bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular treatment of a critical common iliac artery stenosis using intravascular ultrasound guidance in a patient with a known severe iodine contrast allergy
Authors: Fee Charles , Lewis Katharine
Published: January 2023

Introduction:

The mainstay of endovascular treatment in peripheral arterial disease is digital subtraction angiography with an iodinated contrast. In patients with a known contrast allergy, the current most commonly used alternative is to perform carbon dioxide angiography. Operator experience and availability of carbon dioxide (CO2) angiography delivery systems are, however, limited. Intravascular ultrasound is now commonly used in combination with fluoroscopy in peripheral venous interventions and in coronary arterial disease and we propose that this also provides a safe and effective alternative option to guide endovascular intervention in patients with a known contrast allergy.

Case report:

We present a case describing the use of intravascular ultrasound and fluoroscopy to guide endovascular treatment of a critical left common iliac artery stenosis in a patient with known anaphylaxis to iodinated contrast.

Discussion:

Intravascular ultrasound is fast becoming the gold standard treatment option in peripheral venous interventions; however, the use in peripheral arterial disease is limited. We believe this is the first case that reports the use of predominantly intravascular ultrasound in endovascular peripheral arterial intervention with a contrast adjunct.

Conclusion:

We have demonstrated that intravascular ultrasound is a safe and effective alternative or adjunct to iodinated contrast for arterial angiography and stenting in the setting of patient contra-indications.
Laughing in the Face of the Law: Humour as a Thermostat Activating Social Change for Porn Workers
Authors: Nocella Rebecca Rose , Chiaro Delia Carmela
Published: January 2023

The vulnerability of sex workers in the porn industry is a heated debate within feminism. The UK 2014 Audiovisual Media Services Regulations and 2017 Digital Economy Act, which burden the production of online pornography, provoked sex workers’ Face-Sitting and Kink Olympixxx protests. This paper investigates how throughout these protests, humour communicates sex workers’ discomfort on this legislation. Arguing that humour is a thermostat that senses public uneasiness and slowly activates social change, this paper examines the two protests highlighting how sex workers employed unrefined bawdy humour to unearth their neglected rights and move towards more adequate rights.
Prefabricated thermally-activated fiber-polymer composite building slab P-TACS: Toward the multifunctional and pre-fabricated structural elements in buildings
Authors: Khovalyg Dolaana , Mudry Alexandre , Keller Thomas
Published: January 2023

The traditional sequential design of building elements, where every element performs only one dedicated function, carries significant embodied energy. Thus, modular pre-fabricated load-bearing elements could overcome the disadvantages of the current carbon-intensive construction practice and go beyond; as such, lightweight glass fiber-polymer composite profiles could be more advantageous in performance. Cellular structures of such profiles can be advantageous for adding water channels for active heating and cooling indoors and for fire protection. Therefore, the development of such a modular active building slab referred to as P-TACS (Prefabricated Thermally-Activated Fiber-Polymer Composite Slab) is explored in this work. The structural performance of a proposed P-TACS design is verified in terms of serviceability and ultimate limit states. The addition of local carbon fiber inclusions allows for an increase in the span of the slab to 10 m and a more uniform surface temperature. Thermal performance of the structurally optimized geometrical configuration is analyzed by, first of all, determining water parameters based on the 1D approach partially adopted from the standard radiant systems analysis and, secondly, by a detailed 2D thermal analysis using ANSYS Fluent numerical simulations. The hydraulic and thermal performance comparison of the novel P-TACS design with two standard radiant systems (ESS Type A and RCP) reveals that the P-TACS design outperforms the standard embedded surface system ESS Type A, both for floor heating and cooling case. In addition, the response time of P-TACS is three times faster compared to the ESS response time. The main advantage of the P-TACS is in lower mean water temperature, compared to traditional embedded radiant systems (e.g., EES type), required for conditioning the space, potentially resulting in lower operational energy use. The fire outbreak scenario is considered to complete the analysis, and the measures to switch water flow from nominal to fire scenario are proposed.
Understanding African journalistic agency in China–Africa media interactions: The case of Kenya
Authors: Li Hangwei
Published: January 2023

Drawing on field observations and extensive interviews, this study investigates how Kenyan media practitioners exercise their agency when interacting with Chinese stakeholders. When dealing with Chinese stakeholders or China-related stories, Kenyan media practitioners developed three strategies to exercise their journalistic agency: (a) situational negotiation, (b) collective reflection, and (c) resistance, through which they have approached, negotiated with, and resisted their relations with their Chinese counterparts. This article challenges the misconceptions that Chinese media organizations always hold a powerful position vis-à-vis African media organizations, and that African agents are dependents or innocent victims with neither agency nor creativity.
Belt and Road Initiative-supported co-production films: Film policy and disoriented remembrance of the Silk Road past
Authors: Hu Pengnan
Published: January 2023

Through policy analysis and close reading of two films, this article reveals films’ increasing role in China's geopolitical plan, the Belt and Road Initiative (BRI). The co-production film Xuanzang shows that the Silk Road past is used to illustrate BRI's pledge for a beneficial future. Even though Xuanzang's story alludes to history, it was selected for its significance in popular culture, thereby reflecting ‘hyperreality’. In any event, the Silk Road is insufficient for connecting a region characterized by complex histories and societies. As shown in The Composer, the Silk Road is a convenient metaphor used to portray any friendly history.
Effectiveness of iodine-impregnated incise drapes for preventing surgical site infection in patients with clean or clean contaminated wounds: A systematic literature review and cost-consequence analysis
Authors: Sworn Katie , Poku Edith , Thokala Praveen , Sutton Anthea , Foster Steve , Siddall Ian , Reuter Henning
Published: January 2023

Background:

Surgical site infection is a serious complication associated with significant morbidity, mortality and health care expenditure.

Aims:

To determine the clinical effectiveness and economic impact of using iodine-impregnated incise drapes for preventing surgical site infection.

Methods:

MEDLINE, Embase, Cochrane Library and CINAHL databases were systematically searched. Critical appraisal and synthesis of clinical evidence informed a decision analytical cost-consequence model.

Findings:

Nine studies were included in the systematic literature review. Evidence from cardiac surgery patients was considered appropriate to inform the cost analysis. The economic model evaluation estimated cost savings of £549 per patient with the iodophor-impregnated drape in the deterministic analysis and a mean cost saving per patient of £554,172 per 1000 in the probabilistic analysis.

Conclusion:

Using iodine-impregnated drapes in cardiac surgery patients may effectively reduce infections and provide cost-savings, but further research is required.
Alcoholic herbal sex drinks and the construction of masculinities in Nigeria
Authors: Ajayi Daniel Oluwafemi
Published: January 2023

Extant works on masculinities have focused on their differential patterns in Nigeria. However, none of these studies has examined how masculinities are constructed through the metaphorical representation of alcoholic herbal sex drinks and their functions. Drawing insights from Lakoff and Johnson’s conceptual metaphor theory, Forceville’s visual metaphor and van Dijk’s socio-cognitive approach to ideology to analyze the names together with verbo-visual conceptualization of alcoholic herbal sex drinks, this paper discusses some of the subcultural ideologies that delineate masculinities among the manufacturers, sellers, and consumers of these drinks in southwestern Nigeria. Analysis of the data reveals the construction of masculinities by this group in terms of the territorial and subordinating sexual status of the male. Also, the male sex organ and muscular male body are conceptualized by this group as sexual weapons, controllers of the female sexual satisfaction, and the cleaning agents for vagina. The paper concludes that these drinks and the associated sexual beliefs reflect some of the trending subcultural ideologies that discursively shape the construction of masculinities in Nigeria.
Counter-discourse production in social media: A feminist CDA of a Weibo post
Authors: Wang Qiong , Ouyang Huhua
Published: January 2023

This article looks at the mechanism of counter-discourse production as a form of feminist digital activism in China. Taking the case of a Weibo post as an illustrative example, it explores how the counter-discourses against gender asymmetry are created, what accounts for the maintenance and dissemination of the counter-discourses, how the counter-discourses become part of the online discursive activism with online and offline effects, and what inspirations the ecology of such counter-discourse formation has for future feminist digital activism. Applying feminist critical discourse analysis (CDA) with linguistic and textual analysis, it seeks to reveal that, with linguistic device of satire, a Weibo post generated a counterpublic that challenges the dominant patriarchal discourse by exposing the hidden nature of its rhetoric and making visible what used to be taken for granted. It further demonstrates that, by utilizing the digital tool of screenshot and media mechanism of hashtag, the counterpublic produced and disseminated counter-discourses that generated, on top of conscious-raising, the will and agency to spread feminist thinking to compete with the dominant gender discourse and promote activism aimed at changing the status quo.
Advances in the management of non-small-cell lung cancer harbouring EGFR exon 20 insertion mutations
Authors: Low Jia Li , Lim Sun Min , Lee Jii Bum , Cho Byoung Chul , Soo Ross A
Published: January 2023

Epidermal growth factor receptor ( EGFR) mutation is one of the key oncogenic mutations in non-small-cell lung cancer with adenocarcinoma histology. Exon 19 deletions and exon 21 L858R substitutions account for 90%, while EGFR exon 20 insertions constitute 4–10% of EGFR mutations and are the third most prevalent activating EGFR mutations. EGFR exon 20 insertions are associated with decreased sensitivity to EGFR tyrosine kinase inhibitors and, until recently, effective targeted therapy against these tumours remained an unmet clinical need and chemotherapy was the only treatment of choice available. The approval of amivantamab and mobocertinib for patients who have progressed after chemotherapy represents an important step forward in the management of these patients. Here in this review, we summarize the epidemiology, structure and the tumour microenvironment of EGFR exon 20 insertion and also review the systemic treatments, including targeted therapies and ongoing clinical trials in EGFR exon 20 insertion mutations, as well as detection methods for EGFR exon 20 insertion. Lastly, resistant mechanisms and future directions are addressed.
Farrerol Inhibits Vascular Smooth Muscle Cell Proliferation and Protects Them From Oxidative Injury via Bidirectional Modulation of the PI3K/Akt/mTOR Signaling Pathway
Authors: Fang Jiacheng , Jiang Huanhuan , Liu Enli , Ge Rui , Li Qingshan
Published: January 2023

The inhibition of intimal hyperplasia (IH) is an effective strategy to improve the long-term outcome of endovascular therapy and prevent restenosis. Farrerol, a naturally occurring dihydroflavone with a variety of bioactivities, exerts inhibitory effects against balloon injury-induced IH in rats. In the present study, bioinformatics analysis, in combination with in vitro experimental validation, was performed to elucidate the underlying inhibitory mechanisms. The protein–protein interaction (PPI) network was assessed to identify farrerol-related protein targets in the context of IH, based on which biological functions and pathway enrichment were analyzed. The proliferation and cell cycle distribution of vascular smooth muscle cells (VSMCs) were investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2 H-tetrazolium bromide and 5-ethynyl-2-deoxyuridine incorporation assays and flow cytometric analysis, respectively. The level of pro-inflammatory cytokines in the cell culture medium was estimated using an enzyme-linked immunosorbent assay (ELISA). Protein expression in A7r5 cells was determined by western blotting. Forty-six IH-related targets of farrerol were identified, and the PI3K/Akt/mTOR pathway was highly enriched among the 43 predicted pathways ( P < .05). In serum (10% fetal bovine serum)-induced A7r5 cells, farrerol inhibited proliferation through non-cytotoxic effects, induced cell cycle arrest in the G0/G1 phase , and suppressed the activation of the PI3K/Akt/mTOR pathway. In H2O2 (300 µM)-induced A7r5 cells, farrerol reduced the release of IL-1 β and TNF- α and reversed the suppressive effect on the PI3K/Akt/mTOR pathway in response to H2O2 stimulation. In conclusion, farrerol inhibits the proliferation of VSMCs and protects VSMCs from oxidative injury via the bidirectional modulation of the PI3K/Akt/mTOR signaling pathway, which might contribute to the suppression of neointima formation.
Distinguish the Characteristic Mechanism of 3 Drug Pairs of Corydalis Rhizome in Ameliorating Angina Pectoris: Network Pharmacology and Meta-Analysis
Authors: Zhai Zhenwei , Zhu Zhishan , Kong Fanjing , Xie Danni , Cai Jie , Dai Jingyi , Zhong Yanmei , Gan Yanxiong , Zheng Shichao , Xu Ying , Sun Tao
Published: January 2023

Objective: Angina pectoris (AP), affecting over 523 million people, can be alleviated by corydalis rhizome (CR), usually combined with chuanxiong rhizome (CXR), angelica dahuricae radix (ADR), or astragali radix (AR) to enhance the effect. This study aims to distinguish the different mechanisms among 3 drug pairs to treat AP. Methods: The drug pair-disease intersection targets, compound targets, protein–protein interaction (PPI), and herb-compound-target-pathway network were obtained by Cytoscape, STRING, Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses ( http://www.kegg.jp/ or http://www.genome.jp/kegg/ ). Importantly, with principal component analysis (PCA), the key point of KEGG and GO were explored and supported, while by meta-analysis, the different mechanisms of the drug pairs on AP were discovered. Results: JUN, SRC, PIK3CA, and MAPK1 as PPI core network of CR-AP, (CR-CXR)-AP, (CR-ADR)-AP, and (CR-AR)-AP. (highest confidence > 0.9). 10, 45, 35, and 21 key compounds, and 68, 123, 117, and 97 core targets were obtained from CR-AP, (CR-CXR)-AP, (CR-ADR)-AP, and (CR-AR)-AP based on more than 2-fold median value for degree and betweenness centrality, more than the median of closeness centrality. The core pathways of (CR-CXR)-AP and (CR-AR)-AP cover “fluid shear stress and atherosclerosis” and the “pathways in cancer”, while (CR-ADR)-AP was found as the “pathways in cancer” by PCA and KEGG ( P < .01). The core biological processes of (BP) (CR-CXR)-AP, (CR-ADR)-AP, and (CR-AR)-AP were all enriched in the “circulatory system process” by PCA and GO ( P < .01). Moreover, meta-analysis indicated the significant differences ( P < .05) of the 3 drug pairs. Conclusion: CR-CXR, CR-ADR, or CR-AR outperformed CR-AP in AP mitigation. Furthermore, meta-analysis revealed, CR-CXR was superior to alleviating AP by affecting “circulatory system process” and “fluid shear stress and atherosclerosis”, particularly the targets PTGS1, PTGS2, ADRB2, ADRA2C, and NOS, when compared with the drug pair of CR-ADR and the CR-AR.
Histological and Radiological Assessment of Endogenously Generated Repair Tissue In Vivo Following a Chondral Harvest
Authors: McCarthy Helen S. , Tins Bernhard , Gallacher Peter D. , Jermin Paul , Richardson James B. , Kuiper Jan Herman , Roberts Sally
Published: January 2023

Objective

To examine repair tissue formed approximately 15 months after a chondral harvest in the human knee.

Design

Sixteen individuals (12 males, 4 females, mean age 36 ± 9 years) underwent a chondral harvest in the trochlea as a pre-requisite for autologous chondrocyte implantation (ACI) treatment. The harvest site was assessed via MRI at 14.3 ± 3.2 months and arthroscopy at 15 ± 3.5 months (using the Oswestry Arthroscopy Score [O-AS] and the International Cartilage Repair Society Arthroscopy Score [ICRS-AS]). Core biopsies (1.8 mm diameter, n = 16) of repair tissue obtained at arthroscopy were assessed histologically (using the ICRS II and OsScore histology scores) and examined via immunohistochemistry for the presence of collagen types I and II.

Results

The mean O-AS and ICRS-AS of the repaired harvest sites were 7.2 ± 3.2 and 10.1 ± 3.5, respectively, with 80.3% ± 26% repair fill depth on MRI. The histological quality of the repair tissue formed was variable, with some hyaline cartilage present in 50% of the biopsies; where this occurred, it was associated with a significantly higher ICRS-AS than those with no hyaline cartilage present (median 11 vs. 7.5, P = 0.049). Collagen types I and II were detected in 12/14 and 10/13 biopsies, respectively.

Conclusions

We demonstrate good-quality structural repair tissue formed following cartilage harvest in ACI, suggesting this site can be useful to study endogenous cartilage repair in humans. The trochlea is less commonly affected by osteoarthritis; therefore, location may be critical for spontaneous repair. Understanding the mechanisms and factors influencing this could improve future treatments for cartilage defects.
Transvenous onyx embolization of a direct carotid-cavernous fistula via the prevertebral vein at the level of the atlanto-occipital membrane: Technical note
Authors: Zhang Huachen , Ye Zhongyin , Lv Xianli
Published: January 2023

The inferior petrosal sinus (IPS) is the most commonly used transvenous approach to obliterate the carotid-cavernous fistula (CCF). We presented a case of direct CCF was successfully embolized through contralateral jugular vein via the prevertebral vein at the level of the atlanto-occipital membrane. Because of the confluence of the caudal end of the IPS and the prevertebral vein at the medial side of the hypoglossal canal, the transvenous route through the ipsilateral jugular vein was failed. Transcirculation approach via the prevertebral vein at the level of the atlanto-occipital membrane seems to be the choice when venous access is available.
Inheritance and innovation of the diagnosis of peripheral pulmonary lesions
Authors: Xia Yang , Li Qin , Zhong Changgao , Wang Kopen , Li Shiyue
Published: January 2023

As the leading cause of cancer-related deaths worldwide, early detection and diagnosis are crucial to reduce the mortality of lung cancer. To date, the diagnosis of the peripheral pulmonary lesions (PPLs) remains a major unmet clinical need. The urgency of diagnosing PPLs has driven a series of development of the advanced bronchoscopy-guided techniques in the past decades, such as radial probe-endobronchial ultrasonography (RP-EBUS), virtual bronchoscopy navigation (VBN), electromagnetic navigation bronchoscopy (ENB), bronchoscopic transparenchymal nodule access (BTPNA), and robotic-assisted bronchoscopy. However, these techniques also have their own limitations. In this review, we would like to introduce the development of diagnostic techniques for PPLs, with a special focus on biopsy approaches and advanced guided bronchoscopy techniques by discussing their advantages, limitations, and future prospects.
Estradiol-17β [E2] stimulates wound healing in a 3D in vitro tissue-engineered vaginal wound model
Authors: Shafaat Sarah , Roman Regueros Sabiniano , Chapple Christopher , MacNeil Sheila , Hearnden Vanessa
Published: January 2023

Childbirth contributes to common pelvic floor problems requiring reconstructive surgery in postmenopausal women. Our aim was to develop a tissue-engineered vaginal wound model to investigate wound healing and the contribution of estradiol to pelvic tissue repair. Partial thickness scalpel wounds were made in tissue models based on decellularized sheep vaginal matrices cultured with primary sheep vaginal epithelial cells and fibroblasts. Models were cultured at an airliquid interface (ALI) for 3 weeks with and without estradiol-17β [E2]. Results showed that E2 significantly increased wound healing and epithelial maturation. Also, E2 led to collagen reorganization after only 14 days with collagen fibers more regularly aligned and compactly arranged Additionally, E2 significantly downregulated α-SMA expression which is involved in fibrotic tissue formation. This model allows one to investigate multiple steps in vaginal wound healing and could be a useful tool in developing therapies for improved tissue healing after reconstructive pelvic floor surgery.
What planners can learn from geography or what geographers have overlooked about planning
Authors: Hickman Hannah
Published: January 2023

As fields equally concerned with the production of space and place, geographers and planners are engaged in understanding the compact city both as a concept and as a built and lived reality. In response to Haarstad et al.'s renewed agenda for research on compact urbanism, this comment piece seeks to shift their perception of planning and planners as being narrowly focused on urban form, to a more fulsome understanding of planning's contribution.
Mobilizing care? WeChat for older adults’ digital kinship and informal care in Wuhan households
Authors: Yu Haiqing , Zhang Ge , Hjorth Larissa
Published: January 2023

The COVID-19 pandemic saw the digital amplify all aspects of our lives—work, sociality, health, intimacy, care, and inequality. In a time of restrictions and physical distancing, the role of the digital for social inclusion—especially for older adults—was heightened with many having to care at a distance. Our study focuses on older adults from Wuhan and the role of the dominant social media app, WeChat, for intergenerational informal care through digital literacy during and after the pandemic. Often characterized in global media as the place where the virus began, many of the quotidian experiences of Wuhan people have been overlooked. We reflect upon ethnographic fieldwork conducted in Wuhan in 2020–2021 with 10 households. We are particularly interested in how kinship care practices in Wuhan households—as sites for complex configurations of intergenerational practices that converge digital, social, and material worlds—have shifted during the pandemic. We ask: what are the learnings, opportunities and limitations around smartphone apps like WeChat for informal care as part of filial piety? In sum, what are the possibilities and limitations for mobilizing care?
An automated, web-based triage tool may optimise referral pathways in elective orthopaedic surgery: A proof-of-concept study
Authors: Stanley Alexandra L. , Edwards Thomas C. , Jaere Martin D. , Lex Johnathan R. , Jones Gareth G.
Published: January 2023

Introduction

Knee pain is caused by various pathologies, making evaluation in primary-care challenging. Subsequently, an over-reliance on imaging, such as radiographs and MRI exists. Electronic-triage tools represent an innovative solution to this problem. The aims of this study were to establish the magnitude of unnecessary knee imaging prior to orthopaedic surgeon referral, and ascertain whether an e-triage tool outperforms existing clinical pathways to recommend correct imaging.

Methods

Patients ≥18 years presenting with knee pain treated with arthroscopy or arthroplasty at a single academic hospital between 2015 and 2020 were retrospectively identified. The timing and appropriateness of imaging were assessed according to national guidelines, and classified as ‘necessary’, ‘unnecessary’ or ‘required MRI’. Based on an eDelphi consensus study, a symptom-based e-triage tool was developed and piloted to preliminarily diagnose five common knee pathologies and suggest appropriate imaging.

Results

1462 patients were identified. 17.2% ( n = 132) of arthroplasty patients received an ‘unnecessary MRI’, 27.6% ( n = 192) of arthroscopy patients did not have a ‘necessary MRI’, requiring follow-up. Forty-one patients trialled the e-triage pilot (mean age: 58.4 years, 58.5% female). Preliminary diagnoses were available for 33 patients. The e-triage tool correctly identified three of the four knee pathologies (one pathology did not present). 79.2% ( n = 19) of participants would use the tool again.

Conclusion

A substantial number of knee pain patients receive incorrect imaging, incurring delays and unnecessary costs. A symptom-based e-triage tool was developed, with promising performance and user feedback. With refinement using larger datasets, this tool has the potential to improve wait-times, referral quality and reduce cost.
Driving time-based identification of gaps in specialised care coverage: An example of neuroinflammatory diseases in Germany
Authors: Masanneck Lars , Räuber Saskia , Schroeter Christina B , Lehnerer Sophie , Ziemssen Tjalf , Ruck Tobias , Meuth Sven G. , Pawlitzki Marc
Published: January 2023

Objective

Due to the growing complexity in monitoring and treatment of many disorders, disease-specific care and research networks offer patients certified healthcare. However, the networks’ ability to provide health services close to patients’ homes usually remains vague. Digital Health Technologies (DHTs) help to provide better care, especially if implemented in a targeted manner in regions undersupplied by specialised networks. Therefore, we used a car travel time-based isochrone approach to identify care gaps using the example of the neuroinflammation-focused German healthcare and research networks for multiple sclerosis (MS), myasthenia gravis (MG), myositis and immune-mediated neuropathy.

Methods

Excellence centres were mapped, and isochrones for 30, 60, 90 and 120 minutes were calculated. The resulting geometric figures were aggregated and used to mask the global human settlement population grid 2019 to estimate German inhabitants that can reach centres within the given periods.

Results

While 96.48% of Germans can drive to an MS-focused centre within one hour, coverage is lower for the rare disease networks for MG (48.3%), myositis (43.1%) and immune-mediated neuropathy (56.7%). Within 120 minutes, more than 80% of Germans can reach a centre of any network. Besides the generally worse covered rural regions such as North-Eastern Germany, the rare disease networks also show network-specific regional underrepresentation.

Conclusion

An isochrone-based approach helps identify regions where specialised care is hard to reach, which might be especially troublesome in the case of an often disabled patient collective. Patient care could be improved by focusing deployments of disease-specific DHTs on these areas.
Prevalence and determinants of self-medication practices among general population: A cross-sectional study in Thimphu, Bhutan and Chattogram, Bangladesh
Authors: Saha Ayan , Zam Dawa , Khan Ayesha Ahmed , Dutta Preya , Mannan Adnan , Alam Nazmul
Published: January 2023

Background:

Self-medication is a global phenomenon and a potential contributor to negative health consequences on human health including emergence of antibiotic drug resistance globally.

Objective:

The primary objective of this study was to estimate the prevalence and determinants of self-medication in Thimphu, Bhutan and Chattogram, Bangladesh, two neighbouring South Asian country.

Methodology:

A community-based cross-sectional study was conducted in the city of Thimphu, Bhutan and Chattogram, Bangladesh. A pre-tested and semi-structured questionnaire was used to collect information on socio-demographic characteristics, health status and self-medication practices in the previous year.

Results:

Out of the 998 recruited participants, 61.8% (170/275) from Thimphu and 41.5% (300/723) from Chattogram reported self-medication practices in last year of interview. In Thimphu, eye/ear infection (90.9%), fever (84.9%), headache (80.5%) and cough and cold (78.2%) were the major illnesses reported for self-medication, whereas in Chattogram people mostly self-medicated for skin disorder (74.4%), diarrhoeal illness (59.1%) and eye/ear infection (48.1%). Knowledge on side-effects of the drugs taken for self-medication was comparatively higher in Thimphu than in Chattogram. Both in Thimphu and Chattogram, higher odds of self-medication were found for common illnesses with adjusted OR 7.8; 95% CI 3.3–18.4 and adjusted OR 2.0; 95% CI 1.4–2.8, respectively in Thimphu and Chattogram.

Conclusion:

Self-medication was found to be substantially high in both the cities, however, rate of self-medication was higher in Thimphu compared to Chattogram. Knowledge and awareness raising about harmful effect of self-medication and effective regulation over selling of prescription medication in pharmacies should be strengthened in both countries.
Similar Biomechanics Between the Double–Cortical Button and Docking Techniques for Ulnar Collateral Ligament Reconstruction: A Cadaveric Evaluation
Authors: Huffman George Russell , Piper Christine , Gupta Richa , Hast Michael W.
Published: January 2023

Background:

The docking technique is widely used to perform ulnar collateral ligament (UCL) reconstructions because of its high failure torque and reliable clinical outcomes. A double–cortical button technique was recently described, with advantages including the ability to tension the graft at the ulnar and humeral attachments and the creation of single bone tunnels.

Purpose/Hypothesis:

To compare the biomechanics between the docking and double-button UCL reconstruction techniques using cadaveric specimens. We hypothesized that there would be no difference in postoperative stiffness or maximum strength between the techniques.

Study Design:

Controlled laboratory study.

Methods:

Eight matched pairs of cadaveric elbow joints underwent controlled humeral valgus torsion cycles in a test frame. Toe region stiffness, elastic region stiffness, and maximum torque were measured during a 4-step protocol: intact, injured, reconstructed (10 and 1000 cycles), and ramp to failure. Graft strains were calculated using 3-dimensional motion capture.

Results:

After 10 cycles, intact ligaments from the docking and double-button groups exhibited mean ± SD elastic torsional stiffness of 1.60 ± 0.49 and 1.64 ± 0.35 N·m/deg ( P = .827), while docking (1.10 ± 0.39 N·m/deg) and double-button (1.05 ± 0.29 N·m/deg) reconstructions were lower ( P = .754). There were no significant differences in maximum torque between the docking (3.45 ± 1.35 N·m) and double-button (3.25 ± 1.31 N·m) groups ( P = .777). Similarly, differences in maximum graft strains were not significant between the docking (8.1% ± 7.2%) and double-button (5.5% ± 3.1%) groups ( P = .645). The groups demonstrated similar decreases in these measures after cyclic loading. Ramp-to-failure testing showed no significant differences in ultimate torque between the docking (8.93 ± 3.9 N·m) and double-button (9.56 ± 3.5 N·m) groups ( P = .739).

Conclusion:

The biomechanical behavior of the double-button technique was not significantly different from that of the docking technique. Both reconstruction techniques restored joint stability, but neither fully recapitulated preinjury joint stiffness.

Clinical Relevance:

With its procedural advantages, results preliminarily support the use of the double-button reconstruction technique for UCL reconstruction as a reliable single-tunnel technique for primary or revision cases.
Rhythmic mid-Temporal Theta of Drowsiness Activated by Hyperventilation- Uncommon Trigger of a Rare Benign EEG Variant in Pediatrics. An Educational Review
Authors: Asemota Brooke , Dohmeier Jacob M. , Singh Nupur , Gienapp Andrew J. , Rivas-Coppola Marianna , Chourasia Nitish
Published: January 2023

Distinguishing abnormal electroencephalogram (EEG) waveforms from benign variants is critical for accurate interpretation of EEG. Hyperventilation (HV) is one of the basic procedures during EEG to enable activation of epileptiform activity. Rarely, HV can activate benign EEG rhythms. Herein, we illustrate two pediatric cases with bursts of rhythmic mid-temporal theta of drowsiness (RMTD), activated by hyperventilation. Continued awareness of this EEG phenomenology and its variations in pediatrics is important in avoiding misdiagnosis of epilepsy.
The Role of Entrepreneurial Universities in Developing Students’ Awareness and Improving Post-Graduation Entrepreneurship Circumstances
Authors: Bahrami Ziba , Ebrahimi Mohammad Sadegh , Khedri Gholamhossein , Azadi Hossein
Published: January 2023

Graduate recruitment is one of the issues that have always been of interest to educational planners in different countries and the educational system of countries is no exception. Today, developed and developing countries have offered entrepreneurship courses to overcome the challenges of job search. In other words, the solution to these problems should be sought in entrepreneurship skills. The main aim of this research is to examine the role of entrepreneurial universities in the development of entrepreneurship in society, which will eventually lead to sustainable development. This study follows a quantitative methodology by using a self-administered questionnaire. This research’s statistical population consists of postgraduate and undergraduate students who have finished at least two academic years of study. The KMO coefficient and Bartlett’s test were used to establish the questionnaire’s content validity, while Cronbach’s alpha coefficient was used to check its reliability, revealing that the instruments were consistent at 91%. Descriptive and inferential statistics including frequency, mean, Kruskal test, Mann–Whitney test, Pearson correlation coefficient and regression were used to analyze the data. The findings of the correlation study showed that there is a significant relationship between university entrepreneurship factors and university-level awareness of entrepreneurial activities. Furthermore, the results of regression analysis showed that the dependent variable of the entrepreneurial awareness of students was dependent on variables such as the characteristics of the entrepreneurial university, parents’ income, personal awareness of students and communication channels.
Book Review: Renny Thomas, Science and Religion in India: Beyond Disenchantment
Authors: Secco Victor
Published: January 2023

Renny Thomas, Science and Religion in India: Beyond Disenchantment. London: Routledge, 2022, 214 pp., ₹12,090, ISBN 9781032073194.
Book Review: Ritajyoti Bandyopadhyay, Streets in Motion: The Making of Infrastructure, Property, and Political Culture in Twentieth-Century Calcutta
Authors: Ghosh Ujaan
Published: January 2023

Ritajyoti Bandyopadhyay, Streets in Motion: The Making of Infrastructure, Property, and Political Culture in Twentieth-Century Calcutta. Cambridge: Cambridge University Press, 2022, 305 pp., ₹896.95, ISBN: 978-1-009-10011-3.
Identification of Independent Predictors of Increased 90-Day Complication and Revision Rates Following Total Elbow Arthroplasty
Authors: Kunkle Bryce F , Baxter Nicholas A , Welsh Megan E , Friedman Richard J , Eichinger Josef K
Published: January 2023

Introduction

Total elbow arthroplasty (TEA) is an increasingly popular surgical option for many debilitating conditions of the elbow. There currently exists a paucity of literature regarding patient and hospital factors that lead to inferior outcomes following TEA. The purpose of this study is to identify independent predictors of increased complication and revision rates following TEA.

Methods

The National Readmissions Database (NRD) was queried from 2011 to 2018 to identify all cases of TEA (n = 8932). Relevant patient demographic factors, comorbidities, and hospital characteristics were identified and run in a univariate binomial logistic regression model. All significant variables were included in a multivariate binomial logistic regression model for data analysis.

Results

Independent predictors of increased complication rates included age, female sex, Medicare and Medicaid payer status, medium bed-sized center, and 18 of 34 medical comorbidities (all P < .05). Independent predictors of increased revision rates included medium bed-sized centers, non-teaching hospital status, chronic pulmonary disease, depression, and pulmonary circulatory disorders (all P < .05).

Conclusion

This study identified several patient and hospital characteristics that are independently associated with both increased complication and revision rates following TEA. This information can aid orthopedic surgeons during shared decision making when considering TEA in patients.

Level of Evidence

Level III, retrospective cohort study.
To eat or to learn? Wagering the price tag of learning: Zero cost textbook degree
Authors: Correa Elaine , Bozarth Sandra
Published: January 2023

The escalating costs that are associated with earning an undergraduate degree often force students to make difficult choices regarding whether they can afford the financial costs to remain in school. Our students encounter many economic challenges and hardships as they attempted to earn a degree. We believe that required textbook costs for courses should not hinder student learning or be the obstacle that prevents students from completing their courses and graduating. For many students, textbook affordability is a pressing retention need. If the choice that students need to make is deciding on whether they can afford to pay the rent, purchase food for the month, or buy a textbook, the probability of investing in a textbook is slim at best. Within the context of this paper, we discuss the challenges and opportunities that emerge in the California State University system, when moving from traditional high-priced textbooks to low or no cost Open Educational Resources for university course offerings that can reduce the financial burden on students and potentially increase retention to graduation rates.
A cell-based functional assay that accurately links genotype to phenotype in Familial HLH
Authors: Noori Tahereh , Rudd-Schmidt Jesse Alexander , Kane Alisa , Frith Katie , Gray Paul E , Hu Hannah , Hsu Danny , Chung Clara W.T. , Hodel Adrian W , Trapani Joseph A. , Voskoboinik Ilia
Published: January 2023

Familial forms of the severe immunoregulatory disease Haemophagocytic Lymphohistiocytosis (HLH) arise from bi-allelic mutations in the PRF1, UNC13D, STXBP2 and STX11 genes. Early and accurate diagnosis of the disease is important to determine the most appropriate treatment option, including potentially curative stem cell transplantation. The diagnosis of familial HLH (FHL) is traditionally based on finding bi-allelic mutations in patients with HLH symptoms and reduced natural killer (NK) cell cytotoxicity. However, patients often have a low NK cell count or receive immunosuppressive therapies that may render the NK cytotoxicity assay unreliable. Furthermore, to fully understand the nature of a disease it is critical to directly assess the effect of mutations on cellular function; this will help to avoid instances where carriers of innocuous mutations may be recommended for invasive procedures including transplantation. To overcome this diagnostic problem, we have developed a rapid and robust method that takes advantage of the functional equivalence of the human and mouse orthologues of PRF1, UNC13D, STX11 and STXBP2 proteins. By knocking out endogenous mouse genes in CD8+ T cells and simultaneously replacing them with their mutated human orthologues, we can accurately assess the effect of mutations on cell function. The wide dynamic range of this novel system allowed us to understand the basis of otherwise cryptic cases of FHL/HLH and, in some instances, to demonstrate that previously reported mutations are unlikely to cause FHL. This novel approach provides valuable new information to enable more accurate diagnosis and treatment of HLH/FHL patients who inherit mutations of undetermined pathogenicity.
Detecting genomic deletions from high-throughput sequence data with unsupervised learning
Authors: Li Xin , Wu Yufeng
Published: January 2023

Background

Structural variation (SV), which ranges from 50 bp to $$\sim$$
∼
 3 Mb in size, is an important type of genetic variations. Deletion is a type of SV in which a part of a chromosome or a sequence of DNA is lost during DNA replication. Three types of signals, including discordant read-pairs, reads depth and split reads, are commonly used for SV detection from high-throughput sequence data. Many tools have been developed for detecting SVs by using one or multiple of these signals.

Results

In this paper, we develop a new method called EigenDel for detecting the germline submicroscopic genomic deletions. EigenDel first takes advantage of discordant read-pairs and clipped reads to get initial deletion candidates, and then it clusters similar candidates by using unsupervised learning methods. After that, EigenDel uses a carefully designed approach for calling true deletions from each cluster. We conduct various experiments to evaluate the performance of EigenDel on low coverage sequence data.

Conclusions

Our results show that EigenDel outperforms other major methods in terms of improving capability of balancing accuracy and sensitivity as well as reducing bias. EigenDel can be downloaded from https://github.com/lxwgcool/EigenDel.
Multiple variation patterns of terpene synthases in 26 maize genomes
Authors: Sun Yang , Xiao Wenqing , Wang Qing-nan , Wang Jing , Kong Xiang-dong , Ma Wen-hui , Liu Si-xian , Ren Ping , Xu Li-na , Zhang Yong-Jun
Published: January 2023

Terpenoids are important compounds associated with the pest and herbivore resistance mechanisms of plants; consequently, it is essential to identify and explore terpene synthase (TPS) genes in maize. In the present study, we identified 31 TPS genes based on a pan-genome of 26 high-quality maize genomes containing 20 core genes (present in all 26 lines), seven dispensable genes (present in 2 to 23 lines), three near-core genes (present in 24 to 25 lines), and one private gene (present in only 1 line). Evaluation of ka/ks values of TPS in 26 varieties revealed that TPS25 was subjected to positive selection in some varieties. Six ZmTPS had ka/ks values less than 1, indicating that they were subjected to purifying selection. In 26 genomes, significant differences were observed in ZmTPS25 expression between genes affected by structural variation (SV) and those not affected by SV. In some varieties, SV altered the conserved structural domains resulting in a considerable number of atypical genes. The analysis of RNA-seq data of maize Ostrinia furnacalis feeding revealed 10 differentially expressed ZmTPS, 9 of which were core genes. However, many atypical genes for these responsive genes were identified in several genomes. These findings provide a novel resource for functional studies of ZmTPS.
Frailty trajectories and associated factors in the years prior to death: evidence from 14 countries in the Survey of Health, Aging and Retirement in Europe
Authors: Jenkins Natalie D. , Welstead Miles , Stirland Lucy , Hoogendijk Emiel O. , Armstrong Joshua J. , Robitaille Annie , Muniz-Terrera Graciela
Published: January 2023

Background

Age-related changes in frailty have been documented in the literature. However, the evidence regarding changes in frailty prior to death is scarce. Understanding patterns of frailty progression as individuals approach death could inform care and potentially lead to interventions to improve individual’s well-being at the end of life. In this paper, we estimate the progression of frailty in the years prior to death.

Methods

Using data from 8,317 deceased participants of the Survey of Health, Ageing, and Retirement in Europe, we derived a 56-item Frailty Index. In a coordinated analysis of repeated measures of the frailty index in 14 countries, we fitted growth curve models to estimate trajectories of frailty as a function of distance to death controlling both the level and rate of frailty progression for age, sex, years to death and dementia diagnosis.

Results

Across all countries, frailty before death progressed linearly. In 12 of the 14 countries included in our analyses, women had higher levels of frailty close to the time of death, although they progressed at a slower rate than men (e.g. Switzerland (-0.008, SE = 0.003) and Spain (-0.004, SE = 0.002)). Older age at the time of death and incident dementia were associated with higher levels and increased rate of change in frailty, whilst higher education was associated with lower levels of frailty in the year preceding death (e.g. Denmark (0.000, SE = 0.001)).

Conclusion

The progression of frailty before death was linear. Our results suggest that interventions aimed at slowing frailty progression may need to be different for men and women. Further longitudinal research on individual patterns and changes of frailty is warranted to support the development of personalized care pathways at the end of life.