bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous locomotion and manipulation control of quadruped robots using reinforcement learning-based adaptive fractional-order sliding-mode control
Authors: Farid Yousef
Published: March 2023

This paper investigates a model-free reinforcement learning-based approach that enables the quadruped robot to manipulate objects while maintaining its balance and dynamic stability during walking. At first, the dynamics of quadruped robots in two sub-spaces, position control space and force control space, are developed. Then, a new long-term performance index is introduced, and a radial basis function neural network as a critic network is presented to estimate the unobtainable long-term performance index. Based on the exported reinforcement signal, the actor neural network is introduced to generate the feedforward compensation term to cope with the nonlinear dynamics and the system uncertainties. The robustness of the actor-critic reinforcement learning algorithm is enhanced by using a fractional-order sliding-mode controller in the closed-loop system. The online adaptive laws for both the critic and actor-network weights are obtained using the Lyapunov stability theory. As a result, the uniformly ultimately boundedness of the position and the force tracking errors are proven. Finally, numerical simulations are conducted to illustrate the feasibility and effectiveness of the proposed adaptive actor-critic learning-based control scheme.
Anterior basal left ventricular pseudoaneurysm in a single vessel disease
Authors: Rumbinaitė Eglė , Venckus Vilius , Mamedov Arslan , Jakuškaitė Gabrielė , Bučius Paulius , Dobilienė Olivija , Žaliūnas Remigijus , Jakuška Povilas , Benetis Rimantas
Published: March 2023

Introduction

Left ventricular pseudoaneurysm is a rare but serious clinicopathologic entity.

Materials and results

This article describes a case report of 51-year-old man who experienced recurrence of chest pain and dyspnea 4 months later after anterior ST elevation myocardial infarction of first diagonal branch. Anterior basal left ventricular pseudoaneurysm was diagnosed and successful surgical treatment was performed. One year after operation, patient has no cardiovascular events and remains in NYHA class II.

Conclusion

Cardiac magnetic resonance should be performed, if there is a suspicion of left ventricular pseudoaneurysm from transthoracic echocardiography. Surgery is the treatment of choice in case of left ventricular pseudoaneuryms because untreated lesions carry a significantly high risk of rupture.
Wrestling with “the new” state capitalism
Authors: Peck Jamie
Published: March 2023

This paper introduces an Exchange section dedicated to the question of the new state capitalism. It is suggested that the new state capitalism, both as an ascendant concept and as marker of socioinstitutional facts on the ground, signals a significant geohistorical moment, perhaps not a new “era” as such, but a notable inflection point. This warrants critical attention, even if first-generation treatments of the phenomenon itself may have been somewhat wanting. Contributions follow from Ilias Alami, Jennifer Bair, Isabella Weber, Marion Werner, and Heather Whiteside, each of whom provide a critical take on (debates around) the new state capitalism from their own theoretical perspective and vantage point.
Managing digital assets on death and disability: An examination of the determinants of digital asset planning literacy
Authors: Steen Adam , Graves Chris , D’Alessandro Steven , Shi Henry X.
Published: March 2023

Despite its increasing importance, digital financial literacy (DFL) is yet to be adequately understood. This article reports on one aspect of DFL, namely, digital asset planning literacy (DAPL) which is an individual’s awareness of what happens to their digital assets on their death or incapacity. Our results from Australia and Singapore suggest that single, less-educated women are less likely to possess DAPL, and that the number of digital assets is negatively associated with DAPL, while having a Will is positively related to DAPL. With this study, we put forward that financial education should include consumer rights regarding digital financial assets.

JEL Classification: D14; G53; G50; J12; J16
Epicranial headaches part 2: Nummular headache and epicrania fugax
Authors: Cuadrado María-Luz
Published: March 2023

Background

Nummular headache and epicrania fugax are two primary headaches that fall under the heading of epicranial headaches.

Methods

This article reviews the epidemiological and clinical features of nummular headache and epicrania fugax, proposed pathogenic mechanisms and state-of-the-art management, according to the literature.

Results and conclusions

Nummular headache and epicrania fugax are generally viewed as rare headache disorders, but no population-based epidemiological data are available. Nummular headache is characterized by continuous or intermittent head pain, which remains circumscribed in a round or oval area of the scalp, typically one to six centimeters in diameter. Epicrania fugax manifests with brief paroxysms of pain that move along the surface of the head, following a linear or zigzag trajectory through different nerve territories. Nummular headache and epicrania fugax are mostly primary headaches, but some secondary cases have been reported. The pathogenesis of these headaches is not fully understood. Nummular headache could probably originate in epicranial tissues or adjacent intracranial structures, while the origin of epicrania fugax could be extracranial or intracranial. Diagnostic assessment requires careful examination of the symptomatic areas. Underlying disorders should be excluded by additional investigations, including neuroimaging and appropriate blood tests. No controlled clinical trials have been conducted in nummular headache or epicrania fugax. Analgesics and anti-inflammatory drugs, botulinum toxin and gabapentin are currently the most recommended treatment options for nummular headache. In epicrania fugax, the most used treatments are gabapentin, lamotrigine, and other antiseizure medications.
An altered reward system characterizes chronic migraine with medication overuse headache
Authors: Niddam David M , Wu Shih-Wei , Lai Kuan-Lin , Yang Yun-Yen , Wang Yen-Fang , Wang Shuu-Jiun
Published: March 2023

Background

Medication overuse headache shares several characteristics with substance use disorders. However, key features of substance use disorders such as increased impulsivity and alterations in reward processing remain little explored in medication overuse headache.

Methods

Temporal discounting and impulsive decision making behavior and the associated brain mechanisms were assessed in 26 chronic migraine patients with medication overuse headache and in 28 healthy controls. Regions-of-interest analyses were first performed for task-related regions, namely the ventral striatum and the ventromedial and dorsomedial prefrontal cortices. Resting-state functional connectivity between these regions were then explored. An additional 27 chronic migraine patients without medication overuse headache were included for comparison in the latter analysis.

Results

Patients with medication overuse headache showed steeper temporal discounting behavior than healthy controls. They also showed weaker subjective value representations in the dorsomedial prefrontal cortex, when accepting larger delayed rewards, and in ventral striatum and ventromedial prefrontal cortex, when accepting the smaller immediate reward. Resting-state functional connectivity was reduced among the valuation regions when comparing patients with medication overuse headache to the other two control groups.

Conclusions

Patients with medication overuse headache were characterized by altered processing and dysconnectivity in the reward system during intertemporal choices and in the resting-state.
“Each Day We Lose a Little More”: Visual Depictions of Family Caregiving for Persons with Dementia
Authors: Teti Michelle , Benson Jacquelyn , Washington Karla , Rolbiecki Abigail
Published: March 2023

More than 11 million Americans provide unpaid care for people with dementia (PWD) and need emotional, financial, and physical support. This study explored how participants in Caregiver Speaks, a social networking and image-based storytelling intervention designed to help caregivers make meaning of caregiving, described their caregiving experiences and needs. Strategies of thematic analysis were used to identify patterns in 28 different caregivers’ images ( N = 59) and text interactions on social media. Caregivers identified as white (71.4%), as women (92.9%), and as an adult child or child-in-law of the PWD (85.7%). Through images and text, caregivers explained interrelated changes in their behaviors (e.g., managing dual roles), thoughts (e.g., realizing severity of illness), and feelings (e.g., trapped) throughout the caregiving process. Findings reiterate that caregiving changes significantly over time, that visual storytelling helps to concretely capture those changes, and that interventions are needed to respond to caregivers’ hardships across the caregiving time span.
Risk Stratification for Oropharyngeal Squamous Cell Carcinoma Using Texture Analysis on CT – A Step Beyond HPV Status
Authors: Chang Yuh-Shin , Nair Jaykumar Raghavan , McDougall Connor C. , Qiu Wu , Banerjee Robyn , Joshi Manish , Lysack John T.
Published: March 2023

Background and Purpose: Human papillomavirus-associated oropharyngeal squamous cell carcinoma (OPSCC) is increasingly prevalent. Despite the overall more favorable outcome, the observed heterogeneous treatment response within this patient group highlights the need for additional means to prognosticate and guide clinical decision-making. Promising prediction models using radiomics from primary OPSCC have been derived. However, no model/s using metastatic lymphadenopathy exist to allow prognostication in those instances when the primary tumor is not seen. The aim of our study was to evaluate whether radiomics using metastatic lymphadenopathy allows for the development of a useful risk assessment model comparable to the primary tumor and whether additional knowledge of the HPV status further improves its prognostic efficacy. Materials and Methods: 80 consecutive patients diagnosed with stage III-IV OPSCC between February 2009 and October 2015, known human papillomavirus status, and pre-treatment CT images were retrospectively identified. Manual segmentation of primary tumor and metastatic lymphadenopathy was performed and the extracted texture features were used to develop multivariate assessment models to prognosticate treatment response. Results: Texture analysis of either the primary or metastatic lymphadenopathy from pre-treatment enhanced CT images can be used to develop models for the stratification of treatment outcomes in OPSCC patients. AUCs range from .78 to .85 for the various OPSCC groups tested, indicating high predictive capability of the models. Conclusions: This preliminary study can form the basis multi-centre trial that may help optimize treatment and improve quality of life in patients with OPSCC in the era of personalized medicine.
A 3D finite element model to simulate progressive damage in unidirectional- and woven-fibre thermoplastic discontinuous-long-fibre composites
Authors: Belliveau Réjean , Landry Benoit , LaPlante Gabriel
Published: March 2023

Discontinuous-long-fibre (DLF) composites fabricated from pre-impregnated unidirectional (UD) fibre chips are susceptible to structural deficiency. The in-plane highly anisotropic mechanical properties of the chips combined with the random nature of fibre orientation causes local weaknesses within the material when fibres are perpendicular to the load. Recent experimental results have shown that using woven-fibre chips could improve the performance of DLF composites by increasing their average mechanical properties and reducing their variability. To better understand the underlying phenomenon giving an advantage to the woven chips, a finite element model was developed to predict the mechanical properties obtained from a standard tensile test. DLF chips were modelled based on a voxel method where random chip positions were generated by an algorithm developed in this work. ANSYS® software was utilized to model the non-linear response associated with progressive damage of the composite. The maximum stress and the Puck failure criteria were employed to define damage initiation for the woven and UD fibres, respectively. Tensile modulus predictions for both types of chips showed good results when compared to experimental data. Strength predictions for the UD fibres also showed good correlation with experimental results, but the model overestimated the strength of the woven-fibre DLF composite. It appeared that the failure of the UD-fibre composites was associated with matrix failure (transverse tension and in-plane shear). Woven-fibre composites, however, showed damage modes linked to both fibre failure (longitudinal tension) and matrix failure (transverse tension and in-plane shear).
Liposomal Bupivacaine in Dentistry and Oral and Maxillofacial Surgery. A Review of Human and Veterinary Literature.
Authors: Kellner Bill , Duffee Lauren
Published: March 2023

This article reviews the human and veterinary literature regarding liposome encapsulated bupivacaine use in dentistry and oral and maxillofacial surgery. The purpose of this review is to present available information on this local anesthetic in a manner that will allow veterinary dentists and oral and maxillofacial surgeons to use evidence-based information when considering incorporating liposomal bupivacaine into their practice. The twelve human clinical studies and three veterinary reports that met the literature search criteria do not support the use of liposomal bupivacaine in veterinary dentistry and oral and maxillofacial surgery.
Evaluation of Dental and Oral Pathologies of 36 Captive Lions (Panthera leo) and Tigers (Panthera tigris)
Authors: Kopp Eva , Stelzer Peter , Lendl Christine , Meyer-Lindenberg Andrea , Fahrenkrug Peter
Published: March 2023

The documented increase in the occurrence of dental diseases in captive big cats over the past decades has necessitated the need to target dental medical research accordingly. The aim of this study was the systematic evaluation of dental and oral pathologies of lions and tigers which included intraoral dental radiography. Thirty-six animals of both sexes, ranging in age from nine months to 18 years, predominantly in circus husbandry, served as the basis of the present study, and their dental health status was investigated. The preliminary report and history, adspection of the awake animal, and examination under anesthesia provided important information. Eight animals were specifically presented for oral examination because of known dental disease. The remaining 28 animals were anesthetized for other medically necessary procedures, and each animal's oral and dental health status was also evaluated while under anesthesia. In the 28 animals that underwent routine oral cavity examination, pathological changes that had not previously been noticed were found in two-thirds of the animals (19/28). One-quarter of all the animals (9/36) had no abnormal oral cavity findings. Dentoalveolar trauma such as tooth fractures and abrasion (24/36) were diagnosed most frequently. The results highlight the importance of regular oral examinations in big cats. Furthermore, the results suggest that there is a relationship between husbandry conditions and the incidence of dentoalveolar trauma in captive big cats.
Equivalent system based inverse dynamics analysis of transfemoral prosthetic legs: Validation and application
Authors: Sudeesh S , Shunmugam MS , Sujatha S
Published: March 2023

Inverse dynamics analysis of prosthetic legs with polycentric knees is complex due to increased number of links. The present work proposes a simple and general method called equivalent system (ES) analysis. The ES analysis provides forces and moment at hip joint as well as at the functional knee centre (FKC), the instant centre of the polycentric knee. The input to the ES analysis is the motion data. For validation of the proposed method, synthetic motion data for the swing phase of walking with prosthetic legs having different knees are generated by simulations using ADAMS. The hip kinetics evaluated by the proposed method is compared with that from ADAMS. The root mean square errors of the ES analysis are lower than 17 (10−6) N for hip reaction forces and 2.6 (10−6) Nm for the hip moments, thereby validating the proposed method. In order to demonstrate the application of the proposed methodology, the motion data of two transfemoral amputees using single-axis and four-bar knee prostheses are obtained during gait trials. The hip kinetics as well as kinetics at FKC are computed using ES analysis. Hip power during the swing phase is also evaluated and compared. The results are presented in this paper and discussed. The ES analysis is shown to be a versatile tool to provide insights into the human-mechanism interaction.
Relationships Among Smartphone Use, Physical Activity, and Quality of Life in Chinese College Students
Authors: Shi Yuqing , Shi Mengyao , Zhao Ying , Liu Chang , Sui Lu , Zhao Zuhang , Fan Xiang
Published: March 2023

This study aimed to investigate the correlations between smartphone use, physical activity, and quality of life (QOL) among Chinese college students. We enrolled 6323 students who were chosen from three Chinese universities. All participants completed the World Health Organization QOL Scale-Brief, Smartphone Addiction Index, and Physical Activity Questionnaire-Short Form. Smartphone addiction was negatively related to QOL (β = −1.375), whereas physical activity was positively related to QOL (β = .059). The presence of both smartphone addiction and insufficient physical activity decreased QOL scores when compared with the group with sufficient physical activity and non-smartphone addiction (β = −36.505). Physical activity and smartphone use are potentially modifiable risk factors for poor QOL in college students. Thus, interventions to decrease smartphone use and promote physical activity could be beneficial for improving QOL in this population.
Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results
Authors: Gómez Diego J , Veloz Serrano Daniel , Moya Daniel , Crosa Juan I , Cullari Matias L , Taleb Juan P , Quiroga Gonzalo , Maya Xavier A , Muratore Álvaro
Published: March 2023

Aims

Our objective is to compare the functional results in patients that underwent surgery for recurrent anterior shoulder instability (RAGHI) during the COVID-19 pandemic with remotely-based rehabilitation, to those who had surgery before the pandemic and had in-person rehabilitation therapy.

Methods

A retrospective case series of 68 patients were included and divided into two groups: In person-group and Home-based group. Western Ontario Shoulder Instability Index (WOSI) and Subjective Shoulder Value (SSV) scores were used to evaluate objective and subjective clinical parameters. Time and level of return to sports was studied by the Subjective Patient Outcome for Return to Sports (SPORTS) score.

Results

The mean SSV score was 82% (40–100) on the In-Person group compared with 87% (65–100) for the Home-Based group. Results for WOSI score were similar, with an average of 210.42 (90%) for In-Person and 261.45 (88%) for the Home-Based group ( p 0.12). Return to sports was carried out in an average of 6.6 (4–16) months for In-Person group, compared to 6.5 (5–8) months for Home-Based.

Conclusion

Follow-up and rehabilitation methods for patients who underwent surgery for RAGHI, during COVID-19 lockdown, were not significantly ( p 0.12) affected on functional and athletic return in comparison to traditional methods according to WOSI scale.

Level of evidence

IV Retrospective series of cases
The ECB going green: Impact on the interrelationship between monetary policy and banking supervision?
Authors: Heynen Pieterjan
Published: March 2023

The European Central Bank (ECB) has recently launched several initiatives in order to integrate climate-related actions under its monetary policy and banking supervision tasks. The ECB ‘going green’ has sparked debate among legal scholars and central bankers. What has been left untouched, however, is how climate-related action relates to the current organizational structure within which the ECB executes its two main tasks. The SSM Regulation has installed a Chinese Wall between these matters, which have to be conducted in ‘complete separation’ from one another. This article questions this structure in the light of the ECB's climate-related efforts. What are the implications of climate change and the ECB's climate-related actions for the interrelationship between monetary policy and banking supervision? The consequences of climate change are likely to be omnipresent, and will produce effects reaching far beyond specific policy areas. In such a context, the ECB could benefit from more coordination and monitoring of what is decided under each task instead of carrying them out in isolation from each other. It will be argued that climate-related action has triggered an coordinative evolution within the ECB, leading to and more awareness on how monetary policy and banking supervision are inherently intertwined.
A comparative case study illustrating the influence of a system perspective on the outcome evaluation of simple versus complex interventions
Authors: Renger Ralph , Renger Jessica , Van Eck Richard N , Basson Marc D , Renger Jirina
Published: March 2023

When evaluating the effectiveness of an intervention, the evaluation approach must match the intervention complexity, ensuring that the chosen evaluation is “fit for purpose.” For simple interventions, evaluating short-, mid-, and long-term outcomes is appropriate. However, for complex interventions, an additional outcome that must be considered is the essential system property that emerges as a result of the interaction of interdependent intervention components. By focusing on the emergent system property, evaluators are better able to assess the holistic effectiveness of a complex intervention. This article illustrates this principle through a comparative case study of a simple intervention and a complex intervention within a National Institute of Health (NIH) funded Clinical Translational Research center. The analysis illustrates that a more effective and appropriate evaluation results when a complex intervention, deemed to be operating and functioning as a system, is evaluated as a system than could have been achieved by treating each component as independent and evaluating the short-, mid-, or long-term outcomes of each component.
The Need for Improved End-of-Life Care Medical Education: Causes, Consequences, and Strategies for Enhancement and Integration
Authors: Hirani Rahim , Khuram Hassan , Elahi Aria , Maddox Parker Alan , Pandit Maya , Issani Ali , Etienne Mill
Published: March 2023

End-of-life (EOL) care is a unique area of medicine that emphasizes holistic patient-centered care. It requires clinicians to consider a patients’ mental, emotional, spiritual, social and physical comforts and engage patients and their families in complex discussions and decisions. It is an area of medicine that requires sensitivity in communication in order to respond to a wide range of emotions from patients and their families. Given these intricacies, it is essential that healthcare professional trainees are exposed early in their careers so they can be better equipped to address EOL situations effectively. While many medical schools have integrated this important element in pre-clinical education, a formalized and standardized curriculum could allow for students to better engage in EOLcare scenarios that they will face as future physicians. In this editorial, we discuss potential strategies to incorporate EOL care didactics and experiential learning earlier in medical education as well as the consequences of inadequate EOL care education, particularly in medical schools, in its current state.
A thermodynamic damage model for 3D stress-induced mechanical characteristics and brittle–ductile transition of rock
Authors: Zheng Zhi , Su Hao , Mei Guoxiong , Wang Wei , Liu Hong , Zhang Qiang , Wang Yujie
Published: March 2023

Due to the existence of true three-dimensional high-geostress in deep underground engineering, rock shows different mechanical properties and brittle–ductile behaviours from conventional triaxial stress states, however, the different characteristics of rock are not clear. Therefore, a series of true triaxial tests were performed on deeply buried marble to investigate the effects of σ2 and σ3 on the characteristic strength (peak strength, yield strength and residual strength), post-peak deformation and brittle–ductile behaviour. Based on test results, a three-dimensional elastoplastic damage constitutive model that describes plastic hardening and damage softening of rock was established within the framework of irreversible thermodynamics, and a sensitivity analysis of key parameters ( η and ζ) was performed. A method that controls the brittle–ductile behaviour of rock through key parameters η and ζ was studied, and functions of these two parameters with σ2 and σ3 were proposed. The proposed model was implemented numerically with the cutting-plane algorithm in a finite element program. A series of numerical simulation experiments were performed, and numerical simulation and experimental results are consistent. In addition, brittle–ductile transition of marble under untested true triaxial stress levels were reasonably predicted.
Heart Rate Variability in Adults With Substance Use Disorder: A Comprehensive Narrative Review
Authors: Moon Seol Ju Esther , Schlenk Elizabeth A. , Lee Heeyoung
Published: March 2023

Background:

Heart rate variability (HRV) is an indicator of autonomic abnormalities. However, little is known about the role of HRV related to substance use behavior and the association between the changes in HRV and signs of relapse in substance use.

Aim:

The purpose of this study was to review the existing literature on autonomic response to substance use (i.e., opioids, cocaine, and methamphetamine) measured by HRV and its outcomes related to the risk factors of relapse.

Methods:

A systematic search of the literature was conducted using PubMed, PsychINFO, and Ovid Medline databases. The study includes full-text articles published in English from 2010 to 2020, using measures of HRV in human subjects who use substances.

Results:

A total of 14 studies were reviewed. Studies included outpatients with a prescription or nonprescription opioid misuse behavior with a primary diagnosis being chronic pain or substance use disorder (SUD). Significantly decreased resting HRV was found in substance users compared to healthy controls. Lower resting HRV has been significantly associated with stress, craving, and greater symptom severities in individuals with SUD and other substance dependence. HRV indices can be potential measures of homeostatic imbalance and self-regulation flexibility.

Conclusion:

HRV may be a useful tool for monitoring early indication of relapse so that relapse prevention measures can be implemented in a timely manner. Future studies in substance use may benefit from examining HRV in relations to substance use and relapse signs and symptoms in a larger population to guide future relapse prevention strategies.
Well-palpable pulse over an occluded radial artery: A case series reporting ultrasound outcomes
Authors: Lewandowski Paweł , Zuk Anna , Budaj Andrzej
Published: March 2023

We report a case series of four patients with radial artery occlusion complicating vascular access who were scheduled for coronary angiography. We describe the challenges in selecting adequate vascular access in patients with a history of coronary angiography and percutaneous coronary intervention, as well as the benefits of using preprocedural ultrasound examination of forearm arteries to detect radial artery occlusion. Our case series suggests that if the anterior interosseous artery provides partial blood supply to the hand as a collateral circulation of the occluded radial artery, the transulnar approach may be an alternative safe option for coronary angiography and percutaneous coronary intervention in this population.
What is so funny about platform labour in Brazil? Ride-hailing drivers’ use of humour and memes on Facebook groups
Authors: Pires Fernanda , Ataci Tugce , Araujo Willian Fernandes
Published: March 2023

In this article, we focused on data drawn from two Brazilian Facebook groups that discuss on-demand driving (Uber and 99Pop). We focus particularly on the use of humour in the stories that on-demand drivers (ride-hailing) share, as it was identified that humour is widely used within these groups. This article has three objectives: (1) to detect the types of stories shared by on-demand drivers in the Facebook groups; (2) to determine the relationships these stories have with the work of on-demand driving; and (3) to understand the dimensions of professional identity and negotiation of platform labour conditions. Therefore, three dimensions of the stories shared by on-demand drivers were identified: the relationships they establish with their clients, their relationships with the platforms (the affordances and limitations the platforms provide and represent), and the everyday work relationships among the drivers developed by establishing Facebook as a digital workspace. These dimensions lead to the formation and negotiation of their professional identity and reveal how they deal with precarity through humour.
Identifying adverse drug reactions from patient reviews on social media using natural language processing
Authors: Oyebode Oladapo , Orji Rita
Published: March 2023

Drugs have the potential of causing adverse reactions or side effects and prior knowledge of these reactions can help prevent hospitalizations and premature deaths. Public databases of common adverse drug reactions (ADRs) depend on individual reports from drug manufacturers and health professionals. However, this passive approach to ADR surveillance has been shown to suffer from severe under-reporting. Social media, such as online health forums where patients across the globe willingly share their drug intake experience, is a viable and rich source for detecting unreported ADRs. In this paper, we design an ADR Detection Framework (ADF) using Natural Language Processing techniques to identify ADRs in drug reviews mined from social media. We demonstrate the applicability of ADF in the domain of Diabetes by identifying ADRs associated with diabetes drugs using data extracted from three online patient-based health forums: askapatient.com, webmd.com, and iodine.com. Next, we analyze and visualize the ADRs identified and present valuable insights including prevalent and less prevalent ADRs, age and gender differences in ADRs detected, as well as the previously unknown ADRs detected by our framework. Our work could promote active (real-time) ADR surveillance and also advance pharmacovigilance research.
The Current Status and Future Prospects for Conversion Therapy in the Treatment of Hepatocellular Carcinoma
Authors: Bai Jinfeng , Huang Ming , Song Bohan , Luo Wei , Ding Rong
Published: March 2023

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. In China, most HCC patients are diagnosed with advanced disease and in these cases surgery is challenging. Conversion therapy can be used to change unresectable HCC into resectable disease and is a potential breakthrough treatment strategy. The resection rate for unresectable advanced HCC has recently improved as a growing number of patients have benefited from conversion therapy. While conversion therapy is at an early stage of development, progress in patient selection, optimum treatment methods, and the timing of surgery have the potential to deliver significant benefits. In this article, we review the current evidence and clinical experience of conversion therapy in HCC. General conversion modalities such as systemic treatments (systemic chemotherapy, targeted therapy, or immunotherapy), locoregional therapy (transarterial chemoembolization, hepatic arterial infusion chemotherapy, or selective internal radiation therapy), and combination therapy were summarized. We also discuss the current challenges of conversion therapy and provide identify areas for future research to improve the development of conversion therapy in advanced HCC.
Anterior Cruciate Ligament Injury Prevention and Rehabilitation
Authors: Dawkins Jonathan , Teel Jordan , Kitziger Raymond , Khair Michael
Published: March 2023

At all levels of American football, knee injuries are common, with injuries to the anterior cruciate ligament (ACL) making up a significant proportion. Historically, ACL injuries were career-altering for professional players, but innovative techniques in surgery and rehabilitation have returned many to the field. While there is a consensus on surgical techniques for ACL reconstruction, significant discrepancies remain on injury prevention and rehabilitation programs. This review article describes the burden of ACL injury on players in the National Football League, best practices in injury prevention and rehabilitation, and evidence-based recommendations for preparing injured athletes to return to play.
Evaluating Occupant Light Exposure and Usage Patterns in an Inpatient Behavioral Health Unit
Authors: Banasiak Meredith , Wilkerson Andrea , Safranek Sarah
Published: March 2023

Objective:

To (1) evaluate the use case for tunable lighting in inpatient behavioral health, (2) describe differences in staff lighting exposures between static and tunable lighting conditions using wearable sensors, and (3) document occupant lighting control usage patterns.

Background:

Tunable lighting fixtures can vary the amount of light and spectral content, so have been offered as a way to address light and health considerations. Before we can understand potential health benefits of tunable lighting, it is helpful to understand how occupant exposures under tunable lighting differ from those under more traditional lighting systems.

Methods:

Tunable lighting benefits and challenges for inpatient behavioral health were carefully detailed during design. Light exposure measurements were recorded at an old site with static fluorescent lighting and a new site with tunable light-emitting diode (LED) lighting. Behavioral health inpatient unit staff participants voluntarily wore a light measurement device to estimate light exposure. At the new site, controls usage data were recorded each time a button was pressed on a lighting control station.

Results:

While general observations can be made about the data between sites, there is notable variation at both sites depending on the day and hour. Button press data revealed that occupants used the full capability of the tunable lighting system to support different activities and needs.

Conclusion:

Understanding the relationship between occupant well-being and light requires a holistic research approach including thoughtful design accounting for real-world constraints, detailed measurement of light exposure, and understanding how occupants interact and make use of new technology.
Association Between the Medial-Lateral Quadriceps and Hamstring Muscle Thickness and the Knee Kinematics and Kinetics During Single-Leg Landing
Authors: Jeong Jiyoung , Choi Dai-Hyuk , Shin Choongsoo S.
Published: March 2023

Background:

Muscle thickness can influence the joint kinematics and/or kinetics during dynamic activities. The relationship between the muscle thickness of individual quadriceps and hamstrings or medial-to-lateral thigh muscle thickness ratio and the knee kinematics/kinetics with respect to anterior cruciate ligament (ACL) injury risk remains unclear.

Hypothesis:

Higher medial-to-lateral thigh muscle thickness ratio would be associated with lower knee valgus angle/moment and lower tibial internal rotation angle/moment during single-leg landing.

Study Design:

Cross-sectional.

Level of Evidence:

Level 4.

Methods:

Muscle thickness of the vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), and semitendinosus (ST) of 30 healthy participants (16 males and 14 females) were measured using ultrasound. Knee joint kinematics and kinetics during single-leg landing were obtained. Stepwise multiple regression analysis, a follow-up Fisher’s r to z test to examine the sex as a moderator, and independent t tests to evaluate sex difference were performed.

Results:

Both knee valgus moment ( R2 = 0.466, P < 0.001) and tibial external rotation moment ( R2 = 0.330, P < 0.001) at peak anterior tibial shear force during single-leg landing were negatively correlated with medial-to-lateral (ie, (VM+ST):(VL+BF)) thickness ratio regardless of sex, whereas medial-to-lateral thigh muscle thickness ratio was not correlated with knee valgus and tibial external rotation angles. Male participants exhibited higher (VM+ST):(VL+BF) thickness ratio than female participants ( P = 0.005), and lower knee valgus moment ( P = 0.04) and tibial external rotation moment ( P = 0.05), as well.

Conclusion:

The knee joint moments in frontal and transverse planes during single-leg landing were associated with the medial-to-lateral thigh muscle thickness ratio; thus, the medial-lateral thigh muscle thickness could be a potential contributor to frontal and transverse plane knee joint loading during dynamic movement.

Clinical Relevance:

Strength training that aims to selectively strengthen the medial/lateral thigh muscles might be considered in a new ACL injury prevention training program to alter the biomechanical parameters associated with ACL injuries.
Mandible Fractures Undergoing Transfer Rarely Require Acute Intervention
Authors: McIntire Damon R.T. , Spake Carole S.L. , Jehle Charles C. , Basta Marten N. , Crozier Joseph W. , Woo Albert S.
Published: March 2023

Study Design

A retrospective review was conducted of all patients with mandibular fractures who were evaluated by plastic surgery at a Level I trauma center between January 1, 2017 and May 1, 2020. Data including demographic characteristics, mechanism of injury, type of presentation (e.g., primary or transfer), treatment plan, and time to intervention were recorded.

Objective

Mandibular fractures are common traumatic injuries. Because these injuries are managed by surgical specialists, these patients are often emergently transferred to tertiary care hospitals. This study aims to assess the benefits of emergent transfer in this patient group.

Methods

Variables were summarized using descriptive statistics. The relationship with initial disposition was assessed via tests of association, including Student’s t-test, Fisher’s exact test, or chi-square tests. Significance was set to p values less than 0.05. Multivariate regression analysis was conducted to determine predictors of presentation to outside hospital followed by transfer to our institution.

Results

Records from 406 patients with isolated mandibular fractures were evaluated. 145 (36%) were transferred from an outside hospital specifically for specialty evaluation. One patient required intervention in the Emergency Department (ED). Of the 145 patients that were transferred to our facility, eight (5.5%) were admitted for operative management. Patients with open injuries and pediatric patients showed benefit from transfer.

Conclusions

Patients are frequently transferred to tertiary care facilities for specialty service evaluation and treatment. However, when isolated mandible fractures were evaluated, only one patient required intervention in the ED. Patients with grossly open fractures and pediatric patients were more frequently admitted specifically for operative management. This practice of acute interfacility transfer represents an unnecessary cost to our health system as isolated mandible fractures can be managed on an outpatient basis. We suggest that pediatric patients and patients with open fractures be transferred for urgent evaluation and management, whereas most patients would be appropriate for outpatient evaluation.
Morphological Changes in the Tibial Tunnel After ACL Reconstruction With the Outside-In Technique and Adjustable Suspensory Fixation
Authors: Okutan Ahmet Emin , Gürün Enes , Surucu Serkan , Kehribar Lokman , Mahiroğulları Mahir
Published: March 2023

Background:

Anterior cruciate ligament reconstruction (ACLR) using the complete tibial tunnel technique and adjustable-loop cortical suspensory fixation is known to leave a “dead space” that holds the loop device in the tibial tunnel. The consequence of the dead space and its effect on graft healing are still uncertain.

Purpose:

To investigate morphological changes in the tibial tunnel and their effect on graft healing, and to identify factors affecting bone healing in the tibial loop tunnel after ACLR with a quadrupled semitendinosus tendon autograft using adjustable suspensory fixation.

Study Design:

Case series; Level of evidence, 4.

Methods:

Included were 48 patients (34 male, 14 female; mean age, 25.2 ± 5.6 years) who underwent ACLR with a quadrupled semitendinosus tendon autograft using adjustable suspensory fixation. To evaluate tibial tunnel morphology, computed tomography was performed at 1 day and 6 months postoperatively. At 1 year postoperatively, graft healing was assessed on magnetic resonance imaging using the graft signal-to-noise quotient (SNQ). Multivariate regression and correlation analyses were performed to determine any associations between volumetric changes in bone healing and operative variables.

Results:

At 6 months after ACLR, a mean of 63.2% of the tibial loop tunnel was filled by bone. Multivariate regression analysis showed that remnant preservation was significantly associated with the loop tunnel filling rate ( P < .001). At 1 year after ACLR, the tibial loop tunnel was almost completely closed (98.5%). There were no correlations between loop tunnel volume and graft integration or graft SNQ. A significant but weak correlation was found between graft tunnel volume and intratunnel graft SNQ ( P = .10) as well as integration grade in the tibial tunnel ( P = .30).

Conclusion:

Excellent bone filling in the tibial loop tunnel was seen at 1 year after ACLR. Remnant preservation was significantly associated with the loop tunnel filling rate. A weak correlation was found between graft tunnel volume and intratunnel graft SNQ as well as integration grade in the tibial tunnel.
Resilience is an Adverse Event: A Critical Discussion of Resilience Theory in Health Services Research and Public Health
Authors: Suslovic Brianna , Lett Elle
Published: March 2023

Resilience, the individual trait of being able to persist and cope with, often recurrent, negative experiences, has experienced an explosion in recent years as a topic of study. In this commentary, we critique this surge and problematize the co-occurring development of the “resilience as treatment” paradigm. We show that resilience is an expectation foisted primarily on historically and contemporarily oppressed and excluded populations often in response to systemic and structural forms of discrimination. We argue that this represents a fundamental mismatch of intervention and problem; offering an individual-level solution to a structural toxin. In doing so, we re-contextualize resilience as an adverse event, more analogous to scar tissue than a reliable treatment paradigm. Our essay concludes with offering alternatives to resilience that originate with the holistic trauma and liberation health frameworks. These paradigms are united in that, in contrast to resilience, they emphasize healing from structural violence, rather than adapting to it.
BMP7 ameliorates intervertebral disc degeneration in type 1 diabetic rats by inhibiting pyroptosis of nucleus pulposus cells and NLRP3 inflammasome activity
Authors: Yu Xiao-Jun , Wang Ying-Guang , Lu Rui , Guo Xin-Zhen , Qu Yun-Kun , Wang Shan-Xi , Xu Hao-Ran , Kang Hao , You Hong-Bo , Xu Yong
Published: March 2023

Background

Accumulating evidence indicates that intervertebral disc degeneration (IDD) is associated with diabetes mellitus (DM), while the underlying mechanisms still remain elusive. Herein, the current study sought to explore the potential molecular mechanism of IDD in diabetic rats based on transcriptome sequencing data.

Methods

Streptozotocin (STZ)-induced diabetes mellitus type 1 (T1DM) rats were used to obtain the nucleus pulposus tissues for transcriptome sequencing. Next, differentially expressed genes (DEGs) in transcriptome sequencing data and GSE34000 microarray dataset were obtained and intersected to acquire the candidate genes. Moreover, GO and KEGG enrichment analyses were performed to analyze the cellular functions and molecular signaling pathways primarily regulated by candidate DEGs.

Results

A total of 35 key genes involved in IDD of T1DM rats were mainly enriched in the extracellular matrix (ECM) and cytokine adhesion binding-related pathways. NLRP3 inflammasome activation promoted the pyroptosis of nucleus pulposus cells (NPCs). Besides, BMP7 could affect the IDD of T1DM rats by regulating the inflammatory responses. Additionally, NPCs were isolated from STZ-induced T1DM rats to illustrate the effects of BMP7 on IDD of T1DM rats using the ectopic expression method. Both in vitro and in vivo experiments validated that BMP7 alleviated IDD of T1DM rats by inhibiting NLRP3 inflammasome activation and pyroptosis of NPCs.

Conclusion

Collectively, our findings provided novel mechanistic insights for understanding of the role of BMP7 in IDD of T1DM, and further highlighted BMP7 as a potential therapeutic target for preventing IDD in T1DM.
Influence of Exosomes on Astrocytes in the Pre-Metastatic Niche of Lung Cancer Brain Metastases
Authors: Ye Lingyun , Wu Yinfei , Zhou Juan , Xie Mengqing , Zhang Zhemin , Su Chunxia
Published: March 2023

Background

Lung cancer is the most common cause of cancer-related death globally. There are several reasons for this high mortality rate, including metastasis to multiple organs, especially the brain. Exosomes play a pivotal role in tumor metastasis by remodeling the microenvironment of remote target organs and promoting the pre-metastatic niche’s formation. Since astrocytes are indispensable for maintaining the homeostasis of brain microenvironment, it’s of great interest to explore the influence of lung cancer cell-derived exosomes on astrocytes to further understand the mechanism of lung cancer brain metastasis.

Results

Twenty four h after co-culture of H1299 cell-derived exosomes and SVG P12 cells, the viability of astrocytes decreased and the apoptosis increased. The levels of cytokines in the supernatant including GROα/CXCL1, IFN-γ, IL-3, IL-5, IL-15, LIF, M-CSF, NGF, PDGF, and VEGF were significantly enhanced, while IL-7 secretion was significantly reduced. Meanwhile, apoptosis-related proteins MAP2K1, TUBA1C, RELA, and CASP6 were up-regulated. And the differentially expressed proteins were involved in regulating metabolic pathways.

Conclusion

Exosomes of H1299 could induce apoptosis of astrocytes as well as promote their secretion of cytokines that were conducive to the formation of the inflammatory microenvironment and immunosuppressive microenvironment, and affect their metabolic pathways, thus facilitating the formation of pre-metastatic niche in lung cancer brain metastases.