bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in extracellular water with hemodialysis and fall in systolic blood pressure
Authors: Tangvoraphonkchai Kamonwan , Davenport Andrew
Published: February 2021

Introduction:

Intra-dialytic hypotension (IDH) remains the most common complication with outpatient hemodialysis (HD) sessions. As fluid is removed during HD, there is contraction of the extracellular volume (ECW). We wished to determine whether the fall in ECW was associated with a fall in systolic blood pressure (SBP).

Methods:

We retrospectively reviewed the records of adult dialysis outpatients attending for their midweek sessions who had corresponding pre- and post-HD bioimpedance measurements of ECW.

Result:

We reviewed 736 patients, median age 67 (54–76) years, 62.8% male, 45.7% diabetic with a median dialysis vintage of 24.4 (9.2–56.8) months. The percentage fall in ECW (ECW%) was associated with post-dialysis systolic blood pressure (SBP) ( r = −0.14, p < 0.001). Patients with SBP falls of >20 mmHg had a greater fall in ECW% compared to patients with stable SBP 7.6 (4.6–10.1) vs 6.0 (4.0–8.5), p < 0.001). Patients with greater dialyzer urea clearance had greater fall in ECW% ( r = 0.19, p < 0.001). In a logistic model an increased fall in ECW% was associated with weight loss (odds ratio (OR) 1.88, 95% confidence limits (CL) 1.62–2.176, p < 0.001), and session duration (OR 1.45 (CL 1.05–1.99), p = 0.024), and negatively with hemodiafiltration compared to hemodialysis (OR 0.37 (0.19–0.74) p = 0.005 and dialysate sodium to plasma gradient (OR 0.95 (CL 0.90–0.99), p = 0.021).

Conclusion:

We observed an association between the reduction in ECW and SBP with dialysis. Our results would advocate monitoring ECW changes during dialysis and developing biofeedback devices to control ultrafiltration and dialysate sodium to reduce the risk of IDH.
Towards the circular economy: Analysis of barriers to implementation of Turkey’s zero waste management using the fuzzy DEMATEL method
Authors: Ayçin Ejder , Kayapinar Kaya Sema
Published: February 2021

Zero waste has an important position in the circular economy model in terms of manufacturing recyclable products instead of products to be consumed quickly, reducing the amount of waste, developing and implementing recycling/reuse technologies, and thus ensuring resource efficiency. A zero-waste strategy is one of the basic steps to achieve the goal of the circular economy. The number of studies conducted on Turkey’s zero waste management strategies referring to the circular economy is quite limited. To fill this gap in the literature, this study aims to identify the potential barriers which have an important role in zero waste management practices in Turkey. Through a broad literature review and expert opinions, 12 key barriers for zero waste implementation in Turkey have been defined in view of circular economy principles. Then, fuzzy DEMATEL methodology is employed to examine which is the most influential barrier affecting zero waste management success and to identify the interdependence of these barriers. The results indicate that uncertainty of the goals and tactics relevant to the circular economy and lack of financial and economic aid are key causal barriers that affect Turkey’s zero waste management.
Dirty Work and Emotional Labor in Public Service: Why Government Employers Should Adopt an Ethic of Care
Authors: Mastracci Sharon H.
Published: February 2021

This article combines theories on emotional labor in public service and dirty work to argue that organizations should adopt an ethic of care to support their workers. The economics of public services undermine the consumer-sovereignty narrative in government, particularly where public servants are agents of social control and enforcement. Public servants cannot and should not behave according to a customer-service ethos in many important areas of public service. Emotional labor is the process by which workers manage the identity-damaging aspects of public service. This article critiques individual-level human resource management (HRM) approaches and recommends dismantling customer service expectations that are inappropriately applied in public-service contexts.
An analysis of the WTC fires using CIB correlations and simple modeling
Authors: Quintiere JG
Published: February 2021

CIB correlations for compartment burning rates and average gas temperatures are examined for accuracy, utility, and generality. The results are applied to modeling the fire on 9/11 in WTC 1. Specific information is used from the NIST investigation. It is demonstrated that simple heat transfer modeling can predict the truss steel rod temperatures for the E119 tests of WTC done by NIST. The CIB temperature correlation and steel truss modeling are used to predict burning conditions for the WTC 1 96th floor fire and compared to the NIST results. Here a consideration of fuel loads from 20 to 40 kg/m2 was considered compared to just 20 used by NIST. The results suggest that the fully insulated truss bar temperatures would achieve higher values for higher fuel loads. A critical steel truss temperature of 650°C could support failure of the trusses as a theory for the collapse of the towers.
Factors Affecting Sexual Assault Case Processing: Charging Through Sentencing in a Large Southern County
Authors: Diamond Brie , Bowen Kendra , Burns Ronald
Published: February 2021

Factors affecting prosecutorial decision-making represent one of the most understudied parts of the criminal justice system. Documenting these influences in relation to sexual assault cases is even more rare. The present study analyzed the complete prosecutorial case files of a large, southern district attorney’s office regarding all adult sexual assault cases received over a three-year period. Logistic regression and continuation ratio modeling were used to determine which factors were related to continued progression through the court system, from charging to sentencing. The findings indicate that cases with older or Latino defendants, as well as cases involving injury to the victim, were significantly more likely to be charged. A continuation ratio model of subsequent case outcomes indicated that factors such as DNA evidence, the use of a weapon, and the inclusion of a victim impact statement increased the likelihood of a case progressing to later stages of the system. The influence of criminal history and the amount of prosecutor contact with the victim, however, varied across outcomes. Namely, criminal history increased the odds of receiving a prison sentence while prosecutor contacts with the victim increased the odds of case indictment. These findings imply potential shifts in the treatment of these cases while also suggesting areas of improvement. Namely, prosecutors should strive to increase the amount of meaningful contacts with victims and encourage their participation in the court process. These findings also support the use of sexual assault packets by law enforcement to improve and standardize reporting practices for these cases.
Self-esteem, Body Image, and Dating Violence in Colombian Adolescents and Young Adults
Authors: Bolívar-Suárez Yolima , Gómez Jorge Arturo Martínez , Yanez-Peñúñuri Libia Yanelli , Anacona César Armando Rey , Gómez Ana Milena Gaviria
Published: February 2021

Two objectives were formulated. The first was to establish whether characteristics such as self-esteem, perception of body image, and dating perpetration explain dating victimization. The second was to check if sex moderates the relationship between low self-esteem and dissatisfaction and if body dissatisfaction mediates the effect of low self-esteem on being a victim of dating violence (DV). A total of 1,409 Colombian adolescents and young adults, secondary and university students (42.5% men and 57.5% women), aged between 14 and 25 years ( M = 18.6 years; SD = 2.8 years) participated. An explanatory correlational design was used, in which the Rosenberg Self-Esteem Scale, the Body Shape Questionnaire, and the Revised Dating Violence Questionnaire were applied. Six regression models were proposed for both men and women, where it was found that low self-esteem, body dissatisfaction, and violence exerted in the courtship explain the violence received. Also, through the moderated mediation analysis, a moderate conditional indirect effect was verified of low self-esteem in DV victimization (R2 = 0.052***) through body dissatisfaction, being higher in women than in men. The preceding points to the convenience of intervening on self-esteem and body image in adolescents and young victims of this type of violence and considering these aspects in prevention campaigns.
Grassroots INGOs in Africa: Perspectives on What They Are (and Are Not?)
Authors: Appe Susan
Published: February 2021

This research explores philanthropic transfers and exchanges between and among the North and the South, namely, through grassroots international nongovernmental organizations (INGOs), which tend to fall outside of the aid industry. The broad research question that frames this study is as follows: How do these organizations, grassroots INGOs in the global North and their partner organizations in the global South, represent and legitimize their work within the larger realm of development aid in Africa? The research conducts a comparative case study through the analysis of the narratives via organizational stories and artifacts produced and used by grassroots INGOs in the United States and partner organizations in Kenya. The findings show how grassroots INGOs distinguish themselves from what are the traditional images of global philanthropic exchanges and development aid, producing disassociative claims. The research derives a set of properties of grassroots INGOs to explain these perceived distinctions.
Information Needs and Resources and Self-Management Challenges of Parents Caring for a Child with Asthma in China
Authors: Dan Luo , Kintner Eileen Kae , Petrini Marcia , Liu Qian , Yang Bing Xiang , Li Wenqing , Yang Jiong
Published: February 2021

The aim of this assessment was to determine the information needs, resources, and resource preferences and self/family-management challenges of parents caring for a child with asthma in China. The acceptance of asthma and consolidated framework for implementation research guided the study. A cross-sectional, descriptive design was used. Seventy-one parents of a child receiving care in an outpatient respiratory clinic completed a three-part, pragmatic, self-report survey. Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. Parents, who needed more knowledge about asthma, sought information from internet sources. However, most parents preferred receiving information during in-person consultation with trained specialists. Management challenges revolved around understanding asthma information, formulating beliefs about asthma, experiencing distressing thoughts and feelings, forming supportive networks, and meeting their child’s emotional needs. Evidence supports expanding nursing roles in China to include extended time for initial in-person parental interactions and follow-up using reliable clinic-based internet counseling.
Intra-performance: the choreographies of K.G. Guttman
Authors: Zijlmans Kitty
Published: February 2021

This contribution takes as point of departure the particular response-ability allowed by the contemporary choreographic performance works of settler (Canadian) visual artist Karen Ginger Guttman, in which the visitor-beholder’s body becomes involved in the choreographic ‘dance’. These site-situated works echo the Rietveld’s works, but Guttman’s site performances take place in a residential environment, they specifically challenge guest-host-site ‘íntra-actions’ as coined by Karen Barad and reveal constraints that occur in the choreographic ‘dance’ of continuously changing relationalities.
In-plane dynamic crushing behaviors of joint-based hierarchical honeycombs with different topologies
Authors: Zhang Xin-chun , Shen Zhen-feng , Wu He-xiang , Bai Jiang-pan
Published: February 2021

Introducing the hierarchy into cellular materials has attracted increasing attention in the effort to pursue improved absorbed-energy abilities and impact resistance. In this paper, the dynamic crushing properties and energy absorption capacities of joint-based hierarchical honeycombs with different topologies were explored by means of explicit dynamic finite element (FE) analysis using ANSYS/LS-DYNA. Four types of joint-based hierarchical honeycombs with uniform cell-wall thickness were firstly constructed by substituting each vertex of regular honeycombs with a smaller self-similar cell (hexagon or square). The respective influences of hierarchical parameters and impact velocities on in-plane dynamic deformation modes, mechanical characteristic and energy absorption of joint-based hierarchical honeycombs were discussed. Research results showed that the hierarchy had a far greater influence on the in-plane deformation modes of honeycombs. Compared with regular honeycombs, the dynamic plateau stress and specific energy absorption of joint-based hierarchical honeycombs can be improved if the proper hierarchical parameters were chosen. Adding the joint-based hierarchy into regular honeycombs can enhance the crushing stress efficiency (CSE) of the specimens. In addition, by introducing a non-dimensional dynamic sensitivity index, the dynamic shock enhancement of hierarchical honeycombs was also investigated. These researches are useful for the multi-objective dynamic optimization design and controllable properties of cellular materials.
The Gap Between Youth and Politics: Youngsters Outside the Regular School System Assessing the Conditions for Be(com)ing Political Subjects
Authors: Malafaia Carla , Neves Tiago , Menezes Isabel
Published: February 2021

Approaches to youth engagement typically focus on withdrawal from conventional politics and participatory transformation. In this paper, we argue that such approaches fall short in grasping how groups with blended styles of relationship with politics assess their political ownership. This became apparent when, in the context of European elections, the rise of extreme right wing in Europe and intensification of austerity in Portugal, we discussed the circumstances framing youth’s relationship with politics with 40 youngsters outside regular school. Quantitative data from regular-school students on the same topic were used to trigger focus groups and later used by participants to interview their peers. Participants displayed ‘ordinary’ approaches to engagement, attributing an unexpected relevance to vote. Socioeducational disadvantages and self-blaming perspectives were actively contested, and the gap between youth and politics is to be filled by a normative equipment, with the school indicated as a fundamental, structured and unbiased locus of political education.
Augmented fascia temporalis sling for paralytic ectropion of the lower lid
Authors: Bagheri Abbas , Feizi Mohadeseh , Sahebghalam Ramin , Tavakoli Mehdi
Published: February 2021

Purpose:

To report the effect of lower eyelid temporalis fascia sling combined with lateral canthoplasty and tarsorrhaphy for paralytic ectropion.

Methods:

Prospective case series of 10 patients with lower lid paralytic ectropion who were treated with lower eyelid fascia temporalis sling and lateral canthoplasty in addition to lateral tarsorrhaphy as a single-session procedure. Additional medial tarsorrhaphy was applied if the medial lower lid apposition was not adequate at the end of the procedures. Eyelid configuration and function were compared before and after surgery.

Results:

The mean age of patients was 65.8 ± 10 years. Mean marginal reflex distance 1 (MRD1) and MRD2 changed from 3.5 ± 1.4 and 8.6 ± 2.4 mm to 2.2 ± 1.4 and 5.3 ± 1.2 mm respectively ( p = 0.001 and 0.006). Mean pre-operative lagophthalmos improved from 9.2 ± 4.9 to 3.4 ± 1.3 mm ( p = 0.001). The mean follow-up was 28.9 ± 12.1 months. Three patients required additional medial tarsorrhaphy to address residual medial ectropion in the same session.

Conclusion:

Combination of lower lid fascia temporalis sling, lateral canthoplasty and tarsorrhaphy as a single-session procedure can effectively improve the functional and aesthetic complications of paralytic ectropion.
Cannabis use among early adolescents and transdiagnostic mental health risk factors
Authors: Moreno-Mansilla Sara , Ricarte Jorge J , Hallford David J
Published: February 2021

Introduction:

Cannabis is the most widely used psychoactive substance among adolescents worldwide, and the age at which consumption begins to decrease. Cannabis use in adolescents is associated with a wide range of adverse consequences in adulthood including increased vulnerability to psychosis and other mental disorders, as well as suicidal ideation and attempt. The aim of this study is to extend understanding of the link between cannabis use and mental illness by examining whether cannabis use at early ages predicts transdiagnostic variables that are precursors to severe clinical diagnoses.

Methods:

A descriptive cross-sectional study was conducted. The sample was made up of 605 adolescents from 7th to 9th grades, with a mean age of 13.2 years ( SD = 1.0, 47% girls). The variables evaluated were: anomalous perception of reality, intolerance of uncertainty, rumination, suicide attempt, hopelessness, and symptoms of depression and anxiety. The administration of the questionnaires was carried out in groups of 20 participants under the supervision of a researcher in a unique session of 1 hour.

Results:

Adolescent cannabis users scored higher on all variables assessed: anomalous perception of reality (Cohen’s d = .60), rumination ( d = .48), intolerance of uncertainty ( d = .11), suicidal attempt (affirmative answer: 25.9% of users vs 7.7% of non-users), hopelessness ( d = .85), symptoms of depression ( d = .80), and anxiety ( d = .39). A binary logistic regression showed that the only variable uniquely related to cannabis use was hopelessness (Wald = 4.560, OR: 1.159, p = .033).

Conclusions:

Among some mental health risk factors, hopelessness appears uniquely related to cannabis use. Adolescents may use cannabis as a coping strategy for negative thoughts and emotions, or it may be a consequence of cannabis use. Future prevention programs should focus on preventing/treating modifiable factors such as hopelessness, and delaying cannabis use in specific subgroups of adolescents who experience pathologies such as depression or suicide attempts.
‘It’s not that they don’t want to access the support . . . it’s the impact of the autism’: The experience of eating disorder services from the perspective of autistic women, parents and healthcare professionals
Authors: Babb Charli , Brede Janina , Jones Catherine R G , Elliott Mair , Zanker Cathy , Tchanturia Kate , Serpell Lucy , Mandy Will , Fox John R E
Published: February 2021

This study explores autistic women’s experiences of eating disorder services. Estimates suggest that 20%–30% of women in treatment for anorexia nervosa display diagnostic features characteristic of autism. Research suggests that autistic individuals’ needs are not being met by standard anorexia nervosa treatments. In the current study, in-depth interviews were conducted with 15 autistic women with experience of anorexia nervosa, 12 parents of autistic women with anorexia nervosa, and 11 eating disorder healthcare professionals. Using thematic analysis, three overarching themes were identified: misunderstanding autism and autistic traits, one treatment does not fit all, and improving accessibility and engagement within services. We found that there were diverse barriers facing autistic women when in treatment for anorexia nervosa, and these were accentuated by a lack of autism understanding within eating disorder services. Future research should focus on developing interventions that are tailored to the specific needs of autistic individuals with anorexia nervosa.

Lay Abstract

This study explores autistic women’s experiences of eating disorder services. About 20%–30% of people with anorexia nervosa are also autistic, and current treatments seem not to work as well for them. We interviewed 15 autistic women with experience of anorexia nervosa, 12 parents of autistic women with anorexia nervosa, and 11 healthcare professionals working in eating disorder services. We asked autistic women and parents about their experiences of eating disorder services, and we asked healthcare professionals about their experiences treating autistic women with anorexia nervosa. Participants’ views were represented by three overall themes: misunderstanding autism and autistic traits, one treatment does not fit all, and improving accessibility and engagement within services. We found that autistic women face many barriers when in treatment for anorexia nervosa, often because of a lack of autism understanding within eating disorder services. Future research should look at developing anorexia nervosa treatments that can specifically help autistic individuals.
Using Participatory Methods to Enhance Youth Engagement in Substance Use Research
Authors: Valdez Elizabeth S. , Valdez Luis , Garcia David O.
Published: February 2021

Youth engagement in substance use research is critical to the understanding of correlates that lead to detrimental health and social outcomes for adolescents. In addition to the documented challenges related to youth recruitment for substance use research, Latinx youth living on the U.S.–Mexico border may be difficult for researchers to engage in substance use research because they could face retributory harm if they identify their experiences to any entity perceived as an authority (e.g., researchers). Empirical findings that posit viable strategies to engage marginalized youth in substance use research are lacking. Participatory approaches show promise in increasing participation of historically underrepresented youth in research. Building on previously published work on our youth participatory action research mixed-methods study, this article discusses the youth-led participatory approach used to (1) develop and pilot test a culturally, regionally, and linguistically tailored substance use instrument and (2) engage 445 Latinx youth to participate in a cross-sectional study to assess epidemiological patterns of youth substance use on the U.S.–Mexico border. We share lessons learned related to the youth-led instrument design, youth-led recruitment strategy, and assuring participant confidentiality.
Emotion Recognition Deficits in Psychiatric Disorders as a Target of Non-invasive Neuromodulation: A Systematic Review
Authors: Yamada Yuji , Inagawa Takuma , Hirabayashi Naotsugu , Sumiyoshi Tomiki
Published: February 2021

Background. Social cognition deficits are a core feature of psychiatric disorders, such as schizophrenia and mood disorder, and deteriorate the functionality of patients. However, no definite strategy has been established to treat social cognition (eg, emotion recognition) impairments in these illnesses. Here, we provide a systematic review of the literature regarding transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for the treatment of social cognition deficits in individuals with psychiatric disorders. Methods. A literature search was conducted on English articles identified by PubMed, PsycINFO, and Web of Science databases, according to the guidelines of the PRISMA statement. We defined the inclusion criteria as follows: (1) randomized controlled trials (RCTs), (2) targeting patients with psychiatric disorders (included in F20-F39 of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems [ICD-10]), (3) evaluating the effect of tDCS or rTMS, (4) reporting at least one standardized social cognition test. Results. Five papers (3 articles on tDCS and 2 articles on rTMS) met the inclusion criteria which deal with schizophrenia or depression. The significant effects of tDCS or rTMS targeting the left dorsolateral prefrontal cortex on the emotion recognition domain were reported in patients with schizophrenia or depression. In addition, rTMS on the right inferior parietal lobe was shown to ameliorate social perception impairments of schizophrenia. Conclusions. tDCS and rTMS may enhance some domains of social cognition in patients with psychiatric disorders. Further research is warranted to identify optimal parameters to maximize the cognitive benefits of these neuromodulation methods.
Variability in Estimated Modelled Insulin Secretion
Authors: Ormsbee Jennifer J. , Burden Hannah J. , Knopp Jennifer L. , Chase J. Geoffrey , Murphy Rinki , Shepherd Peter R. , Merry Troy
Published: February 2021

Background:

The ability to measure insulin secretion from pancreatic beta cells and monitor glucose-insulin physiology is vital to current health needs. C-peptide has been used successfully as a surrogate for plasma insulin concentration. Quantifying the expected variability of modelled insulin secretion will improve confidence in model estimates.

Methods:

Forty-three healthy adult males of Māori or Pacific peoples ancestry living in New Zealand participated in an frequently sampled, intravenous glucose tolerance test (FS-IVGTT) with an average age of 29 years and a BMI of 33 kg/m2. A 2-compartment model framework and standardized kinetic parameters were used to estimate endogenous pancreatic insulin secretion from plasma C-peptide measurements. Monte Carlo analysis (N = 10 000) was then used to independently vary parameters within ±2 standard deviations of the mean of each variable and the 5th and 95th percentiles determined the bounds of the expected range of insulin secretion. Cumulative distribution functions (CDFs) were calculated for each subject for area under the curve (AUC) total, AUC Phase 1, and AUC Phase 2. Normalizing each AUC by the participant’s median value over all N = 10 000 iterations quantifies the expected model-based variability in AUC.

Results:

Larger variation is found in subjects with a BMI > 30 kg/m2, where the interquartile range is 34.3% compared to subjects with a BMI ≤ 30 kg/m2 where the interquartile range is 24.7%.

Conclusions:

Use of C-peptide measurements using a 2-compartment model and standardized kinetic parameters, one can expect ~±15% variation in modelled insulin secretion estimates. The variation should be considered when applying this insulin secretion estimation method to clinical diagnostic thresholds and interpretation of model-based analyses such as insulin sensitivity.
Variation of Mean Absolute Relative Differences of Continuous Glucose Monitoring Systems Throughout the Day
Authors: Pleus Stefan , Stuhr Andreas , Link Manuela , Haug Cornelia , Freckmann Guido
Published: February 2021

Background:

There is an increasing use of continuous glucose monitoring (CGM) by people with diabetes. Measurement performance is often characterized by the mean absolute relative difference (MARD). However, MARD is influenced by a number of factors and little is known about whether MARD is stable throughout the day.

Material and Methods:

A total of 24 participants with type 1 diabetes were enrolled in the study. The study was performed for seven in-patient days. Participants wore two CGM systems in parallel and performed additional frequent blood glucose (BG) measurements. On two days, glucose excursions were induced. MARD was calculated between pairs of CGM and BG values, with BG values serving as reference values. ARD values calculated from CGM-BG pairs were grouped by hour of the day. Results were analyzed separately for glucose excursion days and for regular days.

Results:

Total MARDs for the complete study duration were 12.5% ± 3.6% and 13.2% ± 2.4% ( n = 24). Throughout the day marked variability of MARD was observed (8.0% ± 1.3%-16.3% ± 2.9% (G5); 9.1% ± 1.4%-16.3% ± 5.3% (FL), up to n = 157 each). Low(est) MARD values were observed before breakfast and dinner, when subjects were in or near a fasting state. Especially after breakfast and lunch, MARD values were higher than average.

Conclusions:

Analytical performance of the two CGM systems, assessed by MARD, was found to vary markedly throughout the day. Activities of daily life likely triggered these variations. An increasing number of CGM users base therapeutic decisions on CGM values, and they should be aware of these variations of performance throughout the day.
Talar and Subtalar T1ρ Relaxation Times in Limbs with and without Chronic Ankle Instability
Authors: Song Kyeongtak , Pietrosimone Brian , Tennant Joshua N. , Nissman Daniel B. , Dederer Katherine M. , Paranjape Chinmay , Wikstrom Erik A.
Published: February 2021

Objective

The primary aim was to determine differences in talocrural and subtalar joint (STJ) articular cartilage composition, using T1ρ magnetic resonance imaging (MRI) relaxation times, between limbs in individuals with unilateral chronic ankle instability (CAI) and compare with an uninjured control. Our secondary purpose was to determine the association between talocrural and STJ composition in limbs with and without CAI.

Design

T1ρ MRI relaxation times were collected on 15 CAI (11 females, 21.13 ± 1.81 years, body mass index [BMI] = 23.96 ± 2.74 kg/m2) and 15 uninjured control individuals (11 females, 21.07 ± 2.55 years, BMI = 24.59 ± 3.44 kg/m2). Talocrural cartilage was segmented manually to identify the overall talar dome. The SJT cartilage was segmented manually to identify the anterior, medial, and posterior regions of interest consistent with STJ anatomical articulations. For each segmented area, a T1ρ relaxation time mean and variability value was calculated. Greater T1ρ relaxation times were interpreted as decreased proteoglycan content.

Results

Individuals with CAI demonstrated a higher involved limb talocrural T1ρ mean and variability relative to their contralateral limb ( P < 0.05) and the healthy control limb ( P < 0.05). The CAI-involved limb also had a higher posterior STJ T1ρ mean relative to the healthy control limb ( P < 0.05). In healthy controls ( P < 0.05), but not the CAI-involved or contralateral limbs (p>0.05), talocrural and posterior STJ composition measures were positively associated.

Conclusions

Individuals with CAI have lower proteoglycan content in both the talocrural and posterior STJ in their involved limbs relative to the contralateral and a healthy control limb. Cartilage composition findings may be consistent with the early development of posttraumatic osteoarthritis.
Spatio-temporal dynamics of flood exposure in Shenzhen from present to future
Authors: Sarica Gizem Mestav , Zhu Tinger , Jian Wei , Lo Edmond Yat-Man , Pan Tso-Chien
Published: February 2021

The Pearl River Delta metropolitan region is one of the most densely urbanized megapolises worldwide with high exposure to weather-related disasters such as storms, storm surges and river floods. Shenzhen megacity has been the fastest growing city in the Pearl River Delta region with a significant increase of resident population from 0.32 million in 1980 to 13.03 million in 2018. Being a flood-prone city, Shenzhen’s rapid urbanization has further exacerbated potential flood losses and forthcoming risk. Thus, evaluating the changes in its exposure from present to future is essential for flood risk assessment, mitigation and management purposes. The main objective of this study is to present a methodology to assess the spatio-temporal dynamics of flood exposure from present to future using high-resolution and open-source data with a particular focus on the built-up area. To achieve this, the SLEUTH model, a cellular automata-based urban growth model, was employed for predicting the built-up area in Shenzhen in 2030. An almost threefold increase was observed in total built-up area from 421 km2 in 1995 to 1166 km2 in 2030, with the 2016 built-up area being 858 km2. Built-up areas, both present (2016) and projected (2030), were then used as the land cover input for flood hazard assessment based on a fuzzy comprehensive evaluation model, which classified the flood hazard into five levels. The analysis indicates that the built-up area subjected to the two highest flood hazard levels will increase by almost 88% (212 km2) from present to future. The approach presented here can be leveraged by policymakers to identify critical areas that should be prioritized for flood mitigation and protection actions to minimize potential losses.
Equine-Assisted Activities and Therapies for Veterans With Posttraumatic Stress Disorder: Current State, Challenges and Future Directions
Authors: Marchand William R. , Andersen Sarah J. , Smith Judy E. , Hoopes Karl H. , Carlson Jennifer K.
Published: February 2021

Posttraumatic stress disorder is common among military Veterans. While effective treatments exist, many Veterans either do not engage in treatment or fail to achieve full remission. Thus, there is a need to develop adjunctive complementary interventions to enhance treatment engagement and/or response. Equine-assisted activities and therapies (EAAT) are one category of animal assisted interventions that might serve this function. The aim of this article is to review the current state and challenges regarding the use of EAAT for Veterans with PTSD and provide a roadmap to move the field forward. EAAT hold promise as adjunctive complementary interventions for symptom reduction among Veterans with PTSD. Additionally, there is evidence that these approaches may enhance wellbeing in this population. At this time, many gaps in the literature exist and rigorous randomized controlled trials are needed before definitive conclusions can be drawn. The authors of this work provide recommendations as a roadmap to move the field forward. These include standardizing the EAAT nomenclature, focusing mechanism of action studies on the human-horse bond using biological metrics and using a standardized intervention model across studies.
A Clinical Triad with Fatal Implications: Recrudescent Diffuse Large B-cell Non-Hodgkin Lymphoma Presenting in the Leukemic Phase with an Elevated Serum Lactic Acid Level and Dysregulation of the TP53 Tumor Suppressor Gene – A Case Report and Literature Review
Authors: Hwang Catherine S , Hwang Dick G , Aboulafia David M
Published: February 2021

Despite representing 30% to 40% of newly diagnosed cases of adult non-Hodgkin lymphoma, diffuse large B-cell lymphoma (DLBCL) rarely presents (1) in the leukemic phase (2) with dysregulation of the TP53 tumor suppressor gene and (3) an elevated serum lactic acid level. In this case report and literature review, we highlight this unfortunate triad of poor prognostic features associated with an aggressive and fatal clinical course in a 53-year-old man with recrudescent DLBCL. A leukemic presentation of de novo or relapsed DLBCL is rare and may be related to differential expressions of adhesion molecules on cell surfaces. In addition, TP53 gene mutations are present in approximately 20% to 25% of DLBCL cases and foreshadow worse clinical outcomes. Finally, an elevated serum lactic acid level in DLBCL that is not clearly associated with sepsis syndrome is a poor prognostic factor for survival and manifests as type B lactic acidosis through the Warburg effect.
Factor XII plays a pathogenic role in organ failure and death in baboons challenged withStaphylococcus aureus
Authors: Silasi Robert , Keshari Ravi S. , Regmi Girija , Lupu Cristina , Georgescu Constantin , Simmons Joe H. , Wallisch Michael , Kohs Tia C. L. , Shatzel Joseph J. , Olson Sven R. , Lorentz Christina U. , Puy Cristina , Tucker Erik I. , Gailani David , Strickland Sidney , Gruber András , McCarty Owen J. T. , Lupu Florea
Published: February 2021

Activation of coagulation factor (F) XI promotes multiorgan failure in rodent models of sepsis and in a baboon model of lethal systemic inflammation induced by infusion of heat-inactivated Staphylococcus aureus. Here we used the anticoagulant FXII-neutralizing antibody 5C12 to verify the mechanistic role of FXII in this baboon model. Compared with untreated control animals, repeated 5C12 administration before and at 8 and 24 hours after bacterial challenge prevented the dramatic increase in circulating complexes of contact system enzymes FXIIa, FXIa, and kallikrein with antithrombin or C1 inhibitor, and prevented cleavage and consumption of high-molecular-weight kininogen. Activation of several coagulation factors and fibrinolytic enzymes was also prevented. D-dimer levels exhibited a profound increase in the untreated animals but not in the treated animals. The antibody also blocked the increase in plasma biomarkers of inflammation and cell damage, including tumor necrosis factor, interleukin (IL)-1β, IL-6, IL-8, IL-10, granulocyte-macrophage colony-stimulating factor, nucleosomes, and myeloperoxidase. Based on clinical presentation and circulating biomarkers, inhibition of FXII prevented fever, terminal hypotension, respiratory distress, and multiorgan failure. All animals receiving 5C12 had milder and transient clinical symptoms and were asymptomatic at day 7, whereas untreated control animals suffered irreversible multiorgan failure and had to be euthanized within 2 days after the bacterial challenge. This study confirms and extends our previous finding that at least 2 enzymes of the contact activation complex, FXIa and FXIIa, play critical roles in the development of an acute and terminal inflammatory response in baboons challenged with heat-inactivated S aureus.
Clinical factors and outcomes of subsegmental pulmonary embolism in cancer patients
Authors: Yan Melissa , Kieser Ryan , Wu Carol C. , Qiao Wei , Rojas-Hernandez Cristhiam M.
Published: February 2021

In the cancer population, patients diagnosed with venous thromboembolism (VTE) are considered to have a threefold increased risk of mortality compared with those without VTE. With the advent of modern computed tomography (CT), the rate of diagnosis of subsegmental pulmonary embolism (SSPE) has increased, likely as a result of improved visualization of the peripheral pulmonary arteries. The clinical significance of SSPE remains unclear because of the lack of randomized controlled clinical trials. The aim of this study was to identify the incidence and risk factors of recurrent proximal PE within 12 months of diagnosis of SSPE in cancer. We performed a retrospective analysis of 206 adult cancer patients who were diagnosed with SSPE from 2014 to 2016 at the University of Texas MD Anderson Cancer Center. At the time of SSPE diagnosis, the majority had metastatic cancer, 108 patients (53.2%) were undergoing chemotherapy, and 23 patients (11.2%) had a history of VTE. Most patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2. Sixty-seven percent of SSPE was discovered incidentally on restaging CT scans, with the majority being a single and isolated event (70.9%). Within 12 months of SSPE diagnosis, 18 patients (8.7%) were found to have a recurrent PE. The patients treated with anticoagulation had a lower rate of PE recurrence (8% vs 13% in those not treated with anticoagulation). Treatment with anticoagulation did not appear to have a significant impact on overall survival (P = .48) when adjusted for ECOG performance status and cancer stage.
Arthroscopic rotator cuff repair in patients over 70 years of age: a systematic review
Authors: Fossati Chiara , Stoppani Carlo , Menon Alessandra , Pierannunzii Luca , Compagnoni Riccardo , Randelli Pietro S.
Published: February 2021

Background

Failure of conservative treatment in patients over 70 years of age with a rotator cuff tear makes surgery a possible option, considering the increase in life expectancy and the high functional demands of elderly patients. The purpose of this systematic review of the literature was to evaluate the subjective and objective outcomes after arthroscopic rotator cuff repair in patients over 70 years of age.

Methods

A systematic review was performed to identify all the studies reporting subjective and objective outcomes in patients aged 70 years or older undergoing arthroscopic rotator cuff repair. Constant Murley Score (CMS), visual analog scale (VAS), American Shoulder and Elbow Surgeons Score (ASES), and Simple Shoulder Test (SST) were used to detect any clinical improvement after surgery. Retear and satisfaction were also analyzed.

Results

Out of 941 studies identified, only 6 papers have been included in the review. All studies reported improvements in postoperative functional outcome scores that exceed the minimal clinically relevant difference. The mean retear rate amounts to 21.9%, which is in line with the failure rate of rotator cuff repair in general population. Moreover, postoperative satisfaction is very high (95%).

Conclusion

This systematic review suggests that arthroscopic rotator cuff repair in patients over 70 years of age could be a valid treatment option after failure of conservative approach.

Level of evidence: 4

Trial registration The study was registered on PROSPERO (registration ID: CRD42018088613)
Time trends of socioeconomic inequalities in adolescent smoking in Okinawa, Japan, 2008–2016: a repeated cross-sectional study
Authors: Takakura Minoru , Miyagi Masaya , Kyan Akira
Published: February 2021

Background

Smoking among Japanese adolescents has decreased noticeably. However, little is known whether the decreasing trend in adolescent smoking can be seen across all socioeconomic status (SES) groups. This study aimed to examine trends in socioeconomic inequalities in smoking among Japanese adolescents between 2008 and 2016.

Methods

We conducted a repeated cross-sectional study using data from three surveys of high school students in Okinawa, Japan, in 2008, 2012, and 2016. The study participants consisted of 7902 students in grades 10 through 12 (15–18 years). Smoking was assessed as current cigarette use. SES indicators included familial SES (parental education and family structure) and student’s own SES (school type). To evaluate absolute and relative inequalities, prevalence differences (PDs) and ratios (PRs) between low and high SES groups were estimated. The slope index of inequality (SII) and relative index of inequality (RII) were also calculated.

Results

Smoking prevalence among boys and girls significantly declined from 11.5% and 6.2% in 2008 to 4.7% and 1.9% in 2016, respectively. Similar decreasing trends in smoking were found among most of the SES groups. The PDs and SII for parental education in boys and family structure in girls decreased over time while those for school type persisted among boys and girls. The PRs and RII for school type in boys increased while those for other SES indicators among both sexes remained stable over time.

Conclusions

Smoking among Japanese adolescents has been declining and time trends of socioeconomic inequalities in smoking varied by absolute and relative measures. Further policies and/or interventions to reduce smoking inequalities should focus on the context of schools, especially in vocational high schools.
Single dose of testosterone in children with hypospadias: any effect on the diameter of the glans penis?
Authors: Chukwubuike Kevin Emeka
Published: February 2021

Background

The purpose of this study was to assess the effect of a single dose of testosterone on the diameter of the glans penis.

Methods

This was a prospective evaluation of the effect of a single dose of testosterone on the diameter of the glans penis of children with hypospadias. The diameter of the glans penis was measured transversely at the level of the coronal sulcus using Vernier calipers. The patients were categorized into two groups: Group A and Group B. Group A received intramuscular testosterone at the dose of 2 mg per kilogram body weight. Group B did not receive any testosterone and served as control. The diameter of the glans penis was evaluated at the beginning of the study and at 4 weeks after the testosterone injection.

Results

Overall, 64 patients were evaluated. There were 32 patients in group A (50%) and 32 patients in group B (50%). The mean diameter in group A before and after testosterone injection was 17.6 mm ± 2.5 SD and 17.8 ± 2.3 SD, respectively. The mean diameter in group B at onset and after 4 weeks was 17.6 mm ± 2.4 SD and 17.7 ± 2.4 SD, respectively. p = 0.12 which is statistically insignificant.

Conclusion

Single dose of testosterone in children with hypospadias does not produce significant increase in the diameter of the glans penis.
Risk factors of premature ejaculation and its influence on sexual function of spouse
Authors: Li Hu , Gao Pan , Gao Jingjing , Wu Xu , Liu Guodong , Dai Yutian , Jiang Hui , Zhang Xiansheng
Published: February 2021

Background

Premature ejaculation (PE) is a multifactorial problem with a complicated aetiology that has detrimental effects on female partners’ sexual function. However, there is a lack of studies on the relationship between the factors related to PE and female sexual dysfunction (FSD) in China. We aimed to identify and explore the relationship between the factors associated with PE and FSD.

Results

Ultimately, information was collected from 761 couples: 445 couples with PE complaints and 316 couples without PE complaints. The mean ages of the men with and without PE complaints were 36.29 ± 9.87 years and 31.48 ± 10.77 years, respectively. Female partners in the group with PE complaints reported lower total and subdomain female sexual function index (FSFI) scores, and approximately 65% of them were diagnosed with FSD (vs. control group: 31.96%). A PE duration of more than 14 months, a self-estimated intravaginal ejaculation latency time (self-estimated IELT) less than 2 min, a negative attitude towards PE problems, men’s introversion, and men’s depression were risk factors for FSD in the PE group.

Conclusions

PE affects not only the patient himself but also the spouse. Comprehensive analysis reveals a clear relationship and interaction between female sexual function and PE. Moreover, in PE treatment, we should not ignore the occurrence of FSD and its impact and should emphasize the treatment of couples together.