bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Land’ as a site of contestation: Empire, identity, and belonging in the Darjeeling Himalayas
Authors: Tamang Sangay , Kipgen Ngamjahao
Published: May 2022

As the dominant narratives of ethnicity have been centered on the issues of ethnic identity and nationalism as a form of pre-given category, the invocation of ‘land’ remains marginal to ethnic politics. Many studies on the politics of ethnic homelands in South Asia has further marginalized the notion of ‘land’ in the study of ethnicity and nationalism and overemphasized ethnic identity as a dominant approach to understand the relationship between state and society. However, land is fundamental to ethnic claims for belongingness in a previously colonized society where indigenous land policy has been reconfigured by the intrusion of British colonialism—took away native land for private interest and subsequently remodified land and citizenship criteria. This article examines an ethnic demand for a homeland in the Darjeeling Hills by bringing to the fore the discussion on land contestation, linguistic politics, and regional aspiration for belongingness. The movement for Gorkhaland in Darjeeling Hills has been articulated as a demand for recognition of Gorkha as Indian citizenship and reflects a distinct attachment of Gorkha to land. Although there has been very little discussion on the issue of land in the demand for Gorkhaland and focused solely on ethnic identity and the development of the Nepali language, we argue in this article that the ethnic movement in Darjeeling has its genesis in the contention of ethnic differences in control over land, resources, and identity, and it is land that has historically framed the politics of ethnicity in the region. Therefore, ‘land is identity’ and must be viewed as a fundamental unit of analysis in ethnic politics.
Sketchbook archaeology: Bodies multiple and the archives they create
Authors: Novak Shannon A
Published: May 2022

Archaeological bodies and their afflictions have multiplied in recent years, along with the specialists who study them. The result is a cascade of data, much of it difficult to reconcile. I argue that variable enactments of disease, rather than reflecting an epistemological disconnect or difference in scale, engender ontological gaps. To pursue these malleable matters, I trace the proliferation of “cancer” from the Spring Street Presbyterian Church burial vaults (1820–1850) in Manhattan. To explore the struggles involved in making many things one, I consider emergent multiplicities of this “disease” within specialists’ laboratories, archival records, and the writing process. Rather than force these different cancers to cohere, or make one “win” based on disciplinary domain (science/humanities) or hierarchy of substance (bone/paper), I rely on Stengers’s (2018) ecology of partial connects. The outcome is not a rubric of knowledge gained, but a sketchbook of lessons learned with bodies multiple along the way.
Effects of music interventions on sleep in people with dementia: A systematic review
Authors: Mu Christina X , Lee Soomi , Boddupalli Samantha , Meng Hongdao
Published: May 2022

Poor sleep health is a risk factor for and a common symptom of dementia. Music has been shown to improve sleep across a wide range of clinical and community populations. However, it is unclear whether and to what extent music interventions may also help alleviate sleep problems in people with dementia. This systematic review is the first review examining the effects of music on sleep outcomes among people with dementia. In accordance with PRISMA guidelines, we extracted 187 articles from nine databases (Academic Search Premier, Ageline, APA PsycArticles, PsycINFO, CINAHL, Embase, PubMed, Scopus, and Web of Science). Eight studies were eligible for this systematic review ( Range sample sizes: 1–59 people with dementia). Results revealed that assessments of sleep in the current literature were limited and mainly focused on sleep duration, subjective sleep quality, or nighttime sleep disturbances. Intervention delivery, music selection, and findings varied. Positive effects of music on sleep outcomes were observed in six out of the eight studies (75%), specifically there were decreases in nighttime sleep disturbances, increases in daytime alertness, and improvements in sleep quality. The remaining two studies found no statistically significant change in sleep outcomes (i.e., daytime sleepiness and quality). Study limitations included small sample sizes and the use of proxy reporters (e.g., caregiver, researcher, blinded clinician) which may reduce the accuracy of the sleep measures. Future research may want to incorporate objectively measured sleep to better understand the role of sleep in dementia care. More research is needed to determine whether music interventions are effective in improving sleep in people with dementia and whether improvements in sleep can slow the progression of dementia.
A computational framework for supporting architectural education of spaces’ furnishing design
Authors: Mahmoud Randa M.A. , Youssef Amr M.A.
Published: May 2022

Self-learning is receiving great attention internationally in different fields, along with the best utilization of different computational applications or methods. This paper introduces a novel computational approach for supporting Architectural Design Education (ADE) in its early stages; a computational implementation through MATLAB has been developed to conduct the proposed processes. As a scope, spaces’ furnishing design has been selected to demonstrate the proposed computational approach and implementation, while office workspaces have been selected as a representative case. However, the proposed approach provides and enhances ADE through three main concepts: (a) generating design alternatives for different cases of furnishing spaces, (b) providing accurate and flexible evaluations to students’/designers’ works with different levels, and (c) tracking students based on their defaults and relevant sensitive modifications. Different applications of the proposed approach have been generated, analyzed, and validated.
Implementation Strategies to Support Built Environment Approaches in Community Settings
Authors: Balis Laura E. , Vincent Jessica
Published: May 2022

Background

Built environment approaches are recommended to improve population physical activity levels. Implementation strategies are needed to improve uptake, but little is known about effective strategies to translate research to practice in community settings.

Purpose

Inform implementation strategies through understanding delivery agents’ perceptions of (1) built environment approaches, (2) a toolkit developed to support implementation, and (3) other required implementation strategies.

Method

A toolkit was developed to detail the process of partnering to change the built environment and provide examples of built environment approaches (e.g., walking paths, traffic calming). Data were collected through focus groups (N = 3) with Extension Agents (n = 46) in 2020. The semi-structured focus group script was based on the Consolidated Framework for Implementation Research and the Technology Acceptance model. Rapid content analysis techniques and a deductive, grounded theory approach were used to interpret the data. Results. Focus groups generated meaning units coded into themes of perceptions of the intervention (subthemes: barriers, resources needed, and facilitators) and perceptions of the toolkit (subthemes: components to add, positive perceptions, and helpful components). The most common resources needed were coalition guidance and funding.

Conclusion

Agents experience barriers and facilitators to implementing built environment approaches and have specific needs for support. Based on the results, we created implementation strategies: (1) Places for Physical Activity toolkit, (2) Coalition Coaching, and (3) Mini-Grants. Future work is needed to investigate the effectiveness of these implementation strategies.
ARISE: First-In-Human Evaluation of a Novel Stent Graft to Treat Ascending Aortic Dissection
Authors: Roselli Eric E. , Atkins Marvin D. , Brinkman William , Coselli Joseph , Desai Nimesh , Estrera Anthony , Johnston Douglas R. , Patel Himanshu , Preventza Ourania , Vargo Patrick R. , Fleischman Fernando , Taylor Bradley S. , Reardon Michael J.
Published: May 2022

Background:

Operative mortality for type A aortic dissection is still 10–20% at centers of excellence. Additionally, 10–20% are not considered as viable candidates for open surgical repair and not offered life-saving emergency surgery. ARISE is a multicenter investigation evaluating the novel GORE® Ascending Stent Graft (ASG; Flagstaff, AZ).

Objective:

The purpose of this study is to assess early feasibility of using these investigational devices to treat ascending aortic dissection.

Methods:

This a prospective, multicenter, non-randomized, single-arm study that enrolls patients at high surgical risk with appropriate anatomical requirements based on computed tomography imaging at 7 of 9 US sites. Devices are delivered transfemorally under fluoroscopic guidance. Primary endpoint is all-cause mortality at 30 days. Secondary endpoints include major adverse cardiovascular and cerebrovascular events (MACCE) at 30 days, 6 months, and 12 months.

Results:

Nineteen patients were enrolled with a mean age of 75.7 years (range 47–91) and 11 (57.9%) were female. Ten (52.6%) had DeBakey type I disease, and the rest were type II. Sixteen (84.2%) of the patients were acute. Patients were treated with safe access, (7/19 (36.8%) percutaneous, 10/19 (52.6%) transfemoral, 2/19 (10.5%) iliac conduit), delivery, and deployment completed in all cases. Median procedure time was 154 mins (range 52–392) and median contrast used was 111 mL (range 75–200). MACCE at 30 days occurred in 5 patients including mortality 3/19 (15.8%), disabling stroke in 1/19 (5.3%), and myocardial infarction in 1/19 (5.3%).

Conclusion:

Results from the ARISE early feasibility study of a specific ascending stent graft device to treat ascending aortic dissection are promising.
Chitosan fabrics with synergy of silver nanoparticles and silver nanowires for enhanced conductivity and antibacterial activity
Authors: Qian Liying , He Duoduo , Qin Haiming , Cao Xiuhua , Huang Jun , Li Junrong
Published: May 2022

Wearable electronic textiles with high conductivity and excellent antibacterial activity are very desirable to minimize health risks and deteriorated performance of the electronic textiles in application. In this work, conductive fabrics were prepared with chitosan nonwovens with inherent antibacterial activity as the substrate. Silver nanoparticles (AgNPs) were synthesized in situ on the surface of chitosan fabric without any additional reducing agent, and silver nanowires (AgNWs) were adhered to the surface of AgNPs-coated chitosan fabrics by simple dip-coating cycles. The synergy of AgNPs and AgNWs enhances the conductivity of the fabric and the stability of AgNPs on the surface of the fabric. According to the analysis of scanning electron microscope and fourier transform infrared spectroscopy spectra, AgNPs were reduced in situ on the fabric. With synergy of AgNPs and AgNWs, the electrical resistance of the fabric is as low as low as 0.93 Ω/sq and 0.20 Ω/sq after one and four dip-coating cycles of AgNWs respectively. Thermogravimetric analysis and inhibition zone assay showed that combination of AgNPs and AgNWs enhanced the thermal stability and antibacterial activity of chitosan fabrics. The chitosan fabrics with conductivity, thermal stability and antibacterial activity can be used in electronic textiles for different applications.
(Re) Stor(y)ing Class: Working-Class Women, Smartness, and Higher Education
Authors: Tomlinson Erin , Gonick Marnina
Published: May 2022

For Canadian-born working-class women, university is often characterized through the axioms of “expanding one’s mind,” “bettering one’s life,” and “saving oneself from a life of hardship.” Associated with these adages is “smartness,” a signature orientation of the academy and a designation that has often excluded the working-class. Our article asks: What does it mean to be a working-class woman in higher education in Canada? How do working-class women negotiate competing notions of “smartness” existing between the university and their home communities? In what ways do these women resist their exclusions from “smartness” and the university project? We answer these questions by drawing on memory stories written by six working-class women who attended or were attending university. The memory stories were written at a series of workshops that one of the authors organized employing the feminist research methodology of Collective Biography. Our analysis illustrates some strategies that working-class and racialized women may use in their encounter with the university including downplaying the value of their working-class backgrounds to make way for the new knowledge to be gained in university, drawing on the strength of community for support, and positioning working-class common sense knowledge as superior to the book knowledge privileged in university. Each story involves the necessity of navigating competing notions of smartness that marks belonging within the university, family, and community.
What is the Role of the Preoperative Blood-Based Inflammation Biomarkers in the Prognosis of Upper Tract Urothelial Carcinoma With Radical Nephroureterectomy? A Single-Centre Retrospective Study
Authors: Luo Zhenkai , Jiao Binbin , Huang Tao , Zhao Hang , Zhang Guan
Published: May 2022

Objective: To assess the prognostic value of preoperative blood-based inflammation biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), on the survival outcomes of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU). Methods: We retrospectively studied the data of 172 patients who were diagnosed with UTUC after RNU during 2008 to 2018. We determined the cut-off value by using X-tile software. The area under the curve (AUC) and concordance index (C-index) were utilized to compare the predictive accuracy between subgroups. We also performed decision curve analysis (DCA) to evaluate the clinical net benefit of prognostic models. The Kaplan–Meier method and Cox proportional hazards regression models were performed to evaluate the association between these inflammation biomarkers and survival outcomes. Results: The median follow-up period was 45.5 (range: 1-143; interquartile range, IQR: 27-77) months. Kaplan–Meier analyses showed that a high NLR or PLR significantly reduced overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS) and metastasis-free survival (MFS), and a low LMR markedly decreased RFS and MFS. The multivariate Cox proportional hazards model revealed that the NLR plus PLR was an independent predictor of worse survival (all P < .05). Additionally, the AUC and C-index of the new prognostic models were the largest for the 1- to 5-year OS, CSS, RFS, and MFS were the largest. Conclusion: Our study confirms that the combination of preoperative NLR and PLR could be an independent risk factor for UTUC patients who have undergone RNU. The addition of NLR and PLR may improve the accuracy of current prognostic models and help guide clinical strategies in the treatment of UTUC.
Contemporary Strategies to Promote Dialysis Access Fistula Maturation
Authors: Walsh Jillian P. , Hentschel Dirk M. , Sharma Gaurav , Lotto Christine E. , Ozaki Charles Keith
Published: May 2022

Background: The inability of a newly created arteriovenous fistula to support hemodialysis due to non-maturation results in increased complications secondary to catheter dependence. 

Methods: In view of the highly variable approaches by providers with heterogenous backgrounds (general surgery, vascular surgery, interventional radiology and interventional nephrology, urology, transplant surgery, etc.) we sought to describe a collection of algorithms that have functioned well in our hands to manage this challenging clinical problem and guide trainees and practicing clinicians alike.

Results: Physical examination along with selective duplex ultrasound and fistulogram can identify most pathologies underlying non-maturation.

Conclusion: Both endovascular and open techniques can be employed to optimize maturation rates in this complex population.
Stakeholders’ Expectations of Return-to-Work After Spinal Cord Injury: A 1-Year Follow-Up
Authors: Farias Lisette , Holmlund Lisa , Asaba Eric
Published: May 2022

Understanding the process of return-to-work is key to supporting people’s social participation and health after a disability. This phenomenographic study aimed to explore the expectations and ways of understanding return-to-work from the perspectives of three stakeholder types: three workers with spinal cord injuries, their employers, and an occupational therapist coordinator. Participants were interviewed twice, at 6 and 12 months, after having participated in a research-based return-to-work intervention in Sweden. A phenomenographic approach was used to analyze the data. The findings highlight how stakeholders’ different expectations prevented them from openly discussing more flexible arrangements to make return-to-work viable and sustainable. The study contributes to occupational therapy practice by raising awareness of the challenges of work reintegration. It also adds to the body of knowledge in occupational science by illuminating how normative social expectations and policy concerning work/productivity influence the return-to-work process.
Hospital managers’ communication networks: A mixed-method study
Authors: Khosravi Bahman , Tajvar Maryam , Jaefaripooyan Ebrahim , MohammadiKangarani Hannaneh , Arab Mohammad
Published: May 2022

This study analyzed the problem-solving and advice-seeking networks of hospital managers working in hospitals affiliated to a university of medical sciences in Iran. This was a mixed-method study and was conducted in two stages. Initially, by conducting a qualitative study, key actors related to the hospital’s managers’ problem-solving and information/advice-seeking networks were identified and the next stage was conducted using social network analysis to identify powerful actors in the network. A questionnaire was used to collect data related to network analysis. Network properties were analyzed using density, degree centrality, and betweenness centrality. When hospital managers need help to solve work-related problems, they usually ask the university’s budget experts, followed by the University’s budget manager, the University’s financial manager, and the University’s deputy of management development and resources. In the financial advice-seeking network, the most common target of managers was the University’s financial manager, University’s budget manager, and University’s budget experts. This means that hospital managers usually seek financial advice from these people. Hospital Managers need to have a better understanding of invisible relationships because these relationships improve or may worsen collaboration and enable knowledge sharing in the organization and thus influence the decision-making process of managers.
Toward a Study of Pinball
Authors: Banfi Ryan
Published: May 2022

Drawing on game theory and interviews that were personally conducted with pinball pioneers—from CEOs of independent and corporate pinball companies to notable designers and historians—this essay argues that pinball machines are not solely collector’s items but complex games that contain original narratives. The narratives in the pinball games are not direct adaptations from the urtext, but rather narratives that arise through gameplay—the player’s use of the pinball to hit the various lights, toys, and ramps that represent the game’s narrative.
Effective Parts of Gentiana straminea Maxim Attenuates Hypoxia-Induced Oxidative Stress and Apoptosis
Authors: Song Dan , Zhang Jingyu , Li Jie , Kong Xiumei , Jiang Yi , Xu Jiaojiao , Zhang Xiaoying , Zhao Qin
Published: May 2022

Hypoxia occurs in physiological situations and several pathological situations, inducing oxidative stress. G straminea Maxim ( G.s Maxim) is a traditional Tibetan medicine that exerts several biological effects. This study focused on the protective effects of G.s Maxim in hypoxia-induced oxidative stress and apoptosis. We found that G. s Maxim significantly increased survival and reduced oxidative stress in hypoxic mice. Various extraction parts of G. s Maxim showed antioxidant activity and significantly improved survival in hypoxia-injured PC12 cells. G.s Maxim reduced hypoxia-induced cell apoptosis and leakage of lactate dehydrogenase. Hypoxic cells had increased malondialdehyde levels but reduced superoxide dismutase activity and G. s Maxim reversed these effects. Moreover, G. s Maxim suppressed hypoxia-induced apoptosis by inducing protein expression of B cell leukemia/lymphoma-2 and reducing the expression of hypoxia-inducible factor-1α, Bcl-2-associated X, and nuclear factor-k-gene binding. These findings suggest that G. s Maxim attenuates hypoxia-induced injury associated with oxidative stress and apoptosis.
Taking Stock and Moving Forward: A Personalized Perspective on Mixed Emotions
Authors: Moore Melody M. , Martin Elizabeth A.
Published: May 2022

Research on mixed emotions is flourishing but fractured. Several psychological subfields are working in parallel and separately from other disciplines also studying mixed emotions, which has led to a disorganized literature. In this article, we provide an overview of the literature on mixed emotions and discuss factors contributing to the lack of integration within and between fields. We present an organizing framework for the literature of mixed emotions on the basis of two distinct goals: solving the bipolar–bivariate debate and understanding the subjective experience of mixed emotions. We also present a personalized perspective that can be used when studying the subjective experience of mixed emotions. We emphasize the importance of assessing both state and trait emotions (e.g., momentary emotions, general levels of affect) alongside state and trait context (e.g., physical location, culture). We discuss three methodological approaches that we believe will be valuable in building a new mixed-emotions literature—inductive research methods, idiographic models of emotional experiences, and empirical assessment of emotion-eliciting contexts. We include recommendations throughout on applying these methods to research on mixed emotions, and we conclude with avenues for future interdisciplinary research. We hope that this perspective will foster research that results in the organized accumulation of knowledge about mixed emotions.
Choice of nominative and topic markers in Korean discourse
Authors: Hwang Heeju
Published: May 2022

In two written sentence completion experiments, I tested whether the choice of nominative and topic markers is subserved by the same mechanisms as anaphor choice and referent choice in Korean. I found that morphological marker choice was sensitive to various factors including connective, grammatical role, and verb semantics, whereas anaphor choice was sensitive only to grammatical role. I also found that morphological marker choice did not systematically vary with verb semantics unlike referent choice. These findings reveal two important properties of referential form production. One is that morphological marker choice relies on different mechanisms than underlie anaphor choice and referent choice. Another is that connective plays a significant role in determining referential form. Despite its role in referent choice and pronoun comprehension, connective has received little attention in current models of referential form production. The current study is the first to systematically test the effect of connective on referential form choice and to demonstrate its effect on morphological marker choice. By revealing how morphological marker choice is related to anaphor choice and referent choice, and identifying the factors that influence morphological marker choice, the results of the study improve our theoretical understanding of morphological marker production and reference production.
Understanding face matching
Authors: Fysh Matthew C , Bindemann Markus
Published: May 2022

Many security settings rely on the identity matching of unfamiliar people, which has led this task to be studied extensively in Cognitive Psychology. In these experiments, observers typically decide whether pairs of faces depict one person (an identity match) or two different people (an identity mismatch). The visual similarity of the to-be-compared faces must play a primary role in how observers accurately resolve this task, but the nature of this similarity–accuracy relationship is unclear. The current study investigated the association between accuracy and facial similarity at the level of individual items (Experiments 1 and 2) and facial features (Experiments 3 and 4). All experiments demonstrate a strong link between similarity and matching accuracy, indicating that this forms the basis of identification decisions. At a feature level, however, similarity exhibited distinct relationships with match and mismatch accuracy. In matches, similarity information was generally shared across the features of a face pair under comparison, with greater similarity linked to higher accuracy. Conversely, features within mismatching face pairs exhibited greater variation in similarity information. This indicates that identity matches and mismatches are characterised by different similarity profiles, which present distinct challenges to the cognitive system. We propose that these identification decisions can be resolved through the accumulation of convergent featural information in matches and the evaluation of divergent featural information in mismatches.
Poorly paid, but proud to work in teams producing ‘quality’: An oral history of women’s experiences working in BBC drama
Authors: May Tom
Published: May 2022

This article presents a range of hitherto unheard women’s testimonies of their experiences working in the BBC Drama Plays department during the 1970s and 1980s. It incorporates the subjective interview testimony of nine women who all worked on BBC1’s prestigious strand of one-off dramas, Play for Today (1970-84) to reveal commonalities and differences in their gendered work experiences. This incorporates topics such as discrimination, pay, working conditions, emotional labour and trade unionism. There is attention to what made working for the BBC unique, compared to ITV or independent production companies. It is discerned that BBC women workers generally saw the BBC as a meritocracy, but also that some regret the decline in the strength of television trade unions, which they saw as leading to a situation of pervasive exploitation in television today.
Theuth, Thamus, and digital civics: Plato’s formulation of memory and its lessons for civic life in the digital age
Authors: Clements Estelle
Published: May 2022

Plato’s story of Theuth and Thamus from the Phaedrus is explored as a means of seeking insight into digital age civic issues. Similar civic challenges in the digital age to those faced by Plato’s contemporaries are observed, including the role of memory in formulating context, its weaponisation, and the misuse of published information. Consideration is given to the potential lessons that can be observed from Plato’s story with the aim of providing understanding of, and approaches to, challenges in digital age civic life through law, technological intervention, and education.
Nonlinear flame response modelling by a parsimonious set of ordinary differential equations
Authors: Doehner Gregor , Haeringer Matthias , Silva Camilo F.
Published: May 2022

In this work we present a parsimonious set of ordinary differential equations (ODEs) that describes with satisfactory precision the linear and non-linear dynamics of a typical laminar premixed flame in time and frequency domain. The proposed model is characterized by two ODEs of second-order that can be interpreted as two coupled mass-spring-damper oscillators with a symmetric, nonlinear damping term. This non-linear term is identified as function of the rate of displacement following [Formula: see text]. The model requires only four constants to be calibrated. This is achieved by carrying out an optimization procedure on one input and one output broadband signal obtained from high-fidelity numerical simulations (CFD). Note that the Transfer Function (FTF) or describing function (FDF) of the flame under investigation are not known a-priori, and therefore not used in the optimization procedure. Once the model is trained on CFD input and output time series, it is capable of recovering with quantitative accuracy the impulse response of the laminar flame under investigation and, hence, the corresponding frequency response (FTF). If fed with harmonic signals of different frequency and amplitude, the trained model is capable of retrieving with qualitative precision the flame describing function (FDF) of the studied flame. We show that the non-linear term [Formula: see text] is essential for capturing the gain saturation for high amplitudes of the input signal. All results are validated against CFD data.
Calcineurin inhibitors in systemic sclerosis – a systematic literature review
Authors: Hofmann Nina N. , Ambühl Robert A. , Jordan Suzana , Distler Oliver
Published: May 2022

Objective:

To review treatment effectiveness and adverse events of calcineurin inhibitors (CNIs) such as cyclosporin A (CsA) and tacrolimus in patients with systemic sclerosis (SSc).

Methods:

A systematic literature search was performed on PubMed and Web of Science using the predefined keywords ‘systemic sclerosis’, scleroderma, cyclosporin*, and tacrolimus. Articles were eligible for inclusion, if SSc patients had been treated with CNIs and data on treatment effects were available.

Results:

This systematic literature review identified 37 papers (19 case reports, 15 case series, 2 controlled studies, and 1 retrospective study) including 134 SSc patients treated with CNIs. In 34 of 37 papers, CsA was used. An improvement of skin fibrosis was observed in 77 of 96 (80.2%) patients using a wide variety of outcome measures and dose regimes. Both controlled studies showed significant improvements, one using a historical control group and one using a no-treatment control group. Improvement in pulmonary function tests (PFTs) occurred in 67.9% (19/28) of the patients who had reduced PFTs at baseline. In 58 (43.3%) cases, adverse renal events were reported, of which 7 (5.2%) were severe such as scleroderma renal crisis (SRC), CsA-associated nephropathy, or death by renal insufficiency. Adverse events led to dose reduction, treatment interruption, or withdrawal in 39 of 134 (29.1%).

Conclusion:

In this systematic literature review, signals for potential effectiveness of CsA for skin and pulmonary fibrosis were found, but the evidence level of the identified studies was too low to allow robust conclusions. Randomized controlled double-blind trials are needed to conclude on the effectiveness of CNIs in SSc. Renal toxicity of CNIs was confirmed in this review and needs to be considered in the design of such studies.
Early childhood leadership: Risk and protective factors during the COVID-19 pandemic
Authors: Neilsen-Hewett Cathrine , Lindsay Gai , Warren Jane , Tonge Karen , Cronin Lyn
Published: May 2022

COVID-19 has impacted Early Childhood Education (ECE) globally. The cancellation of a final year leadership practicum presented an opportunity to partner with pre-service teachers as co-researchers to investigate the leadership experience of four service directors during COVID-19. A multi-case study design included four focus groups consisting of one early childhood sector leader, final year pre-service teachers and one academic mentor aimed to explore the impacts of COVID-19 on service leadership while identifying the leadership strategies that offered protective mitigation for the risks posed by the pandemic. Leadership challenges included shifting health orders, support for the home learning context and disseminating policy shifts to staff and families, all while maintaining viability, managing anxieties of staff, parents and children, while negotiating lockdowns and service restrictions. Findings spoke to the complexity of the situation for leaders, while spotlighting the protective function of high-quality practice; strong service-based philosophy; and prioritisation of relationships.
Distribution of Oxygen Partial Pressures in Native Capillary Fingertip Blood Samples From a Large Diabetes Patient Population
Authors: Setford Steven , Phillips Stuart , Cameron Hilary , Grady Mike
Published: May 2022

A data set comprising 28 533 oxygen partial pressure (pO2) values gathered from nonarterialized fingertip capillary blood samples of a large diabetes population is reported. Data were gathered routinely as part of the ongoing clinical surveillance activities of a blood glucose monitoring (BGM) system manufacturer. Overall, a mean pO2 level of 75.3 mm Hg was recorded, with a standard deviation (SD) of 10.6 mm Hg and a range of 27.7 to 151.5 mm Hg. This data set, unique in terms of size, gathered more than 14 years at four separate clinical sites, provides a robust and comprehensive representation of an unmanipulated pO2 fingertip capillary sample distribution, which should be of interest for physiological reasons, but also from a medical device development perspective, in which the effect of pO2 on device performance may be an important design consideration.
Are SER-II Ankle Fractures Anatomic? Computed Tomography Demonstrates Mortise Malalignment in the Setting of Apparently Normal Radiographs
Authors: Chien Bonnie Y. , Ingall Eitan M. , Staffa Steven , Williams Caroline , Miller Christopher P. , Kwon John Y.
Published: May 2022

Background:

Ankle fracture treatment is predicated on minimal displacement, leading to abnormal joint contact area. The purpose of this investigation is to determine whether computed tomography (CT) detects subtle mortise malalignment undetectable by x-ray in supination-external rotation–II (SER-II) injuries.

Methods:

A total of 24 patients with SER-II injuries, as demonstrated by negative gravity stress radiography, were included. Medial clear space (MCS) measurements were performed on bilateral ankle x-rays (injured and contralateral, uninjured side) at several time points as well as bilateral non-weight-bearing CT performed once clinical and radiographic healing was demonstrated (mean = 66 days post injury, range = 61-105 days). Statistical analyses examined differences in measurements between both sides.

Results:

Final x-rays demonstrated no differences between normal and injured ankle MCS (P = .441). However, CT coronal/axial MCS measurements were different (P < .05). CT coronal MCS measured wider by a mean difference of 0.67 mm (P < .001).

Conclusion:

There is a high incidence of subtle mortise malalignment in SER-II ankle fractures, as demonstrated by CT, which is undetectable when assessed by plain radiographs. Although clinical outcomes are yet unknown, there are important implications of the finding of confirmed, subtle mortise malalignment in SER-II injuries and the limitations of x-ray to detect it.

Level of Evidence:

Level III
The “Love-Tokens” of God: Richard Baxter on Cultivating Love of God through Earthly Pleasures
Authors: Setran David
Published: May 2022

In his later years, Puritan pastor Richard Baxter developed a perspective on spiritual formation that highlighted the centrality of the love of God. Interestingly, Baxter emphasized the ways in which a delight in earthly pleasures—such as nature, relationships, and food—could help Christians cultivate the love of God. He viewed these pleasures as “love-tokens” from God, sent in order to help human beings see his goodness and expand their love for the giver of these gifts. While he recognized the potential of such earthly delights to lure hearts away from God, he also recognized that they could serve as powerful “glasses” through which earth-bound creatures could see God’s beauty and goodness and thus grow in godly delight. In the end, Baxter was able to forge a pathway between asceticism and materialism, encouraging Christians to grow their love for God by tracing earthly mercies back to their divine source.
Is Workload Associated With Hamstring and Calf Strains in Professional Baseball Players? An Analysis of Days of Rest, Innings Fielded, and Plate Appearances
Authors: Chalmers Peter N. , Mcelheny Kathryn , D’Angelo John , Ma Kevin , Rowe Dana , Erickson Brandon J.
Published: May 2022

Background:

The influence of player workload on hamstring and calf injuries in professional baseball players remains unknown.

Hypothesis:

Increased workload would significantly increase hamstring and calf strain injury risk.

Study Design:

Case-control.

Level of Evidence:

Level 3.

Methods:

All professional baseball players who sustained a hamstring or calf injury between 2011 and 2017 were identified using the Major League Baseball (MLB) Health and Injury Tracking System (HITS). A separate player usage dataset was used to determine workload. We then compared these variables between player games 2, 6, 12, and >12 weeks before a documented calf strain to player games from a noncalf injury control group. In a paired analysis, we compared the acute workload (2, 6, and 12 weeks) before injury with the injured player’s workload >12 weeks before injury.

Results:

There were 175 unique calf strains (71% occurred in position players) and 1042 unique hamstring strains (97.8% occurred in position players) documented in the MLB HITS database from 2011 to 2017. In all time periods, position players with fewer days rest, more innings fielded, and more plate appearances were associated with a higher risk of subsequent hamstring and calf strains. Having only 1 day rest was associated with a 2.08-fold increase in percentage of players who sustained a subsequent calf strain compared with those with 4 days rest. Position players with >5 days of rest had a 4.03-fold decrease in percentage of players who sustained a hamstring strain compared with players with 1 day rest. Position players who fielded >9 innings per game had a 2.01-fold increase in percentage of players with a subsequent calf strain and a 3.68-fold increase in percentage of players who sustained a subsequent hamstring strain compared with players who only fielded 1 innings per game.

Conclusion:

Position players with fewer days rest, more innings fielded, and more plate appearance per game had an increased risk of sustaining a hamstring or calf injury.

Clinical Relevance:

Increased workload had a direct relationship with risk of hamstring and calf strains in professional baseball players. Teams should consider more days rest for position players to avoid calf injuries.
Inpatient Telemedicine for Neurology Consultation at Satellite Hospitals: Patient and Provider Perspectives
Authors: PJ Juneja , AM Tolczyk , RE Strowd , LD Strauss , R Graham , L Burton , C Michael , M Ezzeddine , EP Pharr , J Boggs , S Kumar , C O’Donovan , CT Tegeler , Guzik Amy K
Published: May 2022

Background and Purpose: Describe an inpatient teleneurology consultation service novel to our hospital system, and capture feedback from patients, ordering providers, and consulting neurologists. Methods : A single cohort of teleneurology consult patients was surveyed via telephone. Ordering and consulting providers completed online surveys. Quantitative survey data was reported using descriptive statistics and free-response survey data was summarized. Patient demographics and consult data were gathered via retrospective chart review. Results : Telephone survey was obtained from 25 of 53 patients receiving teleneurology consults from June 1–September 30, 2020. Patient-reported benefits included better understanding of condition (72%) and ability to remain close to home. Online surveys were completed by 11 ordering providers and by consulting neurologists on 20 telemedicine encounters. Ordering providers reported they were likely to use the service again (98.7%), agreed it added value to patient care (91%) and was valued by patients (82%), with concern for missed diagnosis (46%) and potential patient transfer (36%) without the service. In contrast, fewer consulting neurologists predicted need for transfer (5%) or missed diagnosis (10%) in the absence of teleneurology, though 20% indicated that length of stay may increase without the service. Conclusion: We confirm feasibility of an inpatient teleneurology service run by an academic medical center. Satisfaction was high among all key stakeholders, with few transfers to a tertiary care center. This service is valuable to patients, ordering providers, and potentially the hospital network, as a community based care model of neurological care, centered on the needs of the patient and hospitalist.
Magnetic Resonance Imaging as a Diagnostic and Research Tool in Patients with Olfactory Dysfunction: A Systematic Review
Authors: Hura Nanki , Yi Julie S. , Lin Sandra Y. , Roxbury Christopher R.
Published: May 2022

Background

Patients with acquired, idiopathic olfactory dysfunction (OD) commonly undergo magnetic resonance imaging (MRI) evaluation to rule out intracranial pathologies. This practice is highly debated given the expense of MRI relative to the probability of detecting a treatable lesion. This, combined with the increasing use of MRI in research to investigate the mechanisms underlying OD, provided the impetus for this comprehensive review.

Objective

The purpose of this systematic review was to both assess the utility of MRI in diagnosis of idiopathic OD and to describe MRI findings among mixed OD etiologies to better understand its role as a research tool in this patient population.

Methods

A literature search of PubMed, Embase, Cochrane, Web of Science, and Scopus for studies with original MRI data for patients with OD was completed. Studies exclusively investigating patients with neurocognitive deficits or those studying traumatic or congenital etiologies of OD were excluded.

Results

From 1758 candidate articles, 33 studies were included. Four studies reviewed patients with idiopathic OD for structural pathologies on MRI, of which 17 of 372 (4.6%) patients had a potential central cause identified, and 3 (0.8%) had an olfactory meningioma or olfactory neuroblastoma. Fourteen studies (42.4%) reported significant correlation between olfactory bulb volume and olfactory outcomes, and 6 studies (18.8%) reported gray matter volume reduction, specifically in the orbitofrontal cortex, anterior cingulate cortex, insular cortex, parahippocampal, and piriform cortex areas, in patients with mixed OD etiologies. Functional MRI studies reported reduced brain activation and functional connectivity in olfactory network areas.

Conclusion

MRI uncommonly detects intracranial pathology in patients with idiopathic OD. Among patients with mixed OD etiologies, reduced olfactory bulb and gray matter volume are the most common abnormal findings on MRI. Further research is required to better understand the role of MRI and its cost-effectiveness in patients with acquired, idiopathic OD.
Management of a patient with polymorphic ventricular tachycardia from aconitum poisoning
Authors: HO Shu Fang , Kuan Kelvin Kaibin
Published: May 2022

An 81-year-old man presented to the Emergency Department with shortness of breath, generalised weakness, numbness, giddiness, nausea and vomiting after consuming an inadequately prepared Traditional Chinese Medicine preparation that contained herbal aconitum (Chuanwu and Caowu). His electrocardiogram (ECG) and rhythm strips showed multiple runs of non-sustained ventricular tachycardia monomorphic ventricular tachycardia and slowed polymorphic ventricular tachycardia. He was treated with intravenous (IV) amiodarone, magnesium and lignocaine, and was started on IV noradrenaline after developing haemodynamic compromise. There was no digoxin detected in the blood and urine. At 12 h, aconitine was not detected in the blood (cut off at <1 ng/mL) but aconitine and hypaconitine was detected in the urine qualitatively. He underwent a coronary angiogram at 12 h post-admission which showed minor coronary artery disease. A formal echocardiogram showed left ventricular ejection fraction 50–55% with no regional wall motion abnormalities of the left ventricle. He made an uneventful recovery and reverted to normal sinus rhythm at 29 h of admission. He was discharged well on Day 4 of admission with a diagnosis of polymorphic ventricular tachycardia secondary to Aconitum poisoning.
Application and observation of artificial intelligence in clinical practice of fundus screening for diabetic retinopathy with non-mydriatic fundus photography: a retrospective observational study of T2DM patients in Tianjin, China
Authors: Hao Zhaohu , Xu Rong , Huang Xiao , Ren Xinjun , Li Huanming , Shao Hailin
Published: May 2022

Objective:

To observe the consistency of a preliminary report of artificial intelligence (AI) in the clinical practice of fundus screening for diabetic retinopathy (DR) using non-mydriatic fundus photography.

Methods:

Patients who underwent DR screening in the Metabolic Disease Management Center (MMC) of our hospital were selected as research participants. The degree of coincidence of the AI preliminary report and the ophthalmic diagnosis was compared and analyzed, and the kappa value was calculated. Fundus fluorescein angiography (FFA) was performed in patients referred to the out-of-hospital ophthalmology department, and the consistency between fluorescein angiography and AI diagnosis was evaluated.

Results:

In total, 6146 patients (12,263 eyes) completed the non-mydriasis fundus examination. The positive DR screening rate was 24.3%. When considering moderate nonproliferative retinopathy as the cut-off point, the kappa coefficient was 0.75 ( p < 0.001), the sensitivity was 0.973, and the precision was 0.642, which was shown in the precision–recall curve. Fifty-nine patients referred to receive FFA were compared with non-mydriatic AI diagnoses. The kappa coefficient was 0.53, and the coincidence rate was 66.9%.

Conclusion:

Non-mydriasis fundus examination combined with AI has a medium-high consistency with ophthalmologists in DR diagnosis, conducive to early DR screening. Combining diagnosis and treatment modes with the Internet can promote the development of telemedicine, alleviate the shortage of ophthalmology resources, and promote the process of blindness prevention and treatment projects.
Post-discharge follow-up of patients with COVID-19: A Brazilian experience
Authors: Nakayama Luis Filipe , Urias Müller Gonçalves , Gonçalves Arthur Sevalho , Ribeiro Rafael Amorim , Macruz Tiago de Almeida , Pardo Rafael Baptista
Published: May 2022

Objective:

The objective of this study is to evaluate post-acute symptoms in patients with confirmed severe and critical coronavirus disease 2019 infections.

Methods:

We evaluated patients with confirmed severe and critical coronavirus disease 2019 infections. Post-acute symptoms were defined as symptoms persisting 4 weeks after the onset of the symptoms and classified as pulmonary, muscular, hematologic, neuropsychiatric, renal, and dermatological.

Results:

We recovered data from 565 patients (43.7% female) with a mean age of 61.1 years. In 18.2%, at least one hospital readmission was necessary and 11.1% died. In 62.6%, there was at least one persistent symptom, and 28.8% had more than one. Among associated factors, obesity, intensive care support, and mechanical ventilation were related to persistent symptoms.

Conclusion:

The most prevalent symptoms were pulmonary and neuropsychiatric sequelae, as reported in previous studies. This finding underscores the severity of the coronavirus disease 2019 infection and the need for follow-up after recovery from the initial illness. Obese patients, those requiring mechanical ventilation, female patients, and increased hospital length are at greater chance of having persistent symptoms.