bluuebunny/crossref_metadata_2025 huggingface dataset:
How Canadian Law Shapes the Health Care Experiences of Women with Female Genital Mutilation/Cutting/Circumcision and Their Providers: A Disjuncture Between Expectation and Actuality
Authors: Jacobson Danielle , Grace Daniel , Boddy Janice , Einstein Gillian
Published: September 2022

This study explored how the reproductive health care experiences of women with female genital mutilation/cutting/circumcision (FGC) were shaped. We used Institutional Ethnography, a sociological approach which allows for the study of social relations and the coordination of health care. From qualitatively interviewing eight women with FGC, we learned that they felt excluded within the Canadian health care system because they were unable to access reconstructive surgery, which was not covered by Ontario’s universal health coverage (Ontario Health Insurance Plan). We then talked with seven obstetricians/gynecologists (OB/GYNs) and learned that while it was legal to perform certain genital (e.g., female genital cosmetic surgery) and reproductive (e.g., elective caesarean section) surgeries commonly requested by Western-born women, it was not legal for them to perform other genital surgeries often requested by immigrant populations (e.g., reinfibulation), nor were these covered by OHIP (e.g., clitoral reconstructive surgery). From participants’ comparison of clitoral reconstructive surgery and reinfibulation to female genital cosmetic and gender confirming surgeries, it became clear that the law and policies within the health care system favored surgeries elected by Western adults over those wished for by women with FGC. We found that the law had an impact on the choices that OB/GYNs and the women they treated could make, shaping their respective experiences. This created ethical dilemmas for OB/GYNs and a sense of exclusion from the health care system for women with FGC.
Analysis of the Differential Efficacy of the Reduced Version Over the Extended Version of an Affective-Sexual Education Program for Adults with Intellectual Disabilities
Authors: Gil-Llario María Dolores , Fernández-García Olga , Huedo-Medina Tania B. , Estruch-García Verónica , Ballester-Arnal Rafael
Published: September 2022

Recently, with the increase in demand, multiple intervention proposals aimed at improving the sexual health of people with intellectual disabilities have emerged. Among them is the SALUDIVERSEX program, which takes a positive approach to sexuality. It has an extended version, consisting of 16 sessions and whose efficacy has already been proven, and a reduced version of 10 sessions. Thus, the present study aimed to test the differential efficacy of the two versions. A total of 208 participants (103 women and 105 men) aged between 19 and 67 years (M = 37.23, SD = 10.66) completed a battery of instruments before and after the intervention. Statistical analyses showed that users who participated in the reduced version of the program presented a significantly higher rate of improvement in their sexual behaviors compared to those who participated in the extended version (Sexual response: β10 = − 0.46 ± 0.19, p = .034; Sex practices: β10 = − 0.52 ± 0.23, p = .037; Use condoms: β10 = − 1.56 ± 0.59, p = .017), as well as a significantly higher decrease in the risk of suffering sexual abuse (β10 = 3.95 ± 0.64, p < .001). However, no statistically significant differences in sexuality knowledge were obtained with respect to the improvement between the two versions (β10 = − 0.09 ± 1.21, p = .94). Meanwhile, the professionals who applied the program found that those who participated in the reduced version, although they presented a significantly greater increase in their knowledge about privacy (β10 = − 0.48 ± 0.08, p < .001), did not improve their concerns about their inappropriate sexual behaviors as much as the users of the extended version (β10 = − 1.35 ± 0.21, p < .001). Thus, although both versions were effective, the reduced version seems to do so to a greater extent and in a shorter time, which makes it the more recommendable option.
Decoupling Between the Atmosphere and the Underlying Surface During Stable Stratification
Authors: Foken Thomas
Published: September 2022

Strong temperature gradients with stable stratification immediately above the surface are typical for radiation cooling, but near-surface temperature inversions (hereinafter referred to as inversions) have hardly been studied. Both phenomena are examined in more detail by means of measurements in the Caspian Sea and Antarctica and compared with measurements made by other authors. For this purpose, tests for decoupling are applied in the first case. In the second case, the inversions can be explained in the context of counter-gradient fluxes and turbulent Prandtl numbers greater than one.
Superhydrophobic surfaces with dual-scale roughness and water vapor-barrier property for sustainable liquid packaging applications
Authors: Zhang Xue , Zhang Hongjie , Cheng Yun , Zhang Liyuan , Shen Wei
Published: September 2022

There is an ongoing unmet global need to manufacture novel sustainable liquid packaging materials, that are not based on plastic film or aluminum foil. Superhydrophobic coating technologies have been proposed for developing more sustainable packaging materials. In this study, the underlying engineering principles for fabricating superhydrophobic surfaces proposed for liquid packaging are investigated, including but not limited to the substrates used and engineering properties of the surfaces. Specifically, to improve the engineering performance of superhydrophobic paper for use in packaging, the feasibility of combining platy montmorillonite (MMT, for its barrier properties) and nano-rolling-pin-shaped precipitated calcium carbonate (PCC, for its superhydrophobicity) into multifunctional coating layers is investigated. Water droplet evaporation experiments are performed to identify how subtle changes in the morphological structures of as-prepared superhydrophobic paper samples can produce a useful roughness structure for packaging applications. Paperboard, which is widely utilized in packaging, is chosen as a substrate to study the challenges of fabricating superhydrophobic paperboards for use in packaging. The results of this study provide engineering principles for using sustainable paper-based materials with a dual-scale roughness structure and barrier properties in liquid packaging applications.

Graphical abstract
Examining Predictors of Psychological Distress Among Youth Engaging with Jigsaw for a Brief Intervention
Authors: Mac Dhonnagáin Niall , O’Reilly Aileen , Shevlin Mark , Dooley Barbara
Published: September 2022

Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9 years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people’s identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services.
Prosets: a new financing instrument to deliver a durable net zero transition
Authors: Mitchell-Larson Eli , Allen Myles
Published: September 2022

Interest in carbon offsetting is resurging among companies and institutions, but the vast majority of existing offerings fail to enable a credible transition to a durable net zero emission state. A clear definition of what makes an offsetting product “net zero compliant” is needed. We introduce the “proset”, a new form of composite carbon credit in which the fraction of carbon allocated to geological-timescale storage options increases progressively, reaching 100% by the target net zero date, generating predictable demand for effectively permanent CO2storage while making the most of the near-term opportunities provided by nature-based climate solutions, all at an affordable cost to the purchaser.
Behavioural responses of a cold-water benthivore to loss of oxythermal habitat
Authors: Rodrigues Tazi H. , Chapelsky Andrew J. , Hrenchuk Lee E. , Mushet Graham R. , Chapman Lauren J. , Blanchfield Paul J.
Published: September 2022

Climate-driven declines in oxythermal habitat in freshwater lakes can impose prolonged constraints on cold-water fishes sensitive to hypoxia. How fish cope with severe habitat limitations is not well understood, yet has implications for their persistence. Here, we use acoustic-positioning telemetry to assess seasonal habitat occupancy and activity patterns of lake whitefish (Coregonus clupeaformis), a cold-water benthivore, in a small boreal lake that regularly faces severe oxythermal constraints during summer stratification. During this stratified period, they rarely (< 15% of detections) occupied depths with water temperatures > 10 °C (interquartile range = 5.3–7.9 °C), which resulted in extensive use (> 90% of detections) of water with < 4 mg L−1 dissolved oxygen (DO; interquartile range = 0.3–5.3 mg L−1). Lake whitefish were least active in winter and spring, but much more active in summer, when only a small portion of the lake (1–10%) contained optimal oxythermal habitat (< 10 °C and > 4 mg L−1 DO), showing frequent vertical forays into low DO environments concurrent with extensive lateral movement (7649 m d−1). High rates of lateral movement (8392 m d−1) persisted in the complete absence of optimal oxythermal habitat, but without high rates of vertical forays. We found evidence that lake whitefish are more tolerant of hypoxia (< 2 mg L−1) than previously understood, with some individuals routinely occupying hypoxic habitat in winter (up to 93% of detections) despite the availability of higher DO habitat. The changes in movement patterns across the gradient of habitat availability indicate that the behavioural responses of lake whitefish to unfavourable conditions may lead to changes in foraging efficiency and exposure to physiological stress, with detrimental effects on their persistence.
“There is a hell and heaven difference among faculties who are from quota and those who are non-quota”: under the veneer of the “New Middle Class” production of Indian public universities
Authors: Dhawan Nandita Banerjee , Belluigi Dina Zoe , Idahosa Grace Ese-Osa
Published: September 2022

The university is a highly politicized and fractious realm for students and academics. Amidst trade-offs between the processes of massification, democratization, commodification, and globalization, the question of transformation for sustainability has become crucial to the social good(s) of higher education. This paper considers academic citizenry within Indian public higher education — a context where the increase in the enrollment of first-generation students and female students, due to affirmative action policies, has not substantially translated into altering the composition of academic staff. Informed by a mixed-method study conducted in 2019 with the participation of academics and those in leadership positions at four higher education institutions, we found that the enactment of such policies was operationalized for the production of the “New Middle Class” by universities. Of concern is that neither the representation nor the participation of academics who are women, “lower” castes, or minorities meets the mark of just, inclusive institutions. Despite the rhetoric of inclusiveness and development, the implementation of related policies clothe subalterns with the veneer of the intellectual class, permitting access on condition that sociocultural identities are concealed, and the hegemonic status quo maintained. Terms such as “quality” and “equality” function as tools for social control rather than serving social justice, where assertions of caste identity and resistance are simultaneously repudiated and misrecognized.
The Moral and Ethical Baseline of Marine Socio-Ecological Values: the Case of Recreational and Artisanal Fishing in NW Mediterranean Coastal Waters (Catalonia, Spain)
Authors: Gómez Sílvia
Published: September 2022

Scant attention has been paid to values not expressed in monetary terms, due in part to the difficulty of assessing them. Moreover, the notion and understanding of “value” differs depending on the discipline and academic approaches. This ethnographic study focused on three marine spaces from the Catalonia region in Spain (Natural Park of Cap de Creus, Medes Islands protected area, and Natura 2000 Network area) addresses the competing values of maritime activities, small-scale fishing and recreational fishing, that make value judgements based on moral and ethical standards with which to legitimize activities and use of marine resources. The results highlight the co-existing market and non-market values involved in carrying out these activities, and the need to identify values as drivers of socioecological systems in order to evaluate sustainability. Through the lens of social theory mainly stemming from social anthropology, the study discusses on the moral and ethical issues at play.
The Efficacy of Disability Employment Service (DES) Providers Working with Autistic Clients
Authors: Hayward Susan M. , Flower Rebecca L. , Denney Kathleen E. , Bury Simon , Richdale Amanda L. , Dissanayake Cheryl , Hedley Darren
Published: September 2022

The efficacy of the Australian Disability Employment Services (DES) for autistic jobseekers has not been examined and is currently undergoing Government reform. To help inform the new DES strategy, we sought the views of: 24 autistic individuals; seven family members of autistic individuals, and; 46 DES employees. Data were collected using surveys and interviews. Data were analysed using Mann Whitney tests plus deductive thematic analysis based on Nicholas and colleagues’ ecosystems model. Participants highlighted a need to adapt existing policies to enhance flexibility of the DES model. There was participant consensus that DES staff require specific education and training to meet the needs of autistic people. Suggestions to inform the new model of DES for autistic people are made.
Work-Related Psychological Wellbeing and Conservative Christian Belief Among Methodist Circuit Ministers in Britain: Distinguishing Between Emotional Exhaustion and Satisfaction in Ministry
Authors: Francis Leslie J. , Haley John M. , McKenna Ursula
Published: September 2022

Drawing on data provided by 803 Methodist circuit ministers serving in Great Britain, the present study was designed to test the association between conservative Christian belief and work-related psychological wellbeing as operationalised by the balanced affect model proposed by the Francis Burnout Inventory. After taking into account the effects of personal factors, psychological factors, contextual factors, and experience factors, holding conservative Christian belief was associated with a higher level of positive affect (satisfaction in ministry) but independent of negative affect (emotional exhaustion in ministry).
Household Food Insecurity and Demographic Factors, Low Birth Weight and Stunting in Early Childhood: Findings from a Longitudinal Study in South Africa
Authors: Harper Abigail , Rothberg Alan , Chirwa Esnat , Sambu Winnie , Mall Sumaya
Published: September 2022

Background

Low birthweight (LBW) as well as early childhood stunting are risk factors for increased childhood morbidity in low-and middle-income countries (LMIC). The Covid 19 pandemic has exacerbated food insecurity and unemployment globally, prompting concerns for maternal and child health.

Objectives

We used data from the great recession of 2008 to examine the relationship between household food security and other risk factors with LBW and stunting using a longitudinal sample of South African women and their offspring.

Methods

Food security indicators, alcohol use, blood pressure and other characteristics were examined in relation to LBW (≤ 2500 g), stunting (height for age ≤ 2SD) and severe stunting (height for age ≤ 3SD). Regression modelling with clustering at maternal ID level were employed to adjust for maternal characteristics and women who gave birth more than once during the reference period.

Results

Birthweight data were available for 1173 children and height for age 1216 children. The prevalence of LBW was 14.7% while stunting and severe stunting was 17.8% and 14.5%. Child hunger in the household, maternal hypertension and alcohol use were associated with low birthweight. Food expenditure below the Stats SA poverty line and low dietary diversity was associated with stunting and severe stunting respectively. Maternal height and low birthweight were associated with both stunting and severe stunting.

Conclusions for Practice

Interventions that can improve household food security and nutritional status during the periconceptional and antenatal period may reduce the prevalence of low birthweight and subsequent stunting in low- and middle-income countries.
The effect of choosing optimizer algorithms to improve computer vision tasks: a comparative study
Authors: Hassan Esraa , Shams Mahmoud Y. , Hikal Noha A. , Elmougy Samir
Published: September 2022

Optimization algorithms are used to improve model accuracy. The optimization process undergoes multiple cycles until convergence. A variety of optimization strategies have been developed to overcome the obstacles involved in the learning process. Some of these strategies have been considered in this study to learn more about their complexities. It is crucial to analyse and summarise optimization techniques methodically from a machine learning standpoint since this can provide direction for future work in both machine learning and optimization. The approaches under consideration include the Stochastic Gradient Descent (SGD), Stochastic Optimization Descent with Momentum, Rung Kutta, Adaptive Learning Rate, Root Mean Square Propagation, Adaptive Moment Estimation, Deep Ensembles, Feedback Alignment, Direct Feedback Alignment, Adfactor, AMSGrad, and Gravity. prove the ability of each optimizer applied to machine learning models. Firstly, tests on a skin cancer using the ISIC standard dataset for skin cancer detection were applied using three common optimizers (Adaptive Moment, SGD, and Root Mean Square Propagation) to explore the effect of the algorithms on the skin images. The optimal training results from the analysis indicate that the performance values are enhanced using the Adam optimizer, which achieved 97.30% accuracy. The second dataset is COVIDx CT images, and the results achieved are 99.07% accuracy based on the Adam optimizer. The result indicated that the utilisation of optimizers such as SGD and Adam improved the accuracy in training, testing, and validation stages.
Semi-intrusive approach for stiffness and strength topology optimization under uncertainty
Authors: Steltner Kai , Pedersen Claus B. W. , Kriegesmann Benedikt
Published: September 2022

A semi-intrusive approach for robust design optimization is presented. The stochastic moments of the objective function and constraints are estimated using a Taylor series-based approach, which requires derivatives with respect to design variables, random variables as well as mixed derivatives. The required derivatives with respect to design variables are determined using the intrusive adjoint method available in commercial software. The partial derivatives with respect to random parameters as well as the mixed second derivatives are approximated non-intrusively using finite differences. The presented approach provides a semi-intrusive procedure for robust design optimization at reasonable computational cost while allowing an arbitrary choice of random parameters. The approach is implemented as an add-on for commercial software. The method and its limitations are demonstrated by academic test cases and industrial applications.
A ridesplitting market equilibrium model with utility-based compensation pricing
Authors: Lu Qing-Long , Qurashi Moeid , Antoniou Constantinos
Published: September 2022

The paper develops a theoretic equilibrium model for ridesplitting markets with specific considerations of origin-destination demand patterns, competition with other transport modes, characteristics of en route matching, and spatial allocation of ridesplitting vehicles, to adequately portray the intertwined relationships between the endogenous variables and decisions. The operation property of the market under distance-based unified pricing is analyzed through the response of system performance indicators to the decisions. Moreover, a gradient descent algorithm is derived to find optimal operating strategies in the monopoly scenario and social optimum scenario. Leveraging the tight connection between trip’s utility and level of service (LoS), the paper then proposes a utility-based compensation pricing method to alleviate the inequity issue in ridesplitting, which results from the variance in waiting time and detour time and the implementation of unified pricing. Specifically, the trip fare of those with an initial utility smaller than a threshold will be compensated following a predefined compensation function. We compare its effectiveness and influence in different scenarios through numerical experiments at Munich. The results show that the proposed pricing method can improve the LoS and equity without losing any profit and welfare, and can even achieve increments in maximum profit and social welfare under certain conditions.
Eyewitness evaluation through inference to the best explanation
Authors: Jellema Hylke
Published: September 2022

Eyewitness testimony is both an important and a notoriously unreliable type of criminal evidence. How should investigators, lawyers and decision-makers evaluate eyewitness reliability? In this article, I argue that Testimonial Inference to the Best Explanation (TIBE) is a promising, but underdeveloped prescriptive account of eyewitness evaluation. On this account, we assess the reliability of eyewitnesses by comparing different explanations of how their testimony came about. This account is compatible with, and complementary to both the Bayesian framework of rational eyewitness evaluation and with prescriptive methods for eyewitness assessment developed by psychologists. Compared to these frameworks, the distinctive value of thinking in terms of competing explanations is that it helps us select, interpret and draw conclusions from the available evidence about the witness’s reliability.
Application of Machine Learning-based Energy Use Forecasting for Inter-basin Water Transfer Project
Authors: Yi Sooyeon , Kondolf G. Mathias , Sandoval-Solis Samuel , Dale Larry
Published: September 2022

Energy use forecasting is crucial in balancing the electricity supply and demand to reduce the uncertainty inherent in the inter-basin water transfer project. Energy use prediction supports the reliable water-energy supply and encourages cost-effective operation by improving generation scheduling. The objectives are to develop subsequent monthly energy use predictive models for the Mokelumne River Aqueduct in California, US. Partial objectives are to (a) compare the model performance of a baseline model (multiple linear regression (MLR)) to three machine learning-based models (random forest (RF), deep neural network (DNN), support vector regression (SVR)), (b) compare the model performance of the whole system to three subsystems (conveyance, treatment, distribution), and (c) conduct sensitivity analysis. We simulate a total of 64 cases (4 algorithms (MLR, RF, DNN, SVR) x 4 systems (whole, conveyance, treatment, distribution) x 4 scenarios (different combinations of independent variables). We concluded that the three machine learning algorithms showed better model performance than the baseline model as they reflected non-linear energy use characteristics for water transfer systems. Among the three machine learning algorithms, DNN models yielded higher model performance than RF and SVR models. Subsystems performed better than the whole system as the models more closely reflected the unique energy use characteristics of the subsystems. The best case was having water supply (t), water supply (t-1), precipitation (t), temperature (t), and population (y) as independent variables. These models can help water and energy utility managers to understand energy performance better and enhance the energy efficiency of their water transfer systems.
A Systematic Review of School Transition Interventions to Improve Mental Health and Wellbeing Outcomes in Children and Young People
Authors: Donaldson Caitlyn , Moore Graham , Hawkins Jemma
Published: September 2022

Normative transitions between educational settings can be important life events for young people, having the potential to influence mental health trajectories across the life course. Interventions to target transitions have been used to support children and young people as they transition between school settings, but there is limited synthesis of their effects. Seven databases were searched to identify studies of universal interventions focused on supporting mental health and wellbeing across three main types of educational transition: preschool to elementary school; school to school (including elementary to middle; middle to high and other combinations depending on country); and high school to post-compulsory education. Effect directions for behavioural, psychological/emotional and social measures of mental health were extracted for each study and synthesized using effect direction plot methodology. Searches identified 6494 records for screening. This resulted in 34 papers being included in the review, consisting of 24 different interventions. Social outcomes appeared more amenable to intervention than behavioural outcomes, with mixed findings for psychological measures of mental health. Intervention characteristics shifted based on the age of young person involved in the transition, with greater focus on parenting and school environment during the early transitions, and more focus on social support for the transition to post-compulsory education. A broad range of interventions were identified for supporting mental health and wellbeing across the three types of educational transition with mixed impact and diverse methodologies. More research is needed to identify transferable intervention mechanisms that may hold across different contexts and settings. PROSPERO registration number: CRD42020176336.
Immune and inflammation: related factor alterations as biomarkers for predicting prognosis and responsiveness to PD-1 monoclonal antibodies in cervical cancer
Authors: Liu Xihan , Zhang Xi , Liu Chang , Mu Wendi , Peng Jin , Song Kun
Published: September 2022

Purpose

We aimed to elucidate the potential mechanisms of effective responsiveness to PD-1 monoclonal antibody and evaluate more reliable biomarkers to improve the ability to predict the populations of cervical cancer (CC) suitable for immunotherapy.

Methods

Peripheral blood samples of CC patients undergoing anti-PD-1 therapy were collected before and after treatment. Differentially expressed genes (DEGs) were analyzed between partial response (PR) and progressive disease (PD) patients. A novel prognostic inflammation and immune–related response gene (IRRG) model was constructed and its prognostic role, correlation with tumor immunity and tumor mutation were evaluated.

Results

DEGs in PR patient after treatment could predict the response to PD-1 monoclonal antibodies. Among PR-specific pathways, tumor immunity, leukocyte migration, and cytokine activities were prominently enriched. Additionally, an IRRG signature comprising CTLA4, AZU1, C5, LAT, CXCL2, GDF7, MPL, PPARG and CELA1 was established and validated to predict the prognosis of CC with great accuracy and specificity. This signature could reflect the tumor microenvironment (TME) and tumor mutational burden (TMB). We also found stimulated adaptive immunity and downregulated inflammation at baseline in patients with sensitive responses to PD-1 monoclonal antibody.

Conclusion

We developed an IRRG signature and verified that it was an independent prognostic factor for predicting survival and could reflect a sensitive response to PD-1 monoclonal antibody, which plays a nonnegligible role in the TME of CC. Further investigations are warranted to confirm that patients with stimulated adaptive immunity and downregulated inflammation at baseline could achieve a better survival benefit from PD-1 monoclonal antibody.
Inner design of artificial test bones for biomechanical investigations using topology optimization
Authors: Fritz Christian , Fischer Lukas , Wund Emmy , Zaeh Michael Friedrich
Published: September 2022

Artificial or human test bones are used for the biomechanical testing of implants. Human test bones are rare and not always available. These must, therefore, be substituted with artificial test bones. However, current artificial test bones are only available with specific characteristics (e.g., age groups or disease characteristics). Additionally, their mechanical properties are only comparable to a limited extent to those of a human bone. This paper presents a methodology for designing additively manufactured artificial test bones for biomechanical testing that replicate the mechanical behavior of a human bone. Topology optimization methods are used to generate the artificial test bone's internal structure. The geometric model is based on a computed tomography dataset of a human bone. The input data can be manipulated in advance to reproduce defects or disease patterns. The bone was fixed at the distal diaphysis and loaded with different biomechanical forces for topology optimization. Boundary conditions due to possible additive manufacturing processes were incorporated into the optimization to ensure manufacturability. The optimization result is compared with experimental data from a human bone. A bone-like internal structure and increased compliance of the topology-optimized test bone model compared to the commercial model were observed.
A Systematic Review of the Genetic Predisposition to Injury in Football
Authors: McAuley Alexander B. T. , Hughes David C. , Tsaprouni Loukia G. , Varley Ian , Suraci Bruce , Roos Thomas R. , Herbert Adam J. , Jackson Daniel T. , Kelly Adam L.
Published: September 2022

Purpose

Synthesise genetic association studies investigating injury involving football players to identify which genetic variants have the most empirical evidence to date.

Methods

A comprehensive search of the PubMed, SPORTDiscus, and MEDLINE databases until March 11th 2022 identified 34 studies. Inclusion criteria: primary investigations, included football players, examined the association of a genetic variant with injury, and were published in English. Risk of bias was assessed using the Newcastle–Ottawa Scale. A narrative synthesis summarised results.

Results

There were 33 candidate gene studies and one genome-wide study, with 9642 participants across all studies (range = 43–1311; median = 227). Ninety-nine polymorphisms were assessed within 63 genes. Forty-one polymorphisms were associated with injury once. Three polymorphisms had their specific allelic associations with injury replicated twice in independent cohorts: ACTN3 (rs1815739) XX genotype was associated with an increased susceptibility to non-contact muscle injuries, ACAN (rs1516797) G allele was associated with increased susceptibility to anterior cruciate ligament (ACL) injuries, and VEGFA (rs2010963) CC genotype was associated with an increased susceptibility to ACL and ligament or tendon injuries. However, several methodological issues (e.g., small sample sizes, cohort heterogeneity, and population stratification) are prevalent that limit the reliability and external validity of findings.

Conclusion

At present, the evidence base supporting the integration of genetic information as a prognostic or diagnosis tool for injury risk in football is weak. Future participation of organisations in international consortia is suggested to combat the current methodological issues and subsequently improve clarity concerning the underlying genetic contribution to injury susceptibility.
Checking Contact Tracing App Implementations with Bespoke Static Analysis
Authors: Flood Robert , Chan Sheung Chi , Chen Wei , Aspinall David
Published: September 2022

In the wake of the COVID-19 pandemic, contact tracing apps have been developed based on digital contact tracing frameworks. These allow developers to build privacy-conscious apps that detect whether an infected individual is in close proximity with others. Given the urgency of the problem, these apps have been developed at an accelerated rate with a brief testing period. Such quick development may have led to mistakes in the apps’ implementations, resulting in problems with their functionality, privacy and security. To mitigate these concerns, we develop and apply a methodology for evaluating the functionality, privacy and security of Android apps using the Google/Apple Exposure Notification API. This is a three-pronged approach consisting of a manual analysis, general static analysis and a bespoke static analysis, using a tool we have developed, dubbed MonSTER. As a result, we have found that, although most apps met the basic standards outlined by Google/Apple, there are issues with the functionality of some of these apps that could impact user safety.
An Introductory Module in Medical Image Segmentation for BME Students
Authors: Buffinton Christine Miller , Baish James W. , Ebenstein Donna M.
Published: September 2022

To support recent trends toward the use of patient-specific anatomical models from medical imaging data, we present a learning module for use in the undergraduate BME curriculum that introduces image segmentation, the process of partitioning digital images to isolate specific anatomical features. Five commercially available software packages were evaluated based on their perceived learning curve, ease of use, tools for segmentation and rendering, special tools, and cost: ITK-SNAP, 3D Slicer, OsiriX, Mimics, and Amira. After selecting the package best suited for a stand-alone course module on medical image segmentation, instructional materials were developed that included a general introduction to imaging, a tutorial guiding students through a step-by-step process to extract a skull from a provided stack of CT images, and a culminating assignment where students extract a different body part from clinical imaging data. This module was implemented in three different engineering courses, impacting more than 150 students, and student achievement of learning goals was assessed. ITK-SNAP was identified as the best software package for this application because it is free, easiest to learn, and includes a powerful, semi-automated segmentation tool. After completing the developed module based on ITK-SNAP, all students attained sufficient mastery of the image segmentation process to independently apply the technique to extract a new body part from clinical imaging data. This stand-alone module provides a low-cost, flexible way to bring the clinical and industry trends combining medical image segmentation, CAD, and 3D printing into the undergraduate BME curriculum.
Correlation of Galectin‐3/Galectin‐3‐Binding Sites with low Differentiation Status in Head and Neck Squamous Cell Carcinomas
Authors: Delorge Sophie , Saussez Sven , Pelc Patricia , Devroede Benoît , Marchant Hadelin , Burchert Maria , Zeng Fu‐Yue , Danguy André , Salmon Isabelle , Gabius Hans‐Joachim , Kiss Robert , Hassid Sergio
Published: September 2022

The accurate determination of levels of differentiation is of prognostic value in human head and neck squamous cell carcinomas (HNSCCs). Because the deliberate selection of biochemical determinants accompanying certain stages of differentiation can refine the predictive power of histochemical assessments, the application of the quantitative evaluation of staining distribution and intensity by computer‐assisted microscopy is one prerequisite to potential improvements. We used 2 innovative approaches with peanut agglutinin based on encouraging results with respect to common lectin‐histochemistry. First, we used a custom‐made neoglycoprotein to monitor the presence of Thomsen‐Friedenreich (T) antigen‐binding sites. Second, we measured the presence of 2 galectins immunohistochemically and, at the same time, measured lectin‐histochemically the presence of accessible ligands for the endogenous lectins. We also monitored the presence of calcyclin, a protein with relevance to cell cycle progression or exocytosis. With 61 cases of HNSCC as their basis, including 31 oral, 20 laryngeal, and 10 hypopharyngeal lesions, the data show that the main modifications observed in connection with a loss of differentiation are related to a modification in the levels of both galectin‐3/galectin‐3‐binding site and T‐antigen/T‐antigen‐binding site expressions. The data obtained also suggest that galectin‐3 could act as an acceptor site for the T antigen. Because the level of differentiation is known to be indicative of the recurrence rate in HNSCCs and our data clearly indicate that galectin‐3 and the T antigen (and their respective binding sites) are involved in dedifferentiation processes, further investigation is warranted into the roles of galectins in HNSCC tumor progression and recurrence analysis.
Characteristics of Sinus‐Related Pain
Authors: Tarabichi Muaaz
Published: September 2022

OBJECTIVES

The goal of this study was to determine possible distinctive features of facial pain when caused by chronic sinusitis and to validate the pain characteristics previously described in the literature.
Complications of Tracheobronchial Airway Stents
Authors: Zakaluzny Scott A. , Lane J. David , Mair Eric A.
Published: September 2022

OBJECTIVE

Our goal was to identify and analyze airway stent complications and to devise approaches to manage stent complications.

STUDY DESIGN AND SETTING

We conducted a retrospective review of patients from a tertiary medical center.

METHODS

Twenty‐eight airway stents were placed in 23 patients for benign (n = 15) and malignant (n = 13) tracheobronchial diseases. All patients were followed clinically for signs of complications.

RESULTS

Nine complications (8 in those with benign disease and 1 in a patient with malignant disease) were identified and included stent migration (n = 3), excessive granulation tissue (n = 2), stent fracture (n = 1), poor patient tolerance (n = 2), and inability to place (n = 1). Avoidance and management strategies for stent complications are introduced.

CONCLUSION

Tracheobronchial stents provide minimally invasive therapy for significant airway obstruction. Stent complications are more frequently encountered in the long‐term treatment of benign conditions. Stents can be successfully removed endoscopically if complications arise, but the longer a metallic stent is in place, the more difficult it is to remove.

SIGNIFICANCE

As airway stent use increases, proper management will be required to avoid and manage complications. This is the first report to focus on stent complications and their management.
Laryngeal Effects of Antigen Stimulation Challenge with Perennial Allergen Dermatophagoides Pteronyssinus
Authors: Reidy Patrick M. , Dworkin James P. , Krouse John H.
Published: September 2022

OBJECTIVE

We conducted a pilot study to assess the effects of antigen stimulation on the appearance and function of the larynx.

STUDY DESIGN AND SUBJECTS

The prospective, double‐blind, randomized study included 9 adult patients with a skin‐prick test positive for Dermatophagoides pteronyssinus.

MAIN OUTCOME MEASURES

Subjects were blindly challenged via nebulizer with either an active antigenic suspension or placebo. Baseline and 30‐minute evaluations of the larynx were performed. Assessments included subjective voice and video‐stroboscopic assessments, acoustic analysis of voice, speech aerodynamic testing, and allergy and voice handicap questionnaires.

RESULTS

Although both inflammation and increased mucus were noted, there were no significant differences between the antigen‐ and placebo‐exposed subjects on any of the measures obtained.

CONCLUSIONS

Our preliminary investigation was not successful in demonstrating a direct causal relationship between antigen exposure and physical or functional changes in the larynx. Future studies will involve modifications to our current methodology, including increasing the concentration of antigen, prolonging the exposure time, and observing for late phase responses.
Changes of Esophageal Motility after Total Laryngectomy
Authors: Choi Eun Chang , Hong Won Pyo , Kim Chung Bae , Yoon Hyu Chul , Nam Ji In , Son Eun Jin , Kim Kwang Moon , Kim Se‐Heon
Published: September 2022

OBJECTIVE

Total laryngectomy completely interrupts the continuity of the proximal digestive tract and may lead to derangement in esophageal motility. The purpose of this investigation was to find out how total laryngectomy changes the resting and the maximum contracting pressures of the upper esophageal sphincter muscle and how it affects the coordination of the contraction and the relaxation between the pharynx and the upper esophageal sphincter muscles. If changes in the function of the upper esophageal sphincter muscle should occur, this study will also demonstrate how it affects the motility of the esophagus and the lower esophageal sphincter muscle.

METHODS

In an attempt to explain postoperative motility changes, the stationary pull through method of manometric evaluation was used to quantify the alteration in esophageal motility. For the manometric evaluation of the esophagus, a polyethylene catheter with 8 internal tubes was used. The study was performed on a group of 15 patients with total laryngectomy and 15 people without esophageal disease or symptoms as the control group.

RESULTS

There was a statistically significant difference between the laryngectomy group and the control group for both the resting and maximum contraction pressures as well as for coordination and relaxation of the upper esophageal sphincter. (P < 0.05) In the laryngectomy group, 3 patients who complained of postoperative dysphasia showed more severe functional changes. The proximal esophageal body pressure and peristaltic waves were significantly decreased in the laryngectomy group. No significant difference between the laryngectomy group and the control group was noted in terms of the lower esophageal resting sphincter pressure and the postdeglution pressure. There also was no significant difference between the two groups in the degree of lower esophageal sphincter coordination and relaxation.

CONCLUSION

From these results, it may be concluded that interruption of the cricopharyngeal muscle and pharyngeal plexus after laryngectomy not only may produce local derangement of upper esophageal sphincter function but also may produce abnormalities in peristalsis of the proximal esophageal body. However, the function of lower esophageal sphincter did not show any significant difference between the laryngectomy group and the control group.
Multivariate Analysis of Prognostic Factors in T3 N0 Laryngeal Carcinoma Treated With Total Laryngectomy
Authors: Gallo Oreste , Sarno Antonio , Baroncelli Rolando , Bruschini Luca , Boddi Vieri
Published: September 2022

OBJECTIVE

The aim of our study was to clarify the real importance of 16 possible prognostic factors analyzed retrospectively for the disease‐free interval and survival of a total of 327 patients with T3 N0 M0 laryngeal carcinoma treated with total laryngectomy.

METHODS

The role of each possible prognostic factor and their joint effect was explored by Cox proportional hazard survival analysis.

RESULTS and CONCLUSIONS

In a Cox univariate analysis for the whole group, tumor site, pattern of growth, tumor size, histologic grading, lymph node status, and the occurrence of postoperative complications were predictive of the risk of tumor recurrence. In univariate analysis, all these factors except for pattern of tumor growth, neck treatment and postoperative complications maintained their prognostic value when analyzed as predictors of survival; however, the loco‐regional control of disease was the most significant one. In a Cox multivariate analysis tumor size, histologic grading and postoperative complications had a significant impact on disease‐free survival, whereas only histologic grading and loco‐regional failure apeared to be prognostic with a significant decrease in overall survival.
Ankyloglossia: The Adolescent and Adult Perspective
Authors: Lalakea M. Lauren , Messner Anna H.
Published: September 2022

OBJECTIVES

We sought to characterize examination findings and functional limitations due to ankyloglossia in adolescents and adults and to evaluate frenuloplasty in this group.

STUDY DESIGN

A prospective study was conducted of 15 individuals with ankyloglossia aged 14 to 68 years. Baseline symptoms were recorded by questionnaire, and tongue mobility measures were compared with that of 20 control subjects. Six subjects were reassessed postfrenuloplasty.

RESULTS

Thirteen of 14 patients with uncorrected ankyloglossia (93%) noted symptoms including speech problems (50%) and mechanical limitations (57%), such as difficulty licking the lips. Mean tongue protrusion and elevation at baseline measured 15.5 ± 6.0 mm and 13.6 ± 8.0 mm, respectively, for patients and 32.0 ± 3.9 mm and 30.3 ± 4.9 mm for control subjects (P < 0.001). Postfrenuloplasty, tongue function improved both subjectively and objectively in 6 of 6 patients, with a mean gain of 9.2 mm for protrusion (P < 0.05) and 13.0 mm for elevation (P < 0.001).

CONCLUSION

Symptoms related to ankyloglossia are prevalent in this age group and respond favorably to frenuloplasty.
An adjunctive method of radiofrequency volumetric tissue reduction of the tongue for OSAS
Authors: Riley Robert W. , Powell Nelson B. , Li Kasey K. , Weaver Edward M. , Guilleminault Christian
Published: September 2022

OBJECTIVES

Temperature‐controlled radiofrequency volumetric reduction (TCRF), a minimally invasive procedure, has been used to treat tongue base obstruction in Obstructive Sleep Apnea Syndrome (OSAS). An adjunctive method was objectively evaluated.

METHOD

A prospective, nonrandomized clinical study was undertaken on 20 consecutive OSAS patients with isolated tongue base obstruction. Under local anesthesia, multiple lesions of the ventral tongue (genioglossus insertion) and dorsal tongue were given at each treatment session. A visual analog scale was used to assess changes in speech and swallowing. Polysomnography and Epworth Sleepiness Scale (ESS) were used to assess outcome. Patients were maintained on nasal continuous positive airway pressure after each treatment.

RESULTS

Patients received a mean 4.6 ± 0.6 treatments for a mean total of 7915 ± 1152 joules. There was no significant change in speech or swallowing at 3 months after completion of treatment. Patients reported a significant decrease in sleepiness with a mean change in ESS from 12.4 ± 2.9 to 7.3 ± 3.0 (P< 0.001). Mean apnea/hypopnea index decreased from 35.1 ± 18.1 to 15.1 ± 17.4 (P< 0.001). Transient mild to moderate pain and swelling occurred after each treatment. There were no significant complications (ulceration, paresthesia, infection).

CONCLUSION

TCRF can successfully treat the OSAS patient with tongue base obstruction. Combined treatment of the ventral (genioglossus insertion) and dorsal tongue appears safe and may improve outcome with less total energy when compared with traditional dorsal‐only applications.