailed overview of the most cited empirical evidence in AI and ML adoption in cancer research that could efficiently help in designing future research. The innovations guarantee greater speed by using AI and ML in the detection and control of cancer to improve patient experience.
Spatial spillovers of tourism activity on housing prices: The case of Croatia
Authors: Vizek Maruška , Stojčić Nebojša , Mikulić Josip
Published: June 2022

The tourism effects on housing prices within cities and regions have been analyzed in the literature, but there is a lack of evidence on the spatial effects of these processes. In areas hit by overtourism, house price hikes have the potential of spillovers to adjacent cities and towns as well as across wider space. Our study widens existing knowledge on the tourism-housing relationship by exploring the existence and extent of spatial spillovers from tourism-intensive cities and towns on housing prices of neighboring areas. A Durbin spatial autoregression panel model is applied on a population of cities and towns from Croatia, one of the small tourism-driven European economies during the 2012–2019 period. Different spatial weight matrices are applied to the model to explore the spatial reach of effects. Our findings, robust to the use of different tourism activity proxies, provide support to the existence of spatial spillover effects. The strongest effects of tourism on housing prices within and between cities come through the conversion of housing stock in rental properties rather than through the increase of private accommodation share in total accommodation capacities. Particularly strong effects are found once full spatial correlation is taken into account.
Proud to support social equality: Investigating the roles of pride, guilt, anger, and disgust in attitudes towards immigrants
Authors: Panno Angelo , De Cristofaro Valeria , Pellegrini Valerio , Leone Luigi , Giacomantonio Mauro , Anna Donati Maria
Published: June 2022

Previous research has demonstrated that low social dominance orientation (social equality orientation) promotes empathy with disadvantaged group members. In three studies, we tested a model relating preference for egalitarianism to positive attitudes towards immigrants through emotional experiences (pride, guilt, moral anger/ anger, disgust). Studies 1 and 2 showed that social equality orientation was positively related to proimmigrant attitudes through increased pride in helping immigrants, controlling for participants’ gender, age, and political orientation. Such a preference for egalitarianism was unrelated to proimmigrant attitudes through guilt for not helping immigrants and moral anger concerning mistreatment of immigrants. By focusing on emotional experience concerning proimmigrant national initiatives (e.g., integrating immigrants into the labor market), Study 3 corroborated the indirect effect of social equality orientation on proimmigrant attitudes through increased pride, controlling for participants’ gender, age, political orientation, as well as competitive jungle and dangerous world beliefs. Although much weaker, we also found a positive association between social equality orientation and proimmigrant attitudes through reduced anger, while no significant association through guilt and disgust was found. Results suggest that, relative to guilt, anger, and disgust, pride is the key channel through which preference for egalitarianism is related to positive attitudes towards immigrants. Implications and future directions for research are discussed.
The birth of identity biopolitics: How social media serves antiliberal populism
Authors: Judge Brian
Published: June 2022

This article establishes a theoretical link between the business model of social media and the resurgence of antiliberal populism. Through a novel set of tactics I term “identity biopolitics,” political campaigns and foreign governments alike can identify voters as members of socioculturally differentiated populations, then target them with political messages aimed at cultivating voters’ awareness of their particular disadvantage within the prevailing liberal order. Identity biopolitics exploits a positive feedback loop between targeting and content: the sociocultural differentiations liberalism declares politically irrelevant are used to target content that cultivates awareness of subjects’ particular depoliticized disadvantage within the prevailing liberal order. The antiliberal populist exploits this condition to drive support for their political program. This article presents case studies of the Internet Research Agency and Cambridge Analytica during the 2016 general election in the United States to demonstrate the symbiosis between social media and antiliberal populism.
Knowledge and practice towards early orthodontic problems among general dentists and paediatric dentists
Authors: Abdelmagid Sara M E , Abass Shaza K
Published: June 2022

Objectives:

To assess the knowledge, practice and challenges faced by general dental practitioners (GDPs), paediatric dentists (PDs) and postgraduate paediatric dentistry students (PGPDSs) in diagnosing and managing early orthodontic problems.

Design:

Cross-sectional study.

Methods:

A total of 159 dentists were enrolled in this study (121 GDPs, 21 PDs and 17 PGPDSs). Data were collected using a self-administered questionnaire involving two sections. Section A included questions regarding demographic features and orthodontic practice. Section B included photos of 12 orthodontic cases that needed early intervention. Knowledge and practice were assessed using six questions for each case that was then rated using predefined scores of poor (score <50%), average (score 50%–75%) and good (score >75%).

Results:

The knowledge scores regarding the identification of early orthodontic problems were average among the three groups with GDPs having the lowest score ( P = 0.0001). The knowledge scores regarding the selection of optimal treatment time were average among the PDs and PGPDSs, and poor among GDPs. GDPs tended to refer most of their cases to an orthodontist except for cases of thumb sucking. PDs and PGPDSs were more confident in treating anterior crossbite, thumb sucking habits and delayed eruption of incisors. All participants scored ‘poor’ regarding the selection of an appropriate orthodontic appliance. There was no significant correlation between knowledge and practice ( P > 0.05).

Conclusion:

PDs and PGPDSs showed higher knowledge and practice scores when compared to GDPs. For all three groups included in this study, lack of clinical skills was the main reason for not treating early orthodontic problems.
A Rare Case of Contained Chronic Rupture of Abdominal Aortic Aneurysm Associated With Vertebral Erosion: Pre- and Post-operative Findings on Computed Tomography and a Narrative Review
Authors: Parillo Marco , Vaccarino Federica , Beomonte Zobel Bruno , Quattrocchi Carlo C.
Published: June 2022

Contained chronic rupture of aortic aneurysm (CCR-AA) is a rare condition that can be associated with vertebral body erosion (VBE) and is often a diagnostic challenge; in fact, CCR-AAs are in general hemodynamically stable and the patients tend to present with a non-specific low-back pain syndrome secondary to vertebral involvement. Furthermore, the differential diagnosis of a retroperitoneal mass can be difficult on medical imaging. We discuss the case of a 79-years-old man, heavy smoker without history of cardiovascular diseases, admitted to the emergency department with signs of left lower limb ischemia. The patient was hemodynamically stable and the medical examination revealed a pulsatile abdominal mass. Doppler ultrasound showed the presence of aneurysmal dilatation of infra-renal abdominal aorta and chronic femoropopliteal occlusion on the left side. The subsequent computed tomography angiography (CTA) demonstrated a voluminous retroperitoneal mass continuous with the infra-renal aorta, which infiltrated the psoas muscles and caused vertebral bodies erosion of the anterior wall in L2, L3 and L4 suspected for CCR-AA or mycotic aortic aneurysm. Furthermore, the examination confirmed the occlusion of the peripheral arterial circulation of the left lower limb. The patient underwent a successful open replacement of the infra-renal abdominal aorta through aorto-aortic prosthetic graft insertion; the visualization during the surgical procedure of a posterior vessel wall opening in continuity with the eroded vertebral bodies associated with negative microbiological culture of the thrombotic material sample, led to the definitive diagnosis of CCR-AA. The post-operative CTA showed successful open vascular treatment. A bypass surgery of the left lower limb was then performed with positioning saphenous graft between femoral common artery and posterior tibial artery. The patient was finally discharged in good clinical conditions.
Angiosarcoma and Vascular Surgery: A Case Report and Review of Literature
Authors: May Lee Marco , Pierobon Elena , Riva Giulio , Germi Lerica , Feliciani Claudio , Naldi Luigi
Published: June 2022

Introduction:

Angiosarcomas (AS) are rare and aggressive neoplasms originating from the endothelium: they represent less than 2% of all soft tissue sarcomas and usually have a poor prognosis. Although more often primary, different risk factors have been described and some cases are associated with vascular surgery. Materials and Methods: We present the case of an 84-year-old man who developed an AS on his thigh 3 years after a popliteal bypass with autologous saphenous vein. We performed a thorough review of the literature describing the main characteristics of the 25 cases (including ours) of AS associated with vascular surgery reported from 1981 to 2022. Results: Most of the patients were males (21 men vs 4 women) with a range age of 50-84 years. Most of AS are associated with Dacron grafts (12 cases), the overall mean time to onset is 7.8 years after surgery. The most common presenting symptoms are pain (20 cases) and weight loss (10 cases), while cutaneous presentation is uncommon; indeed, violaceous and painful papules, plaques, nodules, and skin ulceration have been found in 3 cases only. Due to unspecific symptoms, differential diagnosis is often difficult and a biopsy for histological confirmation is mandatory. Conclusion: Even if it seems to be a very rare complication, AS should always be considered in patients with compatible symptoms and who have undergone vascular surgery in the past.
Tactile Sensation Improves Following Motor Rehabilitation for Chronic Stroke: The VIGoROUS Randomized Controlled Trial
Authors: Borstad Alexandra , Nichols-Larsen Deborah , Uswatte Gitendra , Strahl Nancy , Simeo Marie , Proffitt Rachel , Gauthier Lynne
Published: June 2022

Background. Up to 85% of people with chronic stroke experience somatosensory impairment, which contributes to poor sensorimotor control and non-use of the affected limb. Neurophysiological mechanisms suggest motor rehabilitation may improve tactile sense post-stroke, however, somatosensory recovery has rarely been reported in controlled trials. Objective. To compare the effect of four upper limb motor rehabilitation programs on the recovery of tactile sensation in adults with chronic stroke. Methods. Adults with chronic stroke and mild or moderate upper extremity hemiparesis ( n = 167) were enrolled in a multi-site randomized controlled trial. Participants completed three weeks of gaming therapy, gaming therapy with additional telerehabilition, Constraint-Induced Movement therapy, or traditional rehabilitation. Here, we report the results of a secondary outcome, tactile sensation, measured with monofilaments, before and after treatment, and 6 months later. Results. A mixed-effects general linear model revealed similar positive change in tactile sensitivity regardless of the type of training. On average, participants were able to detect a stimulus that was 32% and 33% less after training and at 6-month follow-up, respectively. One-third of participants experienced recategorization of their level of somatosensory impairment (e.g., regained protective sensation) following training. Poorer tactile sensation at baseline was associated with greater change. Conclusions. About one-third of individuals with mild/moderate chronic hemiparesis experience sustained improvements in tactile sensation following motor rehabilitation, regardless of the extent of tactile input in the rehabilitation program. Potential for sensory improvement is an additional motivator for those post-stroke. Characteristics of those who improve and mechanisms of improvement are important future questions. Clinicaltrials.gov NCT02631850
Does Time to Operative Intervention of Distal Radius Fractures Influence Outcomes?
Authors: Ahmad Farhan , Neral Mithun , Hoyen Harry , Simcock Xavier , Malone Kevin
Published: June 2022

Background:

No investigation has analyzed the time from injury to operative intervention and its effect on complications and functional outcomes in distal radius fractures. This investigation aimed to establish whether the time to surgical intervention from injury was associated with the observed rate of complications in distal radius fractures.

Methods:

A retrospective review of all orthopedic trauma patients who came to our center was conducted from 2008 through 2014. Patients who sustained closed distal radius fractures were included. A postoperative complication following distal radius fracture was defined as reoperation, superficial or deep infection, complex regional pain syndrome, new-onset carpal tunnel syndrome, tendon irritation, and symptomatic hardware.

Results:

In all, 190 patients were included in the study with a mean age of 48 years (SD ±14.7). According to the AO-Müller/Orthopaedic Trauma Association classification, radiographs revealed 80 A fractures, 15 B fractures, and 95 C fractures. Thirty distal radii were fixed within 0 to 3 days after injury, 91 patients within 4 to 10 days, and 69 patients after 10 days. Overall, 28 complications (14.7%) were identified. There was no statistical difference in the rate of complications between the time interval groups ( P = .17).

Conclusions:

Despite the increased popularity of surgical intervention for distal radius fractures, the optimal parameters to maximize patient outcomes have yet to be clearly defined. Time to intervention did not affect the rate of postoperative complication and range of motion.
The 5-Item Modified Frailty Index for Risk Stratification of Patients Undergoing Total Elbow Arthroplasty
Authors: Gordon Adam M. , Conway Charles A. , Sheth Bhavya K. , Magruder Matthew L. , Choueka Jack
Published: June 2022

Background:

Frailty, quantified using the 5-item modified frailty index (mFI-5), has been shown to predict adverse outcomes in orthopaedic surgery. The utility in total elbow arthroplasty (TEA) patients is unclear. We evaluated if increasing frailty would correlate with worse postoperative outcomes.

Methods:

A retrospective assessment of patients in the American College of Surgeons National Surgery Quality Improvement Program undergoing primary TEA was performed. The mFI-5 was calculated by assigning 1 point for each comorbidity (diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and functionally dependent health status). Poisson regression was used to evaluate mFI-5 scores on complications, length of stay (LOS), and adverse discharge. A significance threshold was at P < .05.

Results:

In total, 609 patients were included; 34.5% (n = 210) were not frail (mFI = 0), 44.0% (n = 268) were slightly frail (mFI = 1), and 21.5% (n = 131) were frail (mFI ≥ 2). As mFI score increased from 0 to ≥ 2, the following rates increased: any complication (9.0%-19.8%), major complication (11.0%-20.6%), cardiac complication (0.0%-2.3%), hematologic complication (3.3%-9.2%), adverse discharge (2.9%-22.9%), and LOS from 2.08 to 3.97 days (all P < .048). Following adjustment, Poisson regression demonstrated patients with a mFI ≥ 2 had increased risk of major complication (risk ratio [RR]: 2.13; P = .029), any complication (RR: 2.49; P = .032), Clavien-Dindo IV complication (RR: 5.53; P = .041), and adverse discharge (RR: 5.72; P < .001).

Conclusions:

Frailty is not only associated with longer hospitalizations, but more major complications and non-home discharge. The mFI-5 is a useful risk stratification that may assist in decision-making for TEA.
Methodological Insights From a Virtual, Team-Based Rapid Qualitative Method Applied to a Study of Providers’ Perspectives of the COVID-19 Pandemic Impact on Hospital-To-Home Transitions
Authors: Singh Hardeep , Tang Terence , Thombs Rachel , Armas Alana , Nie Jason X , Nelson Michelle L. A. , Gray Carolyn Steele
Published: June 2022

Background

During the COVID-19 pandemic, rapid virtual qualitative methods have gained attention in applied health research to produce timely, actionable results while complying with the pandemic restrictions. However, rigour and analytical depth may be two areas of concern for rapid qualitative methods.

Methods

In this paper, we present an overview of a virtual team-based rapid qualitative method within a study that explored health care providers’ perspectives of how the COVID-19 pandemic has impacted hospital-to-home transitions, lessons learned in applying this method, and recommendations for changes. Using this method, qualitative data were collected and analyzed using the Zoom Healthcare videoconferencing platform and telephone. Visual summary maps were iteratively created from the audio recordings of each interview through virtual analytic meetings with the team. Maps representing similar settings (e.g. hospital providers and community providers) and Sites were combined to form meta-maps representing that group’s experience. The combinations of data that best fit together were used to form the final meta-map through discussion.

Results

This case example is used to provide a description of how to apply a virtual team-based rapid qualitative method. This paper also offers a discussion of the opportunities and challenges of applying this method, in particular how the virtual team-based rapid qualitative method could be modified to produce timely results virtually while attending to rigour and depth.

Conclusions

We contend that the virtual team-based rapid qualitative data collection and analysis method was useful for generating timely, rigorous, and in-depth knowledge about transitional care during the COVID-19 pandemic. The recommended modifications to this method may enhance its utility for researchers to apply to their qualitative research studies.
Explaining Challenges Experienced and Evaluation of the Working Condition of Midwives: A Mixed-Method Study Protocol
Authors: Fathnezhad-Kazemi Azita , Sharifi Nasibeh , Nayebinia Anvar-Sadat
Published: June 2022

The present study aims to: (a) explain challenges experienced by midwives; (b) evaluate the working condition in midwifery working settings. This exploratory sequential mixed-methods study is conducted in three stages (qualitative, quantitative, and nominal group), in Tabriz and Ilam. A qualitative study will be carried out to explain challenges experienced by midwives and the subjects selected through purposive sampling; moreover, in-depth individual interviewing will be used for data collection. The quantitative phase will be used a cross-sectional approach for evaluating the working condition in midwifery working settings. Finally, using findings of the two phases and nominal group technique some strategies will be given to reduce challenges of the midwifery working settings. The results can be used to develop strategies for creating suitable working conditions. It is hoped that the strategy proposed in the current study could lead to improvements in midwives’ satisfaction and health care services.
Efficacy and safety of vitamin-K antagonists and direct oral anticoagulants for stroke prevention in patients with heart failure and sinus rhythm: An updated systematic review and meta-analysis of randomized clinical trials
Authors: Li Weijia , Seo Jiyoung , Kokkinidis Damianos G , Palaiodimos Leonidas , Nagraj Sanjana , Korompoki Eleni , Milionis Haralambos , Doehner Wolfram , Lip Gregory Y. H. , Ntaios George
Published: June 2022

Introduction:

Heart failure (HF) is a major public health issue associated with significantly increased risk of stroke. It remains uncertain whether oral anticoagulation (OAC) in patients with heart failure and sinus rhythm (HF-SR) could improve prognosis.

Methods:

We performed a systematic search of PubMed and Embase databases for randomized controlled clinical trials assessing oral anticoagulants versus antiplatelets or placebo in patients with HF or ventricular dysfunction/cardiomyopathy without clinical HF and SR. The outcomes assessed were stroke/systemic embolism, major bleeding, myocardial infarction, all-cause mortality, and HF hospitalization.

Results:

Seven trials of 15,794 patients were eligible for our analyses. The overall follow-up duration was 32,367 patient-years corresponding to a mean follow-up of 2.05 years per patient. Four trials included patients treated with warfarin and three included patients treated with rivaroxaban. OAC was associated with reduced rate of stroke or systemic embolism compared to control (odds ratio (OR): 0.57, 95% confidence interval (CI): 0.44, 0.73, number needed to treat (NNT): 71.9) but higher rate of major bleeding (OR: 1.92, 95% CI: 1.47, 2.50, number needed to harm (NNH): 57.1). In the subgroup analysis according to the type of OAC, rivaroxaban was associated with significantly reduced rate of stroke or systemic embolism (1.24 vs 1.97 events per 100 patient-years, respectively, OR: 0.63, 95% CI: 0.45, 0.88, NNT: 82) and higher risk of major bleeding (OR: 1.66, 95% CI: 1.26, 2.20) compared to antiplatelets or placebo. There was no significant differences between groups for the outcomes of myocardial infarction, all-cause mortality, and HF hospitalization.

Conclusion:

This analysis shows that any benefit of OAC for stroke prevention may be offset by an increased risk of major bleeding in HF-SR patients. A well-designed randomized controlled trial of newer safer OACs is needed in this population.
Exploring the mechanism of the excellent catalytic activity of NiFe-layered double hydroxides in oxygen evolution reactions by modifying the iron content
Authors: Liu Ying , Lei Xueyan , Xiong Bing , Chen Jifang , Zou Wei , Fu Zhengping , Lu Yalin
Published: June 2022

Layered double hydroxides are very promising catalysts for water splitting, in particular NiFe-layered double hydroxide, which has attracted significant attention due to its excellent catalytic activity in oxygen evolution reactions using alkaline electrolytes. In this work, samples with different molar ratios of Ni to Fe are prepared by a typical hydrothermal method to study the effect of iron on the catalytic properties of NiFe-layered double hydroxide. All the NiFe-layered double hydroxides exhibit much better oxygen evolution reaction activity than NiOOH, while increasing the iron content slightly affects the activity, which implies that only Fe ions at some specific site contribute to the oxygen evolution reaction activity. The NiFe-layered double hydroxide with a 4:1 molar ratio of Ni to Fe shows the best oxygen evolution reaction catalytic performance, and requires only an overpotential of 176 mV to afford a current of 10 mA cm−2 in 1.0 M KOH, and exhibits a much lower Tafel slope (51 mV dec−1). This work also studies the effect of iron on the electronic structure of nickel and reveals the mechanism behind the excellent oxygen evolution reaction catalytic properties of NiFe-layered double hydroxide.
Linaclotide utilization and potential for off-label use and misuse in three European countries
Authors: Cid-Ruzafa Javier , Lacy Brian E. , Schultze Anna , Duong Mai , Lu Yi , Raluy-Callado Mireia , Donaldson Robert , Weissman Darren , Gómez-Lumbreras Ainhoa , Ouchi Dan , Giner-Soriano Maria , Morros Rosa , Ukah Ahunna , Pohl Daniel
Published: June 2022

Introduction:

Linaclotide is approved for adults with moderate-to-severe irritable bowel syndrome (IBS) with constipation (IBS-C). Linaclotide is not indicated for weight loss or for patients with inflammatory bowel disease (IBD); it is contraindicated in patients with mechanical bowel obstruction (MBO). Some patients with obesity or eating disorders (ED) may use linaclotide off-label for weight loss or as a laxative.

Objectives:

To describe the use of linaclotide in clinical practice, including patients with potential for off-label use or misuse.

Methods:

Post-authorization safety study conducted in three databases from the linaclotide launch date to 2017: the Clinical Practice Research Datalink in the United Kingdom (UK), the Information System for Research in Primary Care database in Spain and the linked Patient, Prescription and Causes of Death Registries in Sweden. Cohorts of patients were identified as having IBS using diagnostic and treatment codes; IBS subtypes were identified using symptoms and treatment codes; patients with obesity, ED, MBO, and IBD were identified using diagnostic codes or body mass index.

Results:

There were 1319, 1981, and 5081 linaclotide users from the United Kingdom, Spain, and Sweden with a median age of 45, 57, and 51 years, respectively; most were females. In the United Kingdom, Spain, and Sweden, respectively: 59.0%, 60.3%, and 31.3% of linaclotide users had an IBS diagnosis recorded, and among those, 68.8%, 61.3%, and 92.7% were classified as IBS-C. The proportions of linaclotide users considered at risk for potential off-label use for weight loss or as a laxative were 17.1%, 29.7%, and 1.7%, and the proportions of users considered at risk of misuse due to a history of MBO or IBD were 3.5%, 4.6%, and 5.7% in the United Kingdom, Spain, and Sweden, respectively.

Conclusions:

Potential linaclotide off-label use and misuse appears limited, as evidenced by the small sizes of the patient subgroups at risk for off-label use and misuse.
Endovascular treatment of unruptured intracranial aneurysms with flow diverters: A retrospective long-term single center analysis
Authors: Simgen Andreas , Roth Christian , Kulikovski Johann , Papanagiotou Panagiotis , Roumia Safwan , Dietrich Philipp , Mühl-Benninghaus Ruben , Kettner Michael , Reith Wolfgang , Yilmaz Umut
Published: June 2022

Purpose

The introduction of flow diverters (FDs) in 2007 greatly enhanced the treatment of intracranial aneurysms. Here, we present our long-term clinical experience in treating unruptured intracranial aneurysms with FDs.

Methods

107 patients with unruptured aneurysms and treated with an FD between 2010 and 2019 were retrospectively reviewed. Aneurysm occlusion, procedural complications, and clinical outcome were evaluated.

Results

Angiographic follow-up was available for 93 patients with a mean long-term follow-up time of 28.4 ± 21.6 months. Additional coiling was performed in 15.1% of patients ( n = 14). Adequate aneurysm occlusion (Kamran grades 3 and 4) at long-term follow-up was achieved in 94.6% of patients ( n = 88). 3.2% ( n = 3) required endovascular retreatment since the last follow-up showed a lack of aneurysm occlusion (Kamran grade 0) due to a foreshortening of the FD. Incomplete opening of the FD and parent vessel occlusion was seen in 1.1% ( n = 1) and 3.2% ( n = 3) of patients, respectively. In-stent stenosis was observed in 57% ( n = 53) of cases at short-term follow-up and 22.6% ( n = 21) at long-term, which were moderate and asymptomatic overall. In-stent stenosis decreased significantly between short- and long-term follow-ups (31.4 ± 17.0% vs 9.7 ± 13.6%, respectively; p ≤ 0.001). Thromboembolic and hemorrhagic events occurred in 7.5% ( n = 7) and 1.1% ( n = 1) of patients, respectively. Good clinical outcome (modified Rankin scale: 0–2) was obtained in 97.8% ( n = 91) leading to an overall treatment-related morbidity of 2.2% ( n = 2). There was no procedural mortality.

Conclusion

Our study shows that FD treatment of unruptured intracranial aneurysms is effective and safe with high occlusion rates and low rates of permanent morbidity at long-term follow-up.