bluuebunny/crossref_metadata_2025 huggingface dataset:
CT-Verified Union Rate Following Arthrodesis of Ankle, Hindfoot, or Midfoot: A Systematic Review
Authors: Leslie Michael David , Schindler Christin , Rooke Gareth M. J. , Dodd Andrew
Published: May 2023

Background:

Ankle, hindfoot, and midfoot arthrodesis surgeries are standard procedures performed in orthopaedics to treat pain and functional disabilities. Although fusions can effectively improve pain and quality of life, nonunions remain a significant concern for surgeons. With the increased availability of computed tomography (CT), more surgeons rely on this modality for increased accuracy in determining whether a fusion was successful. The objective of this study was to report the rates of CT-confirmed fusion following ankle, hindfoot, or midfoot arthrodesis.

Methods:

A systematic review was performed using EMBASE, Medline, and Cochrane central register from January 2000 to March 2020. Inclusion criteria included studies with adults (<18 years) that received 1 or multiple fusions of the ankle, hindfoot, or midfoot. At least 75% of the study cohort must have been evaluated by CT postoperatively. Basic information was collected, including journal, author, year published, and level of evidence. Other specific information was collected, including patient risk factors, fusion site, surgical technique and fixation, adjuncts, union rates, criteria for successful fusion (%), and time of CT. Once data were collected, a descriptive and comparative analysis was performed.

Results:

Included studies (26, n = 1300) had an overall CT-confirmed fusion rate of 78.7% (69.6-87.7). Individual joints had an overall fusion rate of 83.0% (73-92.9). The highest rate of union was in the talonavicular joint (TNJ).

Conclusion:

These values are lower than previous studies, which found the same procedures to have greater than 90% fusion rates. With these updated figures, as confirmed by CT, surgeons will have better information for clinical decision making and when having informed consent conversations.
Development and Validation of a Broad and Fear-Adaptable Measure of Fear Approach and Application to Common Eating Disorder Fears
Authors: Christian Caroline , Vanzhula Irina A. , Ciotti Victoria , Levinson Cheri A.
Published: May 2023

Fear approach is a theorized mechanism of exposure treatment for anxiety-based disorders. However, there are no empirically established self-report instruments measuring the tendency to approach feared stimuli. Because clinical fears are heterogeneous, it is important to create a measure that is adaptable to person- or disorder-specific fears. The current study ( N = 455) tests the development, factor structure, and psychometric properties of a self-report instrument of fear approach broadly and the adaptability of this measure to specific eating disorder fears (i.e., food, weight gain). Factor analyses identified a unidimensional, nine-item factor structure as the best fitting model. This measure had good convergent, divergent, and incremental validity and good internal consistency. The eating disorder adaptations retained good fit and strong psychometric properties. These results suggest that this measure is a valid, reliable, and adaptable measure of fear approach, which can be used in research and exposure therapy treatment for anxiety-based disorders.
Insurance Discrimination, Companion Animal Harm, and Domestic Violence and Abuse — Double Jeopardy in the UK
Authors: Turgoose Di , McKie Ruth E. , Connolly Paris
Published: May 2023

Prompted by Signal et al.’s study, this research examines UK “Pet Insurance” policies to see if and how experiencing domestic violence and abuse (DVA) in interspecies households is excluded under insurance policies terms. Situating our findings within the existing literature on human and companion animal victims of DVA, we discuss the implications for improving cross-reporting and multi-agency action to protect and prevent harm to humans and companion animal victims of DVA. In turn we identify a series of recommendations to combat discrimination in insurance, set out in our conclusion.
Extravasation of monoclonal antibodies commonly used in oncology: Classification, management and the role of the pharmacist
Authors: Bauters Tiene , Clottens Nele , Albert-Marí María A
Published: May 2023

Introduction

Extravasation by conventional cytotoxics has been well documented. While monoclonal antibodies are not considered to have the necrotic potential of some cytotoxic medicines, they require appropriate management in case of extravasation. However, fewer data are available on their classification and appropriate management when extravasation occurs. As monoclonal antibodies are being more commonly used in current daily oncology practice, this is an issue that cannot be ignored.

Methods

A scientific literature review on PubMed was conducted. All findings were critically appraised independently by 6 clinical pharmacists in order to provide a classification according to the extravasation hazard.

Results

A classification of non-conjugated and conjugated monoclonal antibodies according to extravasation hazard has been elaborated for different molecules frequently used in oncology. In addition, general management, in case extravasation of monoclonal antibodies occurs, has been proposed and the role of the pharmacist in the extravasation process has been described.

Conclusion

A classification of hazard extent of extravasation of monoclonal antibodies with concurrent management based on literature data and expert consensus has been elaborated. In addition, the role of the oncology pharmacist is crucial in terms of follow-up and documentation of the extravasated monoclonal antibody and management is described.
Liver cirrhosis following oxaliplatin-based adjuvant chemotherapy for rectal cancer
Authors: Huang Cheng , Chen Jv , Situ Yongli
Published: May 2023

Introduction

Oxaliplatin is a third-generation platinum-based antineoplastic drug that is widely used to treat patients with colorectal cancer. Reported adverse reactions include hepatic sinusoidal obstruction syndrome and liver fibrosis, but there are few reports of cirrhosis associated with chemotherapy. In addition, the pathogenesis of cirrhosis remains unclear.

Case report

We report a case of suspected oxaliplatin-induced liver cirrhosis, an adverse reaction that has not been previously reported.

Management and outcome

A 50-year-old Chinese man was diagnosed with rectal cancer and underwent laparoscopic radical rectal cancer surgery. The patient had a history of schistosomiasis, but history and serology showed no evidence of chronic liver disease. However, after five oxaliplatin-based chemotherapy cycles, the patient presented dramatic changes in liver morphology and developed splenomegaly, massive ascites, and elevated CA125 levels. Four months after discontinuing oxaliplatin, the patient's ascites had decreased significantly and CA125 levels declined from 505.3 to 124.6 mU/mL. After 15 weeks of follow-up, CA125 levels decreased to the normal range, and there has been no increase in ascites in this patient.

Discussion

Oxaliplatin-induced cirrhosis may be a serious complication and should be discontinued based on clinical evidence.
NRX-101, a Rapid-Acting Anti-Depressant, Does Not Cause Neurotoxicity Following Ketamine Administration in Preclinical Models
Authors: Jordan William , Sapko Michael T. , Siegel Richard , Javitt Jonathan
Published: May 2023

Agents that act at the N-methyl-D-aspartate receptor (NMDAR), such as ketamine, have gained increasing attention as rapid-acting antidepressants; however, their use has been limited by potential neurotoxicity. Recent FDA guidance requires a demonstration of safety on histologic parameters prior to the initiation of human studies. D-cycloserine (DCS) is a partial NMDA agonist that, along with lurasidone, is being investigated as a treatment for depression. The current study was designed to investigate the neurologic safety profile of DCS. To this end, female Sprague Dawley rats (n = 106) were randomly divided into 8 study groups. Ketamine was administered via tail vein infusion. DCS and lurasidone were administered via oral gavage in escalating doses to a maximum of 2000 mg/kg DCS. To ascertain toxicity, dose escalation with 3 different doses of D-cycloserine/lurasidone was given in combination with ketamine. MK-801, a known neurotoxic NMDA antagonist, was administered as a positive control. Brain tissue was sectioned and stained with H&E, silver, and Fluoro-Jade B stains. No fatalities were observed in any group. No microscopic abnormalities were found in the brain of animal subjects given ketamine, ketamine followed by DCS/lurasidone, or DCS/lurasidone alone. Neuronal necrosis, as expected, was seen in the MK-801 (positive control) group. We conclude that NRX-101, a fixed-dose combination of DCS/lurasidone, when administered with or without prior infusion of IV ketamine was tolerated and did not induce neurotoxicity, even at supratherapeutic doses of DCS.
Modeling, evaluating, and orchestrating heterogeneous environmental leverages for large-scale data center management
Authors: Ostapenco Vladimir , Lefèvre Laurent , Orgerie Anne-Cécile , Fichel Benjamin
Published: May 2023

Data centers are very energy-intensive facilities that can generate various environmental impacts. Numerous energy, power, and environmental leverages exist and can help cloud providers and data center managers to reduce some of these impacts. But dealing with such heterogeneous leverages can be a challenging task that requires some support from a dedicated framework. This article presents a new approach for modeling, evaluating, and orchestrating a large set of technological and logistical leverages. Our framework is based on leverages modeling and Gantt chart leverages mapping. First experimental results based on selected scenarios show the pertinence of the proposed approach in terms of management facilities and potential impacts reduction.
Investigating paradoxes in the music teaching profession
Authors: Girdzijauskienė Rūta , Economidou Stavrou Natassa , Schaumberger Helmut , Frischknecht Ruth
Published: May 2023

Teachers are regularly confronted with paradoxes in their profession: clashes between different sets of values, their roles and their personal authenticity, the desire to be open but also detached, and the willingness to encourage students to have their own opinion but at the same time to obey and adapt. In this article, we investigate paradoxes in the music teaching profession with the aim of identifying those that are inherent to the field of music education and do not depend on a specific place or cultural context. To comprehend these paradoxes, we conducted a narrative study focused on the experiences of music teachers as presented through their own stories. This narrative study of 12 music teachers who worked with 10- to 15-year-old students in comprehensive schools was carried out in four European countries. The study applied a three-stage narrative interview strategy that asked teachers to share cases from their experience that implied paradoxes in their professional work. Based on this study, three umbrella categories of paradoxes were identified: paradoxes on curriculum negotiation and co-negotiation with students, free action in a regulated environment, and the double identity of music teachers. The study results offered insights applicable to music teacher education which can be summarized as a proposal to expose prospective music teachers to the paradoxes in their future profession and to discuss strategies that might help them manage these paradoxes.
Ducks, elephants and sharks: Using LEGO® Serious Play® to surface the ‘hidden curriculum’ of equality, diversity and inclusion
Authors: Schwabenland Christina , Kofinas Alexander
Published: May 2023

Despite widespread agreement on the importance of preparing management students for working in diverse organisations, there is evidence that this is often ignored or marginalised in formal curricula. Our article draws on the concept of the hidden curriculum to present the results of a project in which business school academics and support staff explored the ‘unthought knowns’ that influence how equality, diversity and inclusion are, or are not, engaged with in the classroom. Our data were generated during workshops using the LEGO® Serious Play® methodology in which participants built LEGO® models to develop their own understandings of equality, diversity and inclusion. The models, and the discussions about them, uncovered complexities and contradictions inherent within these topics, alongside significant levels of anxiety and fear. Our study makes two contributions: first, through the animal metaphors that featured in the models, we identify some of the anxieties that are generated by these topics which are likely to influence the hidden curriculum. Second, our innovative use of LEGO® Serious Play® contains important implications about the actual mechanism through which such insights can be ‘surfaced’ so that they become available for reflection and thought.
Two cases of MT-ND5-related mitochondrial disorder misdiagnosed as seronegative neuromyelitis optica spectrum disorder
Authors: Wilkins Sophie R , Yu Amy W , Steigerwald Connolly , Tanji Kurenai , Iglesias Alejandro D , Hirano Michio , Kister Ilya , Riley Claire S , Abreu Nicolas J
Published: May 2023

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease primarily affecting the optic nerves and spinal cord, which is usually associated with anti-aquaporin-4 antibodies. Here, we present two individuals who were negative for anti-aquaporin-4 antibodies and were initially diagnosed with seronegative NMOSD. Each patient’s clinical course and radiographic features raised suspicion for an alternative disease process. Both individuals were found to have pathogenic variants of MT-ND5, encoding subunit 5 of mitochondrial complex I, ultimately leading to a revised diagnosis of a primary mitochondrial disorder. These cases illustrate the importance of biochemical and genetic testing in atypical cases of NMOSD.
Leigh syndrome mimicking neuromyelitis optica spectrum disorder (NMOSD)
Authors: Kim Nee Na , Abdel-Mannan Omar , Davidson James , Du Pre Pascale , Kneen Rachel , Mankad Kshitij , Hacohen Yael
Published: May 2023

We report two children with molecularly confirmed mitochondrial disease mimicking Neuromyelitis Optica Spectrum Disorder (NMOSD). The first patient presented at the age of 15 months with acute deterioration following a pyrexial illness with clinical features localising to the brainstem and spinal cord. The second patient presented at 5 years with acute bilateral visual loss. In both cases, MOG and AQP4 antibodies were negative. Both patients died within a year of symptoms onset from respiratory failure. Arriving at an early genetic diagnosis is important for redirection of care and avoiding potentially harmful immunosuppressant therapies.
Critical Interpretation of Spatiality in Professional Korean Football Stadiums: Relph’s Theory of Placeness
Authors: Lee Wanyoung , Choi Yoonso
Published: May 2023

This research analyzes Korean professional soccer stadiums using Relph’s concept of placelessness to understand why Korean professional soccer has rapidly declined in popularity and become a minority fan sport. Qualitative research methods were used to conduct a narrative analysis. The interview content was analyzed, and four problems were identified. The findings show that these stadiums are (1) a uniform space that excludes local culture, (2) used as a profit-generating tool for large corporations, (3) spaces controlled by the state, and (4) maximizing economic efficiency. Therefore, they have been used as a uniform space for social, cultural, political, and economic purposes. The Korean national soccer team’s performance in international competitions seems to be satisfactory. However, the domestic professional soccer league is in a vulnerable condition. Thus, these stadiums should be established as true places by removing the element of placelessness in order to recover the popularity of Korean professional soccer.
Autoignition enhancement of ammonia spray under engine-relevant conditions via hydrogen addition: Thermal, chemical, and charge cooling effects
Authors: Bakir Ahmad Hadi , Ge Haiwen , Zhang Zhili , Zhao Peng
Published: May 2023

With the growing trend of decarbonization in ground transportation, low and zero-carbon fuels have attracted extensive research interest. Liquid ammonia is a promising alternative fuel due to its relatively high volumetric energy density, mature production and distribution infrastructure, convenience of storage, and zero carbon emissions. However, ammonia combustion also suffers from low flame speed and weak chemical reactivity. In this work, we computationally investigate the suitable engine-relevant thermochemical conditions for auto-ignition of constant volume ammonia spray, as well as its spray dynamics, vaporization, flash boiling effects, and emissions. The simulation is first validated by comparing it against available experimental data from a vaporizing ammonia spray and is then extended to chemically reactive conditions. Results show that ammonia sprays under engine-relevant conditions (60 bar and 1200 K) can only successfully auto-ignite for cases with ambient hydrogen addition, through enhancement of thermal condition and chemical reactivity. A chemical flux analysis is conducted to further understand the important species and reactions that promote ammonia auto-ignition from hydrogen, which potentially can be introduced via H2 solubility, exhaust gas recirculation, and onboard ammonia thermal decomposition. Furthermore, results have indicated that charge cooling effects can further decrease the temperature in the flow field and make auto-ignition more difficult. This study provided useful insights for the application of ammonia as a zero-carbon diesel fuel for ground transportation.
Damage evaluation and failure mechanism analysis of axially compressed circular concrete-filled steel tubular column via AE monitoring
Authors: Gao Pan , Liu Jiepeng , Wang Xuanding , Jiao Yubo , Shan Wenchen
Published: May 2023

Concrete-filled steel tubular (CFST) columns are frequently used as the main load-bearing components in engineering structures due to their excellent load-bearing capacity. However, the presence of steel tube makes it impossible to accurately detect the damage characteristics of concrete by only relying on traditional mechanical measurement methods. This article quantitatively investigates the concrete damage of circular CFST column during axial compression based on the acoustic emission (AE) technique. Through the cumulative AE parameters including amplitude, count, and energy, the axial compression process of the CFST column can be divided into five main stages (Stage I is divided into two substages) to represent the different damage degree. The damage characteristics of concrete at each stage were explained by combining AE results and mechanical phenomena. A sensitivity analysis of the axial compression process was carried out using the Historic Index ( HI) and Severity ( Sr) and found that the sudden rise in HI and Sr corresponded to the changes in the different loading stages. The Improved b ( Ib) value analysis calculated from the AE amplitudes reflects the evolution mechanism of the crack and can be used for the identification of the final failure moment of the specimen. Finally, a new method for processing and analyzing AE parameters was proposed, which effectively enhanced the dimensionality of real-time monitoring information on the damage of concrete filled in the steel tube.
Longitudinal Associations Between Adolescent Dating Violence Victimization and Adverse Outcomes: A Systematic Review
Authors: Campo-Tena Laura , Larmour Simon R. , Pereda Noemí , Eisner Manuel P.
Published: May 2023

Evidence on the outcomes of adolescent dating violence (ADV) victimization mainly derives from cross-sectional studies, which have limitations in suggesting causal relationships. Furthermore, the complexity of factors and overlapping dimensions in dating violence research, such as the forms of violence experienced, may have contributed to the variability of findings across the literature. To address these gaps and provide a more comprehensive understanding of the impact of ADV, this study reviews findings from prospective cohort studies, with a focus on the type of violence experienced and the gender of the victim. A systematic search was conducted in nine electronic databases and additional relevant journals. Prospective longitudinal studies were included if dating violence victimization occurred during adolescence and chronologically preceded the outcomes. A quality assessment was conducted using the Mixed Methods Appraisal Tool. A narrative approach was used to synthesize findings. After screening 1,838 records, 14 publications met the selection criteria and were included in this review. Our findings suggest that experiencing ADV is longitudinally associated with many adverse outcomes, including higher internalizing symptoms and externalizing behaviors, poorer well-being, increased substance use, and increased revictimization. However, the associations are not consistently reported across studies when considering the type of ADV experienced and the gender of the victim. This review highlights the limited number of longitudinal studies examining the outcomes of ADV victimization, the unbalanced approach in investigating different forms of violence, and the lack of diverse samples examining this subject. Implications for research, policy, and practice are outlined.
Questioning Identity: How a Diverse Set of Respondents Answer Standard Questions About Ethnicity and Race
Authors: Garbarski Dana , Dykema Jennifer , Jones Cameron P. , Neman Tiffany S. , Schaeffer Nora Cate , Farrar Edwards Dorothy
Published: May 2023

Ethnoracial identity refers to the racial and ethnic categories that people use to classify themselves and others. How it is measured in surveys has implications for understanding inequalities. Yet how people self-identify may not conform to the categories standardized survey questions use to measure ethnicity and race, leading to potential measurement error. In interviewer-administered surveys, answers to survey questions are achieved through interviewer–respondent interaction. An analysis of interviewer–respondent interaction can illuminate whether, when, how, and why respondents experience problems with questions. In this study, we examine how indicators of interviewer–respondent interactional problems vary across ethnoracial groups when respondents answer questions about ethnicity and race. Further, we explore how interviewers respond in the presence of these interactional problems. Data are provided by the 2013–2014 Voices Heard Survey, a computer-assisted telephone survey designed to measure perceptions of participating in medical research among an ethnoracially diverse sample of respondents.
Dynamic prediction model of segmented combined electromagnetic launch weft insertion for super-wide width industrial fabrics
Authors: He Yuchen , Li Ding , Zhang Huiru , Xu Qiao , Mei Shunqi , Zhang Zhiming , Tang Xuemei
Published: May 2023

Stable, reliable and high-speed weft insertion is an urgent challenge for high-speed industrial textile weaving devices. More stable and large electromagnetic forces can be provided by the segmented combined electromagnetic launch weft insertion, compared to the conventional electromagnetic launch weft insertion, which facilitates the realization of high-speed weft insertion. For digital electromagnetic launch weft insertion textile devices, it is necessary to respond quickly to the signals fed back by the sensors. Therefore, a fast and high-precision dynamical model capable of characterizing the kinematic properties of the weft inserter is extremely essential for control, which is conducive to the stable and reliable operation of the device. In this paper, we consider the electromagnetic force, weft yarn tension, air resistance, pipe wall friction, and gravity during the movement of the weft inserter, and establish a dynamic prediction model of segmented combined electromagnetic launch weft insertion (DPMSCEI) for control. Combining simulations and experiments to evaluate the performance of DPMSCEI validates the effectiveness and professionalism of DPMSCEI in solving electromagnetic weft insertion dynamics.
A Comparative Evaluation of Topical Application Versus Perilesional Injection of Platelet-Rich Plasma in Diabetic Foot Ulcer
Authors: Rani Digumarthi Asha , Khanna Seema , Mishra S. P. , Kumar Sandip
Published: May 2023

Diabetic foot ulcer (DFU) is globally a major health burden predisposing to limb amputation. Among the various treatment modalities, platelet-rich plasma (PRP) is emerging as a promising agent. It stimulates wound healing by providing a higher concentration of essential growth factors locally. Though the role of PRP in DFU healing is established, still the route of administration with maximal efficacy is yet to be defined. Our study aims to evaluate the efficacy of autologous PRP in the treatment of diabetic ulcers and compare the effect of topical and perilesional injections of PRP in DFU healing. We conducted a single-centre, prospective, interventional study on 60 patients with DFU, in 2 groups of 30 patients each. They were treated with freshly prepared autologous PRP injection perilesionally and topically respectively, once a week for 4 weeks. Ulcer size was assessed, using “imito-measure” software at presentation and 2, 4, 8, and 12 weeks post-therapy. Serum MMP-9 levels were assessed in both groups, pretreatment and post-treatment. For statistical analysis, SPSS software V-23 was used. On assessment, both groups had comparable baseline characteristics, Wagner's grading, and glycemic indices. The percentage reduction in the size of the wound at 2 weeks, 1 month, 2 months, and 3 months was greater in the perilesional group as compared to the topical PRP group.
SHP-1 alleviates atrial fibrosis in atrial fibrillation by modulating STAT3 activation
Authors: Zang Xiaobiao , Zhao Zhihan , Chen Ke , Song Weifeng , Ma Jifang , Fu Haixia , Wang Xianqing , Zhao Yonghui
Published: May 2023

Src homology 2 domain–containing protein tyrosine phosphatase 1 (SHP-1) has a well-established role in myocardial infarction, yet its involvement in atrial fibrosis and atrial fibrillation (AF) has not been elucidated. As cardiac arrhythmias caused by AF are a major global health concern, we investigated whether SHP-1 modulates AF development. The degree of atrial fibrosis was examined using Masson’s trichrome staining, and SHP-1 expression in the human atrium was assessed using quantitative polymerase chain reaction (qPCR), immunohistochemistry (IHC), and western blotting (WB). We also examined SHP-1 expression in cardiac tissue from an AF mouse model, as well as in angiotensin II (Ang II)-treated mouse atrial myocytes and fibroblasts. We found that SHP-1 expression was reduced with the aggravation of atrial fibrosis in clinical samples of patients with AF. SHP-1 was also downregulated in the heart tissue of AF mice and Ang II-treated myocytes and fibroblasts, compared with that in the control groups. Next, we demonstrated that SHP-1 overexpression alleviated AF severity in mice by injecting a lentiviral vector into the pericardial space. In Ang II-treated myocytes and fibroblasts, we observed excessive extracellular matrix (ECM) deposition, reactive oxygen species (ROS) generation, and transforming growth factor beta 1 (TGF-β1)/mothers against decapentaplegic homolog 2 (SMAD2) pathway activation, all of which were counteracted by the overexpression of SHP-1. Our WB data showed that STAT3 activation was inversely correlated with SHP-1 expression in samples from patients with AF, AF mice, and Ang II-treated cells. Furthermore, administration of colivelin, a STAT3 agonist, in SHP-1-overexpressing, Ang II-treated myocytes and fibroblasts resulted in higher levels of ECM deposition, ROS generation, and TGF-β1/SMAD2 activation. These findings indicate that SHP-1 regulates AF fibrosis progression by modulating STAT3 activation and is thus a potential treatment target for atrial fibrosis and AF.
Extensor Carpi Ulnaris Instability: A Comprehensive Review of Pathology and Operative Techniques
Authors: Thirumavalavan Jeyvikram , Ibrahim Zainab , Byrne Rory A. , Arant Kaetlyn R. , Gil Joseph A.
Published: May 2023

The extensor carpi ulnaris (ECU) is primarily responsible for extension and ulnar deviation at the wrist. Secondary to repetitive loading of, or acute trauma to the flexed, supinated and ulnarly deviated wrist, the ECU tendon can be a common source of ulnar-sided wrist pain. Common pathology includes ECU tendinopathy, tenosynovitis, tendon instability, and tendon rupture. Extensor carpi ulnaris pathology commonly occurs in athletes and patients with inflammatory arthritis. Given the multitude of available methods to treat ECU tendon pathology, the aim of our study was to outline operative management of ECU tendon pathology, with emphasis on reviewing techniques for addressing ECU instability. We acknowledge a continuing debate between anatomical and nonanatomical techniques for ECU subsheath reconstruction. However, use of a portion of the extensor retinaculum for nonanatomical reconstruction is commonly used and demonstrates successful outcomes. Future comparative studies on ECU fixation are required to increase data on patient outcomes, to further define and standardize these techniques.
Six-Week Radiographic Follow-up Does Not Change Management for Nonoperatively Treated Extraarticular Metacarpal Shaft Fractures
Authors: Crawford Zachary , Ponce Robert B. , Moore Michael , Schumaier Adam , Ross Phillip , Stern Peter
Published: May 2023

Background:

Metacarpal fractures are common and account for over 30% of all hand fractures. Previous literature has shown similar outcomes between operative and nonoperative management of metacarpal shaft fractures. There is little information regarding the natural history of conservatively managed metacarpal shaft fractures and changes in management based on follow-up radiographs.

Methods:

A retrospective chart review was performed on all patients who presented to a single institution with an extraarticular metacarpal shaft or base fracture between 2015 and 2019.

Results:

Thirty-one patients with 37 metacarpal fractures were included for review: average age 41 years, male 48%, right hand dominant 91%, and average follow-up duration 7.3 weeks. At follow-up, a change of 2.4° in angulation ( P = .0005) and a change in shortening of 0.1 mm ( P = .0386) were noted over the 6-week time interval. No fractures had malrotation at presentation, and none developed malrotation during the follow-up period.

Conclusions:

Recent systematic reviews and meta-analysis have suggested that metacarpal fractures treated nonoperatively had similar outcomes to surgical fixation at 12 months of follow-up. We found that extraarticular metacarpal shaft fractures that do not meet operative indications at the initial visit should be expected to heal reliably with minimal change in angulation and shortening over time. The transition to removable brace or no brace at the 2-week follow-up is likely sufficient, and additional follow-up is not necessary and will reduce cost.

Level of Evidence:

Level III.
Optimization of collateral grading on computer tomography angiography
Authors: Pisani Leonardo , Haussen Diogo C , Mohammaden Mahmoud , Perry da Camara Catarina , Rodrigues Gabriel M , Bouslama Mehdi , Al-Bayati Alhamza , Hu Ranliang , Bianchi Nicholas , Ravindra Bhatt Nirav , Frankel Michael , Nogueira Raul G
Published: May 2023

Background

As compared to single-phase CTA (sCTA), multi-phase CTA (mCTA) has been shown to more accurately estimate collateral flow in acute ischemic stroke (AIS). We sought to determine the characterization of poor collaterals across the three different phases of the mCTA. We also attempted to establish the optimal arterio-venous contrast timing parameters on sCTA that would prevent false positive reads of poor collateral status.

Methods

We retrospectively screened consecutive patients admitted for possible thrombectomy from February 2018 to June 2019. Only cases with intracranial internal carotid artery (ICA) or main trunk of the middle cerebral artery (MCA) occlusion and both baseline mCTA and CT Perfusion available were included. Mean Hounsfield units (HU) of torcula and torcula/patent ICA ratio were used for the arterio-venous timing analysis.

Results

Of the 105 patients included, 35 (34%) received IV-tPA treatment and 65 (61.9%) underwent mechanical thrombectomy. A total of 20 patients (19%) had poor collaterals on the third-phase CTA (ground-truth). The first-phase CTA often underestimated collateral score (37/105 [35%], p < 0.01), however there were no significant differences across the second- and third-phases (5/105[5%], p  =  0.06. Venous opacification Youden's J point for identifying suboptimal sCTAs was found to be 207.9HU in the torcula (65% sensitivity,65% specificity) and 66.74% for torcula/patent ICA ratio (51% sensitivity,73% specificity).

Conclusion

A dual-phase CTA is significantly similar to a mCTA assessment of collateral score and may be applied at community-based centers. Absolute or relative thresholds for torcula opacification may be used to identify poor bolus-scan timing thus preventing erroneous assumptions of poor collaterals on sCTA.
Views of parents of children with Down syndrome on Alzheimer’s disease vaccination
Authors: Batbold Sarah , Cummings Gabrielle , Riggan Kirsten A. , Michie Marsha , Allyse Megan
Published: May 2023

Individuals with Down syndrome (DS) experience increased risk of Alzheimer’s disease (AD). Recent studies suggest that a vaccine against AD may be forthcoming. Parental buy-in is critical to the success of any intervention in this population, as adults with DS often rely on familial support. This study aims to characterize parents’ perceptions of a hypothetical vaccine to prevent AD in individuals with DS. A mixed-methods, anonymous survey was distributed via social media. Participants were asked about their experiences with DS and reactions to proposed interventions. Open-ended responses were thematically analyzed using NVivo 12. Of 1,093 surveys initiated, 532 were completed. Of the parents sampled (N = 532), a small majority (54.3%), supported the proposed AD vaccine. All expressed the need for extensive pre-enrollment education and minimal risk. For many, limited research and long-term sequelae were concerns.
Do South African international cricket pace bowlers have similar bowling volume and injury risk associates compared to other elite fast bowlers?
Authors: Christie Candice J. , McEwan Kayla , Munro Catherine E. , King Greg A. , Le Roux Adrian , Olivier Benita , Jackson Brandon , Manjra Shuaib , MacMillan Candice , Pote Lee
Published: May 2023

Background

Although many cricket-playing nations have conducted research on bowling volume (BV) and injury risk, this relationship amongst international South African pace bowlers is yet to be investigated. Environmental, socio-economic and training strategy differences warrant similar research in a South African context. The purpose of this preliminary study was to establish whether South African pace bowlers have similar BV and injury associates compared to other elite fast bowlers.

Methods

This study was a prospective, observational, cohort study that monitored match and training BV and injuries amongst pace bowlers playing for the South African national team between April 2017 and April 2019. A sample of convenience that included 14 bowlers was selected. Bowling volume was quantified as the number of deliveries bowled during training and competition. Acute-, chronic- and acute:chronic BV ratios were independently modelled as association variables.

Results

There were 39 injuries with the most being to the lumbar spine (25.64%). Moderate-to-low and a moderate-to-high acute:chronic bowling load ratios were associated with a lower risk of injury. Chronic bowling load was associated with injury (z  =  2.82, p  =  0.01). A low acute workload, low chronic workload, moderate-high chronic workload and moderate-low acute:chronic ratio were also associated with an increased risk of injury.

Conclusion

These findings confirm that there appears to be a dose–response effect between training BV and the likelihood of an injury occurring with a moderate-to-low and a moderate-to-high BV ratio being optimal. Considering the small sample size, the findings should be interpreted with caution.
A virtual reality instrument to raise drivers’ awareness on safer driving through road tunnels
Authors: Kirytopoulos Konstantinos , Mourelatos Andreas , Chatzistelios Georgios , Ntzeremes Panagiotis , Konstantinidou Myrto
Published: May 2023

Studies reveal that drivers’ behavior is the most significant factor in road accidents worldwide. Regarding tunnels, which are the most critical element of road infrastructure, despite the significant efforts that have been conducted toward the enhancement of drivers’ education all these years, studies illustrate that there are still serious deficiencies need to be tackled. To address this issue, this research endeavor develops a virtual reality tool based on the serious game idea in order to inform and educate potential users about the specific rules and behavioral patterns that should govern their safe driving when passing through tunnels. To do so, the appropriate behavioral patterns are determined using applicable norms and guidelines while the specific educational requirements are identified. Following that, the novel tool for training users is developed. The tool consists of a virtual reality gaming environment based on the notion of serious games that simulates driving through a tunnel from a first-person perspective. Various scenarios are developed within this environment based on the knowledge gaps identified in the literature, with the aim of assessing users’ knowledge as well as educating them when required. The developed tool was tried by more than 50 drivers, professional and non-professional during tool’s launch activities. In particular, drivers who had recently obtained a driver’s license confirmed that such a tool would be especially useful in the context of their training. The ultimate goal of this study is to provide an efficient tool in order to support both practitioners and authorities to significantly improve the safety level of road tunnels by emphasizing on the driving behavior, since this is considered the most crucial component of each tunnel system.
Environmental commemoration: Guiding principles and real-world cases
Authors: Mihai Mihaela , Thaler Mathias
Published: May 2023

Addressing the political implications of the ever-accumulating destruction of ecosystems and more-than-human life, this paper asks whether and in what ways environmental losses should be publicly commemorated. Our answer is two-pronged. First, we hold that a politics of environmental commemoration would enfranchise those who are already grieving, by lending legitimacy to their experiences. Moreover, commemorative practices might prompt much-needed norm change by nurturing a recognition of our species’ entanglement with the more-than-human world. Second, we programmatically introduce five principles that should guide environmental commemoration, ethically and pragmatically: multispecies justice, responsibility, pluralism, dynamism, and anticlosure. A critical examination of two real-world examples – the memorialization of the passenger pigeon’s extinction and the annual ritual of the Remembrance Day for Lost Species – substantiates our theoretical argument. Finally, the paper engages with several potential criticisms.
Concomitant ligament injuries can be left untreated during surgery of distal radial fractures
Authors: Bakker Daniel , Derksen Bas M. , Kramer Simon B. , Cleffken Berry I. , Schep Niels W. L.
Published: May 2023

Instability of the distal radioulnar joint and scapholunate dissociation may cause pain, functional impairment and subsequent arthrosis. There is no consensus about whether these injuries should be treated acutely in patients undergoing surgery for distal radial fractures. We conducted a prospective cohort study to determine whether concomitant distal radioulnar joint instability or scapholunate dissociation negatively influence patient-related outcomes in these patients. The primary outcome was the patient-reported wrist/hand evaluation at 6 and 12 months after surgery. Out of 62 patients, 58% and 27% had intraoperative distal radioulnar joint instability and scapholunate dissociation, respectively. No significant differences were found in patient-reported scores at follow-up between patients with stable and unstable distal radioulnar joints, nor between patients with and without scapholunate dissociation. Sixty-three per cent of patients with an unstable distal radioulnar joint during surgery were stable on retesting after 6 months. Our study suggests that a wait-and-see policy in these patients therefore seems reasonable.

Level of evidence: III
Effect and Mechanism of Schizandrin A in the Treatment of Liver Cancer Using Network Pharmacology, Molecular Docking, and Target Validation
Authors: Wang Xiaohui , Zhou Lin , Zhang Tao , Chen Hui , Song Xinhao , Wang Feng
Published: May 2023

Background

Liver cancer is a common threat to human health. Schizandrin A (SA) has certain therapeutic effect on liver cancer, but its related mechanism of action is not clear. Elucidating this mechanism is of great significance for the development of drugs to target liver cancer.

Objective

The objective is to study the effect and mechanism of SA on liver cancer.

Methods

The potential targets of SA in the treatment of liver cancer were screened based on network pharmacology, and the core targets were further screened by protein network interaction. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis was performed based on the core targets to find the key pathways of action. The results obtained for key targets and pathways were verified in vitro by pharmacological experiments with HepG2 cells. Specifically, an Enzyme Linked Immunosorbent assay (ELISA) kit was used to detect the content of key indicators (interleukin-1 (IL-1), Tumor Necrosis Factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), superoxide dismutase [SOD], malondialdehyde [MDA], interferon (IFN), and Glutathione peroxidase (GSH-px)), Quantitative Real-time Polymerase Chain Reaction (qRT-PCR) was used to detect the key messenger Ribonucleic Acid (mRNA) (phosphatidylinositol 3 kinase (PI3K), protein kinase B (Akt), vascular endothelial growth factor A (VEGFA), and Transforming Growth Factor Beta-1 (TGF-β1)) after drug intervention, and Western blotting (WB) detected the expression of key target proteins (p-PI3K, PI3K, p-Akt, and Akt).

Results

The results showed that SA mainly acts on IL-1β, TNF-α, IL-6, IL-10, SOD, MDA, TGF-β1, IFN, and VEGFA, affecting the PI3K-Akt signaling pathway and playing an anti-inflammatory role in the treatment of liver cancer. The experimental results showed that SA significantly reduced the inflammation level of HepG2 cells; improved the oxidative stress state (decreasing SOD level and increasing MDA level of cells); downregulated TGF-β1, VEGFA, PI3K, and Akt mRNA levels; and inhibited the expression of the PI3K-Akt signaling pathway.

Conclusions

SA has a significant anti-HepG2 effect, which may be achieved by reducing inflammation levels, improving oxidative stress state, and inhibiting the PI3K-Akt pathway.
Aerial Part Extract of Kummerowia striata as an Anti-Blood Stasis Agent in a Mouse Model of Hen-egg White Lysozyme-Induced Stagnant Blood Flow
Authors: Aoki Shui , Oku Hisae , Kitagawa Fumika , Inoue Naoki , Honda Chie
Published: May 2023

Background/Objective

Stagnant blood ( oketsu in Japanese) is considered a severe pathological condition in traditional Chinese and Japanese medicine. Kummerowia striata is known as a weed in Japan; however, in traditional Chinese medicines, it is used for detoxification and for treating colds, fevers, and bruises. To the best of our knowledge, there is no record of this plant, or its parts, being used as an anti-blood stasis agent. Herein, we demonstrated the effect of the 35% ethanol extract (KS) of the aerial part of K. striata on stagnant blood flow (BF) in the peripheral circulation using an in vivo assay.

Methods

Hen-egg white lysozyme (HEL) was injected into the tail vein of mice to induce stagnant BF, the pathology of which is similar to that of oketsu; then, the changes in BF were observed.

Results

The oral administration of KS (200 mg/kg) significantly improved HEL-induced BF decrease, suggesting that KS can improve blood stasis. Bioassay-guided fractionation of KS resulted in the isolation of 14 flavone and flavonol derivatives. As apigenin (1) and luteolin (2) reportedly have activity in this assay, here, the effects of isovitexin (3), vitexin (5), rhoifolin (12), and vicenin-1 (14) were examined. Compounds 5, 12, and 14 (20 µmol/kg) more effectively inhibited HEL-induced stagnant BF than 1, which was used as a positive control.

Conclusion

The aerial part of K. striata could be useful in the discovery of new leads for the prevention of stagnant blood syndrome.
The Changing Landscape of Substitute School Nursing: A School Nurse Administrator Roundtable
Authors: Galemore Cynthia A. , Brubaker Cheryl R. , MacAdams Dawn , Smith Rachel , Sweeney Deborah , Wehr Amy
Published: May 2023

School nurse administrators increasingly express concerns over the availability of substitute school nurses with return to in-person learning after the height of the COVID-19 pandemic. While healthcare staffing concerns and shortages are not unique to the school setting, the increasing health acuity of the student population, delegation principles, and staffing models complicate the issue. Traditional methods of covering absences may no longer suffice. In this article, five school nurse administrators share strategies, comparing pre-pandemic to current day facilitation of providing coverage for the absences of their healthcare staff.
Migrations and new expulsions: accumulation by dispossession or crisis of capitalist societal reproduction?
Authors: Giavarotti Daniel Manzione , Leite Ana Carolina Gonçalves , Ribeiro Clara Lemme
Published: May 2023

The present paper discusses the relation between population dynamics and accumulation of capital, with special emphasis on a critical dialogue with the theory of accumulation by dispossession as presented by Marxist geographer David Harvey. We depart from a discussion on the so-called primitive accumulation as conceptualized by Karl Marx, in order to identify the fundamental meaning of the said historical process: the formation of capitalism, rooted in the separation between owners of means of production, on the one hand, and owners of the workforce commodity, on the other. From there on, we present a critical appraisal of the land grabbing scholarship, in which we spotlight similarities between land grabbing's expulsive and expropriating effects and the so-called accumulation by dispossession and its supposed capacity to resolve capital's crises. However, we problematize such an interpretation in light of the fundamental crisis of capital, that is, capital's tendency to absorb less and less workers into productive processes, due to capitalist competition and technological development, that in turn undermines capital accumulation itself. Lastly, we explore how contemporary expulsion processes, in a multiscalar register, go hand in hand with distinct confinement strategies as forms of surplus population management, typical of the barbarism provoked by the collapse of capitalism.