bluuebunny/crossref_metadata_2025 huggingface dataset:
Crystal Structure-Free Method for Dielectric and Polarizability Characterization of Crystalline Materials at Terahertz Frequencies
Authors: Zhang Tianyao , Zhang Zhaohui , Arnold Mark A.
Published: March 2021

Terahertz (THz) time-domain spectroscopy provides a direct and nondestructive method for measuring the dielectric properties of materials directly from the phase delay of coherent electromagnetic radiation propagating through the sample. In cases when crystals are embedded within an inert polymeric pellet, the Landau, Lifshitz, and Looyenga (LLL) effective medium model can be used to extract the intrinsic dielectric constant of the crystalline sample. Subsequently, polarizability can be obtained from the Clausius–Mossotti (CM) relationship. Knowledge of the crystal structure density is required for an analytical solution to the LLL and CM relationships. A novel crystal structure-free graphical method is presented as a way to estimate both dielectric constants and polarizability values for the situation when the crystal structure density is unknown, and the crystals are embedded within a pellet composed of a non-porous polymer. The utility of this crystal structure-free method is demonstrated by analyzing THz time-domain spectra collected for a set of amino acids (L-alanine, L-threonine, and L-glutamine) embedded within pellets composed of polytetrafluoroethylene. Crystal structures are known for each amino acid, thereby enabling a direct comparison of results using the analytical solution and the proposed crystal structure-free graphical method. For each amino acid, the intrinsic dielectric constant is extracted through the LLL effective medium model without using information of their crystal structure densities. THz polarizabilities are then calculated with the CM relationship by using the determined intrinsic dielectric constant for each amino acid coupled with its crystal density as determined graphically. Comparison between the analytical and graphical solutions reveal relative differences between dielectric constants of 3.7, 5.1, and 13.6% for threonine, alanine, and glutamine, respectively, and relative differences between polarizability of 0.6, 0.9, and 5.4%, respectively. These values were determined over the 10–20 cm−1 THz frequency range. The proposed method requires no prior knowledge of crystal structure information.
Acquisitions of Startups by Incumbents: The 3 Cs of Co-Specialization from Startup Inception to Post-Merger Integration
Authors: Brueller Nir N. , Capron Laurence
Published: March 2021

Facing constant pressures to grow, established firms increasingly harness external innovation by collaborating with and eventually acquiring startups. To succeed in their exit through acquisition, startup firms and incumbents have to master three steps (the “3 Cs”) that enhance the co-specialization with the acquirer: establishing the Complementarity of offerings, generating Customer endorsement, and attracting an acquirer executive Champion. Drawing on a multiple-case, inductive study of seven Israeli startup acquisitions completed by two acquirers from the information and communications technology (ICT) industry, this article illustrates the different approaches pursued by the startup firms and their acquirers to succeed in managing pre- and post-acquisition processes.
Use of Measuring Tools in Practice Development Projects: A Critical Perspective
Authors: Glasdam Stinne , Sudmann Tobba Therkildsen
Published: March 2021

Background.

Occupational therapists are generally positive towards use of measuring tools. However, such use may be problematic.

Purpose.

To illuminate hidden and adverse effects of using measuring tools in occupational therapy.

Method.

A Foucauldian inspired thematic analysis of the use of measuring tools in 13 reports of practice development projects in Denmark.

Findings.

Three themes were constructed: “Categorisation of loss”, “Conduct of conduct: Self-tracking and competition”, and “Conforming to expected forms of everyday living”. Measuring tools tended to produce generalised truths about older adults and were used to predict outcome of or access to reablement programs. The measurements guided both older people and professionals, and measurements created both motivation and resistance. The tools served as an extension of the healthcare professionals’ authority.

Implications.

When appropriately situated, measuring tools have the potential to empower and enhance older adults’ lives and should be the focus of greater clinical attention.
Sfida al pianeta di Anna Rinonapoli: Intertestualità tra fantascienza ecologica, Stanislaw Lem e Dante
Authors: Attilio Baldi Elio
Published: March 2021

Anna Rinonapoli è una delle scrittrici di fantascienza più importanti della prima generazione in Italia. Le sue opere, scritte tra il 1963 al 1986, come le opere di altre scrittrici italiane di fantascienza, rimangono però poco studiate nel mondo accademico. Questo articolo inizierà a colmare questa lacuna, trattando di Sfida al pianeta (1973), romanzo considerato all'epoca “il primo romanzo fantascientifico a livello letterario” da Inìsero Cremaschi (Rinonapoli, 1973: 5). Dopo una discussione delle possibili ragioni della scarsa attenzione critica dedicata alle opere di Rinonapoli e altre scrittrici di fantascienza, si analizzerà fino a che punto romanzo e autrice possono essere qualificati come “femministi”. Il rapporto di Rinonapoli col femminismo è ambiguo e l’analisi del libro attraverso il concetto di male gaze dimostra che il libro è alquanto problematico nelle descrizioni delle differenze tra uomini e donne. L’articolo argomenta tuttavia che, valutando le imperfezioni stilistiche e di contenuto nel contesto della carriera di Rinonapoli e della posizione delle donne nella fantascienza (italiana), si riescono ad apprezzare meglio sia gli aspetti più riusciti sia quelli meno convincenti del libro. Nella seconda parte dell'articolo si metteranno in evidenza i rapporti intertestuali con altri testi di fantascienza ecologica, ma soprattutto con Stanislaw Lem e Dante Alighieri. Attraverso quest'intertestualità si scopre la complessità del libro di Rinonapoli e il dialogo che esso intrattiene con autori e canoni divergenti, trasmettendo un messaggio ecologico e pacifico ancora di grande attualità.
Health Inequalities in the Time of COVID-19: The Globally Reinforcing Need to Strengthen Health Inequalities Research Capacities
Authors: Cash-Gibson Lucinda , Pericàs Juan M. , Martinez-Herrera Eliana , Benach Joan
Published: March 2021

The full impact of coronavirus disease 2019 (COVID-19) is yet to be well established; however, as the pandemic spreads, and early results emerge, unmet needs are being revealed, and pressing questions are being asked about who is most affected, how, where, and in what ways government responses might be exacerbating inequalities. A number of scholars have called for more in-depth critical research on COVID-19 and health inequalities to produce a strong empirical evidence based on these issues. There are also justifiable concerns about the scarcity of health-equity actions oriented analyses of the situation and calls for more empirical evidence on COVID-19 and health inequalities. A preliminary condition to establish this type of information is strong capacity to conduct health inequalities research. Worldwide, however, this type of capacity is limited, which, alongside other challenges, will likely hinder capacities of many countries to develop comprehensive equity-oriented COVID-19 analyses, and adequate responses to present and future crises. The current pandemic reinforces the pending need to invest in and strengthen these research capacities. These capacities must be supported by widespread recognition and concern, cognitive social capital, and greater commitment to coordinated, transparent action, and responsibility. Otherwise, we will remain inadequately prepared to respond and meet our society’s unmet needs.
Use of Off-Label Nasal Steroid Irrigations in Long-Term Management of Chronic Rhinosinusitis
Authors: Jiramongkolchai Pawina , Patel Siddharth , Schneider John S.
Published: March 2021

Objective:

Chronic rhinosinusitis (CRS) is an inflammatory disease of the paranasal sinuses and mucosa. Topical nasal corticosteroids are a mainstay treatment for CRS by reducing sinonasal inflammation and improving mucociliary clearance. However, topical corticosteroids have limited paranasal distribution, and patient response to treatment has been variable in randomized controlled trials (RCT). Thus, there is significant interest in evaluating the efficacy of nasal steroids delivered by nasal irrigation in order to improve penetration and absorption of topical steroids into the sinonasal mucosa. In this review, we discuss the use of off-label nasal steroid irrigations in the management of CRS.

Methods:

A review of clinical trials evaluating the use of nasal steroid irrigations for CRS in the PubMed electronic database was performed.

Results:

Of the 12 clinical studies identified, 10 evaluated budesonide irrigations while the remaining 2 focused on mometasone. The overwhelming majority of studies for both budesonide and mometasone supported the use of nasal irrigations with corticosteroids over nasal corticosteroid sprays alone. However, the heterogeneity in study design, patient cohort, and volume of steroid irrigation limit the interpretations of these studies.

Conclusions:

Nasal irrigation with corticosteroids is beneficial and safe for the treatment of CRS. Future RCTs controlling for type of surgical intervention, CRS pheno- and endo-type, as well as dosing and duration of nasal corticosteroid irrigations are warranted.
The Relations of Social Network Types With Mental Distress Among Older Korean Americans: The Interactive Role of Living Arrangement
Authors: Park Nan Sook , Jang Yuri , Chiriboga David A. , Chung Soondool
Published: March 2021

The purpose of this study is to identify social network types in older Korean Americans and to examine their direct associations, as well as interactions with living arrangement, on mental distress. Drawn from the Study of Older Korean Americans (SOKA), participants were aged 60 or over and lived in five states. Analyses included 2,140 cases surveyed during 2017−2018. To identify social network types, latent profile analyses were conducted using 10 network-related criterion variables. A model with five social network types was identified as best fit. The groups were labeled as diverse, moderately diverse, family deficit, friend deficit, and restricted. As hypothesized, greater mental distress was associated with belonging to more deprived networks such as family deficit and restricted groups. Interaction effects also suggest that members of the restricted group were more distressed when they lived alone than when they lived with others. Implications based on the results are discussed.
Multifocal lipoatrophy secondary to insulin injection in a patient with type 2 diabetes, hepatitis B virus infection, and liver cirrhosis
Authors: Wu Yuedan , Lou Xiaojia
Published: March 2021

Lipoatrophy secondary to insulin injection is a rare complication of insulin use. Localized lipoatrophy is recognized by a loss of subcutaneous fat caused by insulin injection. We report the case of a 69-year-old non-obese female patient with type 2 diabetes mellitus, decompensated liver cirrhosis, and hepatitis B virus (HBV) infection who developed multifocal lipoatrophy during the administration of human insulin and an insulin analog.
Clinical study of use of large C suture in procedure for prolapse and hemorrhoids for treatment of mixed hemorrhoids
Authors: Yu Jia-He , Huang Xiang-Wu , Wu Ze-Jiang , Lin Hui-Zhong , Zheng Feng-Wu
Published: March 2021

Objective

To investigate the clinical use of a large C suture in the procedure for prolapse and hemorrhoids (PPH) for treatment of mixed hemorrhoids.

Methods

Patients with mixed hemorrhoids (grade III or IV) who underwent treatment with a large C suture during PPH in the Affiliated Hospital (Group) of Putian University from 1 April 2018 to 31 March 2019 were enrolled in this retrospective study. The incidences of anastomotic stenosis and anastomotic hemorrhage after the operation were observed.

Results

The study population comprised 126 patients (46 men and 80 women) ranging in age from 30 to 78 years (mean, 46.1 ± 2.5 years). Of these patients, 60 had circular mixed hemorrhoids, 36 had grade III circular internal hemorrhoids, and 30 had grade IV circular internal hemorrhoids. The onset time among all patients ranged from 0.5 to 25 years. All patients underwent 6 months of postoperative follow-up. None of the patients with mixed hemorrhoids developed anastomotic stenosis, although two patients developed secondary anastomotic bleeding.

Conclusion

Placement of a large C suture during PPH is a reliable technique for treatment of mixed hemorrhoids. It is simple, effective, and applicable and can be helpful for a large number of patients in primary hospitals.
The Organizational Context of Supervisory Bullying: Diversity/Equity and Work-Family Policies
Authors: Rainey Anthony , Melzer Silvia Maja
Published: March 2021

The impact of harmful social relations in the workplace, such as workplace bullying, has become abundantly clear to the social sciences. However, data limitations have prevented researchers from fully examining the organizational component of workplace bullying. Using a sample of linked-employer-employee data collected from the German working population, this paper shows how the interaction of organizational attributes and individual characteristics of workers (specifically, gender) is associated with how workplace bullying manifests itself. A series of diversity/equity and work-family policies are examined. Results show that some programs, but not all, are associated with workplace bullying. More frequent organizational use of mentoring programs for women is associated with higher levels of supervisory bullying, while more frequent use of work-family policies is associated with higher levels of supervisory bullying in cases where the employee and supervisor are different genders.
Green synthesised silver nanoparticles incorporated electrospun poly(methyl methacrylate) nanofibers with different architectures for ophthalmologic alternatives
Authors: Philip Princy , Jose Tomlal , KS Sarath , Kuriakose Sunny
Published: March 2021

Silver nanoparticles with 5–10 nm diameters are synthesised using Couroupita guianensis flower extract. The synthesised silver nanoparticles found to show good antimicrobial activity against gram negative and gram positive bacteria. Poly(methyl methacrylate) nanofibers with pristine, surface roughened and coaxial hollow forms are prepared by electrospinning. The structural and morphological properties of these pure and structurally modified poly(methyl methacrylate) nanofibers are evidenced by various analytical techniques. The antimicrobial studies of poly(methyl methacrylate) nanofibers having different architectures incorporated with silver nanoparticles are carried out. It is found that, all the three forms of poly(methyl methacrylate) nanofibers incorporated with silver nanoparticles show antibacterial properties against both gram positive and gram negative bacteria. Among these, surface roughened poly(methyl methacrylate) nanofibers incorporated with silver nanoparticles show highest antibacterial activity than the other two structural forms. The present study offers an alternative to the existing optical lenses. People especially those who suffer from eye problems can protect their eyes in a better way from infectious agents by wearing optical lens made from C. guianensis stabilised silver nanoparticles incorporated poly(methyl methacrylate) nanofibers than that made from pure poly(methyl methacrylate) nanofibers or films.
Predicting Body-Esteem Based on Type of Sexual Victimization Experience
Authors: Osman Suzanne L. , Nicholson Jamie P.
Published: March 2021

Almost no research exists examining the relationship between body-esteem and sexual victimization experience in adulthood. The current study contributes to the literature by examining body-esteem based on type of sexual victimization experience (i.e., none, sexual contact, attempted sexual coercion, sexual coercion, attempted rape, rape). Participants included undergraduate women ( n = 750) who completed the Body-Esteem Scale ( Franzoi & Shields, 1984 ) and the Sexual Experiences Survey-Short Form Victimization ( Koss et al., 2007 ), and had either no history of sexual victimization experience or experience within the past year. Women with no sexual victimization experience did not differ from women with sexual contact experience, but both groups reported higher body-esteem than women with coercion, attempted coercion, and rape experience. These three latter groups did not differ from one another, but each reported lower body-esteem than women with attempted rape experience, who reported higher body-esteem than those with no experience. Findings are preliminary but suggest that body-esteem may be negatively associated with some types of sexual victimization experience (attempted and completed coercion, rape), but not others (sexual contact, attempted rape), and escaping rape may increase positive feelings toward one’s body.
Patients Living With HIV Are Less Likely to Receive Appropriate Statin Therapy for Cardiovascular Disease Risk Reduction
Authors: Emmons Roshni P. , Hastain Nicholas V. , Miano Todd A. , Schafer Jason J.
Published: March 2021

Background:

Recent studies suggest that statins are underprescribed in patients living with HIV (PLWH) at risk for atherosclerotic cardiovascular disease (ASCVD), but none have assessed if eligible patients receive the correct statin and intensity compared to uninfected controls.

Objectives:

The primary objective was to determine whether statin-eligible PLWH are less likely to receive appropriate statin therapy compared to patients without HIV.

Methods:

This retrospective study evaluated statin eligibility and prescribing among patients in both an HIV and internal medicine clinic at an urban, academic medical center from June-September 2018 using the American College of Cardiology/American Heart Association guideline on treating blood cholesterol to reduce ASCVD risk. Patients were assessed for eligibility and actual treatment with appropriate statin therapy. Characteristics of patients appropriately and not appropriately treated were compared with chi-square testing and predictors for receiving appropriate statin therapy were determined with logistic regression.

Results:

A total of 221/300 study subjects were statin-eligible. Fewer statin-eligible PLWH were receiving the correct statin intensity for their risk benefit group versus the uninfected control group (30.2% vs 67.0%, p < 0.001). In the multivariable logistic regression analysis, PLWH were significantly less likely to receive appropriate statin therapy, while those with polypharmacy were more likely to receive appropriate statin therapy.

Conclusion:

Our study reveals that PLWH may be at a disadvantage in receiving appropriate statin therapy for ASCVD risk reduction. This is important given the heightened risk for ASCVD in this population, and strategies that address this gap in care should be explored.
In vitro evaluation of estrogenic, antiestrogenic and antitumor effects of amentoflavone
Authors: Aliyev AT , Ozcan-Sezer S , Akdemir A , Gurer-Orhan H
Published: March 2021

Apigenin, a flavonoid, is reported to act as an estrogen receptor (ER) agonist and inhibit aromatase enzyme. However, amentoflavone, a biflavonoid bearing two apigenin molecules, has not been evaluated for its endocrine modulatory effects. Besides, it is highly consumed by young people to build muscles, enhance mood and lose weight. In the present study, apigenin was used as a reference molecule and ER mediated as well as ER-independent estrogenic/antiestrogenic activity of amentoflavone was investigated. Antitumor activity of amentoflavone was also investigated in both ER positive (MCF-7 BUS) and triple-negative (MDA-MB-231) breast cancer cells and its cytotoxicity was evaluated in human breast epithelial cells (MCF-10A). Our data confirmed ER agonist, aromatase inhibitory and cytotoxic effects of apigenin in breast cancer cells, where no ER mediated estrogenic effect and physiologically irrelevant, slight, aromatase inhibition was found for amentoflavone. Although selective cytotoxicity of amentoflavone was found in MCF-7 BUS cells, it does not seem to be an alternative to the present cytotoxic drugs. Therefore, neither an adverse effect, mediated by an estrogenic/antiestrogenic effect of amentoflavone nor a therapeutical benefit would be expected from amentoflavone. Further studies could be performed to investigate its in vivo effects.
Stepwise Strategic Mitigation Planning in a Pediatric Oncology Center During the COVID-19 Pandemic
Authors: Szenes Victoria , Bright Rachel , Diotallevi Deborah , Melendez Giselle , Martinez Cassie , Zakak Nicole , Killinger James , Gilheeney Stephen , Roberts Stephen S. , Kamboj Mini , Bender Julia Glade , Kung Andrew L. , Boulad Farid
Published: March 2021

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) first reached the United States in January 2020. Located in New York City (NYC), MSK Kids, at Memorial Sloan Kettering Cancer Center services, is one of the largest pediatric cancer centers in the U.S., caring for children, teenagers, and young adults with cancer, immune deficiencies, and blood disorders. Methods: Implementation for infection mitigation and ongoing care of patients included: (1) the creation of a strategic planning team of physicians, advanced practice providers, nurses, and administrators to develop guidance and workflows, (2) continuous reassessment of patients’ needs for hospital services and visit frequency, (3) the use of telemedicine to replace in-person visits, (4) the use of satellite regional centers to manage patients living outside NYC, (5) pre-screening of patients prior to visits for risks and symptoms of coronavirus disease 2019 (COVID-19) infection, (6) day-of-service screening for risks or symptoms of COVID-19 infection, (7) surveillance testing of children and their caregivers, and (8) creation of cohort plans for the management of COVID-19 positive and uninfected patients within the same institution, in both the outpatient and inpatient settings. Results: We describe the timeline for planning mitigation during the first weeks of the pandemic, and detail in a stepwise fashion the rationale and implementation of COVID-19 containment efforts in the context of a large pediatric oncology program. Discussion: Our experience offers a model on which to base strategic planning efforts at other pediatric oncology centers, for continued preparedness to combat the threat posed by SARS-CoV-2 worldwide.
Clinical Correction of Complete Median Cleft of the Mandible and Lower Lip: A 17-Year Follow-Up of a Case Report With Literature Review
Authors: Liu Weidong , Ma Li , Zhang Shizhou , Zhao Tengda
Published: March 2021

The median cleft of the mandible and lower lip is an extremely rare congenital maxillofacial deformity, and the therapeutic options are controversial. To evaluate the clinical characteristics and identify a better choice of treatment modes used among us and others, we reviewed 34 relevant literature and herein describe a 17-year follow-up of a case with a median cleft of the mandible and lower lip. Based on the literature and our case with good functional and aesthetical outcomes, we propose a prospective clinical treatment: Patients of Tessier 30 cleft associated with cleft of the mandible could undergo mandibular repair after puberty in conditions of a good occlusal relationship and normal maxillofacial development, even with mild masticatory dysfunction.
“I Can’t Blame Mum”: A Qualitative Exploration of Relational Dynamics in Women With Female Genital Mutilation (FGM) in the United Kingdom
Authors: Newton Rebecca J. , Glover Jennifer
Published: March 2021

Female genital mutilation (FGM) is conceptualized as an interpersonal act, commonly initiated by mothers. This study investigates relational dynamics among adult women who experienced FGM in childhood and have since migrated to the United Kingdom. A qualitative research design was employed, using semi-structured interviews and interpretative phenomenological analysis (IPA) with nine women. Three superordinate themes emerged: (a) “The ‘who to blame?’ conflict: Preserving goodness in parents”; (b) “Better or worse? Positioning the self in relation to others”; and (c) “Regaining power: Righting the wrongs.” Implications for understanding the relational consequences of FGM and the discontinuation of its intergenerational transmission are considered.
Making Care Better in the Context of Violence: The Limits of Blame
Authors: Swartz Leslie , Lappeman Maura
Published: March 2021

This brief commentary is a response to the helpful responses to our article on the problem of the concept of gentle violence in obstetric care. We find ourselves in substantial agreement with our interlocutors. We suggest that naming individual actions on the part of health care personnel as violent may not be necessary for changing the behavior of these personnel and may in fact impede change. We suggest further that requiring health care personnel to accept our definitions of violence may in itself be an oppressive or epistemically violent act, probably less likely to lead to desired change than other approaches. We emphasize the need for more dialogue on victimology and the discursive complexities of trying to intervene in situations of structural violence.
Salvage Reconstruction of a Congenital Hypoplastic Thumb Due to Constriction Ring Syndrome Using a Third Toe Transfer, When the Usual Donor Sites of Index Finger, Great and Second Toes Are Not Available
Authors: Wang Pengcheng , Jones Neil F.
Published: March 2021

Isolated third toe-to-thumb transfers have been rarely reported and none in the pediatric population. We describe a third toe-to-thumb transfer for reconstruction of a congenital hypoplastic thumb with excellent functional results and no morbidity in the donor foot.
The Development of Identity Fusion
Authors: Reese Elaine , Whitehouse Harvey
Published: March 2021

The fusion of personal and group identities can lead to self-sacrificial progroup behavior, from acts of charity to violent extremism. Two pathways to identity fusion—via shared biology and shared experiences—have been proposed. In this article, we elucidate a new developmental account of the origins and mechanisms of these two pathways to identity fusion from childhood to adulthood. Whereas fusion based on shared biology occurs from early childhood cued by phenotypic similarity, fusion based on episodic memories of shared experiences is not possible until midadolescence and relies on suitable bonding experiences (e.g., painful initiation rituals, emotionally intense team sports). The critical development that enables fusion based on shared experiences is autobiographical reasoning, which entails connecting one’s past experiences to the present self. Autobiographical reasoning begins in adolescence, which may explain the flourishing of fusion in late adolescence and young adulthood relative to other life periods. Fusion via either pathway is linked to strong progroup behavior. We outline a program of empirical research on the development of identity fusion while addressing relevant methodological challenges. A developmental framework may help foster efforts to harness identity fusion for peaceful rather than violent forms of self-sacrifice for the group.
Reliability analysis and state transfer scheduling optimization of degrading load-sharing system equipped with warm standby components
Authors: Ruan Sheng-Jia , Lin Yan-Hui
Published: March 2021

Standby redundancy can meet system safety requirements in industries with high reliability standards. To evaluate reliability of standby systems, failure dependency among components has to be considered especially when systems have load-sharing characteristics. In this paper, a reliability analysis and state transfer scheduling optimization framework is proposed for the load-sharing 1-out-of- N: G system equipped with M warm standby components and subject to continuous degradation process. First, the system reliability function considering multiple dependent components is derived in a recursive way. Then, a Monte Carlo method is developed and the closed Newton-Cotes quadrature rule is invoked for the system reliability quantification. Besides, likelihood functions are constructed based on the measurement information to estimate the model parameters of both active and standby components, whose degradation paths are modeled by the step-wise drifted Wiener processes. Finally, the system state transfer scheduling is optimized by the genetic algorithm to maximize the system reliability at mission time. The proposed methodology and its effectiveness are illustrated through a case study referring to a simplified aircraft hydraulic system.
Effects on pain of percutaneous treatment of cervical disc herniations using DiscoGel: A retrospective analysis
Authors: Fiori Roberto , Forcina Marco , Di Donna Carlo , Spiritigliozzi Luigi , Cavallo Armando Ugo , Floris Roberto
Published: March 2021

Background and purpose

Cervical discogenic pain originates from degenerated intervertebral discs and is a common condition in the middle-aged population. Cervical discs may herniate and give compressions to cervical nerves, with pain and functional limitation of the arms. DiscoGel is a device that can be useful in the treatment of cervical disc herniation, with very short operating time and low radiation dose.

Material and methods

Between March 2018 and April 2019 we performed this procedure on 38 patients with non-fissurated cervical herniation using 0.3–0.4 mL of DiscoGel injected under fluoroscopic guidance. The most common discs affected were C5–C6, C6–C7 and C4–C5. Outcomes were evaluated with Visual Analogue Scale (VAS) and Neuropathic Pain Symptom Inventory (NPSI) scores at 3, 6 and 12 months follow-up. A magnetic resonance imaging (MRI) scan of the cervical spine was performed 3 months after the procedure.

Results

Postoperative examinations showed: VAS 2.15 ± 1.34 and NPSI 2.29 ± 0.71. Postoperative MRI performed 3 months after the procedure showed a good improvement of cervical disc herniation or bulging or protrusion. The mean dose area product (DAP) was 2803 mGy/cm2 with a mean fluoroscopy time of 4 minutes 22 seconds. Conclusion DiscoGel is a suitable approach for non-fissurated cervical disc herniations, especially in patients that are not suitable for open surgery, with excellent postoperative results, fast recovery and a low radiation dose.
Eve Kosofsky Sedgwick and the difference geography makes
Authors: Seitz David K
Published: March 2021

Ruez and Cockayne point out that queer theorist Eve Sedgwick’s reflections on paranoid and reparative readings accompanying one another came directly out of her queer political as well as textual practice in the U.S. Wrongly dismissed as mundane, this crucial contextualizing work is something geographers do especially well. Indeed, understanding the context for Sedgwick’s theories of paranoid and reparative reading is vital as we reflect on how her concepts travel across time and space.
Early Experience With Pulmonary Root Translocation in Transposition of the Great Arteries With Left Ventricular Outflow Tract Obstruction
Authors: Dharmapuram Anil Kumar , Ramadoss Nagarajan , Goutami Vejendla , Verma Sudeep , Pande Shantanu
Published: March 2021

Background:

The optimal surgical management of patients with transposition of the great arteries (TGA), ventricular septal defect (VSD), and left ventricular outflow tract obstruction (LVOTO) is debatable. This is our initial experience with pulmonary root translocation (PRT), a technique that aims to preserve the pulmonary valve function.

Methods:

From July 2012 to October 2019, 16 patients underwent anatomical repair for TGA, VSD, and LVOTO. The median age was 12 months (range: 7 months to 13 years), and the median weight was 7.75 kg (range: 5.6-29.5 kg). Thirteen patients had a diagnosis of d-TGA and three had congenitally corrected transposition of the great arteries (cc-TGA). The surgical technique involved PRT from the left ventricle (LV) to the right ventricle and routing the LV to the aorta. The left ventricular outflow tract orifice resulting from the pulmonary root extraction was closed with a pericardial patch. In patients with cc-TGA, an atrial switch operation was added. A bidirectional Glenn was necessary in four patients with a long LV to aorta tunnel. One patient required a transannular patch to reconstruct the right ventricular outflow tract (RVOT).

Results:

The median follow-up was 27 months. There was one hospital death due to residual mitral regurgitation. One patient died at home four months after hospital discharge. The remaining patients are doing well with adequate RVOT function and no valve regurgitation.

Conclusions:

Complete correction of TGA, VSD, and LVOTO using PRT was achieved with acceptable risk in patients with pliable and nondysplastic pulmonary valve. The translocated pulmonary root performed well in this short follow-up.
Safe Decompression of the Right Ventricle for PAIVS in Neonates With Coronary Fistulae: Including the Selective Use of Fistula Ligation to Avoid Coronary Steal
Authors: Davidson Noveen , Doig Fiona , Dimpalapang Eliazar , Stirling John , Gentles Thomas , Wilson Nigel , Artrip John , Finucane Kirsten
Published: March 2021

Background:

There are a number of surgical and interventional treatment options for infants with pulmonary atresia with intact ventricular septum (PAIVS). In our practice, we characterize coronary fistulae and interruptions with angiography in the newborn and have developed a strategy to safely decompress the right ventricle in association with ligation of fistulae if necessary.

Methods:

All infants operated for PAIVS at age < 60 days from 1999 to 2018 were retrospectively studied. Pre- and postoperative variables were collected, angiograms were reviewed, and a territory score was created to grade the severity of coronary abnormalities. This study focused on the subgroup of patients who had early surgical decompression of the right ventricle.

Results:

A total of 77 patients were included, with a mean follow-up of 8.6 years. Of these, 55 (71%) had coronary fistulae, including 28 (36%) with coronary artery interruption. Right ventricular decompression (RVD) was performed in 47 (60.5%) patients. There was no 30-day mortality in those who underwent RVD, whereas 6 (20%) without RVD died within 30 days ( P = .003). Ten-year survival was 97.8% and 73.3% for RVD and non-RVD, respectively. In order to prevent coronary steal, 17 patients underwent coronary fistula ligation as their RV was decompressed with 100% early and late survival.

Conclusion:

Early and late survival in infants with PAIVS is better if the RV can be decompressed. Coronary fistula ligation with RVD has been introduced without an adverse outcome in selected patients with large fistulae.
Outcomes Following Heterotopic Placement of Right Ventricle to Pulmonary Artery Conduits
Authors: Saxena Akshat , Salve Gananjay G. , Betts Kim , Arora Nitin , Cole Andrew D. , Sholler Gary F. , Orr Yishay , Ayer Julian G. , Winlaw David S.
Published: March 2021

Background:

We sought to evaluate the outcomes following right ventricle to pulmonary artery (RV-PA) conduit placement in pediatric patients, excluding those with a RV-PA conduit for the Ross procedure which is associated with improved conduit durability, partly related to its orthotopic position.

Methods:

Outcomes for 119 patients who underwent RV-PA conduit placement at a single institution from January 2004 to December 2016 were reviewed. Primary outcome measures were reintervention-free survival (RFS) and overall survival. Survival analyses were performed using the Kaplan-Meier method, and risk factors associated with reintervention were evaluated.

Results:

The median age at the time of conduit placement was 6 months (interquartile range, IQR: 1-14), and the median length of follow-up was 63 months (range: 0-156). During follow-up, 39 patients required conduit-related reintervention, while 6 patients died perioperatively with an overall survival of 90% at 10 years. Among the remaining 113 patients, the RFS at one, five, and ten years was 91% (84%-95%), 72% (60%-80%), and 33% (16%-50%), respectively. The median time to conduit replacement in the series was 43.5 months (IQR: 19.3-76.2). The use of a pulmonary homograft was associated with improved RFS ( P = .03), and this was particularly pronounced in comparison with aortic homografts in neonates. Infection was the indication for replacement in only one patient.

Conclusions:

The majority of the conduits placed during the neonatal period required conduit replacement before the age of five years. Endocarditis was not a common indication for replacement. In neonates and infants, we prefer pulmonary homografts for most indications.
Return to Play After Low-Energy Lisfranc Injuries in High-Demand Individuals: A Systematic Review and Meta-Analysis of Athletes and Active Military Personnel
Authors: Attia Ahmed Khalil , Mahmoud Karim , Alhammoud Abduljabbar , d’Hooghe Pieter , Farber Daniel
Published: March 2021

Background:

Although studies are available on high-energy Lisfranc injuries, the evidence for increasingly reported low-energy Lisfranc injuries in active individuals, including athletes and military personnel, remains scarce and mostly retrospective.

Purpose:

This meta-analysis aimed to review the return-to-play (RTP) and return-to-duty (RTD) rates with regard to the anatomic type and the management of low-energy Lisfranc injuries in a high-demand, active population.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched the MEDLINE (PubMed), EMBASE, Google Scholar, and Cochrane databases through June 2019 to identify studies on low-energy Lisfranc injuries in athletes and military personnel. The primary outcomes were RTP/RTD rates and time to RTP/RTD, and the secondary outcomes were time missed from practice, games missed, time to full recovery, midfoot arthritis rate, and reoperation rate.

Results:

Overall, 15 studies (N = 441 patients) were included in the meta-analysis. Of these, 6 studies were of level 3 evidence, 8 studies were level 4 (case series), and 1 study was level 5. Of the 441 subjects, 380 (86.17%) were able to RTP and RTD. There was no statistically significant difference in RTP rates for operative versus nonoperative treatment, ORIF versus PA, or bony versus ligamentous injuries. The mean time missed from practice/duty for operative versus nonoperative treatment was 58.02 days (95% CI, 13.6-102.4 days; I 2 = 98.03%) and 116.4 days (95% CI, 62.4-170.4 days; I 2 = 99.45%), respectively. The mean time missed from practice/duty for bony versus ligamentous injury was 98.9 days (95% CI, 6.1-191.7 days; I 2 = 99.82%) and 76.5 days (95% CI, 37.9-115.02 days; I 2 = 99.83%), respectively, with no statistically significant differences (standardized mean difference = 3.62 days [95% CI: –5.7 to 13 days]; I 2 = 83.17%).

Conclusion:

This review indicated an overall excellent RTP/RTD rate for low-energy Lisfranc injuries in high-demand individuals. The time missed from athletic participation/military duty was not affected by injury treatment type, the bony versus ligamentous nature of the injury, or athlete player position. However, the low evidence levels and significant heterogeneity of the included studies precludes making conclusions regarding length of time missed or optimal management. Higher-quality studies on low-energy Lisfranc injuries are needed.
Partnering With Patients in a Quality Improvement Curriculum for Internal Medicine Residents
Authors: Wahlberg Kramer J , Burnett Maria , Muthukrishnan Preetika , Purcell Kate , Repp Allen B , van Eeghen Constance , Wahlberg Elizabeth A , Kennedy Amanda G
Published: March 2021

Patient experience is a core component of the Institute for Healthcare Improvement Triple Aim for health care improvement. Although resident physicians must meet quality improvement (QI) competencies prior to graduation, QI training during residency may not adequately prepare residents to improve patient and family experience. We describe an active learning QI curriculum engaging 3 Patient and Family Advisors as partners alongside 15 resident physicians. This partnership proved to be a meaningful experience for both groups, with the development of mutual respect and insight into the contributions that patients and families bring to solving problems in health care quality.
Urban form and productivity: What shapes are Latin-American cities?
Authors: Duque Juan C , Lozano-Gracia Nancy , Patino Jorge E , Restrepo Paula
Published: March 2021

This paper examines the linkages between urban form and city productivity using seven alternative metrics for urban form and applying them to a comprehensive sample of Latin-American cities. While most of the literature has concentrated on the effects of population density (compact vs. sprawling urban development), this paper seeks to assess whether different dimensions of a city’s urban form, such as shape, structure, and land use, affect its economic performance. We found that both the shape of the urban extent and the inner-city connectedness have a statistically significant association with the productivity level of a city.
Prognostic factors for CNS control in children with acute lymphoblastic leukemia treated without cranial irradiation
Authors: Tang Jingyan , Yu Jie , Cai Jiaoyang , Zhang Li , Hu Shaoyan , Gao Ju , Jiang Hua , Fang Yongjun , Liang Changda , Ju Xiuli , Jin Runming , Zhai Xiaowen , Wu Xuedong , Tian Xin , Hu Qun , Wang Ningling , Jiang Hui , Sun Lirong , Leung Alex W. K. , Yang Minghua , Pan Kaili , Cheng Cheng , Zhu Yiping , Zhang Hui , Li Chunfu , Yang Jun J. , Li Chi-kong , Zhu Xiaofan , Shen Shuhong , Pui Ching-Hon
Published: March 2021

To identify the prognostic factors that are useful to improve central nervous system (CNS) control in children with acute lymphoblastic leukemia (ALL), we analyzed the outcome of 7640 consecutive patients treated on Chinese Children’s Cancer Group ALL-2015 protocol between 2015 and 2019. This protocol featured prephase dexamethasone treatment before conventional remission induction and subsequent risk-directed therapy, including 16 to 22 triple intrathecal treatments, without prophylactic cranial irradiation. The 5-year event-free survival was 80.3% (95% confidence interval [CI], 78.9-81.7), and overall survival 91.1% (95% CI, 90.1-92.1). The cumulative risk of isolated CNS relapse was 1.9% (95% CI, 1.5-2.3), and any CNS relapse 2.7% (95% CI, 2.2-3.2). The isolated CNS relapse rate was significantly lower in patients with B-cell ALL (B-ALL) than in those with T-cell ALL (T-ALL) (1.6%; 95% CI, 1.2-2.0 vs 4.6%; 95% CI, 2.9-6.3; P < .001). Independent risk factors for isolated CNS relapse included male sex (hazard ratio [HR], 1.8; 95% CI, 1.1-3.0; P = .03), the presence of BCR-ABL1 fusion (HR, 3.8; 95% CI, 2.0-7.3; P < .001) in B-ALL, and presenting leukocyte count ≥50×109/L (HR, 4.3; 95% CI, 1.5-12.2; P = .007) in T-ALL. Significantly lower isolated CNS relapse was associated with the use of total intravenous anesthesia during intrathecal therapy (HR, 0.2; 95% CI, 0.04-0.7; P = .02) and flow cytometry examination of diagnostic cerebrospinal fluid (CSF) (HR, 0.2; 95% CI, 0.06-0.6; P = .006) among patients with B-ALL. Prephase dexamethasone treatment, delayed intrathecal therapy, use of total intravenous anesthesia during intrathecal therapy, and flow cytometry examination of diagnostic CSF may improve CNS control in childhood ALL. This trial was registered with the Chinese Clinical Trial Registry (ChiCTR-IPR-14005706).
Knockdown of hspg2 is associated with abnormal mandibular joint formation and neural crest cell dysfunction in zebrafish
Authors: Castellanos Barbara S. , Reyes-Nava Nayeli G. , Quintana Anita M.
Published: March 2021

Background

Heparan sulfate proteoglycan 2 (HSPG2)encodes for perlecan, a large proteoglycan that plays an important role in cartilage formation, cell adhesion, and basement membrane stability. Mutations inHSPG2have been associated with Schwartz-Jampel Syndrome (SJS) and Dyssegmental Dysplasia Silverman-Handmaker Type (DDSH), two disorders characterized by skeletal abnormalities. These data indicate a function forHSPG2in cartilage development/maintenance. However, the mechanisms in whichHSPG2regulates cartilage development are not completely understood. Here, we explored the relationship between this gene and craniofacial development through morpholino-mediated knockdown ofhspg2using zebrafish.

Results

Knockdown ofhspg2resulted in abnormal development of the mandibular jaw joint at 5 days post fertilization (DPF). We surmised that defects in mandible development were a consequence of neural crest cell (NCC) dysfunction, as these multipotent progenitors produce the cartilage of the head. Early NCC development was normal in morphant animals as measured by distal-less homeobox 2a (dlx2a)and SRY-box transcription factor 10 (sox10)expression at 1 DPF. However, subsequent analysis at later stages of development (4 DPF) revealed a decrease in the number of Sox10+and Collagen, type II, alpha 1a (Col2a1a)+cells within the mandibular jaw joint region of morphants relative to random control injected embryos. Concurrently, morphants showed a decreased expression ofnkx3.2,a marker of jaw joint formation, at 4 DPF.

Conclusions

Collectively, these data suggest a complex role forhspg2in jaw joint formation and late stage NCC differentiation.
Dysbiosis of gut microbiota and its correlation with dysregulation of cytokines in psoriasis patients
Authors: Zhang Xinyue , Shi Linjing , Sun Ting , Guo Kun , Geng Songmei
Published: March 2021

Background

Psoriasis is an inflammatory skin disease associated with multiple comorbidities and substantially diminishes patients’ quality of life. The gut microbiome has become a hot topic in psoriasis as it has been shown to affect both allergy and autoimmunity diseases in recent studies. Our objective was to identify differences in the fecal microbial composition of patients with psoriasis compared with healthy individuals to unravel the microbiota profiling in this autoimmune disease.

Results

We collected fecal samples from 30 psoriasis patients and 30 healthy controls, sequenced them by 16S rRNA high-throughput sequencing, and identified the gut microbial composition using bioinformatic analyses including Quantitative Insights into Microbial Ecology (QIIME) and Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt). Our results showed that different relative abundance of certain bacterial taxa between psoriasis patients and healthy individuals, including Faecalibacterium and Megamonas, were increased in patients with psoriasis. It’s also implicated that many cytokines act as main effect molecules in the pathology of psoriasis. We selected the inflammation-related indicators that were abnormal in psoriasis patients and found the microbiome variations were associated with the level of them, especially interleukin-2 receptor showed a positive relationship with Phascolarctobacterium and a negative relationship with the Dialister. The relative abundance of Phascolarctobacterium and Dialister can be regard as predictors of psoriasis activity. The correlation analysis based on microbiota and Inflammation-related indicators showed that microbiota dysbiosis might induce an abnormal immune response in psoriasis.

Conclusions

We concluded that the gut microbiome composition in psoriasis patients has been altered markedly and provides evidence to understand the relationship between gut microbiota and psoriasis. More mechanistic experiments are needed to determine whether the differences observed in gut microbiota are the cause or consequences of psoriasis and whether the relationship between gut microbiota and cytokines was involved.