bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Output Stoma Leading to the Diagnosis of Antiphospholipid Syndrome
Authors: Ishikawa Sho , Mukai Shoichiro , Sawada Hiroyuki , Saito Yasufumi , Fujimori Masahiko , Hirata Yuzo , Fukuda Toshikatsu , Sakimoto Hideto , Nakatsuka Hirofumi , Ohdan Hideki
Published: June 2022

Diverting stoma (DS) is widely created in colorectal surgery. High-output stoma (HOS) is a major complication of DS, which can lead to dehydration and thrombosis. Additionally, antiphospholipid syndrome (APS) is a risk factor for thrombosis, and it rarely occurs in men. Herein, we describe a case of multiple thromboses caused by chronic dehydration after HOS. A 48-year-old man visited our hospital with fever and lower abdominal pain; he was diagnosed with sigmoid diverticulitis. He underwent laparoscopic high anterior resection for relapsing diverticulitis and diverting ileostomy during the same operation. On postoperative day 1, an output of 3,000 mL/day was observed from the ileostomy. The stoma output exceeded 2,000 mL/day, which was diagnosed as HOS, and chronic dehydration persisted despite supplementation and restriction of oral water intake. Three months postoperatively, a computed tomography scan before ileostomy closure showed multiple thrombi in the inferior vena cava, right common iliac vein, and pulmonary artery. After antithrombotic therapy, ileostomy closure was performed. As lupus anticoagulant was positive twice and APS was diagnosed, antithrombotic therapy was changed from warfarin to direct oral anticoagulants. Thrombosis did not recur 6 months postoperatively. This is the first report of a case wherein APS was present in the background of thrombosis caused by HOS or chronic dehydration. It is important to be cautious about APS when there is thrombosis after HOS to select appropriate therapeutic agents.
Zoonoses as Important Causes of Hospital Admissions: A 15-Year Study in Portugal
Authors: Canhão-Dias Miguel , Pires Tomás Matos , Henriques Rita , Lopes David G , Madeira de Carvalho Luís Manuel
Published: June 2022

Introduction: Zoonoses represent 75% of emerging diseases. These diseases pose a permanent threat to human health and well-being and have the potential to become increasingly frequent due to habitat degradation; land-use changes; and increased global mobility of humans, animals, and animal products. The objective of this study was to investigate the impact ten zoonoses (brucellosis, cysticercosis, echinococcosis, leishmaniasis, leptospirosis, Lyme disease, rabies, toxoplasmosis, trichinellosis, and West Nile fever) had on human hospitalizations between 2002 and 2016 in Portuguese National Health Service hospitals. Material and Methods: A retrospective nationwide study was conducted using hospitalization records gathered by Administração Central do Sistema de Saúde from all Portuguese public hospitals. Results: Between 2002 and 2016, zoonoses caused 181,741 hospitalizations, a total number of hospitalization days of 2,033,125, and 10,611 deaths. The ten studied zoonoses caused 5,183 hospitalizations, 71,548 hospitalization days, and 176 deaths. All, except Lyme disease, showed a trend of decreasing numbers of hospitalizations. Discussion and Conclusion: The impact of each zoonosis in hospitalized patients regarding their age, sex, the severity of disease, and region can be attributed to the specific characteristics of each disease, regarding means of infection, pathogenicity, and geographic distribution. Hospitalizations caused by zoonoses have declined since the beginning of the century in Portugal. They still represent, however, relevant impacts on Public Health. The promotion of trans professional cooperation guided by One Health principles will further aid in the control of these important diseases.
Genetic Relationships between Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, and Intelligence
Authors: Rao Shuquan , Baranova Ancha , Yao Yao , Wang Jun , Zhang Fuquan
Published: June 2022

Introduction: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) commonly co-occur; both traits exert an influence on intelligence scores. Genetic relationships between these three traits are far from being clear. Methods: The summary results of genome-wide association studies of ADHD (20,183 cases and 35,191 controls), ASD (18,381 cases and 27,969 controls), and intelligence (269,867 participants) were used for the analyses. Local genetic correlation analysis and polygenic overlap analysis were used to explore the shared genetic components between ADHD, ASD, and intelligence. Mendelian randomization (MR) analysis was used to examine the causal associations between ADHD, ASD, and intelligence. A cross-trait meta-analysis was performed to identify pleiotropic genetic variants across the three traits. Results: Our results showed that intelligence has a positive and negative genetic correlation with ASD and ADHD, respectively, including three hub genomic regions showing correlated genetic effects across the three traits. Polygenic overlap analysis indicated that all the risk variants contributing to ADHD are overlapped with half of those for intelligence, and the majority of the shared variants have opposite effect directions between them. The majority of risk variants (80%) of ASD are overlapped with almost all the risk variants of intelligence (97%). Notably, some ASD/intelligence overlapping variants displayed opposing effects on these two conditions. MR analysis showed that the genetic liability to higher intelligence was associated with an increased risk for ASD (OR = 1.12) and a decreased risk for ADHD (OR = 0.78). Cross-trait meta-analyses identified 170 pleiotropic genomic loci across the three traits, including 12 novel loci. Functional analyses of the novel genes support their potential involvement in neurodevelopment. Conclusion: Our results suggest that ADHD is associated with inheriting a reduced set of low-intelligence alleles, whereas ASD results from incongruous effects from a mixture of high-intelligence and low-intelligence contributing alleles summed up with additional, ASD-specific risk variants not associated with intelligence.
Impact of Sites of Metastatic Dissemination on Survival in Advanced Gastroesophageal Adenocarcinoma
Authors: Wang Xin , Espin-Garcia Osvaldo , Jiang Di Maria , Allen Michael J. , Ma Lucy X. , Bach Yvonne , Chen Eric X. , Darling Gail , Yeung Johnathan C. , Wong Rebecca K.S. , Veit-Haibach Patrick , Kalimuthu Sangeetha , Jang Raymond W. , Elimova Elena
Published: June 2022

Introduction: Metastatic gastroesophageal adenocarcinoma (GEA) is a heterogeneous disease with an overall poor prognosis. The impact of sites of metastatic dissemination on survival is not well characterized. This study aimed to evaluate whether certain sites of metastatic disease impacts survival. Methods: A retrospective analysis of 375 patients with metastatic GEA treated at the Princess Margaret Cancer Centre from 2006 to 2016 was performed. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method. Cox proportional hazards regression models were used to assess the association between sites of metastases and OS adjusting for baseline patient characteristics. Results: Median duration of follow-up was 47.8 months. Median OS in this cohort was 11.8 months (95% CI: 10.2–12.9 months). Patients with lymph node only disease, compared to those with other sites of metastases, had the longest median OS (20.4 vs. 10.6 months; p < 0.001) and PFS (11.4 vs. 6.3 months; p < 0.001). On multivariable analysis adjusting for relevant clinical factors including age, sex, and Eastern Cooperative Oncology Group performance status, the presence of lung (HR 1.67, 95% CI: 1.23–2.26; p < 0.001) or bone metastases (HR 1.84, 95% CI: 1.31–2.59; p < 0.001) were independently associated with shorter OS. The majority of patients (68%) were treated with palliative intent first-line platinum-based chemotherapy. Discussion/Conclusion: Patients with metastatic GEA have an overall poor prognosis. The presence of lung or bone metastases is an independent risk factor for decreased survival. Prognostic models incorporating sites of metastasis should be considered in the clinical evaluation of metastatic GEA.
Une tradition coranique égyptienne ? Le codex de ʿUqba b. ʿĀmir al-Ǧuhanī
Authors: Tillier Mathieu
Published: June 2022

La découverte de nombreux fragments coraniques anciens à Fusṭāṭ semble aller à l’encontre du discours véhiculé par les sources littéraires, qui n’accordent à l’Égypte qu’un rôle mineur dans l’histoire de la constitution du Coran. Le présent article tente de résoudre ce paradoxe en retraçant l’histoire de l’introduction du Coran en Égypte dans la seconde moitié du Ier/VIIe siècle. Il met en évidence l’existence d’un codex pré-canonique attribué au gouverneur ʿUqba b. ʿĀmir al-Ǧuhanī (m. 58/677-8), un Compagnon considéré comme une des principales autorités dont se réclamaient les savants égyptiens de l’époque omeyyade. Le codex de ʿUqba, qui n’était vraisemblablement qu’un exemplaire à usage privé, sombra dans l’oubli après que le gouverneur ʿAbd al-ʿAzīz b. Marwān eut fait réaliser une copie officielle du Coran conforme au canon ʿuṯmānien.
Unity and Duality
Authors: Hussung J. Benjamin
Published: June 2022

In Gregory of Nazianzus’s Oration 30, seven of his ten points against Eunomian misreadings of Scripture about the Son deal directly with quotations of Jesus from the Gospels. This study shines new light on Gregory’s exegetical method, arguing that in Oration 30, grammatical, contextual, and partitive exegesis marks Gregory’s interpretation of the Gospels, which serve as foundational texts for understanding the Son’s relationship to the Father. First, I briefly provide support for the Gospels as foundational texts for understanding the Son’s relationship to the Father. Second, I summarize Gregory’s exegesis of each of these seven texts in detail. Third, I analyze Gregory’s exegetical method based on his grammatical, contextual, and partitive exegesis. Perhaps most importantly for Gregory, one must always have before him both the divinity and humanity of the Son. Anything less than this exegetical method leads to misreading the Gospels and misunderstanding the Son himself.
Persecution or Prejudice?
Authors: Waddell S. Blair
Published: June 2022

In 1811, Lord Sidmouth introduced a bill before the House of Lords which would require new qualifications in the registration of dissenting preachers. While a staunch churchman and typically unsympathetic to dissent overall, Sidmouth saw his bill as being helpful to nonconformists. The purpose of his action was to remove uneducated and unqualified itinerants who had free reign to preach across the countryside. But nonconformists perceived his act as a new avenue of persecution. They saw this measure as a threat to their religious liberties. Dissenters from all ranks rallied together to protest the bill. Such a unified voice was unprecedented among nonconformists and they discovered the might of their political power as the measure was defeated. This article seeks to understand the motivations of Sidmouth’s intentions, whether of persecution or of prejudice.
Neotype designation, redescription, biology and distribution of Acanthopsyche alstoni Watt & Mann, 1903 (Lepidoptera: Psychidae) from India
Authors: USHA A. U. , SOBCZYK T. , ROBY T. J. , JOSE JOYCE
Published: June 2022

Acanthopsyche alstoni Watt & Mann, is a lesser known psychid previously known only from the description of its larval cases collected from Assam, India in 1903. There were no descriptions of the adult moth or biology of the species. During surveys for Psychidae in the human inhabited regions of Kerala State, India, more than 100 larval cases were recovered. They were allowed to hatch and characteristics were recorded. This paper provides a detailed redescription of this species and designation of a neotype.
And then there were none: Regional dynamics of non-religious identities, beliefs and practices among Canadian millennials
Authors: Wilkins-Laflamme Sarah
Published: June 2022

Religious nones – or, in other words, those who say that they have no religion when asked – are one of the fastest growing demographics in Canada, especially among young adults aged 18–35. Using statistical data from a 2019 Millennial Trends Survey, a diversity of approaches to religion, spirituality and non-religion can be seen within this broad category of individuals. Based on these findings, the author argues that the two main theoretical frameworks of ‘secular transition’ and ‘spiritual but not religious’ should be understood as complementary, rather than contradictory, in understanding the religious none phenomenon. Evidence of five distinct regional patterns of religious nones across the country is found, which are designated as ‘spiritual British Columbia’, ‘dispersed Prairies’, ‘vestigial and uncertain Ontario’, ‘non-believing Quebec’ and ‘stigmatized Atlantic Canada’ nones.
Health On You programme: Development and implementation of web-based health education intervention for university students
Authors: Alves Regina F
Published: June 2022

Objective:

Engaging in healthy behaviour while studying at university is a defining factor in terms of its impact on a person’s later health in life. Therefore, university students are a priority when it comes to health education interventions. This article describes the development and implementation of a web-based health programme intervention to enable students to acquire knowledge and strategies to allow them to make decisions that favour their health by adopting healthy and positive behaviours.

Design:

The design of the Health On You programme was based on the PRECEDE-PROCEED model and used an online platform designed to facilitate self-learning using interactive teaching strategies. The programme included six modules focusing on the following topics – Drinking responsibly; Living free of smoke; Saying no to illicit drugs and to self-medication; Balanced, Healthy and Sustainable Diet; Moving Yourself; and Preventing Sexually Transmitted Infections.

Setting:

Data collection took place in a public university in northern Portugal.

Method:

In 2021, a cross-sectional study was carried out with a convenience sample of 37 students attending a Portuguese university to assess the implementation process.

Results:

Overall assessment of the programme was fairly positive – 5.00 (with 5 being the highest mark), as well as for each of its developed modules (mean scores, 4.66–5.00).

Conclusion:

The Health On You programme appeared to be an innovative web-based health intervention due to the broad-based approach it adopted, both in terms of the topics tackled and the variety of teaching and learning strategies used to address each of the modules.
Ghana Prison Officers’ Understanding and Practices of International Human Rights Instruments and Guidelines that Protect the Rights of Prisoners
Authors: Golo Harrison Kwame
Published: June 2022

Research on prison officers’ understanding and compliance with the international human rights instruments for the protection of prisoners’ rights and guidelines for justice administration remains scanty. Drawing on data from scenario-based interviews of 24 selected prison officers in the four largest prison facilities in Ghana, this article seeks to explore how Ghana prison officers understand and practice these instruments and guidelines that protect the rights of prisoners. Applying content analysis, the findings reveals that the overwhelming majority of officer participants in this study did not have adequate intellectual and practical understanding of these relevant instruments and guidelines.
Arbitration Under Government Contracts and Government Accountability
Authors: Henckels Caroline
Published: June 2022

Much of the core work of government is now done pursuant to contract with private sector bodies, primarily for efficiency reasons. While the phenomenon of contracting out of governmental functions has attracted increasing scholarly attention in terms of public law accountability, the use of commercial arbitration for the resolution of contractual disputes involving governments has until recently attracted scant attention. The law regulating commercial arbitration does not distinguish between arbitrations between private actors and arbitrations involving governments, treating all commercial disputes as wholly private in nature. By controlling government action, arbitrators contribute to governance but without the hallmarks of the judicial process such as impartiality, transparency, the possibility for third-party participation and judicial oversight. As such, the law does not take into account the public dimension of disputes under government contracts or the role of arbitrators as adjudicators of public law disputes. Nor do there appear to be any constitutional constraints on the use of arbitration in government contracts.
The Hong Kong National Security Law and the Struggle over Rule of Law and Democracy in Hong Kong
Authors: Chopra Surabhi , Pils Eva
Published: June 2022

In this article, we examine the controversial national security law enacted by the People’s Republic of China for the Hong Kong Special Administrative Region in June 2020 and consider how this law interacts with two constitutional struggles that Hong Kong has experienced since its return to Chinese sovereignty in 1997. The first of these is a struggle over preserving rule of law principles protected in Hong Kong’s regional constitution, the Hong Kong Basic Law and international treaty obligations. The second is a struggle for democratisation, pursuant to constitutional commitments in the Basic Law. We argue that the national security law severely damages Hong Kong’s much-vaunted rule of law, as well as its ability to govern itself as a (relatively) liberal-democratic enclave within China. It muffles contestation over rule of law and democratic principles through facilitating rule by fear as a key modality of governance. The national security law expands the state’s coercive powers, and has the capacity to intimidate well beyond the letter of its provisions by creating rules and mechanisms to suspend legal protections altogether. Its provisions serve to reinscribe political discourse that has long been mainstream in Hong Kong as deviant. But at least as much as the NSL’s actual provisions, it is the loss of judicial scrutiny and the possibility of being transitioned into the Mainland legal system that operationalise rule by fear.
Maternal passives addressed to Japanese-speaking children: A usage-based approach
Authors: Mitsugi Sanako , Fukuda Haruka
Published: June 2022

This study examined Japanese-speaking mothers’ passives in the child-directed speech from the CHILDES database. We selected five parent–child corpora and analyzed the overall distribution of the mothers’ passives and further investigated the contribution of the construction and the passivized verbs to sentence meaning. The findings were as follows: (1) There are only a few verbs that accounted for much of the mothers’ passives; (2) mothers’ passives can be categorized into broad classes based on the verb–patient relation; and (3) most of the passives, both direct and indirect, were used to denote adversative meaning and these negative passives collocated with the verbal auxiliary - shimau. We suggest that analyses of child-directed speech should take into account lexical repetition and the semantic redundancy of language as part of a process designed to support language development. Furthermore, highly frequent exemplar passives and their discrete reference in the events and contexts may be facilitative for children’s learning of Japanese passives. The results are evaluated in light of the usage-based proposal of learning.
Ambulatory outpatient venous surgery service: An examination of patient satisfaction and experiences
Authors: Hannon Bernadette , Prizeman Geraldine , Madhavan Prakash , O’Neill Sean , Martin Zenia , O’Callaghan Adrian , Colgan Mary-Paula , Canning Caitriona , O’Donnell Sharon
Published: June 2022

Background

This study aimed to ascertain patients’ experience of the out-patient venous service being provided,; identify the level of patient satisfaction with the service and identify areas for further improvement and development.

Method

A prospective descriptive quantitative study. A questionnaire was distributed to all patients who used the service between June 2017 and March 2018. A total of 195 questionnaires was distributed with 162 valid questionnaires returned; response rate of 83%.

Results

This study found high satisfaction levels with endovenous ablation procedures, with concomitant phlebectomy, in the ambulatory outpatient setting and patient experiences of the service are overwhelmingly positive.

Conclusion

Study findings support the management of ambulatory outpatient varicose vein endovenous ablation procedures as a feasible alternative to day surgery theatre settings and is the blueprint for future management of varicose vein surgery in Ireland.
Moralising racial regimes: surveillance and control after Singapore’s ‘Little India riots’
Authors: Greener Joe
Published: June 2022

This article examines the moral politics of state organised social control in bolstering racialisation in Singapore after the 2013 disturbances in ‘Little India’, when agencies mobilised morally charged discourses regarding alcohol consumption amongst low-income South Asian migrants. Appealing to moral constructions of the ‘riots’ discredited socio-political analyses of the events, after which the state developed a mass architecture of alcohol-related ‘governing through crime’, placing migrant lives under permanent and constant surveillance. The piece contributes to debates about moral economy approaches by connecting the strategic deployment and justification of crime control underpinning racial regimes and reveals inadequacies in critical thinking around ‘race’ in Singapore, most notably a preoccupation with interactional accounts of racism rather than institutional state power.
Racism, radicalisation and Europe’s ‘Thin Blue Line’
Authors: Fekete Liz
Published: June 2022

Following analyses in the US of the reaction to Black Lives Matter in the Blue Lives Matter movement and the recasting of the police as victims, the author explores similar tendencies in Europe, in the context of changes in territorial policing, new technology and enhanced police powers under neoliberalism. She examines how racism has become entrenched in policing as the rank and file are resituating themselves as society’s victims and organising on an ever more extremist agenda. Police excesses are explained away and impunity extended to officers. At the same time, police are assuming the right to a special role and status in society that is not allowed to other agencies or public servants. In some instances, this has spilled over into collusion and collaboration with militarised far-right groups. The penetration of the far Right into policing is compounded by the dehumanisation within policing culture which stigmatises the ‘undeserving poor’ and emphasises threats to social order and governance as arising from marginalised black and ethnic minority communities.
Frontline managers’ task-related emotion regulation, emotional intelligence, and daily stress
Authors: Troth Ashlea C , Townsend Keith , Loudoun Rebecca , Burgess Matt
Published: June 2022

Research has focused on employee emotion regulation as a stable dispositional tendency. Yet effective and healthy emotion regulation requires flexibly choosing between different regulation strategies in response to various workplace situational demands. In this study, we investigate the between- and within-person emotion regulation differences of 83 frontline managers across 10 working days. Using affective events theory, we examine managers’ use of three main emotion regulation strategies (cognitive reappraisal, suppression, expression) in response to the negative affect they experience while engaging in various tasks, and the consequences for their daily stress. The moderating effects of four emotional intelligence abilities are also examined. Our results demonstrate negative emotions associated with work tasks are regulated in ways that are determined by stable, situational, and personal factors. Practical implications for organizations are considered.

JEL Classification: JEL code - D23
Quantifying the Relationship Between the Medial Quadriceps Tendon–Femoral Ligament and Patellar Borders: A Pediatric Cadaveric Study
Authors: Baskar Danika , Stavinoha Tyler J. , Sanchez Mark , Gupta Anshal , Randhawa Sahej D. , Rohde Matthew S. , Vuong Brian , Tompkins Marc A. , Ganley Theodore J. , Ellis Henry B. , Wilson Philip L. , Fabricant Peter D. , VandenBerg Curtis , Green Daniel W. , Segovia Nicole A. , Shea Kevin G.
Published: June 2022

Background:

The medial patellofemoral complex (MPFC) is a structure composed of the medial quadriceps tendon–femoral ligament (MQTFL) superiorly and the medial patellofemoral ligament (MPFL) inferiorly. The pediatric MPFL anatomy has been well described, but the precise anatomy of the MQTFL has only recently been described and studied in skeletally immature patients.

Purpose:

To describe the anatomic relationship between the MQTFL and its insertion on the quadriceps tendon and patella in pediatric specimens.

Study Design:

Descriptive laboratory study.

Methods:

A total of 22 pediatric cadaveric knee specimens were dissected to analyze attachment of the MQTFL to the quadriceps tendon and patella. Dissection was facilitated using lateral parapatellar arthrotomy followed by eversion of the extensor mechanism to evaluate MQTFL fibers from its undersurface.

Results:

The mean specimen age was 7.4 years. Specimens were divided based on age into a younger cohort (1-2 years), middle cohort (4-8 years), and older cohort (9-12 years). The quadriceps tendon attachment (QTA) of the MQTFL proximal to the patella extended a median of 5.0 mm in the younger cohort, 11.4 mm in the middle cohort, and 12.0 mm in the older cohort, with significant differences found between the younger and middle cohorts ( P < .047) and the younger and older cohorts ( P < .001). The QTA as a percentage of patellar articular height averaged 44.4% across all specimens. The vertical height of the patella measured a median of 14.0 mm, 22.3 mm, and 27.3 mm in the younger, middle, and older cohorts, respectively.

Conclusion:

This study expands on the recently described anatomy of the pediatric MPFC to quantify the anatomic relationship between the MQTFL attachment to the quadriceps tendon and patella in a more clinically relevant cohort of donor specimens.

Clinical Relevance:

As access to pediatric cadaveric tissue is extremely limited, a better understanding of MPFC and MQTFL anatomy will support surgeons in preoperative planning and intraoperative considerations for their approach to MQTFL and MPFL reconstruction. This may facilitate improved anatomic surgical stabilization of the patellofemoral joint in pediatric patients.
Evaluation of the relationship between health literacy and self-efficacy: A sample of hemodialysis patients
Authors: Kazak Aysun , Özkaraman Ayşe , Topalı Hasret , Duran Secil
Published: June 2022

Purpose:

The aim of this study was to evaluate self-efficacy and health literacy of patients undergoing hemodialysis, to investigate the relationship between health literacy and self-efficacy, and to determine the factors affecting self-efficacy.

Methods:

The study was conducted in Eskisehir and Gumushane state hospitals affiliated to the Public Hospitals Association with the participation of 198 patients receiving hemodialysis treatment for chronic renal failure. The inclusion criteria were as follows: being ⩾18 years old, receiving hemodialysis, and agreeing to participate in the study. The study data were collected using face-to-face interview technique, and they were analyzed using descriptive statistics, correlation, and regression analysis.

Results:

The mean age of the patients was 59.73 ± 16.32 years. Of the patients, 46% were primary school graduates, and 63.6% reported having other chronic diseases. The mean health literacy and self-efficacy scores were found to be 79.43 ± 26.09 and 23.98 ± 7.42, respectively. The results showed that the self-efficacy scores of the patients increased as the general health literacy scores increased, with a strong linear correlation between these variables ( r = 0.712; p ˂ 0.001). Patients with advanced age, low educational level, and widowed patients had lower self-efficacy and health literacy scores than others (respectively eta2 = 0.263, 0.116, 0.268, 0.141).

Conclusion:

High score of health literacy positively affects the self-efficacy score of hemodialysis patients.
Hybrid approach for management of end-stage heart failure in complex congenital heart disease
Authors: Tessari Chiara , Castaldi Biagio , Toscano Giuseppe , Vida Vladimiro L , Gerosa Gino , Padalino Massimo A
Published: June 2022

Management of end-stage heart failure (ESHF) in children with congenital heart disease is challenging. We report a step-by-step hybrid procedure (transcatheter pulmonary valve and left mechanical assist device implantations) in a child with ESHF after repair of tetralogy of Fallot, as an effective bridge to transplant strategy.
The What, Who, and How of Power
Authors: Florczak Kristine L.
Published: June 2022

This column concerns the power of an RO1 grant from the federal government of the United States. To that end, a discussion of the philosophical viewpoints of power, the process of applying for federal grants, and a consideration of a more inclusive process will ensue.
Information Overload in Patient Education: A Wilsonian Concept Analysis
Authors: Wang Tongyao , Voss Joachim G.
Published: June 2022

The authors of this concept analysis seek to clarify the concept of information overload within the context of patient education in healthcare. A modified six-step Wilsonian concept analysis method with a review of qualified manuscripts from PubMed, PsycInfo, CINAHL, and MEDLINE from 2000 to 2018 was conducted. Information overload occurs when an individual acknowledges that information received is beyond his or her information-absorbing threshold. The causes include quantity and quality of the information and information delivery structures. Information overload is associated with higher levels of stress and poor self-care performance. It is significant for healthcare providers to recognize patients’ feelings of information overload.
Insights into relations in community-led urban interventions in the global South: civil society and co-production in Kampala
Authors: Siame Gilbert , Watson Vanessa
Published: June 2022

For many decades, civil society organisations have been instrumental in driving the development agenda in many parts of the world. In the urban global South, these organisations have championed alternative, transformational and transnational grassroots-led urban development practice. An important dimension of their efforts has involved working with the state to jointly produce urban services and the urban space, an approach termed co-production. While the rapidly growing literature on co-production has applauded the efficacy of the approach, there has been no explicit interrogation of how it is affected by clearly visible divisions within communities and civil society. This paper argues that co-production is implemented within the context of a divided civil society and that success depends to a large extent on how these civil society actors address their internal conflicts to engage with the state as a consolidated community force, able to negotiate while resisting capture by a manipulative state.
Look, Dude: How hyperpartisan and non-hyperpartisan speech differ in online commentary
Authors: Nguyen Allison , Roberts Tom , Anand Pranav , Fox Tree Jean E
Published: June 2022

Identifying the characteristics of hyperpartisan communication that make it so amenable to sharing is crucial to combating the spread of misinformation. We analyzed a corpus of hyperpartisan and non-hyperpartisan writing produced on internet forums and found that markers of spontaneous communication are strongly predictive of hyperpartisan speech, regardless of whether that speech is left- or right-leaning. The markers of spontaneous communication included swear words, discourse markers, local pronouns like I and you, and exclamation marks. This suggests that speakers in hyperpartisan online communities exploit linguistic resources, even those without overtly political or persuasive content, to engage readers through appeal to closeness and familiarity.
Internet Gaming Disorder: A Real Disorder or a Way of Coping? A Case Series
Authors: Singh Shipra , Raut Nitin
Published: June 2022

Internet gaming disorder (IGD) is frequently associated with comorbid psychological issues, and apparently, there exists a bidirectional relationship that either of them predisposes the other. It still remains an enigma whether IGD is an individual entity or a coping mechanism. Here, we aim to describe IGD in 4 adolescent males with comorbid psychiatric or psychosocial conditions using a developmental approach and to bring out different interplays between gaming behavior, psychopathology, and environment. This article also aims at exploring how IGD can be understood as a way of coping with another psychological condition, identifying which could be a key factor in the management.
Efficacy of Risperidone and Methylphenidate for Problem Behaviors and Core Symptoms in Autism Spectrum Disorder: A Randomized Trial
Authors: Mahajan Smriti , Arun Priti , Chauhan Nidhi
Published: June 2022

Background:

Risperidone and methylphenidate are commonly used drugs to manage problem behaviors in individuals with autism spectrum disorder (ASD). Studies report that these 2 drugs may be helpful in improving core symptoms of ASD as well.

Aim:

To assess and compare the efficacy and safety profile of risperidone and methylphenidate for problem behaviors and core symptoms in children and adolescents with ASD.

Setting and Design:

An 8-week, prospective, interventional, randomized, and open-label trial carried out in a tertiary care hospital of northern India.

Materials and Methods:

Forty subjects with a diagnosis of ASD according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition were randomized to risperidone and methylphenidate groups. Childhood Autism Rating Scale, Second Edition, Indian Scale for Assessment of Autism, and Nisonger Child Behavior Rating Form were used for assessments. Adverse effects, physical, and laboratory parameters were monitored regularly.

Statistical Analysis:

Tests applied include chi-square test, repeated measures Analysis of Variance, and Student t test, and nonparametric tests for skewed data. Data was analyzed using SPSS Version 22.0. Level of significance was set at 0.05.

Results:

Both drugs improved inattention, hyperactivity, and stereotypies. Methylphenidate reduced self-isolation, and risperidone improved emotional dysregulation, aggression, and self-injury. Adverse effects were seen in 55% of methylphenidate group (commonly decreased appetite and irritability) and 40% of risperidone group (commonly sedation and increased appetite). Improvement in stereotypy with both drugs and self-isolated behavior with methylphenidate indicates a possible role in improving core symptoms of ASD.

Conclusion:

Both drugs were beneficial in the management of behaviors associated with ASD. Further research to establish their role in reducing core symptoms and long-term safety is warranted.
Mental health services need action on organisational culture and justice
Authors: Looi Jeffrey C.L. , Allison Stephen , Bastiampillai Tarun , Kisely Stephen R.
Published: June 2022

Objective

A commentary on the usefulness of the concepts of organisational culture, organisational climate and justice on the quality and safety of mental health services and how conditions may be improved.

Conclusions

Organisational culture, organisational climate and justice impact upon the quality and safety of care, as well as well-being of staff, in mental health services. Psychiatrists and trainees, should consider, act and advocate for improved organisational culture, climate and justice. Improvement in these organisational domains can be achieved, through a coordinated framework that acts across all levels of administration, mid-level management and frontline clinical staff.
Leiomyosarcoma with widespread metastases in a capybara
Authors: Borkowski Emma A. , Shotton Justine , Smyth Joan A.
Published: June 2022

A 10.5-y-old intact female capybara ( Hydrochoerus hydrochaeris) with a history of chronic weight loss was euthanized following discovery by palpation of a large intra-abdominal mass. Postmortem examination revealed a large, firm, tan mass expanding the uterine body and extensively adhered to the jejunum and abdominal wall. Numerous pinpoint to 3-cm diameter, tan-to-red, raised masses were present throughout the parietal peritoneum, liver, lungs, and intestinal serosa. Histologic examination of the uterine mass revealed well-differentiated smooth muscle intermixed with abundant collagen, interspersed with a highly anaplastic spindle cell population extending to the serosa; the masses in the lung, liver, and peritoneum were histologically very similar to the anaplastic uterine spindle cells. Immunohistochemical staining of the uterus and lung confirmed smooth muscle origin of the anaplastic cells. To our knowledge, leiomyosarcoma has not been reported previously in a capybara, and the widespread metastases in this case represent an unusually aggressive presentation of this rare malignancy. The animal also had an incidental dermal histiocytoma, a tumor that has also not been reported previously in this species, to our knowledge.
Admission Prevalence and Risk Factors of Deep Vein Thrombosis in Patients with Spinal Cord Injury Complicated with Cervical Fractures
Authors: Lv Bing , Wang Haiying , Li Weifeng , Han Gefeng , Liu Xiangdong , Zhang Cheng , Zhang Zipeng
Published: June 2022

The purpose of this study was to investigate the prevalence of deep vein thrombosis (DVT) and to clarify the risk factors of DVT in patients with acute spinal cord injury (SCI) complicated with cervical fractures at admission. From January 2018 to December 2021, a total of 175 patients with acute SCI complicated with cervical fractures in our hospital were retrospectively analyzed. Duplex ultrasound was used to diagnose the DVT. All patients' medical record data, including demographic variables, medical history, and laboratory results, were collected. The patients were divided into DVT group and non-DVT group according to ultrasound results. The prevalence of DVT was determined and risk factors of DVT were identified. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of different factors. The prevalence of DVT at admission was 21.71%(38/175), including one (2.63%) with central DVT, thirty-two (84.21%) with peripheral DVT and five (13.16%) with mixed DVT. The multivariate analysis revealed that decreased lower extremity muscle strength, time from injury to admission, and D-dimer were risk factors for DVT at admission. The diagnostic value of D-dimer was the highest among these risk factors. In conclusion, in patients with acute SCI complicated with cervical fractures, the risk of DVT at admission is very high. Decreased lower extremity muscle strength, time from injury to admission, and D-dimer are risk factors for DVT. Moreover, D-dimer has the highest diagnostic value among these risk factors.
Women's Formal Help-Seeking Before and After Their Abusive Partner Initiates Relationship Violence Treatment
Authors: Murphy Christopher M. , Nnawulezi Nkiru , Ting Laura
Published: June 2022

Intimate partner violence survivors ( N = 122) reported on formal help-seeking before and after their male partners enrolled in a Relationship Violence Intervention Program (RVIP). At baseline, only 20% of survivors had ever received domestic abuse (DA) counseling. DA counseling was more common among survivors with more extensive partner abuse exposures, and for black women residing in suburban versus urban communities. New help-seeking was associated with survivor perceptions of the abusive partner's stage of change. RVIP impact may be enhanced through culturally sensitive survivor outreach that is responsive to a broad range of needs and includes repeated contact over time.
Technology-Based Responses to Technology-Facilitated Domestic and Family Violence: An Overview of the Limits and Possibilities of Tech-Based “Solutions”
Authors: Harkin Diarmaid , Merkel Robert
Published: June 2022

It is increasingly common for domestic and family violence to have an element of technology-facilitated abuse (TFA). As a result, technology-based responses have emerged to address TFA. Using observations from several empirical research projects into TFA, it will be shown that technology-based responses are necessary without being sufficient, and that they have persistent limitations that need to be recognized. Relatedly, it will be argued that there should be an ongoing emphasis on the development of human resources as a support for those experiencing TFA, particularly the use of professional DV support workers.
Evaluation of the FreeStyle Libre, a flash glucose monitoring system, in client-owned cats with diabetes mellitus
Authors: Knies Marieke , Teske Erik , Kooistra Hans
Published: June 2022

Objectives

Home blood glucose monitoring using a portable blood glucose meter is important in the management of feline diabetes mellitus, but taking blood samples may be stressful for owners and cats. A flash glucose monitoring system measuring interstitial glucose, such as the FreeStyle Libre, overcomes some of these drawbacks. The aim of this study was to evaluate the practical use and analytical and clinical accuracy of the FreeStyle Libre in 41 client-owned diabetic cats.

Methods

In this prospective study, interstitial glucose concentrations were measured with the FreeStyle Libre and compared with blood glucose concentrations measured with a portable blood glucose meter (AlphaTRAK) on days 1, 7 or 8 and 14 after application of the device. Cat behaviour during application, location, skin reaction at the attachment site and owner satisfaction were assessed. Accuracy was determined by fulfilment of ISO 15197:2013 criteria, including Bland–Altman plotting and error grid analysis.

Results

Placing the device was easy, with 70% of cats showing no reaction. Most sensors were placed on the thoracic wall. Skin reactions at the attachment site were not present or mild in almost all cats. Owners were very satisfied with the use of the FreeStyle Libre. Median functional life of the sensor was 10 days (range 1–14). Good correlation was found between interstitial and blood glucose measurements (rho[r] = 0.88, P <0.0001). Fifty-three percent of interstitial glucose concentrations were within a maximum deviation of 15% from blood glucose concentrations and 92.7% were within the safe risk zones 0 and 1 of the surveillance error grid.

Conclusions and relevance

The flash glucose monitoring system was easy to use and owners of diabetic cats were satisfied with its use. Although the device did not completely fulfil ISO requirements, it is sufficiently accurate for glucose monitoring in diabetic cats.
Use of tetrasodium EDTA acid for the treatment of intraluminal obstruction of subcutaneous ureteral bypass devices
Authors: Duval Valerie , Dunn Marilyn , Vachon Catherine
Published: June 2022

Objectives

The aim of this study was to evaluate the efficacy and tolerability of a 4% tetrasodium EDTA (tEDTA) infusion protocol in the subcutaneous ureteral bypass (SUB) devices of cats with intraluminal obstruction at a veterinary teaching hospital between July 2017 and April 2020.

Methods

This was a retrospective controlled study. Cats with an obstructed SUB device underwent a 4% tEDTA infusion protocol. Obstruction of the device was diagnosed based on renal pelvic dilation, dilatation of the ureter, mineralized material within the device (cystostomy or nephrostomy catheters) seen on ultrasound, the absence of visible bubbles within the renal pelvis and/or urinary bladder following ultrasound-guided flushing of the device with saline.

Results

A total of 16 tEDTA infusion protocols were performed in 14 cats. The infusion protocol was considered successful in 11/16 SUB devices (68.8%). Six devices (n = 6/11; 54.5%) had recurrence of obstruction with a median time of 87 days. One or more episodes of self-limiting pollakiuria and/or hematuria following infusion was seen in eight patients (n = 8/14; 57.1%).

Conclusions and relevance

Infusions of 4% tEDTA successfully relieved intraluminal obstruction in patients with occluded SUB devices; however, the recurrence of obstruction was common. Additional studies evaluating case selection and optimal protocols are warranted.
Using root cause analysis as a tool to reduce central venous catheters in haemodialysis patients
Authors: Balson Laura , Stevenson Tamasin , Baharani Jyoti
Published: June 2022

Background:

Haemodialysis remains the most common modality of renal replacement therapy. National and international guidelines continue to promote arteriovenous fistulas or grafts as the preferred vascular access for haemodialysis, given the increased risks associated with use of central venous catheters (CVCs). Our renal centre pursues a ‘fistula first’ culture and uses root cause analysis and a patient safety incident based approach to meet the recommended standards of minimal CVC use in dialysis patients.

Methods:

We undertook a retrospective observational review looking at patterns of CVC use amongst our patients to identify themes and changes over time. Using data collected over a 5 year period, we examined 100 patient safety incidents involving CVC use in planned haemodialysis patients. We used a contributory factors framework to identify systemic contributors to each incident.

Results:

During the study period our centre achieved the national standard of at least 60% of incident dialysis patients commencing planned haemodialysis via arteriovenous access. About 26% of cases of CVC use in incident dialysis patients were deemed potentially avoidable. The most common contributory factor identified in these cases was poor communication.

Conclusions:

Using a root cause analysis based methodology to examine CVC use in haemodialysis is a novel approach to quality improvement in this area. Our methodology can be used as a framework by other centres to optimise the provision of safe, effective, and timely vascular access for dialysis, with multiple benefits for both renal services and individual patients.