bluuebunny/crossref_metadata_2025 huggingface dataset:
A literature review of building energy simulation and computational fluid dynamics co-simulation strategies and its implications on the accuracy of energy predictions
Authors: Singh Manan , Sharston Ryan
Published: June 2021

The paper presents a review of existing literature in the field of coupling Computational Fluid Dynamics (CFD) with Building Energy Simulations (BES) to better predict indoor environmental conditions and building energy implications. CFD is capable of providing a detailed analysis of airflow profile and temperature gradients in the space as well as better prediction of heat transfer involving convection and radiation. Whereas BES can provide dynamically changing boundary conditions to CFD to facilitate a precise transient analysis. Combining the two simulations provides a powerful framework to accurately predict building performance parameters. The review examines the variables exchanged between the two simulations and establishes that the Convective Heat Transfer Coefficient (CHTC) as the most important exchanged variable that can significantly improve the accuracy of energy simulations. Issues regarding the application of co-simulation mechanism are then discussed in terms of simulation discontinuities, along with strategies adopted by researchers to overcome the same. In the later sections, the review evaluates the applicability of co-simulation from the perspective of year-long building energy simulations and presents an overview of methods used in research to implement the same. Finally, the conclusions are discussed and the scope for future research in the field is presented.

Practical implication: The review presents a critical analysis of essentially all major coupling strategies that can be used to perform a BES-CFD coupled analysis along with their strengths, limitations and possible application scenarios. Additionally, the problems associated with establishing the co-simulation are examined and various adopted solutions are presented along with methods implemented towards extending the practical applicability of such an analysis to encapsulate year-long simulations.
Angiomatous Polyp Originating From the Inferior Turbinate: A Variant of the Sinonasal Polyp
Authors: Koo Hyung-Bon , Lee Jae-Hoon
Published: June 2021

Angiomatous polyps are an uncommon subtype of sinonasal polyps, characterized by extensive vascular proliferation and ectasia. The authors report the first case of angiomatous polyp originating from the inferior turbinate, which is a variant of the sinonasal polyp.
Supporting societal and economic dynamics of recovery: lessons from Chernobyl and Fukushima
Authors: Schneider Thierry , Lochard Jacques
Published: June 2021

This paper does not necessarily reflect the views of the International Commission on Radiological Protection. Beyond the consideration of radiological aspects, the rehabilitation of living and working conditions after a large nuclear accident is a complex process in which all dimensions of individual and community life are involved and interconnected. Responsibles of socio-economic entities are facing various difficulties/challenges, including the implementation of protective actions for ensuring the protection of employees, the continuity of production of good-quality products in affected areas, and restoring the confidence of consumers. For affected local communities, the deployment of a socio-economic programme is essential to enable a sustainable future while recognising that a return to the pre-accident situation is generally not achievable. In this context, supporting the societal and economic dynamics of the recovery process requires the adoption of specific governance mechanisms respecting a series of ethical and social values, as highlighted by lessons from the post-accident management of the Chernobyl and Fukshima accidents at Chernobyl and Fukushima Daiichi nuclear power plants.
Rivals or Collaborators? Relational Ambidexterity and Absorption Speed
Authors: Yu Chengke , Yang Haibin , Sun He , (John) Lin Zhiang
Published: June 2021

This study investigates how the configuration of rivals and collaborators within a firm’s alliance portfolio affects its speed of absorbing external knowledge (i.e., absorption speed). While prior research on learning alliances has predominantly focused on interfirm overall knowledge flows, we contend that absorption speed plays a critical role in technology-intensive industries where time-based competition is paramount. Additionally, most previous studies do not clearly distinguish a firm’s rivals from its collaborators within the alliance portfolio. Building on interorganizational learning theory, we propose that a simultaneous and balanced presence of both rivals and collaborators within a firm’s alliance portfolio, which we term relational ambidexterity, increases the firm’s speed of absorbing external knowledge. We further contend that while a firm’s internal knowledge variety strengthens the positive relationship between relational ambidexterity and absorption speed, the number of common third parties between a firm and its partner weakens this positive relationship. The results of an event history study of 467 firms in the pharmaceutical industry of the United States from 1990 to 2010 provide general support for our hypotheses.
Exploring spelling ability in school-aged children with literacy learning difficulties using data collected in a clinical setting
Authors: Bailey Benjamin , Ganesalingam Kalaichelvi , Arciuli Joanne , Bale Gillian , Drevensek Suzi , Hodge Marie Antoinette , Kass Carol , Ong Natalie , Sutherland Rebecca , Silove Natalie
Published: June 2021

Spelling analyses can be used to investigate sources of linguistic knowledge underlying children’s literacy development and may be useful in predicting later achievement. This study explored the utility of six analysis metrics in predicting the spelling achievement of school-aged children with literacy learning difficulties via post-hoc analyses of data collected in a clinic. Participants were 48 children aged 7 to 12 years. Spelling accuracy was assessed using the Dalwood Spelling Test (Dalwood Assessment Centre, 2008) at baseline and 37–70 weeks later. Spelling attempts at baseline were analysed using metrics designed to quantify evidence of phonological, orthographic, and/or morphological awareness. Scores from each metric were associated with baseline and later conventional spelling accuracy. A metric which credits evidence of phonological, orthographic and morphological awareness shared a significantly stronger association with baseline conventional spelling accuracy as compared to the remaining metrics. There were no significant differences in the strength of associations among the baseline metrics and later spelling achievement. Supplementary analyses focused exclusively on children’s spelling errors returned a similar pattern of results with a few notable exceptions. The utility of spelling analyses is discussed.
A prospective observational study of emboli exposure in open versus closed chamber cardiac surgery
Authors: Jabur Ghazwan NS , Donnelly Joseph , Merry Alan F , Mitchell Simon J
Published: June 2021

Objective:

Exposure to cerebral emboli is ubiquitous and may be harmful in cardiac surgery utilizing cardiopulmonary bypass. This was a prospective observational study aiming to compare emboli exposure in closed-chamber with open-chamber cardiac surgery, distinguish particulate from gaseous emboli and examine cerebral laterality in distribution.

Methods:

Forty patients underwent either closed-chamber procedures ( n = 20) or open-chamber procedures ( n = 20). Emboli (gaseous and solid) were detected using transcranial Doppler in both middle cerebral arteries in two monitoring phases: 1, initiation of bypass to the removal of the aortic cross-clamp; and 2, removal of aortic cross-clamp to 20 minutes after venous decannulation.

Results:

Total (median (interquartile range)) emboli counts (both phases) were 898 (499–1366) and 2617 (1007–5847) in closed-chamber and open-chamber surgeries, respectively. The vast majority were gaseous; median 794 (closed-chamber surgery) and 2240 (open-chamber surgery). When normalized for duration, there was no difference between emboli exposures in closed-chamber and open-chamber surgery in phase 1: 6.8 (3.6–15.2) versus 6.4 (2.0–18.1) emboli per minute, respectively. In phase 2, closed-chamber surgery cases were exposed to markedly fewer emboli than open-chamber surgery cases: 9.6 (5.1–14.9) versus 43.3 (19.7–60.3) emboli per minute, respectively. More emboli (total) passed into the right cerebral circulation: 985 (397–2422) right versus 376 (198–769) left.

Conclusions:

Patients undergoing open-chamber surgery are exposed to considerably higher numbers of cerebral arterial emboli after removal of the aortic cross-clamp than those undergoing closed-chamber surgery, and more emboli enter the right middle cerebral artery than the left. These results may help inform the evaluation of the pathophysiological impact of emboli exposure.
Brazilian version of the Neck Bournemouth Questionnaire does not have a well-defined internal structure in patients with chronic neck pain
Authors: Araujo Gabriel Gardhel Costa , Fidelis-de-Paula-Gomes Cid André , Pontes-Silva André , Pinheiro Jocassia Silva , Mendes Leticia Padilha , Gonçalves Maria Cláudia , Dibai-Filho Almir Vieira
Published: June 2021

Objective:

To investigate the structural validity of the Brazilian version of the Neck Bournemouth Questionnaire in patients with chronic neck pain.

Design:

Cross-sectional study.

Setting:

Community participants collected via online platform.

Subjects:

Participants with neck pain (minimal pain intensity of 3 points at rest on 11-point Numerical Rating Scale), both genders and aged ⩾18 years old.

Main measure:

The Numerical Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia and the Neck Bournemouth Questionnaire were completed. Exploratory and confirmatory factor analyses were used to identify dimensionality and to compare different structures of the Neck Bournemouth Questionnaire.

Results:

We included 103 participants. The sample consisted mostly of adults (mean age = 33.64 years, standard deviation = 10.48 years), females (n = 82, 79.6%), lean, single and with higher education. The exploratory factor analysis with implementation of the parallel analysis identified the one-dimensional structure of the Neck Bournemouth Questionnaire, with a Kaiser-Meyer-Olkin value of 0.80 and Bartlett’s test significant ( P < 0.05). We observed that all structures tested in this study presented a high amount of residues in confirmatory factor analysis, which were identified by the value of root mean square error of approximation > 0.08 and chi-square/degree of freedom > 3.00.

Conclusion:

The internal structure of the Brazilian version of the Neck Bournemouth Questionnaire is not clear and well-defined. It was not possible to identify the construct measured by the instrument in individuals with chronic neck pain.
Improved quality of care and reduced healthcare costs at the end-of-life among older people with dementia who received palliative home care: A nationwide propensity score-matched decedent cohort study
Authors: Miranda Rose , Smets Tinne , De Schreye Robrecht , Faes Kristof , Van Den Noortgate Nele , Cohen Joachim , Van den Block Lieve
Published: June 2021

Background:

While palliative home care is advocated for people with dementia, evidence of its effectiveness is lacking.

Aim:

To evaluate the effects of palliative home care on quality and costs of end-of-life care for older people with dementia.

Design:

Decedent cohort study using linked nationwide administrative databases and propensity score matching.

Setting/participants:

All home-dwelling older people who died with dementia between 2010 and 2015 in Belgium ( N = 23,670).

Exposure:

Receiving palliative home care support for the first time between 360 and 15 days before death.

Results:

Five thousand six hundred and thirty-seven (23.8%) received palliative home care support in the last 2 years of life, of whom 2918 received it for the first time between 360 and 15 days before death. Two thousand eight hundred and thirty-nine people who received support were matched to 2839 people who received usual care. After matching, those using palliative home care support, in the last 14 days of life, had lower risk of hospital admission (17.5% vs 50.5%; relative risk (RR) = 0.21), undergoing diagnostic testing (17.0% vs 53.6%; RR = 0.20) and receiving inappropriate medications, but were more likely to die at home (75.7% vs 32.6%; RR = 6.45) and to have primary care professional contacts (mean 11.7 vs mean 5.2), compared with those who did not. Further, they had lower mean total costs of care in the last 30 days of life (incremental cost:−€2129).

Conclusions:

Palliative home care use by home-dwelling older people with dementia is associated with improved quality and reduced costs of end-of-life care. Access remains low and should be increased.
Role of platelets in the pathogenesis of delayed injury after subarachnoid hemorrhage
Authors: Dienel Ari , Kumar T Peeyush , Blackburn Spiros L , McBride Devin W
Published: June 2021

Aneurysmal subarachnoid hemorrhage (aSAH) patients develop delayed cerebral ischemia and delayed deficits (DCI) within 2 weeks of aneurysm rupture at a rate of approximately 30%. DCI is a major contributor to morbidity and mortality after SAH. The cause of DCI is multi-factorial with contributions from microthrombi, blood vessel constriction, inflammation, and cortical spreading depolarizations. Platelets play central roles in hemostasis, inflammation, and vascular function. Within this review, we examine the potential roles of platelets in microthrombi formation, large artery vasospasm, microvessel constriction, inflammation, and cortical spreading depolarization. Evidence from experimental and clinical studies is provided to support the role(s) of platelets in each pathophysiology which contributes to DCI. The review concludes with a suggestion for future therapeutic targets to prevent DCI after aSAH.
Impact of sex and APOE ε4 on age-related cerebral perfusion trajectories in cognitively asymptomatic middle-aged and older adults: A longitudinal study
Authors: Wang Rui , Oh Jennifer M , Motovylyak Alice , Ma Yue , Sager Mark A , Rowley Howard A , Johnson Kevin M , Gallagher Catherine L , Carlsson Cynthia M , Bendlin Barbara B , Johnson Sterling C , Asthana Sanjay , Eisenmenger Laura , Okonkwo Ozioma C
Published: June 2021

Cerebral hypoperfusion is thought to contribute to cognitive decline in Alzheimer’s disease, but the natural trajectory of cerebral perfusion in cognitively healthy adults has not been well-studied. This longitudinal study is consisted of 950 participants (40—89 years), who were cognitively unimpaired at their first visit. We investigated the age-related changes in cerebral perfusion, and their associations with APOE-genotype, biological sex, and cardiometabolic measurements. During the follow-up period (range 0.13—8.24 years), increasing age was significantly associated with decreasing cerebral perfusion, in total gray-matter (β=−1.43), hippocampus (−1.25), superior frontal gyrus (−1.70), middle frontal gyrus (−1.99), posterior cingulate (−2.46), and precuneus (−2.14), with all P-values < 0.01. Compared with male-ɛ4 carriers, female-ɛ4 carriers showed a faster decline in global and regional cerebral perfusion with increasing age, whereas the age-related decline in cerebral perfusion was similar between male- and female-ɛ4 non-carriers. Worse cardiometabolic profile (i.e., increased blood pressure, body mass index, total cholesterol, and blood glucose) was associated with lower cerebral perfusion at all the visits. When time-varying cardiometabolic measurements were adjusted in the model, the synergistic effect of sex and APOE-ɛ4 on age-related cerebral perfusion-trajectories became largely attenuated. Our findings demonstrate that APOE-genotype and sex interactively impact cerebral perfusion-trajectories in mid- to late-life. This effect may be partially explained by cardiometabolic alterations.
Mental Imagery in Early Psychosis
Authors: Auvinen-Lintunen Laura , Ilonen Tuula , Kieseppä Tuula , Suvisaari Jaana , Lindgren Maija
Published: June 2021

Dysfunction in mental imagery may contribute to the development of mental disorders. We studied the vividness and controllability of mental imagery in a sample of 42 individuals with recent-onset psychosis, using a cross sectional design. Contrary to earlier studies, the claim that mental imagery is enhanced and the controllability weak in psychotic disorder was not supported. Especially the negative and affective symptoms associated with low vividness, and the stronger the symptoms the patients had, the less vivid was their imagery. Anxiety and self-neglect were the best predictors of low vividness. Only an elevated mood associated with higher vividness. The cognitive performance of the participants did not associate significantly with imagery. Surprisingly, organic modality was reported to be the most vivid modality, whereas visual imagery was the least vivid. Understanding the role of mental imagery in early psychosis may help us to understand and treat these disorders better.
Pathology of growth anomalies in massive Caribbean corals of the family Faviidae
Authors: Rich Louis Pierre , Arnot Charlie , Dennis Michelle M.
Published: June 2021

Growth anomalies (GAs) are a morphologically diverse and poorly understood group of lesions affecting corals. The aim of this study was to describe the prevalence and morphology of GAs affecting the faviid corals Diploria labyrinthiformis, Pseudodiploria strigosa, Psudodiploria clivosa, and Colpophyillia natans on St. Kitts. Three gross morphological variants of GAs (exophytic, nodular, and ruminate) were equally prevalent, together affecting 7.8% of corals surveyed across 5 reefs. Prevalence varied by reef and coral species, being highest in C. natans (35.7%). Median colony diameter was larger in corals with GAs relative to those without (Mann-Whitney U test, P < .001). Histopathological examination of exophytic GAs consistently showed corallite and polyp gigantism ( n = 7), characterized by polyp enlargement and retained microanatomical structures. In contrast, nodular GAs ( n = 9) were consistently hyperplasia of the basal body wall with skeletal dystrophy, composed of micronodular skeletal deposits with abundant hyaline lamellae, bordered by calicoblastic epithelial hyperplasia, interspersed with distorted gastrovascular canals and islands of mesoglea. Endolithic organisms, particularly fungi and algae, were common among GA and apparently healthy biopsies. While pathogenesis of these lesions remains uncertain, a neoplastic basis for GAs on Caribbean faviids could not be established using diagnostic criteria conventionally applied to tumors of vertebrate taxa, in line with other recent observations of coral GAs.
Impact of Vibration on the Levels of Biomarkers: A Systematic Review
Authors: Agrawal Ashish , Chou TM
Published: June 2021

Introduction:

The objective of this systematic review is to assess the effect of vibrational force on biomarkers for orthodontic tooth movement.

Methods:

An electronic search was conducted for relevant studies (up to December 31, 2020) on the following databases: Pubmed, Google scholar, Web of Science, Cochrane Library, Wiley Library, and ProQuest Dissertation Abstracts and Thesis database. Hand searching of selected orthodontic journals was also undertaken. The selected studies were assessed for the risk of bias in Cochrane collaboration risk of bias tool. The “traffic plot” and “weighted plot” risk of bias distribution are designed in the RoB 2 tool. The 2 authors extracted the data and analyzed it.

Results:

Six studies fulfilled the inclusion criteria. The risks of biases were high for 4, low and some concern for other 2 studies. The biomarkers, medium, device, frequency and duration of device, as well as other data were extracted. The outcomes of the studies were found to be heterogenous.

Conclusion:

One study showed highly statistically significant levels of IL-1 beta with <.001. Rate of tooth movement was correlated with levels of released biomarkers under the influence of vibrational force in 3 studies, but it was found to be significant only in 1 study. It was further observed that vibration does not have any significant reduction in pain and discomfort.
Housing, place and populism: Towards a research agenda
Authors: Waldron Richard
Published: June 2021

This exchange considers the unrecognised interplay between two major political–economic trends shaping contemporary Europe, namely the upward trend in housing-induced inequalities and rising support for populist politics. Europe's housing systems have undergone dramatic transformations in recent decades that are exacerbating housing precarity, wealth inequalities and socio-spatial polarisation. At the same time, European politics has witnessed a growing acceptance of populist political rhetoric, values and policies as populists exploit citizens' economic anxieties and perceived cultural grievances. Yet, existing research overlooks the connections between housing system dynamics, housing precarity and political disaffection. In response, this exchange proposes a new approach – housing discontent – to capture how deepening housing precarity and place inequalities are influencing social attitudes, political values and preferences and resulting in a more polarised contemporary politics.
Psychogeography: Walking through strategy, nature and narrative
Authors: Sidaway James D
Published: June 2021

Proposed as an urban pedestrian practice in French texts of the 1950s, the current vogue for English-language references to psychogeography dates from the 1990s. Sampling this corpus, much of it outside academic geography, this article examines some of psychogeography’s trajectories, connections and affinities, notably with nature writing. In minding gaps, the article considers gendered, decolonial and Muslim registers that extend the range of sites and protagonists, heralding other priorities and opportunities both within and beyond the North Atlantic. Finally, reflecting on what lessons lie in psychogeography and its margins for human geography, the article reconsiders questions of narrative and scale.
Wind-driven permanent magnet synchronous generators connected to a power grid: Existing perspective and future aspects
Authors: Mahmoud Mohamed Metwally , Khalid Ratib Mohamed , Aly Mohamed M , Abdel-Rahim Abdel-Moamen M
Published: June 2021

Scholars are motivated to work in the field of renewable energy systems (RESs) especially on grid-connected wind generators because of the exciting and noticeable developments going on in this area. This progress is utilized to obtain the maximal, efficient, and stable electric power from the RESs and integrating it into existing systems to improve its efficiency, stability, reliability, and overall power quality. Recently, permanent magnet synchronous generators (PMSGs) have become the main pillar of advanced wind systems thanks to their fascinating pluses over other types of wind generators. This paper presents the up-to-date trends in converter topologies, control approaches, maximal power production methods, and grid integration issues for PMSG-based wind systems. The performed statistical analyses assure the dominance of the two-level back-to-back converter among the studied power converter topologies, field-oriented control method for the machine side converter, voltage oriented control method for the grid side converter control, perturb and observe algorithm amongst the studied maximum power point techniques, and fault ride-through capability out of grid integration issues. Further, recent general trends in technological advancements for PMSG wind system components are illustrated as a pie chart in terms of percentage figures. It is expected that the researchers working in this field would benefit from this article in terms of the presented state-of-the-art statistical analyses and its related literature given in this study.
Impact of Cooperative Adaptive Cruise Control on a Multilane Highway under a Differentiated Per-Lane Speed Limit Policy
Authors: Xiao Zhe , Guo Xiaoyu , Guo Xiucheng , Li Yi
Published: June 2021

Cooperative adaptive cruise control (CACC) has drawn wide attention in recent years for its potential throughput benefit, as it is a promising intermediate technology to the highly connected and automated vehicles. The impact of CACC on multilane highways has been the subject of several studies, but they assumed traffic under a uniform speed limit. Recent research has revealed that traffic performs differently under a differentiated per-lane speed limit (DPLSL) policy with heavy vehicle (HV) restricted lanes. Whether the benefits of CACC still remain under a DPLSL policy has not been explored. This study developed cellular automaton models to incorporate CACC-equipped and non-equipped vehicles (i.e., passenger cars, HVs) on a two-way eight-lane highway with a DPLSL. Results shown throughputs by lane increase up to 78.5% as the CACC car market penetration rate (MPR) rises. Such increases became sharper (i.e., ≥10%) for inner lanes (i.e., HV restricted lanes) and outer lanes after reaching a 40% and a 60% CACC car MPR, separately. Moreover, HVs induced a 1.5% to 15.7% throughput reduction across lanes even under higher CACC car MPRs (i.e., 60%, 80%). This DPLSL policy may cause the lanes to experience a throughput penalty when they are adjacent to lanes with a different speed limit as the MPR of CACC cars rises. Lastly, in traffic with a 60% CACC car MPR, increases are brought further by considering 10% of HV with CACC, especially on those HV non-restricted lanes. The study is helpful for policy makers to further prepare for the prevalence of CACC in the forthcoming years.
Assessment of Queue Warning Application on Signalized Intersections for Connected Freight Vehicles
Authors: Bashir Sara , Zlatkovic Milan
Published: June 2021

Connected vehicle (CV) systems are at the core of intelligent transportation systems (ITS) for their capability to support a variety of ITS applications and to unite vehicles and infrastructure elements into a well-integrated transportation system. CV refers to vehicles that exchange information with each other and with the infrastructure. The queue warning application (Q-WARN) uses CV technologies to allow vehicles within the queue to broadcast their queued status information automatically to upstream vehicles and to infrastructure. Queue warnings are sent to oncoming vehicles to prevent rear-end or other secondary collisions. This paper focuses on Q-WARN applications for freight vehicles at signalized intersections adjacent to I-80 in Wyoming, which are characterized by heavy truck traffic. The algorithms use the latitude/longitude coordinates of freight CVs and intersections to form a communication link and to share information. Tests were performed in VISSIM microsimulation with Econolite ASC/3 software-in-the-loop controller emulator for different CV market penetration rates. Three locations in Wyoming were used as test-bed cases. The developed Q-WARN algorithms are successful in reducing vehicle delays by an average of 2% to 5%. Time to collision (TTC) significantly increased with an increase in CV rates, by two to five times. The abundance of information obtained from CVs can be used further to enhance signal control algorithms. The developed algorithms can easily be implemented in the field, since they use existing CV communication protocols and signal control logic.
Medial Patellofemoral Ligament Reconstruction for Adolescents With Acute First-Time Patellar Dislocation With an Associated Loose Body
Authors: Gurusamy Pradyuma , Pedowitz Jason M. , Carroll Alyssa N. , Johnson Kristina , Chambers Henry G. , Edmonds Eric W. , Pennock Andrew T.
Published: June 2021

Background:

The management of adolescents with acute first-time patellar dislocation with an associated loose body remains a debated topic. The rate of recurrent dislocation in these patients may be up to 61% if the medial patellofemoral ligament (MPFL) is repaired or not addressed surgically. To our knowledge, a prospective evaluation of MPFL reconstruction for adolescents with acute first-time patellar dislocation with an associated chondral or osteochondral loose body has not been previously performed.

Purpose/Hypothesis:

The purpose of this study was to analyze patients with a first-time patellar dislocation who required surgery for a loose body, comparing those who underwent MPFL repair or no treatment with those who underwent MPFL reconstruction during the index procedure. The hypothesis was that performing MPFL reconstruction would reduce the rate of recurrent instability and improve patient-reported outcomes compared with MPFL repair or no treatment. A secondary objective was to report outcomes of those patients who underwent reconstruction versus those who did not.

Study Design:

Case series; Level of evidence, 4.

Methods:

This was a prospective analysis of adolescents treated with MPFL reconstruction for acute first-time patellar dislocation with associated loose bodies between 2015 and 2017 at a single pediatric level 1 trauma center with minimum 2-year follow-up. Retrospective analysis was previously performed for a similar cohort of adolescents treated with MPFL repair or no treatment. Patient characteristic data, radiographic measurements, and surgical variables were compared. Primary outcome measures included recurrent subluxation or dislocation and the need for further stabilization procedures. Secondary outcomes included Kujala score, Single Assessment Numeric Evaluation score, patient satisfaction, and ability to return to sport.

Results:

A total of 76 patients were included, 30 in the MPFL reconstruction cohort and 46 in the MPFL repair or no-treatment cohort. The only difference noted in patient characteristic, radiographic, or surgical variables was a smaller Insall-Salvati ratio in the reconstruction group (1.29 vs 1.42; P = .011). Compared with MPFL repair or no treatment, MPFL reconstruction was associated with less recurrent instability (10.0% vs 58.7%; P < .001), fewer secondary procedures (6.7% vs 47.8%; P < .001), and more frequent return to sports (66.7% vs 39.1%; P = .003). No differences in patient-reported outcomes were noted.

Conclusion:

Performing concomitant MPFL reconstruction in adolescents with first-time patellar dislocation and an intra-articular loose body results in a 5-fold reduction in recurrent instability, reduces the need for subsequent surgery, and improves patients’ ability to return to sports compared with repairing or not treating the MPFL.
Clinical Efficacy of Bone Marrow Aspirate Concentrate Versus Stromal Vascular Fraction Injection in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis
Authors: Bolia Ioanna K. , Bougioukli Sofia , Hill William J. , Trasolini Nicholas A. , Petrigliano Frank A. , Lieberman Jay R. , Weber Alexander E.
Published: June 2021

Background:

Knee injection using either bone marrow aspirate concentrate (BMAC) or stromal vascular fraction (SVF) from adipose tissue has been shown to result in symptomatic improvement in patients with knee osteoarthritis (OA). It is still unclear whether one of these therapies is superior over the other.

Purpose:

To systematically report the clinical studies evaluating BMAC and SVF in the treatment of knee OA and to compare the clinical efficacy of these 2 injection therapies.

Study Design:

Meta-analysis; Level of evidence, 4.

Methods:

This meta-analysis was performed per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Studies were included if they reported the clinical outcomes after a single BMAC or SVF injection in the knee joint of patients with OA. Studies evaluating preparations of culture-expanded stem cells were excluded. A random effects model was used; the clinical efficacy of BMAC or SVF injection was assessed using the standardized mean difference (SMD) and compared. Visual analog scale (VAS) scores for pain and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) knee index were the primary outcomes. The level of statistical significance was set at P < .05.

Results:

Ten studies and 472 patients with knee OA who received either BMAC (233 patients) or SVF (239 patients) were included. Patients who received an injection had improved VAS outcomes (mean ± SD): from 5.8 ± 1.3 to 2.6 ± 17 for BMAC and from 6.4 ± 1.4 to 3.4 ± 0.5 for SVF. They also experienced significantly reduced pain (SMD [VAS], 2.6 for BMAC and 3.4 for SVF) and improved function (SMD [WOMAC], 1.4 for BMAC and 1.2 for SVF). However, the SVF injection had a significantly greater effect on pain reduction than did the BMAC injection ( P < .0001). Based on WOMAC, the clinical effect of BMAC versus SVF knee injection in patients with knee OA was equivalent ( P = .626). Results were limited by the presence of publication bias as well as variability in the preparation methods utilized in the BMAC and SVF injection protocols. Complications were reported in 50% of the BMAC studies (knee stiffness, persistent knee swelling) and 67% of the SVF studies (knee swelling, knee pain, positive SVF cultures without symptoms of infection, and bleeding at the abdominal harvest site).

Conclusion:

A single BMAC or SVF injection into the knee joint of patients with OA resulted in symptomatic improvement at short-term follow-up. However, SVF seemed to be more effective than did BMAC in the reduction of knee pain. There was significant variation in the BMAC and SVF injection preparation techniques used across the studies and a lack of stratification of outcomes based on the radiologic classification of OA. Therefore, these results should be taken with caution.
Graft Failure, Revision ACLR, and Reoperation Rates After ACLR With Quadriceps Tendon Versus Hamstring Tendon Autografts: A Registry Study With Review of 475 Patients
Authors: Schmücker Malte , Haraszuk Jørgen , Hölmich Per , Barfod Kristoffer W.
Published: June 2021

Background:

It has been indicated that anterior cruciate ligament reconstruction (ACLR) with a quadriceps tendon (QT) graft has a higher risk of revision compared with ACLR performed with a hamstring tendon (HT) graft.

Purpose/Hypothesis:

To investigate whether ACLR with QT graft had a higher risk of graft failure, revision ACLR, or reoperation compared with HT graft in a high-volume center. We hypothesized that there would be no between-group differences.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a registry study with review of medical records. Our study cohort consisted of patients who underwent primary ACLR with either QT or HT graft performed at Copenhagen University Hospital Hvidovre between January 2015 and December 2018. The cohort was identified from the Danish Knee Ligament Reconstruction Registry and linked to the Danish National Patient Registry to identify all hospital contacts after ACLR. The outcome variables were graft failure (rerupture or >3-mm side-to-side difference in anteroposterior [AP] laxity), revision ACLR, reoperation due to cyclops lesion, reoperation due to meniscal injury, and reoperation due to any reason. AP laxity and pivot shift were assessed at 1 year. Kaplan-Meier estimates were used to evaluate the rates of events at 2 years, and comparison was performed with Cox regression analysis.

Results:

A total of 475 patients (252 HT, 223 QT) were included. The rate of graft failure at 2 years was 9.4% for the QT group and 11.1% for the HT group ( P = .46). For the QT and HT groups, respectively, the rate of revision ACLR was 2.3% and 1.6% ( P = .60), the rate of reoperation due to cyclops lesion was 5.0% and 2.4% ( P = .13), and the rate of reoperation due to meniscal injury was 4.3% and 7.1% ( P = .16). The rate of reoperation due to any reason was 20.5% and 23.6% ( P = .37). At 1-year follow-up, AP laxity was 1.4 mm for QT and 1.5 mm for HT ( P = .51), and the proportion of patients with a positive pivot shift was 29-30% for both groups.

Conclusion:

QT and HT grafts yielded similar rates of graft failure, revision ACLR, and reoperation at 2 years of follow-up after ACLR. Graft failure was found in 9% to 11% of patients. Patients with QT ACLR showed a non–statistically significant trend of higher risk for reoperation due to cyclops lesion, and those with HT showed a non–statistically significant trend of higher risk for reoperation due to meniscal injury.
Lateral Elbow Laxity Is Affected by the Integrity of the Radial Band of the Lateral Collateral Ligament Complex: A Cadaveric Model With Sequential Releases and Varus Stress Simulating Everyday Activities
Authors: Arrigoni Paolo , Cucchi Davide , Luceri Francesco , Menon Alessandra , Zaolino Carlo , Zagarella Andrea , Catapano Michele , Radici Mattia , Migliaccio Nicola , Polli Dario , Randelli Pietro S.
Published: June 2021

Background:

An elongation of the radial lateral collateral complex (R-LCL) can provoke symptomatic minor instability of the lateral elbow leading to lateral elbow pain. Biomechanical models investigating the effects of elongation and partial or complete lesions of the R-LCL on lateral elbow stability are lacking.

Purpose:

To evaluate how partial and complete R-LCL release affects radiocapitellar joint stability in a setting of controlled varus load and progressive soft tissue release.

Study Design:

Controlled laboratory study.

Methods:

Ten fresh-frozen cadaveric specimens were obtained and mounted on a custom-made support to control elbow flexion and extension and to allow for controlled varus loading. Stress tests were performed on all intact specimens under gravity load alone, a 0.5-kg load applied to the hand, and a 1-kg load applied to the hand. After load application, anteroposterior radiographs were obtained. The following release sequence was applied to all specimens: release of the anterior half of the common extensor origin, pie crusting of the R-LCL, and R-LCL release. After each release, stress tests and radiographs were performed. The varus joint angulation of the elbow (α) was measured by 2 examiners as the main outcome parameter.

Results:

Significant changes in α from the initial condition occurred after each release, and a significant effect of varus load on α was documented for all release steps. A significant effect of the releases on α could be documented for all identical varus load conditions. A linear regression model was generated to describe the effect of varus load on α.

Conclusion:

Varus loads simulating everyday activities produce changes in the varus joint angulation of the elbow already in the intact specimen, which are linearly dependent on the applied moment and persist after release of the lateral stabilizing structures. With progressive load, a pie crusting of the R-LCL is the minimal procedure able to provoke a significant change in the varus joint angulation, and a complete R-LCL release produces additional increase in the varus joint angulation in all testing conditions.

Clinical Relevance:

These findings confirm the role of the R-LCL as static lateral stabilizer, supporting a pathological model based on its insufficiency and culminating with a symptomatic minor instability of the lateral elbow.
La réponse aux besoins affectifs et cognitifs de l’enfant : Application du modèle cumulatif à la population générale
Authors: Bandola Camille , Clément Marie-Ève , Bérubé Annie
Published: June 2021

Objectifs:

Plusieurs facteurs de risque sont associés à des conduites à caractère négligent. Leur effet cumulatif, soit l’accumulation du risque indépendamment de la présence ou de l’absence de facteurs spécifiques, est toutefois méconnu. La présente étude a pour objectif de déterminer si le cumul prédit la réponse aux besoins affectifs et cognitifs de l’enfant dans la population générale et d’examiner la présence d’un seuil critique.

Méthode:

Un total de 1 102 figures maternelles ayant des enfants âgés de 5 à 9 ans vivant au Québec ont été questionnées par le biais d’un sondage téléphonique. La réponse aux besoins affectifs et cognitifs de l’enfant a été mesurée à l’aide d’une adaptation validée de l’échelle multidimensionnelle des conduites de négligence. Dix facteurs de risque individuels, familiaux et socioéconomiques ont été combinés afin de calculer un indice de risque cumulatif.

Résultats:

Les résultats montrent que l’indice cumulatif prédit la réponse aux besoins affectifs et cognitifs de l’enfant dans la population générale. Cet effet est observé pour les familles présentant au minimum deux facteurs de risque et augmente de manière importante lors d’une exposition à cinq facteurs.

Conclusions:

La présente étude appuie l’hypothèse du cumul, qui avait jusqu’à présent, principalement été examinée au sein d’échantillons vulnérables ou cliniques. Elle favorise une meilleure compréhension statistique des contextes qui rendent difficiles la réponse de l’environnement de l’enfant d’âge scolaire à ses besoins affectifs et cognitifs dans la population générale. Cette avancée est d’autant plus importante considérant les défis liés à l’identification des enfants à risque de voir leurs besoins négligés.
The Ontario Forensic Mental Health System: A Population-based Review
Authors: Chaimowitz Gary , Moulden Heather , Upfold Casey , Mullally Katelyn , Mamak Mini
Published: June 2021

Objective:

The purpose of this study was to increase the understanding of the Canadian forensic psychiatry system by providing a population-based overview of the Ontario forensic mental health system.

Methods:

Data were collected on 1,240 accused adults who were subject to the jurisdiction of the Ontario Review Board (ORB) between 2014 and 2015. Archival data were retrieved from annual ORB hearing hospital reports for accused supervised by all nine adult forensic psychiatry facilities across Ontario.

Results:

The sample included not criminally responsible (NCR; 91.6%) and unfit to stand trial (UST; 8.4%) accused. The majority of the sample was male (85.7%), single (70.1%), unemployed (63.6%), with a high school education (48.8%). Most were on a detention order (78.5%) and almost half were living in the community at the time of the report (48.8%). The majority had prior contact with psychiatric services (83.1%) and/or the criminal justice system (70.6%) before entering the forensic system. A history of elopement (31.5%) and inpatient aggression was high (60.6%). Most had a psychotic spectrum disorder (81.6%) and over half had a substance use disorder (57.2%) in the reporting year. A range of index offences was observed (69.9% violent, 20.3% general, 9.8% sexual), and the majority of the sample (61.0%) had an index offence that resulted in no injury or a minor injury to the victim.

Conclusion:

The Canadian forensic psychiatry system is comprised of a unique subset of justice-involved individuals. This study provides a detailed examination of accused who are subject to the jurisdiction of the ORB and provides key insight into risk factors associated with offending behaviour in this population. The results of this study will provide a framework for future studies examining the association between mental disorder and violence and the treatment trajectories for those in the forensic psychiatry system.
“We Are All Humans and Deserve a Decent Way to Go”: Examining Professional’s Experiences With Providing End-of-Life Care in Correctional Institutions
Authors: Steely Smith Mollee , Cooley Brooke , Bensel Tusty ten
Published: June 2021

The aging prison population has increased dramatically over the past two decades. As this population increases, correctional institutions are faced with health care challenges. Specifically, providing adequate end-of-life (EOL) care for terminally ill inmates has been a concern. Despite issues relating to providing EOL care, little is known about medical and correctional staff’s attitudes toward the implementation of EOL care. The purpose of this study was to understand the challenges faced by correctional and medical professionals, focusing on job satisfaction, obstacles, and emotional effects of providing EOL care in correctional institutions. Our data included 17 semistructured, face-to-face interviews with medical and correctional staff assigned to the EOL care unit in a southern state. Although the entire sample stated overall satisfaction with their job, participants noted several challenges and stressors, which included the lack of resources and difficulties in balancing care. Participants agreed that it was emotionally stressful to maintain appropriate relationships with the inmates, deal with patient manipulation, and be surrounded by dying and death. Implications are discussed relative to the needs and experiences of service providers and how to more effectively treat EOL inmate patients.
Reverse logistics models for the collection of plastic waste: A literature review
Authors: Valenzuela Juan , Alfaro Miguel , Fuertes Guillermo , Vargas Manuel , Sáez-Navarrete César
Published: June 2021

To support the understanding of recycling models applied to plastics, the main objective of this work is to offer a literature review of the different reverse logistics (RL) models for collecting plastic waste (PW). The methodology used for processing the scientific literature was content analysis, using the google scholar search engine. The main keywords used were RL and PW. This article is divided into two parts: the first part discusses the development of circular economy models and RL networks and raises the conceptual framework of the research, and the second part presents mathematical models and exploratory studies, proposed as a solution for RL problems of PW. Articles published between years 2014 and 2019 were reviewed. In total, 102 references were used, 70 of them are part of the literature review. According to our findings, we can state that the most widely used solution method for mathematical modeling is mixed-integer linear programming, and for exploratory studies, it was evaluations. About 93% of studies evaluated raw materials related to PW; only 13% of studies had models with stochastic processes; and 88% of the investigations used continuous variables, being the multiobjective functions one of the most used to provide solutions to RL problems. Regarding the mathematical models, 49% were evaluations, 9% corresponded to multicriteria analysis, 29% to linear and nonlinear programming, and 4% to another type of evaluation or model.
Supporting Youth With Autism Learning Social Competence: A Comparison of Game-and Nongame-Based Activities in 3D Virtual World
Authors: Wang Xianhui , Xing Wanli
Published: June 2021

This study explored youth with Autism Spectrum Disorder (ASD) learning social competence in the context of innovative 3D virtual learning environment and the effects of gaming as a central element of the learning experience. The empirical study retrospectively compared the social interactions of 11 adolescents with ASD in game-and nongame-based 3D collaborative learning activities in the same social competence training curriculum. We employed a learning analytics approach - association rule mining to uncover the associative rules of verbal social interaction and nonverbal social interaction contributors from the large dataset of the coded social behaviors. By comparing the rules across the game and nongame activities, we found a significant difference in youth with ASD’s social performance. The results of the group comparison study indicated that the co-occurrence of verbal and nonverbal behaviors is much stronger in the game-based learning activities. The game activities also yielded more diverse social interaction behavior patterns. On the other hand, in the nongame activities, students’ social interaction behavior patterns are much more limited. Furthermore, the impact of game design principles on learning is then discussed in this paper.