bluuebunny/crossref_metadata_2025 huggingface dataset:
Workplace Wellness Program Interest and Barriers Among Workers With Work-Related Permanent Impairments
Authors: Sears Jeanne M. , Edmonds Amy T. , Hannon Peggy A. , Schulman Beryl A. , Fulton-Kehoe Deborah
Published: April 2022

Background:

Nearly half of U.S. workers have access to workplace wellness programs (WWPs), 58% of workers with access participate. The aim of this study was to assess interest in WWP participation and identify reasons for lack of interest among workers with work-related permanent impairments—a population at elevated risk of adverse health outcomes.

Methods:

Workers who returned to work after a work-related permanent impairment were interviewed 11 to 15 months after workers’ compensation claim closure. Qualitative content analysis methods were used to code open-ended responses.

Findings:

Of 560 respondents, 51.4% expressed interest in WWP participation. Numerous adverse health and economic characteristics were associated with WWP interest, for example, interest was expressed by 63.3% of workers reporting fair/poor health status versus 47.1% reporting good/excellent; 56.9% of workers reporting moderate/severe pain versus 41.4% reporting mild/no pain; 64.7% of workers without health insurance versus 50.1% with health insurance; 69.0% of workers reporting depression versus 47.2% without depression; 70.4% of workers reporting obesity versus 48.0% without obesity; and 63.2% of workers often worried about expenses versus 46.9% reporting sometimes/never worried. Specific participation barriers were described by 34.2% of the 272 workers who were not interested.

Conclusions/Applications to Practice:

A majority of workers with work-related permanent impairments—particularly those with adverse health and economic characteristics—were interested in WWPs. Many workers who reported no interest cited participation barriers. Further research is needed to determine whether addressing such barriers would enhance equitable access. Those undertaking WWP planning, implementation, and outreach should ensure that WWPs are inclusive and serve workers with disabilities.
How Often Would MRI Change the Thoracolumbar Fracture Classification or Decision-Making Compared to CT Alone?
Authors: Aly Mohamed M. , Al-Shoaibi Abdulbaset M. , Abduraba Ali Saleh , Al Fattani Areej , Eldawoody Hany
Published: April 2022

Study design

retrospective study of consecutive patients

Objective

to analyze the frequency of change in Thoracolumbar fractures (TLFs) classification or decision-making after MRI compared by CT alone.

Methods

A retrospective review of 244 consecutive patients with acute TLFs (T1-L5) presented to a single level 1 trauma center between 2014 and 2021. Three and 4 reviewers independently classified all fractures according to AOSpine and AOSpine injury severity score (TLAOSIS) by CT then MRI, respectively. Posterior ligamentous complex Injury (PLC) was diagnosed on CT and MRI by ≥ 2 positive CT findings and Black stripe discontinuity.

Results

MRI changed AO classification in 25/244 patients (10.2%, P < .0001) due to an 8.2% upgrade from type A to type B and a 2% downgrade from type B to type A. The addition of MRI changed TL AOSIS among the 3 treatment recommendation groups in 35/244 (19.7%, 95% CI [14.9%-25.2%]. The best predictor of upgrade from type A to type B and downgrade from type B to type A was a single positive CT finding and the presence of only 2 CT signs as opposed to ≥3 signs, respectively ( P < .0001 P = .03, respectively). Thoracic fractures showed a significantly higher reclassification rate than thoracolumbar and low lumbar (20% vs 10% and 0%, respectively, P = .07).

Conclusion

using appropriate CT/MRI criteria for PLC injury, MRI changed the AOSpine classification by 10% and TLAOSIS based treatment by 19.7%. The best predictors of fracture reclassification by MRI were the number of positive CT findings and fracture level.
The Strategic Construction of Aryan Identity of Brokpas: An Anthropological Perspective
Authors: Chakraborty Mainak , Mitra Santanu , Harashawaradhana
Published: April 2022

The Brokpa community of India is the most celebrated tribal population of the country. This population is not only a major attraction of Ladakh, but also their villages are must visit destination of this country for foreign travellers. The reason of this interest is Brokpas ‘Aryan’ identity and the status of ‘pure’ attached to them. This identity or essence of Brokpa was created strategically and is more of a cultural identity than racial. Even there is no genetical evidence of their Indo-European descent. This article will discuss about the construction of Aryan identity of Brokpa from outside and inside the community, and this identity is affecting the population.
Cyclic High Negative-Pressure External Volume Expansion Reduces Daily Device Application Time With Similar Effects on Recipient Site Preparation in a Murine Model
Authors: Jeong Jinwook , Park Joseph Kyu-hyung , Bin Choy Young , Shim Jung Hee , Kang So Min , Nam Sun-Young , Najmiddinov Bakhtiyor , Heo Chan Yeong
Published: April 2022

Introduction: Recipient site preparation using external volume expansion (EVE) increases graft survival in large-volume fat grafting. To improve patient compliance with using the device, we tested a new cyclic high negative-pressure (CHNP) mode that involves 1 h/day at −55 mm Hg, cycled between 1-second negative-pressure activation, followed by a 2-second deactivation period in an animal model. Material and Method: A miniaturized EVE device was applied to 30 8-week-old male Sprague-Dawley rats. The rats were assigned to 3 groups (no pressure for the control group, conventional −25 mm Hg for 8 h/day for conventional EVE, and CHNP mode for the CHNP group). After 28 days, micro-computed tomography was performed and skin biopsy specimens were obtained. Results: The CHNP group showed a 6.6-fold increase and the conventional EVE group showed a 4.4-fold increase in volume compared to the control group. Hematoxylin and eosin staining showed a similar increase in subcutaneous tissue thickness in both EVE groups, compared to the control group. Masson's trichome and proliferating cell nuclear antigen staining showed significantly higher collagen deposition and subdermal adipocytes in EVE groups. Immunohistochemistry against platelet endothelial cell adhesion molecule 1 showed 2.5- and 2.7-times higher vessel density in the conventional and CHNP EVE groups, respectively. There was no statistically significant difference in subcutaneous tissue thickness, collagen deposition, subdermal adipocyte proliferation, and vessel density between the 2 EVE groups. Conclusion: CHNP produced comparable results in recipient site preparation (subcutaneous tissue thickening and angiogenesis) compared to the conventional protocol, while markedly reducing the daily wear-time from 8 hours to 1 hour. Although further clinical data must be acquired, our new pressure setting seems promising and provides a more patient-friendly pre-expansion environment.
Trends in Anterolateral Ligament Reconstruction and Lateral Extra-articular Tenodesis With ACL Reconstruction in Children and Adolescents
Authors: Madhan Ashwin S. , Ganley Theodore J. , McKay Scott D. , Pandya Nirav K. , Patel Neeraj M.
Published: April 2022

Background:

Anterolateral ligament reconstruction (ALLR) and lateral extra-articular tenodesis (LET) show promise in lowering the risk of rerupture after anterior cruciate ligament reconstruction (ACLR), but there are little data on surgeon practices and preferences in children and adolescents.

Purpose:

To quantify surgeon practices regarding ALLR and LET in the pediatric population.

Study Design:

Cross-sectional study.

Methods:

An electronic survey was administered to 87 surgeons in the Pediatric Research in Sports Medicine society. The questionnaire asked several questions about surgeon and practice characteristics as well as indications, preferences, and techniques for ALLR or LET in the context of primary and revision pediatric ACLR. Chi-square and Fisher exact tests were used to evaluate factors that affect surgical preferences.

Results:

A total of 63 surgeons completed the survey, of whom 62% performed ≥50 pediatric ACLRs annually; 56% sometimes performed anterolateral augmentation with primary ACLR, and 79% with revision ACLR. The most common indications for ALLR or LET in the primary setting were high-grade pivot shift, knee hyperextension, generalized laxity, and type of sports participation. Surgeons whose practice was >75% sports medicine were more likely to perform ALLR or LET with both primary and revision ACLR ( P = .005 and P < .001, respectively). Those who had completed a sports medicine fellowship were more likely to perform these procedures than those with only pediatric orthopaedic training, in both primary (68% vs 36%; P = .01) and revision scenarios (92% vs 60%; P = .002). Of the 28 respondents who did not perform ALLR or LET with primary ACLR, 75% cited insufficient evidence as the reason. However, 96% of surgeons who did perform these procedures expressed interest in studying them prospectively, and 87% were willing to randomize patients.

Conclusion:

Findings indicated that 56% of pediatric sports surgeons sometimes perform anterolateral augmentation with primary ACLR and 79% with revision ACLR. Surgeons with sports medicine fellowship training or a mostly sports practice were more likely to perform these procedures. Insufficient evidence was the most common reason given by surgeons who did not perform anterolateral augmentation. However, there was substantial willingness to prospectively study and even randomize pediatric patients to assess the impact of ALLR or LET in this population.
Osteomyelitis of the Rib in a Child With Indolent Symptoms
Authors: Balamohan Archana , Buchmann Robert F.
Published: April 2022

We describe a case of osteomyelitis of the rib caused by methicillin-susceptible Staphylococcus aureus. The patient presented with a subtle, indolent course leading to a suspected 2-year delay in diagnosis. This case highlights that the diagnosis of rib osteomyelitis, which can readily mimic other diagnoses, such as costochondritis, intraabdominal infections, pneumonia, or malignancies warrants a high index of suspicion. Albeit rare, pediatricians should be aware of the possibility of rib osteomyelitis in healthy children to help ensure a prompt diagnosis and appropriate, timely management.
Marketing, Value Creation and Values Dynamics: Gazing Out to Asia and Europe from Kitakyushu
Authors: Ashta Ashok
Published: April 2022

If businesses were distinct from society and the planet, primarily serving the shareholder by maximizing profits, the focus of value creation would remain on prices and profitability. Yet, a review of research experiences with Asia, Europe and Kitakyushu in conjunction with the definition of marketing (one that is inclusive of customers, partners and broader society) develops perspectives on how values underly value creation. Such perspectives indicate that there are service models that extend beyond the profit motive, highlighting what I refer to as the dynamics of values on value creation. More precisely, much value creation literature has advanced understanding of the perception of the service receiver, while overlooking values of the service provider. The opinion on values dynamics developed in this article offers a novel conceptualization framework of the interplay of values on marketing’s targets (i.e., customers, partners and broader society). It also calls attention to the critical role of location specificity (in this case, Kitakyushu) for subjective sense-making of value creation actions as opposed to currently mainstream Western realist worldviews. Finally, this article highlights a role for de-emphasizing price and profit-centred thinking and embracing a broader humanist worldview in developing the scholarly sub-field of value creation in marketing.
Book review: Amit Ahuja, Mobilizing the Marginalized: Ethnic Parties without Ethnic Movements
Authors: Nandgaye Vicky
Published: April 2022

Amit Ahuja, Mobilizing the Marginalized: Ethnic Parties without Ethnic Movements. New Delhi: Oxford University Press, 2019, 266 pp., ₹550.00 (Paperback). ISBN-13: 9780197529515
Assessing provider perceptions of training: Initial evaluation of the Acceptability, Feasibility, and Appropriateness Scale
Authors: Cho Evelyn , Lyon Aaron R. , Tugendrajch Siena K. , Marriott Brigid R. , Hawley Kristin M.
Published: April 2022

There is a well-documented gap between research and practice in the treatment of mental health problems. One promising approach to bridging this gap is training community-based providers in evidence-based practices (EBPs). However, a paucity of valid, reliable measures to assess a range of outcomes of such trainings impedes our ability to evaluate and improve training toward this end. The current study examined the factor structure of the Acceptability, Feasibility, Appropriateness Scale (AFAS), a provider-report measure that assesses three perceptual implementation outcomes of trainings that may be leading indicators of training success (i.e., acceptability, feasibility, and appropriateness). Providers who attended half-day EBP trainings for common mental health problems reported on the acceptability, feasibility, and appropriateness of these trainings using the AFAS ( N  =  298). Confirmatory factor analysis indicates good fit to the hypothesized three-factor structure (RMSEA  =  .058, CFI  =  .990, TLI  =  .987). Acceptability, feasibility, and appropriateness were three distinct but related constructs. Cronbach's alpha ranged from .86 to .91, indicating acceptable internal consistency for the three subscales. Acceptability and feasibility, but not appropriateness, scores varied between workshops, though variability across workshops was generally limited. This initial evaluation of the AFAS is in line with recent efforts to enhance psychometric reporting practices for implementation outcome measures and provides future directions for further development and refinement of the AFAS.

Plain Language Summary

Clinician training in evidence-based practices is often used to increase implementation of evidence-based practices in mental health service settings. However, one barrier to evaluating the success of clinician trainings is the lack of measures that reliably and accurately assess clinician training outcomes. This study was the initial evaluation of the Acceptability, Feasibility, Appropriateness Scale (AFAS), a measure that assesses the immediate outcomes of clinician trainings. This study found some evidence supporting the AFAS reliability and its three subscales. With additional item refinement and psychometric testing, the AFAS could become a useful measure of a training's immediate impact on providers.
Comparison of the effectiveness of high-flow nasal oxygen vs. standard facemask oxygenation for pre- and apneic oxygenation during anesthesia induction: a systematic review and meta-analysis
Authors: Song Jian-li , Sun Yan , Shi Yu-bo , Liu Xiao-ying , Su Zhen-bo
Published: April 2022

Background

In recent years, high flow nasal oxygen (HFNO) has been widely used in clinic, especially in perioperative period. Many studies have discussed the role of HFNO in pre- and apneic oxygenation, but their results are controversial. Our study aimed to examine the effectiveness of HFNO in pre- and apneic oxygenation by a meta-analysis of RCTs.

Methods

EMBASE, PUBMED, and COCHRANE LIBRARY databases were searched from inception to July 2021 for relevant randomized controlled trails (RCTs) on the effectiveness of HFNO versus standard facemask ventilation (FMV) in pre- and apenic oxygenation. Studies involving one of the following six indicators: (1) Arterial oxygen partial pressure (PaO2), (2) End expiratory oxygen concentration (EtO2), (3) Safe apnoea time, (4) Minimum pulse oxygen saturation (SpO2min), (5) Oxygenation (O2) desaturation, (6) End expiratory carbon dioxide (EtCO2) or Arterial carbon dioxide partial pressure(PaCO2) were included. Due to the source of clinical heterogeneity in the observed indicators in this study, we adopt random-effects model for analysis, and express it as the mean difference (MD) or risk ratio (RR) with a confidence interval of 95% (95%CI). We conducted a risk assessment of bias for eligible studies and assessed the overall quality of evidence for each outcome.

Results

Fourteen RCTs and 1012 participants were finally included. We found the PaO2 was higher in HFNO group than FMV group with a MD (95% CI) of 57.38 mmHg (25.65 to 89.10; p = 0.0004) after preoxygenation and the safe apnoea time was significantly longer with a MD (95% CI) of 86.93 s (44.35 to 129.51; p < 0.0001) during anesthesia induction. There were no significant statistical difference in the minimum SpO2, CO2 accumulation, EtO2 and O2 desaturation rate during anesthesia induction between the two groups.

Conclusions

This systematic review and meta-analysis suggests that HFNO should be considered as an oxygenation tool for patients during anesthesia induction. Compared with FMV, continuous use of HFNO during anesthesia induction can significantly improve oxygenation and prolong safe apnoea time in surgical patients.
Utilization of healthcare by immigrants in Canada: a cross-sectional analysis of the Canadian Community Health Survey
Authors: Ravichandiran Nisanthini , Mathews Maria , Ryan Bridget L.
Published: April 2022

Background

Immigrants to Canada face unique barriers to health care, which leads to inequities in health care utilization. Lower utilization of health care by immigrants to Canada is associated with the deteriorating health of individual immigrants as well as increased costs to the health care system. The existing literature suggests that time since immigration is an important predictor for utilization of health care for Canadian immigrants; however, few studies have included this variable in their analysis. This study aims to examine the relationships between having a regular health care provider and time since immigration, and number of medical consultations in the past year and time since immigration.

Methods

A secondary cross-sectional data analysis using Andersen and Newman’s Framework of Health Service Utilization and data from the 2015–2016 Canadian Community Health Survey (CCHS) was conducted to examine health care utilization among immigrants in Canada. We used multiple logistic regression to examine the relationship between time since immigration and having a regular physician and negative binomial regression to compare the number of consultations of recent (less than 10 years since immigration) and established (10 or more years since immigration) immigrants.

Results

Eighty four percent of immigrant respondents to CCHS 2015–2016 had a regular health care provider. After controlling for other independent variables, established immigrants were 1.75 (95% confidence interval: 1.45–2.10) times more likely to have a regular health care provider compared to recent immigrants. Immigrants had a mean of 3.37 (standard deviation 4.53) medical consultations in the preceding year. There was no difference in the mean number of medical consultations by recent and established immigrants.

Conclusions

After controlling for other independent variables, this study found that time since immigration had a significant effect on having a regular provider but not on number of consultations. Differences in health care utilization for recent and for established immigrants observed in this study may be partially explained by Canada’s evolving immigration policy and the economic and social integration of immigrants over time.
Interleukin-6 and granulocyte colony-stimulating factor as predictors of the prognosis of influenza-associated pneumonia
Authors: Zhang Jiaying , Wang Jingxia , Gong Yiwen , Gu Yudan , Xiang Qiangqiang , Tang Ling-Ling
Published: April 2022

Background

Pneumonia is a common complication of influenza and closely related to mortality in influenza patients. The present study examines cytokines as predictors of the prognosis of influenza-associated pneumonia.

Methods

This study included 101 inpatients with influenza (64 pneumonia and 37 non-pneumonia patients). 48 cytokines were detected in the serum samples of the patients and the clinical characteristics were analyzed. The correlation between them was analyzed to identify predictive biomarkers for the prognosis of influenza-associated pneumonia.

Results

Seventeen patients had poor prognosis and developed pneumonia. Among patients with influenza-associated pneumonia, the levels of 8 cytokines were significantly higher in those who had a poor prognosis: interleukin-6 (IL-6), interferon-γ (IFN-γ), granulocyte colony-stimulating factor (G-CSF), monocyte colony-stimulating factor (M-CSF), monocyte chemoattractant protein-1 (MCP-1), monocyte chemoattractant protein-3, Interleukin-2 receptor subunit alpha and Hepatocyte growth factor. Correlation analysis showed that the IL-6, G-CSF, M-CSF, IFN-γ, and MCP-1 levels had positive correlations with the severity of pneumonia. IL-6 and G-CSF showed a strong and positive correlation with poor prognosis in influenza-associated pneumonia patients. The combined effect of the two cytokines resulted in the largest area (0.926) under the receiver-operating characteristic curve.

Conclusion

The results indicate that the probability of poor prognosis in influenza patients with pneumonia is significantly increased. IL-6, G-CSF, M-CSF, IFN-γ, and MCP-1 levels had a positive correlation with the severity of pneumonia. Importantly, IL-6 and G-CSF were identified as significant predictors of the severity of influenza-associated pneumonia.
Prehospital norepinephrine administration reduces 30-day mortality among septic shock patients
Authors: Jouffroy Romain , Hajjar Adèle , Gilbert Basile , Tourtier Jean Pierre , Bloch-Laine Emmanuel , Ecollan Patrick , Boularan Josiane , Bounes Vincent , Vivien Benoit , Gueye Papa-Ngalgou
Published: April 2022

Background

Despite differences in time of sepsis recognition, recent studies support that early initiation of norepinephrine in patients with septic shock (SS) improves outcome without an increase in adverse effects. This study aims to investigate the relationship between 30-day mortality in patients with SS and prehospital norepinephrine infusion in order to reach a mean blood pressure (MAP) > 65 mmHg at the end of the prehospital stage.

Methods

From April 06th, 2016 to December 31th, 2020, patients with SS requiring prehospital Mobile Intensive Care Unit intervention (MICU) were retrospectively analysed. To consider cofounders, the propensity score method was used to assess the relationship between prehospital norepinephrine administration in order to reach a MAP > 65 mmHg at the end of the prehospital stage and 30-day mortality.

Results

Four hundred and seventy-eight patients were retrospectively analysed, among which 309 patients (65%) were male. The mean age was 69 ± 15 years. Pulmonary, digestive, and urinary infections were suspected among 44%, 24% and 17% patients, respectively. One third of patients (n = 143) received prehospital norepinephrine administration with a median dose of 1.0 [0.5–2.0] mg h−1, among which 84 (69%) were alive and 38 (31%) were deceased on day 30 after hospital-admission. 30-day overall mortality was 30%. Cox regression analysis after the propensity score showed a significant association between prehospital norepinephrine administration and 30-day mortality, with an adjusted hazard ratio of 0.42 [0.25–0.70], p < 10–3. Multivariate logistic regression of IPTW retrieved a significant decrease of 30-day mortality among the prehospital norepinephrine group: ORa = 0.75 [0.70–0.79], p < 10–3.

Conclusion

In this study, we report that prehospital norepinephrine infusion in order to reach a MAP > 65 mmHg at the end of the prehospital stage is associated with a decrease in 30-day mortality in patients with SS cared for by a MICU in the prehospital setting. Further prospective studies are needed to confirm that very early norepinephrine infusion decreases septic shock mortality.
Associations of sodium and potassium intake with chronic kidney disease in a prospective cohort study: findings from the Hispanic Community Health Study/Study of Latinos, 2008–2017
Authors: Swift Samuel L. , Drexler Yelena , Sotres-Alvarez Daniela , Raij Leopoldo , Llabre Maria M. , Schneiderman Neil , Horn Linda Van , Lash James P. , Mossavar-Rahmani Yasmin , Elfassy Tali
Published: April 2022

Background

According to dietary recommendations, reduction of sodium intake has potential to reduce Chronic Kidney Disease (CKD) risk; however the role of dietary potassium and the sodium -to- potassium ratio in the development of CKD is unclear.

Methods

We studied 9778 participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) from four US urban communities. Participants were aged 18–74 yrs., free from CKD at baseline in 2008–2011 and re-examined between 2014 and − 2017. Dietary intake of sodium, potassium and the ratio of dietary sodium -to- potassium were measured from two baseline 24-h dietary recalls. Incident CKD was defined as: 1) estimated glomerular filtration rate (eGFR) decline of 1 unit per year and eGFR < 60 ml/min/1.73m2 or 2) albumin to creatinine ratio ≥ 30 mg/g at the follow-up visit. We used multivariable survey weighted Poisson regression to estimate adjusted incident rates of incident CKD.

Results

At baseline, mean age was 41 years. Average follow up time was 6.2 years. From fully adjusted Poisson regression analyses, self-reported sodium intake was not associated with incident CKD. However, for each 500 mg decrement in potassium intake, there was an 11% increase risk of incident CKD (IRR = 1.11, 95% CI = 1.00, 1.24). Additionally, every 1 M ratio increment of sodium -to -potassium ratio was associated with a 21% increased risk of incident CKD (IRR = 1.21, 95% CI = 1.02, 1.45), p < 0.05).

Conclusions

We conclude that diets low in potassium and high in sodium are associated with increased risk of developing chronic kidney disease among healthy US Hispanic/Latino adults.
Comparison of early warning scores for predicting clinical deterioration and infection in obstetric patients
Authors: Arnolds David E. , Carey Kyle A. , Braginsky Lena , Holt Roxane , Edelson Dana P. , Scavone Barbara M. , Churpek Matthew
Published: April 2022

Background

Early warning scores are designed to identify hospitalized patients who are at high risk of clinical deterioration. Although many general scores have been developed for the medical-surgical wards, specific scores have also been developed for obstetric patients due to differences in normal vital sign ranges and potential complications in this unique population. The comparative performance of general and obstetric early warning scores for predicting deterioration and infection on the maternal wards is not known.

Methods

This was an observational cohort study at the University of Chicago that included patients hospitalized on obstetric wards from November 2008 to December 2018. Obstetric scores (modified early obstetric warning system (MEOWS), maternal early warning criteria (MEWC), and maternal early warning trigger (MEWT)), paper-based general scores (Modified Early Warning Score (MEWS) and National Early Warning Score (NEWS), and a general score developed using machine learning (electronic Cardiac Arrest Risk Triage (eCART) score) were compared using the area under the receiver operating characteristic score (AUC) for predicting ward to intensive care unit (ICU) transfer and/or death and new infection.

Results

A total of 19,611 patients were included, with 43 (0.2%) experiencing deterioration (ICU transfer and/or death) and 88 (0.4%) experiencing an infection. eCART had the highest discrimination for deterioration (p < 0.05 for all comparisons), with an AUC of 0.86, followed by MEOWS (0.74), NEWS (0.72), MEWC (0.71), MEWS (0.70), and MEWT (0.65). MEWC, MEWT, and MEOWS had higher accuracy than MEWS and NEWS but lower accuracy than eCART at specific cut-off thresholds. For predicting infection, eCART (AUC 0.77) had the highest discrimination.

Conclusions

Within the limitations of our retrospective study, eCART had the highest accuracy for predicting deterioration and infection in our ante- and postpartum patient population. Maternal early warning scores were more accurate than MEWS and NEWS. While institutional choice of an early warning system is complex, our results have important implications for the risk stratification of maternal ward patients, especially since the low prevalence of events means that small improvements in accuracy can lead to large decreases in false alarms.
Research involvement among undergraduate health profession students in a resource-limited setting: awareness, attitude, motivators and barriers
Authors: Kiyimba Blaise , Atulinda Linda , Nalunkuma Racheal , Asasira Ignatius , Kabunga Jonathan , Banturaki Davis , Nabyonga Anastacia Ssebbowa , Nakiganda Rachel , Ndyabawe Rachael , Nkalubo Jonathan , Ssewante Nelson , Bongomin Felix , Bakeera-Kitaka Sabrina
Published: April 2022

Background

Involvement of undergraduate health professions students (HPS) in research will facilitate evidence-based clinical practice among future healthcare practitioners. This study aimed to assess research involvement among undergraduate HPS students and associated factors in Uganda.

Methods

A cross-sectional study was conducted using an online assessment tool sent through WhatsApp groups and E-mail addresses of HPS in 12 medical schools in Uganda between 20th September and 5th October 2021.

Results

We enrolled 398 participants with a mean age of 23.9 ± 3.7 years. Of this, 267 (67.1%) were male. One hundred twenty (30.2%) participants previously participated in a research activity: 90 (58.4%) as research assistants, 39 (25.3%) published as first authors, and 25 (16.2%) as co-authors. Training on the conduct of research was received by 242 (65.8%) participants, and 326 (81.9%) had intentions of conducting research in the future. Factors influencing participation in research activities were, age ≥ 25 years (adjusted odds ratio (aOR): 1.9, 95% confidence interval (95% CI): 1.2–3.2, p = 0.012), being male (aOR: 2.1, 95%CI: 1.2–3.6, p = 0.008), and being in a clinical year i.e., year 3 (aOR: 3.2, 95% CI: 1.1–9.3, p = 0.033), year 4 (aOR: 3.3, 95% CI: 1.1–9.5, p = 0.028) and year 5(aOR: 11.6, 95% CI: 3.2–42.1, p < 0.001). Lack of funds (79.6%), and mentorship (63.3%) were reported as major barriers to research.

Conclusions

Despite a high proportion of HPS showing interest in getting involved in research, less than one-third reported previous involvement. Addressing barriers such as funding could potentially improve research involvement and output among undergraduate HPS in resource-limited settings.
Cancer patients’ perspectives on remote monitoring at home during the COVID-19 pandemic- a qualitative study in Norway
Authors: Leonardsen Ann-Chatrin Linqvist , Helgesen Ann Karin , Stensvold Andreas , Magnussen Jannik , Grøndahl Vigdis A.
Published: April 2022

Background

The COVID-19 pandemic triggered an unprecedented demand for digital health technology solutions, such as remote monitoring. Previous research has focused on patients with chronic diseases, and their experiences with remote monitoring during the pandemic. Several recommendations have been presented to reduce the frequency of cancer patients’ visits to oncology centers and minimizing the risk of exposure to COVID-19, such as remote monitoring. However, few studies have explored how this has influenced the healthcare services to cancer patients.

Aim

To explore cancer patients’ perspectives on remote monitoring at home during the COVID-19 pandemic.

Design

The study had a qualitative design, using in-depth, individual interviews.

Methods

A total of eleven interviews were conducted with patients who received remote monitoring during the COVID-19 outbreak. Three of the interviews were conducted by telephone, and eight on a digital platform, audio recorded, and transcribed verbatime. Data were analyzed using reflexive thematic analysis as recommended by Braun & Clarke.

Results

All participants were conscious about being vulnerable to infections due to having cancer and receiving cancer treatment, and the pandemic to them represented an extra burden. Most of the participants experienced that their healthcare services had changed due to the pandemic, but there was no consensus on how the services had changed. All of the participants presented remote monitoring as something «new». Whether they received remote monitoring by telephone, video consultations or more advanced solutions with the possibility to complete a questionnaire or fill in measurements, did not seem to impact their views. However, all agreed that remote monitoring could never totally replace physical consultations in hospital. Participants’ views seemed to grow more positive over time, but still they emphasized both positive and negative aspects of remote monitoring solutions in cancer care.

Conclusion

Remote monitoring was introduced as a necessity in cancer care during the COVID-19 outbreak. This may seem as an efficient solution, allowing for patients to stay at home and avoid infection. Our results indicate that, in the case of cancer patients, it is important that healthcare personnel balance the remote monitoring solution with person-to-person contact.
Routine evaluation of tonsillectomy specimens: A cross-sectional survey of Canadian Otolaryngology: Head and Neck Surgeons
Authors: Kuhnow Alexi , Al-Sayed Ahmed A. , Taylor Benjamin
Published: April 2022

Background

Tonsillectomy is a commonly performed procedure in Canada. The rate of occult malignancy is rare in adult and pediatric populations. At present, no guidelines exist surrounding the need for routine histopathological evaluation of tonsil specimens when no malignancy is suspected.

Methods

We sent a confidential online survey to active members of the Canadian Society of Otolaryngology – Head and Neck Surgery (CSO-HNS) about their current tonsillectomy practice and beliefs surrounding the need for routine histopathological evaluation of tonsillectomy specimens when no malignancy is suspected. We used Opinio survey software for data collection and descriptive statistics.

Results

95 participants completed our survey (response rate 19.3%). Most participants reported performing both adult and pediatric tonsillectomies. When no malignancy is suspected, participant responses were split between whether they send tonsil specimens in pediatrics only (4.2%), in adults only (31.6%), or not sending specimens (29.5%). Half of the participants reported that routinely sending specimens to rule out occult malignancy is an institutional policy. Approximately 75% of participants were in favour of removing this practice in both the pediatric and adult populations.

Conclusion

Eliminating the practice of automatically sending tonsil specimens for histopathological evaluation when no malignancy is suspected was supported by the majority of study participants. This is in keeping with Choosing Wisely, a campaign designed to facilitate conversations about unnecessary medical tests and procedures. Institutional change is likely required in order to alter this practice.

Graphical Abstract
Bedtime Routines Intervention for Children (BRIC) project: results from a non-randomised feasibility, proof-of concept study
Authors: Kitsaras George , Pretty Iain A. , Allan Julia
Published: April 2022

Background

Bedtime routines are highly recurrent family activities with implications for children’s wellbeing, development and health.

Aims

The objective of this study is to co-develop and test in a feasibility, proof-of-concept study a bedtime routines intervention using text messages aimed at first-time parents with young children.

Methods

Fifty first-time parents with children aged 1–3 years were recruited for this study. Parents received a text message-based intervention for 7-consecutive nights which provided support and information on achieving optimal bedtime routines. Parents completed pre- and post-intervention questionnaires focusing on children’s sleep, bedtime routines and parental mood disturbance. Feedback was provided at the end of the study.

Results

Recruitment target and high retention with 98%, or 49 out of 50 participants completing the study were achieved. Pre- and post-intervention, there were improvements in total children’s sleep with children sleeping longer and having less disrupted sleep overall (MD = − 7.77 (SD = 17.91), t(48) = − 3.03, p = .004, CI (− 12.91, − 2.63) and in overall quality of bedtime routines (MD = − 5.00, SD = 7.01, t(48) = − 4.98, p < .001, CI (− 7.01, − 2.98). Parental mood disturbance decreased pre- to post-intervention (MD = 5.87, SD = 15.43, t(48) = 2.66), p = .010, CI (1.44, 10.30). Parents provided positive feedback about the intervention and valued the support that was provided to them.

Conclusions

Bedtime routines were successfully altered with short-term benefits for children’s sleep and parental mood. Future research will need to utilize a more robust, longitudinal approach for a definite exploration of sustained changes in bedtime routines and their long-term implications for children and parents.
Dietetic intervention in psoriatic arthritis: the DIETA trial
Authors: Leite Beatriz F. , Morimoto Melissa A. , Gomes Carina M. F. , Klemz Barbara N. C. , Genaro Patrícia S. , Shivappa Nittin , Hébert James R. , Damasceno Nágila R. T. , Pinheiro Marcelo M.
Published: April 2022

Aim

To evaluate whether dietary pattern changes, antioxidant supplementation or 5–10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA).

Methods

A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were evaluated at baseline and after the 12-week intervention. Statistical analysis used the intention-to-treat approach. The P value was considered to indicate significance when below 0.05.

Results

After 12 weeks, DAS28-CRP and BASDAI scores improved, especially in the Diet-placebo group (− 0.6 ± 0.9; p = 0.004 and − 1.39 ± 1.97; p = 0.001, respectively). In addition, a higher proportion of patients achieved minimal disease activity (MDA) in all groups. The Diet-fish group showed significant weight loss (− 1.79 ± 2.4; p = 0.004), as well as waist circumference (− 3.28 ± 3.5, p < 0.001) and body fat (− 1.2 ± 2.2, p = 0.006) reductions. There was no significant correlation between weight loss and disease activity improvement. Each 1-unit increase in the HEI value reduced the likelihood of achieving remission by 4%. Additionally, each 100-cal daily intake increase caused a 3.4-fold DAS28-ESR impairment.

Conclusion

A 12-week hypocaloric intervention provided suitable control of joint disease activity in patients with PsA, regardless of weight loss. Adding omega-3 supplementation caused relevant body composition changes but not disease activity improvement.

Trial Registration: The study was recorded on Clinicaltrials.gov (NCT03142503).
Broadband design of acoustic metasurfaces for the stabilization of a Mach 4 boundary layer flow
Authors: Zhao Rui , Liu Xiao , Wen Chihyung , Wang Xiaoyong
Published: April 2022

A piecewise acoustic metasurface is designed to suppress the first mode while marginally amplifying the Mack second mode in a Mach 4 flat-plate boundary layer (BL) flow. The results of linear stability theory (LST) and the eN method demonstrate the stabilization effect and transition delay performance, respectively. However, the direct numerical simulation (DNS) results indicate that the designed broadband acoustic metasurface actually weakly excites the first mode with a slightly larger fluctuating pressure amplitude at the surface, which is in contrast to the analysis of LST. The discrepancies are found to lie in the ‘roughness’ effect caused by the recirculation zones inside the microslits and the alternating expansion and compression waves induced at the slit edges, which significantly amplifies the first mode. For further clarification of the competitive mechanism between the acoustic stabilization and ‘roughness’ destabilization effects of metasurfaces on the first mode, a carefully designed metasurface is installed at the maximum growth rate region, which excites the first mode on the metasurface but inhibits its development downstream.
BMP/SMAD1/5 Signaling in the Endometrial Epithelium Is Essential for Receptivity and Early Pregnancy
Authors: Tang Suni , Cope Dominique I , Vasquez Yasmin M , Monsivais Diana
Published: April 2022

The biological processes that control endometrial receptivity and embryo implantation are critical for the successful outcome of pregnancy. The endometrium is the complex inner lining of the uterine wall that is under the cyclical control of estrogen and progesterone and is a site of intimate contact between mother and blastocyst. The bone morphogenetic signaling (BMP) pathway is a highly conserved signaling pathway that controls key cellular processes throughout pregnancy and exerts intracellular effects via the SMAD1/5 transcription factors. To delineate the endometrial compartment–specific roles of BMP signaling, we generated mice with epithelial-specific conditional deletion of SMAD1/5 using Lactoferrin-icre (Smad1flox/flox;Smad5flox/flox;Lactoferrin-cre, “Smad1/5 cKO”). Histological analysis of the reproductive tracts showed that Smad1/5 cKO mice were developmentally normal and displayed no defects in glandular morphology. In fertility analyses, single SMAD1 or SMAD5 deletion had no effect on fertility; however, double-conditional deletion of SMAD1 and SMAD5 resulted in severe subfertility. Timed mating analyses revealed endometrial receptivity defects in the Smad1/5 cKO mice beginning at 3.5 days post coitum (dpc) that perturbed embryo implantation at 4.5 dpc, as demonstrated by the detection of unattached blastocysts in the uterus, decreased COX2 expression, and FOXO1 cytoplasmic mislocalization. We also found that defects that arose during peri-implantation adversely affected embryonic and decidual development at 5.5 and 6.5 dpc. Thus, uterine epithelial BMP/SMAD1/5 signaling is essential during early pregnancy and SMAD1/5 epithelial-specific deletion has detrimental effects on stromal cell decidualization and pregnancy development.
Visualising the cytoskeletal machinery in neuronal growth cones using cryo-electron tomography
Authors: Atherton Joseph , Stouffer Melissa , Francis Fiona , Moores Carolyn A.
Published: April 2022

Neurons extend axons to form the complex circuitry of the mature brain. This depends on the coordinated response and continuous remodelling of the microtubule and F-actin networks in the axonal growth cone. Growth cone architecture remains poorly understood at nanoscales. We therefore investigated mouse hippocampal neuron growth cones using cryo-electron tomography to directly visualise their three-dimensional subcellular architecture with molecular detail. Our data showed that the hexagonal arrays of actin bundles that form filopodia penetrate and terminate deep within the growth cone interior. We directly observed the modulation of these and other growth cone actin bundles by alteration of individual F-actin helical structures. Microtubules with blunt, slightly flared or gently curved ends predominated in the growth cone, frequently contained lumenal particles and exhibited lattice defects. Investigation of the effect of absence of doublecortin, a neurodevelopmental cytoskeleton regulator, on growth cone cytoskeleton showed no major anomalies in overall growth cone organisation or in F-actin subpopulations. However, our data suggested that microtubules sustained more structural defects, highlighting the importance of microtubule integrity during growth cone migration.
Social media in the marketing of educational services
Authors: Tokarski Daniel , Kowalik Maximilian
Published: April 2022

Purpose: The aim of the article is to present the results of the analysis of the University's educational services promotion strategy with the participation of social media in the process of acquiring and maintaining lasting relationships with stakeholders.Methodology: The research concerned the quality of service to stakeholders of the Pope John Paul II State School of Higher Education in Biala Podlaska, (Poland, Lubelskie Voivodeship) and the level of their satisfaction with promotional activities undertaken by the analyzed entity, as well as the determinants of choosing the place of education in correlation with the possibilities of sustainable development. Empirical research was conducted in the third quarter of 2020 using an on-line questionnaire, based on the deliberate selection of respondents.Findings: The analysis of the results focused on promotional activities that the examined entity should keep or develop on the pages of selected social networks. Acquiring new fans was indicated as the best-rated activities of the University, which directly translates into the visibility and range of the generated content. According to the respondents, the surveyed entity should publish content more often via social media in order to build lasting relationships with the immediate environment.Implications: According to the respondents, the University should publish more content on the Internet. Respondents indicated that other students may be helpful in publishing posts. The survey showed that most of the respondents recommended the University to their friends thanks to the earlier reading of its offer on the Internet, on one of the social networks.Originality: An original scientific article on the use of social media in the promotion of educational services, the first references to it appear in the literature on the subject at the beginning of the 21st century.Keywords: internet, educational services, marketing services, social mediaPaper type: Research paper
Krzysztof Pomian – historia nauki i sieć relacji przyjacielsko-intelektualnych
Authors: Rodak Paweł
Published: April 2022

Celem niniejszego artykułu jest wprowadzenie do tekstu Dominique’a Pestre’a, który został wygłoszony na konferencji „Parmi les hommes, les objets et les signes / Among humans, objects and signs. Hommage à Krzysztof Pomian”. Wydarzenie to zostało zorganizowane z okazji 85. rocznicy urodzin prof. Pomiana, jednego z najwybitniejszych żyjących polskich naukowców, od 1973 r. mieszkającego i pracującego głównie we Francji. Konferencja odbyła się w Paryżu w dniach 4–6 kwietnia 2019 r. Jej uczestnikami byli współpracownicy, uczniowie i przyjaciele Krzysztofa Pomiana z Polski, Francji, Belgii, Holandii, Wielkiej Brytanii, Niemiec i Izraela. W artykule został krótko opisany każdy z trzech dni konferencji ze szczególnym podkreśleniem znaczenia prac Krzysztofa Pomiana w takich dziedzinach, jak historia kolekcji i muzeów, historiografia, historia Europy. Wystąpienie Dominique’a Pestre’a zostało umiejscowione w kontekście zainteresowań badawczych Krzysztofa Pomiana oraz rozwoju historii nauki we Francji od lat 80. do dzisiaj. Na koniec zwrócono uwagę na istotne znaczenie sieci relacji przyjacielskich i intelektualnych w rozwoju nauki.