bluuebunny/crossref_metadata_2025 huggingface dataset:
High Rate of Clinically Meaningful Achievement in Outcomes After Subacromial Balloon Spacer Implantation for Massive Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis
Authors: Kunze Kyle N. , Moran Jay , Cecere Robert , Taylor Samuel A. , Fu Michael C. , Warren Russell F. , Dines David M. , Gulotta Lawrence V. , Dines Joshua S.
Published: March 2023

Background:

Subacromial balloon spacers have been introduced as a potential treatment option for patients with massive irreparable rotator cuff tears. However, it is important to comprehensively assess the clinical efficacy of this procedure in the context of an increasing amount of contemporary literature.

Purpose:

To perform a systematic review of the contemporary literature to understand the propensity for clinically meaningful improvements after subacromial balloon spacer implantation for massive irreparable rotator cuff tears.

Study Design:

Systematic review and meta-analysis; Level of evidence, 4.

Methods:

The PubMed, Ovid/MEDLINE, and Cochrane databases were queried in July 2022 for data pertaining to studies reporting clinically significant outcomes after subacromial balloon spacer implantation. Freeman-Tukey double arcsine transformation was used to quantify the pooled rate of clinically meaningful improvements in outcomes as evaluated using the minimal clinically important difference (MCID), Patient Acceptable Symptom State (PASS), and substantial clinical benefit (SCB). Qualitative analysis was performed when data were variably presented to avoid misleading reporting.

Results:

There were 10 studies included, all of which reported MCID achievement. The overall pooled rate of MCID achievement for the Constant-Murley score was 83% (95% CI, 71%-93%; range, 40%-98%), with 6 of 8 studies reporting rates equal to or exceeding 85%. One study reported a 98% rate of PASS achievement for the Constant-Murley score at 3-year follow-up. The rate of MCID achievement for the American Shoulder and Elbow Surgeons (ASES) score ranged between 83% and 87.5%. The rate of PASS achievement for the ASES score was 56% at 2-year follow-up, while the rate of SCB achievement for the ASES score was 83% and 82% at 1- and 2-year follow-up, respectively. At 1-year follow-up, 74% and 78% of patients achieved the MCID for the Numeric Rating Scale and Oxford Shoulder Score, respectively. At 3 years, 69% of patients achieved the MCID for the Numeric Rating Scale and 87% achieved it for the Oxford Shoulder Score.

Conclusion:

Patients who underwent isolated subacromial balloon spacer implantation for massive irreparable rotator cuff tears demonstrated a high rate of clinically significant improvement in outcomes at short- to mid-term follow-up. A paucity of literature exists to appropriately define and evaluate the rates of achieving the PASS and SCB after subacromial balloon spacer implantation, necessitating further study.
Cohort Differences in Depressive Symptoms and Life Satisfaction in 75- and 80-Year-Olds: A Comparison of Two Cohorts 28 Years Apart
Authors: Kekäläinen Tiia , Koivunen Kaisa , Pynnönen Katja , Portegijs Erja , Taina Rantanen
Published: March 2023

Objectives: To examine birth cohort differences in depressive symptoms and life satisfaction in older men and women and the mechanisms underpinning the possible cohort differences. Methods: Two independent cohorts of Finnish men and women aged 75 and 80 were assessed in 1989–1990 ( n = 617) and 2017–2018 ( n = 794). They reported their depressive symptoms (CES-D), current life satisfaction, and evaluation of life until now. Results: The later-born cohort reported fewer depressive symptoms (8.6 ± 7.1 vs. 13.9 ± 8.3) and the differences were similar for the subdomains of depressive symptoms. The later-born cohort was more often mostly satisfied with life until now (90 vs. 70%) but not with the current life than the earlier-born cohort. Better self-rated health and education of the later-born cohort partly explain the cohort differences. Discussion: Older people in Finland report fewer depressive symptoms and they are more satisfied with their past life compared to their counterparts assessed 28 years ago.
Research on anti-rollover warning control of heavy dump truck lifting based on sliding mode-robust control
Authors: Fu Zhongcheng , Hu Mingmao , Guo Qinghe , Jiang Zhigang , Guo Dong , Liao Ziwen
Published: March 2023

In order to improve the rollover stability of heavy dump trucks during lifting and unloading under special circumstances and prevent heavy dump trucks from overturning, a sliding mode-robust control based on anti-rollover early warning control method for heavy dump trucks lifting and unloading was proposed. A four-degree-freedom heavy dump truck lifting and unloading roll dynamic model was established, and the accuracy of the model was verified in the MATLAB/Simulink simulation environment. The controller was designed by combining sliding mode robust control based on HJI theory and active suspension control. The ratio of the gravity carried by the wheel with the lighter bearing capacity to the total gravity of the heavy dump truck was used as the evaluation index for rollover warning. Under two different simulation conditions, compared with conventional sliding mode control and no control, the rollover evaluation index and roll angles were analyzed under three control methods. The results showed that the anti-rollover early warning control method for lifting and unloading of heavy dump trucks proposed in this paper had better anti-rollover capability and better stability.
MOP-SLAM: A real time SLAM system based on multi-head optical flow estimation network
Authors: Chong Yuxiang , Huang Xiaoci , Dai Zhiyong , Zhang Yan , Lv Zezheng , Liang Yaozhong
Published: March 2023

SLAM (simultaneous localization and mapping) is becoming a significant technology in driverless vehicles nowadays. Sometimes the optical flow method can be used to track feature points to reduce the amount of calculation. But the traditional optical flow method is based on the assumption that the luminosity will not change and has high requirements for the environment. Therefore, an optical flow calculation method based on neural network called Optical-Net is proposed in this paper to match and track feature and corner points. We use the multi-head attention module to extract and fuse the features of different scales. The training results show that the Optical-Net designed in this study effectively improves the robustness and accuracy of optical flow estimation when the object has large displacement and small displacement. Meanwhile, to address the problem of reduced matching accuracy during video input due to dynamic blurring, a video dynamic deblurring algorithm based on the one-dimensional Wineman filter is adopted to preprocess the input video. Finally, we replaced the tracking thread in traditional SLAM. The performance of the improved algorithm is verified by experiments on our own driverless car.
Multi-objective optimization of two-stroke compression release braking performance of a heavy-duty engine based on non-dominated sorting genetic algorithm II (NSGA II)
Authors: Wang Yang , Dong Dongsheng , Ge Pingshu , Zhang Tao , Zhang Heng
Published: March 2023

Traditional heavy-duty vehicle service brakes use the friction method to realize vehicle deceleration, which means that longer-term use of the service brake will lead to overheating. It will make the braking capacity significantly reduced, at the same time, the service brake system also will wear much faster. Engine brake has been developed continuously in recent decades since it has the advantages of small install space and weight, no attenuation of braking power, rapid response, and endurance braking. However, the complex structure and large valve load of the valve train are the main obstacles to the widespread use of two-stroke compression release braking. Two-stroke compression release braking power is the effective indicator of the braking capacity and the maximum cylinder pressure (Pmax) can reflect the load of the valve train, therefore, the braking power and Pmax need to be optimized at the same time. In this paper, the multi-objective non-dominated sorting genetic algorithm II (NSGA II) was introduced to optimize the two-stroke compression release braking performance and it was compared with the orthogonal design method. The results indicated that the braking power and Pmax of optimal solution 1 by NSGA II achieved −395.64 kW and 59.37 bar, which were 1.17% and 2.78% improved than that of orthogonal analysis, respectively. In addition, the calculation process shows that NSGA II provides a more comprehensive and reliable method to optimize the valve parameters of the two-stroke compression release brake.
Optimal hybrid Coulomb control for on-track rendezvous and docking of spacecraft
Authors: Kumar Gaurav , Giri Dipak Kumar , Kumar Shashi Ranjan
Published: March 2023

This paper investigates the dynamics of on-track rendezvous and docking of two spacecraft, and stabilization using hybrid Coulomb control. Modeling electrostatic forces and torques for control of complex spacecraft geometries like cylinders is challenging. Point mass assumption of the spacecraft that disregards the chaser dynamics will lead to errors in force estimation during the terminal docking phase, resulting in a mission failure. This paper uses the effective sphere method to model Coulomb interactions between the chaser and the target. The method is coupled with the chaser’s tumbling motion about its body axes to develop a relationship between electrostatic force and attitude. The relative attitude dynamics of the chaser is then derived and incorporated into the system dynamics. Differential gravity and hybrid thrusters are used to stabilize the relative attitude of the two bodies. The charge-voltage relations are used to compute potential variations for the Coulomb control. An optimal linear quadratic tracking control is proposed for tracking a reference trajectory generated using solutions of Clohessy-Wiltshire-Hill’s equations. Numerical simulations are carried out for both non-linear and linear models of the Coulomb spacecraft to validate the proposed concept. Results have also been compared with an existing voltage feedback controller to demonstrate the merits and challenges of electrostatic actuation for rendezvous and docking.
Late-Holocene wildfire record from the Stagmo peat section, Leh valley, NW Himalaya
Authors: Sagwal Sumit , Sengupta Dipanwita , Kumar Anil , Dutt Som , Srivastava Pradeep , Agnihotri Rajesh , Gahlaud Sanjay Kumar Singh , Sarathi Jena Partha , Shivam Ajay , Bhushan Ravi
Published: March 2023

Wildfire is an integral component of the terrestrial ecosystem that plays a significant role in regulating the vegetation cover. The paleofire records stored in lacustrine, peat, or marine sedimentary deposits along with environmental proxy records provide temporal information on fire activity and contemporary climatic conditions on a regional scale. A ~2.8m long peat sedimentary profile from Stagmo, Indus Valley, Ladakh Himalaya was examined for sedimentology and charcoal microfossil contents to investigate fire characteristics and reconstruct wildfires which are compared with paleoclimatic changes and past human activities to assess their significance in biomass burning. Charcoal count (CC) analysis provides a suitable method for investigating climatic and vegetation changes with human intervention when no direct evidence is available in the Late-Holocene Trans Himalaya records. The results bring new insight into the interaction between vegetation, fire, and human activity in the Ladakh Himalaya during the past ~2.8 cal kyr BP. An event characterized by high CC at ~2.8 cal kyr BP is distinct from the whole sequence and cannot easily be explained as only the result of a climatic event. This first high charcoal count phase (2.81–2.55 cal kyr BP) could be a natural response to the expansion of forest and dense vegetation with human management interruption. This paleo wildfire event likely corresponds with the time of the Tibetan Plateau’s immediate human occupation. In the second phase, a relatively low charcoal count (1.65–1.54 cal kyr BP) is supported by the high fuel availability during a transitional phase. The third phase of wildfire reconstruction in Ladakh Himalaya is identified at ~1.38 cal kyr BP. This phase can be correlated with the intensified Indian Summer Monsoon (ISM) advancing to Trans-Himalaya leading to increased human settlement in the region.
Deepfakes: Vehicles for Radicalization, Not Persuasion
Authors: Nieweglowska Maja , Stellato Cal , Sloman Steven A.
Published: March 2023

Deepfakes are an effective method of media manipulation because of their realism and also because truth is not a priority when people are consuming and sharing content online. Consumers are more focused on creating their own reality that aligns with their desires, opinions, and values. We explain how deepfakes differ from other sources of information. Their realism and vividness makes them unusually effective at depicting alternative facts, including fake news. Deepfakes are difficult to detect and will be even harder to detect in the future. However, people share deepfakes not necessarily because they believe them but because they want to reinforce their own identity and social position. The threat posed by deepfakes is that they can radicalize people by sowing chaos and confusion. They rarely change minds. We review the consequences of deepfakes in both the social sphere and private lives. We suggest potential solutions to reduce their negative consequences.
Arthroscopy combined with high tibial osteotomy promotes cartilage regeneration in osteoarthritis
Authors: Wu Jiang , Zhao Bin , Luo Wei , Chen Xiao , Zhao Qian , Ren Fuji , Zheng Huifeng , Huang Jingmin
Published: March 2023

Background

To investigate the effect of arthroscopy combined with high tibial osteotomy (HTO) on cartilage regeneration in patients with knee osteoarthritis.

Methods

A retrospective analysis of 50 patients with varus and medial compartment osteoarthritis of the knee treated by arthroscopy combined with HTO. One year after the operation, a second-look arthroscopy was performed to observe the cartilage regeneration. The regeneration of cartilage was evaluated by different pathological staining of some of the new cartilage. Finally, part of the new cartilages ( n = 6) were taken for quantitative real-time PCR and western blotting experiments to display the mechanism of cartilage regeneration.

Results

One year after arthroscopy combined with HTO, the results of arthroscopy revealed the formation of new tissue in the defect area of the medial compartment’s cartilage in the knee joint. In addition, different pathological staining results indicated that the new tissue was cartilage-like tissue. Furthermore, HTO potently up-regulated the expression of p-ERK1/2 at the protein level in knee osteoarthritis patients compared with control group. However, there was no significant difference in the relative expression of collagen II at mRNA and protein level between control group and knee osteoarthritis patients.

Conclusion

Arthroscopy combined with HTO can promote cartilage regeneration in patients with knee osteoarthritis.
Ethical Implications of Cleft Lip and Palate Repair in Patients with Trisomy 13 and Trisomy 18
Authors: Appel Richard , Grush Andrew E. , Upadhyaya Raghave M. , Mann David G. , Buchanan Edward P.
Published: March 2023

Background

Children born with Trisomy 13 or 18 (T13/18) often have multiple congenital anomalies, many of which drastically shorten their lifespan. Among these defects are cleft lip and palate, the repair of which presents an ethical dilemma to the surgeon given the underlying comorbidities associated with T13/18. The authors present an ethical discussion and institutional experience in navigating this dilemma.

Methods

The authors analyzed existing literature on T13 and T18 surgery and mortality. A retrospective study over ten years was also conducted to identify pediatric patients who underwent surgical correction of cleft lip and/or palate secondary to a confirmed diagnosis of T13/18. The authors identified two patients and examined their treatment course.

Results

The authors’ review of literature coupled with their institution's experience builds on the published successes of correcting cleft lip and palate in the setting of T13/18. It was found that both patients identified in the case series underwent successful correction with no surgical complications.

Conclusion

A careful balance must be struck between improved quality of life, benefits of treatment, and risks of surgery in children with T13/T18. Careful consideration should be given to the medical status of these complex patients. If the remaining medical comorbidities are well managed and under control, there is an ethical precedent for performing cleft lip and palate surgeries on these children. A diagnosis of T13/T18 alone is not enough to disqualify patients from cleft lip/palate surgery.
The Ultimate Trauma: A Murdered Child Counseling Considerations
Authors: Atwood Joan D. , Schaefer-Schiumo Kristin , Russo Ashlyn
Published: March 2023

Nothing is more devastating to a family than the death of their child. A sudden death due to a violent crime such as murder including school shootings can be life-shattering. According to socially prescribed and predictable scripts, children are supposed to outlive their parents. When a child dies before the parent, the blueprint for one's life journey is backwards, leaving no prescribed plan to guide the family through life. When the death occurs as a result of murder, it is even more devastating. This article explores this backward script of a child dying before his or her parents because of murder and the resulting journey the family faces. It first examines the incidences of murdered children and then explores some possible barriers to the healing process. Next, the concept of scripts is explored, exploring different death scripts. The effect of a murdered child on the marital role, the parental role, and siblings is also presented. Psychological reactions are discussed and counseling considerations are presented. Counseling implications are considered throughout. This journey is demonstrated through the experiences of Cameron's family, Cameron was a 16-year-old adolescent who was murdered. This case history is fictitious and was developed to illustrate points in the paper. It is in no way related to any individual or family.
Trimalleolar Fractures Treated by Open Reduction Internal Fixation Compared With Arthroscopically Assisted Reduction and Minimally Invasive Surgery
Authors: Chou Te-Feng Arthur , Tzeng Yun-Hsuan , Teng Ming-Hung , Huang Yen-Chun , Wang Chien-Shun , Lin Chun-Cheng , Chiang Chao-Ching
Published: March 2023

Background:

Currently, the standard of treatment for trimalleolar (TM) fracture is osteosynthesis through open reduction and internal fixation (ORIF). This study assessed whether arthroscopically assisted reduction and minimally invasive surgery (AARMIS) can be an alternative surgical method for TM fractures.

Methods:

This retrospective cohort study included 49 patients with TM that were surgically treated. 27 patients received ORIF and 22 patients underwent AARMIS . At baseline, we recorded the patient’s demographic features, fracture pattern (AO-OTA and Haraguchi classification), and surgical method. For postoperative results, we examined the patient’s radiographic outcome, including time to union, quality of fracture reduction, as well as functional outcomes (American Orthopaedic Foot & Ankle Society ankle hindfoot score, ankle range of motion, and visual analog scale of pain) and perioperative complications.

Results:

At mean follow-up of 46.6[Formula: see text] (ORIF) and 36.4[Formula: see text] months (AARMIS), both groups had comparable radiographic outcomes. No significant difference in rates of early ankle OA were detected. In terms of functional outcome, VAS pain and AOFAS score at postoperative day 3, postoperative month 3, and at final follow-up were not different. In terms of range of motion, we did not find a significant difference in mean range of motion.

Conclusion:

Patients with TM fractures treated with AARMIS achieved satisfactory results and was not significantly different in radiographic and functional performance compared with ORIF.

Level of Evidence:

Level III, retrospective cohort study.
Application of the Mayo Periprosthetic Joint Infection Risk Score for Total Ankle Arthroplasty
Authors: Zhang Zijun , Chien Bonnie Y. , Noori Naudereh , Day Jonathan , Robertson Cassandra , Schon Lew
Published: March 2023

Background:

Assessing patient’s risk of infection is fundamental for prevention of periprosthetic joint infection (PJI) after total ankle arthroplasty (TAA). The Mayo Prosthetic Joint Infection Risk Score (Mayo Score) is based on data from total hip and knee arthroplasty and has not been validated for application for TAA.

Methods:

A total of 405 consecutive TAA cases were followed for 6 months for PJI. Individual patients’ Mayo Scores were calculated and analyzed with logistic regression and receiver operating characteristic (ROC) for predictability for PJI. A critical cut-off Mayo Score for patients at high risk of PJI was determined by best Youden index. Among the Mayo Score–defined high-risk patients, the contribution of different risk factors were compared between the PJI and non-PJI patients.

Results:

There were 10 cases of PJI (2.5%) among the 405 cases within 6 months after TAA. Of the 405 patients, the Mayo Scores ranged between −4 and 13 (median 2; interquartile range 0-5). The average Mayo Score was 2.5 ± 3.4 in the non-PJI patients and 7.7 ± 3.1 in the PJI patients ( P < .001). Logistic regression showed that the probability of PJI increased with higher Mayo Scores (odds ratio 1.48, 95% CI 1.23-1.78). All but 1 PJI patients had a Mayo Score >5. The sensitivity and specificity were 90.0% and 84.3%, respectively, when a Mayo Score >5 was used as a criterion for high risk of PJI.

Conclusion:

This study demonstrated that the Mayo Score could similarly predict PJI risk after TAA as in total hip and knee arthroplasty. Data analysis suggests that a Mayo Score >5 could be a criterion for identifying high-risk patients for PJI, although further validation with a large number of PJI cases is necessary.

Level of Evidence:

Level II, developing diagnositic criteria with consecutive cases.
Delivering Genetic Testing for Patients with Prostate Cancer: Moving Beyond Provider Knowledge as a Barrier to Care
Authors: Gunn Christine M. , Li Emma X. , Gignac Gretchen A. , Pankowska Magdalena , Loo Stephanie , Zayhowski Kimberly , Wang Catharine
Published: March 2023

Introduction

The 2018 National Comprehensive Cancer Network guidelines for prostate cancer genetic testing expanded access to genetic services. Few studies have examined how this change has affected provider practice outside of large cancer centers.

Methods

We conducted a qualitative study of multi-disciplinary health care providers treating patients with prostate cancer at a safety-net hospital. Participants completed an interview that addressed knowledge, practices, and contextual factors related to providing genetic services to patients with prostate cancer. A thematic analysis using both inductive and deductive coding was undertaken.

Results

Seventeen providers completed interviews. Challenges in identifying eligible patients for genetic testing stemmed from a lack of a) systems that facilitate routine patient identification, and b) readily available family history data for eligibility determination. Providers identified non-medical patient characteristics that influenced their referral process, including health literacy, language, cultural beliefs, patient distress, and cost. Providers who see patients at different times along the cancer care continuum viewed benefits of testing differently.

Conclusion

The use of digital technologies that systematically identify those eligible for genetic testing referrals may mitigate some but not all challenges identified in this study. Further research should determine how individual provider perceptions influence referral practices and patient access to genetics both within and across cancer specialties.
“The Echoes of Echo Park”: Anti-Homeless Ordinances in Neo-Revanchist Cities
Authors: Giamarino Christopher , Loukaitou-Sideris A.
Published: March 2023

This article focuses on national and local anti-homeless ordinances and investigates emerging spatial banishment strategies and their impacts on unhoused folks’ basic freedoms. First, we review debates on co-existing geographies of punishment and care through theoretical and legal lenses. Focusing on sixteen cities in the United States, we examine categories of anti-homeless ordinances and their evolution in the past two decades. Next, we focus on Los Angeles and use archival research and interviews with activists to examine the expansion of newly emerging anti-homeless spaces. Our research details ad hoc strategies of spatial banishment targeting homelessness. We find that the city represents a fragmented landscape of “no-go-zones” for the unhoused. We posit that the COVID-19 pandemic enabled various spatial banishment strategies and that Los Angeles is neo-revanchist. We advocate for city policies that abolish spatial banishment strategies and respond to the needs of the unhoused.
Cost savings and cost avoidance with the inpatient clinical pharmacist interventions in a tertiary cancer care hospital
Authors: Abushanab Dina , Gulied Amaal , Hamad Anas , Abu-Tineh Mohammad , Abdul Rouf Palli V , Al Hail Moza , El-Kassem Wessam , El Hajj Maguy S , Al-Badriyeh Daoud
Published: March 2023

Background

The economic benefit of the clinical pharmacist's role in ensuring the optimum use of medicines is potentially considerable, particularly when it comes to cancer management. We sought to evaluate the overall economic impact of clinical pharmacist interventions in the main cancer setting in Qatar.

Methods

The total economic benefit of the clinical pharmacy interventions were analyzed from the public hospital perspective. Patient records in March 2018, July/August 2018, and January 2019 were retrospectively reviewed at the National Center for Cancer Care and Research, Qatar. The total benefit from interventions was the total cost avoidance due to preventable adverse drug events plus any cost savings associated with therapeutic-based resource use. Sensitivity analyses confirmed the results’ robustness and increased generalizability.

Results

A total of 1352 interventions based on 281 patients were analyzed. The majority of the drug-related problems were related to the appropriateness of therapy, followed by dosing and administration. The total population benefit over the 3-months study period was QAR 4,879,185 (USD 1,336,763), constituting cost avoidance of QAR 4,234,012 (USD 1,160,003) and negative resource-use cost savings of −QAR 645,174 (−USD 176,760). Projected annual overall benefit was QAR 14,355,354 (USD 3,932,974). The increase in resource use with therapies was mostly because of the addition of other medications. Cost avoidance was mostly driven by recommending additional medications and discontinuation of medications. The uncertainty analysis demonstrated the robustness of outcomes.

Conclusions

The clinical pharmacist intervention increased resource use and its cost. In overall, however, taking avoided cost of adverse drug events in consideration, it is an economically beneficial practice in the National Center for Cancer Care and Research setting, associated with adverse drug events prevention and substantial economic benefits.
Prevalence and predictors of non-rheumatic valvular heart disease in patients with sickle cell disease: insights from the National In-Patient Database in 2016 and 2017
Authors: Quelal Karol , Torres Andrea , Shahi Anoj , Almani Muhammad Usman , Yadav Neha
Published: March 2023

Sickle cell disease (SCD) life expectancy has increased in high-income countries, approaching the fifth decade in the United States. Aging in SCD has raised concerns about chronic organ damage due to adaptative and maladaptive cardiac remodeling. This study aims to assess the prevalence and predictors of non-rheumatic valvular heart disease (NRVHD) in SCD patients using the United States National Inpatient Sample database from 2016 and 2017. We conducted a weighted analysis on SCD patients during their index hospitalization. We obtained the prevalence of NRVHD and calculated adjusted odds ratios to identify the associated demographic, social, and clinical characteristics using multivariable logistic regression. We identified 192,460 SCD admissions during 2016 and 2017. Of them, 2450 (1.3%) had NRVHD. Mitral insufficiency (MI) was the most common NRVHD present in 52% of the cases. Mitral valve prolapse represented 12.4%, while aortic stenosis and aortic insufficiency in 10.8% and 12.7%, respectively. Right-sided NRVHD had a lower prevalence, with 17.1% of patients having tricuspid insufficiency (TI) and 6.3% pulmonary insufficiency. There were no cases of mitral, tricuspid, or pulmonary stenosis. Characteristics associated with the presence of NRVHD in SCD were secondary pulmonary hypertension, congestive heart failure, chronic kidney disease, and female sex. NRVHDs, especially MI and TI, are comorbidities in SCD. Literature is scarce on this topic. The predictors found for its occurrence could help address modifiable factors that can positively affect patients with SCD who, due to the natural history of the disease, are at risk of developing NRVHD.
Sleep apnea in end-stage renal disease patients: risk factors and mortality
Authors: Prabu Pranav , Acree Lillian , Waller Jennifer L , Linder Daniel F , Bollag Wendy B , Mohammed Azeem , Padala Sandeep , Healy William , Kheda Mufaddal , Baer Stephanie L , Dillard Thomas , Taskar Varsha
Published: March 2023

Sleep apnea (SA) is highly prevalent in the end-stage renal disease (ESRD) population. However, the impact of SA on mortality in ESRD is unclear. This study investigates the relationship between SA and mortality in ESRD. The United States Renal Data System was queried in a retrospective cohort study to identify ESRD patients aged 18–100 years who initiated hemodialysis between 2005 and 2013. Diagnoses of SA and comorbidities were determined from International Classification of Disease-9 codes and demographic variables from Centers for Medicare and Medicaid Services Form-2728. Cox proportional hazards models were used to examine the association of SA with mortality controlling for multiple variables. Of 858,131 subjects meeting inclusion criteria, 587 were found to have central SA (CSA) and 22,724 obstructive SA (OSA). The SA cohort was younger and more likely to be male and Caucasian compared to the non-SA cohort, with more diagnoses of tobacco and alcohol use, hypertension, heart failure, and diabetes. Both CSA (adjusted hazard ratio (aHR) = 1.42, 95% confidence interval (CI): 1.29–1.56) and OSA (aHR = 1.35, 95% CI: 1.32–1.37) were associated with increased mortality. Other variables associated with increased mortality included age, dialysis initiation with a catheter or graft, alcohol use, hypertension, and cardiovascular disease. Factors associated with decreased mortality included female sex, black race, Hispanic ethnicity, diagnosis of heart failure or diabetes, and an ESRD etiology of glomerulonephritis or polycystic kidney disease. Since a diagnosis of either OSA or CSA increases mortality risk, early identification of SA and therapy in this ESRD population may improve survival.
The Ends Against the Middle: The Case of Municipal Golf
Authors: Li Xiaoxiao , Mao Wen , Zaleski Peter A. , Kenny Catherine
Published: March 2023

The theory and empirical analysis of the public provision of private goods have primarily considered the provision of education and healthcare. In this paper, we extend the application of the theories presented in Epple and Romano (1996a, 1996b) to the provision of a more private good—a golf course. While there may be some public social benefits of recreation including golf, for the most part, golf is a private good. We analyze golf course ownership in Pennsylvania, a state with a diversity of municipalities. Our main findings support the ends-against-the-middle hypothesis in which municipalities with a majority of low-income voters and high-income voters are less likely to own a municipal golf course. Municipalities with a majority of middle-income voters are more likely to own a municipal golf course.
Eleventh Triennial Toxicology Salary Survey
Authors: Sullivan Dexter W. , Gad Shayne C.
Published: March 2023

This is the eleventh in a series of salary surveys for toxicologists conducted at three-year intervals that began in 1988. Previous salary surveys were conducted in 1988, 1991, 1995, 1998, 2001, 2004, 2007 (which was posted electronically, but not published), 2012, 2016 and 2020. In addition to presenting the 2022 results, herein we are providing additional data and an analysis of the trends for employment and pay in toxicology over the last 35 years. The eleventh Triennial Toxicology Salary Survey was conducted as a joint project by the American College of Toxicology (ACT) and the Society of Toxicology (SOT). In addition to the two parent organizations, eight others (the Society for Birth Defects Research, the Society of Toxicologic Pathology, the Safety Pharmacology Society, the American Board of Toxicology (ABT), the Academy of Toxicological Sciences, the Roundtable of Toxicology Consultants, the Society of Environmental Toxicology and Chemistry (SETAC), and the Environmental Mutagenesis and Genomics Society) supported the effort by distributing the Survey Monkey-based instrument to their memberships. Surveys were not distributed to regional SOT chapters, causing there to be minimal responses below the doctorate and master's degree levels. It should be noted that there continues to be a significant increase in the number of individuals reporting six-figure incomes and in those receiving significant sums as bonuses.
Comparing COVID-19-related Morbidity and Mortality Between Patients With and Without Substance Use Disorders: A Retrospective Cohort Study
Authors: McLaughlin Angela , Burns Rebecca , Ryan Morgan , Abbasi Wafaa , Harvey Leah , Hicks Jacqueline , Sinha Pranay , Assoumou Sabrina A
Published: March 2023

Objectives:

People with substance use disorders (SUD) are suggested to have higher risk of hospitalization, intubation, or death from coronavirus disease 2019 (COVID-19), although data are mixed. Little is known about other COVID-19-related complications in this group. We compared morbidity and mortality among individuals with and without SUD who were admitted to an urban safety net hospital with COVID-19 early in the pandemic, contemporaneous to other published studies on this subject.

Methods:

We performed a retrospective study of patients ⩾18 years old admitted with COVID-19 from March 16th to April 8th, 2020. SUD included alcohol, opioid, cocaine, amphetamine, and benzodiazepine use disorders and was identified using diagnostic codes, free text clinical documentation, and urine drug screens. The primary outcome was inpatient mortality. Secondary outcomes included clinical complications (eg, secondary infections, venous thromboembolism) and resource utilization (eg, mechanical ventilation, length of stay). We used multivariable regression to assess the relationship between SUD and mortality.

Results:

Of 409 patients, the mean age was 56 years and 13.7% had SUD. Those with SUD were more likely to be male, have experienced homelessness, have pulmonary disease or hepatitis C, or use tobacco or cannabis. After multivariable analysis, SUD was not associated with mortality (aOR 1.03; 95% CI, 0.31-3.10). Secondary outcomes were also similar between groups.

Conclusions:

Our findings suggest that persons with and without SUD have similar COVID-19-related outcomes. Previously reported increased COVID-19 complications may be from medical comorbidities.
Seeking reason and rebirth: Jungian archetypes, scientism, and a question about transhumanism
Authors: Jones Raya A.
Published: March 2023

Attempts to make Carl Gustav Jung’s theory of archetypes scientifically credible tend to invoke biology and evolution theory. These convey faith in the power of science (scientism), taken here as a cultural metanarrative. The essay provides a critical appraisal of both biology-oriented and culture-oriented trends in Jungian studies, and steers the conceptualization of archetypes towards issues of embodied subjectivity and narrativity. Thematic parallels between transhumanism, on the one side, and the rebirth archetype as described by Jung, on the other, serve as a case in point.
Knowledge, perceptions, and readiness of telepharmacy (KPR-TP) questionnaire among pharmacists: Development and psychometric evaluation
Authors: Kusuma Ikhwan Yuda , Pratiwi Hening , Umami Afriza , Kurniasih Khamdiyah Indah , Pitaloka Dian Ayu Eka , Suherman Suherman , Juhász Marcell
Published: March 2023

Introduction

The pandemic increased pressure on healthcare services and forced limited care in all health facilities to ensure the care of all patients. Telepharmacy appears as an alternative to the remote pharmacy practice approach through information and communication technologies, but there are no comprehensive tools to measure pharmacists’ knowledge, perception, and readiness to implement telepharmacy. This study developed and validated a questionnaire version of the Knowledge, Perceptions, and Readiness of Telepharmacy (KPR-TP) for pharmacists.

Methods

The KPR-TP assessed three domains: knowledge, perception, and readiness. Its factor structure, reliability, and validity were assessed using 7730 pharmacists from 34 Indonesian provinces. The validity of the model's three-factor structure was assessed using confirmatory factor analysis. Cronbach's alpha and composite reliability were used to validate the consistency of our factors, whereas convergent and discriminant validity established significant relationships between them.

Results

The goodness-of-fit index indicated that the model was economical and reasonable. Furthermore, the correlation between the three domains revealed a significant positive relationship. KRP-TP is a viable instrument for assessing pharmacists’ perceptions of telepharmacy in Indonesia.

Conclusion

Overall, we discovered that our questionnaire contains critical constructs for assessing a pharmacist's knowledge, perception, and level of readiness to implement telepharmacy. This study will help pharmacists identify appropriate strategies for skill improvement.
‘A team around the child’ professionals’ experiences of unmet needs, access and expectations in children’s palliative care services, a phenomenological study in the UK
Authors: Constantinou Georgina , Cook Erica J , Tolliday Elaine , Randhawa Gurch
Published: March 2023

This study aims to understand the experiences of professionals involved in caring for families of children with life-limiting illnesses to ascertain unmet needs, access issues and expectations of services.

A phenomenological approach comprising semi-structured interviews with professionals from various services was used. Interviews that happened between July and November 2018 were audio-recorded, transcribed verbatim and thematically analysed based on descriptive phenomenology.

In total, 29 interviews were conducted. Findings showed how essential collaborative working was for becoming a team around the child. Barriers to this include complex working relationships, overprotectiveness of families, roles and responsibilities and use of independent care records. The pressures of waiting times and the impact of staffing shortages affected the experiences of providing care. The reality of meeting families’ expectations was shaped by family networking, online research and previous services resistance, which was influential in more challenging interactions. Expectations of care were also impacted by misunderstandings and anxieties surrounding access to services. Overall, professionals were concerned about families being used as a bottomless caring resource and stressed the need for short breaks to alleviate parents.

Interventions that educate families and professionals on these services and how they can benefit the child and family would be well received.
Intergroup sensitivity in a divided society: Calls for unity and reconciliatory behavior during the 2020 U.S. presidential election
Authors: Thürmer J. Lukas , McCrea Sean M.
Published: March 2023

The United States is highly divided along party lines, and this partisan divide has a tremendous impact on social relationships and even health-related behavior. Although group members frequently reject criticism from individuals outside their own group relative to criticism from within the group (intergroup sensitivity effect), it remains unclear whether this effect holds for calls for unity across party lines. Additionally, the democratic process may itself help to mend intergroup sensitivity. Our high-powered experiment with self-identified U.S. Democratic or Republican voters across three time points during the 2020 U.S. presidential election demonstrates consistent rejection of calls for unity across party lines, which differentially affected consequent reconciliatory behavior. While the ascription of unconstructive motives decreased reconciliatory behavior, heightened threat perceptions increased reconciliatory behavior. Effects were consistent across time and party affiliation, indicating that the democratic election process and the determination of the election outcome were unable to mend intergroup sensitivity across the partisan divide. Calls for unity affected the reported emotional experience of pride but these self-reports had no consistent impact on behavior. We discuss how understanding these psychological mechanics of partisanship helps to prevent democratic backsliding and promote reconciliation.
Increasing access to water through flexible entitlements?
Authors: Lange Bettina , Williams Philip Richard , Bendall Barry
Published: March 2023

This article discusses 2 ideas for reforming abstraction of water from the natural environment in order to provide a balance between environmental protection and secure, sustainable access to water also for future generations. This matters in light of an increased risk of water scarcity and drought due to growth and a changing climate. The first of these ideas – a sliding scale of legal protection for abstractions seeks to match the strength of legal protection through the abstraction licence to how much water is abstracted, as well as to how critical to business use, and environmentally beneficial the abstraction is. The second idea – ‘bubble licensing’ – involves capping the amount of water available for abstraction in a catchment and to promote exchanges of water between abstractors, not just through trading, but also through reciprocity exchanges and bartering. This collective action approach is intended to transcend an individual fixed entitlement approach to abstracting water. The article develops its argument through an analysis of literature on water rights, pollution trading, water charges, as well as a reference to ongoing reform debates about abstraction licensing in England.
Contaminated land, green energy and the energy crisis: Should contaminated land sites be targeted and used to produce renewable energy in the United Kingdom?
Authors: Brown Lloyd A. , Ghag Jasbinder K.
Published: March 2023

This opinion asks the question of whether contaminated land sites ‘can’ and ‘should’ be used to provide renewable energy in the United Kingdom (UK)? This question in turn raises many other questions and scenarios which have yet to be considered, explored and resolved, by relevant stakeholders regarding the use of such sites. Detailed assessments need to be undertaken to understand what the impact of using these sites would have on the environment, local communities, and whether the renewable energy obtained would make a significant difference in reducing the UK's reliance on fossil fuels. It may be that due to the long timescales involved, as a result of the need to monitor and evaluate such sites over time (in contrast to the speed of change that is actually required in practice to deal with the current energy crisis), that this proposal does not provide a ‘quick fix’ but is nonetheless something that the UK government should consider more fully now, as it could help with mitigating the ‘energy and environmental crisis’ over the longer term. In other parts of the world such as the United States of America (USA), contaminated land is actively being reused to provide renewable energy.
Odin ex Black watch: Environmental shipbreaking frustrated by Indian courts. Black Watch Cruise Ltd. v. Cruise Vessel Odin ex Name Black Watch
Authors: Stein Daniel
Published: March 2023

Shipowners are facing increased pressure from changing laws and green investors to scrap and recycle their ships in yards with higher environmental and labor standards, rather than on the beaches of India and Bangladesh. Recently, English shipowner Fred Olsen sold a 50-year old cruise ship to a Turkish company with a clause stipulating it be recycled at a shipyard approved under the European and UK Ship Recycling Regulations. The Turkish company did not comply and sold the ship for scrapping in India. Fred Olsen sued the Turkish company in the United Kingdom and petitioned Indian courts to arrest the vessel in Indian waters. The ship was briefly arrested but then sent to the beach for breaking. Fred Olsen is now only able to seek monetary damages, as their environmentally sound intentions, along the effectiveness of any European ship recycling regime, faced a severe setback.
Do differences exist in cross-cultural caregivers’ respect for the autonomy/dignity of people with dementia? Real-time field observations in nursing homes
Authors: Kaplan Felix , Bentwich Miriam Ethel
Published: March 2023

Background

Although published studies have examined the perceptions of caregivers who are attending to older adults with dementia concerning the values of human dignity and/or autonomy in institutional settings, none have explored the possible differences in actual behavior that relates to these values for caregivers from diverse ethno-cultural backgrounds.

Aims

Explore how caregivers with varied cultural backgrounds may differ in their real-time behavior regarding the autonomy and dignity of older adults with dementia and thereby determine whether that real-time behavior reveals new aspects of respect and disrespect for both the autonomy and dignity of those older adults.

Research Design and Methods

A qualitative research based on non-participatory observations, was meticulously recorded using a written journal and a rigorous microanalysis to analyze the collected data. We made 58 shift-based observations (morning and evening) of 29 caregivers from 3 ethno-cultural groups working in 3 nursing homes in Israel. These groups included Israeli-born Jews (Sabras), Israeli Arab-Muslims (Arabs), and immigrants from the Former Soviet Union (IFSU).

Results

(1) IFSU caregivers demonstrated more respect for autonomy and dignity, but also demonstrated disrespect for these values. (2) the main difference between the IFSU caregivers and other caregiver groups pertained to respect for their autonomy. The main specific facets of autonomy where IFSU caregivers surpassed their colleagues were information provision and persuasion. (3) toward both autonomy and dignity of these older adults, previously unaccounted for in the models we used, were discovered among the varied groups of caregivers, with only minor gaps between these groups.

Discussion and Implications

This study—the first of its kind to focus on the real-time behaviors of caregivers from diverse ethno-cultural backgrounds—reveals the potential effects of culture on applying practices related to dignity and autonomy during daily care. The findings may have important implications for caregiver training in multicultural societies.