bluuebunny/crossref_metadata_2025 huggingface dataset:
Renin-Angiotensin-Aldosterone System Inhibitors, Statins, and Beta-Blockers in Diabetic Patients With Critical Limb Ischemia and Foot Lesions
Authors: Cimaglia Paolo , Bernucci Davide , Cardelli Laura Sofia , Carone Anna , Scavone Giuseppe , Manfrini Marco , Censi Stefano , Calvi Simone , Ferrari Roberto , Campo Gianluca , Dalla Paola Luca
Published: May 2022

Medical therapy for secondary prevention is known to be under-used in patients with peripheral artery disease (PAD). Few data are available on the subgroup with critical limb ischemia (CLI). Prescription of cardiovascular preventive therapies was recorded at discharge in a large, prospective cohort of patients admitted for treatment of CLI and foot lesions, stratified for coronary artery disease (CAD) diagnosis. All patients were followed up for at least 1 year. The primary endpoint was major adverse cardiovascular events (MACE). 618 patients were observed for a median follow-up of 981 days. Renin-angiotensin-aldosterone system (RAAS) inhibitors, statins, beta-blockers, and antithrombotic drugs were prescribed in 52%, 80%, 51%, and 99% of patients, respectively. However, only 43% of patients received optimal medical therapy (OMT), defined as the combination of RAAS inhibitor plus statin plus at least one antithrombotic drug. It was observed that the prescription of OMT was not affected by the presence of a CAD diagnosis. On the other hand, it was noticed that the renal function affected the prescription of OMT. OMT was independently associated with MACE (HR 0.688, 95%CI 0.475-0.995, P = .047) and, after propensity matching, also with all-cause mortality (HR 0.626, 95%CI 0.409-0.958, P = .031). Beta-blockers prescription was not associated with any outcome. In conclusion, patients with critical limb ischemia are under-treated with cardiovascular preventive therapies, irrespective of a CAD diagnosis. This has consequences on their prognosis.
Low-frequency vibration control of two flexible appendages using a joint with actively tunable stiffness
Authors: Hu Wei , Wu Jianming , Zhu Qinghua , Zheng Xunjiang , Sun Shaoyong , Tang Yucong
Published: May 2022

Low-frequency and large-amplitude vibration of flexible appendages in space can be induced when a spacecraft performs attitude maneuvers and thermal alternations during orbit operation. In this paper, a novel joint mechanism combined with a semi-active method for variable stiffness control is proposed to suppress the low-frequency vibrations of flexible jointed appendages. The variable stiffness of the joint is derived from the linear relationship between its output torque and rotation angle when direct current (DC) power is applied to the coils. Based on the Lagrange equation and the assumed mode method, the coupling dynamic relationships of the active joint and two flexible appendages are established, and semi-active vibration control simulations are performed. A ground experimental platform is built to simulate the microgravity environment in space. The frequency shift effect of rigid body motion and elastic vibration under impact disturbance are investigated. In addition, the effect of variable stiffness control on the elastic deformation of flexible appendages is studied. The simulation and experimental results indicated that the proposed method can control both the rigid body motion of the system and the elastic vibration of the appendages. It has been found that the major frequency bandwidth of the interference signal is within 0.3–1.0 Hz with a substantial vibration attenuation of 1.82–16.62 dB for the joint and 4.86–11.48 dB for the flexible appendages.
Central nervous system neurotoxicity associated with nelarabine in T-cell acute lymphoblastic leukemia
Authors: Pehlivan Umur A , Gürkan Emel , Açar İbrahim H , Bıçakcı Yunus K
Published: May 2022

Introduction

Nelarabine, a prodrug of arabinosylguanine has lineage-specific toxicity for T lymphoblasts and is used to treat refractory or relapsed T-cell acute lymphoblastic leukemia and T-cell lymphoblastic lymphoma patients. The most commonly observed adverse effects associated with nelarabine are mainly hematological, i.e. neutropenia, anemia, and thrombocytopenia. Additionally, neurological, and gastrointestinal toxicities have been reported. Central nervous system neurotoxicity associated with nelarabine is very rare.

Case description

A 37-year-old man patient diagnosed with T-cell acute lymphoblastic leukemia had experienced generalized tonic-clonic seizure which lasted for a few seconds and upper extremity weakness after three weeks of the nelarabine infusion. Computed tomography and magnetic resonance imaging have shown periventricular and nucleus caudatus abnormalities. Radiological findings suggested toxic leukoencephalopathy and acute infarct of right nucleus caudatus.

Management and outcome

After high-dose steroids, intravenous immunoglobulin, and support treatment, his neurologic symptoms disappeared except for mild peroral numbness. However, radiological sequelae persisted despite clinical improvement.

Conclusion

Physicians involved in the care of these patients who use nelarabine should be aware of the fact that cerebral toxicity of the nelarabine may occur especially in the presence of predisposing factors. It is crucial to monitor closely those patients receiving nelarabine and also those who have additional predisposing factors for neurotoxicity.
What Drives States to Raise Gas Tax Rates? An Empirical Analysis
Authors: Chen Can , Su Min , Zhang Ping
Published: May 2022

Gas taxes represent one of the most important revenue sources for state transportation funding. This study draws upon the theory of policy innovation and diffusion and examines the drivers of legislative decisions to directly increase state gas tax rates among 50 states from 2010 to 2018. Using a discrete event history analysis, this study finds that states raise gas tax rates in response to the growing funding needs of maintaining and improving the quality and performance of state highway infrastructure. Additionally, these findings suggest that state internal characteristics— poverty rate, personal income, rising gas prices, as well as the external influences of neighboring states affect the adoption of a gas tax rate hike.
Anesthetic Challenges in a Patient With TANGO2 Gene Deletion, DiGeorge Syndrome, and Tetralogy of Fallot: A Case Report
Authors: Wrobleski Ivana , Gautam Nischal K. , Hubbard Richard M.
Published: May 2022

Mutations of the transport and Golgi organization 2 (TANGO2) genes are linked with both long-term neurological decline and acute metabolic crises during stress, leading to significant anesthetic risk. Crises are marked by rhabdomyolysis, lactic acidosis, seizures, cardiac dysfunction, and dysrhythmias. Much is unknown about optimal management of this condition, especially in the acute and critical care settings. The following report describes the anesthetic challenges of a patient with simultaneous TANGO2 gene deletion, DiGeorge Syndrome, and Tetralogy of Fallot, who presented for an interventional cardiac procedure with the goal of metabolic crisis-avoidance and facilitation of safe but expeditious recovery and discharge home.
Masculinity and Marriage: Interrogating Possession among Velichappad Men of Northern Kerala
Authors: Balu Gayatri
Published: May 2022

The paper explores the everyday gendered lives of Velichappad men. The focus of the paper is on understanding imprint of rituals of possession beyond the space of enactment to the everyday social and material life of the persons who are possessed. Focusing on the experiences of men gives a deeper insight into the gendered dimensions of possession and its differentiated experiences. In addition, this paper examines the social and economic structures that limit and transform the Velichappads. Meanings of possession are understood by situated ethnography and the non-homogeneity of male experiences is reflected through the narratives. The narratives point toward the need for a conceptual framework that understands possession within the intricacies of gender, caste, and class. Furthermore, this study supports the contention that studies of masculinity be informed by the experiences of the marginalized. Interrogating the experiences of Velichappad men charts the histories of the region’s sexual economies, and its social and material embedding.
Nocturnal normobaric hyperoxia treatment in a case of chronic diabetic macular edema
Authors: Song Soobin , Lemire Colin A. , Seto Brendan , Arroyo Jorge G.
Published: May 2022

Purpose

To study the long-term anatomic and physiologic effects of nocturnal normobaric hyperoxia (NNBH) in a patient with treatment-resistant diabetic macular edema (DME).

Methods

A 64-year-old diabetic man with bilateral DME requiring regular anti-VEGF treatments in both eyes was started on 5 LPM (40% FiO2) NNBH treatment 6-h per night. Visual acuity, OCT measurements of retinal thickness and volume, as well as the number of injections given in each eye were retrospectively examined one year prior and prospectively after initiation of NNBH, as well as before and after a planned 1-month discontinuation of NNBH.

Results

The patient received 12 anti-VEGF injections in the year prior to beginning NNBH treatment (4 OD; 8 OS) and did not require any injections after commencing NNBH treatment. Visual acuity improved and stabilized to 20/20 and macular edema rapidly resolved in both eyes following initiation of NNBH. After a planned 1-month NNBH vacation, DME recurred but quickly resolved once NNBH treatment was restarted.

Conclusion

This model case demonstrates that a 6-h NNBH regimen can be successful in treating DME and improving vision, without the need for intravitreal injections. NNBH is a more acceptable treatment regimen compared to 24-h continuous oxygen delivery and may provide a less invasive alternate method for treating DME in patients with diabetes. Further study is warranted.
Force Fields of Montaña Verde: Spatializing the Commons in the City-as-Oeuvre
Authors: Otte Hanka , Volont Louis
Published: May 2022

This article assesses what a spatial expression of the commons might entail. It asks, “How is ‘common space’ produced when the initiative thereto lies at the institutional rather than at the grassroots level?” The article first proposes a dyadic understanding of common space in terms of endogenous and exogenous commoning: internal governance and external negotiation, respectively. Thereafter, Lefebvre’s spatial triad is mobilized as an ensemble of sometimes conflictive and sometimes complementary “force fields” that act upon these two variants of common space. The article takes as a central case study Montaña Verde (“Green Mountain”), a wooden arch that was built and then dismantled as part of the “Antwerp Baroque 2018” festival. Results showcase how a multiple set of significations was projected upon Montaña Verde: as urban green space, as museum domain, as common-pool resource, and as a means to recast public space to collective use.
Conclusion: An invitation to dialogue with The Life of the Mind
Authors: Marková Ivana , Brinkmann Svend , Cabra Martina , Coultas Claire , Zadeh Sophie , Zittoun Tania
Published: May 2022

In this conclusion to the special issue on The Life of the Mind by Hannah Arendt, we, the authors, reflect back on our dialogue with the philosopher’s text. Our reflexion has two main parts. First, we emphasise transversal themes – themes that most triggered our interrogations and that we as psychologists, all addressed in our separate papers: thinking, of course, but also Arendt’s views on dialogue, her conception of time and temporality, and morality. Second, we emphasise some of the questions emerging from our reading of Arendt, which, we feel, can enrich discussions in psychology, and especially in cultural psychology today. Altogether, we conclude by inviting readers to join in our dialogue.
“It’s easier to think outside the box when you are already outside the box”: A study of transgender and non-binary people’s sexual well-being
Authors: Björklund Frida , Lindroth Malin
Published: May 2022

With a phenomenological approach, we explored transgender and non-binary people’s strategies to experience sexual well-being. Ten self-reports (seven interviews and three written texts) were analyzed, and the analysis resulted in six themes. The first three (Affirming oneself, Having access to care, and Being respected as one’s gender) were strategies for sexual well-being realized through affirming one’s identity, receiving the gender-confirming care wanted, and having one’s gender identity respected by others. The other three themes (Masturbating and fantasizing, Communicating and being open, and Being sexually free in queer spaces) were strategies for one aspect of sexual well-being—pleasure. The results describe strategies that all can learn from: the need to accept and appreciate oneself, not just adapt to gender norms of bodies and behaviors, and to communicate. In addition, it illuminates that being norm-breaking, or stepping out of the gendered paths presented to you, appears to provide new opportunities for people to learn what they enjoy, and this could lead to a broader repertoire of pleasurable sexual practices—practices that take bodily prerequisites into account.
Blast resistance of prestressed steel-grouting composite beams under close-in explosions: Experiment and numerical analysis
Authors: Liu Wenyuan , Fang Qin , Chen Li , Li Zhan , Zhang Yadong , Xiang Hengbo
Published: May 2022

To increase the blast resistance of reinforced concrete or steel–concrete composite structures with long span, an innovative prestressed steel-grouting material composite beam with a hollow web is proposed. In the beam, the flange is filled with grouting material, and an I-type steel web is used to strengthen the shear capacity, and a prestressed tendon is placed in lower flange to improve the flexure resistance. The following three specimens were designed: a double hollow tube, a double tube filled with grouting material, and a prestressed double tube filled with grouting material. The specimens were tested against close-in blast, and overpressure, deformation, and strain were recorded. In order to further understand the blast-resistant performance of the beam, a finite element model was developed by commercial software LS-DYNA. A good agreement between the numerical predictions and test data was observed. It is indicated that the proposed prestressed steel-grouting material composite beam with hollow web exhibits excellent blast-resistant performance.
Developing and validating a predictive model for future emergency hospital admissions
Authors: Stylianou Neophytos , Young Jason , Peden Carol J , Vasilakis Christos
Published: May 2022

Although many emergency hospital admissions may be unavoidable, a proportion of these admissions represent a failure of the care system. The adverse consequences of avoidable emergency hospital admissions affect patients, carers, care systems and substantially increase care costs. The aim of this study was to develop and validate a risk prediction model to estimate the individual probability of emergency admission in the next 12 months within a regional population. We deterministically linked routinely collected data from secondary care with population level data, resulting in a comprehensive research dataset of 190,466 individuals. The resulting risk prediction tool is based on a logistic regression model with five independent variables. The model indicated a discrimination of area under the receiver operating characteristic curve of 0.9384 (95% CI 0.9325–0.9443). We also experimented with different probability cut-off points for identifying high risk patients and found the model’s overall prediction accuracy to be over 95% throughout. In summary, the internally validated model we developed can predict with high accuracy the individual risk of emergency admission to hospital within the next year. Its relative simplicity makes it easily implementable within a decision support tool to assist with the management of individual patients in the community.
“Good morning, COVID!” the inertia of journalistic imaginaries in morning shows’ online comments
Authors: Gutsche Robert E , Forde Sydney L , Pinto Juliet , Zhu Yanqi
Published: May 2022

This textual analysis examines meanings of user comments to Facebook posts of three UK breakfast programs as COVID-19 entered England in 2020. This analysis suggests that during this time of crisis and uncertainty, users’ – even if trolling, interacting through incidental media use, or commenting as regular contributors to the pages – relied on traditional and lasting interpretations of conventional journalistic standards in their discourse surrounding “soft news” content. We argue that such comments represent an “inertia” of longstanding journalistic imaginaries that have survived an increased hybridity of news.
Prosumer activism: The case of Britney Spears’ Brazilian fandom
Authors: Daros Otávio
Published: May 2022

The key argument of this article is that fan communities create, in their own way, a kind of prosumer media activism. Through a netnographic approach, I analyze aspects of fan labor and value creation, self-organization and entrepreneurship, agency and exploitation in an online discussion forum about the American singer Britney Spears in Brazil. Based on this case study on social networking, I develop the argument that it is possible to see digital fandom as a stage for a commodified cyberactivism, in which some social actors in the role of prosumers, on the one hand, exercise their freedom and find, more than gratification, ways to project themselves individually in society. But, on the other hand, they are subject to exploitative relationships, such as unpaid work, to promote the personality whose concrete relationship with their lives often does not go beyond media practices.
An efficient online outlier recognition method of dam monitoring data based on improved M-robust regression
Authors: Han Zhang , Chen Jiankang , Zhang Fang , Gao Zhiliang , Huang Huibao , Li Yanling
Published: May 2022

Common anomaly recognition methods are easy to misjudge and miss outliers for the online monitoring data. This is a bottleneck problem that needs to be overcome in dam safety management moving toward informatization. Based on the data of nine hydropower stations along Dadu River Basin, this paper analyzed existing problems of the common anomaly identification method and an algorithm was proposed based on improved M-robust regression recognition. In this algorithm, the AR factor was introduced to avoid the defect that the traditional model cannot simulate random variables. The extreme value method and robust estimation were utilized to avoid the leverage effect. The model collapse caused by maximum measured value was avoided through improving the residual calculation model of M-robust and optimizing the weight distribution function. The maximum of the three values, residual quartile difference, discrete quartile difference, and measurement accuracy, was used as an anomaly recognition criterion to improve the evaluation criteria. The algorithm compiled was used in the Dadu River Company since 2017. The statistics showed that for the 150,000 measured values per day, the evaluation time could be within 15 min, the missed judgment rate was 0%, and the misjudgment rate was less than 2%. The proposed algorithm achieved a great improvement and can meet the needs of online outlier recognition in dam safety management.
Education, regressive citizenship and reduction of the modern social contract
Authors: Martins Marcos F
Published: May 2022

This paper is the result of bibliographic and documentary research, whose object was the relationship between citizenship and education in Brazil today. The research problem was to identify the extent to which regressive citizenship, understood as an action aimed at reducing social rights, has impacted the modern social contract and, in it, the educational and non-school educational processes, observing the actions of two regressive social movements: MBL (Free Brazil Movement, or Movimento Brasil Livre, in Portuguese) and “Escola sem Partido” (School Without a Party).
Using Attributes of Survey Items to Predict Response Times May Benefit Survey Research
Authors: Schneider Stefan , Jin Haomiao , Orriens Bart , Junghaenel Doerte U. , Kapteyn Arie , Meijer Erik , Stone Arthur A.
Published: May 2022

Researchers have become increasingly interested in response times to survey items as a measure of cognitive effort. We used machine learning to develop a prediction model of response times based on 41 attributes of survey items (e.g., question length, response format, linguistic features) collected in a large, general population sample. The developed algorithm can be used to derive reference values for expected response times for most commonly used survey items.
Carbon nanotube yarns derived from gamma irradiated carbon nanotube forests
Authors: Cai Jackie Y , Min Jie , McDonnell Jill , Wang Lijing , Knott Robert
Published: May 2022

Gamma irradiation has been recognised as an effective microengineering tool for improving interfacial adhesion of carbon nanotubes (CNTs) in their macroscopic structures. In this study, we applied γ-irradiation directly to vertically aligned CNT forests (grown on iron coated silicon wafers) in the presence of air, and the irradiated CNT forests were then spun into CNT yarns under various applied tensions. The effect of γ-irradiation on the CNT forest morphology, spinning performance and mechanical and electrical properties of the resultant CNT yarns were evaluated and compared with the unirradiated controls. The results revealed that CNT yarns spun from the gamma irradiated CNT forests had higher tensile strength and lower breaking elongation than the yarns spun from the unirradiated CNT control forests under the same spinning conditions. Increasing spinning tension improved the strength of CNT yarns spun from both the irradiated and unirradiated forests, but the tension-induced improvements from the irradiated forests were much more profound. The relative improvements in the yarn tenacity due to the γ-irradiation were in the range from 14% to 26% under various spinning tension applied. This study also showed that the gamma irradiated CNT forests retained good spinnability under relatively low spinning tension, but exhibited significantly inferior spinnability at high spinning tension, compared to the unirradiated controls. Possible mechanisms for the spinnability of CNT forests and the mechanical properties of CNT yarns were discussed. Further improvement in the CNT forest spinnability may be needed through the optimisation of γ-irradiation doses applied to the CNT forests.
Preoperative Depression is Associated with Worse Outcomes after The Lower Extremity Revascularization
Authors: Suarez Luis , Melikian Raffi , Alnahhal Khaled I , Allison Genève M , Jimenez Daniel , Urhiafe Vanessa , Salehi Payam , Iafrati Mark
Published: May 2022

Objective

This retrospective study sought to describe the association between preoperative diagnosis of depression and major adverse events after infrainguinal bypass surgery or peripheral vascular intervention (PVI).

Methods

We retrospectively analyzed a consecutive series of all patients undergoing PVI and/or infrainguinal bypass surgery at a single tertiary institution between 2010 and 2019. Propensity matching and Cox regression analysis were conducted to examine the impact of comorbid depression on the incidence of major adverse events (MAEs), defined as re-intervention, major amputation, or death, within 2 years of surgery.

Results

Of all patients ( n = 512) undergoing intervention at our institution, 166 (32.4%) suffered an MAE and 169 (33.0%) patients had a preoperative diagnosis of depression. After propensity score matching, univariate (HR, 1.7; 95% CI, 1.1–2.7) and multivariable hazard analyses (aHR, 1.50; [1.1–2.2]) demonstrate that there is a statistically significant relationship between the diagnosis of depression and increased MAE.

Conclusion

Over one-third of our lower extremity revascularization patients were noted to have a preoperative diagnosis of depression. After intervention, these patients had worse outcomes compared to patients without depression; this finding was more evident in patients who underwent PVI mainly due to high overall mortality rate. Prospective studies are necessary to better understand this association and to ascertain if early intervention can improve post-procedure vascular outcomes.
Response to clopidogrel in patients undergoing lower extremity revascularization
Authors: Tawil Michael , Maldonado Thomas S , Xia Yuhe , Berland Todd , Cayne Neal , Jacobowitz Glenn , Lugo Joanelle , Lamparello Patrick , Sadek Mikel , Rockman Caron , Berger Jeffrey S
Published: May 2022

Objectives

Clopidogrel is effective at decreasing cardiovascular events in patients with peripheral artery disease (PAD); however, its effect on limb outcomes are less known. This study investigated the variability in response to clopidogrel and its relationship with clinical limb outcomes.

Methods

Three hundred subjects were enrolled in the Platelet Activity and Cardiovascular Events (PACE) study prior to lower extremity revascularization, of whom 104 were on clopidogrel. Light transmission platelet aggregation was measured in response to ADP 2 [Formula: see text]m immediately prior to revascularization. Patients were followed longitudinally for a median follow-up of 18 months. The primary endpoint was major adverse limb events (MALE) defined by major amputation or reoperation of the affected limb. Patients were stratified into groups according to percent ADP-induced aggregation. Poor response to clopidogrel was defined by >50% aggregation.

Results

Overall, the median age was 70 (63, 76) and 35.6% were female. Twenty-nine (27.9%) patients experienced MALE during their follow-up. Median aggregation to ADP 2 [Formula: see text] m was 22.5% (Q1-Q3: 10%, 50%) and 27 subjects (26%) were clopidogrel poor responders. Baseline aggregation was higher in subjects who went on to develop a MALE than those without MALE (43% vs 20%, p = .017). Subjects with aggregation > median (22.5%) were more likely to experience MALE than aggregation < median (38.5% vs 17.3%, p = .029). After multivariable adjustment for age, sex, race/ethnicity, BMI, diabetes, coronary artery disease, and aspirin use, aggregation > median was associated with MALE (adjusted HR [aHR] 2.67, 95% CI 1.18–6.01, p = .018). When stratified by established cut-offs for responsiveness to clopidogrel (50% aggregation), poor responders were more likely to experience MALE than normal responders (44.4% vs 22.1%, aHR 2.18, 95% CI 1.00–4.78, p = .051).

Conclusions

Among patients undergoing lower extremity revascularization on clopidogrel, higher baseline percent aggregation is associated with increased risk for major adverse limb events.
Reading spaced and unspaced Korean text: Evidence from eye-tracking during reading
Authors: Baek Hyunah , Choi Wonil , Gordon Peter C
Published: May 2022

In written Korean, spaces appear between phrasal units (“eojeols”). In Experiment 1, participants read sentences in which space information had been manipulated. Results indicated that removing spaces or replacing them with a symbol hindered reading, but this effect was not as disruptive as previously found in English. Experiment 2 presented sentences varying in the proportion of eojeols that ended with postpositional particles as well as the presence/absence of spaces. Results showed that space removal interfered with reading, but its effects were weaker when the sentence contained more postpositional particles. This suggests that postpositional particles provide an extra cue to word segmentation in Korean texts. These findings are discussed in relation to the unique characteristics of the Korean writing system and to the models of eye-movement control during reading in different languages.
Surgical management of the spastic elbow
Authors: Luo Weisang , Nixon Matthew
Published: May 2022

Background

We performed a retrospective review of patients undergoing surgery for elbow spasticity. We present our findings and expected outcomes according to degree of elbow fixed flexion contracture.

Methods

Data collected included age, Modified Ashworth Score, pre and post-operative range of motion, indications for surgery and the Goal Attainment Score. Contracture severity was classified into five groups based on goniometric measurements. Surgical procedures were categorised into three groups.

Results

A total of 114 elbows underwent surgical release. The mean age at surgery was 18.5 years and the mean follow-up was 20 months. Preoperatively, the median Modified Ashworth Score was 2 and the mean contracture was 68° (35° fixed and 33° dynamic). The median number of structures released was 3 (range: 1–6). Surgical procedures were classified as biceps sparing (27%), biceps lengthening (53%) and extended releases (18%). Mean improvement in extension was 59°, and the mean improvement in Goal Attainment Score was 36 (mean attainment score 62). The mean residual contracture was 9°. Patient satisfaction was high with over 90% of surgical indications met.

Discussion

Contracture severity of the spastic elbow can be categorised by degree of fixed flexion deformity and therefore treatment can be allocated accordingly.
Repurposed and investigational disease-modifying drugs in osteoarthritis (DMOADs)
Authors: Oo Win Min , Hunter David J.
Published: May 2022

In spite of a major public health burden with increasing prevalence, current osteoarthritis (OA) management is largely palliative with an unmet need for effective treatment. Both industry and academic researchers have invested a vast amount of time and financial expense to discover the first diseasing-modifying osteoarthritis drugs (DMOADs), with no regulatory success so far. In this narrative review, we discuss repurposed drugs as well as investigational agents which have progressed into phase II and III clinical trials based on three principal endotypes: bone-driven, synovitis-driven and cartilage-driven. Then, we will briefly describe the recent failures and lessons learned, promising findings from predefined post hoc analyses and insights gained, novel methodologies to enhance future success and steps underway to overcome regulatory hurdles.
Utilization of integrated community case management service of childhood illness (ICCM) and associated factors among under-five children in Shashogo district, Hadiya zone, South Ethiopia
Authors: Kassa Endale Abera , Handiso Tilahun Beyene , Admassu Bittiya , Nigussie Aderajew
Published: May 2022

Background:

Integrated community case management (ICCM) service is provision of concurrent clinical and preventive care by trained community health workers for common childhood illnesses in the community. In Ethiopia, integrated community case management (ICCM) service utilization is low and its magnitude is unknown as well as no adequate evidence on its associated factors. This study aimed to investigate use of integrated community case management service of childhood illness and factors associated with it.

Methods:

A community-based cross-sectional study was conducted in Shashogo district. A total of 422 mothers who had under-five children were selected using simple random sampling method. Structured interviewer administered pre-tested questionnaire was used to collect data. Descriptive statistics, binary and multivariable logistic regression analyses were used.

Results:

The proportion of integrated community case management (ICCM) service utilization among sick under-five children in past six months at Shashogo district was 199(47.2%, with 95%CI:(43.2, 51.2)). Receiving training on health extension packages as model family AOR = 2.07(1.05, 4.08), experiencing frequent childhood illness AOR = 1.92(1.11, 3.33), having information about ICCM service AOR = 3.73(1.42, 9.76), and having a postnatal care visit in recent child AOR = 13(7.37, 23.06) were associated with utilization of integrated community case management service.

Conclusion:

ICCM service was not used as planned though there is offer of free of charge service nearby. ICCM service is affected by maternal and child health utilization. Hence, collaborative activities of information, education, and communication activities are needed.
Motivate me to exercise with you: The effects of social media fitness influencers on users’ intentions to engage in physical activity and the role of user gender
Authors: Durau Julia , Diehl Sandra , Terlutter Ralf
Published: May 2022

Objective

Social media fitness influencers are evolving into a new digital form of health communicators whom consumers might turn to for assistance with more physical activity and exercise at home, especially in the current COVID-19 crisis. Drawing from source credibility theory, social cognitive theory, protection motivation theory and literature on physical activity, physical fitness and gender, we analyse how male and female users’ evaluations of social media fitness influencers and user health-related variables impact intentions to exercise with the social media fitness influencer.

Methods

Two consecutive studies using male and female YouTube fitness influencers were carried out. Structural equation modelling was conducted to test the proposed models and estimate the path coefficients.

Results

Study 1 ( N = 507) shows that the respective influencer's perceived trustworthiness, expertise and attractiveness are important for the influencer's evaluation, and that it is the perceived motivating power rather than the attitude toward the influencer that increases intentions to exercise for male and female users. Study 2 ( N = 445) extends Study 1 and shows that physical fitness, training involvement with YouTube fitness videos and lower health increase behavioural intentions. A more negative body image also raises intentions to exercise, but only among female users.

Conclusion

Social media fitness influencers who are perceived as trustworthy, as experts and as attractive, can be effective for increasing men's and women's physical activity. Perceived motivating power of the influencer emerged as a key variable that predicts intentions to exercise. User health-related variables have different effects on intentions to exercise for men and women.
Outcomes Following Norwood Procedures: Analysis of a “Small Volume” Program
Authors: D’Angelo John , Suguna Narasimhulu Sukumar , Pourmoghadam Kamal , Hsia Tain-Yen , Fleishman Craig , Kube Alicia , Lucchesi Nicole , DeCampli William
Published: May 2022

Background

Institutional survival following Norwood procedures is traditionally correlated with a center's surgical volume. Multiple single and multi-institutional studies conducted at large-volume centers have recently demonstrated improved survival following Norwood procedures. We report both short- and long-term outcomes at a single, small-volume institution and comment on factors potentially influencing outcomes at this institution.

Methods

All patients undergoing Norwood procedures from January 1, 2005, to January 1, 2020, at our institution were included in this study. Kaplan-Meier survival and Cox regression risk factor analyses were performed in addition to first interstage risk factor scoring to compare observed versus expected survival.

Results

The cohort included 113 patients. Kaplan-Meier freedom from death or transplant was 88%, 80%, and 76% at 1, 5, and 10 years, respectively. Freedom from death following hospital discharge after Norwood procedures was 94%, 87%, and 83% at 1, 5, and 10 years, respectively. The presence of genetic syndromes was a significant risk factor for mortality. First interstage observed-to-expected mortality following discharge was 0.57 ( P = .04). Postoperative length of stay was comparable to that reported for the period 2015 to 2018 in the Society of Thoracic Surgeons Database.

Conclusions

Survival outcomes at this single, small-volume institution were similar to those reported by large-volume centers and multi-institutional collaborative studies. These results may be related to structural and functional features that have been demonstrated to influence outcomes in other studies. These factors are achievable by small-volume programs with sufficient resource allocation.
Law and Media Trial in India
Authors: Shaikh Shazia
Published: May 2022

Media is often termed as the fourth pillar of India; it is an indispensable part in keeping democracy alive and reaching out to the masses. The media plays an instrumental role in educating and delivering the truth to people. However, in recent times, the media has exceeded its role by bringing its lens into the courtrooms and setting up its own trials, parallelly. The transition from responsible reporting to investigating various high-profile cases or cases of infamous crimes has made the media trial a common practice. From aiming to grab the highest television rating points to trying to stay relevant in the changing times, the media has overstepped its own boundary. The unconscious transition in its role has not only interfered with the fair administration of justice but also pressurised the judiciary to act in a certain way. It has, also, hampered the fundamental and constitutional rights of both the accused and the victim of a crime. The courts have always, unfailingly, guarded the freedom of press, and they continue to do so. However, the judiciary sensed trouble in certain cases when the media began to deliver its own verdict before the evidence was verified or the guilt proved. It is here that the need to demarcate a line arose in order to ensure the media remains well within its job of fair reporting. In an attempt to contain this adverse effect of the media, the legislature and the judiciary have attempted to frame rules and guidelines to that effect. This article attempts to discuss the various facets of media trials and the laws pertaining to them.
Effect of Capital Structure on the Financial and Social Performance of Indian Microfinance Institutions
Authors: Chauhan Swati , Verma Ashutosh , Kumar C. V. R. S. Vijaya
Published: May 2022

This study investigates the effect of capital structure on the social and financial performance of microfinance institutions (MFIs), which have a double bottom line objective of outreach and financial sustainability. Generalized method of moments (GMM) and instrumental variable (IV) estimation were used on the panel data set of 46 non-banking finance companies (NBFCs)-MFIs from 2013–2014 to 2018–2019. NBFC-MFIs are formed after the transformation of NGO-MFIs to access market-based sources of funds to increase their outreach. The results show that Indian MFIs are highly leveraged and have bidirectional causality between capital structure and financial and social performance variables. The study found a positive and significant relationship between capital structure and social and financial dimensions of the NBFC-MFIs. It shows that NBFC-MFIs can maintain the dual objectives even after transformation. The study contributes to the scarce literature by emphasizing the role of capital structure on the performance of MFIs, which are playing an essential role in financial inclusion.
Evaluation of Apixaban in Patients With Antiphospholipid Syndrome: A Case Series and Review of Literature
Authors: Al Sulaiman Khalid , Hafiz Awatif , Badreldin Hisham A. , Korayem Ghazwa B. , Alsuwayyid Faisal , Alrashidi, PharmD Abdulrahman , Alhijris Mohammed , Almutairi, PharmD Faisal , Alharthi Fahad , Alghamdi Saad , Abu Alreesh Ahmed , Aljuhani Ohoud
Published: May 2022

Several guidelines endorsed the indefinite use warfarin or heparin-containing products for acute venous thromboembolism (VTE) treatment and secondary prevention and discouraged the use of direct oral anticoagulants (DOAC) for patients diagnosed with antiphospholipid syndrome (APS). However, adequate anticoagulation despite warfarin therapy remains a challenge in APS patients. Using DOACs in APS patients is seen in clinical practice, despite the lack of evidence to support their use in this population. In this case series, we aim to evaluate the safety and effectiveness of apixaban use in nine patients with primary or secondary APS at King Abdulaziz Medical City (Riyadh, Saudi Arabia). All patients presented with APS and received apixaban with or without concomitant antiplatelet. Three patients had double positivity, and two patients had triple positivity of antiphospholipid antibodies (aPL). Some patients tolerated apixaban during the follow-up period, but recurrent VTE and stroke were reported in some of them. Bleeding complications were evident in some cases as well. In conclusion, warfarin remains the best choice to prevent VTE recurrence in patients with APS. On the other side, apixaban use in patients with APS may have some safety and effectiveness concerns evidenced by VTE recurrence and bleeding complications. The safety and effectiveness of utilizing apixaban in APS patients need to be assessed in well-controlled randomized trials.
Comparing Sex-Specific Outcomes After Rotator Cuff Repair: A Meta-analysis
Authors: Fancher Andrew J. , Mok Anthony C. , Vopat Matthew L. , Templeton Kim , Kimbrel Brandon K. , Tarakemeh Armin , Mulcahey Mary K. , Mullen Scott , Schroeppel John P. , Vopat Bryan G.
Published: May 2022

Background:

Rotator cuff repair (RCR) is a well-studied procedure. However, the impact of patient sex on outcomes after RCR has not been well studied.

Purpose:

To conduct a systematic review and meta-analysis of sex-based differences in outcomes after RCR and to record what proportion of studies examined this as a primary or secondary purpose.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A systematic review was performed using multiple databases according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were written in English, performed on humans, consisted of patients who underwent RCR, evaluated at least 1 of the selected outcomes based on patient sex, and had statistical analysis available for their sex-based claim. Excluded were case reports, review studies, systematic reviews, cadaveric studies, and studies that did not report at least 1 sex-specific outcome or included certain other injuries associated with a rotator cuff injury.

Results:

Of 9998 studies screened and 1283 full-text studies reviewed, 11 (0.11%) studies with 2860 patients (1549 male and 1329 female) were included for quantitative analysis. None of these 11 studies examined the impact of patient sex on outcomes after RCR as a primary outcome. Postoperative Constant-Murley scores were analyzed for 7 studies. Male patients had a postoperative Constant-Murley score of 76.77 ± 15.94, while female patients had a postoperative Constant-Murley score of 69.88 ± 17.02. The random-effects model showed that male patients had significantly higher scores than female patients, with a mean difference of 7.33 (95% CI, 5.21-9.46; P < .0001). Analysis of retear rates in 5 studies indicated that there was no difference in the retear rate between sexes (odds ratio, 0.91 [95% CI, 0.49-1.67]).

Conclusion:

Female patients had lower postoperative Constant-Murley scores compared with male patients, but there was no difference in the retear rate. However, these results were based on an analysis of only 11 studies. The paucity of studies examining the impact of sex suggests that more research is needed on the impact of patient sex on outcomes after RCR.
Phantom architecture: Jeremy Bentham's haunted and haunting panopticon
Authors: Fiddler Michael
Published: May 2022

Drawing upon Jacques Derrida’s notion of hauntology and the nascent field of ghost criminology, this article explores the spectrality of Jeremy Bentham's panopticon. This frames the never constructed building as an example of ‘phantom architecture’. It can be seen as both haunted and haunting. Here, we use Beaumont’s ‘architectural parallax’ to examine this building that is ‘out-of-joint’. It is at once of the past, yet profoundly present, as well as prefiguring the future. We turn first to the spectral presence of an abandoned building designed by Samuel Bentham, Jeremy's brother. We see how Samuel's experiences in Krichev in the 1780s left traces in the prison design that the brothers would work upon. This saw them develop an architecture that would hold in its centre a surveillant ‘entity’ that would haunt those being observed at the building's periphery. Having explored the ‘no longer’, we turn to the ‘not yet’ to see how the panopticon has come to inspirit thought and architectural practice. In tracing these varied spectralities, both within and of the panopticon, we can reveal its enduring impact on the criminological imagination.
Depth of response and response kinetics of isatuximab plus carfilzomib and dexamethasone in relapsed multiple myeloma
Authors: Martin Thomas , Mikhael Joseph , Hajek Roman , Kim Kihyun , Suzuki Kenshi , Hulin Cyrille , Garg Mamta , Quach Hang , Sia Hanlon , George Anup , Konstantinova Tatiana , Risse Marie-Laure , Asset Gaelle , Macé Sandrine , van de Velde Helgi , Moreau Philippe
Published: May 2022

The IKEMA study (Randomized, Open Label, Multicenter Study Assessing the Clinical Benefit of Isatuximab Combined With Carfilzomib [Kyprolis®] and Dexamethasone Versus Carfilzomib With Dexamethasone in Patients With Relapse and/or Refractory Multiple Myeloma Previously Treated With 1 to 3 Prior Lines; #NCT03275285) was a randomized, open-label, multicenter phase 3 study investigating isatuximab plus carfilzomib and dexamethasone (Isa-Kd) vs Kd in patients with relapsed multiple myeloma. This subanalysis analyzed the depth of response of Isa-Kd vs Kd. The primary end point was progression-free survival (PFS); secondary end points included overall response rate, very good partial response or better (≥VGPR) rate, complete response (CR) rate, and minimal residual disease (MRD) negativity rate (assessed in patients with ≥VGPR by next-generation sequencing at a 10−5 sensitivity level). At a median follow-up of 20.7 months, deeper responses were observed in the Isa-Kd arm vs the Kd arm, with ≥VGPR 72.6% vs 56.1% and CR of 39.7% vs 27.6%, respectively. MRD negativity occurred in 53 (29.6%) of 179 patients in the Isa-Kd arm vs 16 (13.0%) of 123 patients in the Kd arm, with 20.1% (Isa-Kd, 36 of 179 patients) vs 10.6% (Kd, 13 of 123 patients) reaching MRD-negative CR status. Achieving MRD negativity resulted in better PFS in both arms. A positive PFS treatment effect was seen with Isa-Kd in both MRD-negative patients (hazard ratio, 0.578; 95% CI, 0.052-6.405) and MRD-positive patients (hazard ratio, 0.670; 95% CI, 0.452-0.993). Exploratory analysis indicates that both current CR and MRD-negative CR rates are underestimated due to M-protein interference (potential adjusted CR rate, 45.8%; potential adjusted MRD-negative CR rate, 24.0%). In conclusion, there was a clinically meaningful improvement in depth of response with Isa-Kd. The CR rate in Isa-Kd was 39.7%. Mass spectrometry suggests that the potential adjusted CR rate could reach an unprecedented 45.8% of patients treated with Isa-Kd.