bluuebunny/crossref_metadata_2025 huggingface dataset:
A randomized non‐inferiority pilot study on the use of methoxyflurane (Penthrox®) for pain control in the emergency department
Authors: Wong Ka Ying , Lau James Siu Ki , Siu Axel Yuet Chung , Kan Pui Gay
Published: August 2021

Background:

Patients commonly visit the emergency department for pain after musculoskeletal injury, but the problem of oligoanalgesia is prevalent. Methoxyflurane (Penthrox®) is an inhalational analgesic for moderate to severe trauma‐associated pain in stable and conscious patients. It is a fast‐acting, effective analgesic that can be readily administered via a non‐invasive route, making it an attractive agent for managing acute pain in the emergency departments.

Objectives:

The aim was to assess the analgesic efficacy of methoxyflurane in patients with acute traumatic pain by comparing it to ketorolac, a standard analgesic treatment for moderate pain in emergency departments in Hong Kong.

Methods:

This was a single‐center, open‐label, randomized controlled, parallel‐group, non‐inferiority pilot study that enrolled adult patients with moderate trauma‐associated pain in an emergency department in Hong Kong. Patients were randomized 1:1 to the methoxyflurane group or the ketorolac group. The primary outcome was the change in pain intensity measured by visual analogue scale from baseline to 5, 15, 30, and 60 min after drug administration.

Results:

Twenty patients received methoxyflurane, and twenty patients received ketorolac. There were significant reductions in pain score over 60 min in both groups. The pain reduction at 5 min was significantly greater for the methoxyflurane group (−13.912 mm; 95% confidence interval = −20.008 to −7.817) than for the ketorolac group (−4.888 mm; 95% confidence interval = −10.983 to 1.208), with the treatment effect (−9.025 mm; 95% confidence interval = −17.656 to −0.393; p = 0.041) demonstrating superiority of methoxyflurane. The treatment effect at 15 and 30 min demonstrated non‐inferiority of methoxyflurane versus ketorolac.

Conclusion:

Methoxyflurane provided non‐inferior analgesia in the first 30 min with a faster onset of action when compared with ketorolac in moderate traumatic pain. It can be considered a non‐invasive, rapid‐acting, and effective first‐line alternative to currently available analgesics for traumatic pain in emergency settings.
Listening to music to cope with everyday stressors
Authors: Krause Amanda E. , Scott William G. , Flynn Sarah , Foong Beatrice , Goh Kitye , Wake Stephanie , Miller Daniel , Garvey Darren
Published: August 2021

Everyday stressors—the irritating and disturbing events that happen in the context of everyday life—are common. The present research examined the relationship between everyday stressors and the use of music listening as a coping mechanism. In particular, it examined the use of music listening to cope with different types of everyday stressor and examined the relationship between this usage and listener characteristics, including demographics and music engagement style. Participants in the USA, Australia, and Malaysia ( N =553) completed an online survey. A factor analysis was used to identify five types of everyday stressor: Social, Financial, Performance Responsibilities, Work-related, and Daily Displeasures. Individuals listened to music significantly more often to cope with social and work-related stressors than performance responsibilities and daily displeasures. Moreover, individuals who demonstrated a stronger affective listening style and those who reported listening to music for emotion/problem-orientated and avoidance/disengagement reasons were found to listen to music most often to cope with everyday stressors. These findings have implications, for both listeners and health professionals, when considering how music listening can be used as a self-administered tool for coping with everyday stressors.
Repeatability of Weightbearing Computed Tomography Measurement of First Metatarsal Alignment and Rotation
Authors: Najefi Ali-Asgar , Alsafi Mohammad Khalid , Malhotra Karan , Patel Shelain , Cullen Nicholas , Welck Matthew
Published: August 2021

Background:

Weightbearing computed tomography (WBCT) can be used to assess alignment and rotation of the first metatarsal. It is unknown whether these measures remain consistent on sequential WBCTs in the same patient when a patient’s standing position may be different. The aim of this study was to establish the repeatability (test-retest) of measurements of first metatarsal alignment and rotation in patients without forefoot pathology on WBCT.

Methods:

We retrospectively identified 42 feet in 26 patients with sequential WBCT studies less than 12 months apart. Patients with surgery between scans, previous forefoot surgery or hallux rigidus were excluded. Hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured using digitally reconstructed radiographs. Two methods of calculating metatarsal rotation (metatarsal pronation angle [MPA] and alpha angle) were measured on standardized coronal CT slices. Interobserver agreement and test-retest repeatability were assessed using intraclass correlation coefficients (ICCs). Standard error of measurement (SEM) and minimally detectable change (MDC95) were calculated.

Results:

Interobserver agreement was excellent for HVA and IMA (ICC 0.96 and 0.90, respectively) and was good for MPA and alpha angle (ICC 0.81 and 0.80, respectively). There was excellent test-retest repeatability for HVA (ICC=0.90) and good test-retest repeatability for IMA (ICC=0.77). There was excellent test-retest repeatability for MPA (ICC=0.91) and good test-retest repeatability for alpha angle (ICC=0.87). The MDC95 was 4.6 degrees for MPA and 6.1 degrees for alpha angle. Five percent of patients had a difference outside of the MDC95 for the alpha angle, compared with 2% for the MPA.

Conclusion:

Measurements of first metatarsal alignment and rotation are reliable between assessors and repeatable between sequential WBCTs in patients without forefoot pathology. Subtle differences in patient positioning during image acquisition do not significantly affect measurements, supporting the validity of this method of assessment in longitudinal patient care.

Level of Evidence:

Level IV, retrospective case series.
Persistent Pain After Cardiac Surgery: Prevention and Management
Authors: Krakowski James C. , Hallman Matthew J. , Smeltz Alan M.
Published: August 2021

Persistent postoperative pain (PPP) after cardiac surgery is a significant complication that negatively affects patient quality of life and increases health care system burden. However, there are no standards or guidelines to inform how to mitigate these effects. Therefore, in this review, we will discuss strategies to prevent and manage PPP after cardiac surgery. Adequate perioperative analgesia may prove instrumental in the prevention of PPP. Although opioids have historically been the primary analgesic approach to cardiac surgery, an opioid-sparing strategy may prove advantageous in reducing side effects, avoiding secondary hyperalgesia, and decreasing risk of PPP. Implementing a multimodal analgesic plan using alternative medications and regional anesthetic techniques may offer superior efficacy while reducing adverse effects.
Huge Paratubal Cyst: A Case Report and a Literature Review
Authors: Tjokroprawiro Brahmana Askandar
Published: August 2021

Paratubal cysts may mimic ovarian cysts, and most of them are diagnosed postoperatively. They originate from the mesosalpinx between the ovary and the fallopian tube. Only a few are large, and most paratubal cysts are less than 10 cm. We report a huge paratubal cyst in a 30-year-old woman, whose only preoperative complaint was abdominal distention over 4 months. Conservative surgery was performed with cyst removal while preserving the ovaries and tubes. A paratubal cyst should be included in the differential diagnosis of a large pelvic masses, especially in the reproductive age.
The March as a Safe Space and Dynamics of Resocialization
Authors: Campos Medina Luis , Jaureguiberry Mondion Josefina
Published: August 2021

In this article, we affirm that the feminist march of March 8, 2019, in Santiago constituted a safe and secure space for the women who participated in it. As a result, it created the conditions for the deployment of individual resocialization processes through which the categories and modes of organization of patriarchal society are challenged. Using the accounts of participants, the article describes some of the elements involved in the production of this safe space, contributing empirical evidence to a debate that tends to be mostly speculative. The article includes a theoretical discussion and analyzes 11 “walking interviews” with women who participated in the march. The interviews were conducted by one of the authors a few days after the march in the places where it took place (in situ).
Beyond anti-welfarism and feminist social media mud-slinging: Jo Littler interviews Angela McRobbie
Authors: Littler Jo , McRobbie Angela
Published: August 2021

In this wide-ranging interview, which took place in spring 2021, Angela McRobbie talks about her work in relation to social politics, the contemporary conjuncture, cultural studies, decolonisation and feminism. Beginning with a discussion on her experience of Covid, it contextualises these reflections through a discussion of anti-welfarism and the scapegoating of dependency, drawing from her new book Feminism and the Politics of Resilience. It moves on to discuss different forms and experiences of feminism: including the neoliberal Anglo-German academic context; the legacies of queer theory and radical feminism; the ‘mud-slinging’ of social media which ‘does not allow us the time and space to rehearse what is really going on’; the need to engage with social policy alongside cultural theory; and the ongoing intersectional work of rewriting the curriculum.
Work ability and psychological distress in a working population: results from the Stockholm Public Health Cohort
Authors: Onell Clara , Holm Lena W. , Bohman Tony , Magnusson Cecilia , Lekander Mats , Skillgate Eva
Published: August 2021

Aims:

Psychological distress is a global public health concern with individual and societal implications causing work-related disability and loss of productivity. It is less known how much work ability contributes to the development of psychological distress. This study aimed to assess the association between self-perceived physical and mental work ability in relation to job demands, and the incidence of psychological distress in a Swedish working population.

Methods:

Data were obtained from three subsamples of the Stockholm Public Health Cohort with baseline in 2010 and follow-up in 2014, based on a working population in Stockholm County aged 18–60 years, with no or mild psychological distress at baseline ( n=29,882). Self-perceived physical and mental work ability in relation to job demands were assessed at baseline with a subscale from the Work Ability Index. Study participants scoring 4 or more on the General Health Questionnaire 12 at follow-up were classified as having developed psychological distress during the study period. Poisson log linear regression was used to calculate crude and adjusted rate ratios with 95% confidence intervals.

Results:

At follow-up, 2543 participants (12%) had developed psychological distress. Reporting poor physical and/or poor mental work ability in relation to job demands at baseline was associated with an almost doubled rate ratio of psychological distress at follow-up, compared to reporting good work ability (rate ratio 1.8; 95% confidence interval 1.6–2.0).

Conclusions:

Poor work ability is associated with a higher incidence of future psychological distress compared to good work ability.
The rate of child restraint system use among children aged under six years in China
Authors: Zheng Xiaoguo , Li Ruili , Yang Huimin , Yin Delu , Yin Tao , Wang Lihong , Chen Bowen
Published: August 2021

Aims:

The child restraint system (CRS) for vehicles is designed to provide specialized protection for children in the event of a crash. The aim of the study was to investigate the rate of CRS use and analyze the factors associated with CRS use among children aged under six years in China, and to provide further insight into developing strategies for promoting public health education.

Methods:

This is a cross-sectional study. The study sites were 36 primary healthcare institutions in 12 provinces across China, and the participants were 34,503 guardians of children aged 0–6 years. Guardians who owned private cars were included and completed surveys about their experience using CRS. Odds ratios and 95% confidence intervals were calculated using multivariate logistic regression models.

Results:

The overall rate of CRS use among children aged under six years in China was 17.3%. Multivariate logistic regression analysis revealed that living in an urban area, low age of the child, guardians having higher education and being looked after by parents had a significant positive association with CRS use among children aged under six years.

Conclusions:

This study confirms that there is a low rate of CRS use among children aged under six years in China, highlighting the considerable need for CRS use education, advocacy and promotion of increasing use.
Overweight and obesity among children in rural areas: The importance of culture
Authors: Heggem Reidun , Zahl-Thanem Alexander
Published: August 2021

Aims:

This paper focuses on how social inequality is associated with overweight and obesity in children. There is a lack of research with a focus on an important distinction in social inequality, namely geography. The aim of this study was to reduce this knowledge gap by looking closely at the links between rurality and overweight.

Methods:

The findings in this paper are based on in-depth interviews with school nurses and teachers in rural Norway. The focus was on their experiences with and knowledge about overweight and obesity numbers in rural versus urban areas.

Results:

We used Bourdieu’s terminology to address the challenges related to urban–rural differences, and found that cultural factors connected to tradition, identity and courtesy play an important role in the rural overweight and obesity discourse.

Conclusions:

Actors and ‘experts’ working with overweight and obesity and national guidelines need to understand rural contexts and customs and address problems of the countryside on rural, not exclusively urban, premises. Different contexts imply different needs when it comes to reducing the inequalities between rural and urban areas regarding overweight and obesity.
Therapeutic virtual reality in prison: Participatory design with incarcerated women
Authors: Teng Melissa Q , Gordon Eric
Published: August 2021

Upon release from prison, women face barriers in every step of their journey home, with most reentry services designed for men. With virtual reality (VR) headsets increasingly affordable and normalized as a mental health treatment modality, VR is being adopted by prisons around the United States. We argue that the risks and affordances of VR in this political context necessitate centering those with lived experience as creative agents to avoid designing media that re-traumatizes, reduces the complexities of reentry, and reproduces oppressive prisoner–guard dynamics. This article documents and analyzes the design process of a VR reentry program for a state prison to help incarcerated women practice responding to high-stress reentry situations, prior to their release. The resulting VR prototype draws on therapeutic VR work but takes a community-based participatory design approach. We conclude by discussing the institutional and cultural tensions of implementing a participatory design process in a US state prison system.
Virtual reality-based conflict resolution: The impact of immersive 360° video on changing view points and moral judgment in the context of violent intergroup conflict
Authors: Hasler Béatrice S. , H. Landau Daniel , Hasson Yossi , Schori-Eyal Noa , Giron Jonathan , Levy Jonathan , Halperin Eran , Friedman Doron
Published: August 2021

We present an experimental study conducted in the context of the Israeli–Palestinian conflict that examined the effect of immersive 360° video on inducing a more critical perception of the ingroup’s actions in the conflict. An immersive experience of a simulated conflict scenario filmed from the outgroup’s point of view led to the judgment of the ingroup actors’ behavior as less moral and less justified compared to watching the same scenario as a two-dimensional video. This effect was not mediated through increased outgroup perspective-taking and empathy but through higher levels of hostile emotions toward the ingroup actors, which in turn were influenced by an increased sense of presence and engagement in the immersive experience. These findings provide initial evidence for the still widely unexplored potential of virtual reality as a new method for conflict resolution.
The belts are set out: The batizado as a symbolic welcome to capoeira culture
Authors: Delamont Sara , Stephens Neil
Published: August 2021

In contemporary capoeira groups, newcomers are symbolically ‘baptised’ into the community at a public ceremony called their Batizado (literally baptism) held during a festival. Novices play a game with a guest expert, get their first belt and thereafter they are members of their teacher’s group. Drawing on a long term, two-handed ethnography of diasporic capoeira contemporanea in the UK, including observation of 53 such festivals, their ceremonial features are analysed. At all the stages of the ‘welcome’, before, during and after the batizado, the topic of gender in capoeira contemporanea is explored. In the last 40 years, women have become enthusiastic participants and are core members of the groups we have studied. The article compares the sociological (symbolic interactionist) and anthropological approaches to ceremonies and rituals such as the capoeira batizado, drawing on Glaser, Strauss and Katz compared to van Gennep, Turner and MacAloon.
Effect of injection and ignition timing on a hydrogen-lean stratified charge combustion engine
Authors: Lee Sanguk , Kim Gyeonggon , Bae Choongsik
Published: August 2021

Hydrogen can be used as a fuel for internal combustion engines to realize a carbon-neutral transport society. By extending the lean limit of spark ignition engines, their efficiency, and emission characteristics can be improved. In this study, stratified charge combustion (SCC) using monofueled hydrogen direct injection was used to extend the lean limit of a spark ignition engine. The injection and ignition timing were varied to examine their effect on the SCC characteristics. An engine experiment was performed in a spray-guided single-cylinder research engine, and the nitrogen oxide and particulate emissions were measured. Depending on the injection timing, two different types of combustion were characterized: mild and hard combustion. The advancement and retardation of the ignition timing resulted in a high and low combustion stability, respectively. The lubricant-based particulate emission was attributed to the in-cylinder temperature and area of the flame surface. Therefore, the results of the study suggest that the optimization of the hydrogen SCC based on the injection and ignition timing could contribute to a clean and efficient transport sector.
Quality of life perspectives for different social groups in a World Centre of Tourism and Leisure
Authors: Choe Jaeyeon , O’ Regan Michael , Kimbu Albert , Lund Niels Frederik , Ladkin Adele
Published: August 2021

While the quality of life (QoL) concept in tourism research has gained momentum, scholarly work has focused on host QoL and tourist-host relations, rather than exploring and analysing the perception, interpretation and understanding of QoL among different social groups in a given tourist destination. Macao is a densely populated tourism destination and designated World Centre of Tourism and Leisure, where local residents and migrants work and cohabit side by side. By broadening the scope of research through in-depth interviews, our research findings highlight how different social groups in Macao experience QoL differently. While all groups perceive positive economic impacts and appreciate career opportunities from tourism development, the analysis raises questions as to the QoL of residents and migrants, and the social sustainability of Macao. The study recommends that authorities embed a social sustainability focus in deliberations, policies and investment so as to achieve its goal of World Centre of Tourism and Leisure status, not only for tourists, but also for those who live and work there.
Revisiting statistical properties of surf parameter with characteristic wave parameters for single random waves including spectral bandwidth effects
Authors: Myrhaug Dag , Wang Hong , Erik Holmedal Lars , Li Hongtao
Published: August 2021

Results from a comparative study of the joint distribution of surf parameter and wave period are provided. First, two transformed joint distributions of wave height and wave period are compared. One of the distributions is a parametric model originating from a best fit to relatively broad-band field data covering a wide range of wave conditions, whilst the other distribution is theoretically based. It appears that the theoretically based distribution does not represent the features of the parametric model especially well, suggesting that parametric models should be used to describe relatively broad-banded data. Then, the theoretically based joint distribution of wave height and wave period is transformed to the joint distributions of surf parameter with wave height and wave period and it is demonstrated how these distributions are affected by the spectral bandwidth. Finally, the theoretically based distribution of wave height and wave period is also transformed to the joint distribution of wave runup time and wave period due to its relation to the stability of rubble-mound breakwaters. Comparisons are made with a limited set of data representing results from small-scale laboratory experiments related to stability of rubble-mound breakwaters. The agreement between measurements and predictions of the distribution of the surf parameter is fair, whilst the agreement is poorer for the probability of resonance.
Culturally Relevant Online Cancer Education Supports Tribal Primary Care Providers to Reduce Their Cancer Risk and Share Information About Cancer
Authors: Cueva Katie , Cueva Melany , Revels Laura , Hensel Michelle , Dignan Mark
Published: August 2021

Background

Culturally relevant education is an opportunity to reduce health disparities, and online learning is an emerging avenue for health promotion. In 2014–2019, a team based at the Alaska Native Tribal Health Consortium developed, implemented, and evaluated culturally relevant online cancer education modules with, and for, Alaska’s tribal primary care providers. The project was guided by Indigenous Ways of Knowing and the principles of community-based participatory action research and was evaluated in alignment with empowerment theory. About 265 unique learners completed 1,898 end-of-module evaluation surveys between March 2015 and August 2019, and 13 people completed a follow-up survey up to 28 months post module completion.

Key Findings

Learners described the modules as culturally respectful and informative and reported feeling more knowledgeable and comfortable talking about cancer as a result of the modules. About 98% of the learners planned to reduce their cancer risk because of the modules, and all follow-up survey respondents had reduced their risk, including by quitting smoking, getting screened for cancer, eating healthier, and exercising more. About 98% of the learners planned to share information with their patients, families, friends, and community members because of the modules, with all follow-up survey respondents indicating that they had shared information about cancer from the modules.

Implications for Practice and Further Research

Culturally relevant online modules have the capacity for positive behavioral change and relatively high correlations between intent and behavior change. Future research could determine which aspects of the modules catalyzed reduced cancer risk and increased dissemination of cancer information.
Moving Evidence to Action: A Strategy to Support the Implementation of Comprehensive Violence Prevention Efforts
Authors: Barranco Lindsey , Freire Kimberley , Payne Gayle Holmes
Published: August 2021

For public health agencies, the pragmatic need to bring together science and practice to affect public health outcomes manifests in the implementation of prevention strategies with the best available evidence. Knowledge translation makes scientific findings understandable to the knowledge user, often through synthesis of the best available evidence. Implementation science promotes the adoption and integration of evidence through prevention strategies implemented within various contexts. Working together, knowledge translation and implementation science can promote the uptake and advancement of scientific and practice-based evidence for strategies that will have the greatest impact across a variety of contexts. Violence Prevention in Practice (VPP) is an online resource designed to help practitioners select, adapt, implement, and evaluate multiple prevention strategies included in five technical packages developed by Centers for Disease Control’s Division of Violence Prevention. A technical package translates the best available evidence into a core set of prevention strategies intended to be broadly implemented. VPP supports communities in using the technical package strategies in combination, drawing on key implementation science principles. In this article, we explain the process for developing VPP and provide a framework that can be used to develop similar guidance in other health promotion areas. The framework explains how both general components, such as selection and adaptation, come together with strategy-specific implementation guidance. Distinct from typical planning models, VPP is not designed as a linear stepwise process, and it allows practitioners to use one or more components alone, as well as helps practitioners link across components as needed.
Sex Education on TikTok: A Content Analysis of Themes
Authors: Fowler Leah R. , Schoen Lauren , Smith Hadley Stevens , Morain Stephanie R.
Published: August 2021

Leading medical and public health societies endorse comprehensive sex education, but only 20 states and Washington, D.C., currently require information about contraception when sex education is taught, and even fewer require the inclusion of topics such as gender diversity or consent. At the same time, social media use, especially the video-sharing app TikTok, is increasing among teens. TikTok, therefore, offers a novel opportunity to make up for shortcomings in sex education and convey sexual health information to adolescents. To describe the availability and content of sexual education on TikTok, we conducted a content analysis of themes for 100 sex education–focused videos. We found that female anatomy was the most frequently addressed topic. Sexual pleasure was the second most common theme, within which discussions of the female orgasm and arousal constituted the most common subtheme. Other common themes include contraception and sexual health. These sought-after topics may be incongruent with those presented in standard school- or home-based sex education or interactions with health care providers, and this disconnect suggests opportunities for health care providers and educators to initiate conversations or offer resources on these themes as part of routine interaction. We conclude with recommendations for future research to consider the factual accuracy of sex education on TikTok and determine how exposure to this content affects adolescents’ understanding of the risks and benefits of intercourse, sexual practices, age- and gender-based sexual norms, and other health behaviors.
RSA encrypted FSK RF transmission powered by an innovative microwave technique for invulnerable security
Authors: Pal Prashnatita , Chandra Sahana Bikash , Poray Jayanta
Published: August 2021

Ensuring the secure communication is the prime concern for all kinds of data communication infrastructure. Several data encryption techniques are in use for secure communication. There is a scope for further improvement in the security level, as well as for the received signal quality. The selection of a proper combination of encryption and modulation techniques can improve the overall effectiveness of both the security level and the received signal quality. The combination of asymmetric cryptography (here use RSA (Rivest–Shamir–Adleman) algorithm) algorithm with the proposed reflex klystron-based frequency shift keying (FSK) modulation technique provides a high level of secure communication system. The performance of the proposed technique is experimentally verified. The conventional FSK modulation technique operates in the low-frequency band, but the proposed FSK modulation technique is powered by high-power microwave devices, which operate in the X band. The experimental result has been demonstrated and successfully verified for secured communication using the X band.
Early and midterm outcomes of hybrid first line treatment in patients with chronic limb threatening ischemia
Authors: Mezzetto Luca , Mastrorilli Davide , Scorsone Lorenzo , Macrì Marco , Criscenti Paolo , Bruno Salvatore , Veraldi Edoardo , Veraldi Gian Franco
Published: August 2021

Objective

The aim of the study was to evaluate the outcome of first line hybrid treatment in patients with chronic limb threatening ischemia (CLTI) and to evaluate possible predictors of primary patency (PP) loss and limb clinical improvement (LCI).

Methods

This was a retrospective non-randomized study. All patients underwent one-stage hybrid common femoral artery (CFA) endarterectomy combined with an inflow and/or outflow endovascular revascularization procedure. Demographic, clinical, and lesion characteristics for each patient were reported. Primary patency analysis was performed using Kaplan–Meier life tables, and univariate and multivariate analysis was used to assess possible predictors of PP loss and clinical improvement.

Results

Complete data were obtained from 132 patients. Patients were divided into two groups according to their Rutherford’s category (RC), group 1 (Rutherford 4) and group 2 (Rutherford 5 and 6). Technical success was 98%. The overall surgical peri-operative complication rate was 8%. At a mean follow-up of 32 ± 23 months, the rate of major adverse limb events (MALE) was 30%; only the rate of major amputation between two groups was significant statistically different ( p = .006). Group 1 had significantly lower amputation rate at 36 months ( p = .01). The presence of high iliac peripheral artery calcium scoring system (PACCS) grade (HR 9.43, 95% CI 2.40–36.9, p = .001), the poor run-off of leg vessels (HR 0.15, 95% CI 0.02–0.92, p = .04), and undergoing CFA endarterectomy combined with outflow endovascular revascularization procedure (HR 4.25, 95% CI 1.07–16.89, p = .04) were independent predictors of PP loss, while severe iliac artery stenosis (OR 0.09, 95% CI 0.02–0.32, p = <.001) and the presence of pre-operative patent leg vessels (OR 8.03, 95% CI 2015–29.95, p = .002) were the significant independent predictors of LCI.

Conclusion

The use of hybrid first line approach in patients with CLTI is a safe and feasible technique. From the analysis of the current study, it is clear that any effort should be made to achieve as many patency leg vessels as possible in order to obtain better and longer lasting clinical outcomes.
Stratified randomization for platform trials with differing experimental arm eligibility
Authors: Selukar Subodh , May Susanne , Law Dave , Othus Megan
Published: August 2021

Background:

Platform trials facilitate efficient use of resources by comparing multiple experimental agents to a common standard of care arm. They can accommodate a changing scientific paradigm within a single trial protocol by adding or dropping experimental arms—critical features for trials in rapidly developing disease areas such as COVID-19 or cancer therapeutics. However, in these trials, efficacy and safety issues may render certain participant subgroups ineligible to some experimental arms, and methods for stratified randomization do not readily apply to this setting.

Methods:

We propose extensions for conventional methods of stratified randomization for platform trials whose experimental arms may differ in eligibility criteria. These methods balance on a prespecified set of stratification variables observable prior to arm assignment that remains the same across experimental arms. To do so, we suggest modifying block randomization by including experimental arm eligibility as a stratifying variable, and we suggest modifying the imbalance score calculation in dynamic balancing by performing pairwise comparisons between each eligible experimental arm and standard of care arm participants eligible to that experimental arm.

Results:

We provide worked examples to illustrate the proposed extensions. In addition, we also provide a formula to quantify the relative efficiency loss of platform trials with varying eligibility compared with trials with non-varying eligibility as measured by the size of the common standard of care arm.

Conclusions:

This article presents important extensions to conventional methods for stratified randomization in order to facilitate the implementation of platform trials with differing experimental arm eligibility.
Variations of external workload across a soccer season for starters and non-starters
Authors: Nobari Hadi , Silva Rui , Manuel Clemente Filipe , Oliveira Rafael , Carlos-Vivas Jorge , Pérez-Gómez Jorge
Published: August 2021

The aims of this study were to (i) analyze within-group (starters and non-starters) for the weekly acute (wAW), chronic (wCW), and acute:chronic workload ratio (wACWR) throughout the pre-, early-, mid-, and end-season periods, and (ii) analyze the within-group differences for the weekly total distance (wTD), sprint total distance (wSTD), high-speed running distance (wHSRd), and repeated sprint (wRS) throughout the soccer season. The study included a professional soccer team that participated in the highest level of the Iranian Persian Gulf Pro League during a full season. A Global Positioning System was used for data collection during the study. Results revealed significant differences between season periods for wAW and wACWR for both starters (wAW: p = 0.003, ηP2 = 0.541; wACWR: p < 0.001, ηP2 = 0.964) and non-starters (wAW: p < 0.001, ηP2 = 0.696; wACWR: p < 0.001, ηP2 = 0.943). Only non-starters had meaningful differences for wCW ( p = 0.009, ηP2 = 0.408). There were significant differences in wTD and wSTD for both starters (wTD: p < 0.001, ηP2 = 0.810; wSTD: p = 0.014, ηP2 = 0.457) and non-starters (wTD: p < 0.001, ηP2 = 0.895; wSTD: p < 0.001, ηP2 = 0.781). Only non-starters showed significant differences ( p < 0.001, ηP2 = 0.722) for wRS, while both groups showed no significant differences for wHSRd. In conclusion, these results revealed that both groups experienced significant differences in wAW, wACWR, wTD, and wSTD, while non-starters presented significant differences in wCW and wRS. Coaches should consider these group differences when planning training sessions. Exposure to wSTD and wRS should be addressed for non-starters, as well as fatigue monitoring for starters, especially for players with full match participation.
Mapping the Landscape and Evolution of Research on Pro-Environmental Behavior of Tourists
Authors: Yu Chu feng , Ma Yong , Ren Jie
Published: August 2021

The pro-environmental behavior of tourists (PEBT) can reduce the impact of tourism activities on the environment, which has attracted more and more attention from scholars. Based on the 159 articles of the PEBT from 2003 to the present in the “Web of Science” database, analyzing the overall characteristics, core knowledge, and knowledge evolution of this field with the help of CiteSpace and Vosviewer software, to systematically grasp the development panorama and find the future direction of the research on PEBT. The results show that economics, ecology, and psychology have a strong knowledge spillover effect for research on PEBT. Three regional research circles, eight-core scientific communities, and four core prior knowledge groups have formed for research on PEBT. The research content mainly focuses on exploring the measurement, forming mechanism, and influencing factors of PEBT. The effect of attitude or place attachment to PEBT has once been the research hotspot in this field. The research focus is to explore PEBT under multiple scenarios from the perspective of multi-disciplinary in recent years. Finally, a series of directions for future research on PEBT were put forward, aiming to bring some useful references to scholars.
Structure of Research Article Abstracts in Political Science: A Genre-Based Study
Authors: Alyousef Hesham Suleiman
Published: August 2021

The research article (RA) abstract is the first section researchers read to determine its relevance to their interests. Researchers need to possess an implicit knowledge of the rhetorical move structure and organization of this section. Unlike most scientific disciplines, political science RA abstracts are unstructured, that is, with no headings (or moves), which makes it more challenging. To the best of our knowledge, the rhetorical move structure in high readership political science RA abstracts has not been researched. This study investigated (a) the rhetorical move structure in 120 political science RA abstracts from six high-impact journals, (b) the most common move patterns, and (c) the move(s) occupying most textual space. The findings indicated the lack of obligatory moves. A move structure model for writing a political science RA abstract is proposed, comprising four conventional moves (Introduction [I]–Purpose [P]–Methods [M]–Results [R]) and two optional step/move, namely, Research Gap step and Discussion [D] move. The results also showed that the first most frequent move pattern is I-P-M-R-D, followed by I-P-M-R and the I-P-R-D. The fact that an RA abstract summarizes the whole RA results in move embedding, particularly in the four moves, I-P-M-R. The findings revealed the importance of the Results move as it occupied nearly one third of text space. The results may contribute to the fields of discourse and genre studies. They may provide invaluable insights for novice political science researchers attempting to publish their work in high-ranking journals. The proposed move structure model can act as a guide for English for Academic Purposes (EAP)/English for Specific Purposes (ESP) tutors and political science authors.
The Impact of Computer and Internet at Home on Academic Results of the Saber 11 National Exam in Colombia
Authors: Barrios Aguirre Fernando , Forero Diego A. , Castellanos Saavedra Martha Patricia , Mora Malagón Sandra Yaneth
Published: August 2021

The use of a computer and internet connection allows high school and university students to access more relevant information. However, there is no consensus on the effects of the use of these tools on academic results. This work evaluates the impact of computers and the internet at home on the results of the Saber 11 test, a national exam taken by all students finishing their secondary education in Colombia, between 2017 and 2019. This impact was estimated from a pooled two-stage least squares (pooled 2SLS) model, applied to data from 1,578,460 Colombian high school students. We found that computers and the internet at home had a positive impact on English language performance in the Saber 11 test in Colombia. This work allows a better understanding of the technological effects on educational achievement and provides information for the design of public policies for education in developing countries.
Understanding the Empty Backpack: The Role of Timing in Disproportionate Special Education Identification
Authors: Cruz Rebecca A. , Firestone Allison R.
Published: August 2021

Studies related to disproportionate special education identification of students from historically marginalized groups have used increasingly complex analyses to understand the interplay of factors that cause and maintain disparities. However, information regarding the influence of students’ grade level at initial special education placement remains limited. Situated in labeling theory and life course theory, we used discrete-time survival analysis to examine temporal student- and school-level factors related to patterns of placement for minoritized students within one large urban school district. Results showed that gender, race, and socioeconomic status were all factors generally associated with special education identification, and that African American and Latinx students were more likely to be placed into special education later in their school careers. This disproportionality in delayed placement was associated with particular special education labels; for example, African American students identified post-elementary school were more likely to be labeled with emotional disturbance and specific learning disability compared to same-age White peers, and Latinx students were more likely to be labeled with specific learning disability and intellectual disability compared to same-age White peers. These results implicate inequities that emerge at the intersections of age, race, and perceptions of ability that should be considered in future studies of educational equity.
Hereditary leiomyomatosis and renal cell cancer presenting as urothelial carcinoma
Authors: Reynolds Samuel B , Charate Rishi , Nguyen Quang L , Moffett Padmini
Published: August 2021

Hereditary leiomyomatosis is a genetic disorder that follows an autosomal dominant pattern of inheritance. Along with a variety of leiomyomas, affected individuals are predisposed to developing an aggressive form of type 2 papillary renal malignancy known as Hereditary Leiomyomatosis Associated Renal Cell Carcinoma (HLRCC) that can occur in both the tubulo-papillary and collecting-duct systems. We present a rare case of HLRCC with components of urothelial carcinoma. The patient was treated with cisplatin-based neoadjuvant chemotherapy followed by left radical nephroureterectomy to achieve complete remission of disease.
How Updates in Chicago Classification Impact Clinical Practice
Authors: Yadlapati Rena , Kahrilas Peter J.
Published: August 2021

Chicago Classification version 4.0 (CC v4.0), published in 2021, presents several modifications largely aimed at minimizing over-diagnosis of inconclusive patterns on high-resolution manometry (HRM). These include: (1) introduction of a standardized HRM protocol for consistency among centers, (2) emphasis on the need for supportive data in instances of inconclusive manometric patterns, (3) required presence of relevant symptoms in certain instances to reduce over-diagnosis and inappropriate interventions, and (4) classification as disorders of EGJ outflow or disorders of peristalsis. These updates aim to improve the clinical application of HRM and patient outcomes.
Manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education for patients with tension-type headache. A systematic review and meta-analysis
Authors: Krøll Lotte Skytte , Callesen Henriette Edemann , Carlsen Louise Ninett , Birkefoss Kirsten , Beier Dagmar , Christensen Henrik Wulff , Jensen Mette , Tómasdóttir Hanna , Würtzen Hanne , Høst Christel Vesth , Hansen Jakob Møller
Published: August 2021

Background

Tension-type headache (TTH) has been ranked the second most prevalent health condition worldwide. Non-pharmacological treatments for TTH are widely used as a supplement or an alternative to medical treatment. However, the evidence for their effects are limited. Therefore, the aim of this study was to review the evidence for manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education as treatments for TTH on the effect of headache frequency and quality of life.

Methods

A systematic literature search was conducted from February to July 2020 for clinical guidelines, systematic reviews, and individual randomised controlled trials (RCT). The primary outcomes measured were days with headache and quality of life at the end of treatment along with a number of secondary outcomes. Meta-analyses were performed on eligible RCTs and pooled estimates of effects were calculated using the random-effect model. The overall certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach (GRADE). In addition, patient preferences were included in the evaluation.

Results

In all, 13 RCTs were included. Acupuncture might have positive effects on both primary outcomes. Supervised physical activity might have a positive effect on pain intensity at the end of treatment and headache frequency at follow-up. Manual joint mobilisation techniques might have a positive effect on headache frequency and quality of life at follow-up. Psychological treatment might have a positive effect on stress symptoms at the end of treatment. No relevant RCTs were identified for patient education. The overall certainty of evidence was downgraded to low and very low. No serious adverse events were reported. A consensus recommendation was made for patient education and weak recommendations for the other interventions.

Conclusion

Based on identified benefits, certainty of evidence, and patient preferences, manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture, and patient education can be considered as non-pharmacological treatment approaches for TTH. Some positive effects were shown on headache frequency, quality of life, pain intensity and stress symptoms. Few studies and low sample sizes posed a challenge in drawing solid conclusions. Therefore, high-quality RCTs are warranted.