bluuebunny/crossref_metadata_2025 huggingface dataset:
Intensive Care Unit Services Preparedness for the Pandemic: An Efficiency Analysis
Authors: Cinaroglu Songul
Published: September 2021

Intensive care unit (ICU) services efficiency and the shortage of critical care professionals has been a challenge during pandemic. Thus, preparing ICUs is a prominent part of any pandemic response. The objective of this study is to examine the efficiencies of ICU services in Turkey right before the pandemic. Data were gathered from the Public Hospital Statistical Year Book for the year 2017. Analysis are presented at hospital level by comparing teaching and non-teaching hospitals. Bootstrapped data envelopment analysis procedure was used to gather more precise efficiency scores. Three analysis levels are incorporated into the study such as, all public hospitals (N = 100), teaching (N = 53), non-teaching hospitals (N = 47), and provinces that are providing high density of ICU services through the country (N = 54). Study results reveal that average efficiency scores of ICU services obtained from teaching hospitals (eff = 0.65) is higher than non-teaching (eff = 0.54) hospitals. After applying the bootstrapping techniques, efficiency scores are significantly improved and the difference between before and after bootstrapping results are statistically significant ( P < .05). Province based analysis indicates that, ICU services efficiencies are high for provinces located in southeast part of the country and highly populated places, such as İstanbul. Evidence-based operational design that considers the spatial distribution of health resources and effective planning of critical care professionals are critical for efficient management of intensive care. Study results will be helpful for health policy makers to deeply understand dynamics of critical care.
Right Heart Morphology and Its Association With Excessive and Deficient Cardiac Visceral Adipose Tissue
Authors: Vučić Domagoj , Bijelić Nikola , Rođak Edi , Rajc Jasmina , Dumenčić Boris , Belovari Tatjana , Mihić Damir , Selthofer-Relatić Kristina
Published: September 2021

Visceral adipose tissue is an independent risk factor for the development of atherosclerotic coronary disease, arterial hypertension, diabetes and metabolic syndrome. Right heart morphology often involves the presence of adipose tissue, which can be quantified by non-invasive imaging methods. The last decade brought a wealth of new insights into the function and morphology of adipose tissue, with great emphasis on its role in the pathogenesis of heart disease. Cardiac adipose tissue is involved in thermogenesis, mechanical protection of the heart and energy storage. However, it can also be an endocrine organ that synthesises numerous pro-inflammatory and anti-inflammatory cytokines, the effect of which is accomplished by paracrine and vasocrine mechanisms. Visceral adipose tissue has several compartments that differ in their embryological origin and vascularisation. Deficiency of cardiac adipose tissue, often due to chronic pathological conditions such as oncological diseases or chronic infectious diseases, predicts increased mortality and morbidity. To date, knowledge about the influence of visceral adipose tissue on cardiac morphology is limited, especially the effect on the morphology of the right heart in a state of excess or deficient visceral adipose tissue.
A Case of Cushing’s Disease Presenting with Isolated Suicidal Attempt
Authors: Al-Harbi Sultan Dheafallah , Mashi Abdulrahman Hassan , AlJohani Naji Jamal
Published: September 2021

Cushing’s disease is an abnormal secretion of ACTH from the pituitary that causes an increase in cortisol production from the adrenal glands. Resultant manifestations from this excess in cortisol include multiple metabolic as well as psychiatric disturbances which can lead to significant morbidity and mortality. In this report, 23-year-old woman presented to mental health facility with history of severe depression and suicidal ideations. During evaluation, she found to have Cushing’s disease, which is unusual presentation. She had significant improvement in her symptoms with reduction of antidepressant medications after achieving eucortisolism. Cushing syndrome can present with wide range of neuropsychiatric manifestations including major depression. Although presentation with suicidal depression is unusual. Early diagnosis and prompt management of hypercortisolsim may aid in preventing or lessening of psychiatric symptoms The psychiatric and neurocognitive disorders improve after disease remission (the normalization of cortisol secretion), but some studies showed that these disorders can partially improve, persist, or exacerbate, even long-term after the resolution of hypercortisolism. The variable response of neuropsychiatric disorders after Cushing syndrome remission necessitate long term follow up.
Inhaled Nitric Oxide via High-Flow Nasal Cannula in Patients with Acute Respiratory Failure Related to COVID-19
Authors: Chandel Abhimanyu , Patolia Saloni , Ahmad Kareem , Aryal Shambhu , Brown A Whitney , Sahjwani Dhwani , Khangoora Vikramjit , Shlobin Oksana A , Cameron Paula C , Singhal Anju , Holtzclaw Arthur W , Desai Mehul , Nathan Steven D , King Christopher S
Published: September 2021

INTRODUCTION

Limited evidence exists regarding use of inhaled nitric oxide (iNO) in spontaneously breathing patients. We evaluated the effectiveness of continuous iNO via high-flow nasal cannula (HFNC) in COVID-19 respiratory failure.

METHODS

We performed a multicenter cohort study of patients with respiratory failure from COVID-19 managed with HFNC. Patients were stratified by administration of iNO via HFNC. Regression analysis was used to compare the need for mechanical ventilation and secondary endpoints including hospital mortality, length of stay, acute kidney injury, need for renal replacement therapy, and need for extracorporeal life support.

RESULTS

A total of 272 patients were identified and 66 (24.3%) of these patients received iNO via HFNC for a median of 88 h (interquartile range: 44, 135). After 12 h of iNO, supplemental oxygen requirement was unchanged or increased in 52.7% of patients. Twenty-nine (43.9%) patients treated with iNO compared to 79 (38.3%) patients without iNO therapy required endotracheal intubation ( P = .47). After multivariable adjustment, there was no difference in need for mechanical ventilation between groups (odds ratio: 1.53; 95% confidence interval [CI]: 0.74-3.17), however, iNO administration was associated with longer hospital length of stay (incidence rate ratio: 1.41; 95% CI: 1.31-1.51). No difference was found for mortality, acute kidney injury, need for renal replacement therapy, or need for extracorporeal life support.

CONCLUSION

In patients with COVID-19 respiratory failure, iNO delivered via HFNC did not reduce oxygen requirements in the majority of patients or improve clinical outcomes. Given the observed association with increased length of stay, judicious selection of those likely to benefit from this therapy is warranted.
The impact of ownership and size heterogeneity on hotel efficiency in the Canary Islands (Spain)
Authors: Pérez-Rodríguez Jorge Vicente , Acosta-González Eduardo
Published: September 2021

This study was conducted to analyse the influence of technological differences on hotel efficiency in the Canary Islands (Spain), with particular regard to the heterogeneity observed in hotel ownership and size. A metafrontier approach, based on non-parametric deterministic efficiency methods (data envelopment analysis and free-disposal hull) and robust non-parametric estimators (order-α), is used. This empirical analysis considered a panel data sample selection model of Canary Islands hotels for the period 2002–2015. The results obtained show that the frontiers against which the hotels are compared (metafrontier or group) and the consideration or otherwise of outliers are factors of crucial importance. We find that efficiency depends on hotel size (large hotels are more efficient than small ones), but not on the type of ownership. The results also show that the impact of the global financial crisis on the average technical efficiency of these hotels was slight or non-existent. Finally, the technological gap narrowed over time, especially in large hotels and those with no majority shareholder.
‘So what’s arts got to do with it?’: An autoethnography of navigating researcher positionality while co-creating knowledge
Authors: Kamlongera Mtisunge Isabel
Published: September 2021

In this autoethnography, I share about my journey navigating multiple researcher positionalities. I commence with a reflection on how one of my positionalities as an ‘outsider-within’ influences my onto-epistemological stance and approach to the research. Through my shared case, where I am a ‘marginal intellectual’ with an intersectional researcher positionality, I highlight the complexities of negotiating power in co-creating knowledge with participants whilst navigating the insider/outsider/in-between researcher positions. I illustrate how a reflexive methodology incorporating Arts-Based processes (ABP) facilitated navigation of power dynamics in order to mitigate the ‘representation crisis’ often resulting from researcher positionalities.
Ethical decision-making of social workers in Spain during COVID-19: Cases and responses
Authors: Úriz María-Jesús , Viscarret Juan-Jesús , Ballestero Alberto
Published: September 2021

In this article we address the ethical decision-making processes of social work professionals in Spain during the first wave of COVID-19. We present some of the findings from a broader international research project led by professor Sarah Banks and carried out in collaboration with the International Federation of Social Workers.

The first wave of COVID-19 had a major impact in Spain, hitting harder the most vulnerable groups. In this unprecedented and unexpected context, social workers had to make difficult ethical decisions on fundamental issues such as respecting service-user’s autonomy, prioritizing wellbeing, maintaining confidentiality or deciding the fair distribution of the scarce resources. There were moments of uncertainty and difficult institutional responses.

The broader international project was carried out using an online questionnaire addressed to social work professionals in several countries. In this article, through several specific cases, we examine the ethical decision-making processes of social work professionals in Spain, as well as the way to resolve that situations. We have used a qualitative content analysis with a deductive approach to analyze the responses and cases.

Findings show many difficult situations concerning the prioritization of the wellbeing of users without limiting their autonomy, the invention of new organizational protocols to provide support and resources for vulnerable people… Social workers had to manage the bureaucracy and had to solve some emergency situations getting personally involved or developing other cooperation mechanisms. The pandemic forced them to look for new forms of social intervention.
A critical appraisal of interdisciplinary research and education in British Higher Education Institutions: A path forward?
Authors: Evis Laura H
Published: September 2021

This article examines the development, impact and integration of interdisciplinary approaches in British Higher Education Institutions. It evaluates how the concept of interdisciplinarity has become popularised over time and embraced by disciplines such as archaeology. It then explores the extent to which interdisciplinary approaches have impacted research agendas, first, by evaluating the interdisciplinary research calls from 2019 for seven UK-based research councils and then, at a discipline level, using archaeology as an exemplar. Overall, interdisciplinary research calls only accounted for, at best, 11.9% of a council’s budget. Interrogation of the funding requirements of four of the largest archaeological-research funders demonstrated that successful archaeology-themed grant applications are reliant on interdisciplinarity. The influence of interdisciplinarity on British University’s research and education agendas was examined through analysing the strategic plans of eight universities, followed by an analysis of the availability and potential benefits of interdisciplinary undergraduate and research programmes. This indicated that interdisciplinary approaches are interwoven into university’s research aspirations but displayed variation in relation to their educational goals, with only 20% of institutions offering specific interdisciplinary degree programmes. Despite this, the skillset and research outputs produced as a result of interdisciplinary collaboration were found to be highly valued, thereby suggesting that interdisciplinarity will increasingly feature in the research and education strategies of British universities.
Exploring Barriers and Facilitators to the Implementation of Pet Robots for People With Dementia in Nursing Homes: A Qualitative Research Protocol
Authors: Koh Wei Qi , Toomey Elaine , Casey Dympna
Published: September 2021

People living with dementia, especially those who live in nursing homes, are susceptible to social isolation and activity disengagement. Pet robots are technology-based substitutes to animal-assisted therapy that have demonstrated positive impacts on people with dementia in long term care settings, such as reducing agitation, improving mood and increasing social engagement. Nevertheless, knowledge about the issues influencing their implementation is lacking, as there is a scarcity of research that have explicitly investigated the barriers and facilitators influencing their implementation in real-world practice. The objective of this study is to understand the multi-level barriers and facilitators to the implementation of pet robots for people with living dementia in nursing homes, from the perspectives of key stakeholders. A qualitative study employing a descriptive qualitative approach will be used. The Consolidated Framework of Implementation Research (CFIR) will be used to guide the research process. Multi-level stakeholders, including people living with dementia, healthcare professionals and organisational decision makers in nursing homes, will be recruited for one-to-one interviews. Data will be analysed through framework analysis, using a combination of both deductive (based on the constructs and domains in the CFIR) and inductive approaches. To the best of our knowledge, this will be the first study to explore multi-level determinants to the implementation of pet robots in nursing homes for people living with dementia. Findings will be used to inform the identification of strategies that may be used to guide the implementation of pet robots for people living with dementia in nursing homes.
Response of round-hole tubes submitted to pure bending creep and pure bending relaxation
Authors: Lee Kuo-Long , Liu Bo-You , Pan Wen-Fung
Published: September 2021

This paper presents experimental study on the response of 6061-T6 aluminum alloy round-hole tubes with five different hole diameters of 2, 4, 6, 8, and 10 mm and four different diameter-to-thickness ratios of 30, 40, 50, and 60 submitted to pure bending creep and pure bending relaxation. Pure bending creep or relaxation is defined as bending the tube to the required moment or curvature and maintaining that moment or curvature for a period of time. The experimental results of pure bending creep show that the curvature increases with time. In addition, larger holding moment, diameter-to-thickness ratio, or hole diameter results in larger creep curvature. As the curvature continues to increase, the round-hole tube eventually breaks. The experimental results of pure bending relaxation show that the relaxation moment decreases sharply with time and tends to a stable value. In addition, larger holding curvature, diameter-to-thickness ratio, or hole diameter results in larger drop of the relaxation moment. Due to fixed curvature, the round-hole tube does not break. Finally, formulas proposed by the research team of Pan et al. were respectively improved to simulate the creep curvature-time relationship for pure bending creep in the initial and the secondary stages and the relaxation moment-time for pure bending relaxation. After comparing with the experimental results, it is found that theoretical analysis can reproduce the experimental results reasonably.
Research on operating characteristics of a centrifugal pump with broken impeller
Authors: Wu Xianfang , Sun Xuelei , Tan Minggao , Liu Houlin
Published: September 2021

The operating characteristics of a centrifugal pump with broken impeller malfunction was studied by tests and numerical simulation. One blade was cut 1/4 as a broken impeller. The energy characteristics, vibration, internal flow, pressure fluctuation, and radial force of the pump were studied in detail. The test results show that as for the pump with broken impeller, the head decreased by 9.85% and efficiency decreased by 1.06% under 1.0 Q0. The vibration increase amplitudes at the outlet flange are the maximum. The APF (axial passing frequency) of all monitoring points increased significantly, and a new frequency – 5APF appeared, except for the inlet of the pump. It can be found that the low-speed region of blade fracture surface is more obvious than other blades through numerical simulation. The radial force of the broken impeller increased obviously and became more concentrated. Due to the broken blade, the peak-to-peak magnitude of pressure fluctuation at the tongue and pump outlet increased by 4.7% and 9.5% respectively. The research results provide some reference for the malfunction diagnosis of centrifugal pump.
Brain herniation on computed tomography is a poor predictor of whether patients with a devastating brain injury can be confirmed dead using neurological criteria
Authors: Ray Andrew , Manara Alex R , Mortimer Alex M , Thomas Ian
Published: September 2021

Background

It is unclear if the presence of compartmental brain herniation on neuroimaging should be a prerequisite to the clinical confirmation of death using neurological criteria. The World Brain Death Project has posed this as a research question.

Methods

The final computed tomography of the head scans before death of 164 consecutive patients confirmed dead using neurological criteria and 41 patients with devastating brain injury who died following withdrawal of life sustaining treatment were assessed by a neuroradiologist to compare the incidence of herniation and other features of cerebral swelling.

Results

There was no difference in the incidence of herniation in patients confirmed dead using neurological criteria and those with devastating brain injury (79% vs 76%, OR 1.23 95%, CI 0.56–2.67). The sensitivity and specificity of brain herniation in patients confirmed dead using neurological criteria was 79% and 24%, respectively. The positive and negative predictive value was 81% and 23%, respectively. The most sensitive computed tomography of the head findings for death using neurological criteria were diffuse sulcal effacement (93%) and basal cistern effacement (91%) and the most specific finding was loss of grey-white differentiation (80%). The only features with a significantly different incidence between the death using neurological criteria group and the devastating brain injury group were loss of grey-white differentiation (46 vs 20%, OR 3.56, 95% CI 1.55–8.17) and presence of contralateral ventricular dilatation (24 vs 44%, OR 0.41, 95% CI 0.20–0.84).

Conclusions

Neuroimaging is essential in establishing the cause of death using neurological criteria. However, the presence of brain herniation or other signs of cerebral swelling are poor predictors of whether a patient will satisfy the clinical criteria for death using neurological criteria or not. The decision to test must remain a clinical one.
The Chemical Composition of Single-Tree Boswellia frereana Resin Samples
Authors: Johnson Stephen , DeCarlo Anjanette , Satyal Prabodh , Dosoky Noura S. , Sorensen Aaron , Setzer William N.
Published: September 2021

Frankincense is an aromatic terpenoid oleo-gum resin produced by trees in the genus Boswellia. It has been used for medicinal and religious purposes for millennia, and is today an important component in perfume and aromatherapy. The resin of Boswellia frereana is especially prized, and has been found to contain a high proportion of monoterpenes. However, previous studies have relied on commercial samples; in this study, we characterize the compositions of essential oil and DCM extract samples from 12 individual B frereana trees. The triterpenoid fraction was largely consistent between samples, with lupeol (14.7%-32.5%), α-amyrin (13.0%-25.2%), 3- epi-lupeol (6.4%-14.2%), and β-amyrin (5.3%-8.0%) as the primary constituents. The essential oil showed more intersample diversity, but still represented a single, variable chemotype characterized by a moderate to high level of α-thujene (14.5%-43.9%) and a varying, often significant, level of α-pinene (3.0%-63.0%).
Impact of previous biologic use and body weight on the effectiveness of guselkumab in moderate-to-severe plaque psoriasis: a real-world practice
Authors: Hung Yi-Teng , Lin Yu-Jr , Chiu Hsien-Yi , Huang Yu-Huei
Published: September 2021

Background:

Real-life data on patients with psoriasis treated with guselkumab are few and are needed to compare with trial-based data. We investigated the effect of clinical factors on real-world effectiveness of guselkumab.

Methods:

This multicentre study retrospectively included 135 patients with psoriasis treated with guselkumab from June 2018 until November 2020. Effectiveness was assessed using the degree of improvement in the Psoriasis Area and Severity Index (PASI) scores at baseline and after 4, 12, 20, 28, and 36 weeks. Predictors of effectiveness were also evaluated.

Results:

At week 36, 67% of the patients achieved PASI 75. Multivariate logistic regression analysis revealed that heavier patients were less likely to achieve PASI 75 at week 4 than patients with lower body weights. Fewer patients exposed to only one biologic achieved PASI 75 at weeks 4, 20, 28, and 36 [odds ratio (OR) = 0.08 (95% CI, 0.01–0.48), 0.21 (95% CI, 0.05–0.74), 0.04 (95% CI, 0.00–0.35), and 0.07 (95% CI, 0.00–0.68), respectively] than biologic-naïve patients. Patients previously treated with more than one biologic were less likely to achieve PASI 75 at weeks 12, 20, 28, and 36 [OR = 0.05 (95% CI, 0.01–0.22), 0.03 (95% CI, 0.01–0.16), 0.00 (95% CI, 0.00–0.03), and 0.00 (95% CI, 0.00–0.044), respectively] than biologic-naïve patients. Patients with previous anti-interleukin (IL)-17 exposure, rather than tumour necrosis factor-α and IL-12/23 inhibitors, had lower PASI improvements to guselkumab than biologic-naïve patients at weeks 12, 20, and 28 [OR = 0.19 (95% CI, 0.03–0.90), 0.10 (95% CI, 0.02–0.55), and 0.03 (95% CI, 0.00–0.29), respectively].

Conclusions:

The effectiveness of guselkumab was compromised in a real-world setting. Delayed onset of therapeutic response was noted in heavier patients. Biologic exposure, the number of previously used biologics, and previous exposure to IL-17 inhibitors were clinical predictors of a reduced response to guselkumab. Physicians may share this information with patients to make treatment decisions.
The great Transformer: Examining the role of large language models in the political economy of AI
Authors: Luitse Dieuwertje , Denkena Wiebke
Published: September 2021

In recent years, AI research has become more and more computationally demanding. In natural language processing (NLP), this tendency is reflected in the emergence of large language models (LLMs) like GPT-3. These powerful neural network-based models can be used for a range of NLP tasks and their language generation capacities have become so sophisticated that it can be very difficult to distinguish their outputs from human language. LLMs have raised concerns over their demonstrable biases, heavy environmental footprints, and future social ramifications. In December 2020, critical research on LLMs led Google to fire Timnit Gebru, co-lead of the company’s AI Ethics team, which sparked a major public controversy around LLMs and the growing corporate influence over AI research. This article explores the role LLMs play in the political economy of AI as infrastructural components for AI research and development. Retracing the technical developments that have led to the emergence of LLMs, we point out how they are intertwined with the business model of big tech companies and further shift power relations in their favour. This becomes visible through the Transformer, which is the underlying architecture of most LLMs today and started the race for ever bigger models when it was introduced by Google in 2017. Using the example of GPT-3, we shed light on recent corporate efforts to commodify LLMs through paid API access and exclusive licensing, raising questions around monopolization and dependency in a field that is increasingly divided by access to large-scale computing power.
Exploring the Factors Influencing Chinese Music Teachers’ Perceptions and Behavioural Intentions in Using Technology in Higher Education: A Pilot Study
Authors: Zhang Xiangming , King Andrew , Prior Helen
Published: September 2021

The development of new technologies drives many aspects of socio-economic development, including the development of education. The behavioural intention of music teachers, particularly in relation to how technology is integrated into the classroom, needs to be understood since it has a direct effect on the pedagogical approach used in classroom learning. Existing theories (the Unified Theory of Acceptance and Use of Technology (UTAUT) and Technological Pedagogical and Content Knowledge (TPACK)) have explored aspects of teachers’ adoption of technologies; this article uses data from a pilot study to develop and test a model that combines the two theories in order to understand more fully the relationship between Individual Beliefs, Technological Competence and Behavioural Prediction of music teachers using technology in the context of the Chinese governmental policy: ‘Internet +’. The participants of this pilot study were 61 music teachers (12 male and 49 female); the proportion of participants in different provincial administrative regions covered more than half of mainland China (18 out of 34). Structural Equation Modelling (SEM) revealed that the overall fit of the model was above the recommended level of acceptable fit. The results showed that Technological Competence has a significant impact on Individual Beliefs; Individual Beliefs have a significant impact on Behavioural Prediction. However, Technological Competence was found to have no significant direct impact on Behavioural Prediction. This study is one of only a few studies that combine the UTAUT and TPACK models into the field of music pedagogy and uses SEM for analysis. This study attempts to fill the gap in the factors influencing the adoption of technology in music education in non-Western cultures and also provides a starting point for understanding Chinese music teachers’ technological beliefs and behavioural intentions.
Community Visioning for Innovation in Integrated Dementia Care: Stakeholder Focus Group Outcomes
Authors: Roberts Emily , Shehadeh Anas
Published: September 2021

It is estimated that 5.4 million Americans have some form of dementia and these numbers are expected to rise in the coming decades, leading to an unprecedented demand for memory care housing and services. In searching for innovative options to create more autonomy and better quality of life in dementia care settings, repurposing existing structures, in particular vacant urban malls, may be 1 option for the large sites needed for the European model of dementia villages. These settings may become sustainable Dementia Friendly City Centers (DFCC), because in the case of enclosed mall construction, the internal infrastructure is in place for lighting, HVAC, with varied spatial configuration of public spaces. This paper describes the community engagement research being conducted by a research team at a Midwestern university, laying groundwork for the DFCC model for centralized dementia programs, services, and attached housing. Using graphics and plans for the DFCC model using an 800 000 ft2 closed mall site, focus groups were conducted with family caregivers of individuals with dementia and long-term care residents to gather their input and response to the model. The participants identified both opportunities and barriers in using an adaptive reuse of a large site for an innovative integrated dementia care model and through the cross-case analysis of the focus group findings, 5 themes were identified which include: community education and acceptance; amenities and activities; maintaining family connections; resident adaptation and staffing.
Addressing Sexual Problems in German Primary Care: A Qualitative Study
Authors: Zannoni Ronja , Dobberkau Elisa , Kaduszkiewicz Hanna , Stirn Aglaja Valentina
Published: September 2021

Although general practitioners (GPs) are often the first contact for patients’ sexual issues, little is known about how German GPs approach, diagnose, and treat sexual problems and disorders. Therefore, the present qualitative study explores approaches and management of sexual health issues used by GPs. The sample included 16 GPs from Kiel and surroundings and Sachsen-Anhalt. The in-depth, semi-structured interviews were coded according to the qualitative content analysis by Mayring using MAXQDA. The results revealed 5 main themes, 2 of which are explored in more detail in relation to the study objective (2 and 4): (1) sexual issues that arise in general practice, (2) addressing sexuality, (3) influencing factors in doctor-patient communication about sexuality, (4) diagnosing and treating sexual dysfunctions, and (5) changes in the approach to sexuality over time. Most GPs did not routinely ask their patients about sexual problems. Common barriers included lack of time, suspected embarrassment on both sides, and fear of offending patients. Almost all GPs tended to diagnose sexual problems individually adapted to patients’ issues, not following a standardized approach. Medication was offered as the main treatment for sexual problems. For complex disorders, most GPs lack sexual medicine knowledge, and they requested a better range of training courses in sexual medicine.
Self-Testing as an Invaluable Tool in Fighting the COVID-19 Pandemic
Authors: Goggolidou Paraskevi , Hodges-Mameletzis Ioannis , Purewal Satvinder , Karakoula Aikaterini , Warr Tracy
Published: September 2021

Objectives:

The United Kingdom and a number of European Union countries are offering and distributing rapid antigen detection tests (RADTs) for self-test use to detect SARS-CoV-2. For instance, Greece, in the midst of its third wave of COVID-19, announced the provision of RADTs for self-testing through retail pharmacies. With the aim to determine the acceptability and feasibility of COVID-19 self-testing, we ran a cross-sectional survey on residents of Greece and Cyprus, aged over 18 years.

Methods:

An online survey using the JISC platform was distributed to 1000 individuals who completed the survey anonymously. Data was collated and analyzed for complete responses by chi-squared and logistic regression analyses.

Results:

A total of 248 complete responses were obtained, with balanced gender distribution and particular demographics representative of the 2 countries. The majority of participants (79%; n = 196) reported willingness to self-test and the remaining individuals reported no (10.5%; n = 26) or don’t know (10.5%; n = 26). Being a university graduate significantly predicted the likelihood of being willing to self-test (odds ratio [OR] = 3.455, P < .001). Pearson Chi-square test found significant differences between university graduates versus non-graduates on the type of COVID-19 test preferred (χ2 = 8.95, df = 3, P < .03); graduates were more likely to prefer saliva testing and less likely to prefer the finger prick test than non-graduates.

Conclusions:

Our survey data evidences the acceptability of home-based self-testing, with a preference for saliva as choice of biological material for sampling. A number of factors, such as accessible reporting, contact tracing infrastructures, central registration, and validation for the implementation of different RADTs need to be taken collectively into consideration before self-testing can be universally and reliably scaled up.
Faculty Members in Polytechnics to Serve the Community and Industry: Conceptual Skills and Creating Value for the Community—The Two Main Drivers
Authors: Ghasemy Majid , Mohajer Leila , Frömbling Lena , Karimi Mehrdad
Published: September 2021

Servant leadership has been proposed as a highly relevant approach to leadership in the higher education context. However, little is known about its contribution to desirable organizational outcomes in academic settings, and even less is known about the role that servant leadership’s multidimensionality plays. Consequently, our study aims to investigate the impact of servant leadership’s two dimensions (creating value for the community and conceptual skills) on academics’ job satisfaction and work motivation. Specifically, we focus on polytechnics due to their significant contribution to the community and industry in developing economies. We applied partial least squares structural equation modeling (PLS-SEM) to analyze the data collected from 228 academics affiliated with Malaysian polytechnics. Our analysis shows that both dimensions of servant leadership are relevant predictors of academics’ job satisfaction and work motivation. In addition, while a robustness check confirms the linearity between the variables in our model, the model exhibits a high out-of-sample predictive power, thereby making assumptions about the model relationships’ generalizability feasible. We also identified job satisfaction as the most important area of improvement that managerial activities should address.
Crossing the Valley of Death for SMEs: Management Practices From China
Authors: An Yilong , Zhang Yinghua
Published: September 2021

The purpose of this article is to explain and solve the early stage of High-tech small and medium-sized enterprises (SMEs) development issue in Tianjin, specifically the so-called Valley of Death. The Valley of Death is used as a metaphor to describe the relative lack of resources and expertise in the area of development. In this article, the resources and expertise mainly refer to the financing and loans required by high-tech SMEs in the early stage. Through the analysis of the actual situation of developing high-tech SMEs in Tianjin, the article illustrates organizations can bridge the Valley of Death through coordination and institutional support. The literature review and normative analysis methodology used in this study gathered data from literature and second-hand materials with extensive experience to construct the framework model of early stage development of Tianjin high-tech SMEs. Results indicate that institutional support has been very effective in addressing the Valley of Death. Implications of these findings suggest local government must understand the challenges in the valley, must facilitate the development of skills for the SMEs, and must supply the resources to SMEs.
Hierarchy of Associations Between BMI-for-Agez-Scores, Growth and Family Social Status Among Urban Bengali Girls of Siliguri Town, West Bengal: A St. Nicolas House Analysis
Authors: Dorjee Binu , Saha Pallabi , Sen Jaydip
Published: September 2021

The present study assesses the association of different socio-economic variables with children’s BMI-for-age z-scores (BAZ) and influence of children’s height on BAZ, a proxy index of nutritional status. The study was undertaken among 322 girls belonging to the Bengali Hindu Caste Population (BHCP) aged 5–13 years. These girls were the students of two schools located in Siliguri town of West Bengal, India. The prevalence of short stature, underweight and overweight was assessed using the World Health Organization’s ( WHO, 2007 , Growth Reference Data for 5–19 years) references. The statistical analyses used were St. Nicolas House Analysis (SNHA), analysis of variance (ANOVA), linear and logistic regression. The prevalence of underweight, overweight and obesity was 19.3%, 17.8% and 5.9%, respectively. The prevalence of short stature (−2.0 HAZ) was 8.7%. The range of BAZ was from −5.69 to 4.15. The variation of BAZ explained by height-for-age z-scores (HAZ) was 11.4%. The BAZ was observed to be associated with mothers’ occupation as revealed by 2% variation through SNHA analysis. The present study observed the usefulness of SNHA for non-parametric data with unequal sub-sample or categories. However, SNHA was not devised to assess the direction and magnitude of variables of interest. The finding of the present study supports the use of BAZ as a proxy adiposity measure among the overweight/obese populations and populations with normal growth in height. The study further supports the recommendations that mother empowerment can help improve nutritional status of a girl child.
Perioperative haematological outcomes following total knee arthroplasty in haemophiliacs
Authors: Mohan Kunal , Broderick James M , Raftery Nicola , McAuley Nuala F , McCarthy Tom , Hogan Niall
Published: September 2021

Purpose:

Patients with haemophilia suffer from recurrent joint haemarthrosis. This can progress to symptomatic arthropathy commonly affecting the knee. While modern coagulation strategies have reduced those proceeding to end-stage arthropathy, total knee arthroplasty (TKA) remains the optimal treatment for some patients. Despite innovation in perioperative haematological management, concerns about the potential for excessive haemorrhage still exist. The aim of this study is to quantify immediate postoperative blood loss and haematological complications in haemophiliacs following TKA.

Methods:

A retrospective study of patients with haemophilia types A or B who underwent a TKA over a 12-year period at a single institution was conducted. These patients were compared to both a non-haemophiliac control group and to published standards in non-haemophiliacs undergoing TKA.

Results:

Twenty-one TKA procedures in 18 patients (72% haemophilia A, 28% haemophilia B) were suitable for inclusion with a mean age of 44 years. The mean haemoglobin drops at 24 and 48 h postoperatively were 2.7 g/dl and 3.8 g/dl respectively. There was no significant difference in haemoglobin drop at 48 h postoperatively when compared to the non-haemophiliac control group ( P = 0.2644). There were no immediate perioperative complications and two patients (9.6%) required postoperative transfusion.

Conclusion:

Haemophiliacs undergoing a unilateral primary TKA in a specialised tertiary referral centre appear to have comparable rates of perioperative blood loss when compared to both a non-haemophiliac control group as and published haemostatic standards in non-haemophiliac patients following TKA. Perioperative management with expert orthopaedic and haematological input is recommended to optimise outcomes in this complex patient group.
Perceived Organizational Support and Intention to Stay: The Mediating Effect of Employee Engagement
Authors: Nargotra Meenakshi , Sarangal Rajani Kumari
Published: September 2021

The present study intends to investigate the influence of perceived organizational support (POS) on employee intention to stay (ITS) in an organization. Further, study examines the mediating role of employee engagement (EE) on the relationship between perceived organizational support (POS) and employee intention to stay (ITS). Data has been collected from 323 employees working in three major private telecom companies, namely, Airtel Limited, Vodafone–Idea Limited and Reliance Jio Infocomm Limited operating in J&K (UT). Data has been scrutinized using structural equation modelling (SEM). Findings of the study indicates that POS has a significant positive influence on ITS and EE, partially mediates the relationship between POS and ITS. The study has significant implications for managers as well as practitioners. First, it contributes to social exchange theory by understanding employees’ perception about organizational support on their intention to stay via engagement. Second, it encourages managers to cultivate an environment of support in order to engage the employees because only the engaged employees show intense desire to stay with their organization. It is the first study that examines the indirect impact of POS on ITS via EE.
Translation, Cross-Cultural Adaptation, Validity, and Reliability of the Indonesian Version of the IKDC Subjective Knee Form
Authors: Deviandri Romy , van der Veen Hugo C. , Lubis Andri M.T. , Postma Maarten J. , van den Akker-Scheek Inge
Published: September 2021

Background:

No questionnaire is currently available for use in patients with anterior cruciate ligament (ACL) injuries in an Indonesian population. The most-used questionnaire in clinical research for these patients is the International Knee Documentation Committee (IKDC) Subjective Knee Form, as its psychometric properties are considered to be excellent.

Purpose:

To translate the IKDC into Indonesian and assess its validity for use in Indonesian-speaking patients with ACL injuries.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

After a forward-and-backward translation procedure and cross-cultural adaptation, the validity and reliability of the questionnaire were investigated. The responses of ACL injury patients on 3 questionnaires, the Indonesian-IKDC (I-IKDC), 36-Item Short Form Health Survey, and Kujala Anterior Knee Pain Scale, were compared. Following consensus-based standards for the selection of health measurement instruments guidelines, construct validity, test-retest reliability, internal consistency, floor and ceiling effects, and measurement error were determined. The Bland-Altman method was used to explore absolute agreement.

Results:

Of 253 ACL injury patients, 106 (42%) responded to the invitation. Construct validity was considered good, as all predefined hypotheses on correlations between the I-IKDC and other scores were confirmed. Reliability proved excellent, with a high test-retest correlation (intraclass correlation coefficient = 0.99). Bland-Altman analyses showed no systematic bias between test and retest. Internal consistency was good (Cronbach α = .90). There were no floor or ceiling effects. Standard error of measurement was 2.1, and the minimal detectable change was 5.8 at the individual level and 0.7 at the group level.

Conclusion:

The I-IKDC, as developed, appeared to be a good evaluation instrument for Indonesian patients with ACL injuries.
Evolving management of colorectal polyps
Authors: Ichkhanian Yervant , Zuchelli Tobias , Watson Andrew , Piraka Cyrus
Published: September 2021

Advances in endoscopic technology have led to increased success in colorectal cancer (CRC) screening and polyp management, with reduction of CRC incidence and mortality. Despite these advances, CRC is still one of the leading causes of cancer deaths, and half of all CRC develops from lesions that were missed during colonoscopy while one-fifth of CRC arise from prior incomplete resection. Techniques to improve polyp detection are needed, along with optimization of complete resection of any abnormal lesions that are found. This article will review the currently available endoscopic resection techniques and will discuss where they fit in the management of polyps of different sizes and types, such as pedunculated versus nonpedunculated, and those with or without suspected invasion.
Self-Compassion, Healthy Lifestyle Behaviors, and Psychological Well-Being in Women
Authors: Koch Julie M. , Ross Julie B. , Karaffa Kerry M. , Rosencrans Anne C. R.
Published: September 2021

Despite pressures on women to make healthy lifestyle choices and a bevy of constantly changing fitness trends and gadgets, national trends related to women’s health reflect a decline in wellness and serious health disparities based on race and socioeconomic status. Therefore, factors underlying women’s success in adopting and maintaining healthy lifestyle behaviors continue to be an essential area for research in health promotion. Previous studies have preliminarily explored the role of self-compassion in women’s health with regard to exercise and eating although less is known about how these factors contribute to overall psychological well-being. In this study, we investigated the relationships between self-compassion, engagement in healthy lifestyle behaviors, and overall psychological well-being among a sample of 340 adults from diverse backgrounds. Results supported the hypothesis that more self-compassionate women engage more frequently in healthy lifestyle behaviors and experience greater psychological well-being. Engagement in healthy lifestyle behaviors partially mediated the relationship between self-compassion and psychological well-being, such that engagement in healthy lifestyle behaviors explained a significant amount of variance in psychological well-being over and above self-compassion. Participants of underrepresented ethnic and racial groups reported higher levels of self-compassion, and higher socioeconomic status participants reported greater engagement in healthy lifestyle behaviors.
Genome-wide CRISPR-Cas9 screen identifies rationally designed combination therapies for CRLF2-rearranged Ph-like ALL
Authors: Sasaki Kensuke , Yamauchi Takuji , Semba Yuichiro , Nogami Jumpei , Imanaga Hiroshi , Terasaki Tatsuya , Nakao Fumihiko , Akahane Koshi , Inukai Takeshi , Verhoeyen Els , Akashi Koichi , Maeda Takahiro
Published: September 2021

Acute lymphoblastic leukemia (ALL) harboring the IgH-CRLF2 rearrangement (IgH-CRLF2-r) exhibits poor clinical outcomes and is the most common subtype of Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL). While multiple chemotherapeutic regimens, including ruxolitinib monotherapy and/or its combination with chemotherapy, are being tested, their efficacy is reportedly limited. To identify molecules/pathways relevant for IgH-CRLF2-r ALL pathogenesis, we performed genome-wide CRISPR-Cas9 dropout screens in the presence or absence of ruxolitinib using 2 IgH-CRLF2-r ALL lines that differ in RAS mutational status. To do so, we employed a baboon envelope pseudotyped lentiviral vector system, which enabled, for the first time, highly efficient transduction of human B cells. While single-guide RNAs (sgRNAs) targeting CRLF2, IL7RA, or JAK1/2 significantly affected cell fitness in both lines, those targeting STAT5A, STAT5B, or STAT3 did not, suggesting that STAT signaling is largely dispensable for IgH-CRLF2-r ALL cell survival. We show that regulators of RAS signaling are critical for cell fitness and ruxolitinib sensitivity and that CRKL depletion enhances ruxolitinib sensitivity in RAS wild-type (WT) cells. Gilteritinib, a pan-tyrosine kinase inhibitor that blocks CRKL phosphorylation, effectively killed RAS WT IgH-CRLF2-r ALL cells in vitro and in vivo, either alone or combined with ruxolitinib. We further show that combining gilteritinib with trametinib, a MEK1/2 inhibitor, is an effective means to target IgH-CRLF2-r ALL cells regardless of RAS mutational status. Our study delineates molecules/pathways relevant for CRLF2-r ALL pathogenesis and could suggest rationally designed combination therapies appropriate for disease subtypes.