bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical outcomes of Ahmed glaucoma valve implantation with plate fixation using vicryl sutures or no plate fixation
Authors: Singer Reut , Kapelushnik Noa , Rotenstreich Ygal , Leshno Ari , Barkana Yaniv , Skaat Alon
Published: April 2021

Purpose:

To summarize the surgical outcomes of Ahmed glaucoma valve (AGV) implantation with plate fixation with vicryl absorbable sutures or no plate suturing.

Methods:

This study was a retrospective case series that included all glaucoma patients who underwent AGV implantation surgery with vicryl absorbable sutures for plate fixation or without plate fixation by a single surgeon between 2014 and 2019. We reviewed their medical records and retrieved clinical data on intra- and postoperative complications, best-corrected visual acuity, intraocular pressure (IOP), and number of IOP-lowering medications.

Results:

Twenty out of 29 eyes (29 patients, mean age 61.04 ± 27.1 years, 17 men) underwent AGV implantation without plate fixation and nine had AGV implantation with fixation with vicryl sutures. Complications were observed in 15 cases (51.7%). Nine of these were defined as failure due to the need for removal or repositioning of the AGV or for further surgery for uncontrolled IOP, of which five were no-fixation cases (5/20, 25%) and four were vicryl-fixation cases (4/9, 44.4%). Six of all surgical failures were related to AGV migration (6/9, 66.6%). There were three cases of extrusion and one case of plate migration in the no-fixation group, and two cases of plate migration and one case of extrusion in the vicryl-fixation group.

Conclusion:

AGV implantation without suture plate fixation or with vicryl suture fixation had a high complication and failure rate, often necessitating reoperation and AGV removal. The high rate of tube-related complications observed after both techniques does not favor either of them. The use of non-absorbable sutures for suturing of the AGV plate is recommended.
Distal superficial femoral vein versus axillary vein central catheter placement under ultrasound guidance for neonates with difficult access: A randomized clinical trial
Authors: Tan Yanzhe , Liu Lifei , Tu Zhenzhen , Xu Ying , Xie Jia , Ye Ping
Published: April 2021

Background:

Epicutaneo-caval catheters (ECCs) are extensively used in premature and ill neonates. This prospective, randomized, observational study aimed to compare the outcomes of ECC placement in the distal superficial femoral and axillary veins in neonates with difficult ECC access.

Methods:

In a neonatal intensive care unit at a tertiary referral center, 60 neonates with difficult ECC access were randomized into two groups with catheters placed using the ultrasound-guided modified dynamic needle tip positioning (MDNTP) technique: distal superficial femoral vein (DSFV) and axillary vein (AV) groups.

Results:

The first attempt success rate was significantly higher in the DSFV group than in the AV group [23/30 (76.7%) vs 11/30 (36.7%), p = 0.001; odds ratio (OR), 0.176; 95% confidence interval (CI) 0.057–0.543]. The mean procedural duration was significantly shorter in the DSFV group than in the AV group [mean: 308.5 (standard deviation: 81.1) s vs 522.74 (134.8) s, t = −7.17, p < 0.001]. The incidence of complications was significantly lower in the DSFV group than in the AV group [4/30 (13.3%) vs 12/30 (40.0%), p = 0.019; OR, 4.333; 95% CI 1.203–15.604]. The number of attempts was significantly fewer in the DSFV group than in the AV group ( p = 0.012).

Conclusions:

The distal superficial femoral and axillary veins are two alternative and safe access points for ECC placement in premature neonates (weight < 2.5 kg) with difficult access. However, access through the distal superficial femoral vein was quicker, easier, and had fewer complications than through the axillary vein.
A novel double clip-based vascular closure device in antegrade and retrograde femoral punctures: A single-center experience in peripheral non-cardiac procedures
Authors: Thurner Annette , Heuer Anjana , Augustin Anne Marie , Gietzen Carsten , Bley Thorsten A , Kickuth Ralph
Published: April 2021

Background:

This retrospective study investigates the efficacy and safety of the novel Celt ACD® vascular closure device (VCD) following antegrade and retrograde common femoral artery (CFA) punctures for the treatment of peripheral artery disease in a challenging patient collective (e.g. calcifications, obesity, and anticoagulation).

Methods:

A total of 208 VCDs (i.e. 100 antegrade and 108 retrograde) were deployed between October 2019 and December 2020 in a tertiary referral interventional radiology department. Fifty-two devices were undersized in relation to the introducer sheath (up to 2 Fr). Technical success and VCD related complications were evaluated in the immediate post procedure period and the following 24 h clinically. In 68% of cases, additional duplex ultrasound was performed prior to discharge.

Results:

The overall technical success rate was 97%. Technical failures following antegrade approach were due to a too acute access angle (⩾60°), rendering it impossible to pass the applicator tip through the sheath lumen. A subgroup analysis of technical success pinpoints severe calcification as another key limiting factor in VCD use ( p = 0.004). Comparing equally sized with undersized device selection ( p = 0.196), direction of approach ( p = 0.265), and body mass index ( p = 0.184) proved to be insignificant. Five (2%, 5/208) major complications occurred: Four antegrade (i.e. one false aneurysm, one vessel laceration with retroperitoneal hemorrhage, two device migrations; 4%, 4/100) and one following retrograde access (i.e. >6 cm hematoma, 1%, 1/108)). Complications were successfully managed with manual compression or interventional procedures.

Conclusions:

The novel clip-based VCD proved to be effective with a low VCD related complication rate.
Aggressive Behavior of Warty Squamous Cell Carcinoma of the Vagina Associated with Uterine Prolapsed: Unusual Report
Authors: Malek Bouhani , Ines Zemni , Saida Sakhri , Ghada Sahroui , Maher Slimene , Khaled Rahal
Published: April 2021

Warty squamous cell carcinoma (WSCC), is a rare variant of squamous cell carcinoma that occurs mostly in younger women, but can occur in old women. It is due to human papillomavirus (HPV) infection. This rare entity has been described in several organs such as vulva, cervix, and penis. To the best of our knowledge WSCC of vagina associated with the third-degree of uterine prolapse has never been reported in the literature. We present an exceptional case of WSCC of vagina occurred in a 77-year-old woman with long disease duration. The physical exam found a large ulcer-budding lesion of the middle and lower third of the vagina that depends on the left vaginal wall. The full work-up concluded to stage IVA of FIGO classification, due to the bladder involvement. The patient underwent a hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic node dissection, left partial cystectomy with left ureteral reimplantation and total vaginectomy, followed by adjuvant radiotherapy. The patient had no recurrence during 8 years of regular follow-up. WSCC can express locally aggressive behavior, such we reported; despite it appears to be less aggressive than the typical well-differentiated squamous cell carcinoma. That leads to individualize WSCC from other verruciform neoplasms.
Genre, gender and television screenwriting: The problem of pigeonholing
Authors: Johnson Beth , Peirse Alison
Published: April 2021

This article draws on the 2018 Writers Guild of Great Britain report ‘Gender Inequality and Screenwriters’, and original interviews with female screenwriters, to assess how the experience of genre plays out in the UK television industry. The report focuses on the experience of women, as a single category, but we aim to reveal a more intersectional understanding of their experiences. Our aim is to better understand the ways in which women are, according to the report, consistently ‘pigeonholed by genre and are unable to move from continuing drama or children’s programming to prime-time drama, comedy or light-entertainment’. Considering the cultural value of genre in relation to screenwriting labour and career progression, we analyse how genre shapes career trajectory, arguing that social mobility for female screenwriters is inherently different and unequal to that of their male counterparts.
Genres and inequality in the creative industries
Authors: Alacovska Ana , O’Brien Dave
Published: April 2021

Genres organize and facilitate cultural, creative and media production and consumption but are rarely central categories in extant research on creative industries. With this editorial article, we aim to reassert, reassess and revisit the salience of genres for understanding inequalities in the cultural and creative industries. We argue that genres, as classificatory devices, structure and order a gendered and racialized division of labour and occupational practice. Genres sanction what is and what is not aesthetically and ethically appropriate to do and think within specific textual categories and, hence also, within genre-specific production cultures. Genres draw boundaries, shaping and normalizing the gendered and racialized professional values and norms that underpin unequal patterns of access, distinction and career advancement within creative occupations. Cultural producers, in turn, are compelled to forge professional genre identities at the same time as constantly having to negotiate their gender and racial fitness to work and prosper in specific categories of cultural production. The contributions to this special issue elucidate, through a plethora of methodological and theoretical approaches, the links between genres and persisting inequalities across the book, screen and music industries.
An Estimation of the Implementation Costs and Financing Options for Introducing a Universal Pension Scheme in Bangladesh
Authors: Rahman Mustafizur , Khan Towfiqul Islam , Sabbih Mostafa Amir
Published: April 2021

The number of people aged more than 60 in Bangladesh is projected to constitute 20% of total population by 2051. The demographic momentum makes it necessary to pursue policies that guarantee a secured life for the country’s senior citizens. Currently, more than 40% of old age population (more than 65 years) in Bangladesh do not receive any type of pension or social security benefits. In this backdrop, introduction of a universal pension scheme (UPS) is an idea that should merit serious consideration. The idea of a UPS is also aligned with several Sustainable Development Goals (SDG) targets. Based on the International Labour Organization multi-pillar pension model, the article deals with required financing under different scenarios of introducing UPS in Bangladesh. The study estimates that for introducing a non-contributory UPS in Bangladesh, it would require an additional average allocation equivalent to 0.1%–0.5% of gross domestic product per annum between now and 2040. The article also estimates financing needs considering two options for the contributory UPS. The article concludes that UPS in Bangladesh can be launched on a limited scale which then could be expanded in scope and coverage in a gradual and phased manner. The article also underscores that introduction of UPS will create opportunities to rationalize the existing safety net programmes that will release funds for underwriting the UPS.

JEL: H53, H55, I31, I38
Randomised controlled study of two counselling models at the Swedish alcohol helpline: Effectiveness and sustainability outcomes at 12-month follow-up
Authors: Nguyen Thi-Thuy-Dung , Säfsten Eleonor , Andersson Filip , Galanti Maria Rosaria
Published: April 2021

Aim: This two-arm parallel randomised controlled trial explored the effectiveness of a brief counselling model compared with the usual multi-session counselling at an alcohol telephone helpline. Methods: A total of 320 callers who contacted the Swedish Alcohol Helpline (SAH) because of hazardous or harmful alcohol use were randomised to either brief structured intervention (self-help booklet plus one proactive call) or usual care (multi-session telephone counselling). The primary outcome was a downward shift in risk level at 12-month follow-up compared with baseline, based on self-reports. Sustained risk level reduction throughout the whole follow-up was also assessed as secondary outcome. Results: Both interventions were significantly associated with a shift to a lower level of risky alcohol use (75% among participants in the brief structured intervention, and 70% in the usual care group) after 12 months. There was no difference between the two interventions in the proportions changing alcohol use or sustaining risk level reduction. Conclusion: In the context of telephone helplines, minimal and extended interventions appear to be equally effective in promoting long-term change in alcohol use.
Out of control? How parents’ perceived lack of control over children’s smartphone use affects children’s self-esteem over time
Authors: Schmuck Desirée , Stevic Anja , Matthes Jörg , Karsay Kathrin
Published: April 2021

As a consequence of children’s nearly ubiquitous smartphone use, many parents experience resignation or frustration due to a perceived loss of control over their child’s excessive smartphone activities. This perceived lack of control may not only increase children’s risk of exposure to online harassment but also affect the relationship between parents and children—both crucial influence factors for children’s self-esteem. We tested these relationships using a two-wave panel study of children between 10 and 14 years ( NT2 = 384) and one of their parents. Findings revealed that parental lack of control over their child’s smartphone use increased the risk of children becoming victims of online harassment and decreased children’s perceived parental support over time. However, while lower perceived parental control decreased children’s self-esteem over time, exposure to online harassment did not. We discuss implications of these findings for intervention and prevention of parental lack of control over children’s smartphone use.
Vibro-impact energy harvester with optimal kinetic and elastic energies absorption
Authors: Khatami Alireza , Dardel Morteza
Published: April 2021

Many vibrating energy harvesters convert elastic or strain energy to electricity, while the energy of the structure is mainly distributed between potential and kinetic energies. The focus of the present work is on maximizing energy harvesting of the structure through the optimal energy absorption of its mechanical energy. The collision mechanism is used for this purpose. Primary piezoelectric harvester on the main structure and secondary piezoelectric harvester utilizing impact force in the form of harvesting beam used for this purpose. The results show that there is a significant increase in energy absorption and bandwidth. The effect of different geometrical and mechanical parameters on the system's efficiency is investigated. Experimental validation is presented to evaluate the theoretically obtained results. The presented mechanism gives up to 80 times improvement in the harvested power.
Microstructure and mechanical properties of Al–Si–Cu–Fe alloy-based ceramic particle-reinforced nanocomposites and microcomposites and a modified model to predict the yield strength of nanocomposites
Authors: Diler Ege A
Published: April 2021

The effects of volume fraction, size, and type of reinforcement particles on the microstructure and mechanical properties of Al–Si–Cu–(Fe) alloy matrix composites were investigated and an analytical model was modified to predict the yield strength of the particle-reinforced nanocomposites. Nano- and micro-particle-reinforced Al–Si–Cu-(Fe) matrix composites (N-AMCs and M-AMCs) were manufactured by adding two different types and sizes of reinforcement particles to Al–Si–Cu–(Fe) alloys at different volume fractions using a two-step stir casting method combined with a high-energy ball milling process and a high-pressure die-casting method. Microstructural analyzes of N-AMCs and M-AMCs were performed using SEM, EDX, and XRD. The Brinell hardness test and the tensile test were carried out to determine the mechanical properties of the N-AMCs and M-AMCs. The hardness of the N-AMCs and M-AMCs was continuously enhanced by increasing the volume fraction of the reinforcement particles, while the yield strength and ultimate tensile strength of the N-AMCs and M-AMCs were improved up to 1.5 vol.% and 4 vol.% of nano-particles and micro-particles, respectively. An analytical model was modified to predict the yield strength of N-AMCs by integrating the effective volume ratio of nano-particles into each strengthening mechanism. The results predicted by the modified model reached nearly 98% agreement with the experimental results up to 1.5 vol.% of the reinforcement particles. Nano-particles had a much greater effect on strengthening mechanisms compared to micro-particles.
Women’s ‘exchange’ in Western and Amerindian societies: a feminist critique of perspectival anthropology
Authors: Wainberg Romina
Published: April 2021

Over the last two decades, Eduardo Viveiros de Castro has developed the concept of ‘perspectival anthropology’ to think philosophically with and through Amerindian cosmology. In this article, I argue that the epistemological roundness of this concept is, in actuality, a by-product of philosophical reification of Amerindian cosmological dynamics. This reification stems from distortive abstractions of specific societal structures, which rely on the silencing of two key phenomena: the fact that the central or unmarked perspective assumed in ‘perspectivism’ is that of men, and the fact that the valorisation of men’s perspective is enabled by the exchange and accumulation of women. By unearthing this exchange system that lies behind the cyclical valuation of males’ gaze, I do not seek to denounce the role of actual women in Amerindian societies. My central aim is to demonstrate that both perspectival anthropology’s depiction of Amerindian cosmology and what Viveiros de Castro calls ‘Western objectivist epistemology’ are made possible by the erasure of women’s capacity for transcendence.
Building an entrepreneurial business model: The case of MKM Building Supplies Ltd
Authors: Coombes Philip H , Nicholson John D
Published: April 2021

Adopting the metaphor of a story, the case study explores and offers insight into the creation and operationalization of an innovative business model by an entrepreneurial firm that challenged and disrupted the competitive dynamics of an established industry sector, namely building supplies. The case is focused on MKM Building Supplies Ltd and its co-founder’s entrepreneurial approach to business model innovation in creating a sustainable start-up business model aimed at market disruption. The entrepreneurial business model is operationalized by a strategy of growing, primarily organically, a national network of branches together with the creation, delivery and realization of value in the form of superior service from their hand-picked local managers who are focused on customer relationships and local markets. The firm is both ethical, whereby humanitarian risks are minimized in their global supply chains, and philanthropic, whereby the branches are also committed to supporting their local communities. The case engages students to consider the impact of entrepreneurial business model thinking and innovation and also the local-national-international tensions in global value chains.
Cultures of rejection at work: Investigating the acceptability of authoritarian populism
Authors: Harder Alexander , Opratko Benjamin
Published: April 2021

This article introduces the concept of cultures of rejection as a framing device to investigate conditions of acceptability of authoritarian populism among workers in Germany and Austria. After situating the concept in the current scholarly debate on right-wing populism and discussing its main theoretical points of reference, we offer an analysis focusing on experiences of crisis and transformation. Two elements of cultures of rejection are discussed in depth: the rejection of racialised and/or culturalised ‘unproductive’ others; and the rejection of the public sphere, linked to the emergence of a ‘shielded subjectivity’. These articulations of rejection are then discussed as related to two dimensions of a crisis of authority: the crisis of state or political authority in the field of labour and the economy; and the crisis of a moral order, experienced as decline in social cohesion. In conclusion, we identify possible avenues for further research, demonstrating the productivity of the conceptual framework of cultures of rejection.
Co-participatory multimodal intergenerational storytelling: Preschool children’s relationship with modality creating elder inclusion
Authors: Boivin Nettie
Published: April 2021

The COVID-19 crisis has highlighted elderly people as a vulnerable and excluded community, and connecting to the younger social media generation requires a shift in intergenerational storytelling performance. Recent research on multimodality has emphasized its benefits for the interactional process in storytelling. This study examines three aspects of storytelling – participation, multimodality, and emotional interaction – and uses co-creation and multimodal discourse analysis to investigate two questions: (1) To what extent can intergenerational storytelling benefit older people’s community engagement? (2) In a globalized world, how do children’s relationships with modalities create new lifelong learning opportunities for elders? Qualitative data were collected from pre- and post-session discussions from six storytelling sessions, video recordings made by the participants, and multimodal artwork created by the children after each session. The results reveal (1) that older participants had to adapt their multimodal storytelling, (2) that children preferred co-participatory multimodal storytelling, and (3) that co-participatory multimodal intergenerational storytelling benefits preschool and elders’ well-being.
Warrantless searches of a mobile phone’s digital contents and privacy interests in Hong Kong
Authors: Yeon Thomas , Kwong Yuan Shang Mathilda
Published: April 2021

This case note examines the latest development on the police’s power to search the digital contents of an arrested person’s mobile phone without a warrant in Sham Wing Kan v Commissioner of Police [2020] HKCA 186; [2020] 2 HKLRD 529. Two issues will be discussed. First, the Court of Appeal’s approach to American and Canadian law in this area will be critically analysed. Second, the safeguards proposed by the Court for a police officer’s warrantless search of the digital contents on a mobile phone will be evaluated. It argues that the Court’s erroneous interpretation of foreign law on the police’s power to search the digital contents on a mobile phone has contributed to the inadequacy of the safeguards proposed by the Court vis-à-vis an arrestee’s privacy rights under the Hong Kong Basic Law and the Hong Kong Bill of Rights.
Development and validation of the ethical challenges in clinical situations-questionnaire (ECCS-Q) by involving health-care providers from a tertiary care health setting
Authors: Gupta Snehil , Singh Swarndeep , Sarkar Siddharth , Batra Atul
Published: April 2021

Background and rationale

Clinicians often encounter a variety of ethical challenges in their routine clinical practice, and it varies across healthcare and cultural settings of their practice. Despite of this, there are no clear-cut available guidelines concerning the right course of action in a given ethically challenging situation. A validated instrument that could capture the health care providers’ (HCP’s) viewpoints in this regard is lacking from Indian settings. Thus, the current study aimed at developing an instrument to assess the HCP’s perspective regarding different ethically challenging situations encountered in the Indian settings.

Methods

The questionnaire was developed by involving 15 medical experts. A mixed-method approach, Delphi-technique, and online survey were used for item generation and validation.

Results

The questionnaire comprised of 11 items (accounts 57% variance; having an α = 0.68) representing four factors: health-resource constraints, medical responsibility of the HCP, obtaining patients/family members’ consent for the treatment, and treatment beyond the standard protocol. The gender and clinical disciplines of the participants were related to their level of endorsement for various domains of the ECCS-Q.

Conclusions

Ethical challenges in the clinical practice fall in different clusters. The clinicians’ course of action in such situations have many socio-demographic and professional determinants. Future studies are warranted to investigate these phenomena.
Implementing Enhanced Primary Care Registered Nurse Reimbursement in Rural Health Clinics: A Policy Analysis
Authors: Switzer Tina , Sawin Erika Metzler , Eaton Melody , Switzer David , Lam Christina , Robinson Jamie , Elkins Deborah
Published: April 2021

Rural Health Clinics (RHCs) were created in 1977 to address the high health care needs, limited provider access, and poor health outcomes of rural Americans. Although innovative at their inception, the provider-centric model of RHC cost-based reimbursement structures has not evolved, leaving limited opportunities for change; many have failed. Comprehensive, proactive change is needed. Registered nurses (RNs) working at the top of their practice scope are a neglected clinical resource that can improve access, quality, value, and satisfaction for rural patient communities. RHC reimbursement policy must evolve to sustain and support this significant RN role. RNs have demonstrated value in care continuity and disease management, but there is little research on the utilization of RNs using their enhanced skill set in RHCs. Using the Bardach and Patashnik’s eight steps of policy analysis, the authors will describe the background and regulations of RHCs, identify current barriers to improving the health of America’s rural residents, and then provide evidence to support a new policy option according to the Quadruple Aim framework. The result is a sustainable policy recommendation designed to best serve rural communities.
“Anything That Can Be Traded, Will Be Traded”: The Contests to Automate and Financialize Advertising Futures Markets
Authors: Kininmonth Samuel
Published: April 2021

This article explores potential advertising futures markets that may emerge from current trends of automation and financialization in digital advertising. Managing price and availability is important to advertisers for securing prices and premium inventory and to publishers for safeguarding long-term revenue. The article compares US network television’s annual upfront events with adtech company the New York Interactive Advertising Exchange (NYIAX). This article contributes two primary observations. First, that buying and selling forward advertising inventory is an important, and understudied, part of advertising markets. Second, the design of infrastructures that enable adverting futures markets are social and contested. The formation and framing of forward media markets has consequences for the advertising industry at a time of critical juncture and for broader media that rely on advertising revenue.
The Clinical Prognostic Value of lncRNA SBF2-AS1 in Cancer Patients: A Meta-Analysis
Authors: Wang Jie , Zhong Pingyong , Hua Hao
Published: April 2021

Background:

The mortality and recurrence of patients with cancer is of high prevalence. SET-binding factor 2 (SBF2) antisense RNA1 (lncRNA-SBF2-AS1) is a promising long non-coding RNA. There is increasing evidence that SBF2-AS1 is abnormally expressed in various tumors and is associated with cancer prognosis. However, the identification of the effect of lncRNA SBF2-AS1 in tumors remains necessary.

Materials and Methods:

Up to November 2, 2020, electronic databases, including PubMed, Cochrane Library, EMBASE, Medline, and Web of Science, were searched. The results were evaluated by pooled odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs).

Results:

A total of 11 literatures on cancer patients were included for the present meta-analysis. The combined results revealed that high expression of SBF2-AS1 was significantly associated with unfavorable overall survival (OS) (HR = 1.48, 95% CI: 1.34-1.62, P < 0.00001) in a variety of cancers. In additional, the increase in SBF2-AS1 expression was also correlated with tumor size ((larger vs. smaller) OR = 2.34, 95% CI: 1.47-3.70, P = 0.0003), advanced TNM stage ((III/IV vs. I/II) OR = 2.78, 95% CI: 1.75-4.41, P < 0.0001), lymph node metastasis ((Positive vs. Negative) OR = 3.06, 95% CI: 1.93-4.86, P < 0.00001), and histological grade ((poorly vs. well/moderately) OR = 2.58, 95% CI: 1.47-4.52, P = 0.001) in patients with cancer. Furthermore, The Cancer Genome Atlas (TCGA) dataset valuated that SBF2-AS1 was upregulated in a variety of tumors, and predicted the worse prognosis.

Conclusions:

Our results of this meta-analysis demonstrate that high SBF2-AS1 expression may become a potential target for predicting the prognosis of human cancers.
Culture Concordance in Different Sections of the Metatarsal Head: Interpretations of Microbiological Results
Authors: Molines-Barroso Raul Juan , García-Morales Esther , Sevillano-Fernández David , García-Álvarez Yolanda , Álvaro-Afonso Francisco J. , Lázaro-Martínez José Luis
Published: April 2021

Microbiological cultures of per-wound bone biopsies have shown a lack of correlation and a high rate of false-negative results when compared with bone biopsy cultures in diabetic foot osteomyelitis. The selection of samples from the area of active osteomyelitis, which contains a complete census of the microorganisms responsible for the infection, is essential to properly guide antimicrobial treatment. We aimed to comparatively evaluate the quantitative and qualitative cultures taken from different areas, in metatarsal heads resected for osteomyelitis. For this purpose, we consecutively selected 13 metatarsal heads from 12 outpatients with plantar ulcers admitted to our diabetic foot unit. Metatarsal heads were divided transversally into 3 portions: plantar (A), central (B), and dorsal (C), and the 39 resulting samples were cultured. Qualitative and quantitative microbiological analysis was performed, and the isolated species and bacterial load, total and species specific, were compared between the 3 metatarsal bone segments. The primary outcome of the study was the bacterial diversity detected in the different bone sections. Cultures were positive in 12 of the 13 included metatarsal heads (92%). A total of 34 organisms were isolated from all specimens. Ten of the 12 cultures (83%) were polymicrobial. Ten of the 13 metatarsal heads (77%) had identical microbiological results in each of the 3 bone sections. The largest number of microorganisms was found in the central section. The overall concordance between sections was 91%. The predominant microorganisms were coagulase-negative staphylococci (41%). Statistical differences were not found in the bioburden between sections (range 3.25-3.41 log10 colony-forming unit/g for all sections; P = .511). The results of our study suggest that microorganisms exhibit a high tendency to spread along the metatarsal bone and that the degree of progression along the bone is species dependent. The central portions of metatarsal bones tend to accumulate a higher diversity of species. Thus, we recommend this area of bone for targeted biopsy in patients with suspected osteomyelitis.
Comparative Evaluation of the Diagnostic Value of Procalcitonin and hsCRP for the Presence of Mild-to-Moderate Diabetic Foot Infections
Authors: Todorova Ani S. , Dimova Rumyana B. , Chakarova Nevena Y. , Serdarova Mina S. , Grozeva Greta G. , Georgiev Georgi K. , Tankova Tsvetalina I.
Published: April 2021

The aim of this study is to compare the efficacy of procalcitonin (PCT) and high-sensitive C-reactive protein (hsCRP) as diagnostic biomarkers in patients with diabetes and mild-to-moderate diabetic foot infections. A total of 119 patients (102 with type 2 diabetes and 17 with type 1 diabetes), of mean age 60.29 ± 10.05 years, divided into 3 groups—diabetic foot ulcer (DFU) with active infection (IDFU group, n = 41), DFU without clinical signs of infection (non-IDFU group, n = 35), and a control group with diabetes without DFU (n = 43). Infection severity was graded according to the International Working Group on the Diabetic Foot guideline—non-IDFU group as Grade 1, IDFU group as Grade 2 (n = 22), and Grade 3 (n = 19). Serum hsCRP was assessed by the immunoturbidimetric method and PCT by the enzyme chemiluminescence immunoassay (ECLIA) method. Levels of white blood cells (WBC) were assessed using the Medonic hematology analyzer and erythrocyte sedimentation rate (ESR) by the Westergren method. Serum hsCRP, WBC count, and ESR were significantly higher in the IDFU group as compared to non-IDFU and control groups, whereas PCT levels did not differ between the groups. hsCRP presented with higher sensitivity (80%), specificity (79%), area under the curve (AUC) 0.856, in comparison to PCT (sensitivity 63%, specificity 62%, AUC 0.617) for the presence of IDFU, as well as in the Grade 3 subgroup (84% sensitivity and specificity, AUC 0.911). The combined model of both markers did not present with better accuracy than using hsCRP alone. In conclusion, hsCRP appears to be a better diagnostic biomarker than PCT in the diagnosis of moderate foot ulcer infection. Both markers fail to distinguish mild infection.
Profile Analysis and Risk Assessment: Identifying Distinct Patterns of Risks and Needs
Authors: D’Amato Christopher , Campbell Christina A. , Papp Jordan , Miller William
Published: April 2021

The goal of this study was to identify distinct and meaningful profiles of the seven criminogenic risk and need domains included on the Ohio Youth Assessment System—Disposition Tool (OYAS-DIS). This goal was accomplished by conducting a latent profile analysis (LPA) on a sample of 4,383 formally processed justice-involved youth assessed by the OYAS-DIS. The LPA determined there were six distinct profiles: (1) Low risk and need, (2) Low/moderate risk and need, (3) Low risk/need with high juvenile justice history, (4) Academic, mental health, and substance use needs, (5) Prosocial skills and decision making, and (6) High risk and need. Results may help juvenile justice practitioners to identify and address specific intervention needs of adjudicated youth.
The Emerging Role on the Use of Platelet-Rich Plasma Products in the Management of Urogynaecological Disorders
Authors: Prodromidou Anastasia , Zacharakis Dimitrios , Athanasiou Stavros , Protopapas Athanasios , Michala Lina , Kathopoulis Nikolaos , Grigoriadis Themos
Published: April 2021

Background: The regenerative efficacy of platelet-derived products has been recently investigated in the treatment of pelvic floor disorders (PFDs). We aimed to synthesize the current evidence of platelet-rich plasma (PRP) products used in urogynaecological disorders including vaginal atrophy, pelvic organ prolapse (POP), urinary incontinence, vaginal fistulas and vaginal mesh exposure. Methods: A meticulous search of the currently available literature on the use of PRP for the management of PFDs was performed using 3 electronic databases. Results: PRP could be a feasible alternative modality for the management of vaginal atrophy with favourable outcomes in vaginal atrophy parameters and patients’ satisfaction, especially when hormone therapy is contraindicated. In patients with POP, an increase in collagen concentration after PRP application was observed while the use of PRP resulted in improvement of stress urinary incontinence symptoms. A considerable proportion of vesicovaginal fistulas were treated after application of PRP-based injections. Conclusions: There is only limited evidence of the use of PRP for PFDs. Platelet-rich plasma appears to be a promising, easy to apply, cost-effective and feasible alternative therapeutic modality for the management of various urogynaecological disorders. Future randomized trials are needed to confirm the efficacy of PRP in the treatment of urogynaecological disorders.
Research and Clinical Significance of the Differentially Expressed Genes TP63 and LMO4 in Human Immunodeficiency Virus-Related Penile Squamous Cell Carcinoma
Authors: Xue Wenrui , Zheng Xin , Hu Xiaopeng , Zhang Yu
Published: April 2021

To study the differential gene expression and clinical significance in human immunodeficiency virus-infected individuals (HIVIIs) with penile squamous cell carcinoma. At our hospital from 2019 to 2020, we selected six samples of HIV-related penile squamous cell carcinoma for the experimental group and six samples of non-HIV-related penile squamous cell carcinoma for the control group. Transcriptome sequencing of sample mRNAs was performed by high-throughput sequencing. Differential gene expression analysis, differential Gene Ontology (GO) enrichment analysis and differential Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were carried out, and the reads per kilobase per million reads (RPKM) value was used as a measure of gene expression. A total of 2418 differentially expressed genes were obtained, of which 663 were upregulated and 1755 were downregulated (absolute value of logFC >1 and p value <.05). On the basis of the significance of the GO enrichment analysis, we found that the tumor protein p63 (TP63) gene was significantly upregulated and that the LIM domain only 4 (LMO4) gene was significantly downregulated in the experimental group compared with the control group. KEGG pathway analysis of the differentially expressed genes revealed that DNA replication was the most significant pathway associated with the upregulated genes and cell adhesion molecule (CAM) metabolism was the most significant pathway associated with the downregulated genes. The gene expression profiles of HIV-related penile squamous cell carcinoma and non-HIV-related penile squamous cell carcinoma are significantly different and involve significant GO enrichment and KEGG metabolic pathways, and this is very meaningful for the study of non-AIDS-defining cancers (NADCs). Differential expression of genes may be an important target for the prevention of penile squamous cell carcinoma in HIVIIs.
Can Approaching Anxiety Like a Habit Lead to Novel Treatments?
Authors: Brewer Judson A. , Roy Alexandra
Published: April 2021

Anxiety disorders make up the most prevalent class of mental illnesses. Given the growing prevalence of anxiety in the United States and beyond, there is an urgent clinical need to develop nonpharmacologic treatments that effectively treat and reduce its core symptoms (eg, worry). A leading theory posits that although worrying may be unpleasant, the immediate emotions that are avoided by concentrating on worry are often perceived as more aversive (eg, fear, anger, grief). From a mechanistic perspective, worry is thought to be learned and reinforced in a similar manner to other types of positively and negatively reinforced behaviors: habits. Mindfulness training, a practice that brings awareness to cognitive, affective, and physiological experiences, when delivered in-person via programs such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), has demonstrated effectiveness in reducing anxiety, but is difficult to scale in this manner. In this review, we explore novel approaches to using mindfulness training to specifically target the theoretical mechanisms underlying the perpetuation of anxiety (eg, worry as a habit), and the emergence of mobile health platforms (eg, digital therapeutics) as potential vehicles for remote delivery of treatment.
Lifestyle Medicine at the University of Central Florida College of Medicine
Authors: Dupuis Léonie , Kay Denise , Pasarica Magdalena , Topping Daniel , Gonzalez Carla , Wasserstrom Sharon
Published: April 2021

From 2009 to present-day, the University of Central Florida College of Medicine has progressively incorporated lifestyle medicine into its curriculum thanks to a variety of student and faculty-led efforts. These efforts include extracurricular learning opportunities through a student-run Lifestyle Medicine Interest Group, curriculum-based didactics through University of Central Florida faculty members’ integration of lifestyle medicine in preexisting sessions, and clinical experiences for students provided by a American Board for Lifestyle Medicine certified practitioner.
The interaction between P2X3 and TRPV1 in the dorsal root ganglia of adult rats with different pathological pains
Authors: Yu Jie , Du Junying , Fang Junfan , Liu Yingjun , Xiang Xuaner , Liang Yi , Shao Xiaomei , Fang Jianqiao
Published: April 2021

Peripheral inflammatory and neuropathic pain are closely related to the activation of purinergic receptor P2X ligand-gated ion channel 3 (P2X3) and transient receptor potential vanilloid 1 (TRPV1), but the interaction between P2X3 and TRPV1 in different types of pathological pain has rarely been reported. In this study, complete Freund’s adjuvant (CFA)-induced inflammatory pain and spared nerve injury (SNI)-induced neuropathic pain models were established in adult rats. The interactions between P2X3 and TRPV1 in the dorsal root ganglion were observed by pharmacological, co-immunoprecipitation, immunofluorescence and whole-cell patch-clamp recording assays. TRPV1 was shown to promote the induction of spontaneous pain caused by P2X3 in the SNI model, but the induction of spontaneous pain behaviour by TRPV1 was not completely dependent on P2X3 in vivo. In both the CFA and SNI models, the activation of peripheral P2X3 enhanced the effect of TRPV1 on spontaneous pain, while the inhibition of peripheral TRPV1 reduced the induction of spontaneous pain by P2X3 in the CFA model. TRPV1 and P2X3 had inhibitory effects on each other in the inflammatory pain model. During neuropathic pain, P2X3 facilitated the function of TRPV1, while TRPV1 had an inhibitory effect on P2X3. These results suggest that the mutual effects of P2X3 and TRPV1 differ in cases of inflammatory and neuropathic pain in rats.
Low-dose IL-2 therapy limits the reduction in absolute numbers of circulating regulatory T cells in rheumatoid arthritis
Authors: Zhang Sheng-Xiao , Wang Jia , Wang Cai-Hong , Jia Rui-Huan , Yan Ming , Hu Fang-Yuan , Liu Guang-Ying , Liu Xue-Yu , Luo Jing , Gao Chong , Li Xiao-Feng
Published: April 2021

Background:

Circulating regulatory T cells (Tregs) are responsible for mediating immune tolerance and maintaining immunological homeostasis. Decreases in Tregs may be involved in the onset of rheumatoid arthritis (RA). Low-dose interleukin-2 (IL-2) has been considered for the treatment of inflammatory diseases mediated by T cells. This study focused on the status of circulating CD4+T subsets and the clinical feasibility of IL-2 therapies in patients with RA.

Methods:

The subjects included 888 patients with RA and 100 healthy controls (HCs); 233 RA patients received IL-2 treatment with 0.5 million international units (MIU)/day from days 1 through 5. The demographic features, disease activity, and levels of CD4+T cells measured by modified flow cytometry were collected in all RA patients before and after treatment.

Results:

RA patients had lower absolute Treg counts (but not Th17) compared with HCs, which was associated with disease activity; previously treated RA patients had the fewest circulating Tregs ( p < 0.05). Patients treated with low-dose IL-2 had a three-fold increase in absolute anti-inflammatory Treg counts, as well as a two-fold increase in the other CD4+T subsets. Moreover, post-treatment levels of markers of disease activity in RA patients treated with IL-2 were significantly lower than the baseline values ( p < 0.001), with no apparent side effects.

Conclusion:

Decreased absolute counts of circulating CD4+T lymphocyte subsets were observed in patients with RA. Circulating Tregs, which mediate immune tolerance, may be involved in the pathogenesis and progression of RA; however, this was ameliorated by low-dose IL-2, without obvious side effects.

Plain language summary

Low-dose IL-2 treatment for rheumatoid arthritis • Circulating Tregs may be involved in the pathogenesis and progression of RA. • The absolute count of Tregs was significantly correlated with disease activity measures. • Low-dose IL-2 was able to effectively expade Tregs and help for RA patients’ symptoms remission without evaluated side effects.
Customer-Oriented Constructive Deviance as a Reaction to Organizational Injustice Toward Customers
Authors: Gong Taeshik , Sun Pengchang , Kang Min Jung
Published: April 2021

To date, research on the deontic model and third-party reactions to injustice has focused primarily on individuals’ tendency to punish the transgressor. In this study, we seek to extend the extant research by arguing that punishment may not be the only deontic reaction and that third-party observers of injustice should engage in activities that help the victim. More specifically, we explore employee’s customer-oriented constructive deviance as a reaction to organizational injustice toward customers. We also investigate how this deviance influences customer satisfaction. In addition, we explore service climate, driven by servant leadership as a moderator on the relationship between employees’ perceptions of organizational unfairness and customer-oriented constructive deviance. The study collected three-level survey data from 95 hotel managers, 396 employees, and 1,848 customers. We find that servant leadership increases service climate, which in turn strengthens the relationship between organizational injustice toward customers and customer-oriented constructive deviance. The findings also reveal that customer-oriented constructive deviance increases perceived service quality, leading to customer satisfaction. Our study significantly contributes to the emerging theory concerning customer-oriented constructive deviance by explaining the antecedents, consequences, and moderators. The study also helps managers deal with customer-oriented constructive deviance in the workplace.