bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Conversion Therapy” Experiences in Their Social Contexts: A Qualitative Study of Sexual Orientation and Gender Identity and Expression Change Efforts in Canada
Authors: Kinitz David J. , Goodyear Trevor , Dromer Elisabeth , Gesink Dionne , Ferlatte Olivier , Knight Rod , Salway Travis 
Published: July 2021

Objective: To describe in what forms, with whom, where, when, and why Canadians experience sexual orientation and gender identity and expression change efforts (SOGIECE). Methods: This qualitative study is grounded in a transformative paradigm. We conducted semi-structured interviews with a purposive sample of 22 adults recruited from across Canada who have experienced “conversion therapy.” Directed content analysis was used, employing deductive and inductive coding approaches, to synthesize the findings and address 5 policy-relevant questions. Results: What are SOGIECE? Formal and informal methods of SOGIECE were used, including pharmacologic interventions, denial of gender-affirming care, and coaching to repress sexual orientation and/or gender identity and expression. With whom did SOGIECE occur? Practitioners included religious leaders, licenced health-care professionals (e.g., psychiatrists and psychologists), peers, and family members. Where did SOGIECE occur? SOGIECE occurred in 3 predominant settings: faith-based, health care, and social life. When did SOGIECE occur? SOGIECE rarely occurred over a restricted time frame; often, SOGIECE began while participants were adolescents or young adults and continued multiple years under various forms. Others described SOGIECE as a context in which their life was embedded for many years. Why did people attend SOGIECE? Cisheteronormative social and religious expectations taught participants that being non-cisgender or non-heterosexual was incompatible with living a good and respectable life. Conclusions: SOGIECE are not a circumscribed set of practices. Our study shows that SOGIECE are a larger phenomenon that consists of intentional and explicit change efforts as well as heterosexual- and cisgender-dominant social norms expressed and enforced across a wide range of settings and circumstances. This study provides critical context to inform contemporary social and health policy responses to SOGIECE. Policies should account for the overt, covert, and insidious ways that SOGIECE operate in order to effectively promote safety, equity, and health for sexually diverse and gender-diverse people.
Ketogenic Diet Therapy for Epilepsy Associated With Aicardi Syndrome
Authors: Sanchez Miguel A. Ramirez , Cervenka Mackenzie C. , Bessone Stacey K. , Kossoff Eric H. 
Published: July 2021

Introduction: Aicardi syndrome is a rare neurodevelopmental disorder associated with epilepsy in females. Ketogenic diet therapy represents a possible nonpharmacologic treatment in Aicardi syndrome patients. Methods: All patients with Aicardi syndrome seen at Johns Hopkins Hospital (Baltimore, MD) and Johns Hopkins All Children’s Hospital (St Petersburg, FL) treated with ketogenic diet therapy since 1994 were evaluated retrospectively. Results: Fifteen patients, ages 4 months to 34 years, were identified. Ten (67%) patients experienced a ≥50% seizure reduction after 3 months, with 3 (20%) having a ≥90% reduction. Only 1 patient was seizure-free for a short period of time. The number of drugs tried prior to ketogenic diet therapy initiation was correlated with ≥50% seizure reduction at 3 months, 5.8 vs 2.6 in responders versus nonresponders ( P = .01). In addition, the mean number of drugs actively received also correlated, 3.0 vs 1.2, P = .005. Ketogenic diet therapy was slightly more successful in those without infantile spasms, 78% vs 50%, P = .33. Conclusion: Ketogenic diet therapy was helpful in Aicardi syndrome, although seizure freedom was rare. It was especially helpful for those who were more drug-resistant and did not have infantile spasms at ketogenic diet therapy onset.
A novel hybrid aircraft propulsion based on the DEA compressor—part B: Performance
Authors: Aryana Babak 
Published: July 2021

This two-parts article introduces a novel hybrid propulsion system based on the DEA compressor. The system encompasses a Pulse Detonation TurboDEA as the master engine that supplies several full-electric ancillary thrusters called DEAThruster. The system, called the propulsion set, can be categorized as a distributed propulsion system based on the design mission and number of ancillary thrusters. Part B of this article explains the performance sizing of the propulsion set designed in part A. Evaluating the performance of the propulsion, computer programs are written for all major components of the both master engine and ancillary thruster. The intake, compressor, detonation process, diffusers, axial turbine, and exit nozzle are modeled under certain flight conditions, and their performances are revealed and analyzed. The flight conditions are considered from the static condition at the sea level up to flight Mach number 5 at an altitude of 20,000 m. The performance of the propulsion set is also compared with some aircraft propulsions modeled by similar studies in all important aspects.
Primordial Haptics, 1925–1935: Hands, Tools and the Psychotechnics of Prehistory
Authors: Stadler Max 
Published: July 2021

‘Psychotechnics’, Weimar Germany’s science du jour, typically is framed as a symptom of ‘technological media’ – obscuring the persistent significance of ‘dexterity’, ‘skill’ and ‘manual labour’ at the time. More broadly, there is a tendency to construe ‘the haptic’ as predominantly a casualty of modernity: skilled hands replaced by conveyor belts; skilled hands defended by the rearguard actions of arts-and-crafts movements; skilled hands destroyed by industrialized warfare. Drawing on contemporary investigations into the ‘organ of touch’, this essay aims to complicate this picture by reconstructing the proto-ergonomic project of Friedrich Herig, a German engineer, amateur prehistorian and expert on craft labour who rose to distinction in the 1920s as a designer of ‘ideal’ hand tools. Herig’s eclectic sources of inspiration reveal that matters of ‘touch’, far from obsolete, were intimately bound up with matters of tools – their design, uses and putative origins – and thus, with matters of (manual) labour.
Diagnosis and Treatment of Snapping Scapula Syndrome: A Scoping Review
Authors: Baldawi Hassan , Gouveia Kyle , Gohal Chetan , Almana Latifah , Paul Ryan , Alolabi Bashar , Moro Jaydeep , Khan Moin 
Published: July 2021

Context: Snapping scapula syndrome (SSS) is commonly misdiagnosed and underreported due to lack of awareness. Objective: This scoping review aims to summarize the current evidence related to SSS diagnosis and treatment to aid clinicians in managing the condition more effectively. Data Sources: PubMed, Medline, and Embase databases were searched for studies related to the etiology, diagnosis, or treatment of SSS (database inception to March 2020). Study Selection: Databases were searched for available studies related to the etiology, diagnosis, or treatment of SSS. Study Design: A scoping review study design was selected to explore the breadth of knowledge in the literature regarding SSS diagnosis and treatment. Level of Evidence: Level 4. Data Extraction: Primary outcomes abstraction included accuracy of diagnostic tests, functional outcomes, and pain relief associated with various nonoperative and operative treatment options for SSS. Results: A total of 1442 references were screened and 40 met the inclusion criteria. Studies commonly reported SSS as a clinical diagnosis and relied heavily on a focused history and physical examination. The most common signs reported were medial scapular border tenderness, crepitus, and audible snapping. Three-dimensional computed tomography had high interrater reliability of 0.972, with a 100% success rate in identifying symptomatic incongruity of the scapular articular surface. Initial nonoperative treatment was reported as successful in most symptomatic patients, with improved visual analogue scale (VAS) scores (7.7 ± 0.5 pretreatment, to 2.4 ± 0.6). Persistently symptomatic patients underwent surgical intervention most commonly involving bursectomy, superomedial angle resection, or partial scapulectomy. High satisfaction rates of surgery were reported in VAS (6.9 ± 0.7 to 1.9 ± 0.9), American Shoulder and Elbow Surgeons scores (50.3 ± 12.2 to 80.6 ± 14.9), and mean simple shoulder test scores (5.6 ± 1.0 to 10.2 ± 1.1). Conclusion: Focused history and physical examination is the most crucial initial step in the diagnostic process, with supplemental imaging used to assess for structural etiologies when nonoperative management fails. Nonoperative management is as effective as surgical management in pain relief and is advised for 3 to 6 months before operative treatment.
Phosphoproteomic analysis of lung tissue from patients with pulmonary arterial hypertension
Authors: Sitapara Ravikumar , Lam TuKiet T. , Gandjeva Aneta , Tuder Rubin M. , Zisman Lawrence S. 
Published: July 2021

Pulmonary arterial hypertension (PAH) is a rare disorder associated with high morbidity and mortality despite currently available treatments. We compared the phosphoproteome of lung tissue from subjects with idiopathic PAH (iPAH) obtained at the time of lung transplant with control lung tissue. The mass spectrometry‐based analysis found 60,428 phosphopeptide features from which 6622 proteins were identified. Within the subset of identified proteins there were 1234 phosphopeptides with q < 0.05, many of which are involved in immune regulation, angiogenesis, and cell proliferation. Most notably there was a marked relative increase in phosphorylated (S378) IKZF3 (Aiolos), a zinc finger transcription factor that plays a key role in lymphocyte regulation. In vitro phosphorylation assays indicated that GSK3 alpha and/or GSK3 beta could phosphorylate IKZF3 at S378. Western blot analysis demonstrated increased pIKZF3 in iPAH lungs compared to controls. Immunohistochemistry demonstrated phosphorylated IKZF3 in lymphocytes surrounding severely hypertrophied pulmonary arterioles. In situ hybrization showed gene expression in lymphocyte aggregates in PAH samples. A BCL2 reporter assay showed that IKZF3 increased BCL2 promoter activity and demonstrated the potential role of phosphorylation of IKZF3 in the regulation of BCL mediated transcription. Kinase network analysis demonstrated potentially important regulatory roles of casein kinase 2, cyclin‐dependent kinase 1 (CDK1), mitogen‐associated protein kinases (MAPKs), and protein kinases (PRKs) in iPAH. Bioinformatic analysis demonstrated enrichment of RhoGTPase signaling and the potential importance of cGMP‐dependent protein kinase 1 (PRKG). In conclusion, this unbiased phosphoproteomic analysis demonstrated several novel targets regulated by kinase networks in iPAH, and reinforced the potential role of immune regulation in the pathogenesis of iPAH. The identified up‐ and down‐regulated phosphoproteins have potential to serve as biomarkers for PAH and to provide new insights for therapeutic strategies.
Association of statin use and the risk of recurrent pulmonary embolism in real‐world Chinese population
Authors: Wang Lu , Shu Tingting , Wang Wuwan , Chen Huaqiao , Feng Panpan , Xiang Rui , Huang Wei 
Published: July 2021

BackgroundPrevious studies have suggested that statins exert protective effects against venous thromboembolism. However, few randomized studies have explicitly concentrated on patients with pulmonary embolism. Thus far, evidence of the effect of statins on the pulmonary embolism recurrence in China remains lacking.MethodsA retrospective analysis was conducted utilizing our University database. Patients with an International Coding of Diseases‐defined diagnosis of pulmonary embolism from 1 January 2017 to 31 December 2019 were included. The patients were divided into two groups, namely, with statin or without statin treatment. Propensity score matching was applied to balance the covariates between the comparison groups. Univariate analysis and multivariable logistic regression were performed to analyze the association between statin use and pulmonary embolism recurrence.ResultsA total of 365 patients diagnosed with pulmonary embolism were included in the research. Pulmonary embolism recurrence accounted for 15.1% of the patients and was observed during the entire study period. In the initial population, no significant difference in recurrence was observed between the groups with and without statins treatment (statin 15.6% vs. non‐statin 14.9%, p = 0.860). After propensity score matching, multivariate logistic regression analysis revealed that the odds ratio of pulmonary embolism recurrence in the statin users was 0.489 (95% confidence interval 0.190–1.258, p = 0.138).ConclusionsOur study provides no support for the use of statins as an adjunctive therapy in patients with pulmonary embolism at the initiated time of diagnosis or as a prophylactical plan when anticoagulation is discontinued attempting to reduce the risk of recurrence.
Risk factors for triatominae infestation in a municipality of Colombia
Authors: Parra-Henao Gabriel , Garzón-Jiménez Sandra P. , Bernal-Rosas Yuly , Olivera Mario J. , Salgado Marlon , Torres-García Orlando A. 
Published: July 2021

Background: Identifying risk factors for Triatominae infestation is essential for the development of vector control interventions. Methods: To determine the intra- and peridomiciliary risk factors associated with triatomine infestation, a cross-sectional analytical study was carried out with random cluster sampling in two stages, which included the identification of risk factors by survey and direct observation, as well as the search and capture of triatomines. The detection of trypanosomes in triatomines was carried out by observing the rectal content and then by conventional polymerase chain reaction (PCR). Results: In 21 of the 207 houses inspected, 13 specimens of R. colombiensis and 19 specimens of P. geniculatus were found. Entomological indices included: dispersion 36%, infestation 10%, infection 65%, colonization 4.7%, density 15%, and concentration 152%. An association was found between the presence of Triatominae and the existence of branches and fissures in the floors, as well as with the presence of accumulated objects and with knowledge about Chagas disease. The risk of having triatomines in urban homes is 5.7 times higher than the risk in rural areas [confidence interval (CI) 0.508–67.567]; 6.6 times in houses with cracked soil (CI 0.555–81.994), 6 times in houses located near caneys (CI 0.820–44.781), and 6.16 times with accumulated objects (CI 1.542–39.238). Conclusion: Chagas disease is a complex problem that requires control based on the vector’s elimination or surveillance, which implies identifying species and their distribution, generating alerts, knowledge, and awareness in the population. It is necessary to intensify surveillance activities for the event, especially in changing aspects of Chagas diseases’ transmission dynamics, such as urbanization and the type of housing associated with the vector’s presence.
The Long-Term Effects of a Housing First Intervention on Primary Care and Non-Primary Care Physician Visits Among Homeless Adults with Mental Illness: A 7-Year RCT Follow-Up
Authors: Mejia-Lancheros Cilia , Lachaud James , To Matthew J. , Lee Patsy , Nisenbaum Rosane , O’Campo Patricia , Stergiopoulos Vicky , Hwang Stephen W. 
Published: July 2021

Background: Housing First (HF)-based interventions have been implemented in North America and beyond to help people exit homelessness. The effect of these interventions on access to primary and specialist care services is not well-defined. This study assesses the long-term effects of an HF intervention for homeless adults with mental illness on primary care physician (PCP) and non-primary care physician (non-PCP) visits. Methods: This is a secondary analysis of the At Home/Chez Soi study, a randomized trial of HF for homeless adults with mental illness in Toronto, Canada. High-need (HN) participants were randomized to HF with assertive community treatment (HF-ACT) or treatment as usual (TAU). Moderate needs (MN) participants were randomized to HF with intensive case management (HF-ICM) or TAU. The primary outcomes were the incidence and the number of visits to a PCP and non-PCP over 7-years post-randomization, compared to the 1-year pre-randomization. Results: Of 575 enrolled participants, 527 (80 HN and 347 MN) participants were included in the analyses. HN participants who received HF-ACT had a significant reduction in the number of visits to a PCP compared to TAU participants (ratio of rate ratios (RRR): 0.66, 95% CI: 0.48-0.93) and a significant reduction in the number of non-PCP visits compared with TAU participants (RRR: 0.64, 95% CI: 0.42-0.97) in the 7-years post-randomization compared to the 1-year pre-randomization. MN participants who received HF-ICM had a significant increase in incident visits to a PCP compared to TAU participants (RRR: 1.66, 95% CI: 1.10-2.50). No effect of HF-ICM was observed on the incidence or number of non-PCP visits. Conclusion: HF has differing effects on visits to PCPs and non-PCPs among homeless people with high and moderate needs for mental health supports. HF does not result in a consistent increase in PCP and non-PCP visits over a 7-year follow-up period. The At Home/Chez Soi study is registered with ISRCTN (ISRCTN, ISRCTN42520374).
One Room Schoolhouse: A Novel Intervention for Inspired Academic Half-Day Learning in Distributed Campus Settings
Authors: Harms Sheila , Acai Anita , Bogie Bryce JM , McConnell Meghan M , McCutchen Ben , Fallen Robyn , Corey JoAnn , Snelgrove Natasha 
Published: July 2021

Introduction: Some studies on academic half days (AHDs) suggest that learning in this context is associated with a lack of educational engagement. This challenge may be amplified in distributed campus settings, where geographical disadvantages demand reliance on videoconferencing or considerable time spent travelling to in-person learning events. Concerns about the educational effectiveness of AHDs by learners within our distributed campus setting led to the development and evaluation of the One Room Schoolhouse (ORS), a unique, evidence-informed, community-based curriculum that partially replaced the AHD sessions delivered at the main campus. It was hypothesized that creating an AHD experience that was clinically reflective of the community in which residents practiced and where residents were given the autonomy to implement novel pedagogical elements would result in better test scores and improved learner satisfaction among ORS learners. Methods: The ORS was implemented at McMaster University’s Waterloo Regional Campus in 2017. Residents across training cohorts (N = 9) engaged in co-learning based on scenarios co-developed from clinical experiences within the region. The learning approach relied on multiple, evidence-informed pedagogical strategies. A multi-method approach was used to evaluate the ORS curriculum. Between-subject analyses of variance were used to compare scores on practice exams (COPE and PRITE), in-training assessment reports (ITARs), and objective structured clinical exams (OSCEs) between learners who took part in the ORS and learners at the main campus. A semi-structured focus group probing residents’ experiences with the ORS was analyzed using interpretive description. Results: ORS learners significantly outperformed learners at the main campus on the November OSCE ( p = .02), but not on the COPE, PRITE, ITARs, or September OSCE ( p’s < .05). Qualitative themes suggested advantages of the ORS in inspiring learning, engaging learners, and improving self-confidence in knowledge acquisition. These findings are aligned with the broader literature on learner agency, social development, and communities of practice. Conclusion: While the quantitative data only showed a significant difference between the 2 curricula on 1 measure (ie, the November OSCE), the qualitative findings offered an opportunity for educators to reimagine what medical education might consist of beyond the confines of a “traditional” AHD. Creating opportunities to enhance personal agency when acquiring knowledge, inspiring engagement about patient-related problems, and incorporating interdisciplinary learning through community engagement were critical pedagogical elements that were attributed to the success of the ORS.
Availability and accessibility of monoclonal antibodies in Bosnia and Herzegovina: Findings and implications
Authors: Tubic Biljana , Marković-Peković Vanda , Jungić Saša , Allocati Eleonora , Godman Brian 
Published: July 2021

Background: Monoclonal antibodies (mAbs) represent the most numerous and significant group of biotherapeutics. While mAbs have undoubtedly improved treatment for many chronic diseases, including inflammatory diseases, they are typically expensive for health care systems and patients. Consequently, access to mAbs has been a problem for many patients especially among Central and Eastern European (CEE) countries. However, biosimilars can potentially help with costs, although there are concerns with their effectiveness and safety. This includes biosimilars for long-acting insulin analogues. Aim: Assess the availability and use of biological medicines, including biosimilars within Bosnia and Herzegovina (B&H). Methods: Assess the availability of mAbs via the current lists of approved and accessed mAbs versus those licenced in Europe and the United States and their utilisation, as well as specifically insulin glargine and its biosimilars, within B&H. Results: The availability of the mAbs in B&H appears satisfactory, which is encouraging. However, current usage is limited to a few mAbs which is a concern for subsequent patient care especially with limited use of biosimilars to address issues of affordability. We also see limited use of biosimilar insulin glargine. Conclusion The limited use of mAbs including biosimilars needs to be addressed in B&H to improve the future care of patients within finite resources. We will monitor these developments.
Trends in Leadership and Award Recognition Among Women in the American Society of Retina Specialists
Authors: Reeves Mary-Grace R. , Pasricha Malini Veerappan , Ludwig Cassie A. , Chandramohan Arthika , Azad Amee D. , Li Angela S. , Rosenblatt Tatiana R. , Sears Connie Martin , Kossler Andrea L. , Do Diana V. , Pan Carolyn K. 
Published: July 2021

Purpose: This work evaluates trends in achievement of women in the retina field, through an analysis of gender representation in the American Society of Retina Specialists (ASRS). Methods: This retrospective, longitudinal study spans 1983 to 2020. Historical data classified by male or female gender were collected from ASRS's overall membership, board of directors and officers, and recipients of the 4 society awards. The proportion of each benchmark held by women was compared with prior decades since the founding of ASRS using the Fisher’s exact test. Results: Women’s representation increased from 11% of ASRS members in 2007 to 19.7% in 2020. From 2010 to 2019, women received a higher proportion of society awards (21.1%) compared with membership prior to the start of that decade. In 2020, women were proportionally well represented in board of director positions (21.9%) and held a significantly higher proportion of board positions than in the period 1983 to 1989 ( P = .02). From 1983 to 2020, women held 4.3% (1 of 23) of presidencies. Conclusions: Although the number of women in retina is increasing, women remain underrepresented in the leadership of ASRS. Interventions to increase exposure to female mentorship and improve childcare benefits are warranted to engage female ophthalmology trainees in retina and ultimately society leadership.