bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis of thermally protective PET–PEG multiblock copolymers as food packaging materials
Authors: Güngör Ertuğral Tuğba , Alkan Cemil
Published: October 2021

One of the storage conditions affecting quality of food stuffs due to short shelf life is temperature. Thermal insulation can be achieved by adding phase change materials (PCMs) to packaging materials. PCMs store and release latent heat of phase change during melting and crystallization operations, respectively. Thus, they can provide thermal protection for packaged foods. The aim of this study is to prepare new food packaging materials poly (ethylene terephthalate)–poly (ethylene glycol) (PET–PEG) multiblock copolymers as solid–solid phase change materials (SSPCM) as potential food packaging materials with thermal energy storage (TES) property. Polyesterification was carried out with PEG at different average molecular weights (1000, 4000 and 10,000 g/mol), ethylene glycol (EG) and terephthaloyl chloride (TPC). Synthesized PET–PEG multiblock copolymers were characterized using Fourier transform infrared (FT-IR) spectroscopy and differential scanning calorimetry (DSC) methods. The crystal structures of PET–PEG multiblock copolymers were characterized by polarized optical microscopy (POM) and their surface properties were determined by performing contact angle tests. TES capacity of the PET–PEG multiblock copolymers was found in range of 26.1–150.5 J/g. Consequently, this study demonstrates the potential of PET–PEG multiblock copolymers suitable for effective thermal preservation in packaging material applications to maintain the quality of packaged food stuffs.
Two-Stage Data Envelopment Analysis Efficiency of Indian General Insurance Companies
Authors: Sinha Ram Pratap
Published: October 2021

The present study compares efficiency-related performance of 15 Indian general insurance companies using a two-stage efficiency evaluation model. Efficiency evaluation has been made for the span 2009–2010 to 2017–2018 using network DEA (data envelopment analysis). The results indicate that the in-sample private sector general insurance companies outcompeted the public sector insurers with regard to first-stage activity (premium mobilization), while the reverse was observed in terms of the second-stage activity (asset management and provision of claim benefits). The study also carried out regression of efficiency scores on several contextual variables. The results indicate that ownership is an influential contextual variable in both stages of productivity while solvency significantly impacts efficiency in the second stage.
The Impact of Superior Roles in Safety Management on Safety Performance in SME Manufacturing in Malaysia
Authors: Zulkifly Syazwan Syah , Baharudin Mohd Rafee , Mahadi Muhammad Razif , Hasan Nor Halim , Ismail Sharifah Norkhadijah Syed
Published: October 2021

Small and medium entrepreneurship (SMEs) is the backbone of countries’ development. Over the years, there have been a large percentage of workplace injuries by SMEs in Malaysia, including financial and other SMEs’ constraints, which inform of inexpensive approach, thus requiring effective approaches to boost their safety performance. SME is unique in terms of characteristics, such as flat organizational structure. Thus, the owner-managers and the supervisors’ safety management, respectively, are proposed to impact the safety performance. This signals the need to examine how owner-managers and supervisors’ safety management practices improve occupational safety performance in SME manufacturing companies. Grounded on the Theories of Accident Causation, the present study applied a research model examining the relationship between owner-manager safety management practices (safety concern, safety policy and safety motivation) and safety management of supervisors, and the overall safety performance in Malaysia’s SME manufacturing. The questionnaires were distributed to the production workers in SME manufacturing firms in Selangor, Malaysia. A total of 165 production workers participated in the study. The data collected were analysed using partial least squares structural equation modelling. Based on the analysis, the study revealed that safety concern, safety policy and safety motivation, each, have a meaningful relationship with safety performance, while the supervisor’s safety management did not significantly affect safety performance. Our results extend previous research by highlighting the importance of owner-manager safety management practices in driving safety performance and indicating how each dimension of safety management practices either enhances or inhibits safety performance. The present study is the first empirical research investigating the relationship between manager and supervisor’s safety management and safety performance in the SME manufacturing setting.
Factors Impacting Resilience of Women Entrepreneurs in India in the Face of COVID-19
Authors: Matharu Sukhjeet Kaur , Juneja Divya
Published: October 2021

Although enough research has been carried out on factors inspiring women to start and operate business, there is a need to assess the role of various factors impacting resilience of Indian women entrepreneurs. Women entrepreneurs all over the world are struggling, adapting diverse strategies and innovating in the face of COVID-19, to fight against the crisis and bouncing back to their normal stage. The present study aims at identifying the direct relationships among selected factors in influencing the resilience of women entrepreneurs. The sample for the study comprised 396 women entrepreneurs from different regions of India. This is a survey-based study; a self-administered questionnaire was used for the collection of data. Analysis of the data collected was done using analysis of moment structures based structural equation modelling. Findings of the analysis state a significant and positive influence of entrepreneurial characteristics, resourcefulness, networking, adaptability and continuity in forming the resilient attitude of women entrepreneurs when faced with a crisis situation. The study can be useful to women entrepreneurs, organizations, government and other institutions extending support to entrepreneurs.
Neural Correlates of Hiccups in Patients with Lateral Medullary Infarction
Authors: Prabhakar Appaswamy Thirumal , Rabi Tephilah , Shaikh Atif I. A. , Aaron Sanjith , Benjamin Rohit , Mani Arun Mathai , Sivadasan Ajith , Mathew Vivek
Published: October 2021

Background

Hiccups is a known presentation of lateral medullary infarction. However, the region in the medulla associated with this finding is not clearly known. In this study, we aimed to study the neural correlates of hiccups in patients with lateral medullary infarction (LMI).

Methods

This retrospective study included all patients who presented with lateral medullary infarction between January 2008 and May 2018. Patients with hiccups following LMI were identified as cases and those with no hiccups but who had LMI were taken as controls. The magnetic resonance imaging of the brain was done viewed and individual lesions were mapped manually to the template brain. Voxel-based lesion-symptom mapping employing nonparametric permutation testing was performed using MRIcron.

Results

There were a total of 31 patients with LMI who presented to the hospital during the study period. There were 11 (35.5%) patients with hiccups. Using the voxel-based lesion-symptom mapping analysis, the dorso-lateral region of the middle medulla showed significant association with hiccups.

Conclusion

In patients with LMI, we postulate that damage to the dorsolateral aspect on the middle medulla could result in hiccups.
Singular Predictors of Hospital-Acquired Pressure Injuries Under Intensive Care: A Retrospective Cohort Study in a Medium-Complexity Hospital
Authors: Argenti Graziela , Ishikawa Gerson , Fadel Cristina Berger , Gomes Ricardo Zanetti
Published: October 2021

A retrospective cohort study of hospital-acquired pressure injuries (HAPI) reported an incidence rate of 34.3% based on 582 medical records of adult patients admitted to the intensive care unit (ICU) of a medium-complexity public hospital in 2017 and 2018. Sixty percent of the patients used respirators, 49.3% presented hypotension, and 48.1% used norepinephrine. The main individual predictors of HAPI in the ICU were “days of norepinephrine” with an odds ratio (OR) of 1.625 (95% CI: 1.473–1.792) and concordance statistic (AUC) of 0.818 (95% CI: 0.779–0.857), “days of mechanical ventilation” with an OR of 1.521 (1.416–1.634) and AUC of 0.879 (0.849–0.909), “ICU stay (days)” with an OR of 1.279 (1.218–1.342) and AUC of 0.846 (0.812–0.881), and “Braden’s sensory perception” with an OR of 0.345 (95% CI: 0.278–0.429) and AUC of 0.760 (0.722–0.799). The duration of mechanical ventilation, norepinephrine administration, and ICU length of stay presented significant discriminative capacity for HAPI prediction.
Denominating “Justification” and “Faith”: Catholics, Lutherans, and a North American Baptist's Response to the Joint Declaration on the Doctrine of Justification
Authors: Brewer Brian C.
Published: October 2021

That the Lutheran World Federation and the Pontifical Council for Unity attempted a joint declaration on the doctrine of justification is worthy of commendation. The resulting Joint Declaration constitutes some of the best contemporary efforts at ecumenical dialogue in the spirit of Christian union. This essay outlines the development of both medieval Catholic and subsequent Protestant conceptions of justification that led to disunion in the Western Church, reviews the initial points of division on the doctrine during the era of the Reformation for the purpose of grasping more fully the ecumenical feat of the JDDJ, and seeks to clarify what issues appear to remain unclear or unresolved in the document. The article also outlines the history of how Baptists in America have understood the doctrine of justification in order to consider how such Baptists might perceive the promise and potential lingering challenges or questions regarding the joint declaration.
Baptists, Scripture, and the Joint Declaration on the Doctrine of Justification
Authors: Starling David
Published: October 2021

The approach taken in this paper is based on two key considerations: (1) the emphasis that the Baptist theological tradition places on the role played by Scripture and its interpretation in the formulation, judgment, and renewal of our confessional statements; and (2) the testimony of the Joint Declaration on the Doctrine of Justification ( JDDJ) that the common understanding it articulates is grounded in a “common way of listening to the word of God in Scripture” ( JDDJ §8) and was derived, at least in part, by “appropriating insights of recent biblical studies” ( JDDJ §13). Its primary content is a brief summary of relevant discussions on justification and related themes in recent New Testament scholarship, some reflections on those discussions, and some suggestions for how those understandings might inform a collective Baptist response to the Joint Declaration. It concludes that the JDDJ should be taken by Baptists as a sign of hope and an encouragement to further conversation, including a distinctively Baptist explication of the common understanding stated in JDDJ §§15–17.
Sibling Constructs: What Are They, Why Do They Matter, and How Should You Handle Them?
Authors: Lawson Katherine M. , Robins Richard W.
Published: October 2021

Researchers often study constructs that are conceptually and/or empirically related, but distinct (i.e., “sibling constructs”). In social-personality psychology, as well as psychology more generally, there is little guidance for how to deal with sibling constructs, which can result in researchers ignoring or mishandling them. In this article, we start by situating sibling constructs in the literature on the jingle-jangle fallacies. Then, we outline 10 conceptual and empirical criteria for determining the degree to which, and in what ways, constructs may share a sibling relationship, using self-esteem and grandiose narcissism as a running example. Finally, we discuss strategies for handling sibling constructs in a systematic and transparent way. We hope that the procedures described here will help social-personality psychologists identify sibling constructs, understand when and why they pose problems for their research, and adopt strategies that ameliorate their adverse effects.
Optimising endotracheal length in adult cats: a retrospective CT study
Authors: Rodriguez Alfonso , Medina-Serra Roger , Plested Mark J , Veres-Nyeki Kata
Published: October 2021

Objectives

The aim of this study was to determine the maximal endotracheal insertion length by measuring the larynx to carina (L–C) distance by means of CT. An additional objective was to establish certain anatomical landmarks to optimise the process of endotracheal intubation (ETI).

Methods

Head, neck and thoracic CT images from adult cats at a single referral hospital between 2013 and 2020 were retrospectively evaluated. After standardising and identifying key markers (larynx, carina and first rib) the L–C, larynx to first rib (L–1R) and first rib to carina (1R–C) distances were measured.

Results

Forty-five adult cats were enrolled in the study, from which a total of nine different breeds were identified. The L–C distance was 14.3 ± 1.1 cm. This was longer in male (14.7 ± 1.1 cm) than in female cats (13.5 ± 0.7 cm). The first rib (1R) was 8.8 ± 0.7 cm from the larynx and the mean 1R–C distance was 5.4 ± 0.7 cm. The carina was found within the fifth intercostal space in 93.3% (n = 42) of the cats.

Conclusions and relevance

The process of ETI in adult cats may be guided by using the L–C and L–1R distance for a maximal and optimal endotracheal tube introduction, respectively. In addition, the maximal insertion length may be guided by estimating the position of the carina parallel to the fifth intercostal space.
Feminist/queer/diasporic temporality in Bernardine Evaristo's Girl, Woman, Other (2019)
Authors: Sánchez-Palencia Carolina
Published: October 2021

Claiming that individuals and communities get their choices, rhythms and practices biopolitically choreographed by temporal mechanisms that dictate which human experiences are included or excluded, Elizabeth Freeman states that those ‘whose activities do not show up on the official time line, whose own time lines do not synchronize with it, are variously and often simultaneously black, female, queer’ (2005). The narrative subject of Bernardine Evaristo's Girl, Woman, Other ( 2019 ) is black, female and (mostly) queer in her design of a polyphonic text featuring twelve black women moving through the world in different decades and occupying a temporal dimension that deviates from the linear and teleological modes. I draw on Edelman (2004) ; Freeman (2010) and Ahmed (2010 , 2017 ) to analyse Evaristo's novel as a text informed by feminist queer temporality and thus explore these characters’ resistance to chrononormative assumptions like ‘the straight time of domesticated gender, capital accumulation, and national coherence’ ( Ramberg, 2016 ). In this light, I address her cast of ‘time abjects’ –lesbians, transgender women, feminist killjoys and menopausal females—as characterized ‘chronotopically’ as their racialized and gendered subjectivities coalesce temporally and spatially seeing their pasts and futures interact in a typically transpositional, queer and diasporic continuum. By invoking Freeman's notion of ‘erotohistoriography’ ( 2010 ) as a distinctive mode of queer time that not only recognizes non-linear chronopolitics, but decidedly prioritizes bodies and pleasures in self-representation, I contend that Evaristo depicts bodies as likewise performing this encounter between past and present in hybrid, carnal and trans-temporal terms. I conclude that in her joining temporality and corporeality, memory and desire, she suggests alternative ways of representing contemporary black British womanhood
Framing policy problems and solutions in education policymaking: Pre-vocational education in Norwegian lower secondary school
Authors: Luimes Maike
Published: October 2021

This article investigates policymaking for Norwegian lower secondary education, with a focus on policy problems and solutions emphasising pre-vocational education. The data consist of official policy documents such as Green and White Papers, hearings, propositions to the parliament, protocols of parliamentary debates and votes in the parliament. The conceptual framework focuses on framing in policymaking and policy problems and solutions. Results reveal that dropout, difficulties in adapting education to the pupils and a gap between the content of schooling and the demands of the world of work are framed as the main policy problems. Different policy solutions emphasising pre-vocational education are presented as legitimised responses to these problems. The three policy problems can be defined as complex issues. Despite the proposed policy solutions, these are not enacted in the curriculum in line with the discussions and votes in parliament. This could be attributed to conflicting values and purposes of Norwegian education. These differences raise the question of whether the problems faced by Norwegian comprehensive schooling are taken for granted, as the proposed solutions appear to be insufficient in dealing with the defined problems.
In/Visible POC: Narratives of a Brown Professor in Teacher Education
Authors: Shah Vidya
Published: October 2021

In this article, I reflect on experiences of Brown (or South Asian) in/visibility in teacher education. Using an autoethnographic approach, I share reflexive personal and professional counternarratives of my experiences as a Brown person and Brown teacher-educator committed to issues of justice in the diverse context of Toronto, Canada. I explore how Brown invisibility operates in desiring recognition, insider knowings, investments in ambiguity, and relational harm and liberation. I trouble the ways in which theoretical frames open and limit experiences and expressions of Brownness, locating myself in between postcolonial and anti-colonial theorizing and notions of racial ambiguity in DesiCrit. I conclude with the importance of making visible the experiences and constructions of Brownness in faculties of education and education more broadly, as a form of solidarity that both resists Brown invisibility and exposes Brown complicity in an aspirational whiteness that maintains racial hierarchies through its invisibility.
Pilot Randomized Controlled Trial in Women With Non-Small Cell Lung Cancer to Assess the Feasibility of Delivering Group-Based Psychosocial Care via Videoconference
Authors: Milbury Kathrin , Kroll Juliet , Chen Aileen , Antonoff Mara B. , Snyder Stella , Higgins Hannah , Yang Chunyi Claire , Li Yisheng , Bruera Eduardo
Published: October 2021

Background:

The goal of this pilot randomized controlled trial was to examine the feasibility and acceptability of delivering group-based psychosocial care via videoconference (ie, Zoom) to women with lung cancer undergoing treatment.

Methods:

At baseline, women indicated their typical computer and internet use and were then randomized to a group-based intervention that either focused on mindfulness training or psychoeducation. Participants completed 1 Zoom “practice run” prior to starting the 5 group sessions (1 per week). After the last session, they evaluated their experiences with the intervention and its delivery.

Results:

With a consent rate of 68%, 54 women (mean age = 66 years; 69% non-Hispanic White; 48% with stage IV disease) were equally randomized. Attendance was high in both arms (session mean, mindfulness = 4.38; education = 4.75; 85% attended all sessions). Across arms, all women rated the program as useful; most preferred group-based delivery (67%) and remote delivery (50%) or had no preference. Although the sample’s typical computer use was relatively low (eg, 19% said that they rarely or never use a computer), most women (76%) indicated that Zoom was “very easy” or “easy” to use. After only 0 to 1 attempts, 56% felt comfortable but 26% stated that they never felt comfortable with the technology.

Conclusions:

It seems to be feasible to deliver group-based psychosocial interventions via videoconference in women with lung cancer undergoing treatment. Challenges regarding scheduling the group sessions and familiarizing older rather than infrequent computer users with the technology were encountered but resolved over the course of the trial.
Successful Incorporation of a Plant-Based Menu Into a Large Academic Hospital
Authors: Saldivar Brittany , Al-Turk Bashar , Brown Michelle , Aggarwal Monica
Published: October 2021

Unhealthy food choices and poor diet have a significant impact on development and progression of cardiovascular disease. Further, plant-based diets have been shown to mitigate cardiovascular risk factors and improve the health status of patients with cardiovascular disease. Currently, hospitals spend substantial healthcare dollars on food expenditures for inpatient services and recent pushes by the American Heart Association (AHA) and American College of Cardiology (ACC) encourage predominantly or full plant-based diets. The University of Florida has been one of the first institutions to incorporate a fully plant-based menu offering to their inpatient population. Herein, we discuss the program instituted at UF, the challenges faced while making this institutional change, and our solutions to these obstacles. The success of our plant-based initiative can serve as a foundation for other healthcare institutions to incorporate plant-based menu programs.
Termination of wanted pregnancy and suicidal ideation in hyperemesis gravidarum: A mixed methods study
Authors: Nana Melanie , Tydeman Florence , Bevan Georgie , Boulding Harriet , Kavanagh Kimberley , Dean Caitlin , Williamson Catherine
Published: October 2021

Background

Difficulty accessing medication and poor patient experience have been implicated as risk factors for termination of pregnancy and suicidal ideation in women with hyperemesis gravidarum. We aimed to gain further insight into these factors in order to further inform and improve patient care.

Methods

We performed a sub-analysis on quantitative data generated through a UK-wide survey of 5071 participants. A qualitative analysis of free text comments was performed using an inductive thematic approach.

Results

41.2% % of women taking prescribed medications had to actively request them. ‘Extremely poor’ or ‘poor’ experiences were described in 39.4% and 30.0% of participants in primary and secondary care respectively. Protective factors for termination of pregnancy and suicidal ideation include holistic support from family, friends and healthcare providers.

Conclusion

Optimal care in hyperemesis gravidarum should incorporate timely access to pharmacotherapy, assessment of mental health, consideration of referral to specialist services and care being delivered in a compassionate manner.
Risk factors for the development of degenerative changes among patients undergoing rotator cuff repair: A systematic review
Authors: Macciacchera Matthew , Siddiqui Salwa , Ravichandiran Kajeandra , Khan Moin , Sheth Ujash , Abouali Jihad
Published: October 2021

Background

Osteoarthritis (OA) of the glenohumeral joint results in significant pain and functional limitations. It is unclear which risk factors increase the risk of developing glenohumeral OA amongst Rotator Cuff Repair (RCR) patients. The purpose of this systematic review was to examine the risk factors which may contribute to the development of osteoarthritic changes post-operatively.

Methods

MEDLINE, Embase, and PubMed databases were searched to identify studies reporting on demographics of patients who develop OA following RCR.

Results

Seventeen articles were identified investigating a total of 1292 patients. The overall quality of evidence was low. Pooled assessment of OA incidence following RCR at minimum 5 years follow-up found 26% of patients developed OA. Patients requiring revision surgery following retears developed OA at a rate of 29%. Surgical technique and patient demographics may also contribute to degenerative changes.

Discussion

This review found correlations between the aforementioned risk factors and glenohumeral joint degeneration at long-term follow-up after RCR. These findings suggest that future long-term studies should aim to identify prognostic factors that may place a patient at increased risk of developing OA. Such data can be used to counsel patients with respect to long-term outcomes following surgical intervention.
The Future of Autoethnographic Criteria
Authors: Herrmann Andrew
Published: October 2021

Recently Szwabowski argued that we should not have any criteria by which to judge, evaluate, or review autoethnographic texts. While there are dangers of conformity whenever criteria are utilized, criteria can also act as a guide. Here, I cover the autoethnography triad of auto-, ethno-, and -graphy as the three main criteria for a work to be considered autoethnographic. I argue that criteria do not necessitate exclusion nor does it necessarily end dialogue. Criteria can act as a way to guide and edify the voices of future autoethnographers, including those who are working in different mediums such as animation, film, and photography.
Disciplining the Akratic user: Constructing digital (un) wellness
Authors: Valasek Chad J.
Published: October 2021

Contemporary discourse around digital well-being tends to focus on self-control when it comes to “addicting” social media apps and digital devices. By acting on behalf of users, designers and engineers promote various self-regulating products and services in order for users to “fix” the distractible brains of typical users. This paper explores the role of the history of psychology on user-experience thinking and engineering and provides a critical genealogy of digital well-being discourse and persuasive technology. In particular, I expand on the role of dual-process models in human–computer interaction and health behavior change from the 1980s to today. By exploring the social construction of the distracted, impulsive, “primitive” animal brain (system 1), I find that it is this part of the mind that the engineer wishes to “treat,” via app design. In order to tame this “primitive” brain, researchers and engineers have turned to behavioral science, hoping to better structure user options and encourage users to manage their own time and normalize screen habits. I argue that normality discourses like this are founded upon ideas of time management and delay of gratification, whereas abnormality is tied to ideas of immediate gratification and time wasting. This dichotomy is not simply to enforce social norms around time wasting, but reinforces social and econoimc inequities. Therefore, unlike some other approaches to digital well-being, I urge future scholarship on the subject to examine the taken-for-granted social-cultural context, which will lead not only to a more politically nuanced understanding of the subject but may also lead to further discussions over how digital well-being could be conceived otherwise.
Integrating online community support into outpatient breast cancer care: Mayo Clinic Connect online platform
Authors: Harmon David M , Young Colleen D , Bear Melissa A , Aase Lee A , Pruthi Sandhya
Published: October 2021

Introduction

Mayo Clinic Connect is an online community of over 100,000 members who support each other through sharing lived experience when facing and managing new diagnoses. The community is moderated by Mayo Clinic staff and volunteer patient mentors.

Methods

Mayo Clinic breast clinic patients undergoing evaluation received a binder of support resources including a brochure about Mayo Clinic Connect at visits between January and May of 2019. Surveys were distributed at subsequent visits between May and December of 2019 to assess patient awareness about the online resource, participation frequency, purpose of use, and benefits for members, as well as reasons for not joining (non-members). The primary aim was to assess patient resilience, coping, and self-management after joining the online community.

Results

Nine hundred surveys were distributed, and 102 participants completed surveys between May and December 2019. Forty-five percent ( n = 46) had heard about Mayo Clinic Connect; 34% ( n = 15) through a brochure. The remainder heard about the community from a Mayo Clinic provider (43%; n = 19) or other resources (22%, n = 10; no response n = 2). Twenty percent ( n = 20) of survey participants registered as Breast Cancer group members, and most of this subgroup (55%; n = 11) reported understanding diagnosis, treatment plans, and finding peer support as reasons for joining. Seventy-five percent of Mayo Clinic Connect participants ( n = 15) reported the community met or exceeded expectations.

Conclusion

This pilot study reveals the potential positive impact of introducing an online peer support group into clinical care plans for patients coping with a new and anxiety-provoking cancer diagnosis.
An Empirical Examination of the Impact of eWom Information on Young Consumers’ Online Purchase Intention: Mediating Role of eWom Information Adoption
Authors: Sardar Affifa , Manzoor Amir , Shaikh Khurram Adeel , Ali Liaqat
Published: October 2021

Customer purchase intention in online shopping stores can be influenced by electronic word of mouth (eWom) communication generated by the comments of consumers on social networking sites. However, the adoption of eWom information by consumers is influenced by various factors. This study investigates the mechanism through eWom antecedents influence eWom adoption and consumer purchase intention. The study also examines how eWom adoption mediates the impact of antecedents of eWom adoption (Quality, Consumer Attitude, Credibility, Usefulness, Needs, and Adoption) on customer’s purchase intention. Using the hypothetic-deductive approach, the current study used a cross-sectional self-administered survey to collect data from a convenience sample of university students residing in Karachi. The SmartPLS software was used to analyze the collected data. Study findings reveal that all predictors of eWom adoption are significant. It was also found that eWOM adoption mediates the impact of eWom antecedents on consumer purchase intention. The results provide significant implications for website designers and digital marketers. For marketers working with social media, the findings of this study are encouraging. Marketers can use these findings to develop viral marketing campaigns and encourage customers to contribute useful and credible eWom that could improve the customers’ purchase intention.
A Strategy for Repair, Augmentation, and Reconstruction of Knee Extensor Mechanism Disruption: A Retrospective Review
Authors: Carlson Strother Courtney R. , LaPrade Matthew D. , Keyt Lucas K. , Wilbur Ryan R. , Krych Aaron J. , Stuart Michael J.
Published: October 2021

Background:

The loss of extensor mechanism continuity that occurs with patellar and quadriceps tendon rupture has devastating consequences on patient function.

Purpose:

To describe a treatment strategy for extensor mechanism disruption and evaluate the outcomes of 3 techniques: primary repair, repair with semitendinosus tendon autograft augmentation, and reconstruction with Achilles tendon allograft.

Study Design:

Case series; Level of evidence, 4.

Methods:

The authors reviewed surgeries for extensor mechanism disruption performed by a single surgeon between 1999 and 2019. Patient characteristics, imaging studies, surgical techniques, and outcomes were recorded. Primary ruptures with robust tissue quality were repaired primarily, and first-time ruptures with significant tendinosis or moderate tissue loss were repaired using quadrupled semitendinosus tendon autograft augmentation. Patients with failed previous extensor mechanism repair or reconstruction and poor tissue quality underwent reconstruction with Achilles tendon allograft. The primary outcome was extensor mechanism integrity at a minimum 1-year follow-up, with extensor mechanism lag defined as >5° loss of terminal, active knee extension. Secondary outcomes included postoperative knee range of motion, International Knee Documentation Committee (IKDC) and Tegner activity scores, and the radiographic Caton-Deschamps Index.

Results:

Included were 22 patellar tendon and 21 quadriceps tendon surgeries (patients: 82.5% male; mean age, 48.1 years; body mass index, 31). Seventeen (39.5%) cases underwent primary tendon repair, 13 (30.2%) had repair using semitendinosus tendon autograft augmentation, and 13 (30.2%) underwent reconstruction using an Achilles tendon allograft. Seventeen (39.5%) cases had at least 1 prior failed extensor mechanism surgery performed at an outside facility. At the last follow-up, 4 (9.3%) cases had an extensor mechanism lag, no cases required additional extensor mechanism surgery, and all cases were able to achieve >90° of knee flexion. Postoperative IKDC scores were significantly improved with all methods of extensor mechanism surgery, and postoperative Tegner activity scores were significantly improved in patients who underwent primary repair and Achilles tendon allograft reconstruction ( P < .05 for all).

Conclusion:

Primary repair alone, repair using quadrupled semitendinosus tendon autograft augmentation, and reconstruction using Achilles tendon allograft were all effective methods to restore extensor mechanism and knee function with the proper indications. Persistent knee extensor lag was more common in chronic extensor mechanism injuries after failed surgery, although patients still reported significantly improved postoperative functional outcomes.
Oral Kaposi’s Sarcoma: A Case Report and Literature Review on Treatment Management
Authors: Thieringer Florian M. , Cede Julia , Glatz Katharina , Roehling Stefan , Stoeckle Marcel , Leiggener Christoph S.
Published: October 2021

Background:

Kaposi’s sarcoma is a common malignancy in HIV patients. Oral manifestation of AIDS-associated Kaposi’s sarcoma occurs in up to 65% of HIV/AIDS patients and is a poor prognostic factor. We report the case of a patient with a progressive bulky manifestation of oral Kaposi’s sarcoma.

Case Presentation:

A 48-year-old male presented with dysphagia due to progressive indolent swelling of the palate. Intraoral inspection revealed an uneven, partially ulcerated, livid mass, approximately 5 cm in diameter, extending antero-posteriorly from the superior vestibulum to the soft palate and across the hard palate, thereby overgrowing remaining teeth and the alveolar arch. Serological testing revealed an HIV infection, and further tests showed HHV8-positivity. The patient underwent surgical debulking of the oral lesions and, following complete remission, received full mouth reconstruction with an implant-supported prosthesis.

Conclusions:

Understanding the relation of HIV and HHV8-infection in terms of disease onset and clinical presentation is important to increase awareness of oral Kaposi’s sarcoma and ensure subsequent appropriate management of affected patients. Clinical staging represents the most important factor for choosing the optimal treatment. The introduction of combined antiretroviral therapy has proven to be efficient in curing oral Kaposi’s sarcoma, while several additional locoregional treatment options, including debulking surgery, may be necessary for symptom relief or to improve cosmesis. Radiotherapy should be applied restrictively due to potentially severe toxic mucosal reactions, whereas additional chemotherapy must be considered in severe cases that present with widespread disseminated disease. A multidisciplinary approach to the treatment of functionally and aesthetically impairing oral Kaposi’s sarcoma is highly recommended.
Morphologic Analysis of Nonosseous Talocalcaneal Coalitions Using 3D Reconstruction
Authors: Yoneda Azusa , Tanaka Yasuhito , Fujii Hiromasa , Isomoto Shinji , Sugimoto Kazuya
Published: October 2021

Background:

Resection of talocalcaneal coalitions has generally involved osseous coalitions. We attempted to evaluate the morphology of nonosseous talocalcaneal coalitions. This study aimed to investigate if the calcaneal articular surface area of feet with talocalcaneal coalitions is different than that of normal feet.

Methods:

Twenty nonosseous talocalcaneal coalition cases with analyzable computed tomography (CT) scans were compared to 20 control cases. Three-dimensional models of the talus and calcaneus were constructed, and the surface areas of the posterior facet (SPF), whole talocalcaneal joint of the calcaneus (SWJ), and coalition site (SCS) of each 3D-CT model were measured. “Calibrated” values of the 2 groups were created to adjust for relative size of the tali and then compared. The preoperative and postoperative AOFAS Ankle-Hindfoot scale was calculated for 9 cases that had undergone single coalition resection.

Results:

The calibrated SPF and SWJ were significantly greater in the coalition group than in the control group (40% and 12%, respectively). No significant difference was detected between the calibrated (SWJ – SCS) value of the coalition group and the calibrated SWJ value of the control group. The AOFAS scale was improved postoperatively in all 9 cases analyzed.

Conclusion:

The calcaneal articular surface of nonosseous talocalcaneal coalition feet in our series was larger than that of the normal feet. This study indicates that the total calcaneal articular surface after coalition resection may be comparable to the calcaneal articular surface of normal feet. We suggest that the indication for coalition resection be reconsidered for nonosseous coalition.

Level of Evidence:

Level III, retrospective comparative study.
Megadose 90Y-ibritumomab tiuxetan prior to allogeneic transplantation is effective for aggressive large B-cell lymphoma
Authors: Chow Victor A. , Cassaday Ryan D. , Gooley Theodore A. , Smith Stephen D. , Sandmaier Brenda M. , Green Damian J. , Orozco Johnnie J. , Tuazon Sherilyn A. , Matesan Manuela , Fisher Darrell R. , Maloney David G. , Press Oliver W. , Gopal Ajay K.
Published: October 2021

Allogeneic hematopoietic cell transplantation (allo-HCT) can be curative for relapsed or refractory B-cell lymphomas (BCLs), although outcomes are worse in aggressive disease, and most patients will still experience relapse. Radioimmunotherapy using 90Y-ibritumomab tiuxetan can induce disease control across lymphoma subtypes in a dose-dependent fashion. We hypothesized that megadoses of 90Y-ibritumomab tiuxetan with reduced-intensity conditioning could safely produce deeper remissions in aggressive BCL further maintained with the immunologic effect of allo-HCT. In this phase 2 study, CD20+ BCL patients received outpatient 90Y-ibritumomab tiuxetan (1.5 mCi/kg; maximum, 120 mCi), fludarabine, and then 2 Gy total body irradiation before HLA-matched allo-HCT. Twenty patients were enrolled after a median of 4.5 prior lines of therapy, including 14 with prior autologous transplant and 4 with prior anti-CD19 chimeric T-cellular therapy. A median 90Y-ibritumomab tiuxetan activity of 113.6 mCi (range, 71.2-129.2 mCi) was administered, delivering a median of 552 cGy to the liver (range, 499-2411 cGy). The estimated 1- and 5-year progression-free survival was 55% (95% confidence interval [CI], 31-73) and 50% (95% CI, 27-69) with a median progression-free survival of 1.57 years. The estimated 1- and 5-year overall survival was 80% (95% CI, 54-92) and 63% (95% CI, 38-81) with a median overall survival of 6.45 years. Sixteen patients (80%) experienced grade 3 or higher toxicities, although nonrelapse mortality was 10% at 1 year. No patients developed secondary acute myeloid leukemia/myelodysplastic syndrome. Megadose 90Y-ibritumomab tiuxetan, fludarabine, and low-dose total body irradiation followed by an HLA-matched allo-HCT was feasible, safe, and effective in treating aggressive BCL, exceeding the prespecified end point while producing nonhematologic toxicities comparable to those of standard reduced-intensity conditioning regimens.
A clinical, histopathological, and molecular study of two cases of VEXAS syndrome without a definitive myeloid neoplasm
Authors: Li Peng , Venkatachalam Shobi , Ospina Cordona Daniela , Wilson Lorena , Kovacsovics Tibor , Moser Karen A. , Miles Rodney R. , Beck David B. , George Tracy , Tantravahi Srinivas K.
Published: October 2021

VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is caused by somatic mutations in UBA1 and is identified by a genotype-driven method. This condition affects unrelated men with adultonset inflammatory syndromes in association with hematologic manifestations of peripheral cytopenia and bone marrow myeloid dysplasia. Although bone marrow vacuolization restricted to myeloid and erythroid precursors has been identified in patients with VEXAS, the detailed clinical and histopathological features of peripheral blood and bone marrows remain unclear. The current case report describes the characteristic hematologic findings in patients with VEXAS, including macrocytic anemia, thrombocytopenia, marked hypercellular bone marrow with granulocytic hyperplasia, megaloblastic changes in erythroid precursors, and the absence of hematogones in addition to prominent vacuoles in myeloid and erythroid precursor cells. Characterizing the clinical and hematologic features helps to raise awareness and improve diagnosis of this novel, rare, but potentially underrecognized disease. Prompt diagnosis expands the general knowledgeable and understanding of this disease, and optimal management may prevent patients from developing complications related to this refractory inflammatory syndrome and improve the overall clinical outcome.
The incidence of cancer-associated thrombosis is increasing over time
Authors: Mahajan Anjlee , Brunson Ann , Adesina Oyebimpe , Keegan Theresa H.M. , Wun Ted
Published: October 2021

Cancer-associated thrombosis (CAT) is an important cause of morbidity and mortality for patients with malignancy and varies by primary cancer type, stage, and therapy. We aimed to characterize the incidence, risk factors, temporal trends, and the effect on mortality of CAT. The California Cancer Registry was linked to the statewide hospitalization database to identify individuals with the 13 most common malignancies diagnosed between 2005 and 2017 and determine the 6- and 12-month cumulative incidence of CAT by venous thromboembolism (VTE) location, tumor type, and stage after adjusting for competing risk of death. Cox proportional hazard regression models were used to determine risk factors associated with CAT and the effect of CAT on all-cause mortality. 942 019 patients with cancer were identified; 62 003 (6.6%) had an incident diagnosis of CAT. Patients with pancreatic, brain, ovarian, and lung cancer had the highest, and patients with breast and prostate cancer had the lowest 12-month cumulative incidence of CAT. For most malignancies, men, those with metastatic disease and more comorbidities, and African Americans (vs non-Hispanic Whites) were at highest risk for CAT. Patients diagnosed with cancer between 2014 and 2017 had a higher risk of CAT compared with those diagnosed between 2005 and 2007. CAT was associated with increased overall mortality for all malignancies (HR ranges 1.89 to 4.79). The incidence of CAT increased over time and was driven by an increase in pulmonary embolism±deep vein thrombosis (PE±DVT). CAT incidence varies based on tumor type and stage and on individual risk factors including gender, race/ethnicity, and comorbidities. For all tumor types, CAT is associated with an increased mortality.
Association of Blastocystis ST6 with higher protease activity among symptomatic subjects
Authors: Karamati Seyed Ahmad , Mirjalali Hamed , Niyyati Maryam , Yadegar Abbas , Asadzadeh Aghdaei Hamid , Haghighi Ali , Seyyed Tabaei Seyyed Javad
Published: October 2021

Background

Blastocystis sp. is an anaerobic intestinal protozoan parasite of humans and a wide range of animals worldwide. In the current study the correlation between the cysteine protease activity of clinical samples of Blastocystis sp. ST1–3 and 6 with the levels of pro-inflammatory cytokines was evaluated.

Methods

Stool samples were collected from subjects with or without clinical symptoms. All samples were cultivated in DMEM medium. The bacteria were eliminated or reduced in Blastocystis sp. positive samples subtypes 1–3 and 6 by a variety of antibiotics and consecutive sub-cultures. To prepare parasite lysate, 1 × 105Blastocystis sp. from each isolate were harvested and lysed using freeze-thaw. Protease activity of each isolate was measured and the gene expression of pro-inflammatory biomarkers in HT-29 cell line sensed by isolates was investigated using quantitative Real-time PCR.

Results

Protease activity assay showed inter- and intra-subtype variations among subtypes regarding the presence of symptoms, while the protease activity of symptomatic isolates was higher than asymptomatic isolates. The highest and lowest levels of protease activity were seen in ST6 and ST2, respectively. However, patterns of the expression of pro-inflammatory biomarkers in HT-29 cell line was different regarding the presence of symptoms and time points. There was no significant correlation between protease activity of different subtypes with the expression levels of pro-inflammatory biomarkers.

Conclusions

Our study indicated a higher protease activity among isolates from symptomatic compared to asymptomatic subjects, suggesting functional role for proteases in clinical symptoms due to Blastocystis sp. The lack of correlation between the levels of expression of pro-inflammatory biomarkers with subtypes regarding the presence of clinical symptoms proposes the importance of host-related factors in presentation of clinical symptoms.