bluuebunny/crossref_metadata_2025 huggingface dataset:
Revision total hip arthroplasty using a Kerboull-type acetabular reinforcement device and allogeneic structural bone graft
Authors: Fujimoto Yusuke , Nakamura Shunsuke , Ijuin Toshiro , Iuchi Tomohiro , Nakajo Masahide , Taniguchi Noboru
Published: August 2022

Purpose: One of the major problems in revision total hip arthroplasty (THA) is severe acetabular bone loss. The aim of our study was to evaluate the clinical outcomes of revision THA using a Kerboull-type reinforcement device (KT plate) and allogeneic structural bone graft. Methods: This retrospective study evaluated 48 hips that underwent revision THA using a KT plate and allogeneic structural bone graft between 2008 and 2016, with a median follow-up of 6.2 years (range 3–12.6 years). Functional outcome was assessed using the Japanese Orthopaedic Association (JOA) hip score. Postoperative and follow-up radiographs were compared to assess migration and breakage of the implant. Results: The mean JOA hip score improved from 45.6 (±16.3) points before surgery to 72.1 (±11.9) points at the most recent follow-up examination ( p < 0.001). Two hips (4.2%) underwent re-revision THA because of cup loosening due to breakage of the KT plate. A total of 13 hips (27.1%) were classified as radiological failures. Binomial logistic regression analysis showed that a Kawanabe classification of stage 4, which indicates massive bone defects in the weight-bearing area, was a risk factor for radiological failure (odds ratio: 4.57; 95% confidence interval: 1.01–26.35). Conclusions: A KT plate with an allogeneic structural bone graft is a useful method of acetabular reconstruction in revision THA that restores bone stock and improves hip function. Our findings indicated that a Kawanabe classification of stage 4 was a risk factor for radiological failure of the implant.
Human rights law and the protection of children: Corporal punishment in perspective
Authors: Greeff Laetitia-Ann
Published: August 2022

Although Australia does not have a federally enacted Bill of Rights, Victoria, the Australian Capital Territory and Queensland have all adopted legislation to protect the human rights of their residents. However, despite this seemingly protective measure, corporal punishment in the home remains lawful under statute or common law in all three jurisdictions. This article examines the efficacy of these rights acts in protecting children from harmful and outdated forms of physical punishment administered by their parents and carers in contravention of articles 19(1) and 37(a) of the Convention on the Rights of the Child.
Judicial Philosophy and the Public’s Support for Courts
Authors: Krewson Christopher N. , Owens Ryan J.
Published: August 2022

How do Americans’ preferences over judicial philosophy influence their support for judges and judicial decisions? Using an experiment attached to an adaptive choice-based conjoint analysis, we find that people hold preferences over judicial philosophies, that they rely on those preferences to evaluate judges and decisions, and that those preferences are not simply stand-ins for ideology and partisanship. These findings suggest that to understand people’s support for judges and judicial decisions one must pay attention to judicial philosophy.
"Unicorn in a Field of Horses": A Rare Case of Carcinosarcomatous Transformation in a Uterine Leiomyoma
Authors: Malvika Shastri , Parikshaa Gupta , Nalini Gupta , Sujata Siwatch , Veenu Singla , Bhavana Rai , Rashmi Bagga
Published: August 2022

Malignant transformation in leiomyoma is rare, with a few documented cases of sarcomatous transformation in leiomyomas. However, carcinosarcomatous transformation in leiomyomas is extremely infrequent. A 45-year-old female presented with a mass sensation per abdomen for the last five months. An abdominal ultrasound revealed multiple uterine fibroids. Contrast-enhanced magnetic resonance imaging revealed a large multiloculated abdominopelvic mass arising from the fundus of the uterus, along with multiple smaller subserosal fibroids. A total abdominal hysterectomy with bilateral salpingectomy was performed. Grossly, the uterus was bosselated with multiple subserosal fibroids. The larger degenerated fibroid showed a smooth outer surface; however, the cut surface was predominantly cystic and filled with necrotic material. Microscopically and immunohistochemically, the larger mass showed a high-grade biphasic tumor comprising carcinomatous and sarcomatous components with the peripheral solid areas showing compressed smooth muscle bundles representing the residual leiomyomatous areas. A final diagnosis of carcinosarcomatous transformation in leiomyoma was rendered. The index report highlights the significance of systematic gross and microscopic examination of all the uterine masses in patients with multiple leiomyomata.
GeneHome – a Novel Model to Deliver Care to Individuals with Genetic Predisposition to Cancer
Authors: Nocera Zachariah Nadia , Lee Marie C. , Chang Maxine D. , Moore Colin , Wang Xia
Published: August 2022

Genetic testing for hereditary cancer predisposition is more widely available, resulting in more patients being identified as carriers of pathogenic variants (PV) of cancer susceptibility genes. PV carriers may be at high risk for multiple cancers of different organ systems. Traditional high-risk cancer screening is often organ specific and conducted separately by specialists. However, with many genes associated with 3 or more types of cancer risks, coordination of such cancer screening can be overwhelming for patients and providers. At Moffitt Cancer Center (MCC), GeneHome clinic functions as a “home” to conduct and coordinate prevention, screening, counseling, and education for individuals carrying germline genetic PVs across the entire spectrum of cancer genes. The screening includes, but is not limited to, history review, physical examination, image studies, blood tests, urine tests, and endoscopy. GeneHome is a novel model for genetic high-risk cancer surveillance and has grown in 4 years since establishment. We sought to study various characteristics of the patient population it serves, common themes in referral patterns and evolution of the clinic since its inception. A total of 821 patients were seen over 42 months, encompassing PV carriers of 46 genes. Patients were 84.9% female and 13.3% male. Most PVs were of BRCA1 and BRCA2. Most patients had private insurance, and most were from Florida. Annual increase in patient visits was over 74.7% over the last year. Overall, GeneHome has been well accepted by providers and patients and is a valuable service for patients with a genetic predisposition to cancer.
Protective effects of Panax ginseng against doxorubicin-induced cardiac toxicity in patients with non-metastatic breast cancer: A randomized, double-blind, placebo-controlled clinical trial
Authors: Hamidian Malihe , Foroughinia Farzaneh , Haghighat Shirin , Attar Armin , Haem Elham
Published: August 2022

Introduction

Anthracycline-based chemotherapy increases the risk of cancer therapeutics-related cardiac dysfunction. Recently, evidences from in vitro experiments and animal studies have shown that ginsenosides may exert cardiovascular protection against cancer therapeutics-related cardiac dysfunction. Here, we aimed to evaluate this effect in a clinical situation.

Methods

In this randomized, double-blind, placebo-controlled clinical trial, women with non-metastatic breast cancer whose left ventricular ejection fraction was ≥ 50% were randomly assigned in 1:1 ratio to receive ginseng (1 g/day) or placebo besides standard chemotherapy. Echocardiographic measurements were performed at baseline, after the fourth, and eighth chemotherapy cycles. High-sensitive cardiac troponin I was assessed at baseline and after the 4th cycle. The primary endpoint of the study was change in left ventricular ejection fraction. Cancer therapeutics-related cardiac dysfunction was defined as a drop in left ventricular ejection fraction of ≥ 10% from baseline.

Results

Results from 30 patients were included in the final analysis (15 patients in each group). In the intervention and control groups, left ventricular ejection fraction was dropped from 62.0 ± 0.9% to 60.7 ± 1.0% (difference = −1.3 ± 1.1%) and from 63.27 ± 1.1% to 58.0 ± 1.3% (difference = −5.27 ± 0.8%), respectively (difference = 3.97%, p = 0.006) at the end of the fourth cycle of chemotherapy. After the eighth cycle of chemotherapy, the mean left ventricular ejection fraction was increased by 0.8 ± 1.3% from baseline in the intervention group, whereas the placebo group experienced a reduction of −7.3 ± 1.4% (difference = 8.1%, p-value < 0.001). None of the patients in the ginseng group in comparison to 1(6.7%, p-value = 0.5) and 5 (33.3%, p-value = 0.02) patients in the placebo group developed cancer therapeutics-related cardiac dysfunction after the fourth and eighth cycles, respectively. High-sensitive cardiac troponin I levels were not significantly different between groups.

Conclusions

Prophylactic ginseng supplementation may protect against doxorubicin-induced early cancer therapeutics-related cardiac dysfunction and early decline in left ventricular ejection fraction in breast cancer patients.
Sandwich structure with negative Poisson’s ratio of periodic rectangular tube: Mechanical properties and energy absorption
Authors: Liu Xin , Yang Peiyan , Yuan Ye , Qu Jia
Published: August 2022

Due to its unique deformation form, Negative Poisson’s ratio sandwich structure has excellent energy absorption, but the low load capacity limits its engineering applications. In this paper, we design a new negative Poisson’s ratio rectangular tube periodic sandwich structure. There are many beams in this structure which appear plastic hinges when compressed. After further compression, the rectangular tube wall buckles and the core shrinks inward, which realizes that the structure exhibits high-performance energy absorption ability and excellent mechanical properties. Three-dimensional finite element model of sandwich structure with negative Poisson’s ratio of periodic rectangular tube quasi-static compression test and low-velocity impact were investigated by the use of ABAQUS/Explicit software. The accuracy of the simulation method was verified by the comparison of test and simulation results. Based on the validated numerical models were further investigated to comprehensively understand the influence of rectangular tube unit cell wall thickness ( t) and cell height ( h) on the load capacity and energy absorption capacity of the specimen. The energy absorption capacity and mechanical properties of the proposed negative Poisson’s ratio sandwich structure could be enhanced by optimizing the design of rectangular tube unit cell wall thickness ( t) and rectangular tube unit cell height ( h). The present findings offer insights into the application of negative Poisson’s ratio sandwich structure impact energy-absorbing structures in aerospace, automotive and other fields.
Mental health emergencies attended by ambulances in the United Kingdom and the implications for health service delivery: A cross-sectional study
Authors: Moore Harriet Elizabeth , Siriwardena Aloysius Niroshan , Gussy Mark , Spaight Robert
Published: August 2022

Objective

In the context of increasing demand for ambulance services, emergency mental health cases are among the most difficult for ambulance clinicians to attend, partly because the cases often involve referring patients to other services. We describe the characteristics of mental health emergencies in the East Midlands region of the United Kingdom. We explore the association between 999 (i.e. emergency) call records, the clinical impressions of ambulance clinicians attending emergencies and the outcomes of ambulance attendance. We consider the implications of our results for optimizing patient care and ambulance service delivery.

Methods

We conducted a retrospective observational study of records of all patients experiencing mental health emergencies attended by ambulances between 1 January 2018 and 31 July 2020. The records comprised details of 103,801 ‘999’ calls (Dispatch), the preliminary diagnoses by ambulance clinicians on-scene (Primary Clinical Impression) and the outcomes of ambulance attendance for patients (Outcome).

Results

A multinomial regression analysis found that model fit with Outcome data was improved with the addition of Dispatch and Primary Clinical Impression categories compared to the fit for the model containing only the intercept and Outcome categories (Chi-square = 18,357.56, df = 180, p < 0.01). Dispatch was a poor predictor of Primary Clinical impression. The most common predictors of Outcome care pathways other than ‘Treated and transported’ were records of respiratory conditions at Dispatch and anxiety reported by clinicians on-scene.

Conclusions

Drawing on the expertise of mental health specialists may help ‘999’ dispatchers distinguish between physical and mental health emergencies and refer patients to appropriate services earlier in the response cycle. Further investigation is needed to determine if training Dispatch operatives for early triage and referral can be appropriately managed without compromising patient safety.
Influence of swirl ratio and radial Reynolds number on wind characteristics of multi-vortex tornadoes
Authors: Zhao Yi , Yan Guirong , Feng Ruoqiang , Kang Houjun , Duan Zhongdong
Published: August 2022

In this study, systematic numerical simulations are conducted to investigate how swirl ratio and radial Reynolds number affect the wind characteristics of multi-vortex tornadoes. By properly controlling boundary conditions, multi-vortex tornadoes are produced in a cylindrical computational domain. Six cases with different swirl ratios are studied to examine the influence of swirl ratio, while five cases with different radial Reynolds number are studied to investigate the influence of radial Reynolds number. To facilitate the characterization, the core size and rotational speed of subvortices, as well as the relative distance between the subvortex and the core radius of the main vortex, are defined. The results demonstrate that the increase in swirl ratio leads to the increase in the number of subvortices. For the overall vortex, the increase in swirl ratio decreases the maximum tangential velocity but increases the core radius of the overall flow. For subvortices, for the case where four subvortices are produced, the increase in swirl ratio increases the core size of subvortices but decreases the rotational speed of subvortices. While the increase in radial Reynolds number does not change the number of subvortices produced, it decreases the core size of subvortices, but increases the rotational speed of each subvortex.
Thus spoke Zuckerberg: Journalistic discourse, executive personae, and the personalization of tech industry power
Authors: Creech Brian , Maddox Jessica
Published: August 2022

As technology chief executive officers have become public figures, their personae operate as loci for journalistic discourse about the intersection of moral responsibilities, regulation, and political-economic power of the tech industry. They possess a power often construed as beyond the reach of politics or civil society to address. This study considers how the ubiquity of tech power has become a kind of common sense in journalistic discourse, specifically looking at news, commentary, and analysis that has circulated around Facebook’s Mark Zuckerberg since 2016, arguing that even as critiques of Zuckerberg’s moral fitness and leadership capacity proliferate, they construct the epistemic bounds within which tech industry power over American public life is understood as legitimate, even as journalists and commentators question certain executives’ ability to wield the tech industry’s infrastructural and cultural power.
The role of affective and cognitive attitude extremity in perceived viewpoint diversity exposure
Authors: Zerback Thomas , Kobilke Lara
Published: August 2022

The current study examines the role of affective and cognitive attitude extremity on perceived exposure to diverse political viewpoints and investigates the possibility of a “primacy of affect.” Based on a multi-level analysis of panel survey data, we show that people with extreme attitudes toward immigrants experience less viewpoint diversity and that this tendency is especially pronounced for affective attitude extremity. However, even those holding extreme attitudes do not find themselves in issue-specific echo chambers, that is, they still encounter relatively diverse sets of viewpoints.
Does ticket sales information disclosure affect speed of ticket sales?
Authors: Chiu Chia-Ning , Kung Ling-Chieh , Sun Pei-Yu
Published: August 2022

We analyze a Taiwanese theatre company’s ticket sales from 2008 to 2012 to investigate whether a consumer’s willingness to pay for a ticket was affected by the company’s disclosure of sales information (sales outcome). Sales are stratified by price band in order to understand the unique demand of each price bracket. We hypothesize that the sales outcome of a price band has a positive effect on the willingness to pay for a ticket in that price band, but that effect from other price bands is negative. Our findings support this hypothesis using the historical data of ticket sales from a Taiwanese theater. We also find that the sales speed decreases when the length of selling period becomes longer.
A Moderated Mediation Model to Explain Consistent Condom Use Intention Among Young Adults in South Africa
Authors: Nkwei Emile Saker , Roberts-Lombard Mornay , Maduku Daniel Kofi
Published: August 2022

Background

Behavioral sustenance is one of the main outcomes of social marketing programs to address health issues, such as HIV and AIDS prevention. However, academic research into consistent condom use is interestingly sparse, particularly in South Africa, the country with the highest HIV-infected population in the world. Young adults are particularly vulnerable because they often engage in unprotected sex.

Focus of the Article

This study explores the factors driving consistent condom use intention with theoretical considerations in the expectation confirmation theory. The study investigates whether factors within the condom product category such as brand satisfaction and brand value enhance or weaken the effect of met/unmet brand expectations on consistent condom use intention of young adults. It further tests whether this potential enhanced or weakened effect significantly differs between male and female condom users.

Research Questions

Does dis/confirmation influence consistent condom use in the presence of brand satisfaction and brand value or not? Does gender moderate the mediations found in the expectation confirmation model?

Importance to the Social Marketing Field

From a theoretical perspective, the study expands the expectancy confirmation theory by focusing on the indirect effects of dis/confirmation on continuance intention. The study also tests the mediated moderating role of gender.

Methods

The study was descriptive in nature and a quantitative survey was used to obtain data from 724 young adults in South Africa. Quota sampling was applied to select respondents. Finally, the structural equation modelling technique was used to assess the measurement and structural models.

Results

Findings indicate that perceived brand value determines consistent condom use intention. The mediating role of perceived brand value on the relationship between dis/confirmation and consistent condom use intention was more pronounced among males compared to females. Dis/confirmation and perceived brand value were significant determinants of condom brand satisfaction. However, the influence of brand satisfaction on consistent condom use intention was not supported.

Recommendations for Research or Practice

The concept of consistent condom use should be integrated in the brand message. A segmented approach based on gender should be used by condom companies to promote their products to young adults. These companies should provide condoms that meet the expectations of male and female young adult consumers as two different market segments.

Limitations

Only one province was investigated in South Africa. Social desirability bias was not controlled.
Diagnostic applications of microsphere-based flow cytometry: A review
Authors: de Figueiredo Adélia Marques , Glória Juliane Corrêa , Chaves Yury Oliveira , Neves Walter Luiz Lima , Mariúba Luis André Morais
Published: August 2022

Microsphere-based flow cytometry is a highly sensitive emerging technology for specific detection and clinical analysis of antigens, antibodies, and nucleic acids of interest. In this review, studies that focused on the application of flow cytometry as a viable alternative for the investigation of infectious diseases were analyzed. Many of the studies involve research aimed at epidemiological surveillance, vaccine candidates and early diagnosis, non-infectious diseases, specifically cancer, and emphasize the simultaneous detection of biomarkers for early diagnosis, with accurate results in a non-invasive approach. The possibility of carrying out multiplexed assays affords this technique high versatility and performance, which is evidenced in a series of clinical studies that have verified the ability to detect several molecules in low concentrations and with minimal sample volume. As such, we demonstrate that microsphere-based flow cytometry presents itself as a promising technique that can be adopted as a fundamental element in the development of new diagnostic methods for a number of diseases.
Optimization design of compliant focusing mechanism for space optical camera with light weight
Authors: Li Yan , Liu Bo , Ge Wenjie , Tong Xinxing
Published: August 2022

Thermal radiation and vacuum lead to the deformation of bearing cylinder with carbon fiber composites which generates the defocus phenomenon for space optical camera. As heavier weight and higher complexity of the rigid focusing mechanism for the space optical camera, a novel compliant focusing mechanism with lighter weight and simple structure was designed and tested in this paper. In order to achieve stroke range and ensure image quality for the compliant focusing mechanism, micro driving displacement from the piezoelectric ceramics was amplified by two-stage flexible hinge lever-type mechanism. Taking the size parameters of the flexure hinges and beams as the design variables, an optimization model of the compliant focusing mechanism was established in which minimizing weight was considered as objection function under the stroke requirements. Consequently, optimal structure parameters of the compliant focusing mechanisms under different input forces can be obtained under the allowable stress and lighter weight. The effectiveness of the proposed compliant focusing mechanism was verified by the simulations and experiments. The results show that the compliant focusing mechanism can achieve a stroke of 2 mm for the focal plane assembly. The proposed method provided a new idea to design the focusing mechanism with lighter weight, simpler structure and higher reliability.
Active obstacle avoidance method of autonomous vehicle based on improved artificial potential field
Authors: Duan Yijian , Yang Changbo , Zhu Jihong , Meng Yanmei , Liu Xin
Published: August 2022

Aiming at the local minimum point problem in an artificial potential field based on a safe distance model, this article proposes an algorithm for active obstacle avoidance path planning and tracking of autonomous vehicles using an improved artificial potential field. First, a possible road operating condition in which the artificial potential field based on the safety-distance model falls into a local minimum point is studied. Subsequently, an improved artificial potential field method is proposed by introducing the second virtual target attraction potential field, which successfully overcomes the local minimum point problem. Second, a model for autonomous vehicle active obstacle avoidance path planning and tracking based on the improved artificial potential field is established. Finally, MATLAB/CarSim co-simulations were performed under the road conditions of constant- and variable-velocity obstacle vehicles. The simulation results demonstrate that the improved artificial potential field method can effectively solve the local minimum point problem of the artificial potential field based on the safe distance model. Additionally, the safety and stability of autonomous vehicle active obstacle avoidance are improved.
A coverage path planning approach for autonomous radiation mapping with a mobile robot
Authors: Abd Rahman Nur Aira , Sahari Khairul Salleh Mohamed , Hamid Nasri A , Hou Yew Cheong
Published: August 2022

In nuclear and radiation-related industries, it is crucial to ensure that the radiation dose exposure to the radiation worker is maintained below the permissible dose limit. A radiation map is a useful tool for visualizing the radiation distribution across the work area and for coordinating activities involving the hotspots (high radiation areas). The goal of this work was to design and implement a coverage path planning approach for autonomous radiation mapping carried out by a mobile robot. Given a 2D occupancy map, a method to generate uniformly distributed sampling points was proposed. The geometry of the region of interest, the radiation detector module, and the radiation measurement parameters were considered in formulating the sampling positions. Next, the coverage path planning planner integrates the nearest neighbor and depth-first search algorithms to create a continuous path that enables the robot to visit all the sampling points. The K-means clustering algorithm is added for systematic coverage of a large number of sampling points. The clustering provides options to partition the region of interest into smaller spaces, where the robot would perform the mapping cluster by cluster. Finally, the method of building the radiation map from the acquired data was also presented. The approach was implemented in ROS using a commercial mobile robot equipped with a Geiger–Muller detector. The performance and reliability of the proposed approach were evaluated with a series of simulations and real-world experiments. The results showed that the robot is able to perform autonomous radiation mapping at various target areas. The accuracy of the generated radiation map and the hotspots classifications were also compared and evaluated with conventional manual measurements. Overall, the theoretical frameworks and experiments have provided convincing results in the automation of hazardous work and subsequently toward improving the occupational safety of radiation workers.
The analgesic effects of β-elemene in rats with neuropathic pain by inhibition of spinal astrocytic ERK activation
Authors: Ma Li-Tian , Bai Yang , Cao Peng , Ren Kai-Xi , Chen Jing , Zhang Ting , Fan Bo-Yuan , Qiao Yu , Yan Hong-Yu , Wang Jing-Jie , Li Yun-Qing , Zheng Jin
Published: August 2022

Neuropathic pain takes a heavy toll on individual well-being, while current therapy is far from desirable. Herein, we assessed the analgesic effect of β-elemene, a chief component in the traditional Chinese medicine Curcuma wenyujin, and explored the underlying mechanisms at the level of spinal dorsal horn (SDH) under neuropathic pain. A spared nerve injury (SNI)-induced neuropathic pain model was established in rats. Intraperitoneal injection (i.p.) of β-elemene was administered for 21 consecutive days. Mechanical allodynia was explored by von Frey filaments. The activation of the mitogen-activated protein kinase (MAPK) family (including ERK, p38, and JNK) in spinal neurons, astrocytes, and microglia was evaluated using immunostaining 29 days after SNI surgery. The expression of GFAP, Iba-1, p-ERK, p-JNK, and p-p38 within the SDH was measured using immunoblotting. The levels of proinflammatory cytokines (including TNF-α, IL-1β, and IL-6) were measured with ELISA. The levels of oxidative stress indicators (including MDA, SOD, and GSH-PX) were detected using biochemical tests. Consecutive i.p. administration of β-elemene relieved SNI-induced mechanical allodynia (with an EC50 of 16.40 mg/kg). SNI significantly increased the expression of p-ERK in spinal astrocytes but not microglia on day 29. β-elemene reversed spinal astrocytic ERK activation and subsequent upregulation of proinflammatory cytokines in SNI rats, with no effect on the expression of p38 and JNK in spinal glia. β-elemene also exerted antioxidative effects by increasing the levels of SOD and GSH-PX and decreasing the level of MDA. Our results suggest that SNI induces robust astrocytic ERK activation within the SDH in the late phase of neuropathic pain. β-elemene exerts remarkable analgesic effects on neuropathic pain, possibly by inhibiting spinal astrocytic ERK activation and subsequent neuroinflammatory processes. Our findings suggest that β-elemene might be a promising analgesic for the treatment of chronic pain.
Disability and oral health in the Association of Southeast Asian Nations - A survey for conceptualisation and development
Authors: Lim Guang Xu David , Hamzah Siti Zaleha , Bernardino Ricca Rocco Mae , Sukhumalind Patcharawan , Ishak Nurul Sa’idah , Adiwoso Adiningrum Wiradidjaja
Published: August 2022

Background

All member states in the Association of Southeast Asian Nations (ASEAN) are ratified signatories of the UN Convention on the Rights of Persons with Disabilities. However, disability and oral health (DOH) can be an elusive ambition for developing nations.

Objectives

This survey aims to conceptualise ‘barriers’, ‘improvements’, ‘challenges in dental practice’, and ‘ways to collaborate’, to inform policy development for DOH within ASEAN.

Methods

The survey employed a novel quasi-qualitative design. It was electronically distributed to dentists with DOH specialty training in ASEAN within the International Association of Disability and Oral Health’s network from September 2018 to June 2020. The ‘barriers’ and ‘improvements’ would be categorised into five dimensions of healthcare - a framework by Levesque and colleagues (2013).

Results

21 valid responses were received from Brunei, Indonesia, Malaysia, Philippines, Singapore and Thailand. From the care provider’s perspective, adequate training (appropriateness) was most prioritised. From the patient’s aspect, low oral health literacy (ability to perceive) was the most significant. ‘Social perception’ was collectively ranked as the key ‘challenge in dental practices’. Suggested ‘ways to collaborate’ could be categorised into five areas: engagement; advocacy; policies; specialty, and; upskilling.

Conclusions

The findings suggest an urgent need to address low oral health prioritisation, a drive to upskill providers, a challenge of ‘social perceptions’, and a consensual appeal for state-level support. A multi-sector collaboration is needed to align current strategies in order to achieve equity for DOH in ASEAN.
Fecal microbiota transplantation treatment for type 1 diabetes mellitus with malnutrition: a case report
Authors: Xie Yan-Chun , Jing Xu-Bin , Chen Xiang , Chen Ling-Zi , Zhang Shao-Hui , Cai Xian-Bin
Published: August 2022

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease. Not only genetics, but the intestinal environment affected by gut microbiota is also the key to pathogenesis. Besides the occurrence of diabetes, gut microbiota dysbiosis may also contribute to the development of diabetes-related complications. Fecal microbiota transplantation (FMT) is an emerging technique that had shown its potential as a treatment for metabolic disease. Here, we report the first case of T1DM with malnutrition and gastrointestinal symptoms treated with FMT. A 24-year-old T1DM patient suffered from poor blood glucose control, recurrent nausea and vomiting, severe malnutrition, and intractable constipation after insulin treatment. The clinical response of the patients after FMT was well, especially nausea and vomiting were significantly relieved. In addition, constipation, nutritional status, and blood glucose control (fasting blood glucose, HbA1c) gradually improved. A degree of similarity was found in gut microbiota composition between the patient and healthy donor after FMT while it was totally different before the treatment. Furthermore, pathway function analysis of MetaCYC database implies that the potential mechanism of the response of FMT may be driven by specific bacteria involved in several metabolic pathways that need further exploration. To sum up, we believe that the reconstruction of intestinal flora by FMT may be a new choice for the treatment of T1DM patients with malnutrition.
Compliance level and factors associated with iron–folic acid supplementation among pregnant women in Dangila, Northern Ethiopia: A cross-sectional study
Authors: Asres Abiyot Wolie , Hunegnaw Woldeamilak Adamu , Ferede Addisu Gasheneit , Azene Tamene Wolie
Published: August 2022

Objectives:

Iron–folic acid non-compliance is a major problem in the study area. Therefore, this study aimed to assess the level of iron–folic acid supplementation compliance and associated factors among pregnant women.

Methods:

A community-based cross-sectional study design was conducted among pregnant women from 1 to 30 November 2018 in Dangila, Northern Ethiopia. A multi-stage sampling technique was used to select the participants. The data were collected using a structured questionnaire. For data entry and analysis, Epi Info 7 and Statistical Package for Social Science (SPSS) 23.0 were used, respectively. Bivariable and multivariable logistic regression analyses were done. Descriptive statistics like mean and standard deviation, and odds ratios with their respective confidence intervals were calculated. Statistically significant was declared at a p value of less than 0.05. The results were presented using text, tables, and figures.

Results:

A total of 589 pregnant women were involved, yielding a response rate of 91.2%. The average age of the participants in the study was 30.90 ± 5.93 years. The average weekly iron–folic acid pill intake was 5.3. The iron-folic acid compliance rate was 76.9% (95% confidence interval: 73.5–80.6). Women who had four or fewer alive children (adjusted odds ratio = 2.68, 95% confidence interval: 1.37–5.23), took less than 30 min to get to the health facility (adjusted odds ratio = 1.90, 95% confidence interval: 1.16–3.10), being a government employee (adjusted odds ratio = 0.16, 95% confidence interval: 0.03–0.81), attended antenatal care conferences (odds ratio = 2,95% confidence interval: 1.16–3.42), and started iron–folic acid tablets in the first trimester (odds ratio = 2.3, 95% confidence interval: 1.39–3.87) were associated with iron–folic acid compliance.

Conclusion:

The level of iron–folic acid supplementation compliance was low. Attending antenatal care training and starting to take iron-folic acid pills early in the first trimester were both factors associated with iron–folic acid supplementation compliance. Health care and health extension workers should emphasize and monitor the iron pill–taking habits of pregnant women in home-to-home visits.
An unusual case of Brown-Sequard syndrome associated with Horner’s syndrome after a penetrating injury with a khuru (Bhutanese dart) to the neck: A case report
Authors: Wangdi Kuenzang
Published: August 2022

The occurrence of Brown-Sequard syndrome with Horner’s syndrome in a child with spinal trauma is a very rare and unusual entity. Brown-Sequard syndrome results from hemisection injury of the spinal cord, mostly in the cervical cord region. The Horner’s syndrome presents when the injury is in the cervical region involving the sympathetic pathway. We present you with the case of a 12-year-old boy who was referred from a local hospital with weakness on the left half of his body after sustaining a penetrating injury to his neck by a khuru (Bhutanese dart). Clinical examination was consistent with the diagnosis of Brown-Sequard syndrome with ipsilateral Horner’s syndrome. Although cervical spine plain radiographs showed no fracture, computed tomography and magnetic resonance imaging showed a C2 lamina fracture at the left side of the spinous process with indentation to the cord. He was managed conservatively with a soft cervical collar, intravenous antibiotics, and physiotherapy. He had complete resolution of Brown-Sequard syndrome and Horner’s syndrome after 1 year. Patients with Brown-Sequard syndrome associated with Horner’s syndrome usually have a good prognosis and full recovery rate with regular physiotherapy and rehabilitation. Early diagnosis and treatment will have a better chance of recovery and return to pre-injury status.
Hereditary factor XII deficiency in an adult patient: A case report
Authors: Al-Ansari Rehab Y , Al-Yami Fatimah , Almulhim Ghayah , Woodman Alexander
Published: August 2022

Factor XII deficiency is a rare autosomal recessive health condition usually discovered incidentally during routine coagulation screening before surgery after investigating a prolongation of the activated partial thromboplastin time. This is a case of a 29-year-old man from Saudi Arabia who was selectively admitted to the surgical department to treat a perianal fistula and found incidentally prolonged activated partial thromboplastin time and factor XII deficiency. Examination of the skin revealed no bruising, petechiae, or ecchymosis. Systemic examination was normal. Laboratory examination showed an activated partial thromboplastin time > 160 s (normal between 27 and 38), which was repeated twice with low factor XII < 5.7% (73–121). Other factors and the work of hemostasis were within the normal range. Surgery was delayed at the request of the patient. One year later, the patient was admitted to the clinic after surgery without bleeding and did not require factor correction before or after surgery. However, treating factor XII–deficient patients specifically for preoperative preparation is challenging. Therefore, this rare case should be recorded and reported the same way as a number of previously rarely reported cases.
COVID-19 in a mosaic trisomy 13 patient with polycystic kidney disease
Authors: Ost Natalie K , Minchew Heather M , Garcia Andrew , Ganatra Hammad A
Published: August 2022

Presentation, management, and outcomes of COVID-19 infections among younger patients is an area of medicine with deficits in research, likely due to the lower incidence of severe COVID-19 disease among the younger population. Management can be challenging, and clinicians often guide their decision-making based on the ever-changing protocols that are tailored mostly to the elderly population. Even more underrepresented in COVID-19 research are patients with chromosomal abnormalities and trisomy syndromes, as they appear less frequently, but have risk of increased morbidity and mortality due to underlying medical conditions. We describe a case of severe COVID-19 infection in a young patient with mosaic trisomy 13 and pre-existing polycystic kidney disease, who developed severe acute hypoxic respiratory failure and acute chronic kidney injury. The patient was provided maximal pharmacological support and her clinical course helps to shape the understanding of COVID-19 infections in the setting of chromosomal abnormalities and complex medical history.
Endometrial cancer rate in Hormone replacement therapy users with postmenopausal bleeding: Retrospective cohort study
Authors: Buchanan Charlotte , Robinson Megan , Macdonald Madeleine C
Published: August 2022

Objective

To establish the endometrial cancer detection rate in women using hormone replacement therapy presenting with postmenopausal bleeding.

Study Design

Retrospective cohort study. Setting and population Rapid access gynaecology clinic at a tertiary hospital. Women aged under 60 years referred with postmenopausal bleeding.

Methods

Retrospective study of referrals received between 1 January 2019 and 31 December 2020 including Hormone replacement therapy (HRT) use and histological diagnosis.

Main outcome measures

Histological diagnosis of endometrial cancer, borderline ovarian tumour or endometrial intraepithelial neoplasia.

Statistical analysis

Chi squared test

Results

1363 women were included. 214 women were using HRT when they experienced PMB and only one of these had endometrial cancer at histology (cancer detection rate 0.47%). 25 of the 1124 women who were not using HRT were diagnosed with endometrial cancer on histology (cancer detection rate 2.18%). Chi squared statistical analysis confirmed this was statistically significant ( p value .0156).

Conclusions

The endometrial cancer detection rate in women aged under 60 years using HRT with PMB is very low. Referral on a two-week wait pathway for suspected cancer diagnosis induces stress and anxiety for the woman and may lead to more invasive initial investigation even though other diagnoses are far more likely. Women aged under 60 years with postmenopausal bleeding that have either commenced HRT or had a change to their preparation within the last 6 months should be seen on a less urgent referral pathway if necessary given the very low probability of endometrial cancer.
Intra- and postoperative opioid-sparing analgesia in a cat undergoing pelvic limb amputation
Authors: Santoro Francesco , Castineiras Diego , Kaartinen Johanna
Published: August 2022

Case summary

A combination of preoperative epidurally administered morphine, peripheral nerve blocks and postoperative wound irrigation with ropivacaine is described as an opioid-sparing analgesic protocol for a feline immunodeficiency virus-positive cat with hypertrophic cardiomyopathy undergoing hindlimb amputation. The reported strategy resulted in a lack of intraoperative sympathetic response, haemodynamic stability and adequate postoperative analgesia. No rescue analgesia was needed at any point.

Relevance and novel information

This report represents an example of how several locoregional techniques can be effectively combined to minimise the perioperative use of systemic opioids and their potential side effects in selected cases.
Operative Management of Hip Fractures Within 24 Hours in the Elderly is Achievable and Associated With Reduced Opiate Use
Authors: Allahabadi Sachin , Roostan Mohammad , Roddy Erika , Ward Derek T. , Rogers Stephanie , Kim Candace
Published: August 2022

Introduction

Morbidity and mortality benefits have been associated with prompt surgical treatment of geriatric hip fractures. The purpose of this study was to evaluate the impact of early (≤24 hr) vs delayed (>24 hr) time to operating room (TTOR) on 1) hospital length of stay and 2) total and post-operative opiate use in geriatric hip fractures.

Materials and Methods

This study was a retrospective review of patients ≥65 years-old at the time of admission for surgery for hip fracture at a Level II academic trauma center. Outcome measures were length of stay (LOS), oral morphine equivalents (OME) throughout hospitalization. Patients were stratified into early and delayed TTOR groups and comparisons were made between groups.

Results

Between the early (n = 75, 80.6%) and late (n = 18, 19.4%) groups, there were no differences in age, fracture pattern, type of treatment, preoperative opiate use, and perioperative non-oral pain management. The early group trended toward shorter total LOS (108.0 ± 67.2 hours vs 144.8 ± 103.7 hours, P = .066), but not post-operative LOS. Total OME usage was less in the early intervention group (92.5 ± 188.0 vs 230.2 ± 296.7, P = .015), in addition to reduced post-operative OME (81.3 ± 174.9 vs 213.3 ± 271.3, P = .012). There were no differences in evaluated potential delay sources such as primary language, use of surrogate decision makers, or need for advanced imaging.

Discussion

Surgical treatment of geriatric hip/femur fractures in ≤24 hours from presentation is achievable and may be associated with reduced total inpatient opiate use, although daily use did not differ.

Conclusion

Establishing institutional TTOR goals as part of an interdisciplinary hip fracture co-management clinical pathway can facilitate prompt care and contribute to recovery and less opiate use in these patients with highly morbid injuries.
Spatial Pattern Change and Influencing Factors of Industrial Eco-Efficiency of Yangtze River Economic Belt (YREB)
Authors: Liu Yijun , Fang Ziyang
Published: August 2022

Industrialization in China has faced severe problems such as resource depletion and environmental degradation. The Yangtze River economic belt (YREB) strategy is one of the essential strategies for the sustainable development of the Chinese economy. Maximizing economic benefits while using the least resources and the least pollution to the environment is critical for China’s sustainable development strategy. This paper proposed the DEA to measure industrial eco-efficiency in the YREB from 2009 to 2018. It analyzed its temporal evolution and spatial differentiation and adopted a spatial econometric model to study how interference in influencing factors affects industrial eco-efficiency. The results revealed that (1) the eastern area of YREB has the highest industrial eco-efficiency compared with the other regions. (2) The industrial total factor productivity in the YREB has been rising over the years, and its change trend shows an inverted “W” pattern of first rising, then falling, then rising, then falling. (3) By further analysis, we observed a statistically significant spatial difference in the Industrial eco-efficiency among the areas in YREB, which suggests that the change scale presents the rule of “downstream bigger than Midstream region and midstream region bigger than “upstream region.” (4) The level of economic development, science and technology innovation, and human resources have significantly positive effects on industrial eco-efficiency, and the effect of economic development is of most significant importance. The industrial agglomeration demoted the efficiency of industrial ecology; Science and technology innovations, on the other hand, had a positive spillover effect, while the industrial concentration had a negative spillover effect.
Parental Autonomy Restricting Behaviors During Adolescence as Predictors of Dependency on Parents in Emerging Adulthood
Authors: Shah Emily N. , Szwedo David E. , Allen Joseph P.
Published: August 2022

Although one goal of the use of autonomy restricting parenting behavior is to keep teens psychologically dependent on the parent, research has yet to examine whether such behavior actually predicts later parental dependency. Thus, the present longitudinal, multi-method study investigates at which points across adolescence this behavior predicts parental dependency in emerging adulthood, and whether this association differs based on which parent uses psychological control within a non-clinical and racially, ethnically, and socioeconomically diverse sample. Teens’ ( N = 184) parents completed measures of perceived parental psychological control exhibited toward their teens during early (age 13) and late adolescence (age 18), as well as their teens’ parental dependency and functional independence during emerging adulthood (age 22). Additionally, interactions between teens and their parents during early and late adolescence were observed and coded to measure autonomy and relatedness restriction. Results indicated that autonomy restricting parenting behaviors were more predictive of parental dependence when used in early adolescence as compared to late adolescence, and revealed several cross-parent effects. Developmental implications for understanding parent-child relationships are discussed.