bluuebunny/crossref_metadata_2025 huggingface dataset:
Dimensions of autonomy in human–algorithm relations
Authors: Savolainen Laura , Ruckenstein Minna
Published: June 2022

This article reorients research on agentic engagements with algorithms from the perspective of autonomy. We separate two horizons of algorithmic relations – the instrumental and the intimate – and analyse how they shape different dimensions of autonomous agency. Against the instrumental horizon, algorithmic systems are technical procedures ordering social life at a distance and using rules that can only partly be known. Autonomy is activated as reflective and informed choice and the ability to enact one’s goals and values amid technological constraints. Meanwhile, the intimate horizon highlights affective aspects of autonomy in relation to algorithmic systems as they creep ever closer to our minds and bodies. Here, quests for autonomy arise from disturbance and comfort in a position of vulnerability. We argue that the dimensions of autonomy guide us towards issues of specific ethical and political importance, given that autonomy is never merely a theoretical concern, but also a public value.
Whistleblowing and the press: Complicating the standard account
Authors: Olesen Thomas
Published: June 2022

Whistleblowers and journalists are key democratic actors who are both concerned with the exposure of wrongdoing in corporations, organizations, and governments. For that reason, they often collaborate to bring incriminating information to public knowledge. In the standard account, the whistleblower initiates the contact to journalists who eventually publish the story. Based on a sample of 16 whistleblower cases, the paper shows that the reality of this relationship is more complex than the standard account suggests. The empirical material documents four different trajectories through which whistleblower information reaches the public sphere, only one of which conforms to the standard account. The paper explains the variation based on a theoretical framework, which highlights the main similarities and differences between whistleblowers and journalists. Seen from the perspective of whistleblowers the relationship is double-sided. On the one hand, engaging with the press entails considerable asymmetry and uncertainty for whistleblowers who do not always know the exact motives of journalists just as they enter the relationship from a much more precarious and unstable position. Whistleblowers are also wary of collaborating with the press because it entails a radical loss of privacy as the story breaks in the public sphere. On the other hand, interacting with the press can offer vital legitimacy, protection, and professional resources for vulnerable whistleblowers. Existing work on this core relationship in democracy is surprisingly small and undertheorized. The paper contributes to the debate by offering a theoretically and empirically grounded typology of the whistleblower-journalism nexus.
Researching masculinities and food protein practices: A trio of more-than-human participatory workshops
Authors: Hurley Paul , Roe Emma
Published: June 2022

Whilst there is research around men and masculinities as they relate to practices of caring in the ecological crisis, less is written about methodologies that can address intersectional challenges, and ways of engagement that can support behaviour change. A process-based workshop methodology is discussed for researching the male-gendered and material performances of environmental caring related to personal food protein consumption practices. It works creatively to address relational inequalities in status both between different masculine positionalities and different food proteins. It contributes to more-than-human participatory methodologies by exploring male-gender – food protein relations, via positioning and inviting practical-engagement with foodstuff as a process for destabilising social and cultural hierarchies attached to thinking about, as well as preparing, cooking and eating, different food proteins. We argue that novel research findings can emerge around individual, collective and community responses to the ecological crisis through the careful methodological attention to masculine inequalities.
Emplaced sounding: voice, identity and place in Zadie Smith’s NW
Authors: Halligey Alexandra
Published: June 2022

Through a close reading of Zadie Smith’s portrayal of the character Keisha/Natalie’s voice and relationship to voice in the novel NW, this article considers how people’s speaking, sounding voices are both emplaced (coming from, made by place) and are key place-making acts. This paper argues for how analysing sound in literature might serve sonic geographic interest in the ‘whole’ voice, with all sound’s representational and more-than representational elements. Through its fictional and poetic expressivity the literary offers propositional perspectives on experiences of sound and its material and affectual role in our world making. From this departure point, the paper proceeds to consider the entangled issues of place and identity politics in NW, motivating that a reading or ‘listening’ in terms of voice might offer valuable insights into these concerns. Attending to three moments in NW centred around the character Keisha/Natalie, the paper argues for how human’s speaking voices might enact and contain the complex difficulties in the co-construction of place and personal identity.
Transaxillary Tri-Branch Aortic Endovascular Graft Repair of Recurrent Thoracoabdominal Aneurysm With Pararenal Aortic Occlusion
Authors: Bertoglio Luca , Lopes Alice , Rinaldi Enrico , Bossi Matteo , Berchiolli Raffaella , Ferrari Mauro , Chiesa Roberto
Published: June 2022

The absence of an adequate ileo-femoral access is usually considered an absolute contraindication to fenestrated and branched aortic repairs. Alternative routes and dedicated stent-graft designs have been advocated. Hereby, we describe the case of a 73-year-old man with a recurrent type IV thoracoabdominal aortic aneurysm and complete thrombotic pararenal aortic occlusion treated successfully with a tri-branch custom-made endograft deployed via a transaxillary access.
Receipt and Sharing of Information to Improve Knowledge About Living Donor Kidney Transplant among Transplant Candidates with Advanced Chronic Kidney Disease
Authors: Mohottige Dinushika , Davenport Clemontina , Lee Hui-Jie , Ephraim Patti , DePasquale Nicole , Cabacungan Ashley , Barrett Tyler , McElroy Lisa , Pendergrast Jane , Diamantidis Clarissa J. , Boulware L. Ebony
Published: June 2022

Introduction: Knowledge about living donor kidney transplant (LDKT) is associated with greater access. Yet, little is known about factors associated with high living donor transplant knowledge. Research Questions: Is receipt of LDKT information from health professionals or sharing information with family and friends associated with higher knowledge? Design: We conducted a cross-sectional analysis of data from preemptive LDKT candidates, which assessed knowledge, receipt of information about living donation from health professionals, and history of having shared living donor information with family members or friends. In multivariable logistic regression models adjusting for participants’ age, race, and total household income, we quantified the association of high knowledge with receipt of living donation information from health professionals and sharing of this information with family/friends. Results: Among 130 participants, the median (IQR) age was 59.5 (52.0–65.0) years, 60% were female, 47.7% were Black, and 49.2% had a high school education or less. Over half (55.4%) had high LDKT knowledge. Nearly one third reported having received living donor information (33.1%) or sharing the information with family/friends (28.5%). After adjustment, those who received (vs. did not receive information) and shared information with family/friends had 3-fold higher odds of high LDKT knowledge (3.05 [1.24, 8.08]). Individuals who received LDKT information (vs. did not) from health professionals had 4-fold higher odds of high LDKT knowledge (adjusted OR [95% CI]: 4.01 [1.49, 12.18]. Conclusions: Receipt of living donation information from health professionals and sharing this information with family/friends were associated with high LDKT knowledge.
Time Is Brain: The Importance of an Accurate SCN1A Prediction Score in the Era of Precision Medicine
Authors: Andrade Danielle M.
Published: June 2022

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Shifting Gears in Clinical Trials- Time to Event Analysis: Music to Some Ears
Authors: Joshi Charuta
Published: June 2022

[Box: see text]
Playing (Against) the Heritage: Absolutism and the French Revolution in French Digital Games Before 2000
Authors: Jankowski Filip
Published: June 2022

This article demonstrates how digital games can confirm or subvert national historical discourses. The author analyzes selected 20th-century French historical adventure digital games about absolutist France and the subsequent French Revolution. Although most of them focused on reconstructing the era (e.g., the state-funded Versailles 1685), the emphasis is placed on two games by Patrick Beaujouan ( Le Passager du temps and Conspiration de l’an III). Their subversive content undermined the sense of reconstructing historical events on the screen. However, as the author concludes, the subversive content of Beaujouan’s games had its prize because they lacked the technical and institutional support that restorative projects such as Versailles 1685 had. However, Beaujouan’s games show that every “historical” game tells us more about contemporary discourses than past events.
A heuristic approach on predictive maintenance techniques: Limitations and scope
Authors: Shukla Khyati , Nefti-Meziani Samia , Davis Steve
Published: June 2022

In view of the trend towards Industry 4.0, intelligent predictive monitoring and decision-making processes have become a crucial requirement in today’s manufacturing industries to safeguard data exchange and industrial assets from damage that would thus prevent the achievement of overall company goals. For enhanced reliability and safe operation of machines, frequent maintenance of the process equipment and the linked auxiliaries in a plant is highly desirable. Poor maintenance of assets can add to downtime, which can in turn affect the overall cost-effectiveness of the plant. With traditional maintenance strategies and planned or timed-based maintenance, one replaces the faulty systems when they are found to be damaged or broken. However, an early and proactive prediction of machine or equipment fault and failure state enables the industry to take the necessary action to replace the faulty system well before it stops operating entirely. This paper briefly reviews the available predictive maintenance techniques for different applications from the perspective of Industry 4.0. Furthermore, the associated challenges and opportunities are identified and discussed.
Contemporary outcomes of initial treatment strategy of endovascular intervention or bypass in patients with critical limb ischemia
Authors: Qato Khalil , Bahroloomi Donna , Conway Allan , Lu Eileen , Pamoukian Vicken , Giangola Gary , Carroccio Alfio
Published: June 2022

Objective

The optimal management for revascularization after critical limb ischemia (CLI) is controversial due to limited studies comparing long-term results of endovascular and open techniques. This study compares long-term outcomes after initial management of CLI via lower extremity bypass (LEB) and percutaneous vascular intervention (PVI).

Methods

This retrospective cohort study investigates outcomes of patients who underwent endovascular or open surgical management for CLI at a single institution from 2013–2018. All patients with diagnosis of CLI were included and separated based on initial therapy of PVI or LEB. Demographic, procedural, and follow-up data were assessed. Primary endpoints included major adverse limb events (MALE), specifically the need for major amputation and reintervention. Secondary endpoints included mortality at 30 days and one year. A multivariable Cox Proportional Hazard regression model was used to assess the relationship between Surgery group and time to MALE/death while controlling for confounding variables.

Results

This study identified 338 patients with an initial diagnosis of CLI who underwent either LEB ( n = 108, 32%) or PVI ( n = 230, 68%). The average age was 71.4, 54.4% were male, 30% were African American, 53.6% were diabetic, and 93.2% had hypertension. Patients who underwent LEB were more predominantly smokers ( p = .003) and less predominantly on dialysis at time of surgery ( p = .01). Re-intervention rates in the bypass group (11%) were not significantly different than the PVI group (9%; p = .95). In the bypass group, 20 (19%) patients had a major amputation with a median time of 189.5 days compared to 23 (10%) patients at a median time of 113 days in the PVI group; however, this difference was not significant ( p = .16). There was no significant difference in 1-year mortality between the LEB (2%) and PVI group (4%; p = .2). The cumulative incidence of MALE/death at 30 days was 4.0% in the bypass group and 3.7% in the PVI group ( p = .2). Incidences of MALE/death were 21.1% and 48.5% in the bypass group and 19.7 and 45.9% in the PVI group at one and 2 years, respectively. Intervention type was not found to be significantly associated with MALE/death after controlling for possible confounders (HR = 0.82, p = .43).

Conclusions

In the initial management of CLI, there is no significant difference in long-term outcomes in terms of major amputation, need for reintervention, limb-salvage, and 1-year mortality.
Advance of T regulatory cells in tumor microenvironment remodeling and immunotherapy in pancreatic cancer
Authors: Gao Zetian , Zhang Qiubo , Zhang Xie , Song Yufei
Published: June 2022

Pancreatic ductal adenocarcinoma (PDAC) is highly aggressive, deadly, and is rarely diagnosed early. Regulatory T cells (Treg) are a multifunctional class of immunosuppressive T cells that help maintain immunologic homeostasis and participate in autoimmune diseases, transplants, and tumors. This cell type mediates immune homeostasis, tolerance, and surveillance and is associated with poor outcomes in PDAC. Tregs remodel the tumor immune microenvironment, mediate tumor immune escape, and promote tumor invasion and metastasis. A promising area of research involves regulating Tregs to reduce their infiltration into tumor tissues. However, the complexity of the immune microenvironment has limited the efficacy of immunotherapy in PDAC. Treg modulation combined with other treatments is emerging. This review summarizes the mechanisms of Tregs activity in tumor immune microenvironments in PDAC and the latest developments in immunotherapy and clinical trials.
An improved nonlinear path following method with on-line transition trajectory generation for fixed-wing unmanned aerial vehicles
Authors: Chen Qingyang , Lu Yafei
Published: June 2022

To enhance the path following ability for fixed-wing unmanned aerial vehicles, and solve the stability and high-accuracy tracking problems due to inappropriate route switchover time during intense maneuvers, an improved nonlinear path following method with on-line transition trajectory generation was proposed in the article. Firstly, the influence of the guidance distance to the nonlinear path following method was verified through a flight experiment, and the importance of the critical time for route switchover was deduced. The on-line transition trajectory generation was expected to realize the automation of the switchover process, including the computation of the critical switchover time and desired paths. Secondly, to generate the on-line transition trajectory, the computation method was derived for typical intense maneuvers, such as the turning maneuver for square trajectory, or the converging maneuver to the expected trajectory under initial numerous errors (such as modifying the waypoint during a flight mission). Finally, to solve the situations in which the transition trajectory does not exist, an adaptive guidance distance algorithm was proposed to improve the flight stability and accuracy. From the simulation and flight experiment results, stability and high accuracy can be guaranteed for different situations with the proposed methods. The path following error is smaller than 1.0 m when it is converged (in downwind or upwind situations), which is important for the method to be used widely.
The quality disparity of stroke care over time: An analysis based on the national dataset from 2011 to 2017
Authors: Li Jingkun , Chen Qihui , Wang Chao , Hou Shuang , Han Xinhao , Liu Meina , Pan Yonghui
Published: June 2022

Background:

Adherence to evidence-based hospital stroke care is variable and may change over time. It is important to determine which process measures are associated with variation in outcome. In a large dataset, we analyzed the association between process and outcome and the fluctuations of indicators over time, and identified quality indicators (QIs) that should be prioritized for improving the quality of stroke care.

Methods:

We analyzed data from 123,259 patients diagnosed with acute ischemic stroke (AIS) who were treated at 109 large tertiary hospitals in China between January 2011 and May 2017. In total, 12 stroke treatment indicators were selected to calculate the hospital process composite performance (HPCP). Hospitals were divided into subgroups according to the time trend of HPCP estimated by the Group-Based Model. We analyzed the influence of hospital subgroups on the patient outcomes using a multi-level model and explored the QIs that led to variation.

Results:

The HPCP trends for stroke indicators of 109 hospitals over 7 years were divided into two groups (Group 1, low-HPCP; Group 2, high-HPCP). After adjusting for patient age, medical insurance, comorbidities, patterns of admission, and NIHSS-scores, patients in the high-HPCP group presented higher rate of independence and longer length of stay compared to the low-HPCP group. The multi-level model showed that there was a statistically significant difference in the utilization rate between the two groups, with most marked differences seen in emergency assessment and function evaluation indicators.

Conclusion:

Variation in the quality of stroke care exists across hospitals, and better adherence to guideline-based care is associated with improved outcomes. We found that QIs related to emergency examination and functional assessment were the main factors differing between good and poor adherers to stroke indicators, suggesting that quality improvement in stroke care could prioritize these QIs.
Regulation (EU) 2018/1805 on the mutual recognition of freezing and confiscation orders: A headlong rush into Europe-wide harmonisation?
Authors: Silva Sandra Oliveira e
Published: June 2022

In a Europe without borders, where assets and capital move freely, the effectiveness of freezing and confiscation orders presupposes close cooperation between Member States. Normally harmonisation precedes mutual recognition. Regulation (EU) 2018/1805 brings about a new strategy for increasing the effectiveness of asset recovery: the aim is to achieve harmonisation through mutual recognition. This article briefly reviews the evolution of Union law on confiscation orders, discusses the scope of the new Regulation, and seeks to anticipate the difficulties that its application may entail as regards the respect for fundamental rights.
Acceptance of the learning management system in the time of COVID-19 pandemic: An application and extension of the unified theory of acceptance and use of technology model
Authors: Esawe Ahmed T , Esawe Karim Taher , Esawe Narges Taher
Published: June 2022

After the spread of the coronavirus around the world, the Egyptian government imposed blended learning on higher education institutions. Consequently, colleges and universities in Egypt are entering a new era where learning is not confined to the classroom alone but also through learning management systems (LMSs). Thus, this study adopts the Unified Theory of Acceptance and Use of Technology (UTAUT) to study how students accept and use the LMSs. An online survey was conducted through a structured questionnaire to collect quantitative data for analysis. Obtained data from 803 respondents were analyzed using structural equation modelling Partially least squares regression was used for the model and hypothesis testing. The results show that trust is vital in determining the acceptance and use of LMSs. The study results may provide insights into a better approach to promoting LMS acceptance.
Point-of-care computer-assisted design and manufacturing technology and its utility in post-traumatic mandibular reconstruction: An Australian public hospital experience
Authors: Kovacs Aaron C , Kaing Tran-Lee
Published: June 2022

Application of load-bearing osteosynthesis plates is the current gold-standard management for complex mandibular fractures. Traditionally, this has required a transcutaneous submandibular approach, carrying with it the risk of damage to the facial nerve and obvious extraoral scarring. The existing literature describes the use of computer-assisted design and manufacturing technology through external vendors to aid transoral mandibular reconstruction. However, the reliance on third-party manufacturers comes with significant drawbacks, notably increased financial costs and manufacturing delays. We describe our experience in using point-of-care three-dimensional-printed surgical models to aid with the application of mandibular reconstruction plates. Utilising a virtual three-dimensional reconstruction of the patient’s preoperative computed tomography facial bones, we fabricate a custom model of the patient’s mandible with the department’s in-house three-dimensional printer. Stock plates are subsequently pre-bent and adapted to the three-dimensional model, with plate and screw position marked and screw lengths measured with callipers. By using a custom three-dimensional-printed surgical model to pre-contour the plates, we are able to position stock reconstruction plates via a transoral approach. Moreover, our unit’s utilisation of in-house computer-assisted design and manufacturing software and hardware allows us deliver a same-day turnaround for both surgical planning and performing the operation. Patient-specific surgical planning guides can facilitate the safe and efficient transoral application of mandibular reconstruction plates. Moreover, the use of point-of-care computer-assisted design and manufacturing technology ensures timely and cost-effective manufacturing of the necessary biomodel.
Visuospatial and Executive Dysfunction in Patients With Acute Kidney Injury, Chronic Kidney Disease, and Kidney Failure: A Multilevel Modeling Analysis
Authors: Jawa Natasha A. , Vanderlinden Jessica A. , Scott Stephen H. , Jacobson Jill A. , Silver Samuel A. , Holden Rachel , Boyd J. Gordon
Published: June 2022

Background:

Neurocognitive impairment is a common finding across the spectrum of kidney disease and carries important consequences for quality of life. We previously demonstrated that robotic technology can identify neurocognitive impairments not readily detectable by traditional testing in patients with acute kidney injury (AKI) and chronic kidney disease (CKD).

Objective:

The present study aimed to assess whether these quantifiable deficits in neurocognition differ based on a diagnosis of AKI, CKD, or kidney failure.

Design:

This was a cross-sectional analysis of participants previously enrolled in an observational study.

Setting:

Patients were enrolled at a tertiary academic hospital, Kingston Health Sciences Centre, Kingston, ON, Canada.

Patients:

Adults with AKI, CKD, or kidney failure.

Measurements:

Each participant underwent robotic neurocognitive assessment using the Kinarm: an interactive robotic device that uses a series of behavioral tasks involving movement of the upper limbs to precisely quantify neurocognitive impairment across a variety of neurocognitive domains.

Methods:

Multilevel modeling was used to determine the effect of Kinarm task type, kidney diagnostic group (AKI vs CKD vs kidney failure), and the interaction between the two, on neurocognitive performance.

Results:

A total of 104 participants within 1 year of an AKI event or with CKD category G3-5 were enrolled. We found that across all of the kidney diagnostic groups, participants performed worst on the Kinarm tasks of Reverse Visually Guided Reaching ( b = 0.64 [95% confidence interval = 0.42, 0.85]), Visually Guided Reaching ( b = 0.28 [0.07, 0.49]), and Trail Making ( b = 0.50 [0.28, 0.72]), relative to all other tasks. There were no significant differences in average performance across tasks based on kidney diagnostic group. However, diagnostic group and neurocognitive task type interacted to determine performance, such that patients with AKI performed worse than those with either CKD or kidney failure on the Reverse Visually Guided Reaching task.

Limitations:

Kinarm assessment was performed at a single time point, and the sample size itself was small, which may lead to the risk of a false-positive association despite the use of multilevel modeling. Our sample size also did not permit inclusion of the underlying etiology of kidney impairment as a covariate in our analyses, which may have also influenced neurocognitive function.

Conclusions:

In this study that utilized the Kinarm to assess neurocognitive function, patients with AKI demonstrated significantly worse neurocognitive functioning than patients with CKD or kidney failure on a task measuring executive function and visuomotor control.
“We Bring Home the Roots”: Black Women Travel Influencers, Digital Culture Bearing, and African Internationalism in Instagram
Authors: Arthur Tori Omega
Published: June 2022

This study examines how travel influencers Jessica Nabongo and Oneika Raymond use Instagram in a process I call “digital culture bearing,” employing the platform to nurture wisdom about Africa. They combine images, captions, hashtags, and geotags to share information about nations within the African continent with principally Black populations. Employing critical technocultural discourse analysis (CTDA) to interpret how race, gender, global travel, and cultural knowledge promotion intersect within Instagram, the study analyzes the platform and practices of digital culture bearing, theorizing new ways of understanding how Black women situate themselves in Africa for their online networks. Ultimately, the study offers considerations of what it means to be a culture bearer in the twenty-first century digi-sphere and articulates new conceptualizations of Black internationalism within social networking sites.
Relationship Between a Teacher Educator's Questions and the Development of Prospective Teachers’ Critical Thinking
Authors: Soysal Yilmaz , Soysal Somayyeh
Published: June 2022

Purpose

This study explores the relationships between the cognitive demands of the questions asked by a teacher educator (TE) and prospective teachers’ (PT) capacity for critical thinking (CT).

Design/Approach/Methods

Participants comprised a TE and 32 PTs. The cognitive demands of the TE's questions and PTs’ CT were analyzed using a systematic observation approach.

Findings

Results indicate that there are tangible connections between the increasing mental demand of TE questions and PTs’ higher-order cognitive processing. The PTs achieved higher-order CT when the TE asked more cognitively demanding questions. For instance, when the TE's questions were pitched at the cognitive demand levels—namely, the analyze, evaluate, and/or create levels—the PT answers were longer and reflected higher CT, such as inductive reasoning, suggesting new ways of thinking, or legitimating the arguments of others. Accordingly, results suggest that intentionally subjecting PTs to sustained higher cognitive demands via questions may help them reach their optimal CT capacity.

Originality/Value

Although proposed teaching strategies have been invaluable in proposing content-specific interventions for fostering the CT of university students, how lecturers should use their questions to conduct such interventions has been overlooked. This study addresses this gap.
Entrepreneurial Value Creation: Study on Small Agri-tech Enterprise
Authors: Swain Sasmita , Patoju Sri Krishna Sudheer , Manjushree Paruchuru
Published: June 2022

In India, agriculture is labour intensive. The agricultural tasks such as sowing, weeding, spraying pesticides and harvesting are done manually. As it provides only seasonal employment, most rural labour force migrates to urban areas to earn a more sustainable income. This intrastate and interstate migration of the labour force creates a massive shortage in rural areas. This migration pushes the labour cost, leading to an increased price of agricultural produce. It is a significant concern for semi-medium and medium farmers with a limited budget for a small scale of operation. Non-availability of labourers pushed farmers to seek and adopt semi-mechanization in agricultural activities. The available farm machinery in the market is costly and primarily caters to the need of big farmers. Higher cost prevents semi-medium and medium farmers from using such machinery. They need farm machinery customized as per their need at an affordable price. Considering the problems faced by the horticultural farmers, ‘Kakade Agro Equipment’ designed farm machinery that could meet the requirements of the local farmers. The present case attempts to understand how small and medium enterprises operating at the local level are solving the problems of semi-medium and medium-scale horticultural farmers using technological innovation in a financially sustainable way.
A Rare Case of Pancreatic Ascites Secondary to Chronic Pancreatitis
Authors: Kayode-Ajala Fisayo , Jesani Shruti , Ejikeme Chidinma , Asrar Henna , Naqi Muniba
Published: June 2022

Pancreatic ascites refer to continuous leakage of pancreatic secretions in the peritoneum leading to accumulation of pancreatic fluid in the peritoneal cavity. Although literature on the incidence of pancreatic ascites and presenting signs and symptoms is scarce, it may be seen in patients with chronic alcoholic pancreatitis. Patients typically present with acute chronic pancreatitis and new-onset ascites, with or without abdominal pain. A diagnostic paracentesis is usually the first step to determine the etiology of the ascites. Mild cases may resolve with conservative management. Optimization of nutrition status is an important factor to reduce morbidity and mortality. More severe cases or cases refractory to conservative management may require endoscopic or surgical intervention. This case report describes a rare presentation of pancreatic ascites in a 35-year-old female.
A Rare Cause of Chronic Hip Pain From PEComa: An Aggressive Mesenchymal Sarcoma
Authors: Randhawa Samender , Pinsker Jessica , Amirapu Madhurya , Sravanthi Metlapalli Venkata , Ashok Kumar Prashanth , Akhtar Komal
Published: June 2022

Perivascular epithelioid cell tumors (PEComas) are related to the tuberous sclerosis complex (TSC) and are commonly benign. When malignant, they can be aggressive with local invasion and metastatic spread. Conventional PEComas do not have TFE3 gene rearrangement and are associated with TSC with a preference for an occurrence at a younger age. We report a case of a young male who had progressive chronic hip pain and was found to have a TFE3-associated PEComa in his pelvic region.
“We Feel Like Everybody's Going to Judge us”: Black Adolescent Girls’ and Young Women's Perspectives on Barriers to and Opportunities for Improving Sexual Health Care, Including PrEP, in the Southern U.S
Authors: Pratt Madeline C. , Jeffcoat Seabrook , Hill Samantha V. , Gill Elizabeth , Elopre Latesha , Simpson Tina , Lanzi Robin , Matthews Lynn T.
Published: June 2022

Black adolescent girls and young women (AGYW) are disproportionately affected by HIV in the southern U.S.; however, PrEP prescriptions to Black AGYW remain scarce. We conducted in-depth interviews (IDIs) with Black AGYW ages 14-24 in Alabama to explore opportunities for and barriers to sexual health care including PrEP prescription. Twelve AGYW participated in IDIs with median age 20 (range 19-24). All reported condomless sex, 1-3 sexual partners in the past 3 months, and 6 reported prior STI. Themes included: 1) Stigma related to sex contributes to inadequate discussions with educators, healthcare providers, and parents about sexual health; 2) Intersecting stigmas around race and gender impact Black women's care-seeking behavior; 3) Many AGYW are aware of PrEP but don't perceive it as an option for them. Multifaceted interventions utilizing the perspectives, voices, and experiences of Black cisgender AGYW are needed to curb the HIV epidemic in Alabama and the U.S. South.
Predictors of Positive Outcomes and a Scoring System to Guide Management After Fasciotomy for Chronic Exertional Compartment Syndrome
Authors: Trew Christopher A.J. , Kocialkowski Cezary , Parsons Tom , Barton Tristan
Published: June 2022

Background:

Chronic exertional compartment syndrome (CECS) of the lower limb usually responds well to fasciotomy in patients with failed nonoperative treatment. Careful history taking and compartment pressure testing are both required to accurately diagnose CECS.

Purposes:

To evaluate patients with CECS after fasciotomy to establish predictive criteria of positive outcomes and to develop a scoring system to aid clinicians in their management of such patients.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

We reviewed data from 28 patients who underwent fasciotomy between 2017 and 2019. All patients had undergone preoperative dynamic intracompartmental pressure (ICP) monitoring. For each patient, subjective preoperative and postoperative pain scores were gained via a questionnaire. The point biserial and Pearson correlation coefficients were used to calculate the association between multiple diagnostic criteria and a reduction in visual analog scale (VAS) pain scores after fasciotomy.

Results:

A reduction in VAS pain scores was strongly correlated with a peak ICP >40 mm Hg ( r = 0.71; P = .0007) and an area under the receiver operating characteristic curve for an intraexercise ICP >22,000 mm Hg·s2 ( r = 0.76; P = .0002). A moderate correlation was found between a history of CECS pain ( r = 0.61; P = .005), a duration of symptoms of <30 minutes after stopping exercise ( r = 0.60; P = .006), and a gradient in the intraexercise ICP >10 mm Hg ( r = 0.60; P = .006). When combined into an objective, weighted scoring system (2 points for factors with r > 0.7; 1 point for r = 0.5-0.7), a score of ≥4 points (of 7) had a strong correlation ( r = 0.85; P < .00001) with postoperative improvement in the VAS pain score. Linear regression of this score demonstrated a good fit ( R 2 = 0.61; P < .0001), indicating a degree of predictive power.

Conclusion:

We identified diagnostic criteria in the history and examination of patients with CECS that can be used to help predict positive outcomes after fasciotomy. We propose a scoring system to aid clinicians in their management of such patients. We recommend taking these results forward in prospective trials to test the efficacy of predictive scoring.
Injuries During Return to Sport After the COVID-19 Lockdown: An Epidemiologic Study of Italian Professional Soccer Players
Authors: Mazza Daniele , Annibaldi Alessandro , Princi Giorgio , Arioli Leopoldo , Marzilli Fabio , Monaco Edoardo , Ferretti Andrea
Published: June 2022

Background:

The injury rate in professional soccer players may be influenced by match frequency.

Purpose:

To assess how changes in match frequency that occurred because of coronavirus disease 2019 (COVID-19) influenced training and match injuries in the Italian Serie A league.

Study Design:

Descriptive epidemiology study.

Methods:

Three phases in the Serie A league, each 41 days long, were evaluated: phase A was the beginning of the 2019-2020 season; phase B was a period after the COVID-19 lockdown was lifted, when the remaining matches of the season were played with greater frequency; and phase C was the beginning of the 2020-2021 season. All male professional soccer players who were injured during the 3 phases were included. Player age, height, position, injury history, and return to play (RTP) were retrieved from a publicly available website. Training- and match-related injuries during each of the 3 phases were collected and compared. Moreover, match injuries that occurred after the lockdown phase (phase B), in which there were 12 days designated for playing matches (“match-days”), were compared with injuries in the first 12 match-days of phases A and C.

Results:

When comparing 41-day periods, we observed the injury burden (per 1000 exposure-hours) was significantly lower in phase B (278.99 days absent) than in phase A (425.4 days absent; P < .05) and phase C (484.76 days absent; P < .05). A longer mean RTP period was recorded in phase A than in phase B (44.6 vs 23.1 days; P < .05). Regarding 12–match day periods (81 days in phase A, 41 days in phase B, and 89 days in phase C), there was a significantly higher match injury rate (0.56 vs 0.39 injuries/1000 exposure-hours; P < .05) and incidence (11.8% vs 9.3%; P < .05) in phase B than in phase A and a longer mean RTP period in phase A than in phase B (41.8 vs 23.1 days; P < .05). Finally, the rate and incidence of training-related injuries were significantly higher in phase B (4.6 injuries/1000 exposure-hours and 6.5, respectively) than in phase A (1.41 injuries/1000 exposure-hours and 2.04, respectively) ( P < .05).

Conclusion:

Both training- and match-related injuries were greater during the abbreviated period after the COVID-19 lockdown. These may be linked to the greater match frequency of that period.
Assessment of Outcomes After Multisurface Osteochondral Allograft Transplantations in the Knee
Authors: Cook James L. , Rucinski Kylee , Crecelius Cory , Fenkell Blake , Stannard James P.
Published: June 2022

Background:

Treatment of multisurface articular cartilage lesions of the knee is a challenging problem.

Hypothesis:

Large multisurface cartilage defects in the knee can be successfully managed with transplantation of high chondrocyte viability osteochondral allografts (OCAs) to result in statistically significant improvements in patient-reported outcome measures of pain and function.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients were prospectively enrolled into a registry to follow outcomes after OCA transplantation. The study included patients who received OCA transplantation for multisurface unipolar defects in 1 knee and had minimum 2-year follow-up data, including patient-reported outcome measures, failures, reoperations, and complications. The OCA transplants had been stored using 2 methods: standard preservation (SP) or Missouri Osteochondral Preservation System (MOPS). Preoperative data were compared with outcomes at 1 year and final follow-up, and risk factors for revision surgery or failure (total knee arthroplasty) were analyzed.

Results:

The sample included 25 patients with a mean age of 37.2 years (range, 13-51 years), body mass index of 27.7 (range, 18-38), and follow-up of 45.1 months (median, 49 months; range, 24-68 months). OCAs stored using SP were transplanted into 6 patients, and those stored using MOPS were transplanted into 19 patients. The initial success rate was significantly higher for MOPS OCAs (94.7%) than SP OCAs (33.3%). There were statistically significant improvements in all patient-reported outcomes at 1 year and final follow-up in the MOPS cohort ( P < .0001 for all). Revision surgery/failure was significantly associated with patients who were nonadherent to the prescribed postoperative restrictions and rehabilitation protocols ( P = .038; odds ratio = 13.5) and with OCAs that had a viable chondrocyte density <70% of the established reference range mean at transplantation ( P = .0037; odds ratio = 76).

Conclusion:

OCA transplantation for treatment of large multisurface cartilage defects in the knee resulted in a 94.7% initial success rate when grafts with high viable chondrocyte density (≥70%) were used and when patients strictly adhered to prescribed postoperative rehabilitation protocols. Successful outcomes were associated with statistically significant improvements in patient-reported outcome measures of pain and function.
Repositioning Practice of Bedridden Patients: An Evolutionary Concept Analysis
Authors: Iblasi Abdulkareem S. , Aungsuroch Yupin , Gunawan Joko , Gede Juanamasta I. , Carver Cheryl
Published: June 2022

Introduction

Repositioning practice is an essential pressure ulcer prevention intervention that has emerged in the history of nursing. Numerous terms are employed to indicate its meaning, such as turning, positioning, or posturing. However, there is no available analysis that distinguishes these terms or analyzes repositioning practice attributes.

Objective

To analyze repositioning practice as a concept of bedridden patients in hospitals by combining methods from Foucault's archeology of knowledge and Rodger's concept analysis.

Concept Description

Repositioning practice passes through three eras: classical, modern, and research. The repositioning practice is “turn a bedridden patient in a harmonized way and ends with anchor and documentation.” The analysis concludes seven attributes for the repositioning practice: pre-turn, assessment, turn, harmonization, anchor, documentation, and time. The analysis assumes bedridden patients, and assigned nurses on duty are the antecedents. Moreover, the main consequence is pressure ulcer prevention, while patient safety and quality of care are the secondary consequences.

Discussion

Repositioning practice understanding has grown with time. Each era has added to or removed from nursing's understanding for repositioning practice until it appears as it now. The current analysis expects further development in repositioning practice understanding and applications.

Conclusion

Repositioning practice is an important nursing intervention and has shown a dynamic movement over history. It is expected that this dynamic will continue in the future.
Placing the Dalit Women at the Intersections: A Sociological Study of Dom Women of Kolkata
Authors: Nishat Atufah
Published: June 2022

This article uses Crenshaw’s ( Standford Law Review, 1989, vol. 43, pp. 1241–1299) concept of intersectionality to understand the everyday experiences at the workplace of the lower-caste Dalit women belonging to the manual scavenging community (Dom community) of Kolkata, West Bengal. This article tries to map out and understand the concept of intersectionality by placing the Dalit women at the intersections of caste, class, and gender oppression and see how these structures play out in her everyday life. This article will attempt to place the experiences of the Dalit women vis-à-vis their male and upper-caste lower-class female counterparts to understand how their experiences are similar or different from them. This article is based on the narratives collected through interviews and tries to explore how lying at the intersections produces everyday instances of violence and humiliation for Dalit women. This article highlights how structures of oppression often overlap in various ways to produce our everyday lives.
Necessity of external iliac lymph nodes and inguinal nodes radiation in rectal cancer with anal canal involvement
Authors: Zheng Rong , Zhang YaZhen , Chen RunFan , Guan Bingjie , Lin YuPing , Wang BiSi , Li XiaoBo , Chi Pan , Chen XiaoPing , Xu BenHua
Published: June 2022

Background and purpose

We aimed to explore the necessity of the external iliac lymph nodes (EIN) along with inguinal nodes (IN) region in clinical target volume (CTV) for rectal carcinomas covering the anal canal region.

Materials and methods

This research premise enrolled 399 patients who had primary low rectal cancer detected below the peritoneal reflection via magnetic resonance imaging (MRI) and were treated with neoadjuvant radiotherapy (NRT), without elective EIN along with IN irradiation. We stratified the patients into two groups based on whether the lower edge of the rectal tumor extended to the anal canal (P group, n = 109) or not (Rb group, n = 290). Comparison of overall survival (OS), locoregional recurrence-free survival (LRFS), disease-free survival (DFS), as well as distant metastasis-free survival (DMFS) were performed via inverse probability of treatment weighting (IPTW) along with multivariable analyses. We compared the EIN and IN failure rates between the two groups via the Fisher and Gray’s test.

Results

P group showed a similar adjusted proportion along with five-year cumulative rate of EIN failure compared with the Rb group. The adjusted proportion and five-year cumulative rate of IN failure in the P group was higher in comparison to the Rb group. There were no remarkable differences in the adjusted five-year OS, DFS, DMFS or LRFS between the two groups. Anal canal involvement (ACI) exhibited no effect on OS, LRFS, DFS, or DMFS.

Conclusions

During NRT for rectal cancer with ACI, it may be possible to exclude the EIN and IN from the CTV.
Mobility test to assess functional vision in dark-adapted patients with Leber congenital amaurosis
Authors: Roman Alejandro J. , Cideciyan Artur V. , Wu Vivian , Mascio Abraham A. , Krishnan Arun K. , Garafalo Alexandra V. , Jacobson Samuel G.
Published: June 2022

Background

Inherited retinal degenerations (IRDs) affect daylight and night vision to different degrees. In the current work, we devise a method to quantify mobility under dark-adapted conditions in patients with severe childhood blindness due to Leber congenital amaurosis (LCA). Mobility thresholds from two different LCA genotypes are compared to dark-adapted vision measurements using the full-field stimulus test (FST), a conventional desktop outcome measure of rod vision.

Methods

A device consisting of vertical LED strips on a plane resembling a beaded curtain was programmed to produce a rectangular pattern target defining a ‘door’ of varying luminance that could appear at one of three positions. Mobility performance was evaluated by letting the subject walk from a fixed starting position ~ 4 m away from the device with instructions to touch the door. Success was defined as the subject touching within the ‘door’ area. Ten runs were performed and the process was repeated for different levels of luminance. Tests were performed monocularly in dark-adapted and dilated eyes. Results from LCA patients with the GUCY2D and CEP290 genotypes and normal subjects were analyzed using logistic regression to estimate the mobility threshold for successful navigation. The relation of thresholds for mobility, FST and visual acuity were quantified using linear regression.

Results

Normal subjects had mobility thresholds near limits of dark-adapted rod vision. GUCY2D-LCA patients had a wide range of mobility thresholds from within 1 log of normal to greater than 8 log abnormal. CEP290-LCA patients had abnormal mobility thresholds that were between 5 and 6 log from normal. Sensitivity loss estimates using FST related linearly to the mobility thresholds which were not correlated with visual acuity.

Conclusions

The mobility task we developed can quantify functional vision in severely disabled patients with LCA. Taken together with other outcome measures of rod and cone photoreceptor-mediated vision, dark-adapted functional vision should provide a more complete understanding of the natural history and effects of treatment in patients with LCA.