bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel synergistic multi-scale modeling framework to predict micro- and meso-scale damage behaviors of 2D triaxially braided composite
Authors: Jiang Hongyong , Ren Yiru , Jin Qiduo
Published: July 2021

A novel synergistic multi-scale modeling framework with a coupling of micro- and meso-scale is proposed to predict damage behaviors of 2D-triaxially braided composite (2DTBC). Based on the Bridge model, the internal stress and micro damage of constituent materials are respectively coupled with the stress and damage of tow. The initial effective elastic properties of tow (IEEP) used as the predefined data are estimated by micro-mechanics models. Due to in-situ effects, stress concentration factor (SCF) is considered in the micro matrix, exhibiting progressive damage accumulation. Comparisons of IEEP and strengths between the Bridge and Chamis’ theory are conducted to validate the values of IEEP and SCF. Based on the representative volume element (RVE), the macro properties and damage modes of 2DTBC are predicted to be consistent with available experiments and meso-scale simulation. Both axial and transverse damage mechanisms of 2DTBC under tensile or compressive load are revealed. Micro fiber and matrix damage accumulations have significant effects on the meso-scale axial and transverse damage of tows due to multi-scale coupling effects. Different from existing meso-/multi-scale models, the proposed multi-scale model can capture a crucial phenomenon that the transverse damage of tow is vulnerable to micro fiber fracture. The proposed multi-scale framework provides a robust tool for future systematic studies on constituent materials level to larger-scale aeronautical materials.
Multiscale modeling of damage and fracture in freeze-thawed shotcrete
Authors: Liu Mengxin , Qiao Pizhong , Sun Lizhi
Published: July 2021

Degradation of fracture resistance, which is a phenomenon encountered in shotcrete as exposed to the cold environment, can lead to structural failure. Microstructural damage induced by freeze-thaw (F-T) cycles serves as the presage to macroscopic failure processes. To reveal the fundamental mechanisms of degradation, it is crucial to characterize and model the F-T damage in multiscales for the heterogeneous nature of shotcrete. In this paper, X-ray micro-computed tomography (micro-CT) is employed to describe the F-T damage in microscale and mesoscale shotcrete. Changes of the modulus of elasticity in cement paste and interfacial transition zone are analyzed using the cloud map obtained from the nanoindentation test. Micro-CT images capture the microstructural geometry, such as microcracks, aggregates, pores, and cement paste. Subsequently, microstructure-based finite-element modeling is developed to simulate the overall mechanical properties and fracture behavior of freeze-thawed shotcrete. The effect of F-T-induced damage is investigated on the three-phase fracture processes in terms of load versus deflection curves and cracking paths of shotcrete beams. The modeling results for damage and fracture are validated against the experimental data using the three-point bending tests of shotcrete beams.
Values, Agency, and Identity in a Music Teacher Education Program
Authors: Tucker Olivia Gail , Powell Sean Robert
Published: July 2021

Many view music teacher education as a locus for socially just transformation of music education through the development of preservice teacher agency and identity development. However, few have directly examined values in music teacher preparation programs, and values are implicit in agency. The purpose of this exploratory, intrinsic case study was to investigate the visible values in music education courses at one institution to add a new dimension to research and practice. We collected data from four instructor and five undergraduate participants through observations, interviews, and syllabus review. Themes of critical thinking, agency, student centeredness, positive teacher-student relationships, and skills and knowledge for teaching emerged from the data. Findings indicate that values may be relative in practice despite shared language among preservice teachers and music teacher educators. We provide guiding questions for program review and future research through the lens of values.
Cystic Encapsulated Papillary Carcinoma in the Male Breast: An Unusual Feature With a Diagnostic Challenge
Authors: Li Rongying , Saluja Karan , Mai Brenda , Covinsky Michael , Sun Hongxia
Published: July 2021

Papillary carcinoma in the male breast is uncommon. Here, we report a case of a large encapsulated papillary carcinoma (EPC) in a 62-year-old male. The patient presented with a left breast mass of 1-year duration and bloody nipple discharge for several days. Mammography and breast ultrasonography showed a large left breast mass. The initial biopsy demonstrated fat necrosis with acute and chronic inflammation only. Due to clinical suspicion, a repeat biopsy was performed and revealed scant fragments of papillary carcinoma in a background of inflammation. The patient underwent left total mastectomy. Grossly, the breast contained a 9.0 cm entirely cystic lesion lined by a hemorrhagic thick fibrotic wall. No solid area was identified in the cyst. The entire cyst wall was examined under microscopy; only a few sections with papillary carcinoma were identified. The lesion was confined to the cyst wall; so, a diagnosis of EPC was made. Compared to the previously reported EPC cases of male breast, the lesion of this case was unusually cystic, which making the diagnosis challenging. Therefore, awareness of this unusual feature, repeat biopsy when the pathology result is discordant, and extensive sampling of the lesion are essential for making the correct diagnosis and guiding patient management.
Outcomes of Tibialis Anterior Tendon Reconstruction with Autograft or Allograft
Authors: Andronic Octavian , Unterfrauner Ines , Jud Lukas , Fritz Benjamin , Viehöfer Arnd F. , Fröhlich Stefan , Imhoff Florian B. , Wirth Stephan H.
Published: July 2021

Background:

In cases of tibialis anterior tendon (TAT) ruptures associated with significant tendon defect, an interposition graft is often needed for reconstruction. Both auto- and allograft reconstructions have been described in the literature. Our hypothesis was that both graft types would have a good integrity and provide comparable outcomes.

Methods:

Patients who underwent TAT reconstruction using either an auto- or allograft were identified. Patient-reported outcomes (PROs) were collected using the 12-Item Short Form Health Survey (SF-12) questionnaire, the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, the Foot Function Index (FFI), and the Karlsson-Peterson score. Functional outcome was assessed by isokinetic strength measurement. Outcomes were further assessed with magnetic resonance imaging (MRI) evaluation of graft integrity. All measurements were also performed for the contralateral foot.

Results:

Twenty-one patients with an average follow-up of 82 months (20-262 months), comprising 12 allograft and 9 autograft TAT reconstructions, were recruited. There were no significant differences in patient-reported outcomes between allograft reconstructions and autografts: SF-12 (30.7 vs 31.1, P = .77); AOFAS (83 vs 91.2, P = .19); FFI (20.7% vs 9.5%, P = .22); and Karlsson-Peterson (78.9 vs 87.1, P = .23). All grafts (100%) were intact on MRI with a well-preserved integrity and no signs of new rupture. There were no major differences in range of motion and functional outcomes as measured by strength testing between the operative and nonoperative side.

Conclusion:

Reconstructions of TAT achieved good PROs, as well as functional and imaging results with a preserved graft integrity in all cases. There were no substantial differences between allograft and autograft reconstructions.

Level of Evidence:

Level IV, retrospective case series.
Opioid Use Treatment and Recovery Services During Pregnancy
Authors: Woods Loralie M. , Connelly Cynthia D.
Published: July 2021

Background:

The maternal and neonatal consequences of not receiving treatment for opioid use disorders (OUDs) is well known. To prevent adverse outcomes and provide appropriate treatment and services, it is imperative to understand factors influencing pregnant women with OUDs to seek treatment.

Objectives:

The purpose of this study is to identify barriers and facilitators related to opioid use treatment and recovery services among pregnant and nonpregnant women who misuse opioids.

Method:

Retrospective analysis of data from the National Survey on Drug Use and Health (NSDUH), using 2016, 2017, and 2018 NSDUH data. Sample included 122 pregnant and 3,305 nonpregnant women who misused opioids.

Results:

Significant associations were noted among women who misused opioids ( n = 3,427); age (χ2 = 25.406, p < .001), race/ethnicity (likelihood ratio [LR] = 17.721, p < .007), geographic location (χ2 = 7.585, p < .023), health insurance (LR = 13.909, p < .016), tobacco use within the past year (χ2 = 7.058, p = .008), and alcohol use within the past month (χ2 = 76.783, p < 0.001), 3.3% pregnant and 1.8% nonpregnant women who misuse opioids perceive a need to obtain treatment; 10.7% pregnant and 6.5% nonpregnant women currently receiving treatment for opioid misuse. The Strengthening the Reporting of Observational studies in Epidemiology checklist was used to develop the study.

Conclusions:

It is our responsibility to equally focus efforts on understanding the construct of perceived need and help seeking behaviors among pregnant women, as well as, deploy known techniques to engage them in recovery. Further research is necessary to explore the construct of perceived need in this population, as well as, strategies to increase engagement.
Safety Assessment of Citrus Peel-Derived Ingredients as Used in Cosmetics
Authors: Burnett Christina L. , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Gill Lillian J. , Heldreth Bart
Published: July 2021

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 47 Citrus peel-derived ingredients, which are most frequently reported to function in cosmetics as skin conditioning agents. The Panel reviewed the available data to determine the safety of these ingredients. Because final product formulations may contain multiple botanical ingredients, each containing similar constituents of concern, formulators are advised to be aware of these constituents and to avoid reaching levels that may be hazardous to consumers. Industry should use good manufacturing practices to limit impurities that could be present in botanical ingredients. The Panel concluded that Citrus peel-derived ingredients are safe in the present practices of use and concentration in both rinse-off and leave-on cosmetic products when formulated to be non-sensitizing and non-irritating, provided that leave-on products do not contain more than 0.0015% (15 ppm) 5-methoxypsoralen (5-MOP).
The Impact of Social Support and Occupational Stress on Burnout in the Trinidad and Tobago Police Service
Authors: Baek Hyunin , Han Sungil , Seepersad Randy
Published: July 2021

Police officers experience very stressful working environments which may lead to a range of negative outcomes including burnout. Police officers in Caribbean countries are no exception as they face demanding work conditions. Despite this, studies have paid little attention to Caribbean policing. Using data from the eight police divisions in Trinidad (N = 331 police officers), this study examined the relationship among social support (supervisor, co-worker, and family), occupational stress (organizational and operational) and burnout (emotional exhaustion, depersonalization, and personal accomplishment). Path analysis was used to test the hypothesis that social support served to reduce occupational stress, which in turn led to reduced burnout. The results suggested that supervisor support reduced organizational stress, while co-worker and family support reduced operational stress. Organizational stress, in turn affected emotional exhaustion and personal accomplishment, while operational stress affected emotional exhaustion and depersonalization.
To Dally with Dalí: Deepfake (Inter)faces in the Art Museum
Authors: Mihailova Mihaela
Published: July 2021

This essay focuses on the nascent symbiotic relationship between deepfakes and art museums and galleries, as demonstrated by three case studies. The first one, housed at the Dalí Museum in St Petersburg, Florida, is a life-size talking avatar of the artist generated from archival footage. The second one, Warriors by James Coupe, revisits Walter Hill’s 1979 film of the same name using deepfake algorithms to insert visitors’ faces into key scenes, sorting them into gangs based on data-driven analysis of their demographic and economic markers. Finally, Gillian Wearing’s fake ad, Wearing Gillian, uses deepfake technology to enable a series of actors to appear on screen with the artist’s face as a way of interrogating questions of identity in a networked digital world. Based on these works, my article examines museums’ employment of deepfakes for advertising, audience engagement, and educational outreach, and the curatorial, ethical, and creative opportunities and challenges involved therein. While deepfake esthetics will be discussed wherever relevant, this is not a formalist analysis; my goal is not to focus on close readings of the deepfake pieces themselves, however fascinating their esthetics. Instead, I will look at the promotional and critical discourse around them in order to unpack the ways in which the acquisition of creative deepfake works by cultural institutions functions as a legitimizing force that is already shifting the narrative regarding the artistic value and social functions of this technology.
Telemedicine-guided thoracentesis of tension pneumothorax in a term newborn
Authors: Abou Mehrem Ayman , Blagdon Ashley , Hoffman Jaco , Dossani Salma , Anderson Christine , Spence Tanya , Gilad Eli
Published: July 2021

We describe a case of a term female infant born in a rural community hospital and who developed a left-sided spontaneous tension pneumothorax shortly after birth. We used telemedicine to guide the family physician and healthcare team at the referring hospital to perform a life-saving thoracentesis using an intravenous cannula. The cannula was kept in place to drain the persistent pneumothorax during transportation to the pediatric intensive care unit at the tertiary hospital.
Oxytocin levels tend to be lower in autistic children: A meta-analysis of 31 studies
Authors: John Simon , Jaeggi Adrian V
Published: July 2021

The oxytocin system may be different in autistic people, which could explain some of the deficits in social behavior and cognition associated with autism spectrum disorder. However, studies comparing oxytocin levels in autistic and neurotypical individuals have shown conflicting results and a 2016 meta-analysis on seven studies concluded that there was no significant difference. Here, we greatly expanded the sample of studies to 31, warranting a reassessment of this finding. We searched Web of Science with MEDLINE®, SciELO Citation Index, and BIOSIS Citation Index for articles that measured oxytocin in plasma/serum ( k = 26 studies), saliva (4), or cerebrospinal fluid (1) in autistic individuals (total n = 1233 participants) compared to neurotypical individuals ( n = 1304). We found that oxytocin levels were significantly lower in autistic people (Cohen’s d = −0.36, 95% confidence interval = [−0.61, −0.10], p = 0.007), with no evidence for publication bias. This overall effect was driven entirely by differences among children ( k = 25, d = −0.44, 95% confidence interval = [−0.72, −0.16], p = 0.002) but not adults ( k = 6, d = 0.03, 95% confidence interval = [−0.55, 0.61], p = 0.92). These results support further research into the use of oxytocin to treat social deficits in children.

Lay abstract

Oxytocin is a hormone that mediates interpersonal relationships through enhancing social recognition, social memory, and reducing stress. It is released centrally into the cerebrospinal fluid, as well as peripherally into the blood, where it can easily be measured. Some studies indicate that the oxytocin system with its social implications might be different in people with autism spectrum disorder. With summarizing evidence of 31 studies, this meta-analysis suggests that children with autism spectrum disorder have lower blood oxytocin levels compared to neurotypical individuals. This might not be the case for adults with autism spectrum disorder, where we could not find a difference. Our findings motivate further exploration of the oxytocin system in children with autism spectrum disorder. This could lead to therapeutic options in treating autism spectrum disorder in childhood.
From hooking up to staying in? Women negotiating appropriate sexuality in nightlife with age
Authors: Vaadal Kristine
Published: July 2021

While much research has explored contemporary constructions of young women’s sexuality, few studies have been sensitive to how age influences women’s sexuality in the context of mainstream nightlife. Drawing on sexual scripting theory, I investigate how 19 Norwegian women (ages 27–34 years) draw on and negotiate cultural scripts when making sense of their nightlife experiences with age. I found that nightlife was an increasingly difficult space to occupy, and that participating could cause tension with the women’s understandings of themselves, their behaviours and their desires in nightlife. While age-related scripts allowed the participants to criticise gender inequality in sexual interaction in nightlife, they simultaneously obscured how gender inequality in nightlife persisted in new forms with age.
Estimating the consequences of a COVID-19 super spreader: A stochastic model of a night on the town
Authors: Kolnes Nils Henrik , Eikeland Snorre Nilsen , Ersdal Tor Albert , Braut Geir Sverre
Published: July 2021

A stochastic model estimated the consequences of a COVID-19 super spreader event occurring in the local municipality of Stavanger, Norway as a result of a night on the town. The model imposed different infection control regulations and compared these different scenarios. For Stavanger’s 161 locations of service, secondary transmissions from a super spreader event was estimated to infect a median of 37, requiring the quarantining of 200 guests given no infection control regulations, 23 and 167 when imposing social distancing regulations and other hygienic infection control measures, 7 infected and 63 quarantined guests with restrictions placed on the guest capacity, and 4 infected and 57 quarantined guests with both forms of restriction in use.
Application of polyhedral meshing strategy in indoor environment simulation: Model accuracy and computing time
Authors: Chen Haofu , Zhou Xiaoqing , Feng Zhuangbo , Cao Shi-Jie
Published: July 2021

Computational fluid dynamics (CFD) has been proven to be a versatile tool for indoor environment simulations. The discretization of computational domain (mesh generation) determines the reliability of CFD simulation and computational cost. For cases with complex/irregular geometries, the widely utilized tetrahedral meshes have critical limitations, including low accuracy, considerate grid number and computing cost. To overcome these disadvantages, the current research developed a polyhedral meshes based meshing strategy for indoor environment simulations. This study applied tetrahedral, hexahedral and polyhedral meshes for evaluating indoor environment cases developed from previous studies. Simulation accuracy, computing time and physical storage of different mesh types were compared. The results show that the polyhedral meshes could save almost 95% of computing time without sacrificing model accuracy, compared with the other two mesh types with the approximately same grid numbers. Due to its large mesh information, the polyhedral meshes occupied the most physical memory. Overall, the polyhedral meshes based meshing strategy produced a superior performance (model accuracy and computing time) for indoor environment simulations and shows a great potential in engineering applications.
Measuring interpersonal transmission of expiratory droplet nuclei in close proximity
Authors: Fu Linzhi , Nielsen Peter V. , Wang Yi , Liu Li
Published: July 2021

Increasing evidence supports the significant role of short-range airborne transmission of viruses when in close contact with a source patient. A full-scale ventilated room (Cleanliness: ISO 14644–1 Class 5) and two face-to-face standing breathing thermal manikins were used to simulate a source individual and a susceptible person. Monodisperse particle generation and measurement techniques were used to evaluate the effect of virus-laden droplet nuclei size on short-range airborne transmission risk. We analysed four particle sizes (1.0, 1.5, 2.5, and 5.0 µm) to simulate the transport of exhaled droplet nuclei within an interpersonal distance of 0.5 m. The results indicated that the size distribution of airborne droplet nuclei could significantly influence transmission, with the inhalation fraction decreasing with increasing droplet nuclei size. Additionally, results showed that proximity to the source manikin could influence transmission. Inhalation fraction decreased with increasing interpersonal distance, fitting well with the 1/ d rule of droplet nuclei concentration decay. Our findings improve the understanding of the mechanism of the disease transmission.
Correlated color temperature: Use and limitations
Authors: Durmus D
Published: July 2021

Correlated color temperature (CCT) is a one-dimensional metric that aims to quantify the perceived visual quality of nominal white light sources. It is often used as a proxy for the color quality of light sources due to its ease of use. However, CCT lacks the accuracy in communicating color information for research purposes. Two light sources with identical CCTs can appear perceptually different, and these differences are not estimated by CCT due to the loss of information caused by reducing spectral power distribution of light sources into a one-dimensional metric. Using supplemental metrics in addition to CCT, providing the absolute spectral power distribution of light sources in graphical and tabular form, and documenting and accounting for potential confounding factors, such as chromatic adaptation, can increase the validity of research results, improve the repeatability of studies, and help address replication concerns.
Moral distress in nurses: Resources and constraints, consequences, and interventions
Authors: Ghazanfari Mohammad Javad , Emami Zeydi Amir , Panahi Reza , Ghanbari Reza , Jafaraghaee Fateme , Mortazavi Hamed , Karkhah Samad
Published: July 2021

Background

Moral distress is a complex and challenging issue in the nursing profession that can negatively affect the nurses’ job satisfaction and retention and the quality of patient care. This study focused on describing the resources and constraints, consequences, and interventions of moral distress in nurses.

Methods

In a literature review, an extensive electronic search was conducted in databases including PubMed, ISI, Scopus as well as Google Scholar search engine using the keywords including “moral distress” and “nurses” to identify resources, constraints, consequences, and interventions about moral distress in nurses, from the earliest records up to 26 December 2020. The required data were extracted from 61 relevant studies by two independent reviewers.

Results

Resources and constraints in the occurrence of moral distress among nurses can be divided into three general categories including internal factors, clinical factors, and external factors. The consequences of moral distress on nurses and the medical system reduced moral sensitivity, development of psychological and physical health problems, and the intention to leave the profession. The potential effective interventions were the implementation of integrated communication programs, strengthening physician–nurse collaboration, nursing involvement in clinical decision-making and end-of-life issues, social support, using a resiliency bundle, interdisciplinary discussion, and promoting nurses’ ethical and communication skills.

Conclusion

There are a wide range of resources and constraints impacting moral distress in nurses that could lead to negative consequences. Further studies are necessary to identify, evaluate, and implement a range of potential effective interventions for the management of moral distress in nurses.
Prognostic Value of Platelet-to-Lymphocyte Ratio, Neutrophil-to-Lymphocyte Ratio, and Lymphocyte-to-White Blood Cell Ratio in Colorectal Cancer Patients Who Received Neoadjuvant Chemotherapy
Authors: Jia Wangqiang , Yuan Long , Ni Hongyan , Xu Benling , Zhao Peng
Published: July 2021

Background:

The objective of this study was to assess the prognostic value of pretreatment platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-white blood cell ratio (LWR) of CRC patients who received neoadjuvant chemotherapy.

Methods:

We analyzed the peripheral blood routine parameters and other clinical data of 145 patients with colorectal cancer who had undergone neoadjuvant chemotherapy between January 2011 and February 2014. Pretreatment blood parameters of 145 patients were collected, and PLR, NLR, and LWR were calculated. The utility of PLR, NLR, and LWR in predicting treatment efficacy and patient survival was statistically evaluated using the chi-square test, log-rank test, Kaplan-Meier curves and logistic regression models, and Cox regression models.

Results:

Receiver operating characteristic curve showed that the best cutoff values of PLR, NLR, and LWR were 154.31, 3.01, and 0.22, respectively. In univariate analysis, tumor location ( P = 0.044), differentiation degree ( P = 0.001), lymph node metastasis ( P = 0.020), and high PLR ( P = 0.042) were significantly correlated with a lower overall response rate (ORR). In addition, clinical stage, lymph node metastasis, and high PLR were correlated with short OS ( P < 0.01) and DFS ( P < 0.01). Moreover, WBC count was correlated with a short OS. Multivariate analysis showed that tumor location ( P = 0.013), differentiation degree ( P = 0.001), and lymph node metastasis ( P = 0.033) were independent predictors of ORR. In addition, lymph node metastasis independently predicted a shorter OS ( P = 0.011). Lymph node metastasis ( P = 0.013) and high PLR ( P = 0.022) were independent prognostic factors for short DFS.

Conclusions:

For CRC patients who received NAC, clinical pathological stage and lymph node metastasis were correlated with lower ORR and survival, while a high PLR that may be of prognostic relevance in CRC patients receiving NAC.
Incidence and Predictive Factors for Amputations Derived From Charcot's Neuroarthropathy in Persons With Diabetes
Authors: Bandeira Mariana A. , dos Santos Alexandre L. G. , Woo Kevin , Gamba Mônica A. , de Gouveia Santos Vera L. C.
Published: July 2021

Charcot's neuroarthropathy (CN) is the progressive destruction of the bones and joints of the feet, as a consequence of severe peripheral neuropathy, which predisposes patients to amputations. The purpose of this study was to measure the cumulative incidence of amputations resulting from CN and risk factors among amputated people with diabetes mellitus (DM). This was an epidemiological, observational, and retrospective study of 114 patients with DM who had an amputation involving the lower limbs. Data were collected from 2 specialized outpatient clinics between 2015 and 2019, including socio-demographic and clinical variables (cause of amputation: CN, peripheral arterial disease [PAD], infected ulcers, fracture, osteomyelitis, and others; body mass index [BMI]; 1 or 2 DM, time since DM diagnosis, insulin treatment, glycated hemoglobin; creatinine; smoking and drinking; systemic arterial hypertension, diabetic retinopathy, diabetic kidney disease, diabetic peripheral neuropathy, acute myocardial infarction, PAD, and stroke; characteristics of amputation [level and laterality], in addition to the specific variables related to CN [time of amputation in relation to the diagnosis of CN, diagnosis of CN in the acute phase, and treatment implemented in the acute phase]). We compared socio-demographic and clinical characteristics, including types of amputation, between patients with and without CN. Statistical analyses were performed using the 2 sample t-test or Wilcoxon–Mann–Whitney test, for quantitative variables, and the Pearson's χ2 test or Fisher's exact test for categorical variables. The investigation of the possible association of predictive factors for a CN amputation was carried out through logistic regression. The amputation caused by CN was present in 27 patients with a cumulative incidence of 23.7% in 5 years. There was a statistically significant association between BMI and the occurrence of CN (odds ratio: 1.083; 95% confidence interval: 1.001–1.173; P = .048); higher values of BMI were associated with a higher occurrence of amputations secondary from CN.
A Bibliometric Analysis of the Top-Cited Articles on Diabetic Foot Ulcers
Authors: You Jiaxing , Liu Chao , Chen Yixin , Zhu Weifen , Li Hongye , Li Lin
Published: July 2021

The aim of this study was to determine the top-cited articles in the field of diabetic foot ulcer (DFU) research. A cross-sectional bibliometric analysis was conducted in January 2021 by using Boolean search terms in the Scopus and the Web of Science databases. The 50 top-cited articles that met the inclusion criteria were ranked and evaluated for several characteristics, including year of publication, country of origin, authorship, publishing journal, topic categories, publishing type, and level of evidence. The median number of citations per article in the list was 442 (interquartile range [IQR], 320-520), with a median of 21.8 citations (IQR, 16.5-34.5) per year since publication. The publication years ranged from 1986 to 2017, with 1998 accounting for the greatest number of studies ( n = 7). The citation classics were published in 20 journals and originated from institutions in 9 countries. The majority of the studies were clinical, of which expert opinion/review with Level V evidence and clinical studies with Levels I and II evidence comprised the greater proportion in the list. This study provides useful insights into the history and development of DFU research. The top-cited list may serve as a quick reference for education curriculums and clinical practice, in addition to providing a foundation for further studies on this topic.
Quality of Life for People with Disabilities: Why Applied Behavior Analysts Should Consider This a Primary Dependent Variable
Authors: Schwartz Ilene S. , Kelly Elizabeth M.
Published: July 2021

Applied behavior analysis (ABA) is a natural science dedicated to using behavioral principles to address socially important problems. One area in which behavior analysts have made compelling gains in the last 50 years is in developing, evaluating, and disseminating effective interventions for people with significant intellectual and developmental disabilities. As the science of ABA has matured, many practitioners, researchers, and consumers have questioned how our field should define appropriate outcomes of behavioral interventions. In this article, we propose that improved quality of life should be the ultimate outcome for consumers receiving behavioral interventions. We explore definitions of quality of life and suggest some strategies that behavior analysts can apply to modify practices to more clearly center quality of life as an outcome variable.
A Work-Centered Approach to System User-Evaluation
Authors: Roth Emilie M. , Bisantz Ann M. , Wang Xiaomei , Kim Tracy , Hettinger Aaron Z.
Published: July 2021

New systems are often based on optimistic assumptions of how they will improve human performance. In the cognitive engineering tradition, these assumed benefits are regarded as hypotheses that need to be tested. An important element of a system user evaluation is to determine whether the hypothesized benefits are realized. Evaluation may also uncover unsupported aspects of performance or unanticipated side-effects of introducing the new technology that need to be addressed. We present a work-centered approach to user evaluation intended to meet these objectives, focusing specifically on design of tailored user-feedback questionnaires ( work-centered questionnaires) that are intended to be diagnostic of how specific system elements do, or do not, support work. We summarize two recent evaluation studies we have conducted that illustrate our approach and the diagnostic power of work-centered questionnaires. We discuss how the goals and approach of a work-centered evaluation differ from more traditional approaches to usability evaluation that emphasize the use of standardized questionnaires and broad assessments of usability.
Another Attempt to Move Beyond the Cross-Sectional U Shape of Happiness: A Reply
Authors: Galambos Nancy L. , Krahn Harvey J. , Johnson Matthew D. , Lachman Margie E.
Published: July 2021

In this reply to Blanchflower and Graham (2021), we address key points in their response to our article, which challenged the robustness of the U shape in different contexts and aimed to move scholarship on life-course happiness beyond a focus on a single cross-sectional curve. We attend to apparent misconceptions in their portrayal of our arguments, identify points of agreement, and emphasize the value of exploring diversity rather than searching for homogeneity in patterns of change in well-being across life. Future longitudinal research to uncover the complex processes that characterize and underlie human happiness will lead to greater understanding that can benefit individuals and societies.
The role of acetic acid in orthopaedic surgery
Authors: Hashmi Yousuf , Zhou Andrew Kailin , Jawaid Anam , Zhou Anli Yue , Shah Vianca , Thahir Azeem , Krkovic Matija
Published: July 2021

Acetic acid has become more commonly used in orthopaedic surgery. The purposed roles include biofilm eradication and surgical debridement, postoperative scar reduction and managing soft tissue injuries. Current research is scarce and does not provide conclusive evidence behind acetic acid’s efficacy in orthopaedic procedures such as biofilm eradication or acetic acid iontophoresis in soft tissue injuries. Current literature on acetic acid’s effects on biofilm eradication is composed of in-vitro studies, which do not demonstrate the potential clinical efficacy of acetic acid. Acetic acid iontophoresis is a novel technique which is now more commonly accepted for soft tissues injuries. Our literature search identified calcifying tendonitis of the shoulder, rotator cuff tendinopathy, heel pain syndrome, plantar fasciitis, achilles tendonitis, calcifying tendonitis of the ankle, myositis ossificans and cervical spondylosis as documented clinical uses. In this narrative review, we present the current uses of acetic acid and acetic acid iontophoresis, while evaluating the evidence revolving around its efficacy, benefits and risks.
Monoclonal gammopathy of undetermined significance
Authors: Chieng Vui Yung , Sampson Rod
Published: July 2021

Monoclonal gammopathy of undetermined significance is a premalignant, plasma cell disorder. Due to the potential risk of progression to multiple myeloma or a plasma cell-related disorder, it is important for GPs to recognise and manage patients in this cohort appropriately. This article aims to improve understanding, recognition and management of these patients in primary care.
Impact of tranexamic acid on clinical and hematologic outcomes following total shoulder arthroplasty
Authors: Kelly McKayla , Turcotte Justin , Fowler M Brook , West Michaline , Lashgari Cyrus , Gelfand Jeffrey
Published: July 2021

Background

The purpose of this study is to evaluate the impact of intravenous tranexamic acid on clinical and hematologic outcomes after total shoulder arthroplasty.

Methods

Retrospective review was conducted for 282 consecutive patients undergoing either anatomic shoulder arthroplasty or reverse total shoulder arthroplasty. Univariate analysis and multivariate linear regression were used to compare outcomes for patients receiving intravenous tranexamic acid with those who did not.

Results

Of the 282 patients included in this study, 78 patients received intravenous tranexamic acid and 204 did not. Patients who received intravenous tranexamic acid had significantly lower pre- to postoperative change in hemoglobin and hematocrit, and decreased postoperative drain output. In addition, patients receiving intravenous tranexamic acid were significantly less likely to have a postoperative hematocrit <30. There were no significant differences in length of stay, rate of 30 day hematoma, surgical site infection, deep vein thrombosis, or readmission between groups.

Conclusion

Intravenous tranexamic acid is associated with a significant reduction in change in hematocrit and hemoglobin and postoperative drain output after both anatomic and reverse total shoulder arthroplasty. Despite improving hematologic outcomes for these patients, tranexamic acid appears to have little impact on clinical outcomes such as length of stay and 30-day complication rates.
Acute lobar nephronia: Pitfalls and insights of an underdiagnosed urologic condition
Authors: El-Khoury Hanna J , Chinni Vidyasagar , Appu Sree , Bolton Damien
Published: July 2021

Background:

Acute lobar nephronia (ALN) is an underdiagnosed urological condition which has scarce publications available. It is described as an acute inflammatory and bacterial infection of the kidney without liquefaction, and in fact likely represents a mid-point between acute pyelonephritis and renal abscess. Patients usually present with fevers, septic shock, and occasionally abdominal and flank pain. To date there is no consensus on its optimal management.

Objective:

The aim of this study was to describe the presentation, evaluation, multidisciplinary involvement and management, and follow-up of ALN.

Method:

An observational study was performed utilising four patients from our single centre urology department. Data collected included basic demographics and diagnosis and management. All four patients are presented below. Observations and comparisons were made between all patients to aid in understanding the commonality between their presentations and managements.

Conclusion:

ALN is an underdiagnosed condition. Its diagnosis and management is difficult and requires a multidisciplinary approach. Many patients require prolonged inpatient management and close follow-up. An underlying renal mass is always an important differential diagnosis to be considered. Level of evidence: Not applicable for this multicentre audit.
A single institution experience: Robotic-assisted laparoscopic renal calyceal diverticulectomies, heminephrectomy and bladder diverticulectomies
Authors: Phan Yih Chyn , Babawale Omikunle , Karim Omer , Wilby Daniel , Ismail Mohamed
Published: July 2021

Introduction:

The use of a robotic surgical system has transformed modern urological surgeries. There is little reported, however, on the use of robotic surgical systems in the management of benign urological diseases. We aim to report our experience in robotic-assisted surgery in renal calyceal diverticulectomies, heminephrectomy and bladder diverticulectomies.

Methodology:

We retrospectively collected the data of patients who had robotic-assisted surgery in our institution from 1 January 2014 to 31 December 2019.

Results:

Over the last five years, our institution has performed over 1500 robotic-assisted urological surgeries. In this five-year period, four robotic surgeons have performed a total of 25 robotic assisted operations to treat benign urological diseases including three renal calyceal diverticulectomies, one heminephrectomy and two bladder diverticulectomies. All patients were satisfied with the outcomes of their surgery when reviewed at their follow up consultations.

Conclusion:

We report a very positive experience in using robotic surgical systems in managing our series of benign urological conditions in our hospital. We should not restrict the use of this tool to cancer surgery, but consider the technology in our surgical armamentarium for all aspects of our urological practice.
Holmium laser enucleation of the prostate: A single-centre case series of 1000 patients
Authors: Whiting Danielle , Penev Branimir , Guest Katherine , Cynk Mark
Published: July 2021

Objective:

To describe the short and long-term complications of over 1000 cases of Holmium laser enucleation of the prostate (HoLEP) in a single centre.

Methods:

A prospective database of all HoLEP procedures performed between December 2003 and March 2017 was analysed.

Results:

A total of 1016 HoLEP procedures were performed. Median patient age was 72 years (range 41–95). There was a significant improvement in urinary flow, post-void residual volume, IPSS and QoL score ( p < 0.0001). Pre-operative acute urinary retention was present in 403 patients (39.7%). Post-operatively five patients (1.2%) continued with a long-term catheter. Early and late complications consisted of failed initial voiding trial (10.6%), stress incontinence (transient 6.5%; persistent 0.3%), frequency/dysuria (5.6%), urinary tract infection (5.3%), urethral stricture (4.8%), submeatal stenosis (1.9%), return to theatre (1.5%), bladder neck stenosis (1.3%), bleeding (1.2%), epididymitis (0.7%), confusion (0.3%), transurethral resection of the prostate conversion (0.2%), ureteric obstruction (0.2%), vomiting (0.2%), anuric renal failure (0.1%), chest infection (0.1%), chest pain (0.1%), myocardial infarction (0.1%), rectoprostatic fistula (0.1%), supraventricular tachycardia (0.1%) and urinary sepsis (0.1%). Five-year reoperation rate was 3.7%.

Conclusion:

HoLEP is a safe treatment for bladder outflow obstruction secondary to an enlarged prostate. It is associated with few early and late complications and has a low reoperation rate.

Level of evidence:

4
Covered Stent Placement for Subclavian Vein Stenosis Associated With Basilic Arteriovenous Fistula
Authors: Rivera Diana M. Torpoco , Taylor Rachel , Fox Andrew , Forbes Thomas J. , Kobayashi Daisuke
Published: July 2021

Arteriovenous fistula (AVF) creation is used to palliate complex cyanotic heart diseases. We report an adult patient with AVF creation who subsequently developed severe left subclavian vein stenosis, causing significant left arm swelling. Covered stent placement successfully treated the venous stenosis, resulting in the normalization of his left arm swelling.
A Connectome-Wide Functional Signature of Trait Anger
Authors: Kim M. Justin , Elliott Maxwell L. , Knodt Annchen R. , Hariri Ahmad R.
Published: July 2021

Past research on the brain correlates of trait anger has been limited by small sample sizes, a focus on relatively few regions of interest, and poor test–retest reliability of functional brain measures. To address these limitations, we conducted a data-driven analysis of variability in connectome-wide functional connectivity in a sample of 1,048 young adult volunteers. Multidimensional matrix regression analysis showed that self-reported trait anger maps onto variability in the whole-brain functional connectivity patterns of three brain regions that serve action-related functions: bilateral supplementary motor areas and the right lateral frontal pole. We then demonstrate that trait anger modulates the functional connectivity of these regions with canonical brain networks supporting somatomotor, affective, self-referential, and visual information processes. Our findings offer novel neuroimaging evidence for interpreting trait anger as a greater propensity to provoked action, which supports ongoing efforts to understand its utility as a potential transdiagnostic marker for disordered states characterized by aggressive behavior.
Does robotic assisted technology improve the accuracy of acetabular component positioning in patients with DDH?
Authors: Zhou Yixin , Shao Hongyi , Huang Yong , Deng Wang , Yang Dejin , Bian Tao
Published: July 2021

Background:

Accurate positioning of the acetabular component is key in performing total hip arthroplasty (THA). However, reconstruction of the acetabulum in the setting of developmental dysplasia of the hip (DDH) is a challenge. Robotic assisted THA has the potential to improve the accuracy of implantation of the acetabular cup in cases with DDH. The purpose of this study was to assess whether robotic technology improves the accuracy of acetabular component positioning in patients with DDH.

Material and methods:

We included 59 THAs using robotic assisted technology from June 2019 to January 2020 as the study group. These were compared to conventional THAs without robotic technology after control for age, gender, body mass index (BMI), Crowe type and operation date. Radiographic measurements were taken by 2 blinded orthopaedic residents. The percentage of hips within the Lewinnek and Collanan safe zones were calculated, along with acetabular rotation centers for the “target zone.” Surgical time and perioperative bleeding were also compared between both groups.

Results:

One patient suffered dislocation in conventional group while no dislocation occurred in robotic group. The acetabular components of the robotic assisted group had more cases located within the Lewinnek ( p = 0.013) and Collanan ( p = 0.008) safe zones than conventional group (94.9% vs 79.7% and 74.6% vs 50.8%). There were 7 cases in conventional group and 4 cases in robotic group that had more lateral or more superior rotational centers of THA, but did not reach statistical significance ( p = 0.342). No statistical difference was detected between groups with regards to blood loss ( p = 0.098) and surgical time ( p = 0.602).

Conclusion:

Robot assisted technology can assist surgeons with implanting acetabular cups more in Lewinnek and Callanan safe zone than conventional techniques without additional blood loss and surgical time.

Level of Evidence:

Therapeutic Level Ⅲ.
Exacerbation of Multiple Sclerosis by BRAF/MEK Treatment for Malignant Melanoma: The Central Vein Sign to Distinguish Demyelinating Lesions From Metastases
Authors: Hemond Christopher C. , Bakshi Rohit , Tauhid Shahamat , Sarrosa Rosila , Ryan Madison , Kamath Vineetha , Thomas James , Edwards Keith R.
Published: July 2021

The emergence of immunomodulators as effective cancer treatments has been an important advance in cancer therapy. The combination therapy of BRAF/MEK inhibition with or without anti-CTLA-4 treatment causes an immunostimulatory effect that has greatly reduced death from melanoma. In this article, we present the case of a patient with prior multiple sclerosis (MS) and who later developed metastatic malignant melanoma, had a marked increase of magnetic resonance imaging (MRI) findings after treatment with the combination of trametinib (MEK) and dabrafenib (BRAF), diagnostic question of metastatic disease versus new MS lesions without brain biopsy is discussed. A healthy 49-year-old man was diagnosed with MS in October 2012. He was stable with an oral disease modifying drug until March of 2016 when the patient discovered a lump in his right groin. Biopsy was positive for S100 and BRAF V600 mutation. Combination MEK/BRAF was given and after immunotherapy an MRI showed 25 new gadolinium-enhancing lesions thought to be metastases. A brain biopsy was recommended but neurology and neuroimaging consultation showed that the MRI was consistent with demyelination (oval/ovoid, homogeneous and open-ring enhancement, and predominance of the central vein sign within lesions) rather than metastasis. Treatment for MS has been successful and there has been no return of his melanoma in 4 years. New immunotherapies are lifesaving but the modulation of the immune system can cause unpredictable events such are markedly increased MS activity. The awareness of the diagnostic value of the central vein sign provided a better outcome for this patient and could be a model in the future for others.