bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient Perspectives on Religiously Affiliated Care in Rural and Urban Colorado
Authors: Fuchs Joseph Robert , Fuchs Jeffrey William , Hauser Joshua M. , Coors Marilyn E.
Published: May 2021

Introduction

Religiously affiliated healthcare organizations play an important role in the delivery of care in the United States. There is a gap in the literature regarding patients’ attitudes toward receiving care at these institutions, especially in geographically diverse populations.

Methods

In this two-site pilot study, we conducted a written survey of 141 adult primary care patients at non-religiously affiliated clinics in rural and urban Colorado. Demographic information, measures of religiosity and spirituality, and opinions regarding religiously affiliated care were collected.

Results

73.3% and 69.6% of patients in rural and urban counties, respectively, had no preference as to the religious affiliation of their care. However, patients in the urban county (24.1%) were more likely than those in the rural county (8.3%) to prefer care that was not affiliated with any religion.

Conclusions

This study suggests that concerns such as proximity to care and patient/provider relationships may be more important to patients than the possible religious affiliation of a healthcare organization. This work is a first step in better understanding patients’ attitudes toward religiously affiliated care in urban versus rural settings.
Estimating the Period Prevalence of Publicly Funded Abortion to Space Live Births, 1999 to 2014
Authors: Studnicki James , Fisher John W. , Longbons Tessa , Reardon David C. , Craver Christopher , Harrison Donna J.
Published: May 2021

Introduction/Objectives:

Although a majority of women who have an abortion report having 1 or more children, there is no published research on the number of abortions which occur between live births, after a first child but before the last. The objectives of this research, therefore, were to estimate the period prevalence of an induced abortion separating live births in a population of Medicaid eligible enrollees and to identify the characteristics of enrollees significantly associated with the use of abortion to enable child spacing.

Methods:

A retrospective, cross-sectional, longitudinal analysis of the pregnancy outcome sequences of eligible enrollees over age 13 from the 17 states where Medicaid included coverage of all abortions, with at least one identifiable pregnancy outcome between 1999 and 2014. Eligibles with a defined sequence of birth-abortion-birth within up to 5 consecutive pregnancies were identified to estimate the number of eligibles who could have practiced birth spacing by abortion. Logistic regression was applied to identify the significant predictor variables of the birth-abortion-birth sequence.

Results:

There were 50 012 (1.02%) of 4 875 511 Medicaid eligible enrollees exhibited a birth-abortion-birth sequence. Eligibles with the birth-abortion-birth sequence are more likely to be Black than White (OR 2.641, CL 2.581-2.702), less likely to be Hispanic than White (OR 0.667, CL 0.648-0.687), and more likely to have received contraceptive counseling (OR 1.14, CL 1.118-1.163). Increases in months of Medicaid eligibility (OR 1.004, CL 1.003-1.004) and months from first pregnancy to second live birth (OR 1.015, CL 1.015-1.016) are associated with the likelihood of undergoing live births separated by one or more induced abortions. Increases in the age at first pregnancy are associated with a decreased likelihood of the birth-abortion-birth sequence (OR 0.962, CL 0.959-0.964).

Conclusion:

Birth spacing via abortion is uncommon among a low-income population for whom the financial barriers to abortion are somewhat alleviated.
Safe Extubation of Patients with COVID-19 for Minimizing Aerosolized Droplets
Authors: Akatsuka Masayuki , Yoshinaka Asami , Hagiwara Hiroya , Yamamoto Shuji
Published: May 2021

Background:

Healthcare workers must be protected during extubation of patients with coronavirus disease 2019 (COVID-19) owing to the presence of aerosolized droplets. Herein, we report a technique for extubating a patient with COVID-19 while minimizing aerosol dispersion.

Case Report:

We retrospectively identified a total of 79 patients admitted to our hospital from February 2020 to January 2021. Six of these patients were intubated for mechanical ventilation, 2 of whom had to be extubated. We prepared a clear vinyl sheet in the shape of a tent to place over the patient, and 2 staff members, both well experienced in airway management, stood outside the tent on either side of the patient. Before extubation, we confirmed that the patient’s consciousness level was good and the patient had no distress by adjusting the dose of sedative drugs. After extubation, a surgical mask was placed on the patient’s face.

Conclusion:

Our experience indicates that this method of extubation in a patient with COVID-19 could be safely implemented to protect healthcare workers.
Developing Risk Assessment Criteria and Predicting High- and Low-Dengue Risk Villages for Strengthening Dengue Prevention Activities: Community Participatory Action Research, Thailand
Authors: Suwanbamrung Charuai , Le Cua Ngoc , Kaewsawat Supreecha , Chutipattana Nirachon , Khammaneechan Patthanasak , Thongchan Supaporn , Nontapet Orratai , Thongsuk Cherd , Laopram Suphap , Niyomchit Chamaiporn , Sinthu Ruchira
Published: May 2021

Background:

Risk assessment criteria for predicting dengue outbreak must be appropriated at village levels. We aimed to develop risk dengue village prediction criteria, predict village dengue risk, and strengthen dengue prevention based on community participation.

Methods:

This participatory research conducted in Southern Thailand included the following 5 phases: (i) preparing communities in 3 districts; (ii) developing risk dengue village prediction criteria; (iii) applying computer program; (iv) predicting village dengue risk with 75 public health providers in 39 PCUs; and (v) utilizing findings to strengthen dengue prevention activities in 220 villages. Data collecting for prediction used secondary data from primary care units in the past 5 year and current year. Descriptive statistics used calculating criteria and comparing with standard level to adjust score of risk.

Results:

Risk dengue village assessment criteria had 2 aspects: dengue severity (3 factors) and dengue outbreak opportunity (3 factors). Total scores were 33 points and cut-off of 17 points for high and low dengue risks villages. All criteria were applied using computer program ( http://surat.denguelim.com ). Risk prediction involved stakeholder participation in 220 villages, and used for strengthening dengue prevention activities. The concept of integrated vector management included larval indices surveillance system, garbage management, larval indices level lower than the standard, community capacity activities for dengue prevention, and school-based dengue prevention. The risk prediction criteria and process mobilized villages for dengue prevention activities to decrease morbidity rate.

Conclusion:

Dengue risk assessment criteria were appropriated within the village, with its smallest unit, the household, included. The data can be utilized at village levels for evaluating dengue outbreak risks.
Perceived Barriers to Primary Care Services Utilization and its Associations with Overall Satisfaction of Patients in Saudi Arabia: A Cross-Sectional Questionnaire-Based Study
Authors: AlOmar Reem S. , AlShamlan Nouf A. , AlAmer Naheel A. , AlThumairi Arwa A. , Almir Bayan M. , Aldawood Heba A. , Bukhamsin Tuqa H. , Alqahtani Hatem A. , Al Shammari Malak A.
Published: May 2021

Introduction:

Primary care plays an integral role in modern healthcare systems. More so in a country that is currently undergoing a reform of its health system. Their remains barriers that hinder patients from seeking medical assistance from primary physicians. This study aims to examine the overall satisfaction of patients toward Primary Healthcare Centers (PHCs) in Saudi Arabia, as well as its association with potential barriers from a sample of patients who presented at the emergency department (ED) for non-urgent cases.

Methods:

This cross-sectional study sampled 403 patients from King Fahd Hospital of the University. A piloted questionnaire was utilized that included questions on sociodemographics, satisfaction of PHCs, as well as organizational, socioeconomic, access, and patient-doctor relationship barriers using a Likert-scale item response. Chi-squared and Fisher’s Exact tests were used to compare categorical variables, and multivariable logistic regression was used to assess the association between overall satisfaction and all factors and barriers.

Results:

The sample consisted of 48.1% males and 51.9% females. Only 5.2% of the patients were hospitalized. Of the total sample, 28.3% reported being always satisfied with PHC services. The most reported barriers were organizational barriers and socioeconomic barriers. The regression analysis found that being a female, highly educated, have high organizational, and patient-doctor relationship were independent predictors for low overall satisfaction with PHCs.

Conclusion:

Findings from this study should allow healthcare planners and policy makers to reduce the impact of these barriers by finding solutions that would target them. This may include strictly implementing policies such as proper implementing of triaging in EDs as well as promoting services that are being provided free of charge at these centers.
Parents’ and Service Providers’ Experiences of Accessing Health Services from an Intellectual Disability Health Team
Authors: Campbell Denise , Milne Jacqueline , Garg Pankaj , Tomsic Gail , Ong Natalie , Silove Natalie
Published: May 2021

A pediatric assessment service for children with Intellectual Disability (ID) was established in a culturally diverse region of Sydney, Australia, to meet the health needs of children and young people with ID. This paper reports on parents’ and providers’ experiences using qualitative and quantitative analysis of surveys. The survey responses from the parents’ enumerated their key concerns and the practical help they received from the service. Responses from service providers reported a high level of satisfaction with the services and valued the quality of assessment reports. The service facilitated inter-agency collaboration and enhanced the access to quality health care.
Treatment Approach of Refractory Helicobacter pylori Infection: A Comprehensive Review
Authors: Cortés Pedro , Nelson Alfred D. , Bi Yan , Stancampiano Fernando F. , Murray Loren P. , Pujalte George G.A. , Gomez Victoria , Harris Dana M.
Published: May 2021

H. pylori is the most common infection in the world and is associated with gastrointestinal and extra-gastrointestinal manifestations, including peptic ulcer disease, gastrointestinal bleeding, and lymphoproliferative disorders. Despite being discovered less than half a century ago, antibiotic resistance, exacerbated by medication non-adherence and inefficacy of proton pump inhibitors, has grown substantially, explaining the rising incidence of refractory H. pylori infection. In this review, we discuss risk factors, treatment options, surveillance and follow-up, as well as emerging therapies for refractory H. pylori.
Enhanced Primary Health Care Intervention: Perceived Sustainability and Challenges Among Implementers
Authors: Perialathan Komathi , Johari Mohammad Zabri , Jaafar Norrafizah , Yuke Lin Kong , Lee Lan Low , Sodri Nur Aliyah , Mohd Yunus Siti Nur Nabilah
Published: May 2021

Purpose:

This study aimed to assess and explore perceived sustainability and challenges of the intervention among Health Care Providers (HCPs) who were involved.

Methods:

The study applied mixed-method embedded design to analyze both quantitative and qualitative data. Quantitative approach was used to evaluate sustainability perception from 20 intervention clinics via self-reported assessment form whereas qualitative data were obtained through in-depth interview (IDI) and focus group discussions (FGDs) 14 health care professionals participated in IDI session and were either care coordinators, liaison officers (LOs)/clinic managers, or medical officers-in-charge for the clinic’s intervention. Nine FGDs conducted comprised 58 HCPs from various categories.

Results:

HCPs from all the 20 clinics involved responded to each listed Enhanced Primary Healthcare (EnPHC) intervention components as being implemented but the perceived sustainability of these implementation varies between them. Quantitative feedback showed sustainable interventions included risk stratification, non-communicable disease (NCD) screening form, referral within clinics and hospitals, family health team (FHT), MTAC services and mechanisms and medical adherence status. Qualitative feedback highlighted implementation of each intervention components comes with its challenges, and most of it are related to inadequate resources and facilities in clinic. HCPs made initiatives to adapt based on clinical setting to implement the interventions at best level possible, whereby this seems to be one of the core values for sustainability.

Conclusion:

Overall perceptions among HCPs on sustainability of EnPHC interventions are highly influenced by current experiences with existing resources. Components perceived to have inadequate resources are seen as a challenge to sustain. It’s crucial for stakeholders to understand implications affecting implementation process if concerns raised are not addressed and allocation of needed resources to ensure overall successfulness and long term sustainability.
Academic Journal Retractions and the COVID-19 Pandemic
Authors: Anderson Caleb , Nugent Kenneth , Peterson Christopher
Published: May 2021

The 2020 COVID-19 pandemic has produced an unprecedented amount of scientific research, with over 100,000 articles on the SARS-COV2 virus or the associated pandemic published within the first year. To effectively disseminate such a large volume of research, some academic journal publishers altered their review criteria, and many articles were made available before undergoing a traditional review process. However, with this rapid influx of information, multiple COVID-19 articles have been retracted or withdrawn. Some researchers have expressed concern that these retractions call into question the validity of an expedited review process and the overall quality of the larger body of COVID-19 research. We examined 68 removed articles and determined that many of the articles were removed for unknown reasons (n = 22) or as duplications (n = 12); 24 papers were retracted for more significant reasons (data integrity, plagiarism, reporting or analysis, and IRB or privacy issues). The majority of removed papers were from the USA (n = 23) and China (n = 19).
Heart Transplantation of a Preterm Infant With HLHS
Authors: Aljohani Othman A. , Mackie Duncan , Fletcher Emily A. , Shayan Katayoon , Vaughn Gabrielle R. , Singh Rakesh K. , Nigro John J.
Published: May 2021

A 33-week gestation, 1.75-kg female infant with mitral stenosis/aortic atresia variant of hypoplastic left heart syndrome and severe ventriculo-coronary connections underwent surgical septectomy and bilateral pulmonary artery banding at five weeks of age (2.10 kg). After separation from bypass, she developed hemodynamic instability requiring venoarterial extracorporeal membrane oxygenation support. She was listed for heart transplantation and transplanted after three days of support with an oversized heart (4.7:1 donor–recipient weight ratio).
Atrial Septal Defect Closure via Left Subclavian Vein Approach in a Patient With Absent Inferior Vena Cava
Authors: Enta Yusuke , Tatebe Shunsuke , Saiki Yoshikatsu , Tada Norio
Published: May 2021

Without the femoral venous approach, transcatheter closure of an atrial septal defect is challenging. We performed percutaneous closure via the left subclavian vein in a patient with absence of the inferior vena cava with azygos continuation. Considering that inferior vena cava anomalies are not extremely rare among those with congenital heart disease, the left subclavian vein approach can be an alternative to the femoral approach.
Octogenarian and Nonagenarians Are at a Higher Risk for Experiencing Adverse 30-Day Outcomes Following ORIF of Ankle Fractures
Authors: Gray Mitchell T. , Hidden Krystin A. , Malik Azeem T. , Khan Safdar N. , Phieffer Laura , Ly Thuan V. , Quatman Carmen E.
Published: May 2021

Introduction:

Despite an increasing number of elderly individuals undergoing surgical fixation for ankle fractures, few studies have investigated peri-operative outcomes and safety of surgery in an octogenarian and nonagenarian population (age >80 years).

Materials and Methods:

The 2012-2017 American College of Surgeons database was queried for patients undergoing open reduction internal fixation for isolated uni-malleolar, bi-malleolar and tri-malleolar ankle fractures. The study cohort was divided into 3 comparison groups (age <65 years, 65-75 and >80). Multi-variate regression analyzes were used to compare the independent effect of varying age groups on 30-day post-operative outcomes while controlling for baseline clinical characteristics and co-morbidity burdens.

Results:

A total of 19,585 patients were included: 5.3% were >80 years, 18.1% were 65-79 years, and 76.6% were <65 years. When compared to the non-geriatric population, individuals >80 years were at a significantly Abstract: higher risk of 30-day wound complications (OR 1.84; p = 0.019), pulmonary complications (OR 3.88; p < 0.001), renal complications (OR 1.96; p = 0.015), septic complications (OR 3.72; p = 0.002), urinary tract infections (OR 2.24; p < 0.001), bleeding requiring transfusion (OR 1.90; p = 0.025), mortality (or 7.44; p < 0.001), readmissions (OR 1.65; p = 0.004) and non-home discharge (OR 13.91; p < 0.001).

Discussion:

Octogenarians undergoing ankle fracture fixation are a high-risk population in need of significant pre-operative surgical and medical optimization. With the majority of patients undergoing non-elective ORIF procedures, it is critical to anticipate potential complications and incorporate experienced geriatric providers early in the surgical management of these patients.

Conclusions:

Octogenarians and nonagenarians are fundamentally distinct and vulnerable age groups with a high risk of complications, readmissions, mortality and non-home discharges compared to other geriatric (65-79 years) and non-geriatric (<65 years) patients. Pre-operative counseling and risk-stratification are essential in this vulnerable patient population.
The Influence of Cervical Spine Angulation on Symptoms Associated With Wearing a Rigid Neck Collar
Authors: Kelani Taiwo D. , Lee Annabelle , Walker Miny , Koizia Louis J. , Dani Melanie , Fertleman Michael B. , Kedgley Angela E.
Published: May 2021

Introduction:

Rigid cervical spine collars can be used to maintain the position of the cervical spine following injury or surgery. However, they have been associated with difficulty swallowing, pressure sores and pain, particularly in older patients. We aimed to investigate the relationship between cervical spine angulation, a rigid neck collar and neck pain in healthy young and older adults.

Methods:

Twenty healthy young adults aged 25 ± 3 years and 17 healthy older adults aged 80 ± 8 years were tested. Magnetic resonance imaging scans of their cervical spines were taken before and after the rigid neck collar was worn for 1 hour. Measurement of vertebral angulation involved digitization of the scans and joint angle calculations using image processing software. Pain was quantified before and after the collar was worn, using a visual analogue scale.

Results:

Pain scores increased in the young group after the collar was worn (p = 0.001). The older group showed no difference in pain score after the collar was worn. Statistical tests showed no significant correlations between the change in cervical angles and the change in pain scores after the collar was worn.

Discussion:

The aging process may contribute to the changing distribution of subcutaneous tissue and increase risk of symptoms associated with wearing a collar. Oesophageal compression is not a result of collar use.

Conclusion:

There is no correlation between cervical spine vertebrae angulation and symptoms associated with wearing a neck collar. Generally, older individuals have greater cervical lordosis angles, and more straight and lordotic neck shapes. Older individuals may be more prone to skin-interface pressures from the neck collar than younger individuals.
Interprosthetic Femoral Fractures Surgical Treatment in Geriatric Patients
Authors: Loucas Marios , Loucas Rafael , Akhavan Nico Safa , Fries Patrick , Dietrich Michael
Published: May 2021

Background:

Total hip (THA) and total knee arthroplasty (TKA) are becoming an increasingly standard procedure in the whole world. In conjunction with an aging population and increased prevalence of osteoporosis, proper management of periprosthetic, and interprosthetic fractures is of great interest to orthopedic surgeons. This study aims to report the clinical and radiographic outcomes, complications and reoperations of IFFs in geriatric patients.

Methods:

A retrospective single-institution case series study was conducted. Between 2011 and 2019, 83 patients underwent surgical treatment for periprosthetic femoral fractures. Thirteen fractures were identified as IFFs. Patient demographics and comorbidities were collected preoperatively, and fractures were classified with the Vancouver and AO unified classification system (AO-UCS).

Results:

We included 12 patients (13 hips) with IFFs (AO-UCS type IV.3 B (2/13) type IV.3 C (3/13), type IV.3 D (8/13)). The average patient age was 86.54 (range, 79-89) years. There were 10 females and 2 males. Perioperative morbidity has been identified in 10 of the 12 patients, and the 3-month and 1-year mortality were reported in 2 and 3 patients, respectively. Cerclage cables were used in 9 of 12 patients. One of 12 patients showed a local complication, with no documented implant failure or revision. Patients achieved complete union and returned to their preoperative ambulatory status, and full weight-bearing at an average of 5 (range, 2 to 7) months later.

Conclusion:

Management of IFF can be challenging because these fractures require extensive surgical expertise. Locking plate seems to be a valuable treatment option for geriatric patients with IFFs. Despite the complexity of this type of fracture, the overall complication and revision rate, as well as the radiographic outcome are good to excellent.

Level of Evidence:

Level III, Therapeutic study.
District-Level School Counseling Supervisors’ Experiences With and Perceptions of Hiring School Counselors
Authors: Goodman-Scott Emily , Upton Amy W. , Neuer Colburn Anita A.
Published: May 2021

Although district-level school counseling supervisors often assist with school counselors’ transition from preparation to practice, including hiring practices, research on this phenomenon is limited. Thus, we conducted an exploratory thematic analysis examining 12 district supervisors’ experiences with and perceptions of hiring preservice school counselors. Results included the following two themes: (a) prioritizing the American School Counselor Association National Model and (b) the relevance of school counselors’ previous teaching experiences. The results also provided insight into supervisors’ appreciation of school counselors’ educational identity.
Advocating for Students During Distance Learning: The Role of the School Counselor
Authors: Hipolito-Delgado Carlos P. , Porras Laura-Elena , Stickney Dane , Kirshner Ben
Published: May 2021

The COVID-19 pandemic forced schools to rush into distance learning, prioritizing academics and limiting consideration of students’ socioemotional needs. Given that distance learning is likely to be a recurring experience, school counselors should understand this unique context to better advocate for student needs. Through this illustrative case study, we sought to understand the distance learning experience of students, specifically examining barriers experienced and desired support, in an urban school district in the Western United States. We conducted classroom observations, interviews, and town hall observation with students who were part of an action civics program in the district. Following thematic data analysis, we found that student participants described themes of challenges (with subthemes of online learning and outside of school), needs (with subthemes of community and student voice), and communication. Based on these findings, we argue for school counselors to use student voice to inform advocacy efforts in addressing student needs during distance learning.
How the Educator–Counselor–Leader–Collaborator Creates Asset-Rich Schools: A Qualitative Study of a School–Family–Community Partnership
Authors: Henry Lynette M. , Bryan Julia
Published: May 2021

This article discusses school counselors’ multifaceted role as educator–counselor–leader–collaborator, inextricably linked roles so necessary to build strengths-based school–family–community partnerships. We examined the effects of one such partnership on 20 elementary school students, using photo elicitation and interviews to explore students’ satisfactions and experiences about the Just Love partnership. Thematic analysis of the data revealed six categories: (a) perceptions of Just Love, (b) positive feelings, (c) positive relationships and connectedness, (d) classroom and school climate, (e) experiences, and (f) support and resources. Each category comprised themes aligned with protective factors and developmental assets that help students thrive.
Core Values in Education From the Perspective of Future Educators
Authors: Toker Gökçe Asiye
Published: May 2021

This study examines the underpinning core values which educators ought to have, and students must acquire at schools adequately according to preservice teachers’ perception. The research was designed according to the quantitative model, and three open-ended questions questionnaire was used for data collection. The research group involved 263 preservice teachers. The data were analyzed using descriptive statistics. Findings, first, revealed 17 values that teachers ought to have, 21 values that school principals ought to have, and 20 values that students ought to acquire. The revealed values were also categorized as follows: moral values, professional values, and cultural values. Examining the ideas of preservice teachers has importance because they carry the existing values and in return affect the value formation of the society in the future.
A Clinical Evaluation of Scapular Dyskinesis Among Professional Bus Drivers With Unilateral Upper Quadrant Musculoskeletal Pain
Authors: Sattasuk Wipawee , Sitilertpisan Patraporn , Joseph Leonard , Paungmali Aatit , Pirunsan Ubon
Published: May 2021

Background:

Professional bus drivers report a high prevalence of upper quadrant musculoskeletal pain which could be associated with scapular dyskinesis (SD). However, the evidence for valid and reliable screening methods for this condition is limited as SD among bus drivers is an emerging area of research. Therefore, the main aim of the study was to investigate the reliability of dynamic scapular motion test (DSMT) using video analysis as an accurate method to evaluate SD and to identify patterns of SD among bus drivers.

Methods:

In total, 32 bus drivers from a private bus company with unilateral upper quadrant musculoskeletal pain participated in the study. The DSMT was conducted and the SD was captured in the video during shoulder flexion–abduction movements. Two investigators analyzed the video recordings and identified the patterns of SD. The intra- and interrater reliability were determined using the percentage of agreement and weighted Kappa coefficients (Kw). Descriptive analysis was used to examine the patterns of SD.

Findings:

The intra- and interrater reliability of DSMT using video analysis were excellent (Kw coefficient: 0.762–0.878 and 0.87–1.00, respectively). About 56.2% and 53.1% of bus drivers presented SD with the shoulder flexion and abduction movements during DSMT. Medial border prominence (Type II pattern of SD) was identified as the common pattern of SD.

Conclusion/Application to practice:

The DSMT using video analysis showed excellent intra- and interrater reliability to evaluate SD. Occupational health practitioners can consider DSMT using video analysis to identify SD among people with upper quadrant musculoskeletal pain at the workplace.
A Normative Approach to Understanding How “Boomerang Kids” Communicatively Negotiate Moving Back Home
Authors: Abetz Jenna S. , Romo Lynsey K.
Published: May 2021

The present study adopts a normative approach to examine the context-specific dilemmas and strategies experienced by individuals returning to their parental home after living independently. Through 31 in-depth interviews with individuals ranging in age from 22 to 31, we identified that the central communicative dilemma participants experienced was articulating the decision to move back home as an investment in the future rather than a source of stigma. Participants indicated various strategies to destigmatize the decision to move home and make the experience a positive step toward their futures and in their relationships with their families: communicate clear expectations, contribute to the household, embody adult behavior, and articulate clear timelines. The findings shed light on the complexities of creating an adult identity at a transitional time and supplement understanding of the moving—back—home experience by illustrating how adulthood embodies specific meanings in this context.
Neurocognitive Heterogeneity in Social Anxiety Disorder: The Role of Self-Referential Processing and Childhood Maltreatment
Authors: Talmon Anat , Dixon Matthew Luke , Goldin Philippe R. , Heimberg Richard G. , Gross James J.
Published: May 2021

Social anxiety disorder (SAD) is characterized by negative self-beliefs and altered brain activation in the default-mode network (DMN). However, the extent to which there is neurocognitive heterogeneity in SAD remains unclear. We had two independent samples of patients perform a self-referential encoding task and complete self-reports of childhood maltreatment, subjective well-being, and emotion regulation. In the replication sample, we also measured DMN activation using functional MRI. We used k-means clustering, which revealed two distinct subgroups of patients with SAD in the discovery sample. Cluster 1 demonstrated higher levels of negative self-referential trait endorsement, lower levels of positive self-referential trait endorsement, and significantly higher levels of childhood emotional maltreatment, lower subjective well-being, and altered emotion-regulation-strategy use. A similar pattern was observed in the replication sample, which further demonstrated higher DMN activation during negative trait judgments in Cluster 1. Participants in the SAD clusters, from both the discovery and replication samples, were significantly distinct from samples of control participants. These findings reveal neurocognitive heterogeneity in SAD and its relationship to emotional maltreatment.
Dynamic Attention Regulation for Prospective Goals in Schizophrenia
Authors: Chen Tao , Liu Lu-lu , Cui Ji-fang , Qin Xiao-jing , Gan Ming-yuan , Tan Shu-ping , Wang Ya , Irish Muireann
Published: May 2021

Whether patients with schizophrenia are impaired in flexibly regulating attention in accordance with fluctuations in cognitive demand to achieve optimal task performance remains unclear. To address this issue, 47 patients with schizophrenia and 47 matched control participants were recruited to complete a time-based prospective memory task. Every 2-min block before the target time was divided into four 30-s intervals, after which the time check and intraindividual response time variability (IIRTV) across these intervals were calculated. Patients with schizophrenia displayed significantly higher IIRTV across all four time intervals and checked time less frequently during the last 30-s interval relative to control subjects. Moreover, the reduced change in time-checking frequency and IIRTV between the first and the last 30-s intervals was related to poorer time-based prospective memory performance in patients with schizophrenia. Our findings provide initial evidence that an inefficient capacity to dynamically allocate attentional resources during an ongoing task hinders dual-task performance in schizophrenia.
Mindfulness-Based Trauma Recovery for Refugees (MBTR-R): Randomized Waitlist-Control Evidence of Efficacy and Safety
Authors: Aizik-Reebs Anna , Yuval Kim , Hadash Yuval , Gebreyohans Gebremariam Solomon , Bernstein Amit
Published: May 2021

Refugees and asylum seekers often suffer from trauma- and stress-related mental health problems. We thus developed mindfulness-based trauma recovery for refugees (MBTR-R)—a 9-week, mindfulness-based, trauma-sensitive, and socioculturally adapted group intervention for refugees and asylum seekers. We conducted a randomized waitlist-control study to test its efficacy and safety among a community sample of 158 Eritrean asylum seekers (46.2% female) with severe trauma history and chronic postmigration stress. Relative to the waitlist-control group, MBTR-R participants demonstrated significantly reduced rates and symptom severity of posttraumatic stress disorder, depression, anxiety, and multimorbidity at postintervention and 5-week follow-up. Therapeutic effects were not dependent on key demographics, trauma history severity, or postmigration living difficulties. Finally, there was no evidence of adverse effects or lasting clinically significant deterioration in monitored outcomes. The brief intervention format, group-based delivery, and limited attrition indicate that MBTR-R may be a feasible, acceptable, readily implemented, and scalable mental health intervention for refugees and asylum seekers.
Substance Use and Sexual-Minority Status: Examining the Mediating Roles of Stress and Emotion Dysregulation in Young Adult Women
Authors: McCabe Connor J. , Hipwell Alison E. , Keenan Kate , Stepp Stephanie D. , Chung Tammy , King Kevin M.
Published: May 2021

Sexual-minority women (SMW) report higher rates of substance use and disorder across the life span and greater levels of minority stress in adolescence and young adulthood. Minority stress mediation models propose that higher levels of social stressors may increase emotion dysregulation, which in turn increases the propensity toward substance misuse. Few studies, however, have prospectively examined the impact of stressors and emotion dysregulation among SMW on early and escalating substance use. In this longitudinal study, we examined whether emotion dysregulation and social stress mediated the association between sexual-minority status and developing substance use (ages 17–22) in a sample of 2,201 heterosexual and 246 SMW participants in the Pittsburgh Girls Study. Results supported serial mediation processes of marijuana-use risk: SMW reported higher levels of social stress in late adolescence, which in turn predicted greater emotion dysregulation that was associated with greater marijuana use by young adulthood.
K-Line Tilt is a Predictor of Postoperative Kyphotic Deformity After Laminoplasty for Cervical Myelopathy Caused by Ossification of the Posterior Longitudinal Ligament
Authors: Sakai Kenichiro , Yoshii Toshitaka , Arai Yoshiyasu , Hirai Takashi , Torigoe Ichiro , Inose Hiroyuki , Tomori Masaki , Sakaki Kyohei , Yuasa Masato , Yamada Tsuyoshi , Matsukura Yu , Oyaizu Takuya , Morishita Shingo , Okawa Atsushi
Published: May 2021

Study Design:

Retrospective single-center study.

Objectives:

K-line is a decision-making tool to determine the appropriate surgical procedures for patients with cervical ossification of the posterior longitudinal ligament (C-OPLL). Laminoplasty (LAMP) is one of the standard surgical procedures indicated on the basis of K-line measurements (+: OPLL does not cross the K-line). We investigated the impact of K-line tilt, a radiographic parameter of cervical sagittal balance measured using the K-line, on surgical outcomes after LAMP.

Methods:

The study included 62 consecutive patients with K-line (+) C-OPLL who underwent LAMP. The following preoperative and postoperative radiographic measurements were evaluated: (1) the K-line, (2) K-line tilt (an angle between the K-line and vertical line), (3) center of gravity of the head –C7 sagittal vertical axis, (4) C2–C7 lordotic angle, (5) C7 slope, and (6) C2–C7 range of motion. Clinical results were evaluated using the Japanese Orthopedic Association scoring system for cervical myelopathy (C-JOA score).

Results:

All the patients had non-kyphotic cervical alignment (CL ≥ 0°) preoperatively; however, kyphotic deformity (CL < 0°) was observed in 6 patients (9.7%) postoperatively. The recovery rate of the C-JOA scores was poor in the kyphotic deformity (+) group (7.8%) than in the kyphotic deformity (−) group (47.5%). The K-line tilt was identified to be a preoperative risk factor in the multivariate analysis, and the cutoff K-line tilt for predicting the postoperative kyphotic deformity was 20°.

Conclusions:

LAMP is not suitable for K-line (+) C-OPLL patients with K-line tilts >20°.
The Correlation Between Negative Nerve Root Sedimentation Sign and Gravity: A Study of Upright Lumbar Multi-Positional Magnetic Resonance Images
Authors: Zhang Qiwen , Mesregah Mohamed Kamal , Patel Kishan , Buser Zorica , Wang Jeffrey C.
Published: May 2021

Study Design:

Retrospective upright MRI study.

Objective:

To validate the presence of positive and negative nerve root sedimentation signs on multi-positional MRI in the upright position and explore the relationship between negative nerve root sedimentation and gravity.

Methods:

T2-weighted axial multi-positional images in the upright position at the intervertebral disc levels from L1–L2 to L4–L5 in 141 patients with non-specific low back pain were retrospectively assessed. A positive sedimentation sign was defined as the absence of nerve root sedimentation or the absence of dorsal conglomeration of nerve roots within the dural sac. A negative sedimentation sign was defined as nerve root sedimentation dorsally or dorso-laterally like a horseshoe. Intra-and inter-observer reliability was evaluated. The relationship between sedimentation sign and dural sac cross-sectional area (CSA), anterior-posterior (AP) diameter was also explored.

Results:

The kappa value of intra-observer reliability was 0.962 and inter-observer reliability was 0.925. Both positive and negative sedimentation signs did appear at all 4 lumbar levels, including L1/2, L2/3, L3/4 and L4/5. A positive sedimentation sign was associated with significantly decreased dural sac CSA and AP diameter at L2/3, L3/4 or L4/5 level when compared to negative sedimentation sign.

Conclusions:

Both negative and positive sedimentation signs appeared at the L1/2, L2/3, L3/4, and L4/5 levels on the upright MRI, which suggested that the presence of nerve roots sedimenting dorsally in patients may not be associated with gravity. Moreover, the current study supports that sedimentation signs on multi-positional MRI images could have the same diagnostic functions as on MRI images.
Optimization of Capital Distribution and Composition of a Shipping Company Fleet Through Evolutionary Algorithms
Authors: Thrassou Alkis , Vrontis Demetris , Georgopoulos Georgios , Lois Petros , Repousis Spyros
Published: May 2021

The research examines the optimization of fleet management of a shipping company through control algorithms, as finding an algorithm that will reduce a marine company’s exposure to risk by diversifying its fleet composition is one way to make it dominant. The study focused on three companies that, in 2014, invested US$$1 billion in a fleet of tankers, using three different techniques to optimize their fleet composition: equal number of ships of all types, the established risk minimization model and the proposed Risky Asset Pricing maximization model. Seven years of data was used for the synthesis and 4 years of data was used for the evaluation. The research findings show that classic portfolio management through risk minimization is ineffective, as it appears to reduce performance below what is a random or evenly distributed fleet. Comparing the three methods, the superiority of the Risky Asset Pricing model is clear. This algorithm looks for solutions where the demand for ships is low but has enormous fluctuation potential and seeks to identify ships that are at high risk with great potential for price increases to maximize investor returns. The value of the research lies in the identification of methods to optimize capital distribution and composition of a shipping company fleet, which presents valuable insights for the benefit of scholars and maritime companies. Moreover, and contrary to extant works that focus on Markowitz’s theory, this article instead describes how evolutionary algorithms can be used to optimize fleet management.
The Impact of HR Practices on Perceived Gender Sensitivity and Gender Bias: A Multilevel Analysis of Hotel Industry
Authors: Khan Farha Naz , Sehrawat Neeraj , Singh Sumanjeet
Published: May 2021

Gender sensitivity aids as a probable solution for facilitating female talent in an organization. This study measures gender sensitivity by applying multilevel modeling in hotel industry with a twofold objective: to identify explanatory predictors at the organizational level as well as to check whether insensitivity is the result of inherent bias in the industry at the individual level. Primary data were obtained from 355 employees and 10 HR (human resource) managers of both five and four-star hotels of Udaipur, India. Since 19.132% of the variation in gender sensitivity lies among the hotels and variation at the individual level is 8.731%, the data is analyzed through hierarchical linear modeling. Perceived gender bias (PGB) and human resource policies and practices (HRP) were found to be both significant and enough to explain variation in gender sensitivity among hotels. Also, an inverse and significant relationship between perceived gender bias (PGB) and perceived gender sensitivity (PGS) and a positive and significant relationship between PGS and HRP were identified.
Preoperative Angiography for Free Fibula Flap Harvest: A Case Series
Authors: Alolabi Noor , Augustine Haley , Farrokhyar Forough , Levis Carolyn
Published: May 2021

Purpose:

To assess if preoperative angiography of the lower extremity is necessary to detect abnormalities that alter operative planning of a free fibula flap (FFF). The secondary objective is to determine whether abnormalities are identified on physical examination.

Methods:

A retrospective case series of patients receiving preoperative lower extremity angiography for FFF was performed. Between November 2004 and July 2016, patients assessed for FFF reconstruction by a single surgeon were reviewed. Outcomes analyzed were preoperative physical examination, angiography findings, changes in operative plan, and perioperative complications including flap failure and limb ischemia. Level of agreement between physical examination and angiography findings was analyzed.

Results:

A total of 132 consecutive patients were assessed for FFF, of which 70 met the inclusion criteria. Mean age was 60.9 (range: 22-88) years old. All patients underwent aortic angiogram runoff, except for 2 who received computed tomography angiography. The surgical plan was altered based on angiography findings in 9 (12.9%) patients, and 7 (77.8%) of these cases had a normal physical examination. A further 6 (8.6%) patients had physical examination findings precluding the use of FFF, whereas imaging demonstrated the contrary. Physical examination demonstrated low predictability of aberrant vascular anatomy, with a sensitivity of 22.2%. There were no limb ischemia complications.

Conclusions:

Routine preoperative angiography of the lower extremity for all patients being evaluated for FFF is important to ensure safety and success of the procedure. Physical examination alone is insufficient to detect vascular abnormalities that may result in limb or flap compromise.
Isolation, Characterization, and Differentiation of Stem Cells From Various Dental Sources: An In Vitro Study
Authors: Katti Sandeep S. , Bhat Kishore , Bogar Chetana
Published: May 2021

Aim:

The aim of the current study was to isolate stem cells from various dental sources such as dental pulp, periodontal ligament (PDL), and apical papilla, and to characterize stem cells by staining for the presence/absence of specific surface markers and also to differentiate stem cells into osteogenic, chondrogenic, and adipogenic cell lineages by exposing them to specific growth factors under the ideal conditions.

Materials and Methods:

A total of 117 samples were included in the study, consisting of 30 pulp, 50 gingival, 35 PDL, and 2 apical papilla samples. The pulp was extirpated and transported to the Central Research Laboratory. Gingival connective tissue was collected from the participants undergoing any crown lengthening procedure or any gingivectomy procedure from the Department of Periodontology. A similar procedure was also followed for apical papilla and PDL. Isolation was done followed by the identification of the cells by immunocytochemistry using different markers. Once the identity of cells was confirmed, these cells were treated with different culture media to attain 70% to 100% confluency. Then the medium was replaced with a conditioning medium containing specific growth factors for differentiation into osteogenic, chondrogenic, and adipogenic cell lineages.

Result:

In our study, the number of samples collected and processed was 117. The isolation rate of stem cells from the above-collected samples was 70%. Statistical analysis—no statistical analysis was done as there was no variability expected.

Conclusion:

Our study showed that stem cells could be isolated, differentiated, and characterized from different dental sources.
Impact of Improved Agricultural Technology Use on Household Income in Eastern Ethiopia: Empirical Evidence from a Propensity Score Matching Estimation
Authors: Wordofa Muluken G. , Hassen Jemal Y. , Endris Getachew S. , Aweke Chanyalew S. , Moges Dereje K. , Rorisa Debbebe T.
Published: May 2021

This article investigates the impact of improved agricultural technology use on farm household income in eastern Ethiopia. Primary data for the study were obtained from a random sample of 248 rural households, 119 of which are improved technology users and the rest are non-users. The research employed the propensity score matching procedure to establish the causal relationship between adoption of improved crop and livestock technologies and changes in farm income. Results from the econometric analysis show that households using improved agricultural technologies had, on average, 23,031.28 Birr 1 higher annual farm income compared to those households not using such technologies. Our findings highlight the importance of promoting multiple and complementary agricultural technologies among rural smallholders. Therefore, we suggest that rural technology generation, dissemination and adoption interventions be strengthened. Moreover, the linkage among research, extension, universities and farmers needs to be enhanced through facilitating multistakeholder innovation platforms.