bluuebunny/crossref_metadata_2025 huggingface dataset:
Contested intersections: Asexuality and disability, illness, or trauma
Authors: Kurowicka Anna
Published: May 2023

This article analyzes the personal writings of asexual people for whom their identity is connected to disability, illness, or trauma. Asexuality is typically understood as an inherent sexual orientation that is neither caused by nor linked to disability or physiological and psychological issues. This approach has allowed asexuality to be widely accepted as an element of human sexual diversity and protects asexual people against unwanted medical intervention. Yet, disability, illness, or trauma informs some asexual people’s sexuality. Attending to their perspectives results in broadening contemporary conceptualizations of asexuality beyond the model of essentialist sexual orientation and contributes to destigmatizing asexual identities that are entangled with disability, illness, or trauma.
Trends in adolescent mental health problems 2004–2020: Do sex and socioeconomic status play any role?
Authors: Buli Benti Geleta , Larm Peter , Nilsson Kent , Giannotta Fabrizia
Published: May 2023

Aims:

This study aims to investigate trends in four types of adolescent mental health problems; that is, psychosomatic symptoms, depressive symptoms, suicidal ideations, and suicide attempts 2004–2020. A second aim is to investigate the moderating roles of socioeconomic status and sex in these trends.

Methods:

The analysis is based on repeated cross-sectional data 2004–2020 among grade 9 students in secondary schools in a Swedish county. In total, data from 19,873 students were included in the analysis. We fitted linear and logistic regression equations and used survey-years’ coefficients to estimate the trends. We also estimated the moderating effects of socioeconomic status and sex using interactions between survey year and socioeconomic status and sex, respectively.

Results:

The trends in all mental health problems declined over time. Through its interaction with survey year, socioeconomic status moderated the trends; psychosomatic symptoms (B = −0.115, P<0.001), depressive symptoms (B = −0.084, P<0.001) and suicidal ideations (odds ratio 0.953, confidence interval 0.924–0.983) significantly declined over time among those with high socioeconomic status. However, socioeconomic status did not have an association with the trend in suicide attempts. Interaction between sex and year of survey was associated with significant decreasing trends in depressive symptoms and suicidal ideations only among girls.

Conclusions:

Adolescent mental health problems have decreased over time, but only for adolescents with high socioeconomic status, or only in depressive symptoms and suicidal ideations for girls. The results shed light on the growing inequalities in health outcomes across levels of socioeconomic status.
Management of traumatic fracture–dislocation of the shoulder in children: A systematic review of published case reports
Authors: Ikram Mohammad Arshad , Burud Ismail , Akbar Zainab , Fadhlina Binti Hisham Sharifah
Published: May 2023

Purpose

Proximal humerus fracture occurring simultaneously with shoulder dislocation in children is extremely rare, with only a few reports of such cases having been reported. A systematic review of case reports was conducted to document outcomes after different treatment methods.

Methods

A systematic search of literature from 1980 to 2021 was performed from the PubMed/Medline, ScienceDirect, and SCOPUS databases. All case reports on traumatic fracture dislocation of the shoulder in children were included.

Results

A total of 18 studies were included with a mean follow-up of 1.5 years. There were 7 boys and 11 girls with an age range from 11 months to 16 years with a median of 6 years. These cases were grouped into two, based on the involvement of the epiphysis with fracture–dislocations. In group A, there were 11 cases (61%) of shoulder dislocation involving the epiphysis. While in group B, there were seven (38%) cases with fracture metaphysis but not involving the epiphysis. Both groups were treated by closed or open reduction with or without internal fixation. All fractures healed in a mean of 7 weeks while the full function was achieved in an average of 21.58 weeks.

Conclusion

This systemic review supports the treatment of patients in group A by open reduction with K-wire fixation. While in group B, closed reduction with intramedullary fixation is a better option as it provides satisfactory clinical and radiological results in a short time.
Effect of maxillary anterior supernumerary tooth extraction on the underlying malocclusion
Authors: Cholakova Radka , Georgiev Konstantin
Published: May 2023

Introduction:

Orthodontic discrepancies are a common finding in patients with supernumerary teeth (ST). The presence of a ST can cause a number of orthodontic discrepancies, including delayed eruption or retention of adjacent teeth, crowding, spacing, and abnormal root formation. The aim of the present study was to assess the effect of extraction of an anterior supernumerary tooth on the underlying orthodontic discrepancies without additional treatment for a 6-month period.

Methods:

This was a prospective, longitudinal, observational, study. It included 40 participants with orthodontic malocclusions due to maxillary anterior supernumeraries. We examined the changes in the crowding and excessive space in the anterior and posterior segments on cast models.

Results:

In the group that presented with crowding, a statistically significant decrease of 0.95 ± 0.17 mm ( P < 0.001) was found between T0 and T1. Of the participants, three exhibited full self-correction. The excessive space at T0 (3.06 mm) decreased by 1.78 ± 0.19 mm to T1 (1.28 mm) in the anterior segment. Seven participants showed full self-correction of the diastemas after the 6-month observation period.

Conclusion:

The results imply that orthodontic treatment can be postponed for at least 6 months after the extraction of the supernumerary tooth as potential self-correction can be expected. This natural alleviation of the malocclusions may make the orthodontic treatment simpler, shorten the treatment time and decrease overall appliance wear time.
Contextualizing Collaborative Planning: Addressing Water Resilience in the Urban Poor Settlements of Ranchi
Authors: Mohan Anjali Karol
Published: May 2023

The research embarks from the standpoint that unequal geographies of service delivery in the Southern city evidence differentiating practices embedded within dominant rational planning practices. It aligns and responds to the call of Southern urban theorists to develop alternative planning practices by anchoring within the socio- spatial specificities of Southern urbanisms. Foregrounding this objective, the research turns to the collaborative planning model and its pragmatic tradition of resisting the subjugating tendencies of instrumental rationality by admitting new ways of knowing and being from the life-world. Drawing upon a multi-actor collaboration that sought to address the circumstance of water insecurity in the urban poor settlements of Ranchi city, the research uses Healy’s (1997) Forum, Arena and Courts as entry points to frame on-ground recursive and collaborative interventions. These include unpacking the context to frame and implement interventions that sought to enhance water security while operationalising supporting actions that aim to sustain the interventions. Within this framing, the paper draws upon the critiques of the collaborative planning model as standpoints for contextual reinterpretation to foreground a) the importance of empowering strategic actors at the bottom of socio-political hierarchies to lead the process; b) conceptualize consensus as a process rather than an end-point recognizing its intrinsic relationship with conflict; and, c) institutionalizing formalized yet flexible processes for consensus-building. Overall the paper argues that collaborative planning with its focus on the particularities of place and on the human capacity to invent, create, and transform presents a viable starting point for resisting the dominating confines of instrumental rationality in significant ways.
Recent Advances in Photothermal Therapies Against Cancer and the Role of Membrane Transporter Modulators on the Efficacy of This Approach
Authors: Al-Ali Ahmed A. Abdulhussein , Al Ward Nameer , Obeid Mohammad A. , Uhd Nielsen Carsten , Mulheran Paul A. , Al Qaraghuli Mohammed M.
Published: May 2023

Recently, much research is focused on the use of photothermal therapy (PTT) as an advanced method to treat various types of cancer. The PTT approach primarily utilizes nanoparticles (NPs) made from metals, carbon, or semiconductors that can convert near-infrared laser irradiation, which penetrates tissues, into local heat that induces cancer cell death. An alternative approach is to utilize NPs (such as liposomes) to carry suitable dye molecules to the same end. Numerous studies concerning PTT have shown that local heat released in cancer cells may suppress the expression of membrane transporter proteins such as P-glycoprotein (P-gp) and multidrug resistance-associated protein 1 (MRP1), thus enhancing cytotoxicity and reverse multidrug resistance. In addition, because NPs may be loaded with different substances, researchers have designed multifunctional NPs for PTT by including several agents such as membrane transporter modulators, anticancer drugs, and photothermal agents. This review will focus on the recent advances in PTT utilizing various types of NPs, and their components and characteristics. In addition, the role of membrane transporters in PTT will be highlighted and different methods of transporter modulation will be summarized from several PTT studies in which multifunctional NPs were used to treat cancers in vitro and in vivo.
Somatic Variants and Surgical Epilepsies: Search and You Will Find
Authors: Andrade Danielle M.
Published: May 2023

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Midazolam, Ketamine, and Propofol: While We Slept, Others Worked on Anesthetizing Infusions for Refractory Status Epilepticus
Authors: Vossler David G.
Published: May 2023

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Development and Implementation of an Emergency Action Plan in Football
Authors: Maher Justin D. , Weiss Leigh
Published: May 2023

Although uncommon, life-threatening injuries and illnesses do occur in American football, and the emergency response team must be ready to act when an emergency arises during training, practice, or competition. An emergency action plan (EAP) is central to the care of an athlete with a suspected life-threatening injury or illness. This set of step-by-step instructions on how the emergency response team will act during an emergency details the members of the team and their roles, plus information on emergency equipment, procedures at each venue, and the transportation of a player to the hospital. The emergency response team should keep the EAP up-to-date and rehearse annually.
Community-Based Participatory Gender and Sexualities Research With LGBTQ+ People With Intellectual and/or Developmental Disabilities
Authors: Hughes Oscar E. , Santinele Martino Alan
Published: May 2023

In this article, we discuss practical lessons for promoting meaningful collaboration in inclusive and community-based participatory gender and sexualities research with LGBTQ+ people with intellectual and/or developmental disabilities. First, we describe the historical and ongoing exclusion from research engagement of people with intellectual and/or developmental disabilities and the importance of including LGBTQ+ people with intellectual and/or developmental disabilities in inclusive and community-based research projects that address gender and sexuality. Then, we provide reflections on how we are striving to embrace core principles of community-based participatory research in our current gender and sexualities research projects. Finally, we end with a call to action for future meaningful and collaborative research that addresses gender and sexuality in the lives of people with intellectual and/or developmental disabilities.
The numerical and experimental analysis of ratcheting behavior for 304 steel sheets under cyclic axial loading
Authors: Shahrjerdi Ali , SafariFard Ali
Published: May 2023

The present study examines the effect of the thickness, cutouts numbers, and different cutouts shapes on the ratcheting behavior of 304 steel sheets under cyclic axial loading. The cutout shapes considered here are circular, triangular, and square cutouts. The effect of the number of circular cutouts in 304 steel sheets on ratcheting behavior is investigated. The Instron 8502 device is used to perform the experiments in which the cyclic axial loading is applied to six specimens with different cutouts and thicknesses at ambient temperature. The obtained results highlight the fact that reducing the thickness and increasing the number of cutouts in the sheets are attributed to the rise in the ratcheting displacement. Accordingly, the ratcheting displacement is more striking in the sheets with triangular cutouts. Notably, a numerical analysis is considered using the isotropic/kinematic nonlinear hardening model and FEM in ABAQUS software. Since a good agreement is seen between the numerical and experimental results, the analysis conducted in this study is reliable in terms of accuracy and authenticity.
A single-centre protocol using low-dose urokinase for catheter-directed thrombolysis in the treatment of acute lower limb ischaemia
Authors: Shi Tao , Zhang Yongbao , Shen Chenyang , Fang Jie
Published: May 2023

Objectives

Catheter-directed thrombolysis is one of the main treatments for acute limb ischaemia. Urokinase is still a widely used thrombolytic drug in some regions. However, there needs to be a clear consensus on the protocol of continuous catheter-directed thrombolysis using urokinase for acute lower limb ischaemia.

Methods

A single-centre protocol of continuous catheter-directed thrombolysis with low-dose urokinase (20,000 IU/hour) lasting 48–72 h for acute lower limb ischaemia was proposed based on our previous experiences. A retrospective study from June 2016 to December 2020 was conducted to evaluate the efficacy and safety of this protocol. The target lesion revascularisation, amputation and death were also monitored during follow-up. The Kaplan–Meier estimator was used for the subgroup analysis, and univariate and multivariate Cox regression analysis was applied to identify risk factors for reinterventions and death.

Results

90 lower limbs were involved, including 51 Rutherford Grade I, 35 Grade IIa and four Grade IIb. During a 60.8-h thrombolysis, 86 cases (95.5%) were considered effective according to the angiogram. No major bleeding complication occurred during thrombolysis, and one amputation occurred after. Freedom from target lesion revascularisation, amputation and death were 75.6%, 94.4% and 91.1% during a mean 27.5-month follow-up, respectively. According to the Kaplan–Meier estimator, aortoiliac lesions had lower reintervention rates than femoropopliteal lesions (Log-rank p = 0.010), and cases without narrowing atheromatous plaque had a lower reintervention rate (Log-rank p = 0.049). Age was an independent risk factor for death ( p = 0.038, hazard ratio 1.076, 95% confidence interval 1.004–1.153).

Conclusions

The single-centre protocol of catheter-directed thrombolysis we proposed for acute lower limb ischaemia was effective and safe. Strict blood pressure control during catheter-directed thrombolysis ensured safety. Aortoiliac lesions and cases without narrowing atheromatous plaque had lower reintervention rates during follow-up.
Rebound Hypoglycemia and Hyperglycemia in Type 1 Diabetes
Authors: Hansen Klavs W. , Bibby Bo M.
Published: May 2023

Aims:

The aim was to investigate rebound hypoglycemic and hyperglycemic events, and describe their relation to other glycemic metrics.

Methods:

Data from intermittently scanned continuous glucose monitoring were downloaded for 90 days for 159 persons with type 1 diabetes. A hypoglycemic event was defined as glucose <3.9 mmol/l for at least two 15-minute periods. Rebound hypoglycemia (Rhypo) was a hypoglycemic event preceded by glucose >10.0 mmol/l within 120 minutes and rebound hyperglycemia (Rhyper) was hypoglycemia followed by glucose >10.0 mmol/l within 120 minutes.

Results:

A total of 10 977 hypoglycemic events were identified of which 3232 (29%) were Rhypo and 3653 (33%) were Rhyper, corresponding to a median frequency of 10.1, 2.5, and 3.0 events per person/14 days. For 1267 (12%) of the cases, Rhypo and Rhyper coexisted. The mean peak glucose was 13.0 ± 1.6 mmol/l before Rhypo; 12.8 ± 1.1 mmol/l in Rhyper. The frequency of Rhyper was significantly ( P < .001) correlated with Rhypo (Spearman’s rho 0.84), glucose coefficient of variation (0.78), and time below range (0.69) but not with time above range (0.12, P = .13).

Conclusions:

The strong correlation between Rhyper and Rhypo suggests an individual behavioral characteristic toward intensive correction of glucose excursions.
Effectiveness of Injury Prevention Programs With Core Muscle Strengthening Exercises to Reduce the Incidence of Hamstring Injury Among Soccer Players: A Systematic Review and Meta-Analysis
Authors: Al Attar Wesam Saleh A. , Husain Mohamed A.
Published: May 2023

Context:

Muscles in the hamstring group are frequently injured in sporting activities. Injury prevention programs (IPPs), including eccentric training of the hamstrings, have proven to be of great value in decreasing the injury rate of hamstring muscles.

Objective:

To examine the effectiveness of IPPs that include core muscle strengthening exercises (CMSEs) in reducing hamstring injury rates.

Data Sources:

This systematic review with meta-analysis was based upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted for relevant studies published from 1985 to 2021 using the following databases: Cochrane Library, MEDLINE, AMED, PubMed, Web of Science, and Physiotherapy Evidence Database (PEDro).

Study Selection:

The initial electronic search found 2694 randomized controlled trials (RCTs). After removing duplicate entries, 1374 articles were screened by their titles and abstracts, and 53 full-text records were assessed, of which 43 were excluded. The remaining 10 articles were reviewed in detail, from which 5 studies met our inclusion criteria and were included in the current meta-analysis.

Study Design:

Systematic review and meta-analysis of RCTs.

Level of Evidence:

Level 1a.

Data Extraction:

Two researchers independently completed the abstract review and performed full-text reviews. A third reviewer was consulted to reach a consensus if any discrepancies were noted. Details were recorded about the participants, methodological aspects, eligibility criteria, intervention data, and outcome measures, including age; number of subjects in the intervention/control group; number of injuries in each group; and the duration, frequency, and intensity of the training conducted in the intervention.

Results:

The pooled results of 4728 players and 379,102 exposure hours showed 47% hamstring injury reduction per 1000 h of exposure in the intervention group compared with the control group with an injury risk ratio of 0.53 (95% CI [0.28, 0.98], P = 0.04).

Conclusion:

The results indicate that CMSEs incorporated with IPPs reduce susceptibility and risk of hamstring injuries in soccer players.
A Movement Matured: Results of a Co-citation Analysis, and Some Reflections on the Relations Between Social Structure and Ideas in Futures Studies
Authors: Dayé Christian
Published: May 2023

Scholars and practitioners have long criticized the inherent dominance of Western ideas in futures studies and claimed the need for a de-centering or decolonizing of the field. As a process of transforming science, de-centering occurs on at least two levels: at the level of thought and at the level of social structure. Sociologists of science, Science and Technology Studies (STS) scholars, and others have conducted research for many years on the interlinkages between social structures and knowledge structures and have developed several concepts to do so. In this article, I discuss some of these concepts and combine these theoretical conceptualizations with a co-citation analysis of recent publications in the futures studies. Based on a sample of futures studies publications that have appeared in the last ten years (n = 500) retrieved from the Web of ScienceTM database, a strongly inter-related network with four clusters can be identified. The works in each these four clusters are related in terms of their subject matter. They concern (1) the politico-intellectual program of futures studies, (2) their epistemological foundations, (3) questions of methodology, and (4) scenarios as the core technique of futures thinking. Both the works and their authors come from a broad variety of cultural backgrounds; they also display a relatively high number of co-citations with works in clusters other than their own. Taken together, these findings indicate that the information space sampled in this study to represent futures studies has already become de-centered to a large degree, both at the level of social structure and at the level of thought.
Adverse drug reactions and associated factors in multidrug-resistant tuberculosis: A retrospective review of patient medical records at Mbarara Regional Referral Hospital, Uganda
Authors: Kushemererwa Oliver , Nuwagira Edwin , Kiptoo Joshua , Yadesa Tadele Mekuriya
Published: May 2023

Objectives:

The World Health Organization pragmatic guidelines recommend shorter duration drug regimens with newer, more efficacious agents for treatment of multidrug-resistant tuberculosis. However, adverse drug reactions associated with the use of newer, second-line agents may pose a major barrier to adequate management of multidrug-resistant tuberculosis. We therefore sought to investigate the prevalence and factors associated with adverse drug reactions among patients with multidrug-resistant tuberculosis.

Methods:

We retrospectively reviewed patient medical records at the tuberculosis treatment unit of Mbarara Regional Referral Hospital, between January 2013 and December 2020. Medical records were included in the study, if the patients were aged ⩾18 years, tested sputum positive for multidrug-resistant tuberculosis, with adequate pharmacovigilance data documented. We assessed all documented health-related patient complaints, deranged laboratory values, and clinician suspected adverse drug reactions for scientific/clinical plausibility. Adverse drug reactions were confirmed using published and manufacturer drug references materials. A multidisciplinary clinician team was involved to decide whether to exclude or include a suspected adverse drug reaction.

Results:

About 6 in 10 (67.4%; 120/178) patients experienced at least one adverse drug reactions during treatment, of which 18.3%, 14.6%, and 11.4% of adverse drug reactions affected the endocrine/metabolic, otic, and musculoskeletal body systems, respectively. Majority of the adverse drug reactions were probable and had a moderate severity. There was an upward trend in adverse drug reaction incidence between 2015 and 2019. Adverse drug reaction occurrence was associated with previous adverse drug reaction history (adjusted odds ratio = 2.85 (1.08, 7.53 at 95% confidence interval)); however, patients who were underweight (adjusted odds ratio = 0.34 (0.16, 0.69 at 95% confidence interval)) and those treated with bedaquiline-based drug regimens (adjusted odds ratio = 0.2 (0.07, 0.59 at 95% confidence interval)) were less likely to experience an adverse drug reaction.

Conclusion:

Majority of patients with multidrug-resistant tuberculosis experience at least adverse drug reaction during the course of treatment. The newer standard shorter duration drug regimens (9–12 months) may be associated with intolerable adverse drug reactions that hamper effective management of multidrug-resistant tuberculosis. There is need for more studies to assess the clinical adverse drug reaction burden associated with the implementation of shorter duration regimens.
A cross-sectional survey of English NHS Trusts on their uptake and provision of active bystander training including to address sexual harassment
Authors: Robertson Ava , Steele Sarah
Published: May 2023

Objective

Reports identify that sexual harassment is troublingly pervasive in the NHS. Active bystander training (ABT) has been promoted to address sexual harassment, alongside other forms of poor behaviour, discrimination, and harassment. We explore ABT across all English NHS Trusts and determine whether the programmes address sexual misconduct in the training content.

Design

Freedom of Information requests asking whether Trusts offer ABT, and if so, about the programme content and delivery, and to NHS England on centrally commissioned ABT.

Setting

213 NHS Trusts in England, and NHS England.

Participants

Not applicable.

Main Outcome Measure

Provision of ABT, and presence of sexual harassment content in the training.

Results

199 Trusts responded by August 2022. Of these, 35 Trusts provide ABT, the majority of which deliver content that is not specific to sexual misconduct, are in London, outsource training using private providers, and only provide workshops on an opt-in basis. One Trust offers a standalone ABT module on sexual harassment. Private providers prohibit Trusts from sharing training material, inhibiting content analysis and evaluation. Among the 163 Trusts without ABT programmes, only 23 (13%) have plans to implement training.

Conclusions

ABT is underutilised in the NHS, despite being identified as an effective intervention in other settings like the military, higher education, and government workplaces. Studies should explore whether wider NHS adoption is warranted. Robust monitoring and evaluation processes are critical to strengthening the available literature regarding the effectiveness of ABT in the healthcare context and engaging in global knowledge sharing across health systems.
The usability testing of the integrated electronic healthcare services for diabetes mellitus patients during the pandemic in Indonesia
Authors: Fitria Najmiatul , Idrus Lusiana , Putri Ayuthya Rizky , Sari Yelly Oktavia
Published: May 2023

Introduction

Diabetes mellitus is a degenerative disease that obliges patients to take continuous healthcare services. During a pandemic situation, all access to healthcare facilities becomes limited. A web-based integrated electronic-healthcare system (IeHS) study was used to overcome this problem. This study aimed to describe patients’ ability to access and understand this web-based application.

Method

An observational study using a web-based IeHS took place in Muara Tebo, Indonesia, in 2021. A total of 82 outpatients with diabetes mellitus participated in this study. These patients belonged to local community-based diabetes mellitus. Only adult patients accustomed to using smartphones were invited to participate in this study. All participants were taught to access the web-based application through video recordings. They were asked to fill out the form regarding their understanding of the web-based integrated e-healthcare application. This form was sent online.

Results

From the calculation of the usability scale, the results show that patients have not been able to take advantage of this application in life (the system usability scale (SUS) score 63.38). There is no significant difference between patients’ characteristics and the SUS score.

Conclusion

Participants’ condition in this study reflects the general state of outpatients. The ability of these participants to access an internet-based application was related to their education level. This condition becomes a challenge for policymakers to improve local human resources to increase their health literacy.
Environmental, Social and Governance Performance Disclosure and Market Value: Evidence from Jordan
Authors: Al Amosh Hamzeh , Khatib Saleh F. A.
Published: May 2023

Our article seeks to investigate the impact of ESG disclosure in its three dimensions, both collectively and individually, on the market value of Jordanian-listed companies from 2012 to 2019. Using a sample of 173 companies listed in ASE, 1,384 observations were collected. The findings indicate that environmental and social disclosure maximize companies’ market value, and the ESG disclosure collectively has positively affected the market value. At the same time, the results do not show any important role in governance. This indicates that companies pay close attention to various stakeholders, particularly external stakeholders, and wish to increase trust and transparency by disclosing their ESG performance. As a result, companies’ confidence in the capital markets is reinforced, and improved disclosure practices positively affect market value. This study adds an empirical contribution to the literature by investigating the influence of sustainability reporting on companies’ market value in the context of emerging economic countries.
Nutritional quality of snacks and beverages sold through vending machines in a large Hispanic-serving urban college campus in the United States: A cross-sectional study
Authors: Samuel Lalitha , Odoom-Darko Ellen , Rosario Suilan Jon del , Blake Charmaine
Published: May 2023

Students from nutritionally-vulnerable neighborhoods face dietary challenges through built environment of college vending machines. In this cross-sectional study, snacks and beverages sold in vending machines for a 4-week period in a Bronx-based Hispanic-serving college were recorded. Nutritional information was recorded from nutrition labels. Proportion of low- and high-sodium foods, “smart snacks” with a limit of 200 kcal and 200 mg of sodium, and foods with added sugar were recorded. Snacks had significantly higher calories and sodium per serving (227 kcal, 208 mg) than beverages (132 kcal, 90 mg) ( t-test, p < 0.001). Almost a third of the snacks (32%) qualified as “smart snacks” for calories and 62% qualified as “smart snacks” for sodium. Beverages contained less than half the number of ingredients as snacks. About 53% of beverages and almost 60% of snacks listed sugar among the first five ingredients. Results underscore the need for colleges to promote less-processed entities with less added sugar.
Solitary Extremity Schwannoma: A 20-Year Review of Outcomes
Authors: Currie Rachel V. , McGarry Kevin M. , Martin Serena V. , Robinson Andrew J. , Lewis Harry
Published: May 2023

Background: Reports on benign peripheral nerve sheath tumour extirpation over the last number of decades describe varying patient outcomes. We present our outcomes following excision of solitary extremity schwannoma over a 20-year period. Methods: A regional histopathology review was conducted for, “benign nerve sheath tumour” and schwannoma between 2000 and 2020. This search provided 131 histologically confirmed schwannomas that were excised from the extremities of 123 patients. Individual charts were reviewed retrospectively to establish presenting features and post-operative outcomes. Results: One hundred and twenty three patients underwent schwannoma excision, including 8 patients with synchronous tumours. The mean age at presentation was 49 years (range 11-92 years). The most common presenting symptoms were the following: palpable mass (88%), pain (70%), paraesthesia (21%), numbness (13%), and motor deficit (4%). Post-operative follow-up ranged from 1 to 168 months (mean 12.3 months) (N  =  99). Fifty-eight cases reported complete resolution of symptoms by end of outpatient follow-up (59%). The remaining reported either residual or new numbness (21%), paraesthesia (11%), pain (10%), weakness (4%), hypertrophic or keloid scar (3%), or a combination. Thirty patients (30%) developed new symptoms post-operatively including numbness (13%), paraesthesia (10%), pain (2%), and weakness (2%). There was a trend towards higher risk of post-operative pain, numbness or paraesthesia in patients undergoing excision of schwannomas on larger mixed nerves than in patients undergoing excision on smaller sensory nerves ( P  =  .0531). Conclusion: Surgical excision of benign schwannomas is a successful procedure, especially for pain management, however, complete symptom resolution cannot be guaranteed, and the risk of new or persisting numbness, paraesthesia, pain, and weakness should be highlighted to patients during the consent process.
Lack of Consensus in Rehabilitation Protocols After Posterior Shoulder Stabilization
Authors: Dacey Sydney , Meghani Ozair , Dove James H. , Lemme Nicholas J. , Byrne Rory A. , Owens Brett D.
Published: May 2023

Background:

Posterior shoulder instability is being identified and treated more frequently by orthopaedic providers. After posterior shoulder stabilization, long-term outcomes in function and mobility are largely dependent on the postoperative rehabilitation period. Thus, it is important to assess the consistency between protocols at different institutions.

Purpose/Hypothesis:

The purpose of this study was to investigate the variability among rehabilitation protocols published by academic orthopaedic programs and their affiliates. It was hypothesized that there would be little consistency in the duration of immobilization, timing of functional milestones, and start dates of various exercises.

Study Design:

Cross-sectional study.

Methods:

Rehabilitation protocols after posterior shoulder stabilization that were published online from Accreditation Council for Graduate Medical Education (ACGME)–accredited orthopaedic surgery programs and their affiliates were evaluated for recommendations on immobilization, exercises, activities, range of motion (ROM), and return-to-sport goals.

Results:

Of the 204 ACGME-accredited orthopaedic surgery programs, 22 programs and 17 program affiliates had publicly available rehabilitation protocols that were included for review. There were 37 programs (94.9%) that recommended the use of sling immobilization for a mean of 4.7 ± 1.8 weeks postoperatively. Active ROM of the elbow, wrist, and hand was the most common early ROM exercise to be recommended (36 programs; 92.3%). The goal of 90° passive external rotation demonstrated the widest range of recommended start dates (0-12 weeks postoperatively). Late ROM exercises and start dates varied between protocols, with the largest standard deviation found in achieving full active ROM (13.5 ± 3.6 weeks). Resistance exercises showed a wide range of recommended start dates. Bench presses and push-ups began, on average, at 13.1 ± 3.4 and 15.3 ± 3.2 weeks, respectively. Return to sport was recommended at 21.7 ± 3.6 weeks.

Conclusion:

There was a high level of variability in postoperative rehabilitation protocols after posterior shoulder stabilization among orthopaedic programs and their affiliates, suggesting that a standard protocol for rehabilitation has yet to be established.
Return to Play and Performance After Anterior Cruciate Ligament Reconstruction in the National Women’s Soccer League
Authors: Abed Varag , Dupati Ajith , Hawk Gregory S. , Johnson Darren , Conley Caitlin , Stone Austin V.
Published: May 2023

Background:

The anterior cruciate ligament (ACL) is commonly injured in elite-level female athletes, which usually requires ACL reconstruction (ACLR).

Purpose:

To analyze return to play (RTP) and changes in performance of players in the National Women’s Soccer League (NWSL) after ACLR.

Study Design:

Descriptive epidemiology study.

Methods:

NWSL players who sustained an ACL tear and underwent surgery between the 2013 and 2020 seasons were identified by multiple online resources. Players were classified as forwards, defenders, midfielders, and goalkeepers. RTP was assessed according to games played, games started, percentage of minutes played, plus/minus net per 90 minutes (a measure of a player’s contribution to their team’s performance while on the field), goals scored, and assists. A subanalysis was performed based on the median age at the time of the injury (≤24 vs ≥25 years). Nonparametric testing methods were used throughout the analysis.

Results:

A total of 30 NWSL athletes were included. Midfielders had the highest percentage of injuries (n = 11; 36.7%), followed by forwards (n = 10; 33.3%). Overall, 27 players returned to the NWSL at a median of 12.1 months (IQR, 10.9-14.3 months), constituting a 90.0% RTP rate. There was a significant decrease in the percentage of minutes played from 1 year before the injury to 1 year after the injury (median, 87.9% [IQR, 80.7%-90.6%] vs 25.1% [IQR, 16.3%-57.2%], respectively; P = .031). Forwards and midfielders had a significant decrease in the number of assists from 1 year before the injury to 1 year after the injury (median, 3.0 [IQR, 1.0-3.0] vs 0.0 [IQR, 0.0-1.0], respectively; P = .037) as well as the number of goals scored when averaging across 2 seasons before the injury to 2 seasons after the injury (median, 3.0 [IQR, 1.5-5.5] vs 1.0 [IQR, 0.5-3.5], respectively; P = .031). On subanalysis, older players started in significantly more games (median, 12.0 [IQR, 3.8-18.5] vs 3.0 [IQR, 0.5-6.0], respectively; P = .048) and had a higher percentage of minutes played (median, 63.0% [IQR, 18.8%-77.3%] vs 14.9% [IQR, 2.0%-21.2%], respectively; P = .046) at 1 year after the injury versus younger players.

Conclusion:

There was a 90.0% RTP rate after ACLR in the NWSL. Players who returned to the NWSL had a lower percentage of minutes played in their first year after RTP, with older players starting in more games and having a greater percentage of minutes played. Compared with preinjury performance, forwards and midfielders had a significant decrease in the number of assists at 1 year after the injury as well as the number of goals scored at 2 years after the injury.
Posterior Horn Lateral Meniscal Root Repair Via Double-Tunnel Transtibial Pullout With Meniscocapsular Release
Authors: Homan Morgan D. , Solaiman Rafat H. , Braaten Jacob A. , Kennedy Nicholas I. , LaPrade Robert F.
Published: May 2023

Background:

Lateral meniscal root tears often occur in the acute setting in concert with anterior cruciate ligament (ACL) tears. Severe changes in tibiofemoral biomechanics and joint degeneration are encountered when these injuries are either unrecognized or are treated with meniscectomy; therefore, meniscal root surgical repair is now preferred for longer-term benefits. The most common repair techniques include side-to-side and transtibial pull-out repair, which may be performed via single or double transtibial tunnel techniques.

Indications:

The primary indication for lateral meniscal root repair with double transtibial tunnels is suspicion for a lateral meniscal root tear based upon injury mechanism, physical examination findings, magnetic resonance imaging findings, and confirmation with diagnostic arthroscopy.

Technique Description:

The root attachment site is decorticated. Adhesions that cause lateral meniscal root retraction are arthroscopically released. Two separate transtibial tunnels are drilled 5 mm apart from the anterolateral tibia, entering the anterolateral tibia distal to Gerdy’s tubercle and entering the joint at the decorticated lateral root attachment site. Two suture tapes are passed through the torn lateral meniscal root in a vertical mattress configuration and shuttled with a passing suture through the tibial tunnels. The suture tapes are tied over a surgical button on the anterolateral tibia with the knee flexed to approximately 90° while the repair is viewed arthroscopically.

Results:

Lateral meniscal root repairs are safe and have very low reoperation rates. It has been reported that the transtibial pullout repair technique of the lateral meniscus significantly decreases lateral meniscus extrusion compared with other repair techniques in patients with combined ACL reconstruction. Zhuo et al also reported significantly improved postoperative clinical outcomes compared with the preoperative state in patients who underwent pullout repair for posterior lateral meniscal root avulsion tears.

Discussion/Conclusion:

The biomechanical and clinical evidence supports concomitant lateral meniscal root repair in the setting of concurrent ACL injury, and no studies to date have demonstrated a clear harm associated with this procedure. In addition, failure to repair the lateral meniscal root places supraphysiologic loads on the ACL graft and may increase the risk of graft failure.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Interaction between myelodysplasia-related gene mutations and ontogeny in acute myeloid leukemia
Authors: McCarter Joseph G. W. , Nemirovsky David , Famulare Christopher A. , Farnoud Noushin , Mohanty Abhinita S. , Stone-Molloy Zoe S. , Chervin Jordan , Ball Brian J. , Epstein-Peterson Zachary D. , Arcila Maria E. , Stonestrom Aaron J. , Dunbar Andrew , Cai Sheng F. , Glass Jacob L. , Geyer Mark B. , Rampal Raajit K. , Berman Ellin , Abdel-Wahab Omar I. , Stein Eytan M. , Tallman Martin S. , Levine Ross L. , Goldberg Aaron D. , Papaemmanuil Elli , Zhang Yanming , Roshal Mikhail , Derkach Andriy , Xiao Wenbin
Published: May 2023

Accurate classification and risk stratification are critical for clinical decision making in patients with acute myeloid leukemia (AML). In the newly proposed World Health Organization and International Consensus classifications of hematolymphoid neoplasms, the presence of myelodysplasia-related (MR) gene mutations is included as 1 of the diagnostic criteria for AML, AML-MR, based largely on the assumption that these mutations are specific for AML with an antecedent myelodysplastic syndrome. ICC also prioritizes MR gene mutations over ontogeny (as defined in the clinical history). Furthermore, European LeukemiaNet (ELN) 2022 stratifies these MR gene mutations into the adverse-risk group. By thoroughly annotating a cohort of 344 newly diagnosed patients with AML treated at the Memorial Sloan Kettering Cancer Center, we show that ontogeny assignments based on the database registry lack accuracy. MR gene mutations are frequently observed in de novo AML. Among the MR gene mutations, only EZH2 and SF3B1 were associated with an inferior outcome in the univariate analysis. In a multivariate analysis, AML ontogeny had independent prognostic values even after adjusting for age, treatment, allo-transplant and genomic classes or ELN risks. Ontogeny also helped stratify the outcome of AML with MR gene mutations. Finally, de novo AML with MR gene mutations did not show an adverse outcome. In summary, our study emphasizes the importance of accurate ontogeny designation in clinical studies, demonstrates the independent prognostic value of AML ontogeny, and questions the current classification and risk stratification of AML with MR gene mutations.
pandasGWAS: a Python package for easy retrieval of GWAS catalog data
Authors: Cao Tianze , Li Anshui , Huang Yuexia
Published: May 2023

Background

Since the NHGRI-EBI Catalog of human genome-wide association studies was established by NHGRI in 2008, research on it has attracted more and more researchers as the amount of data has grown rapidly. Easy-to-use, open-source, general-purpose programs for accessing the NHGRI-EBI Catalog of human genome-wide association studies are in great demand for current Python data analysis pipeline.

Results

In this work we present pandasGWAS, a Python package that provides programmatic access to the NHGRI-EBI Catalog of human genome-wide association studies. Instead of downloading all data locally, pandasGWAS queries data based on input criteria and handles paginated data gracefully. The data is then transformed into multiple associated pandas.DataFrame objects according to its hierarchical relationships, which makes it easy to integrate into current Python-based data analysis toolkits.

Conclusions

pandasGWAS is an open-source Python package that provides the first Python client interface to the GWAS Catalog REST API. Compared with existing tools, the data structure of pandasGWAS is more consistent with the design specification of GWAS Catalog REST API, and provides many easy-to-use mathematical symbol operations.
Coat color inheritance in American mink
Authors: Thapa Persia Carol , Do Duy Ngoc , Manafiazar Ghader , Miar Younes
Published: May 2023

Background

Understanding the genetic mechanisms underlying coat color inheritance has always been intriguing irrespective of the animal species including American mink (Neogale vison). The study of color inheritance in American mink is imperative since fur color is a deterministic factor for the success of mink industry. However, there have been no studies during the past few decades using in-depth pedigree for analyzing the inheritance pattern of colors in American mink.

Methods

In this study, we analyzed the pedigree of 23,282 mink extending up to 16 generations. All animals that were raised at the Canadian Center for Fur Animal Research (CCFAR) from 2003 to 2021 were used in this study. We utilized the Mendelian ratio and Chi-square test to investigate the inheritance of Dark (9,100), Pastel (5,161), Demi (4,312), and Mahogany (3,358) colors in American mink.

Results

The Mendelian inheritance ratios of 1:1 and 3:1 indicated heterozygous allelic pairs responsible for all studied colors. Mating sire and dam of the same color resulted in the production of offspring with the same color most of the time.

Conclusion

Overall, the results suggested that color inheritance was complex and subjected to a high degree of diversity in American mink as the genes responsible for all four colors were found to be heterozygous.
Building an improved transcription factor-centered yeast one hybrid system to identify DNA motifs bound by protein comprehensively
Authors: Jingwen Wang , Jingxin Wang , Ye Zhu , Yan Zhu , Caozhi Liu , Yanyu Chen , Fanli Zeng , Su Chen , Yucheng Wang
Published: May 2023

Background

Identification of the motifs bound by a transcription factor (TF) is important to reveal the function of TF. Previously, we built a transcription factor centered yeast one hybrid (TF-Centered Y1H) that could identify the motifs bound by a target TF. However, that method was difficult to comprehensively identify all the motifs bound by a TF.

Results

Here, we build an improved TF-Centered Y1H to comprehensively determine the motifs bound by a target TF. Recombination-mediated cloning in yeast was performed to construct a saturated prey library that contains 7 random base insertions. After TF-Centered Y1H screening, all the positive clones were pooled together to isolate pHIS2 vector. The insertion regions of pHIS2 were PCR amplified and the PCR product was subjected to high-throughput sequencing. The insertion sequences were then retrieved and analyzed using MEME program to identify the potential motifs bound by the TF. Using this technology, we studied the motifs bound by an ethylene-responsive factor (BpERF2) from birch. In total, 22 conserved motifs were identified, and most of them are novel cis-acting elements. Both the yeast one hybrid and electrophoretic mobility shift assay verified that the obtained motifs could be bound by BpERF2. In addition, chromatin immunoprecipitation (ChIP) study further suggested that the identified motifs can be bound by BpERF2 in cells of birch. These results together suggested that this technology is reliable and has biological significance.

Conclusion

This method will have wide application in DNA-protein interaction studies.