bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of protective mechanical ventilation during extracorporeal membrane oxygenation for the treatment of acute respiratory failure
Authors: Kingsley Julian , Kandil Omneya , Satalin Joshua , Bary Akram Abdel , Coyle Sierra , Nawar Mahmoud Saad , Groom Robert , Farrag Amr , Shah Jaffer , Robedee Ben R , Darling Edward , Shawkat Ahmed , Chaudhuri Debanik , Nieman Gary F , Aiash Hani
Published: January 2024

Acute respiratory failure (ARF) strikes an estimated two million people in the United States each year, with care exceeding US$50 billion. The hallmark of ARF is a heterogeneous injury, with normal tissue intermingled with a large volume of low compliance and collapsed tissue. Mechanical ventilation is necessary to oxygenate and ventilate patients with ARF, but if set inappropriately, it can cause an unintended ventilator-induced lung injury (VILI). The mechanism of VILI is believed to be overdistension of the remaining normal tissue known as the ‘baby’ lung, causing volutrauma, repetitive collapse and reopening of lung tissue with each breath, causing atelectrauma, and inflammation secondary to this mechanical damage, causing biotrauma. To avoid VILI, extracorporeal membrane oxygenation (ECMO) can temporally replace the pulmonary function of gas exchange without requiring high tidal volumes (VT) or airway pressures. In theory, the lower VT and airway pressure will minimize all three VILI mechanisms, allowing the lung to ‘rest’ and heal in the collapsed state. The optimal method of mechanical ventilation for the patient on ECMO is unknown. The ARDSNetwork Acute Respiratory Management Approach (ARMA) is a Rest Lung Approach (RLA) that attempts to reduce the excessive stress and strain on the remaining normal lung tissue and buys time for the lung to heal in the collapsed state. Theoretically, excessive tissue stress and strain can also be avoided if the lung is fully open, as long as the alveolar re-collapse is prevented during expiration, an approach known as the Open Lung Approach (OLA). A third lung-protective strategy is the Stabilize Lung Approach (SLA), in which the lung is initially stabilized and gradually reopened over time. This review will analyze the physiologic efficacy and pathophysiologic potential of the above lung-protective approaches.
Multiple thromboses, including intracardiac thrombi, accompanied by HIT during ECMO successfully treated with NOACs: A case report
Authors: Yun Won-Sik , Kim Sanghyo , Jung Lae-Young
Published: January 2024

Introduction

Unfractionated heparin remains the mainstay of anticoagulation therapy during extracorporeal membrane oxygenation (ECMO) maintenance. However, its continued use in clinical practice exposes patients to the risk of developing heparin-induced thrombocytopenia (HIT).

Case Report

A 50-year-old male was diagnosed with multiple thromboses, including an intracardiac thrombi, accompanied by HIT during ECMO after cardiogenic shock related to acute myocardial infarction. The patient was successfully treated with new oral anticoagulants (NOAC), without significant complications.

Discussion

HIT during ECMO resulting in multiple thromboses is rare. To our knowledge, this is the first reported case of NOAC use in this context.

Conclusion

Although thrombocytopenia and thrombosis can occur for various reasons during ECMO maintenance, it is important to consider HIT as a potential cause. NOACs can be considered as a therapeutic option.
Older adults in psychedelic-assisted therapy trials: A systematic review
Authors: Bouchet Lisa , Sager Zachary , Yrondi Antoine , Nigam Kabir B , Anderson Brian T , Ross Stephen , Petridis Petros D , Beaussant Yvan
Published: January 2024

Background:

Growing clinical interest in psychedelic-assisted therapies has led to a second wave of research involving psilocybin, lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA) and other substances. Data suggests that these compounds have the potential to treat mental health conditions that are especially prevalent in older adults such as depression, anxiety, existential distress, and posttraumatic stress disorder.

Aims:

The goal of this study was to quantify the prevalence of older adults enrolled in psychedelic clinical trials and explore safety data in this population.

Methods:

A systematic review was conducted following the 2020 PRISMA guidelines. Search criteria included all trials published in English using psychedelic substances to treat psychiatric conditions, including addiction as well as existential distress related to serious illness. Articles were identified from literature searches on PubMed, EBSCO, and EMBASE.

Results:

4376 manuscripts were identified, of which 505 qualified for further review, with 36 eventually meeting eligibility criteria. Of the 1400 patients enrolled in the 36 studies, only 19 were identified as 65 or older, representing less than 1.4% of all trial participants. For 10 of these 19 older adults, detailed safety data was obtained. No serious adverse events (AEs) occurred in any older adults and only transient mild-to-moderate AEs related to anxiety, gastrointestinal upset, and hypertension were reported during the psychedelic dosing sessions.

Conclusions:

While existing data in older adults is limited, it suggests that psychedelic-assisted psychotherapy can be safe and well tolerated in older adults. Therefore, psychedelic-assisted psychotherapy should be more rigorously investigated for the treatment of psychiatric conditions in this population.
A dispensable role of oligodendrocyte-derived laminin-α5 in brain homeostasis and intracerebral hemorrhage
Authors: Kang Minkyung , Nirwane Abhijit , Ruan Jingsong , Adithan Aravinthan , Gray Marsilla , Xu Lingling , Yao Yao
Published: January 2024

Laminin, a major component of the basal lamina in the CNS, is also expressed in oligodendrocytes (OLs). However, the function of OL-derived laminin remains largely unknown. Here, we performed loss-of-function studies using two OL-specific laminin-α5 conditional knockout mouse lines. Both mutants were grossly normal and displayed intact blood-brain barrier (BBB) integrity. In a mouse model of intracerebral hemorrhage (ICH), control mice and both mutants exhibited comparable hematoma size and neurological dysfunction. In addition, similar levels of hemoglobin and IgG leakage were detected in the mutant brains compared to the controls, indicating comparable BBB damage. Consistent with this finding, subsequent studies revealed no differences in tight junction protein (TJP) and caveolin-1 expression among control and knockout mice, suggesting that neither paracellular nor transcellular mechanism was affected in the mutants. Furthermore, compared to the controls, both mutant lines showed comparable oligodendrocyte number, oligodendrocyte proliferation rate, MBP/MAG levels, and SMI-32 expression, highlighting a minimal role of OL-derived laminin-α5 in OL biology. Together, these findings highlight a dispensable role of OL-derived laminin-α5 in both brain homeostasis and ICH pathogenesis.
The role of users in the organization of digital information: A Portuguese experience in an academic museum and archive setting
Authors: Silva Patrícia Isabel , Terra Ana Lúcia
Published: January 2024

With the evolution of digital platforms, ordinary users have gained the opportunity to participate in the organization of digital knowledge. This has given rise to folksonomies or social indexing, and the duty of information services to integrate user participation in the organization of their digital collections, and thus incorporate folksonomies in their information organization practices. This article presents a case study of the involvement of users of an academic museum and archive in the indexing of a set of resources within a project on digital preservation. The main objective of this study was to analyse the labels or tags suggested by a group of six students from several scientific areas who participated in the experience, and explain the criteria they used to choose and assign the terms to represent the content of the documents. The responses were categorized based on content analysis. The labels assigned by the students were also compared with the indexing terms used by information professionals. Although the students were not familiar with the methods of information professionals, they gained enough sensitivity to understand the need for term validation and recognize that term selection is a subjective choice.
Arthroscopic Latarjet Versus Arthroscopic Free Bone Block Procedures for Anterior Shoulder Instability: A Proportional Meta-analysis Comparing Recurrence, Complication, and Reoperation Rates
Authors: Cozzolino Andrea , de Giovanni Roberto , Malfi Paolofrancesco , Bernasconi Alessio , Scarpa Simona , Smeraglia Francesco , Russo Raffaele , Mariconda Massimo
Published: January 2024

Background:

Several arthroscopic glenoid bone augmentation techniques have been introduced to treat patients affected by anterior shoulder instability associated with critical bone loss. The efficacy of the different arthroscopic bony procedures has not been compared yet.

Purpose:

To compare the recurrence, complication, and reoperation rates of the arthroscopic Latarjet (AL) and arthroscopic free bone block (ABB) procedures for anterior shoulder instability.

Study Design:

Meta-analysis and systematic review; Level of evidence, 4.

Methods:

A systematic search was conducted in MEDLINE/PubMed, Web of Science, and Embase to identify clinical studies reporting the outcomes of the AL and ABB procedures. The following search phrases were used: “Arthroscopic” AND “Bone Block” OR “Bone Graft,” and “Arthroscopic” AND “Glenoid Augmentation” OR “Glenoid Reconstruction,” and “Arthroscopic” AND “Latarjet” OR “Coracoid Graft” OR “Coracoid Transfer.” Exclusion criteria were <24 months of minimum follow-up, sample size <10 cases, revision after previous glenoid bone grafting, epilepsy, and multidirectional instability. Data regarding the study design, patient characteristics, surgical technique, and outcomes were extracted and analyzed. A proportional meta-analysis was conducted to compare the complication, recurrence, and reoperation rates between the 2 groups. Multiple subgroup analyses were performed to analyze the incidence of each complication and assess the weight of different fixation methods (in the whole cohort) or different graft types (in the ABB group). The modified Coleman Methodology Score was used to assess the risk of bias.

Results:

Of 5010 potentially relevant studies, 18 studies regarding the AL procedure (908 cases) and 15 studies regarding the ABB procedure (469 cases) were included. The 2 groups were comparable in age ( P = .07), sex ( P = .14), glenoid bone loss ( P = .14), number of preoperative dislocations ( P = .62), proportion of primary and revision procedures ( P = .95), length of follow-up ( P = .81), modified Coleman Methodology Score ( P = .21), and level of evidence ( P = .49). There was no difference in the recurrence ( P = .88), reoperation ( P = .79), and complication ( P = .08) rates. The subgroup analyses showed a higher rate of hardware-related complications for screw fixation compared with flexible fixation ( P = .01).

Conclusion:

The AL and ABB procedures had similar recurrence, reoperation, and complication rates. Screw fixation of the bone graft was related to an increased risk of complications compared with flexible fixation.

Registration:

CRD42022368153 (PROSPERO).
Treatment of Severely Shortened or Comminuted Clavicular Fractures in Older Adolescent Athletes
Authors: Spence David D. , Wilson Philip L. , Pennock Andrew T. , Nepple Jeffrey J. , Pandya Nirav K. , Perkins Crystal A. , Li Ying , Ellis Henry B. , Sabatini Coleen S. , Edmonds Eric W. , Willimon S. Clifton , Bae Donald S. , Busch Michael T. , Kocher Mininder ,   FACTS Study Group, Heyworth Benton E.
Published: January 2024

Background:

Recent evidence suggests that for completely displaced midshaft clavicular fractures, surgery offers no clear benefit over nonoperative treatment in a general adolescent population from 10 to 18 years of age. However, the comparative outcomes of comminuted and/or severely shortened clavicular fractures specifically in older adolescent athletes have not been explored in a focused, methodologically rigorous fashion.

Hypothesis:

The study hypothesis was that outcomes would be superior in older adolescent athletes who underwent operative treatment compared with nonoperative treatment for comminuted and/or severely shortened clavicular fractures.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A level 2, multicenter, prospective cohort study investigating the outcomes of midshaft fractures in adolescents between 2013 and 2017 was filtered to analyze the subcohorts of athletes 14 to 18 years of age with either fracture comminution or fracture shortening of ≥25 mm or both. Patient characteristics, injury mechanisms, fracture characteristics, and treatments were compared. Complications, rates, timing of return to sports (RTS), and patient-reported outcomes (PROs) were analyzed.

Results:

The 2 treatment groups, which included 136 older adolescent athletes (69 nonoperative, 67 operative), showed similar distributions of primary sport type, competition level, comminution, shortening, and 2-year PRO response rate (n = 99; 73%). The operative group demonstrated 3 mm–greater mean superior displacement, which was therefore statistically controlled for as a confounder in the comparative PRO analysis. No 2-year differences in nonunion, delayed union, symptomatic malunion, refracture, clinically significant complications, or rates of RTS were detected between treatment groups. The difference in timing of RTS (operative, 10.3 weeks; nonoperative, 13.5 weeks) was statistically significant. After controlling for the minor difference in superior displacement, regression analysis and matched comparison cohorts demonstrated no differences between the nonoperative and operative groups in mean or dichotomized PRO scores.

Conclusion:

In this prospective, multicenter cohort study investigating older adolescent athletes with comminuted and/or severely shortened clavicular fractures, contrary to the study hypothesis, there were no differences in complications, RTS, or PROs between nonoperatively and operatively treated patients at 2 years. Comparably excellent outcomes of severe clavicular fractures in adolescent athletes can be achieved with nonoperative treatment.
Study on impact resistance of sandwich glass based on CT scan-3D reconstruction
Authors: Shi Jing , Wei Xiangrui , Yan Yanling , Zhang Youning , He Jingjing , Zhang Yunkuan , Wang Xiang
Published: January 2024

Utilizing the light gas gun system, impact tests on sandwich glass specimens with various structural configurations were performed at high-speed, medium-speed, and low-speed to evaluate the impact resistance of polyvinyl butyral (PVB) sandwich glass. An impact damage test method that incorporates stress data and three-dimensional fracture data was proposed in conjunction with the CT scan-3D reconstruction technique. The experimental findings demonstrated that as glass thickness grew, sandwich glass’ rigidity increased noticeably, and impact resistance of sandwich glass was significantly improved. On the other hand, under the action of elastic deformation energy absorption and horizontal cohesion of the PVB interlayer, the thicker interlayer could consume and disperse more impact energy, making the veins radially distributed and reducing the flying of debris. The conclusion that thin glass-thick interlayer could equivalently replace thick glass-thin interlayer to a certain extent was obtained. The study offers crucial technological backing for sandwich glass’s industrial applicability.
Parent and Child-Reported Strengths of Children With ADHD
Authors: Miller Courtney Leigh , Jelinkova Kristina , Charabin Emma C. , Climie Emma A.
Published: January 2024

A strength-based approach to childhood attention-deficit/hyperactivity disorder (ADHD) research highlights children’s positive attributes that can support their areas of difficulty. However, research on perceptions of a child’s positive attributes is understudied. Specifically, there is little research that examines strength-based perceptions of children with ADHD, and only one known article addresses parent perceptions of their children with ADHD. As such, this study analyzed parent and child-reported strengths in children with ADHD. Parent and child-reported strengths were measured using the Behavioral and Emotional Rating Scale—Second edition, Parent Form and Child Form (BERS-2). Results indicated that parents and children perceived strengths in the interpersonal, intrapersonal, and affective domains to be similar, falling in the Average range. However, children indicated their family involvement and school functioning fell within the Average range, whereas parents rated these domains below average. Positive parental perspectives of their children may promote positive parent-child interactions and serve as an overall protective factor for children with ADHD. Domains which parents and children see as strengths should be utilized to support areas of weakness. Strength-based research for children with ADHD and positive interventions utilizing strengths may benefit families with ADHD, as well as classroom teachers and school psychologists.
Property and Trusts: A Modern Project to Create Individual and Collective Personae
Authors: Kim Jongchul
Published: January 2024

The concept of trusts, absent from the classical writings of Marx and Weber on capitalism, was introduced by Frederic Maitland and John Locke as an explanatory framework for the central institutions of capitalism. While these two theorists offered compelling arguments, they relied on intuition and utilized the concept primarily to justify the existing social structure. This paper aims to bring analytical rigor to this intuitive theory and proposes that critical theory embraces the idea of trusts as a critical conceptual tool to unravel the nature of capitalist institutions. Examining limited liability corporations, the modern state, and public debt, the incorporation of trusts into critical theory provides key advantages. First, it facilitates analyzing capitalist institutions in terms of rights and responsibilities, unveiling moral dynamics. Second, it highlights the role of personhood in distributing rights and responsibilities. Third, it can help understand why modern society is ensnared by the shackles of debt.
Exploration of Norepinephrine Dose-Capping Practices: Report From an International, Interprofessional Survey of Critical Care Clinicians
Authors: Smith Susan E. , Perona Stephen , Weingart Scott D.
Published: January 2024

Purpose: The Joint Commission standards for titrated infusions require specification of maximum rates of infusion. This practice has led to the development of protocolized maximum doses that can be overridden by provider order (“soft maximums”) and to dose caps that cannot be superseded (“hard maximums”). The purpose of this study was to determine the prevalence of and attitudes towards dose capping of norepinephrine. Methods: A 20-item cross-sectional survey assessing norepinephrine dose capping practices, perceptions of norepinephrine protocols, and respondent and practice site demographics was distributed electronically to the mailing list of an international medical podcast. Responses were stratified according to use of weight-based dosing (WBD) or non-WBD of norepinephrine. The primary objective was to characterize norepinephrine dosing practices including protocolized maximum doses and/or dose capping. Categorical and continuous variables were compared using the Chi-square test and Mann-Whitney U test, respectively, with P < .05 indicating statistical significance. Results: The survey was completed by 586 physicians, nurses, pharmacists, and advanced practice providers. WBD was used by 51% and non-WBD by 47%. A standardized titration protocol was reported by 65% and dose capping was reported by 19%. The protocolized maximum dose ranged from 20-400 mcg/min for respondents using non-WBD (median [interquartile range] 30 [30-50]) and ranged from .2-10 mcg/kg/min for respondents using WBD (1 [.5-3]). The dose cap was 50 (40-123) mcg/min with non-WBD and 2 (1-3) mcg/kg/min with WBD. Conclusions: An international, multi-professional survey of critical care and emergency medicine clinicians revealed wide variability in norepinephrine dosing practices including maximum doses allowed.
Outcomes in Variceal Bleeding Associated With Continuous Octreotide in Patients With Delayed Endoscopy
Authors: Laws Matthew B. , Wahking Rebekah , Blackburn Erin , Williams Whitney , Schadler Aric , Fritz Megan Kunka
Published: January 2024

Background: Variceal hemorrhage treatment includes endoscopy within 12 hours of admission and octreotide therapy for 2-5 days post-endoscopy. Duration of pre-endoscopy octreotide can be prolonged when intervention is delayed. Objective: This study aimed to evaluate the impact of extended pre-endoscopy octreotide on rebleeding after endoscopy when comparing short vs long durations of post-endoscopy octreotide. Methods: This was a single center, retrospective cohort evaluating adult cirrhotic patients with esophageal variceal hemorrhage admitted between July 1, 2017 and June 30, 2020. Study groups included patients receiving octreotide ≥12 hours prior to endoscopy followed by ≤ 48 (short course) or >48 hours (standard course) after endoscopy. The primary outcome was post-endoscopy rebleeding, defined as hemoglobin decrease of ≥2 g/dL from baseline or the requirement of ≥1 unit of packed red blood cells. Results: Of the 169 patients included, 88 patients received short course octreotide after endoscopy, and 81 patients received standard course octreotide after endoscopy. Twenty-nine (33%) patients in the short course group and 43 (53.1%) in the standard course group experienced the primary endpoint (OR 2.3, 95% CI 1.24 - 4.29; P = .008). Conclusion: Extended pre-endoscopy octreotide may be beneficial in preventing rebleeding when intervention is delayed. Further studies are needed to determine the necessary octreotide duration in delayed endoscopy and varying bleeding risk.
Effect of tooth root fillet on root bending stress
Authors: Zhang Qiang
Published: January 2024

The tooth root fillet exerts a significant effect on the root bending stress of gear teeth. However, the current study predominantly focuses on theoretical analysis and numerical methods, with insufficient emphasis on effective experimental verification. Therefore, this paper completes root bending stress tests on gear teeth and conducts an analysis of how the tooth root fillet impacts root bending stress. Firstly, the paper provides a summary of the generation theory of the tooth root fillet using rack cutters/hobs, which serves as the foundational machining principle for tooth root fillet. Secondly, using three typical tooth root fillet as examples, the study conducts root bending stress tests. The R-S-N curves corresponding to these three tooth root fillet profiles are derived using both conventional group methods and a variable load approach, involving lifting and lowering. Finally, the paper analyses the influence of these three types of tooth root fillet on the root bending stress of gear teeth. Through a comparison of S-N curves at the same reliability level, it identifies the optimal tooth root fillet among the three.
Virtual registration of comminuted bone fracture and preoperative assessment of reconstructed bone model using the Procrustes algorithm based on CT dataset
Authors: Arumugam Senthilmurugan , Ranganathan Rajesh , Narayanasamy Venkatesh Kumar
Published: January 2024

A research work was undergone in a virtual bone reduction process for reconstruction of the comminuted pelvic bone fracture using a CT scan dataset of patients. This includes segmentation, 3D model optimization and bone registration technique. The accuracy of the reconstructed bone model was validated using Finite Element Method. Analysed and applied various segmentation techniques to segregate the injured bone structure. The ICP (Iterative Closest Point), Procrustes algorithm and Canny edge detection algorithm were applied to understand the bone registration process for surgery in detail. The average RMS error, mean absolute distance, mean absolute deviation, and mean signed distance of the reconstructed bone model using proposed algorithms involving 10 patient datasets in a group were found to be 1.77, 1.48, 1.51 and −0.31 mm respectively. The calculated RMS error value proved minimal error in semi-automatic registration than other existing automatic registration techniques. Therefore, the proposed approach is suitable for virtual bone reduction for comminuted pelvic bone fracture. This method could also be implemented for various other bone fracture reconstruction requirements.
On the soft tissue ultrasound elastography using FEM based inversion approach
Authors: Eshaghinia Seyed Shahab , Taghvaeipour Afshin , Aghdam Mohammad Mohammadi , Rivaz Hassan
Published: January 2024

Elastography is a medical imaging modality that enables visualization of tissue stiffness. It involves quasi-static or harmonic mechanical stimulation of the tissue to generate a displacement field which is used as input in an inversion algorithm to reconstruct tissue elastic modulus. This paper considers quasi-static stimulation and presents a novel inversion technique for elastic modulus reconstruction. The technique follows an inverse finite element framework. Reconstructed elastic modulus maps produced in this technique do not depend on the initial guess, while it is computationally less involved than iterative reconstruction approaches. The method was first evaluated using simulated data (in-silico) where modulus reconstruction’s sensitivity to displacement noise and elastic modulus was assessed. To demonstrate the method’s performance, displacement fields of two tissue mimicking phantoms determined using three different motion tracking techniques were used as input to the developed elastography method to reconstruct the distribution of relative elastic modulus of the inclusion to background tissue. In the next stage, the relative elastic modulus of three clinical cases pertaining to liver cancer patient were determined. The obtained results demonstrate reasonably high elastic modulus reconstruction accuracy in comparison with similar direct methods. Also it is associated with reduced computational cost in comparison with iterative techniques, which suffer from convergence and uniqueness issues, following the same formulation concept. Moreover, in comparison with other methods which need initial guess, the presented method does not require initial guess while it is easy to understand and implement.
Characteristics of the axial compressor with different stator gaps in compressed air energy storage system
Authors: Li Pengfei , Zuo Zhitao , Zhou Xin , Li Jingxin , Guo Wenbin , Chen Haisheng
Published: January 2024

The axial compressor in compressed air energy storage (CAES) system needs to operate stably and efficiently within a wide working range. The stator gap plays a critical role in suppressing corner separation and enhancing blade throughflow. The primary objective of this study is to determine the optimal combination of stator gaps to further expand the stable working range of the compressor while ensuring high efficiency. In this study, the flow characteristics of different stator gaps of the five-stage axial compressor in a specific CAES system are researched numerically. Firstly, the impact of different stator gaps on the aerodynamic performance is analyzed. The stator gap effectively broadens the stable working range of the compressor, with the hub gap exhibiting greater potential for expansion compared to the shroud gap. Subsequently, a comparative analysis is conducted on the internal flow of the third stage stator under near-stall conditions. Different gap leakage forms different vortex structures, and the gap leakage can effectively eliminate the accumulation of low-energy fluid in the corner area, optimize the limit streamlines on the blade suction surface and the temperature distribution. The low-velocity area caused by different stator gaps is also different. Finally, energy loss and energy dissipation with different stator gaps are explored. The gap leakage flow results in high energy loss, and different stator gaps exhibit notable differences in distribution of the high energy loss regions. Different types of stator gaps exhibit consistent high energy dissipation areas, which include the leading-edge stagnation area, boundary layer area on blade surface, and wake area. It is important to note that the high energy loss area does not necessarily coincide with the high energy dissipation area. The combined application of two loss evaluation methods contributes to a more comprehensive investigation of the loss distribution characteristics of the compressor.
Categorizing discourses of welfare chauvinism: Temporal, selective, functional and cultural dimensions
Authors: Leruth Benjamin , Taylor-Gooby Peter , Győry Adrienn
Published: January 2024

Welfare chauvinism, that is, the exclusion of non-citizens who live permanently within a state from social benefits and services, has become a mainstream form of welfare policy opposition advocated by some political parties and members of the public. While existing studies have successfully cast a light on the roots and scope of these policies, welfare chauvinism effectively encompasses a wide range of ideas that all have different meanings. Drawing on the stances taken by populist radical right parties, this article introduces five categories (or frames) of welfare chauvinism: temporary, selective, functional, cultural and, in its most extreme form, unconditional chauvinism. The article then illustrates how such categorization is applied empirically by focusing on the stances taken by three populist radical right parties and open-ended discussions held during mini-publics in examples of three different institutional forms of welfare state: Denmark, Germany and the United Kingdom. This article offers a more precise depiction of how this form of opposition to welfare state policies plays out in the public sphere, taking full account of how different forms and frames of welfare chauvinism yield different policy outcomes and implications in different institutional and political contexts.
A 12-month follow-up study of patients with systemic lupus erythematosus after immunization against SARS-CoV-2
Authors: Zavala-Flores Ernesto , Salcedo-Matienzo Jannin , Huamanchumo-Guzman Roberto , Berrocal-Kasay Alfredo , Alarcón Graciela S
Published: January 2024

Objective

To identify all post-BNT162b2 vaccination (BioNTech and Pfizer) events during the ensuing 12 months in patients with systemic lupus erythematosus (SLE) from the Immuno-Rheumatology Department at Cayetano Heredia Hospital’s cohort, Lima, Perú.

Methods

A 12-month follow-up study was conducted from the first dose of immunization with the BNT162b2 vaccine, which was given between May and June 2021, to SLE patients from this cohort.

Results

The initial population was constituted by 100 patients (100 patients received the 1st dose, 90 the 2nd dose, and 85 the 3rd dose of this vaccine); 33 patients presented a SLE reactivation (flare), 9% (9/100) post 1st dose, 26.6% (24/90) post 2nd dose, and 16.4% (14/85) post 3rd dose. The most common types of flare were articular (26) and renal (14) with 5/33 (15.1%) requiring hospitalization for flare management. A negative association with flare occurrence was found between the use of hydroxychloroquine RR 0.43 (0.21–0.85) and the opposite was the case for azathioprine RR 2.70 (1.39–5.25). During follow-up, 26 patients developed SARS-CoV-2 infection of whom three required hospitalization, one of whom died.

Conclusions

33 of 100 SLE patients immunized with BNT162b2 vaccine against SARS-CoV-2, presented SLE flares (47 episodes in total); 5 of these patients required in-hospital management and all fully recovered; 26 patients had SARS-CoV-2 infection; three required hospitalization, one died.
Parent-Focused Interventions to Support Children’s Early Math Learning
Authors: Libertus Melissa E.
Published: January 2024

Even before starting formal schooling, children show substantial variations in math skills suggesting that the home learning environment plays an important role in shaping young children’s math skills. Here, I review interventions aimed at providing young children with opportunities to learn math at home to identify what types of parent-guided activities may be effective at improving young children’s math. I also review interventions that may impact the frequencies and quality of the learning opportunities that parents provide to their children even if benefits for children’s math outcomes were not found or have not been tested yet. While some studies show that parent-guided math activities can impact children’s math skills, future work should carefully consider for whom interventions are most effective as both child and parent characteristics such as children’s general cognitive skills or foundational number skills as well as parents’ attitudes toward math may impact the effectiveness of the interventions.
Learning to Communicate: A Photovoice Study With Intensive Care Residents During Night Shifts in the Intensive Care Unit
Authors: Quintero Diana , Reinoso Chávez N Natalia , Vallejo Juliana
Published: January 2024

This study explored the learning experiences of intensive care residents in an intensive care unit (ICU) during night shifts and the development of communication skills in this community of practice. This action research qualitative study used the photovoice method in four workshops. A group of nine residents shared their learning experiences and collectively analyzed, built, and presented proposals to improve residents’ communication skills in the community of practice in which they become intensivists. Participatory thematic analysis was conducted. Students concluded that night shifts in the ICU offered a perfect situational learning environment for communication with one-on-one resident–teacher relationships, less administrative work, and more resident responsibility, improving intensivist identity. Role models, reflective thinking, and teamwork are essential for fostering communication skills among intensivist community members and are all trainable. The results and student suggestions were presented to teachers and decision-makers in the clinic. These photovoice strategies developed students’ abilities to share their critical views and suggestions with decision-makers for subsequent implementation, enhancing their confidence in their learning process, strengthening trust-based relationships with teachers, and improving future intensivists’ practice communities.
Maternal Exposure to Stress During Covid-19 and Non-Syndromic Orofacial Clefts: A Cohort Retrospective Study
Authors: Sabbagh Heba Jafar , AlSharif Mona Talal , Abdulhameed Fatma Dawood , Aljohar Aziza Johar , Alhussain Reema Mahdi , Alghamdi Sultan Musaad , Alrejaye Najla Sulaiman , AlGudaibi Latifa Yousef , Sallout Bahauddin Ibraheem , Albaqawi Badi Shoaib , Alnamnakani Eman Abdulbaset , Brekeit Lougin Khalid , Basri Osama Adel , Almalik Manal Ibrahim , Al Soqih Norah Suliman , Alshaikh Ali Bakr , Aburiziza Abdullah Jameel , Al Qahtani Faisal Ali , Alghamdi Bushra Musaad , Alraddadi Asalah Khalid , Khaja Hadeel Hamza , Alamoudi Rana Abdullah
Published: January 2024

Objective

The coronavirus (COVID-19) pandemic presents an opportunity to study stress's effect on the development of non-syndromic orofacial clefts (NSOFCs). This study was aimed at assessing maternal stress exposure during the pregestational to first trimester pregnancy periods and the development of NSOFCs during a year of the COVID-19 pandemic.

Design

Cohort study of infants with NSOFCs and controls matched based on recruitment site and age.

Setting

Government hospitals in Saudi Arabia between November 2020 and November 2021.

Main Outcome Measures

Data collection included NSOFC clinical examination and maternal stress exposure assessment using the Modified Life Events Questionnaire, the Fear of COVID-19 Scale, and a focus on the lack of pregnancy planning and a threatened miscarriage.

Results

Of the 557 infants recruited, 191 had NSOFCs. Logistic regression analysis with adjusted odds ratios (AORs) that removed the effects of confounders showed that any of the seven stressful life events (AOR:3.78, P < .001) and the family histories of relatives with NSOFCs (AOR:9.73, P < .001) increased the AOR for NSOFC development. In contrast, maternal folic acid (AOR:0.56, P.010), threatened miscarriage (AOR:0.17, P = .001), fear of COVID-19 (AOR:0.83, P = .038), and suspected COVID-19 infection (AOR:0.43, P = .008) decreased the AOR for NSOFC development.

Conclusion

Along with an established risk associated with family history of birth defects, stressful life events may be a risk factor for NSOFC development. Beyond folic acid's known benefit, it may be that higher maternal health concerns contribute to increased protective health behaviors during pregnancy. Ongoing research is needed to specify the maternal risk factors for NSOFC.
Things That Could Have Helped Me Cope: Adults Reflect on What They Needed as Children After the Deportation of a Parent
Authors: Muruthi Bertranna A. , Taschman Katrina , McRell Amanda Stafford , Zarate Jose , Cañas Reid E. Thompson , Romero Lindsey , Hernández Daisy
Published: January 2024

Experiencing parental deportation during childhood is associated with higher rates of mental health and behavioral health challenges. This adversity may be exacerbated by the uncertainty of what is happening to their deported parent and to their family system following a deportation experience. Effective clinical intervention can reduce the likelihood and/or severity of physical health, mental health and behavioral health difficulty caused by the trauma of parental deportation; however, clinicians have insufficient resources and guidance on effectively engaging with children and their families following parental deportation. Semi-structured qualitative interviews were conducted with English-speaking Latino individuals from the United States who experienced parental deportation between the ages of 6 and 17 ( n = 10). Using interpretive phenomenology analytic procedures, three major themes emerged related to participants’ experiences of their family after their parent’s deportation: (a) I wish I knew what was happening, (b) I wish people had checked in on my emotions, and (c) I wish people had been supportive and included us in the conversation. These findings are examined from an ambiguous loss framework to provide clinical implications of children’s needs after parental deportation. Suggestions are offered from the adults who lost their parent to deportation as a child about what they needed following their loss. By understanding what children need in these moments of crisis, practitioners, providers, and others are better prepared to address this form of complex childhood adversity.
Embodied Resilience: A Phenomenological Inquiry into the Reintegration Struggles and Triumphs of Transnational Mothers Amidst the COVID-19 Pandemic
Authors: Lanada Jonel P.
Published: January 2024

The COVID-19 pandemic unleashed a global crisis with far-reaching impacts on various aspects of society, including labor migration and family dynamics. Among the vulnerable populations affected were transnational mothers who, having migrated in pursuit of economic opportunities, found themselves unexpectedly laid-off and compelled to return to their home countries. This phenomenological research endeavored to unravel the lived experiences of these laid-off transnational mothers as they navigate the complex journey of emergency return and reintegration during the pandemic. Drawing on a qualitative phenomenological approach, this study engaged in-depth interviews to explore the dimensions of these mothers’ experiences. The research journey illuminated the challenges, coping mechanisms, and transformations that emerged as these mothers embarked on a journey of returning to rebuild their lives and identities. Findings revealed that the sudden job loss and subsequent return disrupted established life trajectories, leading to a profound sense of dislocation and ambiguity. The mothers’ narratives captured the struggles of renegotiating roles within families and communities, grappling with economic instability, and confronting the intersections of gender, migration, and resilience. By bringing these individual stories to the forefront, the research underscored the urgent need for tailored support mechanisms, inclusive policy responses, and heightened awareness of the unique challenges faced by transnational mothers in crisis situations.
Depression and Anxiety Among Parents During the COVID-19 Pandemic: The Role of Cumulative Stress and Emotion Dysregulation
Authors: Cheung Rebecca Y. M. , Vaydich Jenny Lee
Published: January 2024

The COVID-19 pandemic has introduced many new stressors for parents worldwide. This study investigated the link between parents’ cumulative stress and psychological distress during the pandemic. Parents’ emotion dysregulation was further examined as a moderator between cumulative stress and psychological distress. A total of 155 parents in the United States participated in the present study. Path analysis was conducted to evaluate the effects of cumulative stress, including COVID-19-related stress, general stress, and parental stress, as well as emotion dysregulation on parents’ psychological distress, including depression and anxiety. The present findings indicated that parents’ general stress, parental stress, and emotion dysregulation predicted symptoms of depression. Emotion dysregulation further exacerbated the effect of parental stress on depression. Parents’ general stress and emotion dysregulation were also predictive of anxiety symptoms. In addition, emotion dysregulation exacerbated the effect of COVID-19-related stress on parental anxiety. This study revealed that parents’ stress and emotion dysregulation were additively and interactively associated with their psychological distress. The findings inform researchers and practitioners that parents’ stressors have cumulative effects on their psychological distress and that emotion dysregulation can worsen the negative effect of stress on mental health in challenging times, such as the pandemic.
Image Rotation Alters Apparent Fibula Length: An Evaluation of Talocrural Angle, Shenton Line, and Dime Sign
Authors: Jackson Nicholas J. , Root Kevin T. , Nichols Jennifer A. , Reb Christopher W.
Published: January 2024

Background:

Fibula shortening can compromise ankle stability and force transmission, thereby impacting clinical outcomes. Because radiographs depict 3-dimensional anatomy in 2 dimensions, accurate radiographic assessment of fibula length is a commonly encountered clinical challenge. The talocrural angle (TCA), Shenton line, and dime sign are useful parameters of fibula length. Yet, the impact of 3-dimensional limb positioning on these radiographic parameters is not established.

Methods:

Bone models were constructed from CT scans of 30 lower limbs. Fibula length was computationally manipulated, and digitally reconstructed radiographs were generated reflecting 1-degree increments of sagittal and axial plane rotation of each limb for each fibula length condition. The TCA was computationally measured on each image. The presence of an aligned mortise view, intact Shenton line, and intact dime sign was assessed by 2 observers.

Results:

The mean TCA, which was 78.0 (95% CI ± 1.6) degrees for a true mortise projection with anatomic fibula length, changed by approximately 1 degree per millimeter of fibula length change. On average, 14.7 degrees of caudal rotation obscured 2 mm of fibular shortening by virtue of producing the same TCA as a true mortise view with anatomic fibula length, designated a false positive view. Axial rotation had a comparatively small effect. Observers 1 and 2 were, respectively, 91% and 88% less likely to accurately judge the image alignment of the false positive images compared to true mortise images. Moreover, intraobserver agreement was poor to moderate (mean 0.47, range 0.13-0.59) and interobserver agreement was uniformly poor (mean 0.08, range 0.01-0.20).

Conclusion:

In our study using digitally reconstructed radiographs from CT scans of 30 limbs, we found that sagittal plane rotation impacts the radiographic appearance of fibula length as measured by the TCA. Limb axial rotation had a comparatively small effect. Further study of human perception of Shenton line and dime sign is needed before the effect of rotation on these parameters can be fully understood.

Level of Evidence:

Level IV, case series.
The Role of HATCH Score in the Prediction of Ischemic Cerebrovascular Events in Patients with Heart Failure and Atrial Fibrillation
Authors: Aydın Sidar Şiyar , Aksakal Emrah
Published: January 2024

The presence of both atrial fibrillation (AF) and heart failure (HF) increases the risk of an ischemic cerebrovascular event (CVE) by roughly fivefold. The HATCH score is a score used to predict new-onset AF. Although there are some differences, it contains risk factors similar to the CHA2DS2-VASc score. Our study aimed to investigate the relationship between the HATCH score and ischemic CVE. This retrospective study obtained data from 1719 HF patients between 2015 and 2022. About 673 patients with AF were included in the study. In the univariate and multivariate Cox regressions, we found that CHA2DS2-VASc and HATCH scores were independent predictors of ischemic CVE (p = 0.001 and < p = 0.001, respectively). The ROC analysis, AUC for the CHA2DS2-VASc score was 0.884 (95% CI 0.828-0.940, <p = 0.001). For the HATCH score, the AUC was 0.978 (95% CI 0.966-0.991, <p = 0.001). The HATCH score can be an independent predictor of the development of ischemic CVE in HF patients with AF.
Active disturbance rejection adaptive fuzzy backstepping control of uncertain flexible marine riser system
Authors: Zhou Li , Wang Guorong , Wan Min
Published: January 2024

In this paper, vibration control of a flexible marine riser with uncertain parameters subjected to distributed disturbance and boundary disturbance is studied. The existing vibration control algorithms have the problems of relying on the accurate mathematical model of the system, complex control laws, and need to measure multiple states of the system, which cannot effectively deal with the uncertainty of model parameters and external disturbances. To effectively suppress the vibration of a marine flexible riser system with uncertain parameters, an adaptive fuzzy backstepping control algorithm was designed. First, the backstepping method and Lyapunov function are used to analyze the subsystem and design the virtual control law. On this basis, an adaptive fuzzy system was designed. The fuzzy system was used to approach the unknown nonlinear term in the design process of the control law and the uniform boundedness of the system was proved by the Lyapunov stability theory. The designed control algorithm has a simple structure, and it can effectively restrain the riser vibration and improve the control rate. Finally, the numerical simulation results show that the designed control algorithm is effective in suppressing the vibration of flexible risers and the control effect is better than previous PID control and robust adaptive control.