bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic bilateral revision after metal stent deployment for hepatic hilar obstruction using molting technique (with videos)
Authors: Yamamura Masahiro , Ogura Takeshi , Ueno Saori , Okuda Atsushi , Nishioka Nobu , Yamada Masanori , Ueshima Kazuya , Matsuno Jun , Yamamoto Yoshitaro , Higuchi Kazuhide
Published: April 2022

Background:

After multiple uncovered self-expandable metal stent (UCSEMS) deployments, endoscopic revision becomes complex and potentially challenging. A novel stent delivery system with a dilation function has recently been developed in Japan. This study evaluated the technical feasibility of this device for patients with unresectable malignant hilar biliary obstruction (MHO) after multiple UCSEMS deployments.

Method:

Participants comprised consecutive patients with unresectable MHO who had undergone multiple UCSEMS deployments and required endoscopic revision for the right or left hepatic bile ducts, as decided by cholangiography under endoscopic retrograde cholangiopancreatography (ERCP) guidance.

Results:

A total of 14 patients requiring endoscopic revision of right and left hepatic bile ducts were enrolled in this study. Among these 14 patients, guidewire insertion through the mesh of previously placed stents failed in 2 patients. As a result, these two patients underwent only unilateral UCSEMS deployment. Because clinical success was not obtained, transmural placement of the UCSEMS under Endoscopic Ultrasound (EUS) guidance to the segment of the liver not being drained was performed in those patients. The molting technique was attempted in 12 patients, proving successful in all patients. The technical success rate was therefore 92.8% (12/14). Mean procedure time was 23.2 min.

Conclusion:

This novel stent delivery system with a dilation function may be useful in endoscopic revision techniques for bilateral UCSEMS deployment.
Advanced technology for assessment of endoscopic and histological activity in ulcerative colitis: a systematic review and meta-analysis
Authors: Nardone Olga Maria , Snir Yifat , Hodson James , Cannatelli Rosanna , Labarile Nunzia , Siau Keith , Hassan Cesare , Yanai Henit , Dotan Iris , Ghosh Subrata , Iacucci Marietta
Published: April 2022

Background:

Advanced endoscopic technologies led to significant progress in the definition of endoscopic remission of ulcerative colitis (UC) and correlate better with histological changes, compared with standard endoscopy. However, while studies have assessed the diagnostic accuracy of endoscope technologies individually, there are currently limited data comparing between technologies. As such, the aim of this systematic review was to pool data from the existing literature and compare the correlations between endoscopy and histologic disease activity scores across endoscope technologies.

Methods:

We searched PubMed and Embase until February 2021 for eligible studies reporting the correlation between endoscopy and histology activity scores in UC. Studies were grouped by endoscope technology as standard-definition white light (SD-WLE), high-definition white light (HD-WLE) or electronic virtual chromoendoscopy (VCE) and comparisons made between these groups.

Results:

A total of N = 27 studies were identified, of which N = 12 were included in a meta-analysis of correlations between endoscopic and histological activity scores. Combining these studies identified considerable heterogeneity ( I2: 89–93%) and returned a pooled correlation coefficient ( ρ) for the SD-WLE group of 0.74, which did not differ significantly from HD-WLE ( ρ: 0.65, p = 0.521) or VCE ( ρ: 0.70, p = 0.801). In addition, N = 4 studies reported the accuracy of endoscopic activity scores on WLE and VCE to diagnose histological remission. Pooling these found significantly higher accuracy for VCE, compared with WLE [risk ratio: 1.13, 95% confidence interval (CI): 1.07–1.19, p < 0.001].

Conclusion:

Activity scores assessed using endoscopy are strongly correlated with activity on histology regardless of endoscopic technology. VCE seems to be more accurate in predicting histological remission than WLE. However, given the heterogeneity between the included studies, head-to-head trials are warranted to confirm these findings.
Linaclotide for treating patients with irritable bowel syndrome with predominant constipation: a multicentre study of real-world data in China
Authors: Liu Lan , Zhang Weihao , Zhao Wei , Guo Shuang , Wang Yaojun , Lv Xiaojun , Li Bing , Wang Haiping , Xu Enbin , Li Quan , Zhu Qin , Gou Xiao bo , Zhao Weidong , Guo Jianqiang
Published: April 2022

Introduction:

Linaclotide, a guanylate cyclase C agonist that improves the symptoms of irritable bowel syndrome with predominant constipation (IBS-C), has been recently approved for IBS-C treatment. This study aimed to report real-world data on linaclotide treatment in China.

Methods:

This was a prospective multicentre study of the effectiveness of linaclotide treatment in patients with IBS-C from 10 primary medical institutions. Changes in defecation, abdominal symptoms, the IBS symptom severity scale (IBS-SSS), IBS quality of life questionnaire (IBS-QOL), Zung Self-Rating Anxiety Scale and Self-Rating Depression Scale in patients were evaluated to determine the drug’s clinical efficacy and safety.

Results:

We enrolled 97 patients (mean age: 52.39 ± 13.99 years), 55 of whom were women (56.7%). In terms of efficacy, the number of the patients’ defecation per week and Bristol stool form scale scores significantly increased at week 4 and week 12 compared with the values at the baseline. The baseline average IBS-SSS score was 211.01 ± 81.23. Of the patients, 24 had severe IBS-C, and their IBS-SSS scores at week 4 (51.81 ± 54.42) and week 12 (9.3 ± 30.39) significantly decreased and showed a pronounced improvement. The IBS-QOL total scores at week 4 and week 12 gradually decreased compared with that at the baseline and the QOL significantly improved. Treatment satisfaction rate was 79.3% in week 4 and 100% in week 12, showing a gradually increased satisfaction and significant differences. However, 11 cases (11.3%) had diarrhoea.

Conclusion:

Linaclotide has proved to be a safe and effective drug to improve IBS-C symptoms and severity.
Application of artificial intelligence in diagnosis of pancreatic malignancies by endoscopic ultrasound: a systemic review
Authors: Goyal Hemant , Sherazi Syed Ali Amir , Gupta Shweta , Perisetti Abhilash , Achebe Ikechukwu , Ali Aman , Tharian Benjamin , Thosani Nirav , Sharma Neil R.
Published: April 2022

Background:

Pancreatic cancer (PC) is a highly fatal malignancy with a global overall 5-year survival of under 10%. Screening of PC is not recommended outside of clinical trials. Endoscopic ultrasonography (EUS) is a very sensitive test to identify PC but lacks specificity and is operator-dependent, especially in the presence of chronic pancreatitis (CP). Artificial Intelligence (AI) is a growing field with a wide range of applications to augment the currently available modalities. This study was undertaken to study the effectiveness of AI with EUS in the diagnosis of PC.

Methods:

Studies from MEDLINE and EMBASE databases reporting the AI performance applied to EUS imaging for recognizing PC. Data were analyzed using descriptive statistics. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the included studies.

Results:

A total of 11 articles reported the role of EUS in the diagnosis of PC. The overall accuracy, sensitivity, and specificity of AI in recognizing PC were 80–97.5%, 83–100%, and 50–99%, respectively, with corresponding positive predictive value (PPV) and negative predictive value (NPV) of 75–99% and 57–100%, respectively. Types of AI studied were artificial neural networks (ANNs), convolutional neural networks (CNN), and support vector machine (SVM). Seven studies using other than basic ANN reported a sensitivity and specificity of 88–96% and 83–94% to differentiate PC from CP. Two studies using SVM reported a 94–96% sensitivity, 93%–99% specificity, and 94–98% accuracy to diagnose PC from CP. The reported sensitivity and specificity of detection of malignant from benign Intraductal Papillary Mucinous Neoplasms (IPMNs) was 96% and 92%, respectively.

Conclusion:

AI reported a high sensitivity with high specificity and accuracy to diagnose PC, differentiate PC from CP, and differentiate benign from malignant IPMN when used with EUS.
Risk factors associated with the occurrence of total knee arthroplasty in patients with knee osteoarthritis: a nested case–control study
Authors: Pelletier Jean-Pierre , Dorais Marc , Paiement Patrice , Raynauld Jean-Pierre , Martel-Pelletier Johanne
Published: April 2022

Objectives:

The aim of this study was to investigate changes over time in osteoarthritis risk factors most closely associated with the occurrence of total knee arthroplasty (TKA). We hypothesize that the robustness of a longitudinal case–control study will provide new information on the association between changes in various clinical and structural parameters in different time frames before TKA.

Methods:

Cases (195; TKA after cohort entry) and controls (468) matched for age, gender, income, WOMAC pain, Kellgren–Lawrence grade and follow-up duration were from the Osteoarthritis Initiative cohort. Associations between changes in sociodemographic, clinical, imaging and osteoarthritis therapies with the occurrence of TKA were performed using conditional logistic regression analyses.

Results:

Worsening of WOMAC scores (cOR 1.02–1.20, p ⩽ 0.012), KOOS (1.02–1.04, p ⩽ 0.014), knee injuries sustained in the previous 30–40 years (women 2.70, p = 0.034) and valgus alignment (1.10, p = 0.052) were associated with the occurrence of TKA. Also associated with TKA was cartilage volume loss in the lateral (overall 1.76, p = 0.025; women 1.93, p = 0.047) and medial compartments (⩾10%, overall 1.54, p = 0.027; men 2.34, p = 0.008), occurrence of medial meniscal extrusion (overall 1.77, p = 0.046; men 2.86, p = 0.028), and increase in bone marrow lesions (BMLs) for women (1.09, p = 0.048). The association of risk factors with TKA was reinforced when both an increase in WOMAC pain and cartilage volume loss (1.85, p = 0.001) were combined. Pain medication usage, mainly narcotics and intra-articular steroid injections (IASI), was also associated with TKA, with no impact on changes in cartilage loss or structure.

Conclusion:

This study provides new information about gender differences in risk factors associated with the occurrence of TKA. Worsening of valgus alignment, cartilage volume loss in the lateral compartment, BMLs and older injuries are important risk factors in women, while medial compartment cartilage loss and meniscal extrusion are in men. The use of pain medication and IASI although associated was found not causal with TKA.
Clinical and immunological study of Tofacitinib and Baricitinib in refractory Blau syndrome: case report and literature review
Authors: Álvarez-Reguera Carmen , Prieto-Peña Diana , Herrero-Morant Alba , Sánchez-Bilbao Lara , Martín-Varillas José Luis , González-López Elena , Gutiérrez-Larrañaga María , San Segundo David , Demetrio-Pablo Rosalía , Ocejo-Vinyals Gonzalo , González-Gay Miguel A. , Blanco Ricardo
Published: April 2022

Blau syndrome (BS) is an autoinflammatory disorder characterized by non-caseating granulomatous dermatitis, arthritis, and uveitis. We present a case of refractory and severe BS that was treated with the Janus kinase inhibitors (JAKINIBS), Tofacitinib (TOFA) and then Baricitinib (BARI). Our aim was to describe the clinical and immunological outcomes after treatment with JAKINIBS. Blood tests and serum samples were obtained during follow-up with TOFA and BARI. We assessed their effects on clinical outcomes, acute phase reactants, absolute lymphocyte counts (ALCs), lymphocyte subset counts, immunoglobulins, and cytokine levels. A review of the literature on the use of JAKINIBS for the treatment of uveitis and sarcoidosis was also conducted. TOFA led to a rapid and maintained disease control and a steroid-sparing effect. A decrease from baseline was observed in ALC, CD3+, CD4+, CD8+, and natural killer (NK) cell counts. B-cells were stable. Serum levels of interleukin (IL)-4 and tumor necrosis factor alpha (TNF-α) increased, whereas IL-2, IL-6, IL-10, and IL-17 maintained stable. TOFA was discontinued after 19 months due to significant lymphopenia. The initiation of BARI allowed maintaining adequate control of disease activity with an adequate safety profile. The literature review showed seven patients with uveitis and five with sarcoidosis treated with JAKINIBS. No cases of BS treated with JAKINIBS were found. We report the successful use of JAKINIBS in a patient with refractory and severe BS.
The enhanced activity of dinuclear metallophthalocyanines amino-functionalized carbon nanotube-based oxygen reduction reaction catalysts
Authors: Zhang Gai , Zhang Yufan , Tan Amin , Zhou Hongwei , Zhao Weifeng , Chen Weixing
Published: April 2022

Dinuclear metallophthalocyanines Fe2Pc2(CP)4 containing carboxyl substitutes were wrapped with amino-functionalized carbon nanotubes (MWCNTs-NH2) to enhance electrocatalytic activity for oxygen reduction reaction (ORR) using a facile “in situ” amidation reaction. The morphological characteristics and chemical environment of the Fe2Pc2(CP)4/MWCNTs-NH2 composites were characterized by scanning electron microscope (SEM), X-ray diffraction, Ultraviolet–visible (UV-Vis), Fourier Transform infrared (FTIR), and X-ray photoelectron spectroscopy. The electrocatalytic activity of ORR was tested and analyzed by cyclic voltammetry and linear sweep voltammetry. The results showed that the π–π interactions between the Fe2Pc2(CP)4 and MWCNTs-NH2 dramatically enhanced the π electron density in the conjugated structure, and oxygen could be reduced much more easily. Moreover, the oxygen reduction reactions mainly proceeded a one-step four electron process for Fe2Pc2(CP)4/MWCNTs-NH2 catalysts. The dispersion and electrocatalytic performance of M2Pc2Rn had be enhanced after being loaded on functionalized carbon nanotubes.
Telehealth Technologies in Diabetes Self-management and Education
Authors: Sharma Vidya , Feldman Marie , Sharma Ramaswamy
Published: April 2022

Background:

The coronavirus pandemic of 2019 (COVID-19) forced worldwide recognition and implementation of telehealth as a means of providing continuity of care by varied health care institutions. Diabetes is a global health threat with rates that continue to accelerate, thereby causing an increased need for clinicians to provide diabetes care and education to keep up with demand. Utilizing technology to provide education via phone/smartphone, video/audio, web, text message, mobile apps, or a combination of these methods can help improve patient access and clinical outcomes, cut costs, and close gaps in care.

Methods:

While numerous publications have summarized the various tools and technologies available for capturing remote clinical data and their relevance to diabetes care and self-management, this review focuses on self-educational telehealth tools available for diabetes self-management, their advantages and disadvantages, and factors that need to be considered prior to implementation. Recent relevant studies indexed by PubMed were included.

Results:

The widespread use and popularity of phones/smartphones, tablets, computers, and the Internet by patients of all age groups, cultures, socioeconomic and geographic areas allow for increased outreach, flexibility, and engagement with diabetes education, either in combination or as an adjunct to traditional in-person visits. Demonstrated benefits of using health technologies for diabetes self-management education include improved lifestyle habits, reduced hemoglobin A1C levels, decreased health care costs, and better medication adherence. Potential drawbacks include lack of regulation, need for staff training on methodologies used, the requirement for patients to be tech savvy, privacy concerns, lag time with technology updates/glitches, and the need for more long-term research data on efficacy.

Conclusions:

Telehealth technologies for diabetes self-education improve overall clinical outcomes and have come a long way. With increasing numbers of patients with diabetes, it is expected that more optimal and user-friendly methodologies will be developed to fully engage and help patients communicate with their physicians.
Advancing the standard: venetoclax combined with intensive induction and consolidation therapy for acute myeloid leukemia
Authors: Lachowiez Curtis A. , Atluri Himachandana , DiNardo Courtney D.
Published: April 2022

The B-cell lymphoma 2 (BCL-2) inhibitor venetoclax (VEN) in combination with lower-intensity therapy is an efficacious treatment for acute myeloid leukemia (AML). VEN in combination with the hypomethylating agent azacitidine improved rates of response and measurable residual disease (MRD)-negative remissions in addition to overall survival in the pivotal phase 3 VIALE-A trial compared with azacitidine monotherapy and has since emerged as the current standard of care in older or unfit patients with AML. In younger, fit patients with AML, intensive induction and consolidation chemotherapy (IC) is commonly employed as frontline therapy; however, relapse remains the principal cause of treatment failure in approximately 30–40% of patients. Improved IC regimens that increase MRD-negative response rates, result in durable remissions, and enable transition to curative allogeneic hematopoietic stem cell transplantation in appropriate patients remain an area of active inquiry. Preliminary results from trials investigating the combination of VEN with IC have reported promising findings to date, with composite complete remission and MRD-negative remission rates of approximately 89–94% and 82–93%, respectively, correlating with improved 12-month event-free and overall survival compared to historical outcomes with IC. Herein, we discuss ongoing trials investigating VEN in combination with IC in addition to outcomes within specific molecularly defined subgroups; review the molecular mechanisms of sensitivity and resistance to VEN, and highlight future combinations of VEN with novel targeted therapies for the treatment of AML.
Teacher identity in technology-assisted language learning: Challenges and affordances
Authors: Bahari Akbar
Published: April 2022

The majority of studies on second/foreign language teacher identity have explored the face-to-face environment compared to the technology-assisted language learning (TALL) environment. The paucity of research despite the significance of teacher identity served as the rationale to conduct a systematic review. Scopus and Web of Science indexed journal articles on language teacher identity that met the predetermined exclusion-inclusion criteria were systematically reviewed. Forty-four articles published between 2010 and 2020 were reviewed to convey the reported affordances and challenges of distance learning for language teacher identity. Pedagogically, the findings inform pre-service and practicing teachers who seek a better understanding of teacher identity in TALL in terms of affordances and challenges. Theoretically, the findings shed light on the future research trend and inform researchers about the most frequently reported challenges that need to be addressed concerning L2 teacher identity.
Systematic review and meta-analysis of comorbidities and associated risk factors in Indian patients of community-acquired pneumonia
Authors: Ghia Canna Jagdish , Rambhad Gautam Sudhakar
Published: April 2022

Objective:

Comorbidities and risk factors have a major implication on incidence, complications, mortality, and management of community-acquired pneumonia complications and treatment outcomes. This study attempts to identify the same in the Indian population through a systematic review and meta-analysis.

Methods:

We screened observational studies (between January 1990 and February 2021) that reported potential comorbidities and other factors associated with increased risk of community-acquired pneumonia in the Indian population (⩾12 years) using PubMed, Google Scholar, and manual search. The risk of bias was identified using the Joanna Briggs Institute checklist for prevalence studies. Meta-analysis was conducted by using the random intercept logistic regression model.

Results:

Twenty-three studies were included in this analysis. The most prevalent comorbidities were chronic obstructive pulmonary disease (24.2%; 95% confidence interval: 16.4%–34.2%), hypertension (23.7%; 95% confidence interval: 13.6%–38.1%), and diabetes mellitus (16%; 95% confidence interval: 9.9%–24.7%). The prevalence of community-acquired pneumonia was high in patients with a current or previous history of smoking (51.4%; 95% confidence interval: 42.3%–61%) and advanced age ⩾50 years: (55.8%; 95% confidence interval: 48.4%–62%).

Conclusions:

Comorbid conditions like chronic obstructive pulmonary disease, hypertension, and diabetes mellitus and factors like advanced age and smoking history were common risk factors for community-acquired pneumonia in the Indian population.
Encouragement for Further Study of Tranexamic Acid Administration for Sacroiliac Joint Fusion Surgery
Authors: Beyer Ryan S. , Hatter Matthew J. , Streetman Daniel , Brown Nolan , Gendreau Julian
Published: April 2022

TO THE EDITOR: We read with great interest the article by Huynh et al.regarding the association between tranexamic acid (TXA) and blood loss in patients undergoing surgical treatment for hip fracture (Huynh PAN, Miller M, Will R. Intravenous Tranexamic Acid Decreases Blood Transfusions and Blood Loss for Patients with Surgically Treated Hip Fractures. Geriatric Orthopedic Surg Rehabil. 2021). The authors illustrated, via retrospective chart review of 505 patients who were surgically treated for hip fractures, that patients administered TXA had statistically significant decreases in perioperative blood loss and reduced relative risk of transfusion. Huynh et al. reported no statistically significant increases in thromboembolic events in patients given TXA. Mechanistically, TXA is a synthetic anti-fibrinolytic that competitively inhibits the plasminogen activation pathway. By preventing activated plasmin from de-stabilizing the fibrin matrix, TXA promotes clot formation. Given the anti-fibrinolytic effects of TXA, concerns in the literature exist regarding its use being associated with increased risk for thromboembolic events. However, it is important to note the complication profile associated with TXA is minimal, as elucidated by Brown et al., specifically finding that no patients who were administered TXA perioperatively experienced a thromboembolic event (or at least, there were no reports of thromboembolism or any other adverse events). While administration of TXA may theoretically increase the risk for thrombosis, Brown et al. showed this does not seem to occur in spinal laminectomy and fusion with posterior instrumentation. Similarly, in a systematic review of the literature describing TXA use in intracranial tumor resection, this study revealed a statistically significant reduction in the need for intraoperative blood transfusion in patients administered TXA. Upon consideration of postoperative outcomes, no significant increase in complication rate was found. This evidence in the existing literature on TXA use in orthopedic, spinal, and cranial neurosurgery exemplifies the wide potential of TXA for reducing blood loss with minimal complications in surgical procedures, especially involving the craniospinal axis.
Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell’s Disease
Authors: Pan Dan , Chen Dayong
Published: April 2022

Objective:

To compare the clinical efficacy of unipedicular and bipedicular percutaneous kyphoplasty (PKP) for Kummell’s disease.

Methods:

A retrospective study was performed to review 40 patients with stage I and II Kummell’s disease who underwent PKP in our hospital from January 2015 to June 2018. Based on the transpedicular approach of PKP, those patients were randomly divided into unipedicular group (n = 19) and bipedicular group (n = 21). Operative time, bone cement injection volume and cement leakage rate were compared in the two groups. Pre- and post-operative visual analogue score (VAS), local kyphotic angle and average vertebral height were also evaluated.

Results:

All patients underwent surgery successfully. Compared with preoperative condition, VAS was significantly decreased at 1 day after operation and the last follow-up in both groups ( P < .05), and local kyphotic angle and average vertebral height were restored markedly ( P < .05). Operative time of both groups had no significant difference ( P > .05). Bone cement injection volume was larger in bipedicular group ( P < .05). At 1 day after operation and the last follow-up, the local kyphotic angle and average vertebral height in bipedicular group were restored better than those in unipedicular group ( P < .05). There were 4 cases of cement leakage in both groups, with leakage rates of 21.1% and 19.0%, respectively, and the difference was not significant ( P > .05).

Conclusion:

Both unipedicular and bipedicular PKP are effective for treating patients with stage I and II Kummell’s disease, while postoperative pain relief and imaging results in bipedicular group were better than those in unipedicular group.
An Evolutionary Analysis of Relational Governance in an Innovation Ecosystem
Authors: Liu Bo , Shao Yun-Fei , Liu Guowei , Ni Debing
Published: April 2022

Despite considerable research highlighting the significance of relational governance in inter-organizational relationships, few have involved the connections between relational governance and innovation ecosystems. This study explores this issue to discover the influential mechanisms of relational governance in innovation ecosystem co-evolution. Building an evolutionary game model, we embody trust and reciprocity (two dominance of relational governance) into co-evolutionary relationships of an innovation ecosystem composed of focal firms, research institutes, customers, and governments, and discuss how relational governance affects innovation strategies of actors. Moreover, the impacts of benefit distribution are also examined. We reveal that (1) focal firms and governments prefer cooperative strategies; (2) reciprocity and trust foster cooperation; increasing benefit distribution drives all actors to collaborate except research institutes; (3) governments finitely encourage cooperation through regulation; and (4) the power of relational governance is restricted due to the below-the-average strategies of customers and research institutes and the neutralizing effects of benefits. Our findings offer a complementary and novel framework for relational governance and extend a deeper understanding of innovation ecosystem studies.
Investigating Knowledge Management Practices in an EFL Context in Pakistan
Authors: Ahmed Ushaque , Aslam Rabia , Khan Najmonnisa , Asad Muhammad Mujtaba
Published: April 2022

Currently, English as a foreign language (EFL) teachers are supposed to recognize that, creativity among students can be developed through knowledge management practices. The current study aimed to investigate EFL teachers’ knowledge management practices from learner insight. The explanatory mixed method research design was used to investigate the phenomenon. Quantitative data was collected from 298 A-Level students through a survey questionnaire, and qualitative data was collected through 7 A-Level students through an in-depth semi-structured interview. The findings suggested that EFL teachers arrange seminars and co-curricular activities to create knowledge; discussion in and outside classrooms are used to share knowledge; social media and movies are used to utilize knowledge; and notebooks are used to store knowledge in the EFL classroom. The study revealed that benchmark and technological devices to manage knowledge are not frequently practiced by EFL teachers. The study concluded that teachers should be trained in the area of knowledge management regularly.
Internal Dynamics of Dividend Policy in East-Asia: A Comparative Study of Japan and South Korea
Authors: Khan Basharat , Zhao Qiujun , Iqbal Amjad , Ullah Irfan , Aziz Shahab
Published: April 2022

Japanese and Korean financial systems are distinct from those in the western economies. Considering this, we examine how the dividend policy of the firms in two of the largest economies of East Asia is determined by the internal attributes of firms. Firm-level data from 1,773 Japanese and 1,035 Korean firms were evaluated using panel data techniques, and some interesting similarities and differences in the dividend policies of both countries were unearthed. For example, in both countries, larger firms pay higher dividends, whereas those firms with volatile earnings pay low dividends. It was also determined that Korean firms pay more dividends when their profitability surges. On the other hand, cash dividends in Japanese firms decline when there is an increase in their profitability level. Overall, the dividend policy of Korean firms resembles more to those in Anglo-Saxon countries, while the dividend policy of Japanese firms bears little resemblance to other established financial systems. This study is the first to compare and contrast the internal dynamics of dividend policy for both the Japanese Keiretsus and Korean Chaebols while evaluating a huge universe of firms from both countries. Transnational studies are important to draw parallels and differences. The findings of this study offer important implications for various stakeholders, including managers, investors, and policymakers. Also, the results pave the way for a theoretically enriched understanding of dividend policy by comparing and contrasting diverse financial systems.
Age Matters? The Moderating Effect of Age on the Longitudinal Relationship between Upward and Downward Comparisons on Instagram and Identity Processes During Emerging Adulthood
Authors: Noon Edward J. , Vranken Ilse , Schreurs Lara
Published: April 2022

This study tested whether age moderates the longitudinal relationships between upward and downward comparisons on Instagram and three identity processes (i.e., commitment, in-depth exploration, and reconsideration of commitment). Two hundred and eleven British emerging adults completed two self-report surveys, two months apart, in early 2020. A cross-lagged panel model with interaction terms found that age moderated the relationships between both upward and downward comparisons on Instagram and commitment. Contingent moderations were found: the relationship between upward comparisons and commitment was negative for older participants, whilst the relationship between downward comparisons and commitment was negative for younger participants. Significant age differences were not found in the paths between the comparison behaviours and the two exploratory processes. Findings therefore provide evidence to suggest that developmental factors may inform the identity implications of social comparisons on Instagram during emerging adulthood, and thus, developmental sensitivity is required when supporting emerging adults to navigate the platform.
The Development and Internal Evaluation of a Predictive Model to Identify for Whom Mindfulness-Based Cognitive Therapy Offers Superior Relapse Prevention for Recurrent Depression Versus Maintenance Antidepressant Medication
Authors: Cohen Zachary D. , DeRubeis Robert J. , Hayes Rachel , Watkins Edward R. , Lewis Glyn , Byng Richard , Byford Sarah , Crane Catherine , Kuyken Willem , Dalgleish Tim , Schweizer Susanne
Published: April 2022

Depression is highly recurrent, even following successful pharmacological and/or psychological intervention. We aimed to develop clinical prediction models to inform adults with recurrent depression choosing between antidepressant medication (ADM) maintenance or switching to mindfulness-based cognitive therapy (MBCT). Using previously published data ( N = 424), we constructed prognostic models using elastic-net regression that combined demographic, clinical, and psychological factors to predict relapse at 24 months under ADM or MBCT. Only the ADM model (discrimination performance: area under the curve [AUC] = .68) predicted relapse better than baseline depression severity (AUC = .54; one-tailed DeLong’s test: z = 2.8, p = .003). Individuals with the poorest ADM prognoses who switched to MBCT had better outcomes compared with individuals who maintained ADM (48% vs. 70% relapse, respectively; superior survival times, z = −2.7, p = .008). For individuals with moderate to good ADM prognoses, both treatments resulted in similar likelihood of relapse. If replicated, the results suggest that predictive modeling can inform clinical decision-making around relapse prevention in recurrent depression.
Bone Density Distribution in the Cervical Spine
Authors: Lovecchio Francis , Ang Bryan , Louie Philip K. , Chaudary Chirag , Shah Sachin P. , Punyala Ananth , Yao Yu-Cheng , Steinhaus Mike , McCarthy Michael H. , Huang Russel , Lebl Darren , Lafage Virginie , Albert Todd J. , Iyer Sravisht , Qureshi Sheeraz , Kim Han Jo
Published: April 2022

Study Design

Retrospective cohort study

Objective

Given changes in bone density induced by degenerative disease, general measures of bone health (ie DEXA) are inadequate to evaluate bone density in surgical areas of interest. Regional differences in HU in the cervical spine may influence surgical strategies. The purposes of our study were to determine whether cervical Hounsfield units (HU) vary by level, examine their relationship with age, comorbidities, and alignment, and propose a technique to measure HU in the lateral masses.

Methods

Two hundred twenty-four patients with degenerative spine pathology with a cervical computed tomography were included (2015-2019). Measurements were performed in each vertebral body (C2-T1; mid-axial, anterior-axial, posterior-axial, mid-coronal, and mid-sagittal) and 2 regions of the lateral masses (C3-C6; mid-cor, mid-sag). To evaluate reliability, 6 observers each measured 355 HU values, inter-relater reliability assessed with intraclass correlation coefficients Correlations of HU with age, BMI, comorbidities, and cervical alignment were evaluated.

Results

Bone density differed by level, with the lowest HU scores in the lower cervical spine (C6-T1) ( P < .001). No correlations were found between LM HU and age, BMI, CCI, or alignment ( P > .05). Increased kyphosis was weakly correlated with VB HU, while age and CCI showed moderate correlations with VB HU at all levels (P<.001). ICC for HU measurements were good to excellent for the VBs, but poor to moderate for the LMs.

Conclusion

Bone is least dense in the lower cervical spine. HU scoring is not reliable in the lateral masses. We recommend that a level-specific approach to bone density is considered in surgical planning.
Limb-Girdle Muscular Dystrophy R9 due to a Novel Complex Insertion/Duplication Variant in FKRP Gene
Authors: Willis Erin , Moore Steven A. , Cox Mary O. , Stefans Vikki , Aravindhan Akilandeswari , Gokden Murat , Veerapandiyan Aravindhan
Published: April 2022

Limb-girdle muscular dystrophy R9 (LGMD2I, LGMDR9) is an autosomal recessive disorder caused by pathogenic variants in the fukutin-related protein ( FKRP) gene. We describe a 17 year old boy with LGMDR9 whose symptoms began at age 5 years. Muscle histopathology, immunostaining, and western blotting were consistent with a dystroglycanopathy. Genetic testing identified maternal inheritance of the most common pathogenic FKRP variant c.826C>A (p.L276I). Also detected was a novel insertion and duplication on the paternally inherited FKRP allele: a single nucleotide insertion (c.948_949insC) and an eighteen nucleotide duplication (c.999_1017dup18) predicted to result in premature translation termination (p.E389*). Based on the clinical features and course of the patient, heterozygosity for the common pathogenic FKRP variant, and abnormal glycosylation of alpha-dystroglycan, we suggest that the novel FKRP insertion and duplication are pathogenic. This case expands the genetic heterogeneity of LGMDR9 and emphasize the importance of muscle biopsy for precise diagnosis.
Understanding the Connection Between Student Wellbeing and Teaching and Learning at a Canadian Research University: A Qualitative Student Perspective
Authors: Lindsay Brittany L. , Bernier Emily , Boman Jennifer , Boyce Melissa A.
Published: April 2022

Postsecondary students’ ability to learn is affected by their mental health and wellbeing. Research in the teaching and learning context, however, has predominantly focused on teaching practices that facilitate motivation, learning, and academic success while overlooking the importance of student mental health and wellbeing. The current study aimed to fill this gap by using qualitative interviews to explore student perspectives on current and possible future supports that can cultivate student mental health and wellbeing in the teaching and learning context. Through 14 one-on-one interviews with students, five major themes were developed: (1) prioritize mental health, (2) provide and guide to accessible supports, (3) increase mental health literacy, (4) foster connections and social support, and (5) strengthen best practices in teaching and learning. Students emphasized that the institution has a role to play in several of these areas and elaborated on what practices and policies were least and most supportive of student mental health and wellbeing in teaching and learning. This study has implications for higher education institutions, and how they promote mental health and wellbeing, disseminate information and resources, and how faculty and staff can support students through their policies (e.g., flexibility in deadlines), course materials (e.g., assessments), course delivery (e.g., equity, diversity, and inclusion [EDI] considerations), and interactions (e.g., normalizing mental health conversations).
Duty Hours Tracking – Is There an App for That?
Authors: Jorgensen Alexis , Savage Nastassia M. , Sun Xinxin , Domson Gregory
Published: April 2022

BACKGROUND

To monitor duty hour compliance residency programs have used self-report methods which can be skewed by recall bias and data falsification. The purpose of this study was to compare the accuracy of and resident attitudes towards two duty hours tracking tools within our Orthopedic residency. We compared our institution's current self-report method of duty hours tracking via New Innovations (NI) with an automated method utilizing Hours Tracker (HT), a smartphone application which automatically logs work hours via GPS coordinates. The primary outcome measures were number of duty hour violations and survey results on resident perceptions.

METHODS

The participants were 22 residents of our 25 resident Orthopedic program. Over four weeks, residents tracked duty hours through the standard, selfreport method (NI) and simultaneously through the automated app (HT). Residents also completed an anonymous survey at the end of the study related to perceptions of the methods.

RESULTS

There was no significant difference in overall number of violations between NI and HT. HT detected more violations of the 8 hours off requirement (12 vs. 5, p = 0.03). Survey data revealed residents found HT significantly easier to use (p = .004) and less burdensome (p < .001) but in greater violation of privacy (p = .001). Residents reported they were more likely to falsify their hours when using NI (p = .002) and that the results of NI would be more likely used against them (p = .042). When analyzing by training year, junior residents indicated HT was overall easier to use than senior residents (p = .048).

CONCLUSIONS

Our study showed NI and HT are at least equivalent in accuracy with the app being overall better received, particularly by junior level residents. Until we begin accurately tracking duty hours and engaging residents with an easy to use, well-received interface to which report hours, effective developmental program changes will be difficult to achieve. An app-based approach is a starting point for re-thinking duty hours tracking within this digital age.
Kshatriya Movement Among Koch-Rajbanshis in Assam
Authors: Ray Samujjal
Published: April 2022

The Kshatriya movement among Koch-Rajbanshis has been one of the most influential movements during the early 19th century. This article tries to locate Panchanan Barma’s influence within the Koch-Rajbanshi community in the context of Assam. This article also attempts to highlight the ongoing debates over the Kshatriya movement among Koch-Rajbanshis in Assam. It further argues that cultural analysis is necessary to re-examine the Koch-Rajbanshi identity.
Early vitrectomy in eyes with non-diabetic vitreous hemorrhage
Authors: Foo Edward , Grassi Piergiacomo , Spiteri-Cornish Kurt
Published: April 2022

Background:

Optimal management of non-diabetic vitreous hemorrhage (NDVH) is controversial, and reliability of B-scan ultrasonography in detecting retinal tears (RTs) has been reported to be highly variable by previous literature.

Objectives:

To report outcomes of conservative versus surgical management of NDVH and reliability of B-scan ultrasonography in detecting RTs and rhegmatogenous retinal detachment (RRD).

Design:

Retrospective observational single-center cohort study.

Methods:

Ninety-six consecutive NDVH from 96 eyes (96 patients) with minimum follow-up duration of 12 months were included.

Results:

Seventy-two eyes (75%) underwent early pars plana vitrectomy (PPV), 19 (20%) were managed conservatively and 5 (5%) underwent late PPV. Initial mean best corrected visual acuities (BCVAs) were 1.95 ± 1.19, 1.19 ± 1.38, and 1.14 ± 1.04 logMAR respectively, the difference was statistically significant ( p = 0.039). Mean final BCVAs were 0.92 ± 1.19, 0.59 ± 0.87, and 1.25 ± 1.89 logMAR, respectively, the difference was not significant ( p = 0.447). When comparing initial and final BCVAs, the difference was significant only in the early PPV group ( p = 0.00001) and was not significant in the conservative group ( p = 0.066) and in the late PPV group ( p = 0.46). Complications included RRD ( n = 2) and re-bleed in vitrectomized cavity ( n = 1) in the early surgical group, need for additional laser or cryoretinopexy to RTs ( n = 2), retinal detachment ( n = 1), neovascular glaucoma ( n = 1), persistent vitreous hemorrhage ( n = 2) in the conservative group. B-scan ultrasound showed preoperative 11.53% sensitivity and a 60.0% positive predictive value for diagnosing retinal tears (RTs) in NDVH.

Conclusion:

The benefit of early PPV in NDVH seems to outweigh the risks of surgery, especially in the context of low sensitivity of B-scan in identifying RTs, and significant improvement in final BCVA following surgery may occur. NDVH should be promptly referred to vitreoretinal services, as surgery may be a safer and more advisable option.
School-Based Interventions for Promoting Sexual and Reproductive Health of Adolescents in India: A Review
Authors: Vincent Rosna , Krishnakumar K.
Published: April 2022

In India, the prevalent stigma and taboos regarding sexuality prevent adolescents from acquiring information about sexual and reproductive health. This review assessed the school-based interventions for adolescents designed to enhance their sexual health knowledge, attitudes, and behaviors. Studies were gathered from 4 online databases: PubMed, DOAJ, Google Scholar, and ScienceDirect. Relevant studies conducted in India among adolescents, published in peer-reviewed journals between 2000 and 2020, available in the public domain and written in English, were considered for the review. 14 studies were selected through database searches that fulfilled the eligibility criteria. Findings highlighted that school-based sexuality education positively influences adolescents to develop their knowledge, attitude, and behavior related to sexual and reproductive health outcomes. Sexual and reproductive health (SRH) programs and interventions are limited to small-scale experiments conducted in a few schools. The researchers recommend educating adolescents about pregnancy prevention, sexually transmitted infections (STIs), sexual hygiene, and reproductive health. Comprehensive reproductive health education programs should be implemented in every school setting to ensure that all school-going adolescents are convinced of the importance of sexual and reproductive health.
Infrared Spectroscopic Analysis in the Differentiation of Epithelial Misplacement From Adenocarcinoma in Sigmoid Colonic Adenomatous Polyps
Authors: Nallala Jayakrupakar , Griggs Rebecca , Lloyd Gavin R , Stone Nick , Shepherd Neil A
Published: April 2022

Purpose:

The differential diagnosis of epithelial misplacement from invasive cancer in the colon is a challenging endeavour, augmented by the introduction of bowel cancer population screening. The main aim of the work is to test, as a proof-of concept study, the ability of the infrared spectroscopic imaging approach to differentiate epithelial misplacement from adenocarcinoma in sigmoid colonic adenomatous polyps.

Methods:

Ten samples from each of the four diagnostic groups, normal colonic mucosa, adenomatous polyps with low grade dysplasia, epithelial misplacement in adenomatous polyps and adenocarcinoma, were analysed using IR spectroscopic imaging and data processing methods. IR spectral images were subjected to data pre-processing and cluster analysis based segmentation to identify epithelial, connective tissue and stromal regions. Statistical analysis was carried out using principal component analysis and linear discriminant analysis based cross validation, to classify spectral features according to the pathology, and the diagnostic attributes were compared.

Results:

The combined 4-group classification model on an average showed a sensitivity of 64%, a specificity of 88% and an accuracy of 76% for prediction based on a ‘single spectrum’, whilst a ‘majority-vote’ prediction on an average showed a sensitivity of 73%, a specificity of 90% and an accuracy of 82%. The 2-group model, for the differential diagnosis of epithelial misplacement versus adenocarcinoma, showed an average sensitivity and specificity of 82.5% for prediction based on a ‘single spectrum’ whilst a ‘majority-vote’ classification showed an average sensitivity and specificity of 90%. A 92% area under the curve (AUC) value was obtained when evaluating the classifier using the Receiver Operating Characteristics (ROC) curves.

Conclusions:

IR spectroscopy shows promise in its ability to differentiate epithelial misplacement from adenocarcinoma in tissue sections, considered as one of the most challenging endeavours in population-wide diagnostic histopathology. Further studies with larger series, including cases with challenging diagnostic features are required to ascertain the capability of this modern digital pathology approach. In the long-term, IR spectroscopy based pathology which is relatively low-cost and rapid, could be a promising endeavour to consider for integration into the existing histopathology pathway, in particular for population based screening programmes where large number of samples are scrutinised.