bluuebunny/crossref_metadata_2025 huggingface dataset:
Soft Loading Protocol of Short Strategic Implants in Posterior Mandibles Supporting Removable Bilateral Free-End Prostheses: 1-year Results of a Prospective Cohort Study
Authors: Enkling Norbert , Thanendrarajah Thanuja , Mathey Ayse , Janner Simone , Schimmel Martin , Abou-Ayash Samir
Published: March 2022

Purpose: To evaluate 1-year survival and success rates of 6-mm short implants placed in mandibular molar sites with two different abutments (dome/ball) retaining existing removable partial dentures (RPDs). Materials and Methods: In 19 patients, 38 implants of 6-mm length were placed bilaterally. After 4 months, each participant received the dome abutment, which 2 months later was exchanged with the ball abutment. Clinical data were recorded at abutment connection (4 months postsurgery) and at 6 and 12 months postsurgery, including probing depth, bleeding on probing, presence of plaque, and standardized radiographs. Implant success was assessed using the following criteria: presence of pain, mobility, radiographic bone loss, probing depth, and the presence of exudate. For descriptive analyses, mean and SD values were calculated. Paired sample t tests and linear regressions with a significance level of α < .05 were applied to analyze the evolution of peri-implant parameters and the influence of implant placement depth. Results: The overall mean marginal bone level alteration (DMBL) was 1.05 ± 0.69 mm. A statistically significant marginal bone loss over time was observed at the mesial and distal aspects of all implants (P < .05). The implant survival rate was 100%. No implants showed pain, exudate, mobility, or probing depth > 7 mm. Three implants were classified as having satisfactory survival due to a DMBL > 2 mm (resulting success rate: 92.1%). No influence of implant placement depth was found. Conclusion: These short-term results suggest that short implants can be used in mandibular molar sites for additional posterior support of free-end RPDs. However, in individual cases, DMBL > 2 mm may occur.
Lessons From ACST-2
Authors: Meschia James F. , Brott Thomas G.
Published: March 2022

The recent 130-center, international, second ACST trial (Asymptomatic Carotid Surgery Trial) involving 3625 patients found that regardless of whether a patient underwent stenting or endarterectomy, the periprocedural risk of disabling or fatal stroke was about 1% and the 5-year estimated risk of nonprocedural disabling or fatal stroke was 2.5%. With advances in technique, technology, and patient selection, stenting done by appropriately trained and experienced operators can achieve safety and efficacy comparable to endarterectomy for asymptomatic patients. The ongoing CREST-2 trial (Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Trial) will clarify whether revascularization, by either stenting or endarterectomy, remains an important therapeutic goal in the setting of modern intensive medical therapy.
Regret-Based Nash Equilibrium Sorting Genetic Algorithm for Combinatorial Game Theory Problems with Multiple Players
Authors: Konak Abdullah , Kulturel-Konak Sadan
Published: March 2022

We introduce a regret-based fitness assignment strategy for evolutionary algorithms to find Nash equilibria in noncooperative simultaneous combinatorial game theory problems where it is computationally intractable to enumerate all decision options of the players involved in the game. Applications of evolutionary algorithms to non-cooperative simultaneous games have been limited due to challenges in guiding the evolutionary search toward equilibria, which are usually inferior points in the objective space. We propose a regret-based approach to select candidate decision options of the players for the next generation in a multipopulation genetic algorithm called Regret-Based Nash Equilibrium Sorting Genetic Algorithm (RNESGA). We show that RNESGA can converge to multiple Nash equilibria in a single run using two- and three- player competitive knapsack games and other games from the literature. We also show that pure payoff-based fitness assignment strategies perform poorly in three-player games.
Cicero, Socrates, and the Fear of Death
Authors: Watton Matthew
Published: March 2022

This article examines the connections between the arguments against the fear of death in Plato’s Apology and the first book of Cicero’s Tusculan Disputations. It argues that Cicero’s dialogue adapts and develops Socrates’ arguments and dialectical method. Cicero signals this debt through his philosophically loaded translation of Ap. 40c-42a at Tusc. 1.97-99. But Cicero also casts Socrates as a foil, drawing an important contrast between Socrates’ philosophical stance and his own: while Socrates deploys irony to hide his view about the nature of death, Cicero advocates a particular form of skepticism that allows one to suspend judgment on certain matters, while nevertheless accepting certain ethically beneficial conclusions.
Mixed Disputes
Authors: De Herdt Sandrine W.
Published: March 2022

It is now clear that a dispute concerning sovereignty over land territory does not fall within the scope of a dispute concerning the interpretation or application of the United Nations Convention on the Law of the Sea (LOSC), unless the external issue arose as an incidental question in the application of the Convention. Less clear, however, is under what circumstances the competence of LOSC tribunals extend to the determinations of law that are ancillary/incidental to the main issue regarding a dispute concerning the interpretation or application of the Convention. This article brings together recent developments in LOSC jurisprudence regarding the issue of mixed disputes and points to some of the current uncertainties.
Great Expectations?
Authors: Stern Rebecca Thorburn
Published: March 2022

In the Nordic countries children’s rights generally hold a particularly high normative status. All Nordic countries except for Denmark have incorporated the key human rights treaty on children, the UN Convention on the Rights of the Child (the crc), into the domestic legal order, giving the crc status as domestic law. Drawing on wider literature to define a key set of “expectations on incorporation”, the article analyses the extent to which incorporation of the crc in the domestic legal order of four out of five Nordic countries has had an impact on legal developments in the Nordics in the wake of the 2015 “refugee crisis”. It is suggested that in asylum law, where the risk of a conflict of interest between the individual and the State in many ways is obvious, there seems to be significant room for improvement when it comes to the actual impact of the crc.
Operator-variable binding in the initial state: A cross-linguistic study of VP ellipsis structures in Chinese and English
Authors: Fangfang Guo , Foley Claire , Yu-Chin Chien , Chi-Pang Chiang , Lust Barbara
Published: March 2022

This paper investigates the claim that the binding relation between an operator and a variable is part of the innate language faculty, in accord with a theory of Universal Grammar. We present results of a study of the acquisition of VP ellipsis structures in Mandarin Chinese. Children from 3 years, 5 months to 6 years, 11 months show early knowledge of the ambiguity in sloppy identity structures and of operator-variable binding. Results are compared to those from an earlier parallel study in English (Foley, Núñez del Prado, Barbier, and Lust, 1992a,b,c).
Observations sur les particules na 那 et ye 也
Authors: Tsan-Hsiong Wang
Published: March 2022

A diachronic analysis on interrogative sentences syntax in Chinese shows that na 那 and ye 也, two particles employed during the Pre-Modern period in interrogative sentences expressing an alternative are basically different, though they seem to play a similar role. The present paper also describes the interactions between these two particles.
Three extreme cases of neutralisation: nasality, retroflexion and lip-rounding in Naxi
Authors: Michaud Alexis
Published: March 2022

New data on dialects of Naxi (a Sino-Tibetan language) allow for some progress in the analysis of their phonemic system. The present analyses bear on three contrasts: (i) between oral and nasal rhymes; (ii) between retroflex and non-retroflex coronal initials; and (iii) between syllables with and without lip-rounding. From a strictly synchronic point of view, these phenomena constitute extreme instances of neutralisation; from a diachronic point of view, their analysis provides some landmarks for reconstruction.
Mandarin dialect phylogeny
Authors: Baxter William H.
Published: March 2022

This paper investigates the phylogenetic relationships (the relationships of shared ancestry) of ten Chinese dialects: eight generally classified as Mandarin, and two others (Chángshā 長沙 and Hángzhōu 杭州). Using six of the Mandarin dialects, a ‘Proto-Macro-Mandarin’ (PMM) phonological system is reconstructed, from which the other four dialects also appear to be derivable. Taking 29 phonological innovations as a basis, the phylogeny of the ten dialects is estimated using a technique borrowed from biology (Camin-Sokal parsimony). The results suggest that a classification of Chinese dialects based on phylogeny could be rather different from the generally accepted classification.
The Value of Vale: Negotiating the Progressivity of Service in a Market Restaurant
Authors: Márquez Reiter Rosina , Cantarutti Marina Noelia
Published: March 2022

This paper examines the interactional functions of the Spanish conversational particle vale in the self-recorded service encounter interactions of a bidialectal restaurant server in an Ecuadorian restaurant in Madrid whose clientele are, by and large, of Ecuadorian descent.

The article details the sequential contexts in which vale is found as well as the grammatical and prosodic design of the turns where it is deployed, and contrasts its use with slots in the same dataset where alternatives were deployed instead. It also compares the findings with resonant descriptions from prior interactional studies of its English counterpart: okay, given the similarities in the interactional functions observed for vale.

Vale was identified as a standalone particle in third position during the ordering activity bearing rising or falling intonation to register the (in)completeness of the order and contingencies around it, and also as a turn-final agreement-eliciting tag with rising-falling intonation appended to announcements of imminent service to welcome clients or serve the dishes.
Association of Atherogenic Index of Plasma With Angiographic Progression in Patients With Suspected Coronary Artery Disease
Authors: Shui Xing , Chen Zefeng , Wen Zheqi , Tang Leile , Tang Wenyu , Liao Yixuan , Wu Zhen , Chen Lin
Published: March 2022

The present study aimed to explore the correlation of atherogenic index of plasma (AIP) with angiographic progression of coronary artery disease (CAD). AIP was defined as the base 10 logarithm of the ratio of the triglyceride to high-density lipoprotein cholesterol concentration. The extent of coronary lesion was assessed by the Gensini Score (GS) system and angiographic progression was defined as the GS rate of change per year >1 point. A total of 896 patients with suspected CAD who underwent coronary computed tomography angiography twice at intervals of >6 months were included. Baseline AIP was positively correlated with remnant cholesterol (r = .644, P < .001). When patients were assigned into four groups according to baseline AIP quartiles, the incidence of CAD progression significantly increased across the quartiles of AIP (Q1 [lowest]: 23.7 vs Q2: 29.9 vs Q3: 33.9 vs Q4 [highest]: 34.8%; P = .042). After multivariate adjustment, the odds ratio for CAD progression was 1.89 when comparing the highest to the lowest quartile of AIP (95% confidence interval: 1.18–3.02; P = .008). Therefore, AIP was independently correlated with angiographic progression of CAD beyond conventional risk factors, suggesting that AIP may play a role in early risk stratification as a simple surrogate of residual risk.
Views From the Margins: Exploring How Vulnerability Contributes to Shaping Men’s Identities in Informal Urban South Africa
Authors: Zweig Patricia
Published: March 2022

Globally, the proliferation of informal settlements continues unabated, challenging us to understand life in these risk-prone urban ‘hotspots’. Although women and children are vulnerable to risks in these marginalised environments, young men are more often considered generators of risk while their own susceptibilities are disregarded. Addressing this oversight, this study, undertaken in informal areas of Cape Town, South Africa, using a range of qualitative methods, investigated the vulnerabilities of young Xhosa men. The findings reveal conflicted masculine identities, shaped by the complex environments young men encounter in navigating life on the margins. Demonstrating the tensions shaping their identities and behaviour, the nature of their vulnerabilities is shown to be constructed over time in response to the changing landscapes young men encounter. It also reveals how they develop individualised defence mechanisms and coping strategies to survive in these environments, contesting the hegemonic forms of masculinity they are more often labelled with.
The Italian Left and Ben Bella’s Authoritarianism in Algeria, between Unconditional Support and Faint Criticism (1962–1965)
Authors: Roggero Caterina
Published: March 2022

Based on the intersection of primary and secondary sources, this article seeks to take stock of the position taken by the Italian Left, and in particular by the Italian Communist Party as regards Ben Bella’s authoritarianism (1962–1965). This position is taken into consideration regarding the so-called ‘1962 summer crisis’, the repressive measures against opposition groups and the 19 June 1965 coup d’état. This article argues that Partito Comunista Italiano (PCI) and partially Italian Left maintained an unconditional support for Ben Bella during his presidency. The relationship with Front de Libération Nationale was blindly defended and continued despite everything and everyone.
On Leadership: Why schools can’t “fail fast”
Authors: Starr Joshua P.
Published: March 2022

Business leaders tout the benefits of decision-making processes that disrupt the status quo and enable their companies to “fail fast” and then move on to the next things. As Joshua Starr explains, failing fast isn’t really an option for public school leaders who have to seek public approval for their decisions. And in contentious times, transparency in decision making is as important as ever. Those leaders who’ve taken the time to build relationships and share their decision-making processes with stakeholders will garner trust that will help when they make decisions that don’t work out as planned.
The Estimated Propensity to Issue Going Concern Audit Reports and Audit Quality
Authors: Chu Ling , Fogel-Yaari Hila , Zhang Ping
Published: March 2022

Auditors’ propensity to issue Going Concern Audit Reports (GCARs) is one of the proxies often used for audit quality. Although this propensity is a distinguishing characteristic of auditors, it does not indicate quality according to both theory and practice. In theory, higher quality auditors make fewer audit errors; they are more likely to issue GCARs to clients that deserve them and less likely to issue GCARs to clients that do not. Therefore, the propensity itself does not indicate quality. In practice, Public Company Accounting Oversight Board (PCAOB) inspection reports reveal that the GCAR is rarely mentioned as a deficiency, and in the few cases in which it is discussed, the deficiency is attributed to evidence gathering and estimations, rather than to the GCAR decision itself. The theory and practice motivate our study. This article investigates the empirical ability of the GCAR propensity to proxy for audit quality and finds that different samples and different models yield different determinations of auditor quality. Our findings caution against the use of the propensity to issue GCARs as a proxy for audit quality.
Level 3 Income and CEO Cash Compensation in the Financial Industry
Authors: Young Chaur-Shiuh , Tsai Liu-Ching , Hsu Hui-Wen
Published: March 2022

This article examines the role of fair value gains or losses related to Level 3 valuations in CEO cash compensation for U.S. financial firms. Our results show that Level 3 income is compensation-relevant. By separating Level 3 income into unrealized and realized Level 3 income, we find that CEO cash compensation is less sensitive to unrealized than realized Level 3 income, which indicates that compensation committees have a higher concern for the clawback problem associated with unrealized Level 3 income. A further analysis separating Level 3 income into positive and negative components shows that Level 3 losses are more compensation-relevant than Level 3 gains, thereby validating the argument that Level 3 losses are more credible than Level 3 gains. Overall, we find that Level 3 income is relevant for CEO cash compensation and that this phenomenon is mainly driven by its realized and loss components.
Review essay: When we talk about platforms and culture, what are we talking about?
Authors: Ye Zhen
Published: March 2022

In this essay, two recently published books, Platforms and Cultural Production, by Thomas Poell, David Nieborg, and Brooke Erin Duffy, and Instagram: Visual Social Media Cultures, by Tama Leaver, Tim Highfield, and Crystal Abidin, are reviewed. By placing these two books in dialog with each other, I aim to explore two ways to understand and analyze culture in the context of platform society. Firstly, culture can be understood as cultural commodities that are produced and consumed in a platform environment. Secondly, various social groups make use of platforms in distinct ways, and cultures emerge from these creative practices.
Disparities in Index of Care for Otolaryngologic Procedures Performed in Ambulatory and Inpatient Settings
Authors: Gadkaree Shekhar K. , McCarty Justin C. , Sajjadi Autefeh , Dresner Harley S. , Lindsay Robin W. , Varvares Mark A. , Friedlander David F. , Bergmark Regan W.
Published: March 2022

Objective

To compare the same surgical procedure performed in ambulatory and inpatient settings to determine the demographics associated with this selection, the differences in 30‐day revisit rates, and the total 30‐day cost of care.

Study Design

Retrospective cohort analysis.

Setting

Ambulatory and inpatient centers in Florida, New York, and Maryland.

Methods

The Healthcare Cost and Utilization Project, the State Ambulatory Surgery and Services Database, and the State Inpatient Database were used to identify patients undergoing commonly performed otolaryngologic procedures in 2016. The State Emergency Department Database and State Inpatient Database were used to identify 30‐day revisits.

Results

A total of 55,311 patients underwent an otolaryngologic procedure: 51,136 (92.4%) ambulatory and 4175 (7.6%) inpatient. Adjusted odds of receiving care in the ambulatory setting was significantly lower for Black patients (odds ratio, 0.69 [95% CI, 0.55‐0.85]; P =. 001) and nonspecified other races (odds ratio, 0.71 [95% CI, 0.52‐0.95]; P =. 001) as compared with White patients. Women had 1.16‐higher adjusted odds of undergoing a procedure in the ambulatory setting (95% CI, 1.05‐1.29; P =. 005). Insurance status and income were associated with location of care in the subcategorization of head and neck surgery. Adjusted inpatient procedure costs were significantly more than ambulatory (median, $59,112 vs $14,899); 30‐day adjusted costs were $71,333.07 (95% CI, $56,223.99‐$86,42.15; P <. 001) more expensive for inpatient procedures vs ambulatory; and the adjusted 30‐day odds of revisit were 2.23 times greater (95% CI, 1.44‐3.44; P <. 001) for ambulatory surgery across all procedures.

Conclusions

Disparities exist in the use of ambulatory settings to provide otolaryngologic surgery. Additional research is required to ensure equitable triaging of surgical care setting.
Cochlear Implantation in Adults With Single‐Sided Deafness: A Systematic Review and Meta‐analysis
Authors: Oh Samuel J. , Mavrommatis Maria A. , Fan Caleb J. , DiRisio Aislyn C. , Villavisanis Dillan F. , Berson Elisa R. , Schwam Zachary G. , Wanna George B. , Cosetti Maura K.
Published: March 2022

Objective

To determine the clinical outcomes of adult patients with single‐sided deafness (SSD) undergoing ipsilateral cochlear implantation.

Data Source

An electronic search of Medline and Embase articles.

Review Methods

A systematic review was performed with a search strategy developed by a licensed librarian to identify studies of adult patients with SSD who underwent ipsilateral cochlear implantation. Articles were managed in Covidence and evaluated by 2 independent reviewers. Risk of bias was assessed and data were extracted, including patient demographics, etiology of deafness, duration of deafness, and postoperative change in speech recognition, tinnitus, sound localization, and quality of life (QoL). A meta‐analysis was performed, and pooled mean differences were calculated for each outcome of interest via random effects models by each outcome, as well as subgroup analyses by the individual clinical score used.

Results

Of 2309 studies identified, 185 full texts were evaluated, and 50 were ultimately included involving 674 patients. Speech perception scores in quiet and noise, tinnitus control, sound localization, and QoL all significantly improved after implantation. Pooled outcomes demonstrated score improvements in speech perception (standardized mean difference [SMD], 2.8 [95% CI, 2.16‐3.43]), QoL (SMD, 0.68 [95% CI, 0.45‐0.91]), sound localization (SMD, −1.13 [95% CI, −1.68 to −0.57]), and tinnitus score reduction (SMD, −1.32 [95% CI, −1.85 to −0.80]).

Conclusions

Cochlear implantation in adults with SSD results in significant improvements in speech perception, tinnitus control, sound localization, and QoL.

Level of evidence: 2.
Histopathology and localization of SARS-CoV-2 and its host cell entry receptor ACE2 in tissues from naturally infected US-farmed mink (Neovison vison)
Authors: Ritter Jana M. , Wilson Tais M. , Gary Joy M. , Seixas Josilene N. , Martines Roosecelis B. , Bhatnagar Julu , Bollweg Brigid C. , Lee Elizabeth , Estetter Lindsey , Silva-Flannery Luciana , Bullock Hannah A. , Towner Jonathan S. , Cossaboom Caitlin M. , Wendling Natalie M. , Amman Brian R. , Harvey Robert R. , Taylor Dean , Rettler Hannah , Barton Behravesh Casey , Zaki Sherif R.
Published: March 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes respiratory disease in mink similar to human COVID-19. We characterized the pathological findings in 72 mink from US farms with SARS-CoV-2 outbreaks, localized SARS-CoV-2 and its host cellular receptor angiotensin-converting enzyme 2 (ACE2) in mink respiratory tissues, and evaluated the utility of various test methods and specimens for SARS-CoV-2 detection in necropsy tissues. Of SARS-CoV-2-positive animals found dead, 74% had bronchiolitis and diffuse alveolar damage (DAD). Of euthanized SARS-CoV-2-positive animals, 72% had only mild interstitial pneumonia or minimal nonspecific lung changes (congestion, edema, macrophages); similar findings were seen in SARS-CoV-2-negative animals. Suppurative rhinitis, lymphocytic perivascular inflammation in the lungs, and lymphocytic infiltrates in other tissues were common in both SARS-CoV-2-positive and SARS-CoV-2-negative animals. In formalin-fixed paraffin-embedded (FFPE) upper respiratory tract (URT) specimens, conventional reverse transcription–polymerase chain reaction (cRT-PCR) was more sensitive than in situ hybridization (ISH) or immunohistochemistry (IHC) for detection of SARS-CoV-2. FFPE lung specimens yielded less detection of virus than FFPE URT specimens by all test methods. By IHC and ISH, virus localized extensively to epithelial cells in the nasal turbinates, and prominently within intact epithelium; olfactory mucosa was mostly spared. The SARS-CoV-2 receptor ACE2 was extensively detected by IHC within turbinate epithelium, with decreased detection in lower respiratory tract epithelium and alveolar macrophages. This study expands on the knowledge of the pathology and pathogenesis of natural SARS-CoV-2 infection in mink and supports their further investigation as a potential animal model of SARS-CoV-2 infection in humans.
Predictors of Revictimization in Online Dating
Authors: Fereidooni Fatemeh , Daniels Judith , Lommen Miriam
Published: March 2022

Introduction: While a significant association between childhood maltreatment and sexual victimization in adulthood has been established in previous research, it is unknown whether this also applies to the context of online dating. Therefore, we aimed to investigate whether revictimization is common in online users and which mechanisms mediate this risk. Method: The participants were 413 heterosexual women aged between 18 and 35 who used mobile dating applications in the year before the assessment. The participants reported information on using mobile dating applications, motives for engaging in casual sex, protective dating strategies, and general motives for online dating. Results: Childhood maltreatment severity was positively related to both cyber and in-person sexual victimization severity. Motives related to regulating negative affect and self-esteem mediated the relationship between childhood maltreatment severity and in-person sexual victimization severity in adulthood. Furthermore, those motives moderated the association between cyber and in-person sexual victimization. The effect of cyber victimization on in-person sexual victimization was stronger at higher levels of affect/self-esteem regulatory sex motives compared to lower levels. The affect/self-esteem regulatory sex motives were not related to protective dating strategies. Discussion: The results of the study imply that a history of childhood maltreatment is a risk factor for sexual victimization in adulthood among young heterosexual women who use online dating. One of the factors linking these variables in this population might be affect/self-esteem regulatory sex motives. Future studies should aim at replicating these associations prospectively.
Electroacupuncture ameliorates neuroinflammation in animal models
Authors: Xin Yue-yang , Wang Jin-xu , Xu Ai-jun
Published: March 2022

Background:

Neuroinflammation refers to a wide range of immune responses occurring in the brain or spinal cord. It is closely related to a variety of neurodegenerative diseases, for which it potentially represents a new direction for treatment. Electroacupuncture (EA) is one method of acupuncture treatment, which can be used as an adjuvant therapy for many diseases. This review focuses on molecular mechanisms of EA in the reduction of neuroinflammation, summarizes relevant basic research and outlines future directions for investigation.

Findings:

A growing body of basic research has shown that EA can ameliorate neuroinflammation centrally (in animal models of ischemic stroke, Alzheimer’s disease, traumatic brain injury, spinal cord injury, Parkinson’s disease and vascular dementia) and peripherally (e.g. after a surgical insult or injection of lipopolysaccharide) and that its effects involve different molecular mechanisms, including activation of the α7 nicotinic acetylcholine receptor signaling pathway and P2 type purinergic receptors, inhibition of nuclear factor κB, and mitigation of damage secondary to oxidative stress and NOD-like receptor protein 3 inflammasome activation.

Conclusions:

EA is capable of regulating multiple cell signal transduction pathways to alleviate neuroinflammation in animal models. Although the findings of animal studies are encouraging, further prospective clinical trials are needed to verify the efficacy of EA for the treatment of neuroinflammation.
Preoperative electroacupuncture for postoperative nausea and vomiting in laparoscopic gynecological surgery: a randomized controlled trial
Authors: Zhu Juan , Li Sha , Wu Wenzhong , Guo Jie , Wang Xiaoqiu , Yang Guang , Lu Zhigang , Ji Fangbing , Zou Rong , Zheng Zhen , Zheng Man
Published: March 2022

Objective:

We aimed to evaluate the effectiveness and safety of preoperative electroacupuncture (EA) on the incidence of postoperative nausea and vomiting (PONV), and severity of postoperative pain, in gynecological patients undergoing laparoscopic surgery. The effects of EA administered at different preoperative time points were compared.

Methods:

A total of 413 patients undergoing elective laparoscopic gynecological surgery were randomly allocated into 4 groups receiving EA the day before surgery (Group Pre, n = 103), 30 min before (Group 30, n = 104) or both (Group Comb, n = 103), or usual care alone (Group Usual, n = 103). All acupuncture groups had usual care. The incidence of PONV and pain at 24 h were primary outcomes. Secondary outcomes included the severity of postoperative nausea, vomiting and pain, requirement for antiemetic medication and quality of recovery (QoR)-15 scores after surgery.

Results:

There were significant differences between the four groups in nausea and vomiting incidence (0–24 h), postoperative antiemetic use (0–48 h), and postoperative pain (0–6 h), with the EA groups recording the lowest levels. Regarding primary outcomes, incidence of nausea and vomiting at 6-24 h was 28/11/18/11% (p = 0.003) 23/5/8/9% (p < 0.001), respectively, for Groups Usual/Pre/30/Comb. Accordingly, EA reduced the incidence of nausea and vomiting at 6-24 h by 61/34/60% and 79/65/61% for Groups Pre/30/Comb, respectively. Regarding secondary outcomes, incidence of nausea and vomiting at 0-6 h was 20/9/11/7% (p = 0.013) and 17/7/9/6% (p = 0.021), respectively, for Groups Usual/Pre/30/Comb. Rescue antiemetics at 0–6 h were required by 18/4/11/4% (p = 0.001) in Groups Usual/Pre/30/Comb. The mean numerical rating scale (NRS) pain score (0–10) at 0–6 h was significantly different between groups (2.45/1.89/2.01/1.97 for Groups Usual/Pre/30/Comb, p = 0.024). There were no significant differences between the three EA-treated groups.

Conclusion:

In gynecological patients undergoing laparoscopic surgery and treated with multimodal antiemetic methods, one session of preoperative EA may be a safe adjunctive treatment for PONV prophylaxis. Optimal timing of EA requires further verification.

Trial registration number:

ChiCTR-INR-16010035 (Chinese Clinical Trial Registry).
Effect of hydric aging on the static and vibration behavior of 3D printed bio-based flax fiber reinforced poly-lactic acid composites
Authors: Kesentini Zeineb , El Mahi Abderrahim , Rebiere Jean-Luc , El Guerjouma Rachid , Beyaoui Moez , Haddar Mohamed
Published: March 2022

Moisture accumulation and life span in a hydric setting are major concerns for natural fibers used for the reinforcement of bio-based composites. This article discusses the effect of water aging on the mechanical properties of poly-lactic acid composites reinforced with flax fibers produced by 3D printing. Water absorption of composites is measured and it was observed that the bio-based composite seems to be Fick’s model with a percentage of absorption at saturation equal to 1.2%. To determine the effect of water absorption on static and vibration mechanical properties, various immersion periods are chosen. Water aging obviously influences the stiffness and tensile failure; so, a decline in the Young’s modulus from 2.2 to 1.7 GPa and in strength from 36 to 30.5 MPa is seen. Nevertheless, the damping factor shows an increase by about 16% as a function of the immersion period. These results could be explained by the plasticizing effect of water on bio-based composites, stimulated by moisture absorption.
Ethical decision-making confidence scale for nurse leaders: Psychometric evaluation
Authors: Birkholz Lorri , Kutschar Patrick , Kundt Firuzan Sari , Beil-Hildebrand Margitta
Published: March 2022

Background

Ethical decision-making confidence develops from clinical expertise and is a core competency for nurse leaders. No tool exists to measure confidence levels in nurse leaders based upon an ethical decision-making framework.

Aims

The objective of this research was to compare ethical decision-making among nurse leaders in the U.S. and three German-speaking countries in Europe by developing and testing a newly constructed Ethical Decision-Making Confidence (EDMC) scale.

Methods

The cross-sectional survey included 18 theory-derived questions on ethical decision-making confidence which were used to develop the scale.

Participants

A convenience sample of nurse leaders from the U.S. and three German-speaking countries in Europe who self-identified as holding a leadership position.

Ethical Considerations

Ethical approval was given by the IRB Board of a U.S. university. Participation in the survey implied voluntary consent.

Results

The scale’s item structure dimensionality and subscale’s reliability were analyzed and compared between nurse leaders from all four countries. A principal component analysis (PCA) produced a 15-item bi-dimensional EDMC scale yielding a skill-related (9-item) and a behavior-related (6-item) confidence dimension. EDMC subscales showed good-to-excellent internal consistency. In both subscales, U.S. nurse leaders rated their mean EDMC score higher than their German-speaking counterparts in Europe.

Discussion

This exploratory study is the first of its kind to focus on nurse leaders’ confidence regarding ethical decision-making in an international context. An overarching factor structure was identified, which is shared by the two samples of nurse leaders and to examine (sub)scales’ psychometric properties.

Conclusion

This newly developed scale is an effective tool for measuring ethical decision-making confidence in nurse leaders. The promising results of this study should be replicated to ensure validity and reliability of the EDMC scale measuring skill-related and behavior-related concepts and include nurse leaders from various cultural, social, and demographic groups.
Neighbourhood and the Perception of the Quality of Medical Treatment
Authors: Chugh Kabir , Gulati Namrata , Ray Tridip
Published: March 2022

Numerous studies have explored the role of the economic characteristics of a neighbourhood on the health status of its residents. We contribute to this work by examining the effects of the change in concentration of affluence on the perception of the quality of medical treatment received by the poor. We consider different neighbourhoods characterised by their level of prosperity. Based on the Asset Index, a particular primary sampling unit is identified as poor, middle or rich neighbourhoods to capture regional differences in the level of poverty. In each of these regions, we measure how the percentage of poor who claim that they were treated nicely varies with the change in the percentage of rich. The results reveal that, after a point, the probability of the perception of receiving superior treatment initially increases with an increase in the percentage of rich people and then starts declining. The principal component analysis is used to create weights in the asset index. The estimation is based on the nationally representative India Human Development Survey-2 (IHDS-2) household data collected in 2011–2012. We employ an ordered logit model for the analysis, as the perception of the quality of treatment, the dependent variable, is ordered in nature. Furthermore, we use Heckman’s two-step correction method to control for the plausibility of ‘self-selection’.

JEL: I14, I39
Percutaneous Mechanical Thrombectomy for Acute Symptomatic Iliofemoral Deep Venous Thrombosis Patients With Recent Aneurysmal Subarachnoid Hemorrhage
Authors: Nie Menglin , Fu Jian , Sun Jianming , Wang Haiyang
Published: March 2022

Purpose:

To investigate the efficacy, safety, and mid-term outcomes of percutaneous mechanical thrombectomy (PMT) for acute symptomatic iliofemoral deep venous thrombosis (DVT) patients with recent (within 4 weeks) aneurysmal subarachnoid hemorrhage (aSAH).

Materials and methods:

From January 2016 to February 2020, 11 acute symptomatic iliofemoral DVT patients with a recent history of aSAH were enrolled in this study. All patients had a history of aneurysm ligation or clipping previously, computed tomography (CT) scans revealed ventricular hemorrhage had been absorbed obviously and no residual aneurysm. The mean time of DVT onset after aSAH ictus was 19.2±4.5 days, and the mean Glasgow score was 6.8 ± 0.7 (range, 6–8). These patients underwent PMT with an 8 French Aspirex®S device (Straub Medical AG, Wangs, Switzerland), subsequent stenting was performed to relieve the underlying stenosis, followed by anticoagulation alone. The procedure-related complications were assessed after intervention. The follow-ups were conducted up to 1 year, the patency was evaluated via duplex ultrasonography, and the incidence of post-thrombotic syndrome (PTS) was evaluated using the Villalta scale.

Results:

Grade III (>90%) clearance was achieved in all 11 patients. Stenting was performed in 7 patients (63.6%). There were no cerebral rebleeding events or other severe complications except 1 puncture site bleeding during treatment. A total of 90.9% (10 of 11) of patients were alive at the 12 month follow-up, and 7 patients achieved a good functional outcome. At the 1 year follow-up, there was 1 patient (10%) with mild PTS. The ultrasound showed that the patency of the iliofemoral veins was 100%, and femoral valvular incompetence was observed in 1 patient.

Conclusion:

Percutaneous mechanical thrombectomy seems to be a feasible and safe treatment for acute iliofemoral DVT in selected patients with recent aSAH, and it shows promising results in restoring patency and reducing the risk of PTS.
Nanopore Detection of Cancer Biomarkers: A Challenge to Science
Authors: Bhatti Huma , Lu Zuhong , Liu Quanjun
Published: March 2022

Cancer is the most complex and leading cause of fatality worldwide. Despite meritorious research in the field of cancer, it is still a substantial threat to human life. In this article, we address a question on the present strategies and manifest the importance of critical biomarkers for cancer screening and early diagnosis before the symptoms appear. However, this goal can only be achieved if scientists will focus on ultra-sensitive detection techniques such as “Nanopore.” Nanopore sensing is a simple and rapid single-molecule detection technique that can detect multiple cancer biomarkers in femto-Molar concentrations in real time. Last but not least, we propose a systematic policy to win the war against cancer that is a big challenge to science.
Laparoscopic Reintervention for Intraperitoneal Leaks After Colonic Surgery: Do We Need a Routine Stoma?
Authors: Chen Yi-Chang , Fingerhut Abe , Tsai Yuan-Yao , Chang Sheng-Chi , Ke Tao-Wei , Shen Ming-Yin , Tzu-Liang Chen William
Published: March 2022

Introduction

No universal consensus exists on the management of intraperitoneal anastomosis leakage after colonic surgery. The aim of the study was to evaluate the outcomes of laparoscopic reintervention without stoma creation for intraperitoneal leaks after colonic surgery.

Material and Methods

Single tertiary center study conducted from January 2010 to December 2020. 54 patients with intraperitoneal leakage were divided into 2 groups according to whether they received a stoma (n = 37) or not (n = 17) during laparoscopic reintervention. Short term outcome was analyzed.

Results

Patients in the no stoma group had lower American Society of Anesthesiologists (ASA) score ( P = .009), lower Acute Physiology And Chronic Health Evaluation II (APACHE II) score (5 vs. 10; P < .001) compared with the stoma group. Intensive care unit admission (43.2% vs. 5.8%; P = .006) and major complications (35.1% vs. 5.8%; P = .015) occurred more in the stoma group compared to the no stoma group. After multivariate logistic regression analysis, initial surgical procedure ( P = .001) and APACHE II score ( P = .039) were significant predictors of no stoma. The APACHE II score( P = .035) was an independent predictor of major complications. Finally, Receiver Operating Characteristic curve analysis showed that the cutoff value of APACHE II score for no stoma was 7.5.

Conclusions

In our study, APACHE II score was an independent predictor of stoma formation and the cutoff value of APACHE II score for no stoma was 7.5. Our results need to be confirmed by larger and randomized studies. In particular, a specific APACHE II threshold to omit a stoma in this setting remains to be determined.
The Musical Experiences of Adults with Severe Sight Impairment: An Interpretative Phenomenological Analysis
Authors: Castle Claire L. , Greasley Alinka E. , Burland Karen
Published: March 2022

Research has shown that having a sight impairment (SI) may impact on participation in recreational and social activities. Yet, the musical lives of these individuals have seldom been explored, despite evidence of the importance of music to the lives of many, and the well-being benefits associated with musical engagement. The current study used semistructured interviews to explore the musical lives of 20 individuals living with a severe SI (SSI). Interpretative phenomenological analysis of interview transcripts identified four main themes: The importance of music and sound; Accessibility and inclusion in musical experiences; The impact of changing sight and changing perceptions on musical experiences; and Establishing identities in music. The study offers detailed insight into the musical lives of participants, identifying physical, social, and individual factors which impact on their musical engagement. Participants’ accounts highlighted the importance of music to their lives, as well as challenges experienced in relation to activities such as music listening, music-making, and attending live events. Findings demonstrate that while music may fulfill important functions in the lives of individuals living with SSI, musical participation may be impacted by issues of accessibility.
The Use of Intraoperative CT Hounsfield Unit Values for the Assessment of Bone Quality in Patients Undergoing Lumbar Interbody Fusion
Authors: Mertens Robert , Hecht Nils , Bauknecht Hans-Christian , Vajkoczy Peter
Published: March 2022

Study Design

Retrospective Cohort Study

Objective

To evaluate the accuracy of intraoperatively measured computed tomography (CT) Hounsfield unit (HU) values by comparison with preoperative CT HU values and to compare the radiation exposure between preoperative and intraoperative CT scans.

Methods

HU values of lumbar vertebrae were measured and compared between preoperative and intraoperative CT scans in patients undergoing lumbar interbody fusion. In patient group one, Canon CT scanners were used preoperatively and the AIRO CT scanner was used intraoperatively. In patient group two, Canon CT scanners were used preoperatively and the O-arm Cone Beam CT (CBCT) scanner was used intraoperatively. In a subgroup analysis of patient group one, radiation by means of CT Dose Index (CTDI) was compared between Canon and AIRO CT scanners.

Results

In the first patient group, a total of 250 vertebrae were analysed in 74 patients showing a strong Pearson correlation of >.94 between pre- and intraoperative HU values. Bland-Altman analysis indicated consistency and equivalence with a bias of 3.9 and 95% limits of agreement from −27.17 to 34.97 when comparing all pre- and intraoperative HU values of L1–5. In the second patient group, a total of 27 vertebrae were analysed in 10 patients showing weak Pearson correlation and Bland-Altman analysis indicated no equivalence. CTDI did not differ between Canon and AIRO CT scanners.

Conclusion

Correct and reliable CT HU measurement as mandatory key factor for the intraoperative assessment of bone quality and robotic-assisted surgery is feasible with intraoperative AIRO CT imaging without increase of radiation exposure.
‘Best day since the bad germs came’: Exploring changing experiences in and the value of coastal blue space during the COVID-19 pandemic, a Fylde Coast case study
Authors: Earl Joseph , Gormally-Sutton Alexandra , Ilic Suzana , James Mike R
Published: March 2022

Blue spaces have long been associated with beneficially impacting human health and wellbeing. This article reflects upon the impact of the COVID-19 pandemic on people’s experiences in coastal blue space and the health and wellbeing benefits derived from exposure to the space. Undertaken after the UK’s first lockdown during Summer 2020, the work employed a qualitative mixed methods approach through a survey and interviews to provide an in-depth case study of people’s experiences in and value of coastal blue space before and during the pandemic on the Fylde Coast in Lancashire. Findings show that participants valued the physical and mental health benefits derived from routine visits to coastal space, stimulated by emotional connections, a sense of escape and sensorial immersion. However, a busier coast in the lockdown’s aftermath provoked a changed experience in coastal space for many participants due to a detachment from coastal space and the provoking of negative emotional experiences driven by heightened fears, reduced safety and increased litter. Mitigatory responses, through a changed coastal routine, and reflective responses, through a changed value of the coast, were found, the latter due to an increased appreciation of the health benefits from coastal exposure for some participants. Importantly, the findings highlight the need for coastal management to account for these experiences in protecting the health value of coastal space.
Executing Lung Sonography to Assess Acute and Chronic Disease: Can These Techniques Be Used to Monitor Adults and Children Surviving COVID-19?
Authors: Evans Kevin D. , Bloom Isaiah W. , Al Sultan Huriah
Published: March 2022

Lung ultrasonography (LUS) has been used as a clinical diagnostic tool for the location of pleural fluid and marking patients for a thoracentesis, for decades, but has not been deemed as appropriate for other diagnostic uses. In the context of the COVID-19 pandemic, the necessity of a portable, low-cost, and non-ionizing diagnostic choice is needed to assess patient lungs. LUS has become a strong candidate to fill this diagnostic gap. With the use of Lichtenstein’s bedside LUS in emergency (BLUE) protocol, LUS may have potential to diagnose lung disease and assist with treatment decisions. While evidence of LUS as a COVID-19 diagnostic tool is not conclusive, early diagnostic results are promising. Further research on the use of LUS and the clinical implementation of the technique have a true potential to improve patient outcomes.