bluuebunny/crossref_metadata_2025 huggingface dataset:
Discrimination between Pancreatic Cancer, Pancreatitis and Healthy Controls Using Urinary Polyamine Panel
Authors: Nissinen Samuli I. , Venäläinen Markus , Kumpulainen Pekka , Roine Antti , Häkkinen Merja R. , Vepsäläinen Jouko , Oksala Niku , Rantanen Tuomo
Published: February 2022

Backround

Polyamines play an important role in cellular proliferation, and the change in polyamine metabolism is reported in various cancers. We searched for urinary polyamine signature for distinguishing between pancreatic cancer, premalignant lesions of the pancreas (PLP), acute and chronic pancreatitis, and controls.

Methods

Patients and controls were prospectively recruited in three Finnish hospitals between October 2013 and June 2016. The patients provided a urine sample at the time of the diagnosis. The panel of 14 polyamines was obtained in a single run with mass spectrometry. The polyamine concentrations were analysed with quadratic discriminant analysis and cross-validated with leave-one-out cross-validation.

Results

Sixty-eight patients with pancreatic cancer, 36 with acute pancreatitis, 18 with chronic pancreatitis and 7 with PLP were recruited, as were 53 controls. The combination of 4 polyamines – acetylputrescine, diacetylspermidine, N8-acetylspermidine and diacetylputrescine – distinguished pancreatic cancer and PLP from controls (sensitivity = 94%, specificity = 68% and AUC = 0.88). The combination of diacetylspermidine, N8-acetylspermidine and diacetylspermine distinguished acute pancreatitis from controls (sensitivity = 94%, specificity = 92%, AUC = 0.98). The combination of acetylputrescine, diacetylspermidine and diacetylputrescine distinguished chronic pancreatitis from controls (sensitivity = 98%, specificity = 71%, AUC = 0.93).

Conclusions

Optimally selected urinary polyamine panels discriminate between pancreatic cancer and controls, as well as between acute and chronic pancreatitis and controls.
Leaking and Containing: Researching With Children and the Sketchbook
Authors: Cornwall Jeffrey M. , Park Hayon
Published: February 2022

Working with the concept of “leaking,” two art education researchers explore methodological and philosophical approaches to researching with children. Thinking with their individual studies in early childhood classrooms, the authors consider how conventional methods and methodology might leak when encountering the relations of children, classroom, materials, teacher, researcher, and so on. In both of their fieldwork, the notebook intended for field-note taking began to leak, becoming a sketchbook where the researcher and children could engage in collaborative thinking, making, and doing. This leaking provoked a (re)consideration of research with children as a site in which proficient and equally capable participants conjoin to explore the possibilities of research. The emergent events surrounding the sketchbook allowed to rethink the liminal space of researcher positionality, methodology, methods, children’s art, and childhood.
Creating opportunities to read and build fluency at home
Authors: Hindin Alisa , Steiner Lilly
Published: February 2022

The purpose of this study was to examine the outcomes of a home-based, repeated reading intervention in which texts are matched to children’s school-based instructional reading level. Results indicated that across the five cases, improvements were evident in reading accuracy, rate, and fluency for the take-home texts and all participants’ instructional reading levels increased during the intervention. Parents’ support for children’s reading differed across cases. The five participating children read more than 18,000 words during the course of the intervention.
Truth, hope and the disclosure of a dementia diagnosis: A scoping review of the ethical considerations from the perspective of the person, carer and clinician
Authors: Merl Helga , Veronica Doherty Kathleen , Alty Jane , Salmon Katharine
Published: February 2022

This paper explores contemporary approaches to balancing truth with the provision of hope during the disclosure of a dementia diagnosis. We discuss the ethical significance of these practices as they relate to each member of the triad – the person, the carer and the clinician – at the point of diagnosis and beyond. The process of disclosing a diagnosis of dementia is complex. It encompasses breaking bad news while balancing hope, with truth about a progressive life-limiting condition. The process of receiving the diagnosis likewise challenges the person who may be unprepared for the diagnosis, while carers seek information and supports. The impact of receiving a diagnosis of dementia can be life-changing and harmful at the personal level – for both the person and carer. This risk of harm becomes a critical consideration for clinicians when deciding on the level of truth: what information should be relayed and to whom? That risk is also balanced against the ethical issue of patient autonomy, which includes the right to know (or not) and make informed decisions about therapeutic interventions. While the consensus is that the autonomy of the person living with dementia must be upheld, controversy exists regarding the extent to which this should occur. For instance, at diagnosis, it is common for clinicians to use euphemisms rather than the word dementia to maintain hope, even though people and carers prefer to know the diagnosis. This practice of therapeutic lying is a pervasive ethical issue in dementia care, made more acceptable by its roots in diagnosis disclosure.
Aspirin use in patients with diagnosed diabetes in the United States and China: Nationally representative analysis
Authors: Wang Xin , Hao Guang , Chen Zuo , Zhang Linfeng , Kang Yuting , Yang Ying , Zheng Congyi , Zhou Haoqi , Chen Lu , Wang Zengwu , Gao Runlin
Published: February 2022

Background

The epidemiological data on the use of aspirin in diabetic patients is very limited. The main purpose of this study is to examine the current status of aspirin use in the United States (US) and China in large representative populations.

Methods

Data came from the National Health and Nutrition Examination Survey (NHANES) and China Hypertension Survey (CHS), two nationally representative cross-sectional studies.

Results

The percentage of aspirin use was 73.8% in US diabetic patients with ASCVD, and the percentage of aspirin use in diabetic patients with high ASCVD risk was marginally higher in men ( p = .052), 54.5% in men and 37.1% in women. The percentages of aspirin use in diabetic patients with intermediate and low ASCVD risk were 55.1% and 35.0%, respectively. In China, the percentage of aspirin use in diabetic patients with ASCVD was 53.5%, and were 14.3%, 9.7%, and 3.2% among diabetic patients with high, intermediate, and low ASCVD risk, respectively.

Conclusions

In summary, the percentage of aspirin use in primary prevention in US diabetic patients in men was higher than in women, and this percentage for primary and secondary prevention in US patients was higher than that in Chinese patients.
Working With Robots: Human Resource Development Considerations in Human–Robot Interaction
Authors: Kim Sehoon
Published: February 2022

Advancements in robotic technology have accelerated the adoption of collaborative robots in the workplace. The role of humans is not reduced, but robotic technology requires different high-level responsibilities in human–robot interaction (HRI). Based on a human-centered perspective, this literature review is to explore current knowledge on HRI through the lens of HRD and propose the roles of HRD in this realm. The review identifies HRD considerations that help implement effective HRI in three human-centered domains: human capabilities, collaboration configuration, and attributes related to contact. The eight HRD considerations include employees’ attitudes toward robots, their readiness for robot technology, communication with robots, human–robot team building, leading multiple robots, systemwide collaboration, safety interventions, and ethical issues. Theoretical implications, practical implications, and limitations are discussed. This paper contributes to HRD by introducing potential areas of multidisciplinary collaborations to help organizations implement robotic systems.
Effect of swearing on strength: Disinhibition as a potential mediator
Authors: Stephens Richard , Dowber Harry , Barrie Amber , Almeida Sannida , Atkins Katie
Published: February 2022

Swearing fulfils positive functions, including benefitting pain relief and physical strength. Here we present two experiments assessing a possible psychological mechanism, increased state disinhibition, for the effect of swearing on physical strength. Two repeated measures experiments were carried out with sample sizes N = 56 and N = 118. Both included the measures of physical performance assessing, respectively, grip and arm strength, and both included the Balloon Analogue Risk Task (BART) to measure risky behaviour. Experiment 2, which was pre-registered, additionally assessed flow, emotion including humour, distraction including novelty, self-confidence, and anxiety. Experiments 1 and 2 found that repeating a swear word benefitted physical strength and increased risky behaviour, but risky behaviour did not mediate the strength effect. Experiment 2 found that repeating a swear word increased flow, positive emotion, humour, distraction, and self-confidence. Humour mediated the effect of swearing on physical strength. Consistent effects of swearing on physical strength indicate that this is a reliable effect. Swearing influenced several constructs related to state disinhibition, including increased self-confidence. Humour appeared to mediate the effect of swearing on physical strength, consistent with a hot cognitions explanation of swearing-induced state disinhibition. However, as this mediation effect was part of an exploratory analysis, further pre-registered experimental research, including validated measures of humour, is required.
Improved performance in youth netballers using two different length netball specific warm-ups
Authors: Belcher Suzanne , Whatman Chris , Brughelli Matt , Borotkanics Robert
Published: February 2022

Purpose

Neuromuscular warm-up has been shown to reduce injury risk and improve performance; however, barriers to implementation are common. To improve uptake by coaches Netball New Zealand developed two warm-ups of differing complexity and duration. This multi-site trial investigated the association between two netball specific warm-ups and improvements in performance outcome in youth netball players.

Methods

Twelve teams from six schools performed either the NetballSmart Dynamic Warm-up (NSDW, n = 37); or Power warm-up (PWU, n = 40), three times a week for 12 weeks. Performance was measured using 505 change-of-direction (COD), isometric mid-thigh pull (IMTP), Y-balance, vertical jump (VJ) and horizontal jump (HJ) tests. Paired t-tests assessed mean differences pre and post the interventions. Generalised linear mixed effects models evaluated effects between the NSDW and PWU groups.

Results

There was no significant difference between the NSDW or PWU for any of the outcomes (all p > 0.05). Significant improvements were found in Y-balance (NSDW: Right (R) = 6.4 cm, Left (L) = 7.5 cm, p = 0.001; PWU: R = 4.2 cm, p = 0.004, L = 4.2, p = 0.006) and IMTP (NSDW: 162N; p = 0.001 PWU: 151N, p = 0.001) for both warm-up groups, and the NSDW also enhanced 505 performance (-0.07 s, p = 0.024). VJ and HJ failed to improve for either warm-up.

Conclusion

Based on performance outcomes coaches should be free to choose the warm-up they feel best fits their team environment, reducing barriers to implementation. Additionally, they may benefit from adding further COD, horizontal and vertical jumping movements to either their warm-up or skills training sessions.
Software reliability and cost models with warranty and life cycle
Authors: Shrivastava Avinash K , Sharma Ruchi , Pham Hoang
Published: February 2022

With increasing number of tech-savvy users, the demand for software with advanced features is also growing exponentially. To meet these expectations, software firms are coming up with innovative strategies to attract customers to buy their products and remain loyal. One of the key strategies is to provide product assurance is post-sales support. Software firms provide a warranty to fix the failures encountered during the operational phase for a pre-defined time period. Software reliability literature consists of various modeling framework to decide release time under pre-defined warranty period under the consideration of no post-release testing. Very limited work has been done in the direction of post-release testing with warranty. In this work, we propose a framework to obtain optimal release and warranty time of software to minimize the overall cost under reliability constraint. We have provided the algorithm to obtain the analytical solution of release and warranty time. To make our proposed work more realistic we have considered the change point phenomenon and imperfect debugging of fault in our modeling framework. We have also conducted a sensitivity analysis on the model parameters to check their impact of the firms scheduling strategy. The proposed work is validated on a real-life data set.
The clinical frailty scale – does it predict outcome of the very-old in UK ICUs?
Authors: Lonsdale Dagan O , Tong Liting , Farrah Helen , Farnell-Ward Sarah , Ryan Chris , Watson Ximena , Cecconi Maurizio , Flaatten Hans , Fjølner Jesper , Jung Christian , Guidet Bertrand , de Lange Dylan , Szczeklik Wojciech , Muessig Johanna M , Leaver Susannah K
Published: February 2022

Introduction

The age of patients admitted into critical care in the UK is increasing. Clinical decisions for very-old patients, usually defined as over 80, can be challenging. Clinicians are frequently asked to predict outcomes as part of discussions around the pros and cons of an intensive care unit (ICU) admission. Measures of overall health in old age, such as the clinical frailty scale (CFS), are increasingly used to help guide these discussions. We aimed to understand the characteristics of the very-old critically unwell population in the UK and the associations between frailty and outcome of an ICU admission in our healthcare system (National Health Service, NHS).

Methods

Baseline characteristics, ICU interventions and outcomes (ICU- and 30-day mortality) were recorded for sequential admissions of very old patients to UK ICUs as part of the European VIP 1 and 2 studies. Patient characteristics, interventions and outcome measures were compared by frailty group using standard statistical tests. Multivariable logistic regression modelling was undertaken to test association between baseline characteristics, admission type and outcome.

Results

1858 participants were enrolled from 95 ICUs in the UK. The median age was 83. The median CFS was 4 (IQR 3–5). 30-day survival was significantly lower in the frail group (CFS > 4, 58%) compared to vulnerable (CFS = 4, 65%) and fit (CFS < 4 68%, p = .004). Sequential organ failure assessment (SOFA) score, reason for admission and CFS were all independently associated with increased 30-day mortality ( p < .01).

Conclusion

In the UK, frailty is associated with an increase in mortality at 30-days following an ICU admission. At moderate frailty (CFS 5–6), three out of every five patients admitted survived to 30-days. This is a similar mortality to septic shock.
The Effectiveness of Telemedicine Solutions in Type 1 Diabetes Management: A Systematic Review and Meta-analysis
Authors: Udsen Flemming Witt , Hangaard Stine , Bender Clara , Andersen Jonas , Kronborg Thomas , Vestergaard Peter , Hejlesen Ole , Laursen Sisse
Published: February 2022

Background:

Telemedicine holds a potential to strengthen self-management support outside health care settings in the everyday management of type 1 diabetes (T1D). However, existing effectiveness reviews are older or include a relatively narrow focus on specific definitions of telemedicine or included databases.

Objective:

To conduct a systematic review of the effectiveness of telemedicine solutions versus any comparator on diabetes-related outcomes among people with T1D.

Methods:

Studies including adults (≥18 years) with T1D published before October 14, 2020, were eligible. Primary outcome was glycated hemoglobin (HbA1c, %). The Cochrane Library, PubMed, EMBASE, and CINAHL were searched. Meta-analysis based on the mean difference in HbA1c% was used to pool effects. The Cochrane tool was applied to assess risk-of-bias, and the certainty of evidence was graded using the GRADE approach.

Results:

A total of 22 studies were included (with 1615 participants). Treatment effect for HbA1c% favored telemedicine (mean difference of −0.26% [95% confidence interval:−0.37% to −0.15%]) with moderate effect certainty. Heterogeneity was moderate ( I2 = 33.30%). Although not significant, secondary outcomes were all in favor of telemedicine except number of severe hypoglycemic events and diabetes knowledge, but the certainty of the evidence for those outcomes was all low or very low.

Discussion:

Reducing average HbA1c% levels are important to combat the risk of diabetic complications and premature death. However, the evidence mostly consist of small studies with a relative short duration and the estimated pooled effect is smaller than could be expected from quality improvement strategies in general for diabetes management.

PROSPERO number:

CRD42020123565.
Capitalizing on transparency: Commercial surveillance and pharmaceutical marketing after the Physician Sunshine Act
Authors: Mulinari Shai , Ozieranski Piotr
Published: February 2022

How corporations surveil and influence consumers using big data tools is a major area of research and public debate. However, few studies explore it in relation to physicians in the USA, even though they have been surveilled and targeted by the pharmaceutical industry since at least the 1950s. Indeed, in 2010, concerns about the pharmaceutical industry's undue influence led to the passing of the Physician Sunshine Act, a unique piece of transparency legislation that requires companies to report their financial ties to physicians and teaching hospitals in a public database. This article argues that while the Sunshine Act has clearly helped expose important commercial influences on both prescribing and the scale of industry involvement with physicians, it has also, paradoxically, fuelled further commercial surveillance and marketing. The article casts new light on innovative pharmaceutical marketing approaches and the key role of data brokers and analytics companies in the identification, targeting, managing, and surveillance of physicians. We place this analysis within the political economies of the pharmaceutical industry, surveillance-based marketing, and transparency, and argue that policies to promote increased transparency must be tightly tied to policies that impede the commodification and use of transparency data for surveillance and marketing purposes.
Chilean University Students’ Digital Learning Technology Usage Patterns and Approaches to Learning
Authors: González Carlos , López Dany , Calle-Arango Lina , Montenegro Helena , Clasing Paula
Published: February 2022

Purpose

This study aims to explore Chilean students’ digital technology usage patterns and approaches to learning.

Design/Approach/Methods

We conducted this study in two stages. We worked with one semester learning management systems (LMS), library, and students’ records data in the first one. We performed a k-means cluster analysis to identify groups with similar usage patterns. In the second stage, we invited students from emerging clusters to participate in group interviews. Thematic analysis was employed to analyze them.

Findings

Three groups were identified: 1) digital library users/high performers, who adopted deeper approaches to learning, obtained higher marks, and used learning resources to integrate materials and expand understanding; 2) LMS and physical library users/mid-performers, who adopted mainly strategic approaches, obtained marks close to average, and used learning resources for studying in an organized manner to get good marks; and 3) lower users of LMS and library/mid-low performers, who adopted mainly a surface approach, obtained mid-to-lower-than-average marks, and used learning resources for minimum content understanding.

Originality/Value

We demonstrated the importance of combining learning analytics data with qualitative methods to make sense of digital technology usage patterns: approaches to learning are associated with learning resources use. Practical recommendations are presented.
Corporate Social Responsibility Practices: A Strategy for Indian Startups to Sustain
Authors: Malpani Rashi , Ghosh Anupam
Published: February 2022

The need for creating an environment for sustainable growth of startups for the well-being of an economy cannot be overemphasized. Many experts have proposed that corporate social responsibility (CSR) practices are integral to the long-term survival and success of startups (Jenkins, Confronting the challenges of participatory culture: Media education for the 21st century, 2009). At the same time, they also argue that it is very challenging for startups to adopt these practices effectively ( Salamzadeh, 2015 ). In this background, this is an empirical study of promoters of startups in a developing economy, India, to test the linkages between CSR practices and startup success. The study empirically examines the perception of the promoters regarding these linkages, studies the CSR practices adopted by them, and identifies the challenges faced by them in using CSR for sustainable growth. The findings of the study reveal that there is a distinct relationship between startup success (sustainability) and CSR activities. The article empirically proves that the sustainability of a startup is positively dependent upon internal, external, and environmental CSR initiatives. It also concludes that definite structural interventions are required by policymakers to achieve the twin objectives of startup success and societal well-being.
Prevalence of Borderline Acetabular Dysplasia in Symptomatic and Asymptomatic Populations: A Systematic Review and Meta-analysis
Authors: Freiman Serena M. , Schwabe Maria T. , Fowler Lucas , Clohisy John C. , Nepple Jeffrey J.
Published: February 2022

Background:

Patients with borderline acetabular dysplasia are a controversial patient population in hip preservation, as some have primarily impingement-based symptoms and others have instability-based symptoms. Borderline dysplasia is most commonly defined as a lateral center-edge angle (LCEA) of 20° to 25°. However, its prevalence has not been well established in the literature.

Purpose:

To (1) define the prevalence of borderline hip dysplasia in the general population as well as in populations presenting with hip pain using a systematic review and meta-analysis of the literature and (2) describe differences between male and female patients as well as differences in prevalence from that of classic acetabular dysplasia.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic review of the literature was performed using search terms to capture borderline dysplasia, or studies reporting prevalence by LCEA. The search yielded 1932 results, of which 11 articles met inclusion criteria and were included in the final systematic review. Studies were grouped by patient cohort as (1) asymptomatic general population, (2) asymptomatic targeted population (eg, athletes in a specific sport), and (3) symptomatic hip pain population. The reporting of prevalence rates by subject or by hip was recorded. In a study, the rates of borderline dysplasia were compared with those of classic acetabular dysplasia (LCEA, <20°).

Results:

The 11 studies included 19,648 hips (11,754 patients). In the asymptomatic general population, the pooled estimate of the prevalence of borderline dysplasia was 19.8% by subject and 23.3% by hip (range, 16.7%-46.0%). The targeted subpopulation group included 236 athletes with subgroups in ballet, football, hockey, volleyball, soccer, and track and field with prevalence ranging from 17.8% to 51.1%. The prevalence of borderline dysplasia in groups presenting with hip pain was 12.8% (range, 12.6%-16.0%). Borderline acetabular dysplasia was 3.5 times more common than classic acetabular dysplasia in the asymptomatic general population.

Conclusion:

This study demonstrated a prevalence of borderline dysplasia of 19.8% to 23.3% in the asymptomatic general population. Additionally, an estimated prevalence of 12.8% of hips in symptomatic patients highlights the common decision-making challenges in this population.
The Efficacy of Platelet-Rich Plasma for Ligament Injuries: A Systematic Review of Basic Science Literature With Protocol Quality Assessment
Authors: Kunze Kyle N. , Pakanati Jeevana J. , Vadhera Amar S. , Polce Evan M. , Williams Brady T. , Parvaresh Kevin C. , Chahla Jorge
Published: February 2022

Background:

Despite the existence of many clinical studies on platelet-rich plasma (PRP) interventions for ligamentous pathology, basic science consensus regarding the indications, mechanisms, and optimal composition of PRP for treating ligament injuries is lacking.

Purpose:

To (1) compare the efficacy of PRP in animal models of ligament injury with placebo and (2) describe the potential variability in PRP preparation using accepted classification systems.

Study Design:

Systematic review.

Methods:

The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PubMed, Embase, and Ovid MEDLINE were queried in April 2020 for in vivo and in vitro basic science studies regarding PRP use for ligament injury. Study design, results, PRP composition, and analyzed cellular and molecular markers were extracted, and outcomes relative to control models were documented. Bias was assessed using the SYRCLE risk-of-bias tool.

Results:

Included were 43 articles (31 in vivo and 12 in vitro studies) investigating the anterior cruciate ligament/cranial cruciate ligament (n = 32), medial collateral ligament (n = 6), suspensory ligament (n = 3), patellar ligament (n = 1), and Hock ligament (n = 1). Platelet concentration was reported in 34 studies (77.3%); leukocyte composition, in 12 (27.3%); and red blood cell counts, in 7 (15.9%). With PRP treatment, 5 of 12 in vitro studies demonstrated significant increases in cell viability, 6 of 12 in gene expression, 14 of 32 in vivo studies reported superior ligament repair via histological evaluation, and 13 in vivo studies reported superior mechanical properties. Variability in PRP preparation methods was observed across all articles, and only 1 study reported all necessary information to be classified by the 4 schemes we used to evaluate reporting. Among the in vivo studies, detection and performance bias were consistently high, whereas selection, attrition, reporting, and other biases were consistently low.

Conclusion:

Conflicting data on the cellular and molecular effects of PRP for ligament injuries were observed secondary to the finding that included studies were heterogeneous, limiting interpretation across studies and the ability to draw meaningful conclusions. Clinical trials and any causal relationship between PRP use in ligament injuries and its potential for regeneration and healing should be pursued with caution if based solely on basic science data.
Leading From the Middle: How Principals Rely on District Guidance and Organizational Conditions in Times of Crisis
Authors: Kaul Maya , Comstock Meghan , Simon Nicole S.
Published: February 2022

COVID-19 has presented unprecedented challenges to schools, leaving principals to lead rapid organizational change with limited guidance or support. Drawing on interviews from a larger, national study of principals at the onset of the COVID-19 pandemic, we analyzed the experiences of 20 principals in four large, urban school districts—Boston, Denver, New York, and San Diego. We found that principals relied on both district guidance and preexisting school structures and conditions as they led through the crisis. Although no principals were satisfied with district guidance, principals responded to guidance on a spectrum—from abiding, to challenging, to subverting guidance. Principals’ responses were associated with their perceptions of the internal capacities of their schools, as well as the district guidance. Our findings support an emergent typology of principals as middle managers during crisis, which sheds light on how principals act as middle managers and how districts can support their work.
Transnational circuits of policy knowledge and discursive migration. The formation and transformation of planning policies in Argentina
Authors: Rolo Rodrigo Alves , Duineveld Martijn , Van Assche Kristof
Published: February 2022

We analyse the migration of academic and policy discourses that contributed to (de)legitimise the formation of planning policies in Argentina since the 1950s. We focus on the communicative/collaborative rationality discourses emanating from Anglo-American academic circles that played a role in the revival of the Argentine planning system between 2004 and 2015. We adopt an evolutionary approach to policy travel and policy learning, deploying the concepts of discursive migration and discursive configuration to better understand how ideas, people and goods/resources reinvent themselves when transnationally circulating policy knowledge takes root locally. The migration process in Argentina led to the reinforcement of prevalent coordination mechanisms, redirecting concerns and conflicts into governance structures already existing, involving players already present and forms of expertise already dominant. The migrating collaborative discourse (self) transformed in relation to the receiving governance environment, becoming an effective compliance-gaining technique, while national actors found ways to engage and discipline provinces they depended on more than before.
Malignant Fungating Wounds of the Head and Neck: Management and Antibiotic Stewardship
Authors: O’Neill Liam , Nelson Zach , Ahmad Nadir , Fisher Alec H. , Denton Ana , Renzi Michael , Fraimow Henry S. , Stanisce Luke
Published: February 2022

Objective

Malignant fungating wounds (MFWs) are unfortunate and underreported manifestations of some advanced head and neck cancers. The management of MFWs is complex and challenging. MFWs are often mistaken for infectious processes/abscesses and treated indiscriminately with oral or intravenous antibiotics. Our aim is to promote awareness of MFWs and provide education on their management. We summarize their cost‐effective and evidence‐based therapies and highlight antibiotic stewardship with respect to their management.

Data Sources

A literature review was performed of PubMed, Cochrane Review, SCOPUS, Embase, and Google Scholar databases regarding topical and systemic treatments for MFWs.

Review Methods

Full‐text articles were identified with the following terms: fungating, ulcerative, wound, tumor, malignancy, antibiotics, topical, dressings, radiotherapy, head, neck, scalp, face, lip, and ear. Treatment recommendations were extrapolated, categorically summarized, and retrospectively assigned with an evidence level based on the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation).

Conclusions

In the absence of systemic signs and symptoms of infections, MFWs should not be treated as conventional infections or abscesses, with prophylactic oral or intravenous antibiotics. Topical treatments such as ointments and wound dressings are the mainstay in terms of managing the unsightly appearance and fetid odor from these entities.

Implications for Practice

MFWs are most often not amenable to definitive/curative surgical or nonsurgical therapy, but consultation with a head and neck oncologic specialist will help to determine if the underlying malignancy requires surgery, radiation therapy, or palliative treatment.
Comparing Functional Efficiency of Conventional 2 Plate System & Perpendicular Miniplates in Mandibular Symphysis Fractures Using Bite Force as an Indicator
Authors: Hashmi Ghulam Sarwar , Rahman Sajjad Abdur , Rahman Tabishur , Anwer Syed Fahad
Published: February 2022

In the conventional method of fixation of symphyseal fractures, 2 miniplates are fixed in the interforamina region of the mandible at the lateral cortex. However, with the better understanding of tension and compression areas defined according to the place of energy insertion, it is now possible to fix miniplates at the lower border of the mandible. In this study we assumed that the application of perpendicular miniplates, in contrast to the placement of the plates on the lateral surface of the mandibular cortex, will constrict the motion in horizontal as well as vertical planes leading to better functional outcomes, which can be evaluated by measuring bite forces. The results obtained were affirmative with the hypothesis.
Preparing Families for Age of Majority: Five Considerations
Authors: Francis Grace L. , Stanley Jared L.
Published: February 2022

Age of majority refers to when a state legally considers a person to be an “adult.” For young adults with extensive support needs, this is often a time when individualized education program (IEP) teams discuss issues related to student decision-making, guardianship, and alternatives to guardianship. The purpose of this article is to provide IEP teams with considerations to prepare families (i.e., parents and their young adults with extensive support needs) to prepare for age of majority. The five considerations discussed are (a) providing information about guardianship and alternatives, (b) assessing and teaching decision-making skills, (c) practicing supported decision-making, (d) designing opportunities for failure and feedback, and (e) considering the need for emotional support.
Tips for Special Education Teachers to Create Effective Partnerships With Paraprofessionals
Authors: Lockman Turner Elissa , Curran Mansouri Mary
Published: February 2022

Paraprofessionals are often assigned to work one-on-one with students with disabilities and are often assigned to support students with extensive support needs in general education classrooms. Paraprofessionals have been found to enact effective practices only when given clearly defined roles and provided with direction around enacting these roles. We describe tangible ways special education teachers can create more effective partnerships with paraprofessionals to better support students. Specifically, we discuss ways to clearly define roles and responsibilities, how to embed training and support, ideas to engage in proactive scheduling to better support students, and ways to purposefully collaborate and build capacity to maximize the role of paraprofessionals.
When Good Theories Backfire
Authors: Keil Mark
Published: February 2022

As project management scholars, we should not automatically assume that theories borrowed from other fields will produce desirable results when applied to the project management domain. To illustrate this, I focus on the problem of project escalation and discuss how three theories that have been widely touted as producing good outcomes in other fields may produce undesirable consequences when applied to the project escalation context. I argue that when good theories backfire, this creates an opportunity for project management scholars to expose the boundary conditions of such theories.
A pragmatic guide to choosing biologic therapies in severe asthma
Authors: Kavanagh Joanne E. , Hearn Andrew P. , Jackson David J.
Published: February 2022

There are now several monoclonal antibody (mAb) therapies (“biologics”) available to treat severe asthma. Omalizumab is an anti-IgE mAb and is licensed in severe allergic asthma. Current evidence suggests it may decrease exacerbations by augmenting deficient antiviral immune responses in asthma. Like all other biologics, clinical efficacy is greatest in those with elevated T2 biomarkers. Three biologics target the interleukin (IL)-5–eosinophil pathway, including mepolizumab and reslizumab that target IL-5 itself, and benralizumab that targets the IL-5 receptor (IL-5R-α). These drugs all reduce the exacerbation rate in those with raised blood eosinophil counts. Mepolizumab and benralizumab have also demonstrated steroid-sparing efficacy. Reslizumab is the only biologic that is given intravenously rather than by the subcutaneous route. Dupilumab targets the IL-4 receptor and like mepolizumab and benralizumab is effective at reducing exacerbation rate as well as oral corticosteroid requirements. It is also effective for the treatment of nasal polyposis and atopic dermatitis. Tezepelumab is an anti-TSLP (thymic stromal lymphopoietin) mAb that has recently completed phase 3 trials demonstrating significant reductions in exacerbation rate even at lower T2 biomarker thresholds.

Many patients with severe asthma qualify for more than one biologic. To date, there are no head-to-head trials to aid physicians in this choice. However,post-hocanalyses have identified certain clinical characteristics that are associated with superior responses to some therapies. The presence of allergic and/or eosinophilic comorbidities, such as atopic dermatitis, nasal polyposis or eosinophilic granulomatosis with polyangiitis, that may additionally benefit by the choice of biologic should also be taken into consideration, as should patient preferences which may include dosing frequency. To date, all biologics have been shown to have excellent safety profiles.
Early onset of efficacy with fremanezumab in patients with episodic and chronic migraine: subanalysis of two phase 2b/3 trials in Japanese and Korean patients
Authors: Takeshima Takao , Nakai Masami , Shibasaki Yoshiyuki , Ishida Miki , Kim Byung-Kun , Ning Xiaoping , Koga Nobuyuki
Published: February 2022

Background

Early onset of action has become recognized as an important efficacy feature of preventive migraine treatment, which can help overcome adherence issues commonly associated with older medications. Preventive treatments that target the calcitonin gene-related peptide (CGRP) or the CGRP receptor have been previously shown to provide early onset of action.

Methods

This subanalysis of primary endpoints of two separate phase 2b/3 studies sought to determine the onset of action of fremanezumab in Japanese and Korean patients with episodic migraine (EM) and chronic migraine (CM).

Results

In EM patients (n = 357), both fremanezumab quarterly and fremanezumab monthly led to greater reductions in weekly migraine days (days/week) than placebo from the first week after the initial injection and thereafter during the remainder of the study period. Similarly, CM patients (n = 571) had a greater reduction in headache days of at least moderate severity (days/week) with fremanezumab (total) than placebo. The percentage of patients with a migraine day (EM) or headache day at least moderate severity (CM) was lower in those treated with fremanezumab than placebo and this effect was apparent from as early as Day 2 (1 day after first injection).

Conclusions

These results suggest that fremanezumab has an early onset of action, as noted in previous post hoc analyses of anti-CGRP monoclonal antibodies.

Trial registration

ClinicalTrials.gov.NCT03303092, Registered 5 October 2017,NCT03303079, Registered 5 October 2017.
A positive correlation between GC content and growth temperature in prokaryotes
Authors: Hu En-Ze , Lan Xin-Ran , Liu Zhi-Ling , Gao Jie , Niu Deng-Ke
Published: February 2022

Background

GC pairs are generally more stable than AT pairs; GC-rich genomes were proposed to be more adapted to high temperatures than AT-rich genomes. Previous studies consistently showed positive correlations between growth temperature and the GC contents of structural RNA genes. However, for the whole genome sequences and the silent sites of the codons in protein-coding genes, the relationship between GC content and growth temperature is in a long-lasting debate.

Results

With a dataset much larger than previous studies (681 bacteria and 155 archaea with completely assembled genomes), our phylogenetic comparative analyses showed positive correlations between optimal growth temperature (Topt) and GC content both in bacterial and archaeal structural RNA genes and in bacterial whole genome sequences, chromosomal sequences, plasmid sequences, core genes, and accessory genes. However, in the 155 archaea, we did not observe a significant positive correlation of Topt with whole-genome GC content (GCw) or GC content at four-fold degenerate sites. We randomly drew 155 samples from the 681 bacteria for 1000 rounds. In most cases (> 95%), the positive correlations between Topt and genomic GC contents became statistically nonsignificant (P > 0.05). This result suggested that the small sample sizes might account for the lack of positive correlations between growth temperature and genomic GC content in the 155 archaea and the bacterial samples of previous studies. Comparing the GC content among four categories (psychrophiles/psychrotrophiles, mesophiles, thermophiles, and hyperthermophiles) also revealed a positive correlation between GCw and growth temperature in bacteria. By including the GCw of incompletely assembled genomes, we expanded the sample size of archaea to 303. Positive correlations between GCw and Topt appear especially after excluding the halophilic archaea whose GC contents might be strongly shaped by intense UV radiation.

Conclusions

This study explains the previous contradictory observations and ends a long debate. Prokaryotes growing in high temperatures have higher GC contents. Thermal adaptation is one possible explanation for the positive association. Meanwhile, we propose that the elevated efficiency of DNA repair in response to heat mutagenesis might have the by-product of increasing GC content like that happens in intracellular symbionts and marine bacterioplankton.
Evaluation of complications associated with bifocal bone transport as treatment for either proximal, intermediate or distal femoral defects caused by infection: outcome analysis of 76 patients
Authors: Peng Cong , Liu Kai , Tian Qi , Tusunniyazi Maimaitiaili , Kong Weiqi , Luan Haopeng , Liu Xiaokang , Zhao Yan
Published: February 2022

Background

The purpose of this study was to evaluate the outcomes of bifocal bone transport in the treatment of femoral bone defects caused by infections.

Methods

Clinical and radiographic data of patients with infected femoral nonunion treated by the bifocal bone transport at our hospital were analyzed retrospectively, from January 2008 to December 2019. Depending on the location of bone defects, the patients were divided into three groups (proximal, intermediate, and distal). The Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria was applied to assess the bone and functional outcomes. Postoperative complications of three groups were documented and compared.

Results

Seventy-six cases of infected femoral bone defects (31 cases of proximal, 19 cases of intermediate, and 26 cases of distal) were managed by bifocal bone transport successfully with a mean follow-up time of 30.8 months (range, 23 to 41 months). There were 58 men (76.3%) and 18 women (23.6%), with a mean age of 38.8 years (range, 23 to 60 years). The bone union was received in 76 cases with a mean of 6.9 months (range, 5 to 8 months). Pin tract infection was observed in twenty-nine cases (38.1%), 7 cases (9.2%) of muscle contractures, 3 cases (7.9%) of joint stiffness, 13 cases (17.1%) of axial deviation, 2 cases (2.6%) of delayed union, one case (1.3%) of nonunion, and none (0%) of transport gap re-fracture. One patient (1.3%) was scheduled for knee arthroplasty when bone transport treatment ended.

Conclusions

Bone transport using an external rail fixator was a practical method to treat the femoral bone defects, since the satisfactory rate of bone union and limb function recovery. Complications of distal femoral bone transport were more severe than the proximal and intermedia, but the rate of complication was the least of the three groups. Soft-tissue-related complications were more likely to occur in the intermediate bone transport.
The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial
Authors: Shahabi Negar , Kolivand Mitra , Salari Nader , Abbasi Parvin
Published: February 2022

Background

Telenursing facilitates access to efficient care and acceptance and compliance with treatment at home. Given wide complications of lack of compliance with treatment in causing complications and progression of diabetes and role of the family in attending the patient, this study aimed to investigate the effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2.

Methods

This was a randomized controlled clinical trial. The study population was patients with diabetes mellitus type 2 referred to Alzhara hospital at Gilan Gharb in 2019, of which 60 individuals out of them were classified randomly into two groups of intervention and control. Eight 30-min sessions of family-centered training were held through telenursing for the intervention group. Data were gathered before and after the intervention by standard questionnaire of Mudanlo in both groups and was analyzed using SPSS software version 22.

Results

There was no significant difference among the two intervention and control groups before the study regarding demographic variables (p > 0.05). The scores of subscales of making effort for treatment, intention to take the treatment, adaptability, integrating illness into life, stick to the treatment, indecisiveness for applying treatment, and total score of compliance were significantly increased after training intervention (p = 0.001).

Conclusions

Results of the study indicates positive effects of performing family-centered empowerment pattern using telephone call follow-up on increasing compliance with diet regimen in patients. Therefore, it is recommended to perform family-centered patterns in health policy-makings and also hospitals and other diabetic patients.