bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Beliefs and Attitudes Involved in the Willingness to Intervene in Cases of Intimate Partner Violence Against Women in a Spanish Sample
Authors: Badenes-Sastre Marta , García-Sánchez Efraín , Lorente Acosta Miguel , Expósito Jiménez Francisca
Published: December 2024

Intimate partner violence against women (IPVAW) is a public health and social responsibility issue affecting women worldwide. The role of society is essential to help victims to get out of the violent relationship and reduce their risk of revictimization. In this regard, the social response to IPVAW depends to some extent on public beliefs and attitudes toward IPVAW. Hence, this research explores the direct relationship between sexism and the willingness to intervene in cases of IPVAW, indirectly through acceptance of myths of IPVAW, perceived severity of IPVAW, risk assessed of victims’ health and life as well as to the establishment of equal relations, attribution of the responsibility to the aggressor, and victim blaming. A Spanish sample of 487 participants was collected through incidental sampling. Participants responded to an online survey that was disseminated via email and social media. A parallel path analysis model showed that greater sexism was associated with lower willingness to intervene in cases IPVAW, via greater acceptance of the myths of IPVAW and less attribution of responsibility to the aggressor. IPVAW perceived severity, risk assessed, and victim blaming did not explain the effect of sexism on willingness to intervene. This research emphasizes the need to focus on egalitarian education that mitigates sociocultural risk factors such as patriarchal beliefs and attitudes that explain IPVAW and favors a climate of acceptance and tolerance of this problem, making it difficult for victims to break with the violent relationship.
Why do Rural Migrant Mothers in Urban China Digitally Monitor Their Children?
Authors: Murphy Rachel , Wu Gaohui
Published: December 2024

We examine how and why some rural intra-provincial working migrant women in cities in central China used digital monitoring technologies in their mothering. The discussion draws on our 22 face-to-face interviews with the rural migrant mothers of at least one child ages 7–14 years. Our analysis highlights the intersectionally constituted time pressures arising from these women’s need to balance their responsibilities in paid work and childcare. We focus on how some of the mothers used smartwatches and home security cameras to pursue three core aspects of intensive mothering: being continually accessible to their children, supervising their children’s safety and well-being, and encouraging their children to study. We especially explore how these mothers used digital monitoring in navigating the time and space constraints to providing maternal care, practices that we call “time stretching.” The conclusion reflects on the implications of these women’s digital time-stretching efforts for feminist theories of mothering and care.
Alterations in Response Switching in Parkinson’s Disease: New Insights Into Cueing
Authors: Peleg Ori , Soret Rébaï , Charras Pom , Peysakhovich Vsevolod , Mirelman Anat , Levy Daniel A. , Maidan Inbal
Published: December 2024

Switching, a critical executive function, can manifest as task switching (TS) or response switching (RS). Although TS impairments in Parkinson’s disease (PD) are well-studied, RS, especially in contexts requiring adaptive behavior to external or internal cues, is less explored. This study evaluated the impact of PD on RS under exogenous and endogenous cueing. Using a gamified, remote task triggering these cues, RS was assessed in 85 PD patients and 82 neurologically healthy participants (NHP). RS cost was quantified by comparing reaction times between repeating and changing responses. A linear mixed model analyzed the effects of group, cueing mode, and their interaction on RS cost. PD patients exhibited increased RS costs under exogenous cueing but not under endogenous cueing. These findings indicate that while PD patients can effectively use predictive endogenous cues, they struggle with less predictive exogenous cues, emphasizing the need for compensatory strategies and technological aids in daily activities.
Synchronization of the vibration system driven by four eccentric rotors with perpendicular and coplanar axes
Authors: Chen Xiaozhe , Zhang Chengbin , Ban Mutian , Liu Junqi
Published: December 2024

This paper proposes a vibration mechanical structure capable of achieving two synchronous motion states. Its distinctive feature lies in utilizing four eccentric rotors (ERs) with coplanar and perpendicular axes as the excitation source. By modeling this vibration system and conducting theoretical analysis, the synchronous condition and its stability for achieving synchronous motion among four ERs are obtained. Based on theoretical results, the dynamic characteristics, coupling torques, synchronous capability coefficients and phase differences of ERs are discussed numerically. According to the stable phase difference, the variation of the excitation resultant force from four ERs is also investigated. Finally, experiments valid the system has two synchronous states. In pre-resonance, four ERs are in-phase resulting in the linear motion of the vibrating body. However, in post-resonance, ERs along the parallel axes are in-phase, while ERs along the perpendicular axes are in anti-phase. Hence, the body remains stationary because excitation forces cancel each other out. In summary, these conclusions provide a theoretical basis for the structural design of vibratory machinery.
Predicting International Student Suicidality by Merging Identity, Suicide, and Acculturation Frameworks: A Hierarchical Logistic Regression
Authors: Lundeen Lindsay A. , Giordano Amanda L. , Ziomek-Daigle Jolie
Published: December 2024

This study combined suicide, acculturation, and identity change frameworks to predict the likelihood of suicidality endorsement among collegiate international students. Participants included 179 undergraduate and graduate international students enrolled at a large Southern university. Ultimately, depression, perceived burdensomeness, and ethnic identity significantly predicted suicidality endorsement after controlling for age, time spent in the United States, gender, and alcohol consumption. Acculturation stress and thwarted belongingness did not statistically significantly predict suicidality endorsement. We offer implications for academic communities and future research surrounding international students and suicide.
Pulling at All Threads: Reflections on Using Multimodal Critical Discourse Analysis Within Arts-Based Health Research
Authors: Joy Phillip , Hammond Brianna , Hammond Chad , Bonardi Olivia , Wassef Kinda , Ferlatte Olivier
Published: December 2024

Multimodal critical discourse analysis is a dynamic approach to qualitative data analysis that expands critical discourse analysis to include multiple communicative modes—such as images, graphics, video, and sound/music—into the semiotic analysis of ideology and power relations within contemporary forms of communication. We reflect on the potential of multimodal critical discourse analysis to be combined with arts-based health research as an analytic method to deconstruct discourses that shape the health and well-being of marginalized communities. Specifically, we frame this potential within our research about men’s body image based a project using cellphilming and the deconstruction of cis-heteronormative and related ideologies.
Angiopoietin-2 and Mortality Outcomes in End-Stage Renal Disease with Heart Failure as a Comorbidity
Authors: Robbin Vanessa , Bansal Vinod , Vellanki Kavitha , Siddiqui Fakiha , Hoppensteadt-Moorman Debra , Fareed Jawed , Syed Mushabbar
Published: December 2024

Angiopoeitin-2 (Ang2) is a vascular growth factor involved in regulating angiogenesis and endothelial remodeling. Higher Ang2 levels have been associated with mortality in the general population and among male hemodialysis patients, but its effects on concomitant heart failure with reduced ejection fraction (HFrEF) and end-stage renal disease (ESRD) are unknown. Plasma samples from 73 ESRD patients and 40 healthy patients were analyzed for Ang2 concentrations using ELISA. Patient groups were stratified into those with or without HFrEF (EF < 50%). At two years following sample collection, the medical record was reviewed for mortality. The optimal cut-off value for Ang2 to predict all-cause mortality was 1671 pg/mL (AUC 0.73, sensitivity 0.714, specificity 0.750) based on the regression analysis. Statistical analyses included Mann–Whitney U tests, Cox proportional hazards model, and Log-rank test. Multiple comorbidities were present; coronary artery disease 46%, diabetes 69%, hypertension 97%, and smoking 49%. Patients with one- and two-year mortality had higher Ang2. Ang2 levels above the optimal cut-off are associated with mortality within the entire ESRD sample and within the group with both ESRD and HFrEF. In the Cox proportional hazards analysis, Ang2 levels were associated with mortality within the larger ESRD sample but not in the group with ESRD and HFrEF. Ang2 has potential as a non-specific biomarker for prognostication in patients with cardiorenal syndrome given its association with mortality, despite modest sex-based differences. Future research should be conducted with larger samples to evaluate if it has prognostic value in individuals with HFrEF and ESRD of varying severity and temporality.
Opening the Tent for the Scholarship of Hope
Authors: Mayan Maria
Published: December 2024

The contributions of Norman Denzin to qualitative inquiry are vast, meaningful, and humbling. His wish for his memorial, however, was not for people to simply “say nice things” about him; he wanted people to challenge the field and question where we are going as a qualitative community. This address asks the reader to consider the “qualitative tent” and the dangers of staying within its confines. It challenges the qualitative community to open the tent to engage with communities, including those that are structurally disadvantaged, but also policy-makers, government administration, industry, and others complicit in maintaining structural disadvantage. It asks us to engage with communities to ultimately fulfill what Norman so deeply cared about and asked us to do— support social justice, reduce inequity, and produce real change. By engaging with communities, our qualitative tent becomes a place for the scholarship of hope, so desperately needed in our troubled and upended world.
Analysis of the dynamic response of aerostatic bearings based on the dynamic equilibrium position method
Authors: Wang Wenbo , Liu Meihong , Yu Hechun , Li Bin , Zhang Guoqing
Published: December 2024

To fully consider the influence of time-varying pressure and film thickness, the transient Reynolds equation is typically employed for numerical computations in the analysis of gas bearing-rotor systems. Solving the transient Reynolds equation is complex and time-intensive. To enhance computational efficiency, this paper presents an optimized algorithm, termed as the equilibrium position (EP) method, which leverages the solution of the steady-state Reynolds equation to analyze the axis shift induced by rotor imbalance. By neglecting certain transient terms while retaining the essential physics, the proposed method achieves high computational accuracy and significantly reduces computational time. The computational errors are evaluated, and comparisons with orbit method simulations demonstrate the method's efficiency and accuracy. In applications such as predicting rotor vibration amplitude or estimating unbalanced forces during ultra-precision machining and rotor design, the EP method offers a streamlined computation process without compromising on result fidelity.
Getting things done?: Process, performance, and decision-evasion in consociational systems
Authors: McCulloch Allison
Published: December 2024

Do consociations suffer an immobilism problem and under what conditions? In this article, I contrast two perspectives: consociation’s propensity to ‘get things done’ versus its tendency to ‘kick the can down the road’. Employing a case-study approach to the Northern Ireland Assembly, I present a threefold measurement of consociation’s decision load capacity, assessing the issues which receive legislative assent, those blocked by formal vetoes in the legislative process, and those issues which do not make it onto the legislative agenda at all, whether due to non-decision-making or to outsourcing to actors outside the system. Consociations, I argue, are prone to deliver a sparse legislative agenda, characterised by the resolution of ‘safe issues’, and the evasion of more contentious issues.
Experimental investigation of the corrosion effect and repair effectiveness for an RC beam with the corroded stirrups
Authors: Sung Hsin-Fang , Chiu Chien-Kuo , Liao Wen-I , Chou Wan-Yi
Published: December 2024

To investigate the effectiveness of selected repair materials and reinforcement methods on the shear strength of reinforced concrete (RC) beams with corroded stirrups, 14 RC beam specimens were designed with corroded stirrups exhibiting weight loss rates of 10% and 17%. Additionally, control specimens without repairs were included to assess the impact of pre-corroded stirrups on strength development. A three-point bending test was conducted to evaluate the shear strength of the specimens under various repair and reinforcement scenarios. Epoxy mortar, cement mortar, and non-shrinkage cement mortar were selected as repair materials, while spot-welded steel wire mesh (WWM) and carbon fiber-reinforced plastics (CFRP) were used to enhance repair effectiveness. The results indicate that, for the specimens with corroded stirrups showing weight loss rates of 10% and 17%, their shear strengths decreased by up to 17% and 21%, respectively, compared to specimens without any corrosion. Additionally, the shear strengths of the specimens repaired using epoxy mortar were slightly increased by reinforcing with WWM and CFRP. However, the shear strengths of most specimens with repair and reinforcement were lower than their original shear strengths. For practical design applications, this work introduces a novel approach to quantifying the effectiveness of repair materials in conjunction with reinforcement methods, based on the softened strut-and-tie model (SST), which was verified using experimental data.
Study on the measurement of buckle pressure of rail elastic strip fastener based on modal method and ultrasonic method
Authors: Zhang Fan , Song Wentao , Chen Feifan
Published: December 2024

The railway elastic strip fastener system is heavily used in the laying of seamless lines, where the buckle pressure of elastic strip fasteners is an important part of railway safety inspection. This paper investigates and analyzes the eigenfrequency measurement method of the buckle pressure of the rail elastic strip fastener based on the modal theory, and analyzes the relationship between the first two orders of characteristic frequency and the buckle pressure using COMSOL Multiphysics simulation. Meanwhile, based on the relationship between the axial load of the spiral stud and the buckle pressure of the sling, the buckle pressure of the railway fastener can also be obtained by measuring the propagation time of the transverse and longitudinal waves in the spiral stud. Through experiments, the second-order characteristic frequency of the elastic strip vibration, the relationship between the buckle pressure and the preload torque of the fastener, and the relationship between the horizontal and vertical wave acoustic time difference and the buckle pressure of the elastic strip are measured, which provides an effective solution for accurately measuring the buckle pressure of the elastic strip.
Trust has a price?! Unraveling the dynamics between trust in the media and the willingness to pay in the post-pandemic scenario
Authors: Voci Denise , Karmasin Matthias , Luef Sonja , Förster Sandra , Kaltenbrunner Andy
Published: December 2024

This study examines the link between media trust and consumers’ willingness to pay (WTP) for online news in the post-pandemic era. A 2023 survey of 1000 Austrian participants investigated how trust affects WTP and identified key predictors and moderators. Findings reveal a strong correlation between media trust and both WTP and media expenditure (ME), highlighting trust’s critical role in media organizations’ financial sustainability, as consumers favor credible news and trusted brands. Accordingly, media companies must develop a comprehensive strategy to (re)build trust, emphasizing the unique quality of their content and fostering trust in their brands to encourage paid over free content. By following this dual approach, media companies can adapt to the digital landscape, meet consumer expectations, and ensure economic and democratic sustainability.
Student rent strikes: The constitution of activist-learner identities
Authors: Young Helen , Wenham Lucy
Published: December 2024

Social movement research often foregrounds politics over education. In relation to identity, the emphasis is on who is participating and why, rather than identity-in-flux. Here, we focus on theories of identity and recognition to conceptualise the constituting and re-constituting of activist-learner identities within a social movement. In England during Covid-19 lockdowns, some university students were required to pay rent for accommodation they could not occupy, or with reduced amenities. We conducted semi-structured interviews with some of the many students who had responded collectively through rent strikes. The students’ mutual understanding grew, engendering greater appreciation of their variously privileged and marginalised subjectivities. There was a strong sense of the rent strikes as part of a broader social movement against marketised higher education and linked to wider campaigns for social and climate justice. We explore how such collective experiences contribute to constituting and re-constituting activist-learner identities and transform possibilities for future activism.
Plasma acute phase proteins as potential predictors of intra-amniotic inflammation and infection in preterm premature rupture of membranes
Authors: Cho Hee Young , Park Kyo Hoon , Oh Eunji , Lee Min Jung , Choi Bo Young , Im Eun Mi
Published: December 2024

Background

We aimed to investigate the potential of altered levels of various acute phase proteins (APPs) in the plasma, either used alone or in combination with ultrasound-, clinical-, and conventional blood-based tests, for predicting the risk of intra-amniotic inflammation (IAI), microbial invasion of the amniotic cavity (MIAC), histologic chorioamnionitis (HCA), and funisitis in women with preterm premature rupture of membranes (PPROM).

Methods

A total of 195 consecutive pregnancies involving singleton women with PPROM (at 23 + 0–34 + 0 weeks) who underwent amniocentesis and from whom plasma samples were obtained at amniocentesis were retrospectively included in this study. Amniotic fluid (AF) was cultured to assess the MIAC and analyzed for interleukin (IL)-6 levels to define IAI (AF IL-6 level of ≥2.6 ng/mL). The plasma concentrations of hepcidin, mannose-binding lectin (MBL), pentraxin-2, retinol-binding protein 4 (RBP4), serum amyloid A1 (SAA1), and serpin A1 were determined using ELISA. Ultrasonographic cervical length (CL), neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein levels were measured. IAI/MIAC was defined as IAI, MIAC, or both.

Results

Multivariate logistic regression analyses showed the following: (1) elevated plasma levels of hepcidin and SAA1 and decreased levels of RBP4 in the plasma were independently associated with IAI/MIAC and (2) decreased plasma RBP4 levels were independently associated with funisitis; however, (3) none of the plasma APPs investigated were associated with acute HCA when adjusted for baseline covariates. Using stepwise regression analysis, noninvasive prediction models comprising plasma RBP4 levels, CL, NLR, and gestational age at sampling were proposed, which provided a good prediction of IAI/MIAC and funisitis (area under the curve: 0.80 and 0.72, respectively).

Conclusions

Hepcidin, RBP4, and SAA1 were identified as potential APP biomarkers in the plasma predictive of IAI/MIAC or funisitis in patients with PPROM. In particular, combination of these APP biomarkers with ultrasound-, clinical-, and conventional blood-based markers can significantly support the diagnosis of IAI/MIAC and funisitis.
First line treatment with subcutaneous efgartigimod in impending myasthenic crisis: a case report
Authors: Kwiedor Isabelle , Menacher Martina , Ellßel Monika , Naumann Markus , Bayas Antonios
Published: December 2024

In acetylcholine receptor (AChR) antibody-positive generalized myasthenia gravis (gMG), neonatal Fc-receptor (FcRn) inhibition has broadened the therapeutic spectrum. Myasthenic crisis (MC), heralded by an impending myasthenic crisis (iMC), is a critical condition requiring treatments with rapid onset and sustained efficacy. Currently treatments used for iMC, including intravenous immunoglobulins and plasma exchange/immunoadsorption, have limitations, such as delayed onset of action and potential side effects. So far, there is limited data on the use of FcRn inhibitors in the management of impending or manifest MC (mMC). Here, we present a case of AChR antibody-positive gMG with iMC, where subcutaneous administration of the FcRn inhibitor efgartigimod resulted in rapid clinical remission. Within 24 h of administration, the patient exhibited significant improvement in respiratory and bulbar muscle function, preventing progression to manifest MC and the need for mechanical ventilation. This rapid response was accompanied by a marked reduction in AChR antibody level by 89.8% within 4 weeks. This case supports the potential of efgartigimod as a fast-acting and effective treatment option for managing iMC, offering an alternative to existing therapies.
Assessing attitudes, readiness and motivation of students towards e-learning: A qualitative case study in Uttar Pradesh, India
Authors: Kumar Pradeep , Pandey MP
Published: December 2024

This paper investigates postgraduate students’ attitudes, preparedness, and willingness to embrace e-learning at three institutes in Uttar Pradesh, India-MJP Rohilkhand University, AMU Aligarh, and IFTM University. The study is based on the growing popularity of e-learning after COVID-19 and the goal of the study is to determine how students regard and use digital learning materials. A qualitative case study methodology was used, involving 45 postgraduate students from various fields through semi-structured interviews. Thematic analysis was performed in order to reveal the main-patterns of attitude, technological readiness, motivation, and perception of challenge in e-learning. Results show that although for the vast majority of students positive attitude towards e-learning is found because of its flexibility and accessibility, there are still important problems, for example, in technical matters and lack of interaction with professors. Levels of motivation were greater at AMU Aligarh because students valued the reduction in e-learning time, but lower at the two other universities as a result of self-discipline challenges. Technological readiness varied, with students from more rural areas facing greater challenges in accessing reliable internet and devices. The research highlights the importance of better digitalization of infrastructures, dynamic e-learning spaces and selective support in order to maximize student immersion and learning results. Research provides to the wider literature in e-learning an answer to the specific gap in different educational settings in India.
Exploring the relationships between self-efficacy, self-care, and glycaemic control in primary care diabetes management
Authors: Quynh Anh Le Ho Thi , Quoc Huy Nguyen Vu , Minh Tam Nguyen , Wens Johan , Derese Anselme , Peersman Wim , Ha My Vo Ngoc , Thang Tran Binh , Phuong Anh Nguyen Thi , Truc Ly Tran Thi , Pype Peter
Published: December 2024

Objectives:

Our study aimed to identify the complex interplay between self-efficacy, self-care practice, and glycaemic control among people with type 2 diabetes mellitus (PWDs) to inform the design of more targeted and effective behavioural interventions in primary care.

Methods:

A cross-sectional descriptive study was performed with 294 PWDs managed in primary care. The Diabetes Management Self-Efficacy Scale (DMSES) and Summary of Diabetes Self-Care Activities (SDSCA) questionnaire measured patients’ self-efficacy and self-care practice. Multivariate logistic regression models were developed to explore how SDSCA, DMSES, and their combined effect relate to glycaemic control, adjusting for patient characteristics. Network analysis in R software examined relationships between self-efficacy and self-care dimensions across glycaemic control subgroups using a Gaussian graphical model with the extended Bayesian information criterion.

Results:

Half the PWDs (50.7%) had suboptimal glycaemic control. Better glycaemic control was consistently associated with higher self-efficacy (odds ratio (OR) = 0.76, 95% confidence (CI) (0.60, 0.97), p = 0.03), shorter duration of diabetes (OR = 1.89, 95% CI (1.08, 3.31), p = 0.03), normal waist circumference (OR = 1.76, 95% CI (1.02, 3.05), p = 0.04), absence of diabetes complications (OR = 2.09, 95% CI (1.10, 3.98), p = 0.02), and treatment with oral hypoglycaemic agents (OR = 3.05, 95% CI (1.53, 6.09), p < 0.01). Network analysis among people with well-controlled HbA1c revealed that diet adherence and self-efficacy had the most robust connection, with diet self-efficacy strongly associated with most self-efficacy dimensions. Self-efficacy in exercise, blood glucose monitoring, and foot care are the most central factors in the network structures for PWDs with suboptimal glycaemic control.

Conclusions:

Our study highlights the critical role of self-efficacy in diabetes primary care. For people with optimal glycaemic control, prioritising self-efficacy in diet adherence is crucial for sustaining glycaemic outcomes and supporting other self-care behaviours. Among those with suboptimal glycaemic control, enhancing self-efficacy in exercise, blood glucose monitoring, and foot care is essential. Targeted education programs, personalised counselling, and E-health tools can further empower patients to manage their diabetes more effectively.
Migration and Development: New Evidence from the Kerala Migration Survey 2023
Authors: Rajan S Irudaya
Published: December 2024

The Kerala Migration Survey (KMS) 2023 is in its ninth round of a long-standing series of global migration monitoring studies. Since 1998, K. C. Zachariah and S. Irudaya Rajan have pioneered a unique approach to studying all aspects of migration from Kerala. Originally undertaken by the Centre for Development Studies (CDS) in Thiruvananthapuram, the 2023 edition of KMS was conducted by the Gulati Institute of Finance and Taxation (GIFT), with funding from the Department of Non-Resident Keralites’ Affairs (NORKA), Government of Kerala as well as technical support from the International Institute of Migration and Development (IIMAD). The Kerala Model Migration Surveys have been replicated in many states of India—Tamil Nadu, Punjab, Goa, Gujarat, Jharkhand, and Odisha.
Occupational Health Injuries and Illness Among Women Workers in the Chemical Industry: A Scoping Review
Authors: Romero-Serrano Rocío , Arnaiz Carmen , Torres-Enamorado Dolores , Lancharro-Tavero Inmaculada , Arroyo-Rodríguez Almudena
Published: December 2024

Background:

The number of women in the chemical industry has recently increased due to more women pursuing science careers. It is necessary, therefore, to analyze the emerging health risks for female workers in the chemical industry. This study examines the relationship between occupational health and sex/gender in the chemical industry, with a gender perspective.

Methods:

We present a scoping review ( n = 97). After removing duplicates and applying eligibility criteria, we selected 27 articles published in the last decade that explored the industry’s occupational risks.

Findings:

Most of the papers include predominantly male samples and describe adult populations, mainly from developed countries. The studies focus on various employment contexts of chemical industries. We identified health risks in oncology, dermatology, and the respiratory system, among others. We found that particular emphasis was given to the relationship between occupational exposure and cancer, especially breast cancer. Furthermore, we observed sex/gender differences in the prevalence of respiratory and dermatological disorders. These results highlight the need to consider specific sex/gender-based health risk factors in the chemical industry.

Conclusions/Application to Practice:

The chemical industry is considered a crucial health determinant, however, the studies focused on sex/gender-based differences without considering gender-specific physiology and work circumstances. Although some studies do mention sex/gender disparities, such as occupational rhinitis, which is more frequent in women, studies are scarce. The absence of a segregated analysis with a gender perspective could lead to the ignorance of emerging health risks for female workers, highlighting the urgent need to include a gender perspective in future research.
Surgical Correction of Thoracic and Thoracolumbar TB Kyphosis by Posterior Only Approach Using Rajasekaran’s Kyphosis Classification
Authors: Kalanjiyam Guna Pratheep , Ramachandran Karthik , Rajasekaran Shanmuganathan , Shetty Ajoy Prasad , Kanna Rishi Mugesh
Published: December 2024

Study design

Prospective analysis of retrospective data.

Objectives

To analyse the clinical and radiological outcomes of thoracic and thoracolumbar TB kyphosis by a posterior-only approach using kyphosis classification.

Methods

Patients with thoracic and thoracolumbar spinal TB who underwent posterior-only surgical correction for kyphotic deformity >30° were categorized into Group: A (Active TB) and Group B (Healed TB). Demographic, clinical and radiological data were collected, and kyphotic deformity was classified according to Rajasekaran classification.

Results

52 patients with a minimum 2-year follow-up were included. Group A included 25 patients with mean preop kyphosis of 39.5° (31.2°-53.7°), and Group B included 27 patients with mean preop kyphosis of 85° (44.2°-125.2°). Among 25 patients in Group A, 19 were Type IIIA, and 6 were Type IIA kyphosis. In Group B, 18 patients were Type IIIB, 5 were Type III C, 3 were Type IIA, and 1 was IIIA kyphosis. All patients in group A underwent posterior column shortening by Smith-Peterson Osteotomy, with 14 patients requiring additional anterior column reconstruction. Patients in Group B required Closing-Opening Wedge Osteotomy (18), Halo followed by vertebral column resection (6), disc bone osteotomy (2) and pedicle subtraction osteotomy (1). Mean kyphosis at 2 years follow-up was 20.8° (11.2°-32.8°) in Group A and 53.5° (8.1°- 96.4°) in Group B.

Conclusions

Correction of kyphosis in spinal TB involves completely different strategies in active and healed disease. Hence, a posterior-only treatment approach using Rajasekaran’s kyphosis classification can help surgeons in appropriate decision-making.
Is Public Health Education and Training Adequately Responding (or Not) to Emerging Priorities?
Authors: Kemper Seeley Geri , Robinson Priscilla , Severinsen Christina , Coombe Leanne
Published: December 2024

Recent work by the World Federation of Public Health Associations’ Professional Education Training (WFPHA PET) working group has identified five emerging areas (OneHealth, Systems Thinking, Public Health Ethics, Political Engagement, and Disaster and Emergency Health) within the discipline of public health that practitioners need to have a basic understanding to prepare themselves for the future of the field. However, these areas are not necessarily included in public health competency sets or curricula globally. The WFPHA PET held a fireside chat of experts to discuss the main issues faced in integrating these specialties into public health education, training, and practice. Common threads seen across the panel included: (1) The current pace of change in these areas of public health; (2) ‘Nimble’ ways of identifying emerging (wicked) problems; (3) The need for innovative ways of teaching; (4) The need for sophisticated public health-related communication systems; (5) Understanding current political imperatives. To enhance the capacity of the public health workforce, it is essential to update course materials and integrate new and innovative materials and teaching strategies while retaining core content. This is complex, but necessary to further strengthen the workforce. The COVID-19 pandemic provided us with a unique experience and opportunity to reflect on how and what we teach, with the first step to bolster public health curricula and training to address current competency gaps in emerging priority areas to strengthen the public health workforce.
Postacute Myocardial Infarction Differences in Physical Activity Behavior, Anxiety, and Depression Levels
Authors: Shajrawi Abedalmajeed Methqal , Al-Akash Hekmat Yousef , Al-Smadi Ahmed Mohammad , Masa'deh Rami , Aburuz Mohannad Eid , Khalil Heba , Hweidi Issa Moh'd , Saifan Ahmad Rajeh
Published: December 2024

Background

There are limited studies regarding physical activity, anxiety, and depression levels among patients with postacute myocardial infarction (AMI). This is a need for more research on physical activity, anxiety, and depression levels based on the type of AMI following hospitalization to develop interventions to improve these outcomes.

Objective

To compare physical activity behavior, anxiety, and depression levels among patients with post-ST-elevation myocardial infarction (STEMI) and post-non-ST-elevation myocardial infarction (NSTEMI) not involved in cardiac rehabilitation program following hospitalization.

Methods

A descriptive cross-sectional study design was employed with a convenience sample of 254 patients with post-AMI, 4 weeks after hospitalization. Participants, recruited from three hospitals in Jordan.

Results

The sample characteristics included the following: 140 males (54.3%), 120 married (47.2%), diagnosed with STEMI (n = 137, 53.1%) or NSTEMI (n = 117, 45.3%). And 41.3% of participants had moderate-to-severe anxiety level (General Anxiety Disorder-7 [GAD-7] > 10), while 22.0% had moderate to severe depression levels (Patient Health Questionnaire-9 [PHQ-9] > 10). Post-STEMI and post-NSTEMI participants had moderate levels of anxiety, with 14.39 (3.45) versus 13.37 (3.51); and depression levels of 12.66 (3.28) versus 12.22 (3.54), respectively. There was no significant difference in depression level between patients with post-STEMI and post-NSTEMI, but the former had statistically significant higher anxiety level than the latter. The mean self-reported exercise duration and exercise frequency of patients with post-STEMI were significantly higher than for their post-NSTEMI counterparts: 151.7 (76.33) versus 87.78 (37.62) minutes per week, and 2.92 (1.44) versus 1.97 (0.88) times per week (respectively). Furthermore, patients with post-STEMI had less mean sedentary time: 582.92 (128.92) and 641.54 (147. 27) minutes per day ( p > .05) (respectively).

Conclusions

Healthcare providers have to consider the differences in physical activity behavior, anxiety, depression levels based on types of AMI when developing interventions and establishing cardiac rehabilitation program to improve physical activity behavior and reducing sedentary time.
Axial Rotation Analysis in Total Ankle Arthroplasty Using Weight-Bearing Computer Tomography and Three-Dimensional Modeling
Authors: Barbero Agustin , Efrima Ben , Ovadia Joshua , Indino Cristian , Maccario Camilla , Giuseppe Usuelli Federico
Published: December 2024

Category:

Ankle Arthritis; Other

Introduction/Purpose:

Post-operative alignment is the most critical indicator for a successful total ankle arthroplasty (TAA). Total ankle malrotation is associated with an increased risk for polyethylene wear and medial gutter pain. Currently, there is no consensus on the correct way to measure the alignment of the tibial and talar component rotations in the axial plane. In the current study, the post-operative analysis system was assessed using weight-bearing computer tomography and a three-dimensional (3D) model. The purpose of the study was to assess the inter-observer and intra-observer agreement of this system.

Methods:

Four angles were measured by two raters independently in two separate readings: posterior tibial component rotation angle (PTIRA), posterior talar component rotation angle (PTARA), tibia talar component axial angle (TTAM), and tibial component to the second metatarsal angle (TMRA). Agreement analysis was quantified according to the interclass coefficient

Results:

Sixty TAAs across 60 patients were evaluated. A good inter-observer agreement and intra-observer agreement when measuring the PTIRA, PTARA, and TTAM angles was observed along with an excellent inter-observer agreement and intra-observer agreement when measuring the TMRA angle.

Conclusion:

In conclusion, the current 3D model-based measurement system demonstrates good to excellent inter and intra-agreement. According to these results, 3D modelling can be reliably used to measure and assess the axial rotation of TAA components. Figure 3: Example case of how to measure the angles for assessing axial rotation of TAA and forefoot. 3 A) Posterior TIbial component Rotational Angle (PTIRA). The chosen slice is the one with the straightest posterior wall component of the tibia. The angle is measured on the following steps. First a reference is put on the posterior wall of the tibial component (blue horizontal line). Then the angle is measured starting from the center of the tibial axis (red dot explained on fig. 2), going to the fibular axis (medial part of the red line at the right of the draw), and finally ending 90° to the posterior reference line. 3 B) Posterior TAlar component Rotational Angle (PTARA). The chosen slice is the one with the straightest posterior wall component of the talus. For the angle measurement. The same steps as figure 3 A are followed with the talar component. 3 C) Talar component to 2nd Metatarsal Rotational Angle (TMRA): Defined as an intersection between a line parallel to the lateral border of the tibia component and a line perpendicular to the anatomical axis of the second metatarsal. This was measured using a 3D rendering tool
Bilateral External Torque CT Reliably Detects Syndesmotic Lesions in an Experimental Cadaveric Study
Authors: Beeler Silvan , Ongini Esteban , Hochreiter Bettina , Sutter Reto , Viehoefer Arnd , Wirth Stephan H. , Calek Anna-Katharina
Published: December 2024

Category:

Sports; Trauma

Introduction/Purpose:

If tibiofibular syndesmosis injury is missed, chronic instability may lead to persistent pain and osteoarthritis. So far, no reliable diagnostic method has been available. The primary objectives of this study were to determine whether defined lesions of the syndesmosis can be correlated with specific tibiofibular joint displacements caused by external rotation (ER) torques and to compare its performance with arthroscopy. Secondary objectives included evaluation of Intraclass-Correlation-Coefficients (ICCs) and suitability of the healthy contralateral ankle as a reference.

Methods:

Seven pairs of healthy lower legs were tested and assigned to two groups (1) Supination-ER (SER) and (2) Pronation-ER (PER). In the intact state and after each surgical step, an ankle arthroscopy and three CT scans were performed. During the scans, the specimens were placed in an external torque device with 2.5Nm, 5Nm and 7.5Nm.

Results:

The arthroscopic and radiological parameters showed significant correlations in all pairwise comparisons. The receiver operating curve (ROC) analyses yielded best prediction of syndesmotic instability with the anterior tibiofibular distance (AD) on CT with a sensitivity of 84.1% and a specificity of 95.2% (area under the curve (AUC) 94.8%, CI 0.916-0.979, p< 0.0001) and middle tibiofibular distance at arthroscopy with a sensitivity of 76.2% and specificity of 92.3% (AUC 91.2%, CI 0.837-0.987, p< 0.0001). Higher torques increased the rate of true positive results.

Conclusion:

Bilateral external torque CT reliably detects experimental syndesmotic rotational instability compared to the healthy side with greater sensitivity and similar specificity to the arthroscopic lateral hook test. Translation of these experimental findings to clinical practice remains to be established.
Burr to Bone Time for Joint Preparation in Minimally Invasive Foot and Ankle Fusion Surgeries: A Cadaver Study
Authors: Idris Maksat , Vulcano Ettore , Chien Bonnie Y.
Published: December 2024

Category:

Ankle; Midfoot/Forefoot

Introduction/Purpose:

Minimally invasive surgical (MIS) techniques have been implemented in various foot and ankle procedures, including joint arthrodesis. While these techniques can be effective in reducing complications and improving outcomes, there remains variability with surgeon learning curves, the type of instruments used, and approach to intraoperative imaging. This study seeks to aid surgeons through more reproducible guidelines by measuring the time needed for joint preparation with an MIS specific burr.

Methods:

A total of 8 cadaveric limbs (4 left and 4 right feet) were used for the preparation of the 1st metatarsophalangeal (MTP), 1st tarsometatarsal (TMT), talonavicular (TN), subtalar and ankle joints. The active burr use time to debride all cartilage from each joint was recorded. Each joint was prepared with an open approach to precisely determine the amount of time needed for cartilage removal. Descriptive statistics and a Kruskal-Wallis with post-hoc comparisons were used to analyze the data.

Results:

The 1st MTP was prepared with a mean (SD) time of 54.49 (34.65) seconds; the 1st TMT 51.82 (19.69) seconds; the TN joint 87.89 (43.77) seconds; the subtalar joint 59.46 (37.84) seconds; and the ankle joint 95.59 (54.99) seconds. Only the ankle joint preparation times compared with 1st MTP, 1st TMT and subtalar joints were significantly longer.

Conclusion:

This study provides burr time metrics for joint debridement in MIS foot and ankle arthrodesis procedures. Although there remains variability in types of burrs used, joint sizes and individual experience with the instruments, the timing of joint preparation can be an objective reference for surgeons to effectively and safely perform minimally invasive techniques. Figure 1. Comparison of joint preparation time across different joints The error bars depict one standard deviation of uncertainty. Asterisk (*) lines indicate a statistically significant difference (P < 0.05) based on unadjusted P values from the Dunn post hoc group comparisons. *Abbreviations: metatarsophalangeal (MTP), tarsometatarsal (TMT), talonavicular (TN).
Clinical and Radiological Outcomes of Flexible Flatfoot Correction with Calcaneal Osteotomy
Authors: Kim Sunghoo , Lee HoSeong
Published: December 2024

Category:

Midfoot/Forefoot; Hindfoot

Introduction/Purpose:

Various surgical procedures have been used to correct flexible flatfoot deformity; however, the most effective procedure for this deformity remains controversial. This study was performed to evaluate the radiographic and clinical effectiveness of double calcaneal osteotomy (medial displacement calcaneal osteotomy with lateral column lengthening) to correct flexible flatfoot deformities.

Methods:

Thirty-one patients who had 44 symptomatic flexible flatfeet and underwent double calcaneal osteotomy were examined retrospectively with a mean follow-up of 50 months. Visual analog scale, foot and ankle activity measure, and other clinical data were obtained from medical records. Various radiographic variables for assessing flatfoot and osteoarthritic change in tarsal joints were analyzed from weightbearing radiographs.

Results:

Results revealed that clinical scores and radiographic variables were significantly improved postoperatively. The mean values of medial sliding and lateral lengthening were 7.6 and 8.7 mm, respectively. No osteoarthritic changes were observed.

Conclusion:

Double calcaneal osteotomy could be used to correct flatfoot deformities effectively and sustainably and provide symptomatic relief and patient satisfaction.
Clinical Results of All-Inside Lateral Ankle Ligament Complex Repair were Comparable to Open Brostrom Procedure in High-Demand Patients with Chronic Ankle Instability: Randomized Controlled Study
Authors: Lee Sung Hyun , Lim Gyeong Hun
Published: December 2024

Category:

Ankle; Arthroscopy

Introduction/Purpose:

The open modified Broström-Gould procedure is widely accepted as the reference standard for lateral ankle stabilization. However, there is a lack of research comparing the outcomes of arthroscopic repair and open repair procedures for chronic ankle instability (CAI), despite the increasing number of publications on arthroscopic repair of the anterior talofibular ligament (ATFL). This study aimed to compare the clinical and radiological outcomes of arthroscopic repair and open repair of the lateral ligament complex (LLC) in patients with CAI.

Methods:

We prospectively randomized 64 patients who underwent ligament repair surgery for CAI into two groups: arthroscopic LLC repair (group A, 33 patients) and open modified Broström-Gould procedure (group O, 31 patients). High-demand patients, as determined by a Tegner Activity level ≥ 6, with CAI were included. Subjective outcomes were measured using the pain visual analog scale, American Orthopaedic Foot & Ankle Society score, Foot and Ankle Outcome Score, and the Karlsson Ankle Function Score. Posturographic analysis was performed using a Tetrax device as an objective outcome. Radiologic evaluations were conducted preoperatively and at 2 years postoperatively using stress radiographs and axial view magnetic resonance imaging (MRI). A subgroup analysis was also performed according to arthroscopic ligament quality (excellent to fair vs. poor).

Results:

Both groups showed significant improvements in all clinical scores, objective posturography results, and stress radiographs at 2 years postoperatively (all p < 0.05), with no significant differences between the groups in terms of preoperative and postoperative values (all p > 0.05). Additionally, we identified 5 cases of retear (7.8%) based on postoperative MRI evaluation (9.1% [3/33] in group A and 6.5% [2/31] in group O). One patient in group O experienced postoperative soft tissue infection. However, there were no significant differences between the two groups (p > 0.05). There was no difference in clinical results between each group in subgroup analysis according to ligament quality (p > 0.05).

Conclusion:

Arthroscopic LLC repair produced similarly favorable outcomes when compared with open lateral ankle ligament repair. In addition, arthroscopic LLC repair, as a minimally invasive technique, provide comparable outcomes to open procedure, even when the ligament tissue was poor.