bluuebunny/crossref_metadata_2025 huggingface dataset:
Pediatric Minor Head Trauma: Factors Affecting the Anxiety of Parents
Authors: Aldinc Hasan , Gun Cem , Yaylaci Serpil , Barbur Erol
Published: April 2021

Managing the anxiety of the parents of pediatric patients with head trauma is challenging. This study aimed to examine the factors that affect anxiety levels of parents whose children were admitted to the emergency department with minor head trauma. In this prospective study, the parents of 663 consecutive pediatric patients were invited to answer a questionnaire. Parents of 600 children participated in the study. The parents who believed they were provided sufficient information and who were satisfied with the service received had significantly more improvement in anxiety-related questions. Cranial X-ray assessment had a significantly positive impact on the anxiety of the parents, whereas cranial computed tomography and neurosurgery consultation did not. In assessing pediatric minor head trauma, cranial computed tomography imaging and neurosurgery consultation should not be expected to relieve the anxiety of the parents. However, adequately informing them and providing satisfaction are the factors that could lead to improvement.
Focal Concerns and Intimate Partner Violence Case Processing: Predicting Arrest Using a Stratified Random Sample of Police Case File Data
Authors: Franklin Cortney A. , Bouffard Leana A. , Garza Alondra D. , Goodson Amanda
Published: April 2021

Focal concerns has utility for explaining criminal justice decisions, including among police. At present, there is no research that has examined focal concerns and arrest decisions in non-sexual, intimate partner violence (IPV) cases. This study used a stratified random sample of 776 IPV incidents from an urban police department in one of the five largest and most diverse US cities to assess the effect of focal concerns on arrest. A multivariate binary logistic regression model demonstrated victim injury, suspect IPV and general criminal history, evidence, witnesses, victim preference for formal intervention, women victims, and intoxicated suspects predicted arrest. When the suspect was on scene, this was the strongest predictor of arrest. Implications and future research are discussed.
Urban platforms as a mode of governance
Authors: Haveri Arto , Anttiroiko Ari-Veikko
Published: April 2021

This article provides an analysis of urban platform governance by mapping out the major forms of public governance and depicting the role of platforms in this field. By fusing theoretical analyses and empirical views from three urban platforms set up by the largest cities in Finland, we assess the relevance of platforms as an emerging form of local public governance. It is plausible to view platforms as hybrids that incorporate features of both networks and markets, and, to some extent, even hierarchies. However, platforms also have some irreducible features, which makes it possible to perceive them as a fourth mode of governance. Platform logic broadens the view of network governance to a broader set of connections, the orchestration of multiple logics and ecosystem thinking.

Points for practitioners

Today, city governments create and maintain urban platforms to bring together different actors and enable value-added collaboration in service provision, governance and planning. This article helps local policymakers and managers understand platform logic in involving various audiences in the creation of public value. When governing platforms, local public managers may use many of the same methods as with networks. Platform governance, however, extends the view to a broader set of connections, the orchestration of multiple logics and ecosystem thinking.
The Art and Times of ABDIAS NASCIMENTO: QUILOMBOLA EXTRAORDINAIRE
Authors: Sterling Cheryl
Published: April 2021

This paper explores the aesthetic trajectory of Abdias Nascimento in the context of his life’s work, arguing that he has to be apprehended as a Quilombola warrior figure, through his entwinement of political and artistic agency. More specifically, it explores how Nascimento harnesses the creative matrix found in the lived history, myth and figuration from candomblé as a dramatist and as a painter. First, it delves into his creation of the Teatro Experimental do Negro (TEN), the first black theater in Brazil and his use of candomblé as a template of dramaturgy in his play, Sortilégio. However, the main analysis centers on his paintings, which combines candomblé symbology, along with other African cultural forms, to create culturally meaningful aesthetic forms that affirmed Afro-Brazilian subjectivity and their historical belonging in the nation and connection to the larger Africana world.
A Qualitative Study of Intention and Impact of Ayahuasca Use by Westerners
Authors: Bathje Geoff J. , Fenton Jonathan , Pillersdorf Daniel , Hill London C.
Published: April 2021

Ayahuasca has gained the attention of researchers over the past decade as psychedelic-assisted therapy for MDMA and psilocybin have progressed through FDA approved clinical trials. In spite of the increase in research, there are relatively few clinical studies of ayahuasca and little qualitative research on the therapeutic or healing uses of psychedelics in general. The present study included 41 Western participants who were interviewed about their participation in facilitated group ayahuasca experiences (e.g., in shamanic, neoshamanic, spiritual, and religious settings). Participants were interviewed about their intentions for participating, along with the perceived impact of the experiences. In particular, we focused on impacts that participants perceived to be sustained and enduring. We identified an impressive range of beneficial impacts, including improvements in areas that are often a focus of psychotherapy, such as mental health and substance use, health behaviors, interpersonal relationships, sense of self, attitude. Extratherapeutic effects were also observed in areas such as changes in creativity, somatic sensations, physical health/pain, sense of connection to nature, spirituality, and concern for the greater good. Two participants also reported problematic experiences, apparently related to set and setting. Implications for research and practice, along with a humanistic framework for interpreting these findings is provided.
As an Act of Protest and Emotional Catharsis About the Ugly Truth of Racism
Authors: Kangalee Dennis Leroy , Greene Eric , Gupta Nisha
Published: April 2021

In this edited interview, psychologists Eric Greene and Nisha Gupta interview filmmaker Dennis Leroy Kangalee about his film As an Act of Protest (2002), which is about a young African American actor named Cairo Medina who goes through a station-of-the-cross journey to find the meaning of his life and eradicate the racism and police brutality that continue to plague the world. In this conversation, Dennis shares the genesis of the film as a response to the police brutality occurring in New York in the late 1990s, the psychological struggles he experienced while making this film and enduring backlash to it, and his desire to convey raw emotional truths about the ugliness of racism and racial trauma through a style of radically honest filmmaking that can foster catharsis, reflection, and transformation.
Geographic Differences and Social Determinants of Health Among People With HIV Attributed to Injection Drug Use, United States, 2017
Authors: Jin Chan , Nwangwu-Ike Ndidi , Gant Zanetta , Johnson Lyons Shacara , Satcher Johnson Anna
Published: April 2021

Objective

People who inject drugs are among the groups most vulnerable to HIV infection. The objective of this study was to describe differences in the geographic distribution of HIV diagnoses and social determinants of health (SDH) among people who inject drugs (PWID) who received an HIV diagnosis in 2017.

Methods

We used data from the National HIV Surveillance System (NHSS) to determine the counts and percentages of PWID aged ≥18 with HIV diagnosed in 2017. We combined these data with data from the US Census Bureau’s American Community Survey at the census tract level to examine regional, racial/ethnic, and population-area-of-residence differences in poverty status, education level, income level, employment status, and health insurance coverage.

Results

We observed patterns of disparity in HIV diagnosis counts and SDH among the 2666 PWID with a residential address linked to a census tract, such that counts of HIV diagnosis increased as SDH outcomes became worse. The greatest proportion of PWID lived in census tracts where ≥19% of the residents lived below the federal poverty level, ≥18% of the residents had <high school diploma, the median annual household income was <$40 000, and ≥16% of the residents did not have health insurance or a health coverage plan.

Conclusion

To our knowledge, our study is the first large-scale, census tract–level study to describe SDH among PWID with diagnosed HIV in the United States. The findings of substantial disparities in SDH among people with HIV infection attributed to injection drug use should be further examined. Understanding the SDH among PWID is crucial to reducing disparities in HIV diagnoses in this population.
Local Autonomy in Temporary Organizations: The Case of Smart City Pilots
Authors: Mukhtar-Landgren Dalia
Published: April 2021

Local actors are to an increasing extent engaging in national and European Union (EU)–based development and sustainability agendas. These ventures often materialize in the form of temporary organizations such as pilots and projects. This article contributes to debates on project-based, experimental and temporary organizations by unpacking the organizational architecture of pilots and analyzing how the democratic autonomy of local public actors is formed. Through the example of smart city pilots, the study shows how a range of intersecting relations and hierarchies enable and circumscribe public-sector autonomy—from local actors’ attempts to align pilots with political goals to the limitations of standardized and scalable knowledge and strict funding requirements.
A school-based intervention to reduce gender-stereotyping
Authors: Spinner Lauren , Tenenbaum Harriet R. , Cameron Lindsey , Wallinheimo Anna-Stiina
Published: April 2021

Children’s adherence to gender stereotypes can be detrimental, yet interventions to tackle stereotyping have achieved mixed success. Few studies have examined interventions developed collaboratively by educators and researchers, and the impact of interventions that focus on increasing perceived similarities between genders has yet to be tested. The present study evaluated an intervention among 6- to 10-year-old British children (47 boys; 37 girls) compared to a control group (61 boys; 47 girls). Led by their class teacher via weekly 30-minute lessons, over a four-month period, children learned to identify and challenge stereotypes, and explored similarities between genders and diversity within gender (e.g., not all girls like pink). Key measures of gender flexibility in relation to toy play, occupations, and perceived similarity to gender groups were utilised. After controlling for baseline scores, the intervention group felt more similar to the other gender and reported that they could do a wider range of occupations in the future. Those who showed less flexibility around toy play at baseline were more flexible after the intervention. Boys in the intervention group reported that gender stereotypes were more unfair than did the control group. Findings are discussed in relation to theories of gender stereotyping and intervention research.
Effect of Daily Stress on Desire for Physical Proximity and Emotional Closeness
Authors: Estlein Roi , Lavee Yoav
Published: April 2021

The current study explores how fluctuations in proximity seeking and emotional closeness in married couples are associated with stress experiences of daily hassles and with global evaluations of the relationship and personality traits. To document the associations of daily experiences of self-related, relational, and external sources of stress with both partners’ regulation of closeness and distance, perceived marital quality, attachment, and neuroticism, we employed a mixed-method research that included a repeated time sampling approach (a daily diary) and survey instruments. Multivariate multilevel statistical and actor–partner interdependence models revealed that all sources of stress were negatively associated with proximity seeking and dyadic emotional closeness but somewhat varied across men and women. In addition, global assessments of marriage and personal traits related to experiences of daily hassles and to dyadic closeness. Findings are discussed in terms of their theoretical, operational, and practical implications.
Social Determinants of Health, Environmental Exposures and Home Radon Testing
Authors: Stanifer Stacy R. , Rayens Mary Kay , Wiggins Amanda , Hahn Ellen J.
Published: April 2021

Home radon testing is a primary lung cancer prevention strategy, yet the majority of Americans have not tested their home. This descriptive, ecological study uses 54,683 observed radon values collected in Kentucky homes from 1996 to 2016 to examine the association of county-level social determinants of health and environmental exposures on home radon testing rates. Multivariate linear regression analysis indicates that as median home value, rurality, and radon risk potential increased, counties experienced an increase in annual home radon testing rates. As adult smoking prevalence increased, counties experienced a decrease in annual rates of residential radon testing. These findings indicate that counties with low median home values, high adult smoking prevalence, and high incidence of lung cancer may benefit most from prevention interventions aimed at promoting home radon testing, adopting radon- and smoke-free home policies, and integrating radon risk reduction messaging into tobacco cessation and lung cancer screening programs.
Emigrant Draft Evasion in the First World War: Decision-Making and Emotional Consequences in the Transatlantic Italian family
Authors: Daly Selena
Published: April 2021

In 1911, Italians living abroad constituted one-sixth of Italy’s population, numbering roughly five million people. During the First World War, approximately 300,000 men returned from the Americas and other European countries to answer the call to arms and complete their military service. However, this number constitutes only 13 per cent of those men living abroad who were liable for conscription. Thus, this article will examine the larger phenomenon of draft evasion among emigrant Italians across the Atlantic, where most evaders resided. I will begin by analysing evasion in the context of Italian mobilization and the factors influencing emigrants’ decision-making. I argue that the decision was a joint one, negotiated between family members on both sides of the ocean. I will thus also explore the impact of this decision on personal relationships, through three case studies of familial separation initially caused by emigration and then compounded by draft evasion: a husband in California and his wife in Liguria; a son in the Dominican Republic and his mother in Calabria; and a woman in Argentina whose husband had evaded the draft, and her sister in Liguria, exploring the emotional toll this decision took on them and their loved ones.
Impact of physician-based palliative care delivery models on health care utilization outcomes: A population-based retrospective cohort study
Authors: Brown Catherine R L , Webber Colleen , Seow Hsien-Yeang , Howard Michelle , Hsu Amy T , Isenberg Sarina R , Jiang Mengzhu , Smith Glenys A , Spruin Sarah , Tanuseputro Peter
Published: April 2021

Background:

Increasing involvement of palliative care generalists may improve access to palliative care. It is unknown, however, if their involvement with and without palliative care specialists are associated with different outcomes.

Aim:

To describe physician-based models of palliative care and their association with healthcare utilization outcomes including: emergency department visits, acute hospitalizations and intensive care unit (ICU) admissions in last 30 days of life; and, place of death.

Design:

Population-based retrospective cohort study using linked health administrative data. We used descriptive statistics to compare outcomes across three models (generalist-only palliative care; consultation palliative care, comprising of both generalist and specialist care; and specialist-only palliative care) and conducted a logistic regression for community death.

Setting/participants:

All adults aged 18–105 who died in Ontario, Canada between April 1, 2012 and March 31, 2017.

Results:

Of the 231,047 decedents who received palliative services, 40.3% received generalist, 32.3% consultation and 27.4% specialist palliative care. Across models, we noted minimal to modest variation for decedents with at least one emergency department visit (50%–59%), acute hospitalization (64%–69%) or ICU admission (7%–17%), as well as community death (36%–40%). In our adjusted analysis, receipt of a physician home visit was a stronger predictor for increased likelihood of community death (odds ratio 9.6, 95% confidence interval 9.4–9.8) than palliative care model (generalist vs consultation palliative care 2.0, 1.9–2.0).

Conclusion:

The generalist palliative care model achieved similar healthcare utilization outcomes as consultation and specialist models. Including a physician home visit component in each model may promote community death.
Virtually Together: Developing a Local Social Network for Neighborhoods
Authors: Koletsi Maria , Sfakianos Nikolaos , Papadopoulou Athina , Karras Dimitris , Vagias Georgios , Koskinas Konstantinos
Published: April 2021

The paper presents the main preliminary findings of GEITONIA research project (Growing and Enabling of Information Technologies for Online Neighborhoods: Implications and Applications). Focusing on the development of a local social network for neighborhoods of Nea Smyrni community in Attica (Greece), the main results of an exploratory mixed methods research study, are discussed. The local social network is a non-commercial social medium that operates as a mobile application. Residents of the local community will have the opportunity to use the application for a pilot period, create their virtual neighborhoods, interact with other neighbors, and expand local social ties in a continuum of physical and virtual spatialities. Moreover, taking into consideration residents’ perceptions, demands and visions, regarding a local social network for their neighborhoods, the research project aims to enhance the rule that sets the focus on the users, as co-creators and co-producers of communication technologies.
Competing Ontologies: A Redux Primer for Public Administration
Authors: Stout Margaret , Love Jeannine M.
Published: April 2021

Over the last decade, a growing number of public administration theorists have taken up the question of how ontology—assumptions about the nature of existence—shapes our understanding of governance. This substantially updated primer, originally published in Public Administration Review, introduces the essay, provides a basic explanation of ontology, describes the fundamental debates in philosophies of ontology, and discusses why ontology is important to social and political theory and therefore public administration theory and practice. Using an ideal-type approach grounded in differing ontological assumptions, a Governance Typology is provided to support analysis of differing public administration theories. An integrative approach to governance is offered that is grounded in relational process ontology—a foundation that may support a viable synthesis of the other four primary ideal-types. The essay concludes with a call for personal reflection on the part of scholars and practitioners regarding their own ontological commitments and an invitation to collaborative inquiry.
Elevated free testosterone levels and reduced very low-density lipoprotein levels in men with lifelong premature ejaculation: a preliminary study
Authors: Zhao Jun , Ma Yubo , Zhai Xiaoqiang , Li Hecheng , Wang Ziming , Chong Tie
Published: April 2021

Objective

To investigate sex hormone and blood lipid levels in patients with lifelong premature ejaculation (LPE) in China.

Methods

Sex hormone and blood lipid levels were measured in 156 patients with LPE and 76 healthy controls. The Premature Ejaculation Diagnostic Tool (PEDT) and Chinese Index of Sexual Function for Premature Ejaculation-5 Questionnaires (CIPE-5) were applied to diagnose and grade LPE.

Results

PEDT and CIPE-5 scores were significantly altered in the LPE group compared with the control group. Free testosterone levels were significantly higher in the LPE group than in the control group. Free testosterone levels were also significantly higher in the mild, moderate, and severe LPE subgroups than in the control group. Total testosterone and prolactin levels tended to be lower in the control group than in the LPE group. Very low-density lipoprotein levels were significantly lower in the LPE group and LPE subgroups than in the control group. Triglyceride levels were highest in controls and decreased with progression of LPE.

Conclusions

Patients with LPE have higher free testosterone levels and lower very low-density lipoprotein levels than controls. These findings indicate that these factors might be indices for LPE. However, the reasons for these phenomena need to be further investigated.
Risk factors for 28-day mortality in patients with sepsis-related myocardial injury in intensive care units
Authors: Zhang Meng , Duan Meili , Zhi Deyuan , Lin Jin , Liu Pei , Wang Yajun
Published: April 2021

Objective

This study aimed to identify the risk factors for death in patients with sepsis-related myocardial injury.

Methods

A retrospective study was conducted in 158 patients with sepsis-related myocardial injury in a mixed medical intensive care unit from January 2009 to March 2020. The patients were divided into those who survived and those who died on the basis of whether they survived after 28 days. Demographic and clinical parameters were collected. Multivariate logistic regression was performed.

Results

Sixty-nine (43.7%) patients died within 28 days after admission to the intensive care unit. Multivariate logistic regression analysis showed that the oxygenation index (odds ratio [OR]: 0.979, 95% confidence interval [CI]: 0.970–0.989), acute kidney injury (OR: 4.787, 95% CI: 1.674–13.693), norepinephrine dose (OR: 1.706, 95% CI: 1.375–2.117), and abdominopelvic cavity infection (OR: 0.257, 95% CI: 0.076–0.866) were significantly associated with mortality within 28 days after admission in patients with sepsis-related myocardial injury.

Conclusions

Patients with sepsis-related myocardial injury have a high mortality rate. A high oxygenation index, occurrence of acute kidney injury, high norepinephrine dose, and occurrence of abdominopelvic cavity infection are independent risk factors for 28-day mortality in patients with sepsis-related myocardial injury.
Recurrent pheochromocytoma with catecholamine cardiomyopathy and left ventricular thrombus: a case report
Authors: Chen Renzheng , Wang Yong , Yang Jie , Cheng Xiaofeng , Wang Jiang , Huang Lan
Published: April 2021

Pheochromocytoma is a rare and usually benign tumor of the adrenal glands. We report a case of a 40-year-old woman with recurrent pheochromocytoma and catecholamine cardiomyopathy. She had no history of other types of tumors or connective tissue disease. She had already undergone surgery twice to remove the pheochromocytoma, which had now recurred for the second time. A thrombus in the left ventricle was also noted upon imaging examination, which dissipated after anticoagulation therapy using dabigatran, allowing the patient to opt for an elective third surgery. This paper describes the clinical outcome of using the anticoagulant dabigatran to treat left ventricular thrombosis in this rare case of recurrent pheochromocytoma, and thus further contributing to the knowledge of the clinical management of this rare and complicated disease.
Clinical and reproductive outcomes of uterine smooth muscle tumor of uncertain malignant potential: a single-center retrospective study
Authors: Ning Chengcheng , Zhang Lihong , Zhao Chenyan , Chen Xiaojun , Liu Xiaoxia , Gu Chao
Published: April 2021

Objective

To evaluate the clinical outcomes, histopathological features, and obstetric and oncological outcomes of uterine smooth muscle tumor of uncertain malignant potential (STUMP).

Methods

We conducted a single-center, database review of patients with STUMP between January 2001 and December 2015. We investigated the clinical, operative, histopathologic, recurrence, and fertility outcomes of the included cases.

Results

Nineteen patients with STUMP were studied. Three were reclassified as sarcoma after slide review, and 16 patients were finally included in the study. The mean age was 45 years. Ki-67 expression was ≥10% in 25.0% of cases and 30% in the only recurrent case. Recurrence occurred 52 months after a diagnosis of STUMP in a 56-year-old female patient who underwent hysterectomy. Two of six patients who underwent myomectomy had fertility requirements, and both successfully delivered babies without recurrence. Recurrence was not related to mitosis, degree of atypia, or necrosis. There was also no relationship between type of surgery or surgical approach and recurrence.

Conclusions

Patients with STUMP warrant a pathological review process in centers with experience. Fertility-preservation is worth attempting, but young patients must be followed-up closely. Ki-67 might be a valuable marker predicting recurrence.
Translation and cultural adaptation of the Sensory Profile 2 to the Persian language
Authors: Shahbazi Marjan , Mirzakhany Navid , Alizadeh Zarei Mehdi , Zayeri Farid , Daryabor Aliyeh
Published: April 2021

Introduction

The purpose of this study was to translate and cross-culturally adapt the original Sensory Profile 2 questionnaires to Persian and access the psychometric properties of the adapted questionnaires.

Method

The translation and cultural adaptation of the original questionnaires were carried out under the published guidelines. Furthermore, we employed the multiple methods to establish the validity and reliability of the Sensory Profile 2 questionnaires. We calculated the content validity, internal consistency, and test–retest, along with the standard error of measurement. The study included 1272 children, between 0 and 14 years old, without any disabilities. They were selected from child developmental centers and elementary and middle schools of Tehran, the capital of the Islamic Republic of Iran.

Results

The item-level content validity index and the scale-level were satisfactory for all the items, quadrant, section, and factor of the Sensory Profile 2. The values of alpha for all questionnaires were ranged from 0.67 to 0.91. Furthermore, the test–retest reliability values for all questionnaires ranged from 0.72 to 0.95.

Conclusions

The Sensory Profile 2-Persian version can considered as a valid and reliable tool for utilization in Persian-speaking children between 0 and 14 years old.
(Overlooked) Association between Express Bus Station/Stop Proximity and Multifamily Rents with a Surprise about Transit Mode Synergism and Implications for Transit and Land Use Planning
Authors: Nelson Arthur C. , Hibberd Robert
Published: April 2021

Despite hundreds of studies into the association between real estate value and proximity to fixed-route transit (FRT) systems, none has assessed the association with respect to express bus transit (XBT) stations/stops. Ours is the first to do so. Using a static, cross-section quasi-experimental research design, we evaluate CoStar multifamily (MF) rent per square foot to estimate the difference in rent with respect to proximity to XBT stations/stops. However, we are also interested in knowing whether there are synergistic price effects at the intersection of XBT and other FRT systems such as light rail transit (LRT). In this article, we estimate the MF rent premium with respect to XBT and LRT (XBT+LRT) station/stop proximity separately, rent premiums for combined XBT and LRT stations/stops and for those MF cases that are more than 1.0 mi beyond the nearest LRT station. In all cases, whether separately or combined with LRT stations or away from LRT stations, we find positive associations between MF rent and proximity to XBT stations/stops. However, we also find evidence of negative externalities at or near XBT, LRT, and XBT+LRT stations/stops. Express bus transit and land-use planning implications are offered.
Toward Just-in-Time Data Communications over Shared Networks and Computational Resources on Massive Client Environment
Authors: Asai Hirochika , Doi Yusuke , Onishi Ryokichi
Published: April 2021

Intelligent driving has been benefiting from advances in automotive big data analysis and on-demand data communications, where efficient vehicle-to-cloud communication is a key technology able to collect a huge amount of data from vehicles. However, as the capacities of the network and computational resources of the cloud are not unlimited, simultaneous data transfer based on a best-effort manner results in a resource starvation problem. Therefore, an application is needed to prioritize data communication to alleviate the problem and complete the data transfer just in time. This paper highlights the problem of resource starvation led by best-effort data transfers. It proposes protocols for data communication and control that could enable just-in-time data communication, notably for data collection. We demonstrate through experiments that the proposed mechanism enables efficient and effective data collection over the shared network resources.
Anterior Cruciate Ligament Reconstruction Alone Versus With Lateral Extra-articular Tenodesis With Minimum 2-Year Follow-up: A Meta-analysis and Systematic Review of Randomized Controlled Trials
Authors: Onggo James Randolph , Rasaratnam Hari Krishnan , Nambiar Mithun , Onggo Jason Derry , Pai Vishal , Damasena Iswadi , Riazi Arash , Babazadeh Sina
Published: April 2021

Background:

Lateral extra-articular tenodesis (LEAT) aims to improve anterolateral stability of the injured knee during anterior cruciate ligament reconstruction (ACLR) surgery. Inconclusive evidence surrounding the efficacy and safety of LEAT has propelled clinical interest and ongoing discussions.

Purpose:

To establish level 1 evidence by assessing randomized controlled trials (RCTs) with minimum 2-year follow-up that directly compared ACLR with LEAT (LEAT group) and ACLR alone (non-LEAT group) in terms of clinical outcomes and complications.

Study Design:

Meta-analysis and systematic review; Level of evidence, 1.

Methods:

Meta-analysis was performed with a multidatabase search (Cochrane, EMBASE, OVID Medline, PubMed, and Web of Science) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on September 9, 2020. Data from published RCTs meeting inclusion criteria were extracted and analyzed with an inverse variance statistical model.

Results:

A total of 7 RCTs were included, consisting of 517 LEAT and 589 non-LEAT patients. Only autografts were used for ACLR and LEAT. A variety of LEAT techniques and autograft fixation methods were used. We found improved stability (residual positive pivot shift: risk ratio [RR], 0.59; 95% CI, 0.39-0.88; P = .01) and better clinical outcomes (International Knee Documentation Committee [IKDC] score: mean difference [MD], 2.31; 95% CI, 0.54-4.09; P = .01; and Lysholm score: MD, 2.71; 95% CI, 0.68-4.75; P = .009) in the LEAT than non-LEAT group. Graft rerupture rate was 3 times less likely (RR, 0.31; 95% CI, 0.17-0.58; P < .001) in the LEAT group than the non-LEAT group.

Conclusion:

Good-quality evidence is available to support the efficacy of LEAT in improving anterolateral knee stability and reducing graft reruptures in primary ACLR. LEAT should be considered in patients with high risk factors. Although Lysholm and IKDC scores were statistically better in the LEAT group, these are unlikely to be clinically significant. Future studies should aim to identify patient populations that would best benefit from LEAT with ACLR.
Oculoplastic Surgeons’ Surgical, Clinical, and Management Experiences During the COVID-19 Crisis
Authors: Homer Natalie A. , Epstein Aliza , Shore John W. , Somogyi Marie
Published: April 2021

During the COVID-19 crisis, the American Society of Ophthalmic Plastic and Reconstructive Surgeons (ASOPRS) recommended cessation of all nonurgent oculofacial services, imparting unprecedented challenges in patient care and practice management. An anonymous survey was performed to assess surgeons’ surgical, clinical, and financial experiences during the COVID-19 restrictions. Results were collected from April 20 to May 1, 2020 and analyzed. A total 112 ASOPRS members participated. A significant majority (81.52%) performed surgeries during the COVID-19 restrictions. Fourteen percent did not allow trainee participation. While operating, 34.41% always wore an N-95 mask. Preoperative patient COVID-19 testing was mandated in 37.21% of practices. Fewer than half of surgeons were required to leave the operating room during intubation. A large majority (88.76%) of ASOPRS members used telemedicine, with most finding the virtual platform to function moderately well (62.92%) for oculofacial evaluations. Senior ASOPRS members were less interested in continuing virtual patient encounters in the future ( P = .0130). Nearly all private practice surgeons (95.38%) had applied for federal funding and 83.51% expressed concern about the long-term financial well-being of their practice. ASOPRS surgeons have provided emergency oculofacial patient care during COVID-19, though often without proper safety precautions. New virtual patient evaluation platforms and financial practice hardships have posed additional challenges.
Arteries of the Lower Limb—Embryology, Variations, and Clinical Significance
Authors: Qazi Emmad , Wilting Joerg , Patel Neeral R. , Alenezi Abdullah O. , Kennedy Sean A. , Tan Kong T. , Jaberi Arash , Mafeld Sebastian
Published: April 2021

Objectives:

The purpose of this article is to review the embryology of the lower limb arterial anatomy along with common variants and their clinical relevance.

Design:

Embryologic variations of the lower limb arterial system may be explained by i.) persistence of primordial arterial segments, ii.) abnormal fusion, iii.) segmental hypoplasia/absence, or a combination of both. Persistent sciatic artery, corona mortis, and popliteal entrapment syndrome will also be discussed with associated symptoms, and potential complications.

Conclusion:

Knowledge of these variations is essential for surgical and endovascular management as failure to recognize them can result in complications.
Sensory Function and Psychological Factors in Children With Complex Regional Pain Syndrome Type 1
Authors: Truffyn Emma E. , Moayedi Massieh , Brown Stephen C. , Ruskin Danielle , Duerden Emma G.
Published: April 2021

Objective:

To assess thermal-sensory thresholds and psychosocial factors in children with Complex Regional Pain Syndrome Type 1 (CRPS-I) compared to healthy children.

Methods:

We conducted quantitative sensory testing on 34 children with CRPS-I and 56 pain-free children. Warm, cool, heat, and cold stimuli were applied to the forearm. Children with CRPS-I had the protocol administered to the pain site and the contralateral-pain site. Participants completed the self-report Behavior Assessment System for Children.

Results:

Longer pain durations (>5.1 months) were associated with decreased sensitivity to cold pain on the pain site ( P = .04). Higher pain-intensity ratings were associated with elevated anxiety scores ( P = .03). Anxiety and social stress were associated with warmth sensitivity (both P < .05) on the contralateral-pain site.

Conclusions:

Pain duration is an important factor in assessing pediatric CRPS-I. Hyposensitivity in the affected limb may emerge due to degeneration of nociceptive nerves. Anxiety may contribute to thermal-sensory perception in childhood CRPS-I.
Factors Predisposing to Post Dural Puncture Headache in Children
Authors: Bandatmakur Madhav , Bench Carter , Ngwa Ngum , Osman Heba , Dave Pooja , Farooqi Ahmad , Sivaswamy Lalitha
Published: April 2021

Background:

Knowledge of the factors that predispose to postdural puncture headache in children may help reduce the occurrence of this complication.

Materials and Methods:

A retrospective cohort study of children who presented to the study institution between 2010 and 2018 was conducted. Children were divided into 2 groups: those who experienced postdural puncture headache and those who did not. The 2 groups were compared with respect to certain demographic, technical, and personnel-related factors. Only children who had opening pressure documented during the procedure were included in the core study group.

Results:

In univariate analysis, children aged ≥10 years, female gender, children with higher body mass index, standard blinded lumbar puncture procedure, use of sedation, higher opening pressure, and presence of pseudotumor cerebri increased the probability of postdural puncture headache. In multivariable logistic regression analysis, presence of pseudotumor cerebri was the only factor that attained statistical significance when the opening pressure was measured and documented.

Conclusions:

The risk factors for postdural puncture headache in a pediatric cohort varied from risk factors that are classically implicated in adults.
Mechanisms Underlying Neurologic Injury in Intrauterine Growth Restriction
Authors: Wan Lijia , Luo Kaiju , Chen Pingyang
Published: April 2021

Intrauterine growth restriction is a condition that prevents normal fetal development, and previous studies have reported that intrauterine growth restriction is caused by adverse intrauterine factors. This condition affects both short- and long-term neurodevelopmental disorders. Studies have revealed that neurodevelopmental disorders can contribute to gray and white matter damage and decrease the brain volume of affected individuals. Further, these disorders are associated with increased risks of mental retardation, cognitive impairment, and cerebral palsy, which seriously affect the quality of life. Although the mechanisms underlying the neurologic injury associated with intrauterine growth restriction are not completely clear, studies have revealed that neuronal apoptosis, neuroinflammation, oxidative stress, excitatory toxicity, disruption of blood-brain barrier, and epigenetics may be involved in this process. This article reviews the manifestations and possible mechanisms underlying neurologic injury in intrauterine growth restriction and provides a theoretical basis for the effective prevention and treatment of this condition.
Solriamfetol for the Management of Excessive Daytime Sleepiness
Authors: Cuomo Megan C , Sheehan Amy H , Jordan Joe K
Published: April 2021

Objective:

To review efficacy, safety, and place in therapy of solriamfetol for management of excessive daytime sleepiness (EDS) in patients with narcolepsy and obstructive sleep apnea (OSA).

Methods:

PubMed (1966 to January 2021) was searched using the terms solriamfetol, JZP-110, ADX-N05 and Sunosi. Human studies published in peer-reviewed medical journals in English language were reviewed.

Results:

The efficacy and safety of solriamfetol has been reported in 2 phase II trials and 4 phase III trials (TONES 2, TONES 3, TONES 4, and TONES 5). Statistically significant improvements in the maintenance of wakefulness test were reported with solriamfetol 150 mg and 300 mg vs placebo in participants with narcolepsy (7.65- to 10.14-minute difference from placebo). In subjects with OSA, statistically significant improvements in maintenance of wakefulness test difference from placebo were also observed in those taking solriamfetol 75 mg, 150 mg, or 300 mg vs placebo (4.5- to 12.8-minute difference from placebo). Statistically significant reductions in Epworth Sleepiness Scale scores were also reported in phase III trials in subjects with narcolepsy or OSA taking solriamfetol vs placebo (ranging from − 4.7 to − 1.9 difference from placebo). Common adverse events in reported in phase III trials were headache, nausea, decreased appetite, anxiety, dry mouth, and diarrhea. Solriamfetol appears to have a reduced risk for drug interactions and fewer adverse effects compared to other agents available for management of EDS in patients with narcolepsy and OSA.

Conclusions:

Solriamfetol is an effective option for management of EDS in patients with narcolepsy and OSA.
Acute Diuretic-Sparing Effects of Sacubitril-Valsartan: Staying in the Loop
Authors: Orvin Nicholas J. , Beavers Janna C. , Russell Stuart D.
Published: April 2021

Background:

Previous literature has suggested a potential diuretic sparing effect as early as 6 months following sacubitril-valsartan initiation in patients with heart failure with reduced ejection fraction (HFrEF); however, whether this effect manifests earlier after initiation is unclear. Objective: To evaluate the acute diuretic-sparing effects of sacubitril-valsartan.

Methods:

This was a single-center, retrospective analysis of outpatients with HFrEF initiated on sacubitril-valsartan with follow up within 90 ± 30 days and a concomitant loop diuretic prescription. The primary outcome was the percent of patients with an increase, decrease or no change in loop diuretic total daily dose (TDD). Key secondary outcomes included change in loop diuretic TDD (mg furosemide equivalents) and hospital admissions or emergency department (ED) visits.

Results:

A total of 145 patients were included (overall cohort) with 120 continuing sacubitril-valsartan at follow up (on-treatment cohort). In the on-treatment cohort, 20% (n = 24) had a reduction in loop diuretic TDD and 10% had an increase (n = 12). Median change in loop diuretic TDD was unchanged from baseline to follow up (p 0.13). In patients on >80 mg TDD of furosemide at baseline (n = 9), mean change was-53 ± 44 mg (p 0.006). Hospitalizations (6.2%) and ED visits (0.7%) for heart failure were infrequent.

Conclusion:

Patients may require a loop diuretic dose reduction within 2-3 months following sacubitril-valsartan initiation. This diuretic-sparing effect appears larger in those on higher baseline loop diuretic doses, and closer follow up may be warranted for these patients.
On some antecedents of behavioural economics
Authors: Hansen Kristian Bondo , Presskorn-Thygesen Thomas
Published: April 2021

Since its inception in the late 1970s, behavioural economics has gone from being an outlier to a widely recognized yet still contested subset of the economic sciences. One of the basic arguments in behavioural economics is that a more realistic psychology ought to inform economic theories. While the history of behavioural economics is often portrayed and articulated as spanning no more than a few decades, the practice of utilizing ideas from psychology to rethink theories of economics is over a century old. In the first three decades of the 20th century, several mostly American economists made efforts to refine fundamental economic assumptions by introducing ideas from psychology into economic thinking. In an echo of contemporary discussions in behavioural economics, the ambition of these psychology-keen economists was to strengthen the empirical accuracy of the fundamental assumptions of economic theory. In this article, we trace, examine, and discuss arguments for and against complementing economic theorizing with insights from psychology, as found in economic literature published between 1900 and 1930. The historical analysis sheds light on issues and challenges associated with the endeavour to improve one discipline’s theories by introducing ideas from another, and we argue that these are issues and challenges that behavioural economists continue to face today.
Using multiple imputation to classify potential outcomes subgroups
Authors: Li Yun , Bondarenko Irina , Elliott Michael R , Hofer Timothy P , Taylor Jeremy MG
Published: April 2021

With medical tests becoming increasingly available, concerns about over-testing, over-treatment and health care cost dramatically increase. Hence, it is important to understand the influence of testing on treatment selection in general practice. Most statistical methods focus on average effects of testing on treatment decisions. However, this may be ill-advised, particularly for patient subgroups that tend not to benefit from such tests. Furthermore, missing data are common, representing large and often unaddressed threats to the validity of most statistical methods. Finally, it is often desirable to conduct analyses that can be interpreted causally. Using the Rubin Causal Model framework, we propose to classify patients into four potential outcomes subgroups, defined by whether or not a patient’s treatment selection is changed by the test result and by the direction of how the test result changes treatment selection. This subgroup classification naturally captures the differential influence of medical testing on treatment selections for different patients, which can suggest targets to improve the utilization of medical tests. We can then examine patient characteristics associated with patient potential outcomes subgroup memberships. We used multiple imputation methods to simultaneously impute the missing potential outcomes as well as regular missing values. This approach can also provide estimates of many traditional causal quantities of interest. We find that explicitly incorporating causal inference assumptions into the multiple imputation process can improve the precision for some causal estimates of interest. We also find that bias can occur when the potential outcomes conditional independence assumption is violated; sensitivity analyses are proposed to assess the impact of this violation. We applied the proposed methods to examine the influence of 21-gene assay, the most commonly used genomic test in the United States, on chemotherapy selection among breast cancer patients.