bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy, Adverse Events, and Challenges of Dienogest in the Management of Symptomatic Adenomyosis: A Comparison with Different Hormonal Treatments
Authors: Kobayashi Hiroshi
Published: January 2023

Background: Adenomyosis is an estrogen-dependent gynecologic condition that can cause pain symptoms, heavy menstrual bleeding, and infertility. Several treatments, including hormonal therapy, can improve patients’ quality of life through alleviating symptoms. Dienogest (DNG), a 19-norsteroid derivative oral progestin, is a promising treatment option for adenomyosis. Objectives: This review aims to summarize the clinical outcomes (efficacy and adverse events) of DNG treatment for symptomatic adenomyosis compared with other hormonal treatments, discuss the mechanism underlying adverse events, and identify future challenges. Methods: A literature search was performed across the PubMed and Google Scholar databases up to March 2022 to identify relevant literature. Outcome: Out of 449 identified records, 37 articles met the inclusion and exclusion criteria. Five prospective and three retrospective studies showed that DNG and other hormonal agents had similar efficacy for pain relief; however, the most common adverse event of DNG was abnormal uterine bleeding. Specific demographic and clinicopathologic characteristics have been identified as associated with an increased risk of bleeding. Several factors, such as diffuse or type 1 adenomyosis, advanced reproductive age, severe dysmenorrhea, elevated serum CA125 levels, or low hemoglobin levels, may be implicated in bleeding risk; however, there is no accurate and reliable parameter. Future challenges with the widespread use of DNG include validation of candidate risk indicators and approaches to treat diffuse or type 1 adenomyosis. Conclusions and Outlook: DNG represents an important therapeutic option to be included in the treatment algorithm for adenomyosis owing to sufficient pain relief, despite high rates of bleeding-related adverse events. Clinicians should consider an individual’s potential risk factors for bleeding until high-quality evidence is available.
Patient Satisfaction on Services Rendered by Malasakit Center in Amang Rodriguez Memorial Medical Center
Authors: Habon Mary Apple F. , Jamandre Ma. Venessa B. , Malco RRexy T. , Vigonte Florinda G. , Malang Bernandino P. , Abante Marmelo V.
Published: January 2023

This study was carried out to determine the level of patient satisfaction with the services rendered by the Malasakit Center in Amang Rodriguez Memorial Medical Center. It aimed to identify the service frequently requested by the patient and/or their representative and its frequency, as well as the level of satisfaction. This study employed descriptive research to describe the nature of the situation that existed in the study together with a survey questionnaire as the research instrument tool. The 125 respondents were selected through convenience sampling. The findings of this study revealed that most of the patients and their representatives’ access Malasakit centers with the query on the document requirement. Eight other services were also sought from the Malasakit Center such as medical help/aid, follow up and status of the documents submitted. These services were rated with a high level of satisfaction with a weighted mean rating of 3.84. The study concluded that various services were accessed by the patients and/or patients' representatives. The patients' and/or patients' representatives' degree of satisfaction with the service of the Malasakit Center at the Amang Rodriguez Memorial Medical Center is extremely high or highly satisfactory. The health practitioners will be educated and equipped to handle the services provided by the Malasakit Center as a result of these measures.
Project DESMOS: Development and Evaluation of Self-directed Module in Statistics and Probability
Authors: Sagge Roberto Jr. , Espiritu Evarose E.
Published: January 2023

Learning is weak not because learning is weak. Learning becomes weak because the modules were not prepared to become self-directed. The goal of this design and development project was to create a self-directed statistics and probability instructional module. Data were gathered from teachers, learners, and experts. The data-gathering instruments were Competency Checklist, Students’ and Experts’ Evaluation Checklist, and Reflection Guide. According on teacher perceptions, a survey of the learners' five least-mastered competencies served as the foundation for the development of the module. This module was pilot tested on a group of Grade 11 learners. Learners utilized the module at home and were asked to answer the exercises. Learners took pictures and short videos while they were answering the module. Afterward, learners evaluated the module. In order to assess the module's level of acceptability, experts were requested to complete the Expert's Evaluation Checklist. Thematic analysis, rank, the mean, and standard deviation were all used as data analysis tools. The results show that the following were the five least-mastered competencies: solving problems involving confidence interval of the population mean, solving problems involving regression analysis, solving problems involving sample size determination, solving problems that require population proportion test of hypothesis, and solving problems involving correlation analysis. Additionally, the experts rated the produced module's acceptability as "highly acceptable." While the learners gave the module a "highly acceptable" rating. As a result, the developed module is appropriate for assisting learners in performing the competencies in the area of Statistics and Probability. It is recommended that teachers should use the Self-directed instructional module for whatever mode of learning their school will have.
Social Media as A Tool for Direct Selling Business in Dipolog City, Zambo-anga Del Norte
Authors: Soledad Emerald A.
Published: January 2023

The presence of social media has disrupted the way people live, behave and interact. Philippines is ranked number one as active social media users with an average of 4.17 hours per day. Direct selling businesses in the country continue grow each year, and have introduced new products and expanded new customer reach. With this information presented, the right use of social media will help direct selling businesses reach a well-engaged community of buyers. The research aims to develop relevant marketing strategies to promote the use of social media in direct selling. Descriptive research was being utilized with two sets of researcher-made questionnaires. A pre-survey activity was performed prior to the actual data gathering to validate the reliability of the survey tool. There were one hundred twenty (120) total respondents: comprised of one-hundred (100) direct selling customers and twenty (20) direct sellers, who participated in the data gathering process. Furthermore, the study will use frequencies, percentages, and weighted means for the data treatment. The findings of the study show that Facebook, Twitter, Instagram, and YouTube are the most widely used channels among the respondents of the study. The extent of social media usage by the direct sellers is moderate and social networking site is the most preferred platform to use in doing direct selling-related activities to achieve convenience, productivity, product availability and market growth. Therefore, it can be concluded that social media can be a strategic tool for direct selling business in Dipolog City, Zamboanga del Norte, Philippines.
Market Demand and Interest Profiling of Cebu Institute of Technology - University Students at The Onset of Online Learning
Authors: Polinar Mark Anthony N. , Diano Rafaeliza P. , Navares Alein B. , Rago Erlyn Ivy O.
Published: January 2023

This research was undertaken to understand the customer segments of the Cebu Institute of Technology- University using demographic, geographic, and socio-economic lenses. At the same time, this study also determined the students' technological capacity, technical capability, and willingness to enroll in the University's second summer term of 2020. The study used a descriptive research method to obtain data from 2,133 college students as the respondents using random sampling. Based on data gathered from the six colleges of the University, from first- to fifth-year levels, the closure of schools led them to go back to their provinces, resulting in the geographic distribution of respondents, with 48% situated outside of Cebu City. Moreover, one of the most significant impacts of the pandemic is the decline of combined household income from a mean of P34, 591.22 pre-pandemic to P23,923.85 during the pandemic when community quarantines were still enforced. Additionally, 72% of respondents have limited to moderate internet connectivity, sourced majorly from mobile data at 66% and personal or family-owned Wi-Fi at 50%. Widely used devices used at home were mobile phones at 97% and laptop computers at 56%. Recommendations included providing financial support through university-based and third-party programs and conducting marketing initiatives targeting the higher-income class to cushion the global economic crisis's negative financial impact.
Employees Work Engagement: Correlations with Employee Personal Characteristics, Organizational Commitment and Workplace Happiness
Authors: Tugade Guinevere Yvonne G. , Arcinas Myla M.
Published: January 2023

Using data collected from 76 employees of a manufacturing company in Manila, Philippines, this study conducted a correlation analysis to determine the relationship between the level of their engagement at work and their personal characteristics, organizational commitment in the workplace, and job satisfaction. A self-administered structured survey questionnaire was use in the survey. The collected data was analyzed using descriptive statistics to determine the mean scores, frequencies, and percentages, and parametric inferential statistics were employed to examine the correlations between variables. The results indicate a high level of employee work engagement and job satisfaction, as well as a moderate level of employee organizational commitment. Employee age, position and monthly salary were significantly correlated with employee work engagement. The level of employee engagement increases with age, position and income. Results also revealed a significant and strong positive correlation between the level of employee engagement and employee happiness at work. Implications for practices are offered.
Health Information System Users in Public Health Facilities: A Descriptive Analytics
Authors: Cortez Joey Ernehst M. , Ishii Jorge Kenneth G. , Ongkiko Angelica Mae R. , Ortega Clinton R. , Malang Bernandino P. , Vigonte Florinda G.
Published: January 2023

Health Information Systems (HIS) are vital in making or developing the policies of health programs in the Philippines. The HIS is broadly defined as a system that integrates data collection, processing, reporting, and use of the information necessary for improving health service effectiveness and efficiency through better management at all levels of health services. This study is conducted to visualize the current situation of the health information system users in public health facilities in the Province of Bataan. It endeavors to answer on how the health facilities in the Province are described based on their report platform, the number of personnel, trained and untrained per facility, and the needs of the facilities when it comes to the training of the encoders. The researchers used the descriptive method specifically the Dashboarding, Analysis, and Reporting or DAR method for this study. This study focused on the data gathered from the Health Information Systems Assessment Tool. The assessment was conducted with 24 different health facilities in the Province of Bataan. The study revealed that 14 out of 24 (58%) of the Rural Health Units (RHUs) in the Province of Bataan used paper-based reporting while 10 out of 24 (42%) of the RHUs used a health information system. Twenty one out of 48 encoders (44%) are untrained while 27 out of 48 (56%) are trained. Capability training in each health information system used is proposed. In conclusion, the Province of Bataan is supporting the implementation of the use of health information systems (HIS) by designating encoders for every public health facility.
Teaching Styles and Teaching Performance of the Faculty of A University in Cebu City: Basis for A Faculty Development Program
Authors: Narisco Lalaine O. , Narsico Peter G. , Polinar Mark Anthony N.
Published: January 2023

Teachers must be relevant in their teaching style to respond effectively to the challenges brought about by environmental changes. This study measured how well the teachers could utilize various styles and methods to create meaningful teaching-learning experiences. This study determined the gap between the full use of styles, methods, and the current practices in the university in Cebu City to bridge the current practices with what is perceived to be ideal. The research design made use of the quantitative method. Using a stratified sampling technique, the data were collected from 2,683 respondents through questionnaires for teaching styles and teaching performance. The respondents came in three clusters: namely, teachers, students, and administrators in six colleges. Based on the findings, the various teaching styles ranged from being practiced often to being always practiced, and their teaching performance ranged from very good to excellent. A seminar-workshop was proposed to improve the areas of teaching styles and teaching performance with the lowest ratings. In the seminar, teachers will be introduced to the core principles related to the topics and will engage in activities designed for principle integration in actual classroom situations. Furthermore, periodic 360-degree performance evaluations shall be conducted to ensure adherence and compliance with the agreed core principles.
Climate Impacts of Convective Cloud Microphysics in NCAR CAM5
Authors: Lin Lin , Liu Xiaohong , Fu Qiang , Shan Yunpeng
Published: January 2023

We improved the treatments of convective cloud microphysics in the NCAR Community Atmosphere Model version 5.3 (CAM5.3) by 1) implementing new terminal velocity parameterizations for convective ice and snow particles, 2) adding graupel microphysics, 3) considering convective snow detrainment, and 4) enhancing rain initiation and generation rate in warm clouds. We evaluated the impacts of improved microphysics on simulated global climate, focusing on simulated cloud radiative forcing, graupel microphysics, convective cloud ice amount, and tropical precipitation. Compared to CAM5.3 with the default convective microphysics, the too-strong cloud shortwave radiative forcing due primarily to excessive convective cloud liquid is largely alleviated over the tropics and midlatitudes after rain initiation and generation rate is enhanced, in better agreement with the CERES-EBAF estimates. Geographic distributions of graupel occurrence are reasonably simulated over continents; whereas the graupel occurrence remains highly uncertain over the oceanic storm-track regions. When evaluated against the CloudSat–CALIPSO estimates, the overestimation of convective ice mass is alleviated with the improved convective ice microphysics, among which adding graupel microphysics and the accompanying increase in hydrometeor fall speed play the most important role. The probability distribution function (PDF) of rainfall intensity is sensitive to warm rain processes in convective clouds, and enhancement in warm rain production shifts the PDF toward heavier precipitation, which agrees better with the TRMM observations. Common biases of overestimating the light rain frequency and underestimating the heavy rain frequency in GCMs are mitigated.
Efficacy and accuracy of faecal sampling by a digital rectal examination for faecal immunochemical testing
Authors: Maclean William , Benton Sally C , Whyte Martin B , Rockall Timothy , Jourdan Iain
Published: January 2023

Aim

A digital rectal examination (DRE) during routine assessment for patients with abdominal symptoms provides an opportunity to obtain faeces from the glove for faecal immunochemical testing (FIT). Here, we compared sampling via DRE to the standard faecal sampling by patients.

Method

Patients were recruited to a prospective observational cohort study between July 2019 and March 2020. Patients provided a sample for the FOB Gold Wide® which was compared to a further sample taken at clinic via DRE. Clinicians reported whether they obtained a ‘good’ sample filling all the grooves, a ‘poor’ sample filling some of the grooves or no faecal sample. Cohen’s kappa was used to compare percentage agreement around a negative threshold of <10 μg haemoglobin/g of faeces. Sensitivity for serious bowel disease (SBD) was calculated.

Results

Of 596 patients who underwent attempted DRE sampling, there were 258 (43.3%) ‘good’ samples, 117 (19.6%) ‘poor’ samples and 221 (37.1%) with no sample to wipe in the grooves. Cohen’s kappa dropped from 0.70 to 0.30 for the ‘good’ and ‘poor’ samples, respectively. Of those with DRE samples and definitive diagnostic outcomes, the sensitivity for SBD dropped significantly from 76.0% to 41.7% between ‘good’ and ‘poor’ samples, respectively ( p = 0.041).

Conclusions

A ‘good’ sample obtained by DRE provides comparable results to samples obtained by patients. This creates potential benefit in speed and ease of testing for patients. However, not all DRE sampling attempts are successful, and the clinician must be satisfied that enough faeces is obtained to wipe adequately into all grooves.
Corporate Philanthropy and CEO Outside Directorships Under Authoritarian Capitalism
Authors: Muller Alan , Tan Weiqiang , Peng Mike W. , Pfarrer Mike
Published: January 2023

Scholars have long suggested that CEOs can benefit from corporate philanthropy. However, little is known about this relationship in contexts of authoritarian capitalism such as China, where the state not only uses its control of economic entities to pursue social goals but also plays a key role in CEOs’ careers. We theorize how corporate philanthropy among state-controlled firms increases the CEO’s likelihood of receiving career benefits from the state in the form of outside directorships. Outside directorships represent an important form of social capital in the Chinese context, and corporate philanthropy is an important mechanism through which social capital can be acquired. In addition, we theorize how two factors—the degree of state ownership and the number of independent directors on the CEO’s board—moderate this relationship. Analyzing a 12-year panel of state-controlled, publicly-listed firms in China comprising 6,594 firm-year observations, we find general support for our ideas. In so doing, we contribute to scholarship on the business–society relationship and corporate governance in the context of authoritarian capitalism.
A Clinical Study of Girls With Idiopathic Central Precocious Puberty and Psychological Behavior Problems
Authors: Xie Li-Ling , Yang Yu , Xiong Xiang-Yu , Yang Li , Wu Xian , Zhang Dong-Guang
Published: January 2023

To understand the psychological effects on behavior of girls with idiopathic central precocious puberty (ICPP) and to explore the role of gonadotropin-releasing hormone analog (GnRHa) in the reversal or blocking of the negative psychological effects on behaviors of girls with ICPP. A total of 100 girls with ICPP diagnosed at the Department of Endocrinology of Jiangxi Children’s Hospital were divided into the treatment group and observation group with 50 cases in each group. The control group consisted of 50 healthy girls examined at our hospital during the same period. The Achenbach Child Behavior Check List ([CBCL] for parents) was used to evaluate the psychological effects on behavior of the girls diagnosed with ICPP and the girls in the control group, and the scores of related behavioral factors were calculated. At the same time, the psychological effects on behaviors of the girls with ICPP treated with GnRHa were followed up. (1) There were 100 girls with ICPP and 30 with behavioral problems. There were 50 normal healthy girls (control group) with 3 cases of behavior problems. Of the 50 girls with ICPP, after treatment, 8 had behavioral issues. The rate of abnormal psychological effects on behavior in the group of girls with ICPP before treatment was significantly higher than in the control group ( P < .01), and after treatment, the rate was lower than before treatment ( P < .05). (2) The scores of depression, social withdrawal, poor communication, and school discipline violation in the ICPP group were higher than those in the control group, with a statistical significance ( P < .01). (3) After 24 months of GnRHa treatment for girls in the ICPP group, the scores of 4 factors, including depression, social withdrawal, poor communication, and violation of discipline in the Achenbach CBCL, were significantly different before and after treatment ( P < .05). (1) Girls with ICPP have low self-esteem, low self-confidence, high incidences of psychological effects on behavior problems, manifested in depression, withdrawal, poor communication, discipline violations, and other aspects; (2) GnRHa treatment can reverse the low self-esteem and low self-confidence of girls with ICPP to varying degrees.
Lead Poisoning From Home-Prepared Indian Spices in 3 Families
Authors: Tan Shirlee W. , Cohen Sharon G. , Wilson Matt A. , Johnson Tory P. , Ivers Jessica A.
Published: January 2023

Spice consumption, along with other environmental factors, can contribute to pediatric lead poisoning. Although public health efforts have increased awareness of contamination of spices, false assumptions regarding the safety of home-prepared spices have emerged. Here, we present the clinical features, family beliefs, and environmental toxicology of 3 spice-associated pediatric lead poisoning cases.
Hospital and ICU Admission Risk Associated With Comorbidities Among Children With COVID-19 Ancestral Strains
Authors: Ungar Stephanie P. , Solomon Sadie , Stachel Anna , Shust Gail F. , Clouser Katharine N. , Bhavsar Sejal M. , Lighter Jennifer
Published: January 2023

A large proportion of children have been affected by COVID-19; we evaluated the association between comorbidities and hospitalization/ICU (intensive care unit) admission among 4097 children under age 21 years with symptomatic COVID-19 (not just polymerase chain reaction [PCR]–positive or multisystem inflammatory syndrome in children associated with COVID-19 [MIS-C]) from 2 large health systems from March 2020 to September 2021. Significant comorbidities and demographic factors identified by univariable analysis were included in a multivariable logistic regression compared with children ages 6 to 11 without comorbidities. In all, 475 children (11.6%) were hospitalized, of whom 25.5% required ICU admission. Children under 1 year had high hospitalization risk, but low risk of ICU admission. Presence of at least 1 comorbidity was associated with hospitalization and ICU admission (odds ratio [OR] > 4). Asthma, obesity, chronic kidney disease, sickle cell disease, bone marrow transplantation, and neurologic disorders were associated with hospitalization (adjusted odds ratio [AOR] > 2). Malignancy, intellectual disability, and prematurity were associated with ICU admission (AOR > 4). Comorbidities are significantly associated with hospitalization/ICU admission among children with COVID-19.
Evaluation of Income and Food Insecurity as Risk Factors for Failure to Thrive: An Analysis of National Survey Data
Authors: Edwards Bathai , Schaefer Eric W. , Murray-Kolb Laura E. , Daymont Carrie
Published: January 2023

Limited data exist regarding the relationship between socioeconomic risk factors and failure to thrive (FTT). Using data from the National Health and Nutrition Examination Survey (NHANES) from years 1999 to 2014, we sought to determine whether there was a higher prevalence of underweight (<5th percentile weight-for-age [WFA], weight-for-length [WFL], or body mass index-for-age [BFA]), and, therefore, likely a higher risk of FTT, in US children <3 years with low household income or food insecurity compared with children without these factors. Among 7356 evaluated children, there were no significant differences in the prevalence of underweight by adjusted household income quintile, food security, household Women, Infants, and Children (WIC) status, or federal poverty income ratio. These findings do not support a link between low income or food security and underweight in children and, therefore, do not provide support for an association between low income or food security and FTT.
Toleration by Victimized Coffeeshops in Amsterdam
Authors: Jacques Scott , Moeller Kim
Published: January 2023

Dutch coffeeshops are quasi-illegal. Their sale of cannabis is de jure prohibited but de facto permitted. In this sense, their criminal acts are tolerated. Less often explored, and less well understood, is that coffeeshops also tolerate crimes against them. “Doing nothing” is a common way to manage conflict. Why and how does it occur? In this article, we use the opportunity and rationality perspectives to analyze qualitative data obtained during interviews with 50 personnel of coffeeshops in Amsterdam, the Netherlands. After presenting our findings, we discuss their general implications for tolerant, and intolerant, ways to manage conflict.
Indigenizing Social Disorganization Theory: An Exploration of Victimization in Native Communities
Authors: Gilbert Sheena L. , Wright Emily M.
Published: January 2023

Prior research that is grounded in social disorganization theory has found that community characteristics impact victimization. Despite the robust literature using social disorganization theory, very few studies have used this theory to examine violence and victimization in Indigenous communities. The following study examined counties in 14 states that fully or partially contained reservation land ( N = 251) to determine the applicability of this theory to a unique population. Findings indicate that social disorganization theory can be used to predict victimization in Indigenous communities. In addition, a more culturally tailored model (i.e., Indigenized model) predicted victimization slightly better than the traditional model, however, the difference between the models was not significant. We conclude with a discussion of our findings and offer future directions for research.
The Trafficking Defence in Criminal Law: Nexus and Compulsion
Authors: Knight Stephen
Published: January 2023

The United Kingdom has accepted international obligations under the Palermo Protocol, the Council of Europe Trafficking Convention, and the EU Trafficking Directive, in relation to the non-prosecution and non-punishment of victims of trafficking for offences they commit which are linked to their trafficking. The obligations are given effect by the Crown Prosecution Service (CPS) discretion not to prosecute, the abuse of process jurisdiction, the common law defence of duress, and the statutory defences under s 45 Modern Slavery Act 2015. In relation to adult victims of trafficking, in each case the question arises of whether they were compelled to commit the offence with which they are charged. This article shows how the English & Welsh courts and the CPS have had insufficient regard to the United Kingdom's international obligations in interpreting ‘compulsion’, and that improvements are necessary to prevent breaches of the United Kingdom's obligations and the re-traumatisation of victims of trafficking.
Morphological distance between spoken Palestinian dialect and standard Arabic and its implications for reading acquisition
Authors: Joubran-Awadie Nancy , Shalhoub-Awwad Yasmin
Published: January 2023

When the written language that children learn to read and write is distinct from the oral language they acquired as their mother tongue, they may encounter substantial challenges. The linguistic distance between two varieties of the same language could have an impact on the literacy acquisition journey. The present study focuses on Arabic, a prototypical case of diglossia, where the distance between the spoken and standard varieties has been intensively examined phonologically and lexically. However, a paucity of studies has addressed their morphological distance. This study takes one step in this direction by describing, analyzing, and quantifying the distance of morphemes in content words from spoken Palestinian dialect (SPD) to Modern Standard Arabic (MSA). It is the first to map this distance by form and function in the three predominant systems: derivation, inflection, and clitics in nouns and verbs. All morphemes were arranged on an axis targeting four main levels that varied in the extent of the morphological distance from SPD to MSA, beginning with ‘identical’ morphemes (same form, same function), followed by ‘strongly overlapping’ morphemes (morpho-phonological difference in form, same function), then ‘partially overlapping’ morphemes (different form, same function), and ending with ‘unique’ morphemes (unique form, same/different function). The mapping showed significant findings indicating that most morphemes are non-identical between SPD and MSA, comprising 81.4% of the total. Most of these non-identical morphemes (64.9%) were assembled to the ‘partially overlapping’ and ‘unique’ levels, appearing mainly in the verb inflection category. Implications for the possible impact of morphological distance on reading acquisition are discussed.
The ambivalences of visibility: News consumption and public attitudes to same-sex relationships in the context of illiberalism
Authors: Mihelj Sabina , Kondor Katherine , Štětka Václav , Tóth Fanni
Published: January 2023

Over the past decade, the rights of people whose sexual orientation does not conform to prevailing norms have become a divisive issue in many countries. Despite a long tradition of research on media and sexual minorities, the role of the media in these recent backlashes remains poorly understood. We argue that this is partly because work in this area is often underpinned by a simple, linear narrative that unambiguously links visibility to empowerment. We highlight the ambivalent impact of mediated visibility and argue that in the context of elite-driven polarization, illiberalism and low levels of media freedom, visibility can become a vehicle of control. To explore this proposition, we examine the link between media and public attitudes to same-sex relationships in four east European countries, combining a population survey with semi-structured interviews. The results confirm the need to consider the conditions of mediated visibility in particular socio-political contexts, showing that where control over the conditions of visibility remains in the hands of homophobic elites, specific types of media, which are controlled by ruling elites, including Public Service Media, can contribute to negative attitudes, while digital media play a more ambiguous role.
Outcomes for Treatment of Capsulolabral Adhesions With a Capsular Spacer During Revision Hip Arthroscopy
Authors: Ruzbarsky Joseph J. , Comfort Spencer M. , Martin Maitland D. , Briggs Karen K. , Philippon Marc J.
Published: January 2023

Background:

The presence of adhesions is a common source of pain and dysfunction after hip arthroscopic surgery and an indication for revision surgery. The placement of a capsular spacer in the capsulolabral recess after lysis of adhesions has been developed to treat and prevent the recurrence of adhesions.

Purpose:

To evaluate patient-reported outcomes (PROs) and survivorship at a minimum of 2 years after revision hip arthroscopic surgery with capsular spacer placement for capsular adhesions.

Study Design:

Case series; Level of evidence, 4.

Methods:

Between January 2013 and June 2018, a total of 95 patients (99 hips) aged ≥18 years underwent revision hip arthroscopic surgery for the treatment of capsular adhesions with the placement of a capsular spacer. Overall, 53 patients (56 hips) met the inclusion criteria and had a minimum 2-year follow-up, forming the cohort of this study. Exclusion criteria included confounding metabolic bone diseases (eg, Legg-Calve-Perthes disease, Marfan syndrome), labral deficiency, or advanced osteoarthritis (Tönnis grade 2 or 3). Preoperative and postoperative outcome scores (modified Harris Hip Score [mHHS], Hip Outcome Score–Activities of Daily Living [HOS-ADL], Hip Outcome Score–Sport-Specific Subscale [HOS-SSS], 12-Item Short Form Health Survey [SF-12], and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]) were collected and compared in addition to the revision rate, conversion to total hip arthroplasty, and patient satisfaction.

Results:

The mean age of the cohort was 32 ± 11 years, with 32 female hips (57%) and a median number of previous hip arthroscopic procedures of 1 (range, 1-5). The arthroplasty- and revision-free survivorship rate at 2 years was 91%. Overall, 5 patients (6 hips; 11%) underwent revision surgery at a mean of 2.4 ± 1.4 years after capsular spacer placement, with symptomatic capsular defects being the most common finding. There were 4 patients (7%) who converted to total hip arthroplasty. For hips not requiring subsequent surgery (n = 46), there was a significant improvement in outcome scores except for the SF-12 Mental Component Summary, with rates of achieving the minimal clinically important difference of 70%, 70%, and 65% for the mHHS, HOS-ADL, and HOS-SSS, respectively.

Conclusion:

Capsular spacers, as part of a systematic approach including lysis of adhesions with early and consistent postoperative physical therapy including circumduction exercises, resulted in improved PROs as well as high arthroplasty– and revision-free survivorship (91%) at a minimum 2-year follow-up. Capsular spacers should be considered in revision hip arthroscopic procedures when an adequate labral volume remains but adhesions continue to be a concern.
Clinical and Second-look Arthroscopic Results for Derotational Distal Femoral Osteotomy With Medial Patellofemoral Ligament Reconstruction for Recurrent Patellar Dislocation With Increased Femoral Anteversion: A Series of 102 Cases With a Minimum Clinical Follow-up of 2 Years
Authors: Zhang Zhi-Jun , Di Meng Lin Qian , Song Guan-Yang , Li Yue , Cao Yan-Wei , Zheng Tong , Feng Hua , Zhang Hui
Published: January 2023

Background:

Derotational distal femoral osteotomy (DDFO) has been used to treat patients with recurrent patellar dislocation (RPD) with increased femoral anteversion. However, no study has reported second-look arthroscopic findings in the patellofemoral joint after DDFO.

Purpose:

To report clinical and second-look arthroscopic outcomes for DDFO with combined medial patellofemoral ligament reconstruction (MPFL-R) in treating RPD with increased femoral anteversion.

Study Design:

Case series; Level of evidence, 4.

Methods:

From 2015 to 2019, 131 consecutive patients (144 knees) with RPD were treated with combined MPFL-R and DDFO. Patients with a femoral anteversion angle >30° and a minimum 2-year clinical follow-up period were included in the study. Three-dimensional computed tomography was performed to evaluate rotational deformities of the lower leg. Radiographic parameters presenting bony abnormalities associated with RPD were measured. Second-look arthroscopic evaluations were available for 86 knees to assess patellar tracking and chondral lesion changes. Moreover, clinical and radiologic outcomes were assessed pre- and postoperatively at a minimum 2 years.

Results:

A total of 102 knees in 92 patients were included in the present study with a mean clinical follow-up of 4.1 years (range, 2.0-5.6 years). Mean ± SD femoral anteversion changed significantly from 34.7°± 7.5° preoperatively to 11.3°± 0.2° postoperatively ( P < .001), and mean tibial tubercle–trochlear groove distance decreased significantly from 19.6 ± 3.5 mm preoperatively to 17.4 ± 3.2 mm postoperatively ( P < .001). In the majority of knees, at the time of second-look arthroscopic assessment, chondral lesion status remained unchanged at the lateral patellar facet (96%) and trochlear groove (95%); in contrast, chondral damage at the medial patellar facet was aggravated in 9 cases (10%). All functional scores (Tegner, Lysholm, visual analog scale, and Kujala scores) improved significantly at final follow-up. None of the patients experienced redislocation or subluxation after surgery.

Conclusion:

Chondral lesions in the patellofemoral joint remained unchanged in the majority of cases in second-look arthroscopy after combined MPFL-R and DDFO. Moreover, high-grade trochlear dysplasia and arthroscopic residual patellar maltracking might be associated with cartilaginous deterioration at the medial patellar facet after surgery.
What Motivates Physicians to Address Caregiver Needs? The Role of Experiential Similarity
Authors: Park Taeyoung , Pillemer Karl , Loeckenhoff Corinna , Suitor J. Jill , Riffin Catherine
Published: January 2023

Despite the significant stress of family caregiving, caregivers’ needs and risks are often overlooked in healthcare settings. This study examined the factors associated with primary care physicians’ perceived responsibility to identify and address caregiver needs and risks. Using a national random sample of U.S. primary care physicians ( N = 106), multivariable logistic regression analyses were conducted to examine associations of physicians’ perceived responsibility to assess caregivers’ needs with experiential similarity (personal experience with caregiving), structural similarity (being older and female), and secondary exposure variables (time seeing older adults in the outpatient setting). Most (76.5%) physicians felt responsible for identifying caregivers’ needs and risks. In multivariable models, physicians who had personal experience with caregiving were four times more likely than those without it to feel responsible for identifying caregivers’ needs and risks and assessing caregivers’ mental health concerns. Thus, physicians may benefit from educational interventions that immerse them in caregivers’ lived experiences.
Precarity and Subcontracting Relationships: The Case of Parcel Delivery Drivers in France
Authors: Rème-Harnay Pétronille
Published: January 2023

This article seeks to show, taking the example of delivery drivers, how inter-firm relations affect worker precarity. It is based on an in-depth field study carried out in the Paris region and backed up by the statistical analysis of national surveys. It focuses in particular on the role played by firms’ dependence in the precarity of work and employment, considering that both dependence and precarity should be considered ubiquitous. It then seeks to measure this dependence and highlight the factors that may increase it as the relative size of the firms, the chain of dependence and the position of firms in this chain. In this way, it sets out to show why the contractual status of employees can no longer provide job security in the context of unbalanced subcontracting relationships.
Research and application of load spectrum technology of reliability running test method for vehicle
Authors: Jin Hongjie , Zang Liguo , Mao Yvlin , Xue Cheng , Jiao Jing
Published: January 2023

In order to maximize the use of load spectrum data in vehicle reliability driving test, as much as possible to solve practical problems, this paper preprocesses, edits, and compiles the original data obtained based on the multi-channel data acquisition system firstly. Then the effective and simplified application data of load spectrum of vehicle reliability driving test are obtained. Secondly, based on the measured load spectrum, the test and use equivalent relationship and acceleration coefficient of different components are calculated. The road simulation bench research is carried out to verify the reliability of the bench test and provide the basis for the indoor simulation reliability test. The reliability driving specification is studied, and the test speed of each road is determined. Meanwhile, the stress amplitude analysis method is used to analyze the fault, study the fault mechanism and improve it through optimization design. Finally, the influence mechanism of road surface on vehicle is studied by spectrum and amplitude analysis. This study which is based on solving practical problems expands the application field and direction of the measured test load spectrum from the test practice, and provides ideas and feasible methods for the application of reliable driving load spectrum.
Mechanical characterization and frictional wear behavior analysis on nano tungsten carbide and molybdenum disulfide particles reinforced aluminium 7075 composites
Authors: Vignesh Kumar D , Arulselvan S , Arul Marcel Moshi A , Veera Ajay C , Balamurugan P
Published: January 2023

Hybrid metal matrix composites are gaining more importance in recent years. In this current investigation, aluminium alloy (AA7075) composites have been prepared with nano tungsten carbide (WC) and molybdenum disulfide (MoS2) as reinforcements using stir casting method and investigated. The nano tungsten carbide particles were added into the matrix in the proportions 0%, 0.5%, 1%, 1.5% and 2%, and molybdenum disulfide was added in the constant proportion of 5 wt.% to the molten metal. The prepared Al-hybrid composite samples were tested for their hardness, compression and tensile strength. Microstructure examination has also been performed to understand the distribution pattern of nano tungsten carbide and molybdenum disulfide particles in the base matrix by scanning electron microscope. From the results, it was found that there was steady improvement in composite properties when compared with the base metal while adding WC and MoS2. Thus, the prepared AA7075/MoS2/WC composites were guaranteed for high strength, hardness and exceptional microstructure stability. Dry sliding wear behavior on AA7075/MoS2/WC composites was investigated with the aid of pin-on-disc apparatus. Grey Relational Analysis tool was employed to identify the optimal setting of process variables, which results in lower wear rate and COF. The significance of factors such as sliding distance, sliding velocity and load on the wear characteristics was investigated by means of ANOVA. ANOVA results unveiled that load was the majorly influencing factor in attaining optimal wear characteristics. The tested samples have been investigated using scanning electron microscopy and reported.
Does campaign-style environmental regulation induce green economic growth? Evidence from China's central environmental protection inspection policy
Authors: Pan Dan , Yu Yi , Hong Wei , Chen Shengdong
Published: January 2023

Well-designed environmental regulations are a prerequisite for achieving green economic growth. However, the effectiveness of campaign-style environmental regulation—a widely used environmental management instrument in developing nations or even in some developed nations, on green economic growth remains under-researched and has not reached a consistent conclusion. This paper takes advantage of China's Central Environmental Protection Inspector policy—the strictest and largest campaign-style environmental regulation policy in China's history, as a natural experiment and uses the difference-in-differences method to explore the effect of campaign-style environmental regulation on green economic growth, and further analyze its underlying mechanisms and heterogeneity effects. The panel data covering 280 prefecture-level cities in China from 2009 to 2019 are used. Our results show that Central Environmental Protection Inspector can result in an average of 14.2% increase in green economic growth, and this effect is sustainable for a long time. Mechanism analysis shows that Central Environmental Protection Inspector boosts green economic growth mainly by promoting green innovation and optimizing industrial structure. Further heterogeneity analysis reveals that the positive effect of Central Environmental Protection Inspector on green economic growth is greater in eastern China and underdeveloped cities.
Minimum sample size for developing a multivariable prediction model using multinomial logistic regression
Authors: Pate Alexander , Riley Richard D , Collins Gary S , van Smeden Maarten , Van Calster Ben , Ensor Joie , Martin Glen P
Published: January 2023

Aims

Multinomial logistic regression models allow one to predict the risk of a categorical outcome with > 2 categories. When developing such a model, researchers should ensure the number of participants ([Formula: see text]) is appropriate relative to the number of events ([Formula: see text]) and the number of predictor parameters ([Formula: see text]) for each category k. We propose three criteria to determine the minimum n required in light of existing criteria developed for binary outcomes.

Proposed criteria

The first criterion aims to minimise the model overfitting. The second aims to minimise the difference between the observed and adjusted [Formula: see text] Nagelkerke. The third criterion aims to ensure the overall risk is estimated precisely. For criterion (i), we show the sample size must be based on the anticipated Cox-snell [Formula: see text] of distinct ‘one-to-one’ logistic regression models corresponding to the sub-models of the multinomial logistic regression, rather than on the overall Cox-snell [Formula: see text] of the multinomial logistic regression.

Evaluation of criteria

We tested the performance of the proposed criteria (i) through a simulation study and found that it resulted in the desired level of overfitting. Criterion (ii) and (iii) were natural extensions from previously proposed criteria for binary outcomes and did not require evaluation through simulation.

We illustrated how to implement the sample size criteria through a worked example considering the development of a multinomial risk prediction model for tumour type when presented with an ovarian mass. Code is provided for the simulation and worked example. We will embed our proposed criteria within the pmsampsize R library and Stata modules.
Current Progress in Treating Systemic Lupus Erythematosus Using Exosomes/MicroRNAs
Authors: Liu Yi-jing , Miao Hai-bing , Lin Shu , Chen Zhen
Published: January 2023

Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease associated with impaired organ functions that can seriously affect the daily life of patients. Recent SLE therapies frequently elicit adverse reactions and side effects in patients, and clinical heterogeneity is considerable. Mesenchymal stromal cells (MSCs) have anti-inflammatory, tissue repair, and immunomodulatory properties. Their ability to treat autoimmune diseases largely depends on secreted extracellular vesicles, especially exosomes. The effects of exosomes and microRNAs (miRNAs) on SLE have recently attracted interest. This review summarizes the applications of MSCs derived from bone marrow, adipocyte tissue, umbilical cord, synovial membrane, and gingival tissue, as well as exosomes to treating SLE and the key roles of miRNAs. The efficacy of MSCs infusion in SLE patients with impaired autologous MSCs are reviewed, and the potential of exosomes and their contents as drug delivery vectors for treating SLE and other autoimmune diseases in the future are briefly described.