bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of COVID-19 on Pregnant Women and Children: Recommendations for Health Promotion
Authors: Witt Whitney Perkins , Harlaar Nicole , Palmer Ashley
Published: January 2023

COVID-19 continues to have severe repercussions on children and pregnant women. The repercussions include not only the direct impact of COVID-19 (ie, children getting infected by COVID-19) but also indirect impacts (eg, safeguarding from child maltreatment, obesogenic behaviors, language and socioemotional development, educational consequences [eg, interrupted learning]; social isolation; mental health; behavioral health [eg, increased substance use in adolescence]; health and economic impact of COVID-19 on caregivers and family relationships. It has also shed light on long-standing structural and socioeconomic issues, including equity in nutrition and food security, housing, childcare, and internet access. Using a socioecological, life course, and population health approach, we discuss the implications for pregnant women and children’s health and well-being and give recommendations for mitigating the short and long-term deleterious impact COVID- 19 on women, children, and their families.
Developmental trajectories of ethnic and national identities in adolescents from migrant families: The role of social identification with family and classmates
Authors: Karataş Savaş , Crocetti Elisabetta , Schwartz Seth J. , Rubini Monica
Published: January 2023

Given that adolescents from migrant families live within at least two cultural contexts (i.e., the heritage and the destination cultures), they generally must negotiate and construct ethnic and national identities. Accordingly, the present three-wave longitudinal study was designed to identify distinct developmental trajectories of ethnic and national identities among adolescents from migrant families ( n = 244, 56.6% female; Mage = 14.90, SDage = 0.84 at Time 1). Multivariate latent class growth analyses indicated that participants could be classified into one of four groups based on their identity profiles: ethnic-oriented identity, national-oriented identity, dual identity, and marginalized identity. Further, social identification with family and classmates was examined as a predictor of memberships in these distinct identity profiles. Results of multinomial logistic regression analysis indicated that greater social identification with family increased the probability of being classified into the ethnic-oriented and dual identity profiles rather than into the marginalized identity profile, whereas greater social identification with classmates increased the likelihood of being classified into either national-oriented or dual identity profiles rather than into the marginalized identity profile. These findings provide novel insights into the roles of families and peers as influential socializing agents during the negotiation of ethnic and national identities among immigrant youth.
Investigation of reciprocating wear characteristics of carbon steel at varying load, relative humidity, and operating temperature using ANN-NSGA methodology
Authors: Kumar Abhinandan , Mukhopadhyay Arkadeb
Published: January 2023

Steel's friction and wear characteristics depend not only on the load applied and the nature of the contact surface but also on the environmental circumstances directly and indirectly. This research deals with an investigation of tribological behavior and the wear mechanism of low carbon steel and the effect of load (10 N–100 N), varying temperature (room temperature—200 °C), and relative humidity ranging between 30% and 70% under high-frequency reciprocating condition. Variation of wear rate and coefficient of friction with test parameters was evaluated by generating 3D surface and contour plots. Wear surface morphologies were also characterized. The synergistic effects of the parameters led to a very complex trend in the variation of wear rate and coefficient of friction. Due to the complexity of the problem, an artificial neural network was coupled with the genetic algorithm for the modeling and optimization of tribological characteristics. Simultaneous minimization of wear rate and coefficient of friction was obtained at 18.7349 N load, 199.99 °C temperature, and 49.8332% relative humidity. The worn surface comprised a low shear oxide film and pressed debris patches. The artificial neural network model was also obtained with a significantly high accuracy having an overall R-value close to 1 for both wear rate and coefficient of friction.
Parameter optimization of electrophoretically deposited graphene oxide coating on the frictional characteristics of AISI 52100 alloy steel
Authors: Kamal Vivek V , Arunkumar Sudha Subramanian chettiar , Bindu Kumar Karthikeyan , Rani Santhakumari amma
Published: January 2023

Wear-resistant coatings help to extend the life of materials by improving their tribological properties. Among the various coating methods, electrophoretic deposition (EPD) is a simpler, low cost and effective coating method in which the charged particles in colloidal suspension are deposited on the substrate. Graphene oxide (GO) has been coated by different deposition methods, but the optimization of EPD coating factors for improving frictional characteristics has been studied limitedly. This work aims to optimize various parameters of EPD coating such as voltage, deposition time, concentration and sintering temperature for a lower tribological response. Experiments were conducted using the L16 orthogonal array created by the Taguchi optimization method. After sintering the samples, tribological tests were done using a Pin-on-Disc apparatus. The influence of coating parameters and the optimum combination of the factors for a lower coefficient of friction (COF) was found and experimentally validated. A crack density study has been done to study the influence of porosity on frictional characteristics. Results showed that the COF of the optimum GO-coated substrate (0.152) was lowered by 71.33% while comparing with the COF of uncoated substrate (0.53) under the same test conditions.
Hybrid surface modification for improved tribological performance of IC engine components – a review
Authors: Murari Govind , Nahak Binayaka , Pratap Tej
Published: January 2023

The worldwide increase in demand for automotive sectors requires improved components life cycle, fuel economy and emission control. However, the occurrence of high temperature and variable loading on contact surfaces of internal combustion (IC) engine causes excessive friction results into reduced component life cycle, degrades emission level and fuel economy too. A small improvement in tribological performance and oil sealing through surface modification can able to enhance the functional performance of IC engine components significantly. Hence, in this work, a detailed discussion on the comparison of different hybrid surface modification techniques such as coatings, textures, and nanoparticles can work synergistically to improve the tribological performance of IC engine components. The process capabilities, limitations, and their effect on tribological performances of IC engine components are also presented. An analysis of surface texture parameters such as geometry, dimension, motion parameters, surface roughness, and oil transport mechanism is done to know the effects on the performance of the IC Engine. Further, the hybridization of different processes with nanoparticles (metallic, metallic oxides, carbon nanoparticles) is briefly presented. Finally, the effect of modified surface chemistry and characterization such as asperity, topography, microhardness, residual stress, and adhesive strength characteristics is also related to the tribological performances of IC engine components.
Asymmetric nexus of coal consumption with environmental quality and economic growth: Evidence from BRICS, E7, and Fragile Five countries by novel quantile approaches
Authors: Kartal Mustafa Tevfik , Ertuğrul Hasan Murat , Taşkın Dilvin , Ayhan Fatih
Published: January 2023

The study analyzes the asymmetric nexus of coal consumption with environmental quality and economic growth. In this context, the study focuses on eight leading emerging countries that take place in BRICS, E7, and Fragile Five groups. Also, the study uses yearly data from 1989 to 2021 and performs novel quantile methods, such as Granger Causality-in-Quantiles and Quantile-on-Quantile Regression (QQR). Also, quantile regression is used for robustness check. The results present that (i) there are causalities from coal consumption to both environmental quality and economic growth at 10% significance, whereas quantile and country-based results differ; (ii) effects of coal consumption on environmental quality are much stronger in lower quantiles for Brazil, Indonesia, India, South Africa, and, Turkey, but in higher quantiles for China, Mexico, and Russia; (iii) effects of coal consumption on economic growth are much stronger in lower quantiles for Brazil, Indonesia, India, Russia, South Africa, and Turkey; in higher quantiles for China; lower and middle quantiles for Russia; and all quantiles for Mexico; and (iv) the robustness of the QQR results are validated. Hence, empirical outcomes underline the highly crucial effects of coal consumption on environmental quality and economic growth in the countries. The results imply that policymakers should focus on efforts to decrease coal consumption gradually by applying a macro transition plan to increase environmental quality without causing economic decline by considering changing effects of coal consumption at quantiles and countries.
Book review: Mary E. John and Meena Gopal (Eds), Women in the Worlds of Labour: Interdisciplinary and Intersectional Perspectives
Authors: Dewan Ritu
Published: January 2023

Mary E. John and Meena Gopal (Eds), Women in the Worlds of Labour: Interdisciplinary and Intersectional Perspectives (Orient BlackSwan, 2021), 423 pages, ₹995, ISBN 9788194925897 (Paperback).
Book review: Asha Hans, Amrita Patel, Bidyut Monhanty and Swarnamayee Tripathy, Women Reinventing Development: The Odisha Experience
Authors: Das Sarada Prasanna
Published: January 2023

Asha Hans, Amrita Patel, Bidyut Monhanty and Swarnamayee Tripathy, Women Reinventing Development: The Odisha Experience (New Delhi: Aakar, 2020), 333 pp., ₹995, ISBN 978-93-5002-67-17 (Hardbound).
Recurrent and atypical immune checkpoint inhibitor-induced pneumonitis
Authors: Jeon Won Jin , Nguyen Jasmine , Castillo Dani Ran , Park Kiwon , Brothers Joel , Nguyen Anthony , Mirshahidi Hamid
Published: January 2023

Introduction

Pembrolizumab (Keytruda) is a monoclonal antibody against the programmed cell death-1 (PD-1) receptor on lymphocytes, which is one of the immune checkpoint inhibitors (ICIs) approved for multiple solid and hematologic malignancies. Although ICIs have proven to be more effective and less toxic compared to chemotherapy, there are reports of adverse side effects with ICIs. For example, pneumonitis is a potentially lethal side effect occurring in 1%–5% of patients who received ICIs in clinical trials, and there are case reports with clinical and radiological features of checkpoint inhibitor-pneumonitis (CIP).

Case report

We report an unusual case of pneumonitis with atypical imaging in a patient who received pembrolizumab for metastatic p16-positive squamous cell carcinoma of the base of the tongue. We discuss the approach to the recognition and management of atypical CIP in patients on pembrolizumab with the intent to standardize workup and increase awareness among healthcare providers in the new era of immunotherapy.

Management and Outcome

Serologic workup including laboratory studies for complete blood count (CBC), lactate, procalcitonin, SARS-CoV-2 (COVID-19), Legionella, Cytomegalovirus (CMV), Coccidioides, Coxiella, and viral respiratory panel were negative for infectious processes. Since CIP was suspected, the patient was started on steroid therapy. Interval computed tomography (CT) of the chest without contrast showed a resolution of pneumonitis.

Discussion

In this case report, we discuss our workup of CIP and initial testing to rule out other possible causes of the patient's symptoms and radiographic findings, and management of the patient's diagnosis of atypical CIP which led to complete clinical recovery from CIP.
Serum liver enzymes and metabolic syndrome from the Rafsanjan Cohort Study
Authors: Khalili Parvin , Ayoobi Fatemeh , Kahkesh pour Firoozeh , Esmaeili-Nadimi Ali , Abassifard Mitra , La Vecchia Carlo , Jamali Zahra
Published: January 2023

Our investigation aimed at evaluating the relationship between metabolic syndrome, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), and alkaline phosphatase (ALP) in the Rafsanjan cohort study (RCS). We used data obtained from the RCS, as a part of the prospective epidemiological research studies in Iran. In this cross-sectional research, 9895 participants from the baseline phase of RCS who completed medical questionnaire were included. Metabolic syndrome (MetS) defined using NCEP-ATP III criteria. The relationship between elevated serum liver enzymes levels even within the normal range and metabolic syndrome was evaluated by logistic regressions. The prevalence of MetS was 34.42% in the participants of study. The mean concentrations of AST, ALT, ALP, and GGT increased with increasing MetS components. After adjusting for all potential confounders, elevated serum concentrations of ALT, AST, GGT, and ALP even within the normal range were related with an increased odds of MetS. MetS was associated with increased levels of liver enzymes even within the normal range. These results indicated the potential for elevated liver enzymes as biomarkers for the possible presence of MetS.
Genetic variations in OLR1 gene associated with PCOS and atherosclerotic risk factors
Authors: Sahin Serap Baydur , Nalkiran Ihsan , Ayaz Teslime , Irfan Guzel Ali , Eldes Tugba , Calapoglu Tugba , Sevim Nalkiran Hatice
Published: January 2023

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. The aim of this study was to investigate the association of oxidized low-density lipoprotein receptor 1 ( OLR1) gene variations with the susceptibility of PCOS and to examine the relationship between the frequencies of OLR1 gene variations and atherosclerotic risk factors. Genomic DNA was extracted from blood samples collected from 49 patients with PCOS and 43 healthy controls. The variants in the OLR1 gene were identified using next-generation sequencing (NGS). Heterozygous rs11053646 (K167N), rs11611438, rs11611453, and rs35688880 genotype frequencies were significantly higher in the PCOS group than that of control group. Single nucleotide polymorphism (SNP) rs34163097 minor A allele increased the PCOS risk by ∼10-fold (p = 0.03). SNPs rs11053646, rs11611438, rs11611453, rs34163097, and rs35688880 were positively correlated with body mass index (BMI). The logistic regression model (area under the curve: 0.770, p = 0.000) further revealed a combination of 2-h plasma glucose (PG-2 h), dehydroepiandrosterone sulfate (DHEAS), and rs11053646 as predictors of PCOS phenotype. This is the first study reporting the NGS data of OLR1 gene variants which might be associated with the pathogenesis of PCOS and several atherosclerotic risk factors, particularly higher BMI and DHEAS. To fully understand the genetic basis of PCOS and the contribution of OLR1 gene variants to PCOS pathogenesis, additional large-scale studies are warranted.
Diabetes mellitus is associated with more adverse non-hemodynamic left ventricular remodeling and less recovery in patients with primary aldosteronism
Authors: Chen Uei-Lin , Liao Che-Wei , Wang Shuo-Meng , Lai Tai-Shuan , Huang Kuo-How , Chang Chin-Chen , Lee Bo-Ching , Lu Ching-Chu , Chang Yi-Ru , Chang Yi-Yao , Hung Chi-Sheng , Chueh Jeff S , Wu Vin-Cent , Tsai Cheng-Hsuan , Lin Yen-Hung ,   TAIPAI study group
Published: January 2023

The elevated aldosterone in primary aldosteronism (PA) is associated with increased insulin resistance and prevalence of diabetes mellitus (DM). Both aldosterone excess and DM lead to left ventricular (LV) pathological remodeling. In this study, we investigated the impact of DM on LV non-hemodynamic remodeling in patients with PA. We enrolled 665 PA patients, of whom 112 had DM and 553 did not. Clinical, biochemical, and echocardiographic data were analyzed at baseline and 1 year after adrenalectomy. LV non-hemodynamic remodeling was represented by inappropriate excess left ventricular mass index (ieLVMI), which was defined as the difference between left ventricular mass index (LVMI) and predicted left ventricular mass index (pLVMI). Propensity score matching (PSM) was used with age, sex, systolic, and diastolic blood pressure to adjust for baseline variables. After PSM, the patient characteristics were balanced between the DM and non-DM groups, except for fasting glucose, HbA1c, and lipid profile. A total of 111 DM and 419 non-DM patients were selected for further analysis. Compared to the non-DM group, the DM group had significantly higher ieLVMI and LVMI. After multivariable linear regression analysis, the presence of DM remained a significant predictor of increased ieLVMI. After adrenalectomy, ieLVMI decreased significantly in the non-DM group but not in DM group. The presence of DM in PA patients was associated with more prominent non-hemodynamic LV remodeling and less recovery after adrenalectomy.
The Influence of Time Orientation on Infection Risk Evaluation: Moderating Role of Public Health Crisis
Authors: Fong Lawrence Hoc Nang , Sun Sunny , Chan Irene Cheng Chu , Law Rob
Published: January 2023

The outbreak of COVID-19 has offered a painful lesson to the stakeholders of the travel and hospitality industry. To speed up the recovery of the industry, practitioners need to better understand the factors that influence potential travelers’ evaluation of infection risk when traveling abroad. Hence, this study proposes time orientation (future and present orientations) as a robust determining factor. Analyzing 614 pre-pandemic and 606 mid-pandemic survey responses, this study consistently found that future and present orientations positively predict the evaluation of infection risk because of the highly perceived value of cleanliness. The presence of the pandemic amplifies the positive prediction of present orientation on the evaluation of infection risk. These findings extend the literature of time orientation by revealing its influence on travel risk and the psychological mechanisms behind it. Meaningful implications are provided for travel operators to identify the potential travelers.
Is there clarity in ambiguity? A literature review of party positional ambiguity
Authors: Lefevere Jonas
Published: January 2023

The issue positions of political actors are often ambiguous, resulting in uncertainty on the part of voters. Such ambiguity constitutes a challenge to representation, as it prevents voters from getting a clear understanding of parties’ positions. Ironically, despite growing interest in the concept, the concept itself is remarkably ambiguous: different studies use different conceptualisations of ambiguity, which hampers theory integration. This paper proposes a three-dimensional conceptualization of ambiguity: party positions are ambiguous to the extent that parties deemphasize them, remain vague or are inconsistent on them. A review of 103 studies establishes the prevalence of these three dimensions in the literature, shows that most studies focus on a single dimension, and reveals lacunae in the current research on ambiguity. Based on the three-dimensional conceptualisation, the paper then develops a preliminary framework on the causes of ambiguity, outlines key gaps in the literature and suggests promising avenues of theory development.
Identifying research priorities with children, youth, and families: A scoping review
Authors: Modanloo Shokoufeh , Correll Quinn , Correll Rhonda , Major Nathalie , Quinlan Michelle , Reszel Jessica , Wilding Jodi , Lin Zhou Zhi , Franck Linda S , Harrison Denise
Published: January 2023

Increased patient advocacy has resulted in a shift toward more active patient engagement in the research. A scoping review was conducted to explore the literature on healthcare research priority settings wherein children, youths, or their families were involved in the priority-setting process. Six databases including MEDLINE, CINAHL, PsycINFO, Embase, Web of Science, and Global Health and the James Lind Alliance website were searched up until September 2019. All primary studies involving children (<18 years of age) or families in developing research priorities in health care were included. All retrieved references were uploaded into Covidence, and two independent reviewers screened the search results. Descriptive thematic analysis was used to identify common themes. A total of 30 studies with 4247 participants were included. Less than half of the participants ( n = 1237, (33%) were pediatric patients and their families. A total of 455 research priorities were identified. Three common themes emerged: (i) quality of care delivery, (ii) self-efficacy in health behaviors, and (iii) community engagement in care. This scoping review revealed priority research health topics from the perspectives of children, youths, or their families. The findings may be used as a foundation for future research to improve the health outcomes of children, youths, or their families according to their identified priorities.
What are the impetuses Behind E-health applications’ self-management services’ ongoing adoption by health community participants?
Authors: Guo Jin , Shan Shan , Ali Khan Yousaf
Published: January 2023

Over the past 20 years, the identification of interventions related to healthcare management has been greatly facilitated by improvements in the well-being and health of the entire population. However, regardless of the positive developments in smart health applications and e-health research, there are two important gaps, (1) the role of gamification variables in the continued use of eHealth applications has not been adequately assessed, and (2) the extent to which people’s perception of the continued use of e-health applications is encouraged through habit. Customers and companies can derive considerable value from exploring E-Health applications’ health self-management services. Accordingly, estimating such services’ ongoing adoption by customers is aimed for in this research, with habits, intrinsic and extrinsic variables incorporated into a study model which is then tested. This paper examined perceived autonomy, perceived competence, perceived relatedness has positively related to enjoyment and habit. Reward has positively related to perceived autonomy and continued to use. Enjoyment and Habit have positively associated with the decision to continue to use in e-Health Apps. 269 individuals who have used Chinese e-health applications comprised the data collection sample, being reached via an online questionnaire. Data analysis was undertaken using Partial Least Squares Structural Equation Modelling (PLS-SEM). It was found that the ongoing adoption of e-health self-management services was perpetuated to a greater extent by intrinsic variables; in terms of strategizing for companies’ e-services, the results can inform this process.
Information flows from local to national: Evidence from 21 major US cities
Authors: Guo Lei , Zhang Yiyan
Published: January 2023

Local journalism is in decline in the United States. As one way to assess the state of local journalism, this study examines the information flows between local and national media in the online media ecosystem. Focusing on metropolitan journalism, this paper empirically investigates whether and when a city’s local news coverage can influence national news portrayal of the city. This research draws from intermedia agenda setting (IAS) theory and examines a large news data set related to the most populated 21 US cities. The results suggest that local media are not more likely to transfer the salience of their urban issues to the national media agenda than reversely. In addition, a city’s economic power and the scale of its local journalistic infrastructure, especially the traditional media sector, are significantly correlated with its local media’s power to determine how the city is portrayed in the national media.
Numerical characterization of hydrogen under-expanded jets with a focus on Internal Combustion Engines applications
Authors: Anaclerio Giuseppe , Capurso Tommaso , Torresi Marco , Camporeale Sergio Mario
Published: January 2023

In the context of reducing carbon dioxide ([Formula: see text]) emissions, hydrogen is gaining momentum as a possible fuel for Internal Combustion Engines (ICEs). In-cylinder direct injections allow for a higher specific power density while enabling different levels of charge stratification. The high-pressure injection leads to the onset of under-expanded jets, characterized by complex patterns of shock waves and expansion fans. In ICEs simulations, such physics needs to be correctly solved to obtain a reliable assessment of the mixture formation. In this paper, the main features of hydrogen under-expanded jets are examined under the conditions typically found in turbocharged engines. Improved correlations are provided for the assessment of the Mach disk height and diameter, up to a Nozzle Pressure Ratio (NPR) equal to 60. The dependency of the hydrogen-air mixing on the cylinder temperature has been analyzed, and the unsteady jet dynamics has been examined by continuously varying the combustion chamber pressure. To the authors’ knowledge, no studies of this kind can be found in the literature for the specific case of hydrogen. Lastly, a preliminary investigation of the jet-jet interaction (a Coanda-like effect) is reported. This phenomenon is observable when multi-hole injectors are employed, and it may have a great impact on the mixture formation.
Multi-objective optimization of fuel injection performance of a common rail injector
Authors: Gu Yuanqi , Fan Liyun , Lan Qi , Wei Yunpeng , Zhou Jiasheng , Du Kun
Published: January 2023

The improvement of injector performance is important for the operation of common rail (CR) fuel systems. In this study, the optimization work has been carried out on a large-flow common rail injector. First, to simulate the injection process, a one-dimensional (1-D) model was developed and validated against the experimental data. The mathematical approximation model was also established to correlate the injection performance with the factors. Then, a multi-objective model by taking three design objectives into account was established and solved. Finally, Pareto front was obtained and the final optimization solution was determined. Furthermore, an extensive validation and analysis for the optimized results under various operating conditions was also carried out. Results shows that the three objectives, total response time, injection pressure fluctuation and injection pressure drop respectively, are improved by 11.75%, 39.12%, and 10.03% under the typical condition. And the proposed multi-objective optimization program based on design of experiment (DOE) technique, response surface methodology (RSM) and Elitist Non-dominated sorting genetic algorithm (NSGA-II) in present work can exhibit a good capability to optimize the problem of the injection performance in a CR fuel system.
Desert Bus: Abusive Game Design, The Martyrdom Effect, and Fan Activism on Twitch.tv
Authors: Condis Megan
Published: January 2023

Desert Bus began as vaporware. A decade after it was initially shelved, it was rediscovered and became a way for gamers to show off their insider knowledge of rare and hard-to-find bits of gaming history. A few years later, its reputation for being one of the least fun video games ever made it the centerpiece of a long-running charity event. In this essay, I will conduct a textual analysis of Desert Bus and argue that the uniquely painful gaming experience that the game provides players makes it a perfect vehicle for charity streaming, providing both a sense of gamer authenticity and credibility to the Desert Bus for Hope event and an emotional incentive for viewers to give. This research stands to benefit scholars working on cult media, a field in which work on video games is relatively rare in comparison to work on television and film.
Listening to the Margins: Reflecting on Lessons Learned From a National Conference Focused on Establishing a Qualitative Research Platform for Childhood Disability and Race
Authors: Moola Fiona J. , Ross Tim , Amarshi Aliya , Sium Aman , Neville Alyssa R. , Moothathamby Nivatha , Dangerfield Beth , Tynes-Powell Tamara , Pathmalingam Tharanni
Published: January 2023

The late Black feminist scholar, bell hooks, suggested that the margin can be a place of radical possibility, where marginalized people nourish their capacity for collective resistance. On the margin, it is possible to generate a counter-language. In this paper, we chronicle, describe and reflect upon how bell hooks' ideas inspired the creation of a national 2-day conference titled, ‘Listening to the Margins’. This conference was focused on understanding the intersectional experiences of childhood disability and race with a view to better supporting racialized disabled children, youth, and their families. This conference was needed because intersectional experiences of childhood disability and race have been silenced in childhood disability studies, critical race studies, and various other resistance-oriented systems of thought. Racialized children with disabilities and their families are often unsupported as they navigate Euro-centric healthcare systems. Reflecting on lessons learned from our conference, we suggest several strategies for advancing meaningful research programs with racialized disabled children. Strategies include centering the art of listening, amplifying the margin, engaging the arts to promote empathy, embracing psychosocial support in work on ableism and racism, developing clinical tools and practices that are grounded in lived patient experiences, and advancing decolonizing research that recognizes the role research has historically played in perpetuating colonial violence. In totality, this article unpacks how sitting on the margins, as bell hooks suggested, has allowed us to occupy a place of discomfort and creativity necessary to disrupt dominant discourses. In so doing, we have made space for the hidden narratives of racialized disabled children and their families.
Novel modification of a branched arch endograft with a retrograde left common carotid branch for acute pseudoaneurysm post type A repair
Authors: Lim Eric TA , Benson Ruth , Lyons Oliver , Laing Andrew , Khanafer Adib
Published: January 2023

Objective

Pseudoaneurysm formation post type A aortic dissection repair is rare. Revision surgical repair is challenging, with a risk of death from haemorrhage.

Methods

We present a 56-year-old man who presented with a rapidly enlarging distal ascending aortic anastomotic pseudoaneurysm following a recent ascending and hemiarch replacement for acute type A aortic dissection.

Results

A tight kink in the ascending aortic graft precluded an endovascular repair utilizing two antegrade branches, and so a novel custom-made 3 inner branched aortic endograft was designed, with an antegrade brachiocephalic inner branch and retrograde left common carotid and subclavian artery inner branches. The patient required an angioplasty to dilate the kinked/coarcted surgical graft, but made an uneventful recovery.

Conclusion

An aortic arch inner branch design with an antegrade brachiocephalic branch but retrograde left common carotid and left subclavian branches was feasible and may prove particularly useful when there is limited space in the ascending aorta.
Influence of crural vessel run-off on short- and mid-term outcomes following femoro-popliteal bypass grafting
Authors: Preece Ryan , Mann Lydia , Kulkarni Sachin R , Paravastu Sharath CV
Published: January 2023

Objectives

To determine the influence that the number of patent crural run-off vessels has on short- and mid-term outcomes following femoro-popliteal bypass.

Methods

All patients undergoing index femoro-popliteal bypass grafting between 2013 and 19 at our unit were included. Preoperative imaging was used to stratify patients into cohorts with either one or ≥2 patent run-off vessels. Primary outcomes measures included bypass patency and limb salvage rates at one and 3 years post-operatively. Survival analysis was performed using Kaplan–Meier curves and Logrank test.

Results

147 bypasses performed on 143 patients were included. 24 patients had one-vessel run-off and 123 had ≥2 vessels patent. Patients with one-vessel run-off had a higher proportion of emergency admissions (54% vs 41%) and diabetes (42% vs 31%). 31% of patients underwent diagnostic angiogram imaging in addition to having duplex ultrasound and/or computed tomography angiography. There were no significant differences in primary, primary-assisted or secondary patency rates between the cohorts at 12 or 36 months. Limb salvage rates were significantly higher amongst those with ≥2 vessel run-off at 12 (86% vs 71%, p = 0.03) and 36 (85% vs 71%, p = 0.04) months. For those with occluded grafts, a higher proportion of patients with ≥2 vessel run-off subsequently had an attempt at redo bypass grafting.

Conclusions

Femoro-popliteal bypass is a reasonable treatment option for patients with one-vessel run-off. However, whilst patency rates are comparable, clinicians should be aware of the lower successful limb salvage rates for patients with one patent vessel (especially those presenting with tissue loss).
Mnemicity: A Cognitive Gadget?
Authors: Mahr Johannes B. , van Bergen Penny , Sutton John , Schacter Daniel L. , Heyes Cecilia
Published: January 2023

Episodic representations can be entertained either as “remembered” or “imagined”—as outcomes of experience or as simulations of such experience. Here, we argue that this feature is the product of a dedicated cognitive function: the metacognitive capacity to determine the mnemicity of mental event simulations. We argue that mnemicity attribution should be distinguished from other metacognitive operations (such as reality monitoring) and propose that this attribution is a “cognitive gadget”—a distinctively human ability made possible by cultural learning. Cultural learning is a type of social learning in which traits are inherited through social interaction. In the case of mnemicity, one culturally learns to discriminate metacognitive “feelings of remembering” from other perceptual, emotional, action-related, and metacognitive feelings; to interpret feelings of remembering as indicators of memory rather than imagination; and to broadcast the interpreted feelings in culture- and context-specific ways, such as “I was there” or “I witnessed it myself.” We review evidence from the literature on memory development and scaffolding, metacognitive learning and teaching, as well as cross-cultural psychology in support of this view before pointing out various open questions about the nature and development of mnemicity highlighted by our account.
The unsolved problem of radial longitudinal dysplasia: how can we reliably prevent recurrence, preserve growth and optimize function?
Authors: van Nieuwenhoven Christianne A. , Mann Max , Hülsemann Wiebke
Published: January 2023

Congenital radial longitudinal dysplasia remains an ‘unsolved problem' in hand surgery. The challenges presented by the skeletal deficiency of the distal radius and soft tissue dysplasia of the severe radial longitudinal deficiency have been addressed by a number of techniques that aim to stabilize the position of the hand relative to the forearm and optimize forearm growth and hand function. Analysis of hand function and position in these children is difficult because of the abnormal ‘wrist' mechanics, and the published results of the techniques used to date often lack a standardized approach and importantly the perception of function from the patient's perspective. The existing data is reviewed and compared with the results of cohorts from two major congenital upper limb centres. Soft tissue distraction prior to radialization or centralization may offer benefit in ulnar growth and forearm length but there is a need for further research into the long-term functional outcomes of the various techniques available to determine the optimal choice for these children.

Level of evidence: V
Implementing changes to reduce infections in ICU patients. Water services and waste systems
Authors: Weinbren Michael , Inkster Teresa , Walker Jimmy
Published: January 2023

Background

Evidence linking the role of water services in transmission of infection to patients in ICUs has increased in recent years.

Aims

This research based commentary set out to identify potential solutions for water and wastewater systems in ICU settings.

Methods

Databases and open source information was used to obtain data on approaches to water and wastewater-related issues in ICU settings. This and the authors experiences have been used to describe approaches to these problems.

Findings

The lack of updated guidance has required some ICUs to develop unique responses, including ‘water free’ patient care combined with reduction in water services. The options consider guidance, compliance, training and education as key factors to successful outcomes and protecting vulnerable patients in ICU.

Discussion

The authors found a number of problems with water and wastewater systems in ICU to which there has not been a cohesive response in terms of guidance to support users and designers. The resultant void permits new projects to proceed with suboptimal and designs which place patients and staff at risk. As an interim measure a series of solutions suitable for existing units and new builds need to be considered.
Antifungal Efficacy of Gallic Acid Extracted From Pomegranate Peel Against Trichophyton rubrum: In Vitro Case Study
Authors: Fan GaoFu , Xu ZhenGuo , Liu XiuShu , Yin Wei , Sun LiHua , Wu Dan , Wei MengQiang , Wang Wei , Cai YuHua
Published: January 2023

Objectives: Trichophyton rubrum is one of the main pathogens causing superficial dermatophytosis, producing symptoms such as skin itching and pain, which seriously affects the quality of life of patients. Pomegranate peel extract is rich in gallic acid (GA), which has been reported to have biological effects including antifungal activity. However, the morphological and molecular mechanisms underlying the effects of GA on T rubrum are not well understood. The objectives of this study were to determine the antifungal efficacy of GA extracted from pomegranate peel against T rubrum in vitro, and to explore the underlying molecular mechanisms. Methods: The effects of 0-, 0.5-, and 1 mg/mL GA in pomegranate peel extract on T rubrum was investigated by detecting cell viability using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays. Transmission electron microscopy (TEM) was used to analyze the ultrastructure of T. rubrum, and transcriptome sequencing was used to analyze the enrichment pathway of differentially expressed genes. The identification of biosynthesis-related and key genes in the pathways involved using real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) technology. Terbinafine hydrochloride (TERB) as a positive control group. Results: Pomegranate peel extract has a GA content of 1.0 mg/mL. Compared with untreated group, following treatment with 1.0 mg/mL GA content is rich in pomegranate peel extract, and the microstructure of T rubrum is destroyed. TEM results show that the number of lipid droplets in T rubrum was significantly increased, mitochondrial vacuoles degenerated, the serosa were damaged, and the boundary of thallus was unclear. In addition, 1 mg/mL GA can significantly inhibit T rubrum proliferation, and its inhibition ability is better than TERB. Transcriptomics results show that GA can change the gene expression profile of T rubrum, specifically: The biosynthesis was blocked, drug resistance was weakened, the transport of ATP-binding cassette (ABC) drugs transporter was increased, and the mitogen-activated protein kinase (MAPK) pathway was significantly inhibited. Conclusions: Pomegranate peel extract is rich in GA, which strongly inhibited the growth of T rubrum and reduced its drug resistance. This extract is a promising natural antifungal agent for clinical use.
What lies beneath: A case report of Morel-Lavallée lesion
Authors: Joseph Udayan , Thangayah Jeevan R
Published: January 2023

A Morel-Lavallée lesion is a rare internal degloving injury that patients present with to the Emergency Department (ED) typically following high impact trauma. The diagnosis is often missed due to its uncommon presentation and emphasis on other concomitant injuries that may have occurred as a result of polytrauma. Potential long-term complications from these closed soft-tissue injuries highlight the need for early recognition. We present one such case encountered in our ED and aim to familiarize readers with the presentation, diagnostic and treatment modalities, and challenges emergency physicians might face when encountering patients with such lesions.
In-hospital mortality from acute coronary syndrome in Africa: a systematic review and meta-analysis
Authors: Adem Fuad , Abdi Semir , Amare Firehiwot , Mohammed Mohammed A
Published: January 2023

Objective:

There is an increasing recognition of the burden of cardiovascular disease in Africa. However, little is known about the pooled prevalence of acute coronary syndrome (ACS)-associated in-hospital mortality and contributing factors.

Methods:

PubMed, Medline, Embase, Web of Science (Core Collection), and supplementary sources including Google Scholar, World Cat, Research Gate, and Cochrane Library were searched. Chi-square test and I2-statistic were used to assess heterogeneity. Egger’s and Begg’s tests and funnel plots were used to assess publication bias. Data were analyzed using Stata software (version 15.0).

Result:

Twenty nine studies with a total sample of 11,788 were included. The pooled estimate of all-cause in-hospital mortality was 22% (pooled proportion (PP) = 0.22; 95% confidence interval (CI): 0.17–0.27. The In-hospital mortality rate was lower at the cardiac centers (PP = 0.14; CI: 0.05–0.23) compared to referral hospitals (PP = 0.24; CI: 0.17–0.31]) The mortality rate was comparable in Eastern (PP = 0.23; CI: 0.19–0.27) and Northern Africa (PP = 0.22; CI: 0.16–0.28). The incidence of in-hospital heart failure, cardiogenic shock, arrhythmia, bleeding, acute stroke, and reinfarction were 42, 17.0, 20.0, 16.0, 4.0, and 5.0%, respectively.

Conclusion:

All-cause in-hospital mortality rate associated with ACS is high in Africa. The mortality rate at cardiac centers was 10% lower when compared with referral hospitals. Establishing coronary units, strengthening existing cardiac services, and improving availability and access to cardiovascular medicines could help in reducing the burden of ACS in the continent.
Knowledge and attitude of healthcare workers toward advanced cardiac life support in Felege Hiwot Referral Hospital, Bahir Dar, Ethiopia, 2022
Authors: Adal Ousman , Emishaw Solomon
Published: January 2023

Objective:

The aim of this study was to investigate the knowledge and attitude regarding advanced cardiac life support among healthcare workers, 2022.

Methods:

A cross-sectional study was conducted from March to May 2022 among healthcare workers who were working in Felege Hiwot Comprehensive Specialized Hospital Bahir Dar, Ethiopia. All physicians and nurses who were willing to participate this study were involved. A structured self-administered questionnaire was used for data collection. The data were entered into the statistical software Epi Data version 4.6.0.4 and analyzed with statistical package for social science version 26. Logistic regression analysis was used to differentiate the effects of each independent variable on the dependent variable.

Results:

Among the total study participants (400) with a response rate of 96%, most (238) (59.5%) healthcare workers (nurses and physicians) had poor knowledge toward advanced cardiac life support. Two hundred twenty-five (56.25%) healthcare workers had positive attitude. Being a physician, having more than 6 years of work experience, working in an emergency department for more than 10 years, and having advanced cardiac life support training all contribute to superior knowledge of advanced cardiac life support.

Conclusion:

Most healthcare workers, especially, nurses, have under estimated knowledge and a negative attitude toward advanced cardiac life support. This implies they require knowledge building and attitude empowerment regarding advanced cardiac life support. Being a physician, having training in advanced cardiac life support, having work experience of more than 6 years, and working in an emergency unit for more than 10 years were positively associated with better knowledge of advanced cardiac life support among healthcare workers.
Rapid resolution of hypertriglyceridemia-induced pancreatitis via plasmapheresis: A unique case report
Authors: Wang Victoria , Jinnah Anna , Pellegrini James R , Pelletier Brandon
Published: January 2023

Hypertriglyceridemia is a well-established cause of acute pancreatitis. Initial treatment for hypertriglyceridemia-induced pancreatitis has consisted of supportive measures; however, triglyceride levels can remain high, causing prolonged organ failure and sepsis. Plasmapheresis has been proposed as a treatment option to effectively reduce triglyceride levels. We present a patient case of hypertriglyceridemia-induced pancreatitis that was treated with standard acute pancreatitis interventions along with plasmapheresis, after which triglyceride levels reduced significantly. Further research is necessary to determine the clinical benefits of plasmapheresis in treating this type of pancreatitis.
Rheocarna® as an alternative therapeutic option for patients with chronic limb-threatening ischemia: A case report
Authors: Satake Akinori , Nakano Yusuke , Niwa Toru , Ando Hirohiko , Takashima Hiroaki , Amano Tetsuya
Published: January 2023

Recently, a new low-density lipoprotein apheresis device (Rheocarna®; Kaneka Corporation, Osaka, Japan), a blood purification therapy, was approved in Japan for managing chronic limb-threatening ischemia with refractory ulcers. Here, we describe a case of chronic limb-threatening ischemia that was treated with the Rheocarna. A 65-year-old Asian man with an ulcer on the right heel was admitted to our hospital. Angiography revealed chronic total occlusion with severe calcification of the anterior tibial, peroneal, and posterior tibial arteries. The patient underwent distal bypass of the saphenous vein; however, the bypass was occluded in the early postoperative period. The Rheocarna was used, and the ulcers improved significantly postoperatively. Although endovascular treatment was eventually performed on the occluded bypass graft to completely heal the ulcer, the Rheocarna could be an alternative treatment option in challenging cases of chronic limb-threatening ischemia.