bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges Encountered by Healthcare Providers in COVID-19 Times: An Exploratory Study
Authors: Sengupta Mitali , Roy Arijit , Ganguly Arnab , Baishya Kuldeep , Chakrabarti Satyajit , Mukhopadhyay Indraneel 
Published: June 2021

Healthcare establishments are unique and complex. The Indian healthcare system comprises of public and private healthcare establishments. Different challenges are encountered by the healthcare professionals in their daily operations. The sudden emergence of COVID-19 posed a new threat to the already burdened healthcare system. The pandemic changed the healthcare paradox with newer workplace and societal challenges faced by the healthcare personnel. The purpose of this study is to identify the antecedents of workplace and societal challenges faced by the healthcare personnel. Our study conducted in Kolkata and other adjoining areas of West Bengal included respondents who volunteered for individual in-depth interviews. The sample size was kept at n = 20 after due technical considerations. Freelisting and pile sorting was done to generate clusters. The qualitative study identified five constructs with 18 items under workplace challenges and three constructs with five items under societal/community challenges. Workplace challenges included resource availability, adequacy and allocation, financial issues, perceived managerial ineffectiveness, inconsistent guidelines and perceived occupational stress, while societal/community challenges included dread disease, social adaptiveness and challenges related to essential services. A salience threshold was established and the multidimensional scaling provided four major clusters: financial support and sustainability, adaptive resilience, infection risk mitigation and healthcare facility preparedness. Suggestive actions for the identified challenges were summed as enhanced production of diagnostic kits through public–private partnership models and industrial production reforms. Enhanced testing facility for COVID-19 will help to identify new cases. Financial stresses need long-term sustainable alternative that will avoid pay cuts and unemployment. Treatment regimen, diagnostic protocols, waste disposal guidelines should be worked upon and leading national agencies be consulted for technical support, research and development.
Clinical depression: the fault not in our stars?
Authors: Parker Gordon 
Published: June 2021

Objective: To consider how a mental health professional might respond to a newly diagnosed depressed patient who inquires into its potential genetic origins and whether they might pass depression on to their children. Methods: Data are provided on risk and pursuit of genetic pathways. Results: As most studies have focussed on DSM-defined major depression – and which is not an entity – no definitive data are available, while there are some few studies indicating a greater genetic risk in those with melancholic than those with non-melancholic depression. Conclusion: We will not know the genetic contribution to clinical depression unless its key sub-types are evaluated as separate conditions. Findings may assist a clinician’s response to an inquiring patient.
Morphometric Variations and Growth Analysis of the Side Face Profiles of Chinese Children
Authors: Li Haijun , Chen Huimin , Liu Liming , Zhao Yujie 
Published: June 2021

Objective: We aim to use geometric morphometric methods to analyze the contours of the side face profile and its variations in 116 children in Hunan province, China, in order to reveal common morphological features and growth of the side face profiles of Chinese children. Design: We photographed the side faces with consistent standardized procedures. Thirty-seven landmarks were recorded, which comprehensively reflected the facial sagittal plane. The collection of coordinate data regarding landmarks was conducted by tpsDig software. Other analyses, such as average shape analysis, principal component analysis, variations analysis, and allometric analysis, were conducted using tpsRelw and tpsRegr. Result: Based on the 37 landmarks, principal component analysis was used on the profiles of boys and girls. The result shows that PC1 and PC2 account for 35.46% and 27.44% of the side face contour variations, respectively. There is no significant difference in the side profiles of boys and girls. Overlapping distributions between the boys and girls occurred. A significant difference occurs when principal component analysis was used on the side profiles of children and adults. Conclusions: There is a significant difference in the side face profiles between adult males and females. Adult males have a higher brow (the 8th landmark) than females, and adult females have a more curved forehead. However, the side face profiles of boys and girls around 10 years of age are generally similar, which suggests that the significant difference in side face profiles between adult males and females may be formed after the age of 10. This study is of great significance for both orthodontists and pediatricians to use different norms for kids and adults and different norms for males and females for each of those age groups.
Goal attainment scaling—community-based: A method to incorporate personalized outcomes into intervention research with youth and adults on the autism spectrum
Authors: Lee Chung Eun , Shogren Karrie A , Segal Jordan , Pezzimenti Florencia , Aleman-Tovar Janeth , Taylor Julie Lounds 
Published: June 2021

Given the wide heterogeneity in the autism population, one challenge for intervention studies is to identify outcome measures that have similar meaning across individuals. This is particularly pronounced in intervention studies of adults with autism spectrum disorder, where outcomes such as employment, independence, or community living are common targets. However, these outcomes can be more challenging to obtain for those who have greater support needs, for example, and therefore may be more or less salient depending on the sample under study. Goal attainment scaling can help address this issue as it allows individuals to identify personally meaningful goals and track progress toward these goals. While goal attainment scaling is gaining popularity in the autism field as an outcome measure, most intervention studies that use goal attainment scaling have been situated in clinical or school settings. Generating reliable and scalable goals outside of these settings can be challenging. In this article, we describe the promise of goal attainment scaling for tailoring individualized outcomes among youth and adults with autism spectrum disorder and discuss the challenges of current goal attainment scaling methods in community-based intervention research. We then describe a new goal attainment scaling approach that is rigorous, practical, and can be used across research settings to measure individualized outcomes. Lay abstract Among people with autism—all who have the same diagnosis—there are major differences on a nearly limitless number of areas, such as language, daily living skills, intellectual ability, sensory difficulties, and physical and mental health diagnoses. Despite these many differences, the targeted outcomes of intervention studies are often measured the same way across autistic adults, including outcomes such as getting a job, achieving greater independence, or getting more services. People have different goals and abilities, and it is important to have a way for intervention studies to measure outcomes in a way that is more personal to each individual. To address this issue, we developed a new approach—called “Goal Attainment Scaling—Community-based” or GAS-CB—to measure individualized outcomes across different research settings. In this article, we describe the need for individualized outcomes in autism intervention research and current approaches to gathering these outcomes, with our discussion focused on a method called goal attainment scaling. We then describe reasons why current goal attainment scaling approaches might not be useful in intervention research that takes place in the community. Finally, we discuss a new goal attainment scaling approach (GAS-CB) that can be flexibly used for research participants with very different characteristics.
The use of the Amplatzer Vascular Plug in the prevention of endoleaks during abdominal endovascular aneurysm repair: A systematic literature review on current applications
Authors: Bracale Umberto M , Petrone Anna , Provenzano Michele , Ielapi Nicola , Ferrante Liborio , Turchino Davide , del Guercio Luca , Pakeliani David , Andreucci Michele , Serra Raffaele 
Published: June 2021

Objectives The Amplatzer Vascular Plug (AVP) is a vascular occlusion device designed to provide optimal embolization in several fields of the endovascular surgery. A full literature review was conducted to analyze AVPs in comparison with coils for the prevention of endoleaks during endovascular abdominal aortic aneurysm repair. Methods A systematic review was designed under PRISMA statement guidelines for systematic reviews and meta-analyses. The results were updated with a subsequent electronic search using Medline and Scopus databases up to December 2019. Results Eighteen articles making this comparison were found. In 79.7% of the cases, the target vessel was the internal iliac artery; in 1.6%, the common iliac artery; and in 16.7%, the inferior mesenteric artery. Risk of complications (buttock claudication, groin hematoma, endoleaks, and erectile dysfunction) after AVP was low. A cost comparison revealed that the mean cost for coils was around US$2262, while the average cost for the AVP was US$310. Conclusions The AVP is an effective and safe device for occluding peripheral vessels, proved to have lower complications rates. Compared with coil embolization, the AVP technique is potentially associated with lower procedural costs.
Retrospective Analysis of Tacrolimus Intrapatient Variability as a Measure of Medication Adherence
Authors: Herblum Jordana , Dacouris Niki , Huang Michael , Zaltzman Jeffrey , Prasad G. V. Ramesh , Nash Michelle , Chen Lucy 
Published: June 2021

Background: Increased intrapatient variability (IPV) in tacrolimus levels is associated with graft rejection, de novo donor-specific antibodies, and graft loss. Medication nonadherence may be a significant contributor to high IPV. Objective: The objective of this study is to determine the utility of tacrolimus IPV in detecting nonadherence by examining the relationship between self-reported adherence and tacrolimus coefficient of variability (COV), a measure of IPV. Design: Retrospective cohort study. Setting: St. Michael’s Hospital, Toronto, Ontario. Patients: All patients who were at least 1-year post-kidney transplant as of March 31, 2019, prescribed tacrolimus as an immunosuppressant and had a self-reported adherence status. Patients were excluded from the primary analysis of examining the correlation between COV and self-reported adherence if they lacked a calculatable COV. Measurements: Self-reported adherence, COV, demographic data, transplant, and medication history. Methods: A modified Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS) administered by healthcare professionals to assess self-reported adherence was used. The COV of tacrolimus trough levels was calculated and its correlation to BAASIS response was noted. The median COV was used as a cutoff to examine the characteristics of patients deemed “high COV” and “low COV.” Results: A total of 591 patients fit the initial criteria; however, only 525 had a recent calculatable COV. Overall, 92.38% of the population were adherent by self-report. Primary analysis identified a COV of 25.2% and 29.6% in self-reported adherent and nonadherent patients, respectively, though the result was not significant ( P = .2). Secondary analyses showed a significant correlation between younger age at transplant and at the time of adherence self-reporting with nonadherence ( P = .01). In addition, there was a strong correlation between those nonadherent with routine post-transplant blood work and younger age ( P < .01). Limitations: The limitations included modified nonvalidated BAASIS questionnaire, social desirability bias, BAASIS only administered in English, and patients with graft failure not active in clinic not being captured. Conclusions: The COV should not be used as the sole method for determining medication adherence. However, COV may have some utility in capturing individuals who are not adherent to their blood work or patients who are having a poor response to tacrolimus and should be switched to another medication.
Effectiveness of massage therapy on fatigue and pain in patients with multiple sclerosis: A systematic review and meta-analysis
Authors: Salarvand Shahin , Heidari Mohammad Eghbal , Farahi Kazem , Teymuri Erfan , Almasian Mohammad , Bitaraf Saeid 
Published: June 2021

Background Fatigue and pain are prevalent symptoms of multiple sclerosis (MS) and frequent complaint in MS patients, which reduce their quality of life. This study aimed to assess the effect of massage therapy on pain and fatigue in MS Patients. Method The original and Persian databases were searched included PubMed, web of science, embase, ovid, scopus, and the Cochrane Library, SID, and Iranedex from inception to November 2020. Studies that reported the effect of massage on fatigue and pain were included. Two investigators extracted all relevant data, independently. For deriving analysis, mean difference (MD) and standardized mean difference (SMD) were used. Result Ten studies were eligible acoording criteria. The effect of massage on fatigue showed significant improvement (−1.62; 95% CL −2.40, −0.83; p < .00001), also results of the systematic review showed a significant reduction in pain severity. Conclusion Massage as a complementary and non-pharmacological therapy might have been associated with alleviating fatigue and pain in M.S. patients. Based on the current study, massage intervention for MS patients could have possible clinical value for palliating pain and fatigue and improving quality of life; however, this matter needs further and more significant trial studies.
Repelolicer: A Reality or Snake Oil
Authors: Hussain Umer , Yu Bo 
Published: June 2021

While head lice continue to be a worldwide health issue, there remains a dearth of scholarship detailing how various organizations are developing different products to deal with this problem. In this case study, the authors ponder upon a novel entrepreneurial idea developed by the students to tackle the lice issue in Pakistan. A team of students developed Repelolicer, an ultrasonic wave-emitting hairband to stop lice infestation among younger-aged girls. The Repelolicer team developed various strategies to target the Pakistani market. However, due to inadequate knowledge of the external market, the entrepreneurial idea failed to succeed. Research Objective: This case study aimed to explore challenges faced by an entrepreneurial venture using the first-mover strategy while penetrating the lower strata market via a product, which had a stigmatized effect. Link to Theory: In the extant scholarship, first-movers are considered to have strategic advantages against new rivals. In this study, we explore the disadvantages of first-mover in a complex Pakistani market situation through the lens of the resource-based view (RBV) and industrial organization (IO) perspective. Phenomenon Studied: This case study focuses on exploring the reasons behind the failure of tech-based first-movers (i.e., Repelolicer) in the Pakistani market scenario. The study also elucidates various external factors—a new venture should explore before launching a product in a Pakistani market situation. Case Context: The context in this case study is the lice problem among younger-aged girls in Pakistan’s lower strata market. Findings: The study participants unveiled that despite Repelolicer having competitive advantages because of internal factors, the Repelolicer team could not fully understand invisible forces in the external market. This lack of understanding led to their product failure. The Repelolicer team was also unable to comprehend how the product design might have further escalated the stigma attached to lice in society. Lastly, their pricing and promotion strategy was incompatible with the complex market situation. Discussions: This study adds to the limited knowledge about first-movers’ disadvantages in developing countries, such as Pakistan. The study results revealed that being a first-mover, even with all the adequate resources, is not always advantageous. The new ventures can especially face disastrous consequences for being the first-mover due to their lack of experience and knowledge of the local market. The study results also showed that new ventures should take the IO perspective with the RBV approach to succeed in a complicated market situation. The theoretical and practical implications of the case study have been outlined.
Preventing Tommy John Surgery: The Identification of Trends in Pitch Selection, Velocity, and Spin Rate Before Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers
Authors: Mayo Benjamin C. , Miller Adam , Patetta Michael J. , Schwarzman Garrett R. , Chen Jeffrey W. , Haden Marshall , Secretov Erwin , Hutchinson Mark R. 
Published: June 2021

Background: Ulnar collateral ligament (UCL) reconstruction is a common surgery among Major League Baseball (MLB) pitchers that results in a significant number of missed games. Little has been reported regarding game-by-game trends that can identify those on the verge of becoming injured. Purpose: To determine if there is a patterned change in MLB pitchers’ pitch selection, velocity, or spin rate in games leading up to Tommy John surgery that may predict subsequent UCL surgery. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of MLB pitchers who underwent primary UCL reconstruction between 2009 and 2019 was performed. Pitch characteristics were evaluated on a game-by-game basis for the 15 games leading up to surgery. A Mann-Kendall trend test was used to identify trends in pitch selection, velocity, and spin rate for multiple pitch types. A Kendall τb correlation coefficient was identified, with values closer to 1 or –1 signifying a stronger monotonic trend. Results: A total of 223 MLB pitchers underwent UCL reconstruction in the time period. In the 15 games leading up to surgery, decreases in pitch velocity for 4-seam fastballs (τb = –0.657; P < .001), 2-seam fastballs (τb = –0.429; P = .029), and sliders (τb = –0.524; P = .008) were significantly associated with game number closer to injury. There was a significant positive association in the spin rate for cutters (τb = 0.410; P = .038) and a significant negative association in spin rate for 4-seam fastballs over the course of these 15 games (τb = –0.581; P = .003). In addition, there was a significant positive association in the percentage of curveballs thrown (τb = 0.486; P = .013). Conclusion: The study results suggest that there is a patterned change in certain pitch statistics in MLB pitchers in the games leading up to Tommy John surgery. Although the absolute change from game to game may be small, it may be possible for these trends to be monitored before a player becomes injured, thus reducing the significant burden Tommy John surgery places on these athletes.
Moderating Roles of Resilience and Social Support on Psychiatric and Practice Outcomes in Nurses Working During the COVID-19 Pandemic
Authors: Schierberl Scherr Anna E. , Ayotte Brian J. , Kellogg Marni B. 
Published: June 2021

Introduction Staff and equipment shortages and an easily transmissible virus make working in the COVID-19 pandemic demanding physically and psychologically. Nurses on the frontlines are particularly vulnerable to the adversity of working under these conditions, particularly with regard to mental health. Thus, understanding risk and protective factors for this vulnerable and essential group is critical for identifying potential targets of interventions. We had two aims for the current study: (a) to examine work functioning and symptoms of depression, anxiety, and posttraumatic stress (PTSD) among nurses who did and did not care for patients with COVID-19; and (b) to determine if resilience and social support moderate these relationships. Methods For three weeks in July 2020, nurses across the United States were invited to participate in an online survey collecting data on demographics, resilience, social support, and screening measures of depression, PTSD, anxiety, and distracted practice. Data were analyzed using descriptive statistics and hierarchical regression for each outcome measure. Conclusions Our findings support a growing body of research reporting that nurses are experiencing mental health sequelae during the COVID-19 pandemic, especially those providing direct care to patients with the virus. We found that compared to nurses who did not care for patients with COVID-19, those who did reported increased symptoms of PTSD, depression, and anxiety. A novel contribution is our finding that nurses providing direct COVID-19 care also experienced increased levels of distracted practice, a behavioral measure of distraction linking to a potential impact on patient care. We also found that resilience and social support acted as moderators of some of these relationships. Fostering resilience and social support may help buffer the effects of providing care to patients with COVID-19 and could potentially decrease nurse vulnerability to developing psychological symptoms and impairment on the job.
Does Preservation of Coracoacromial Ligament Reduce the Acromial Stress Pathology Following Reverse Total Shoulder Arthroplasty?
Authors: Baek, MD Chang Hee , Kim, MD Jung Gon , Lee, MD Dong Hyeon , Baek Gyu Rim 
Published: June 2021

Introduction Acromial pathologies (AP), such as acromial stress reaction (ASR), acromial stress occult fracture (ASOF), and acromial stress fracture (ASF), are known as complications that deteriorate the clinical score and patient satisfaction after reverse total shoulder arthroplasty (RSA). Several factors that increase stress on the acromion have been reported as risk factors for AP, but this is also unclear. Thecoracoacromial ligament (CAL) is a structure that distributes the stress loading on such an acromion, although its importance has been mentioned, there is a lack of research. Therefore, we investigated the incidence of AP according to the preservation of the CAL and whether it is a risk factor. Methods The study was retrospectively conducted on patients who underwent RSA from 2016 and 2018. Patients with CAL transection was classified into group 1 and CAL preservation was classified into group 2. ASR and ASOF were identified through symptoms and ultrasound, and ASF identified through simple radiograph or computed tomography. The incidence of AP in each group was checked and compared. Results Of the total of 265 patients. Among 197 cases of group 1, 21 cases of ASR(10.7%), 28 cases of ASOF (14.2%),10 cases of ASF (5.1%), and 59 cases of total AP (29.4%). Among 68 cases in group 2, 2 cases (2.9%) of ASR, 6 cases of ASOF(8.8%), 1 case of ASF (1.5%), and 9 cases of total AP (13.2%). It was confirmed that ASR and ASOP were significantly decreased in the group preserving CAL. (P = .008) Conclusion In the case of preservation of CAL during surgery, it was confirmed that the incidence of ASR, ASOF was reduced. Therefore, preservation of CAL can be regarded as a modifiable risk factor that can reduce the risk of AP by distributing the stress applied to acromion after RSA surgery.