bluuebunny/crossref_metadata_2025 huggingface dataset:
Impunity entrenched: the erosion of human rights in the UK
Authors: Webber Frances
Published: April 2022

In this article, the author provides a roundup of the UK Conservative government’s legislative programme in 2021, arguing that, in the service of an authoritarian agenda, it uses law to undermine the rule of law and executive accountability, and to criminalise marginalised and/or racialised groups, including asylum seekers and those helping them, black youth, protesters and human rights defenders, and Gypsies, Roma and Travellers. Through an analysis of various new bills that attack human and civil rights, including the Police, Crime, Sentencing and Courts Bill, the Nationality and Borders Bill, the Overseas Operations Act, the Elections Bill and the Judicial Review and Courts Bill, she demonstrates the cumulative impact of the legislative programme that has entrenched the demonisation of minorities and human rights defenders, whilst giving unprecedented powers to police, hobbling the courts, nobbling other regulators and blocking effective legal, political and public accountability for ministers. The result, she argues, is an erosion of human rights and the entrenchment of impunity for the government and its agencies.
Effect of Self-Determination on Postsecondary Enrollment of English Learners With Disabilities
Authors: Newman Lynn A. , Trainor Audrey A. , Javitz Harold S.
Published: April 2022

We examined the effect of three components of self-determination—autonomy, empowerment, and self-realization—on the postsecondary enrollment of English learners with disabilities, using quasi-experimental propensity score modeling and data from the U.S. National Longitudinal Transition Study-2. Results support the hypothesis that self-determination components affect postsecondary school enrollment. English learners with disabilities with higher autonomy scores were more likely to enroll in 2-year colleges, and those with higher empowerment scores were more likely to enroll in 4-year colleges. However, prior research found that English learners with disabilities are less likely to act autonomously or report empowerment-related behaviors than other students with disabilities or students in the general population. Considering the increasing importance of postsecondary education, the current study’s findings demonstrate the importance of promoting both the self-determined behaviors of this dually identified population of students and the learning environment supports that facilitate the practice of self-determination.
Marketing Against Extremism: Identifying and Responding to Moral Disengagement Cues in Islamic State Terrorist Propaganda
Authors: Frazer Rebecca
Published: April 2022

This study presents selective moral disengagement as a paradigm for analyzing extremist marketing messages and developing effective countermessages. Selective moral disengagement explicates eight mechanisms common to extremist media content that can influence seemingly ordinary people to support and commit atrocities. Through a qualitative content analysis, the author investigates the use of moral disengagement mechanisms in an online propaganda magazine ( Rumiyah) of the so-called Islamic State (IS) terrorist organization. This article demonstrates the extensive use of the eight moral disengagement mechanisms throughout a variety of genres of IS propaganda articles. In addition, a ninth moral disengagement strategy—humanization of perpetrators—emerged. The analysis reveals internal inconsistencies in IS’s approach to moral disengagement. The author argues that careful consideration of the use of these mechanisms in IS propaganda clarifies the understanding of IS’s marketing strategy and informs countermessaging efforts. Specific countermessaging approaches are proposed for combatting IS given these findings. Further, a roadmap is given for extending the selective moral disengagement analysis paradigm into other extremist marketing contexts, including U.S. domestic terrorism.
A Life in Nursing Science: A Dialogue With Dr. Marlaine C. Smith
Authors: Morrow Mary R. , Smith Marlaine C.
Published: April 2022

The year 2022 is Nursing Science Quarterly’s 35th year in publication, and we are dialoging with nurse theorists. We hope to uncover influences and origins of their theoretical thinking and hear about their current projects related to nursing science. In this scholarly dialogue column, we dialogue with Dr. Marlaine C. Smith, nurse theorist, Professor Emeritus, Christine E. Lynn College of Nursing, Florida Atlantic University, and president of the Society of Rogerian Scholars. Her contribution to nursing science began with her own inquisitiveness, the influence of nursing faculty and mentors, and an academic career based steeped in leadership and nursing theory. Her middle-range theory of unitary caring synthesizes her work in the science of unitary human beings and caring science.
Implementing a Spiritual Care Subject for Holistic Nursing Practice: A Mixed Method Study
Authors: Cooper Katherine Louise , Chang Esther
Published: April 2022

Aim: The aims of this sequential explanatory mixed method study were twofold 1. Firstly, to evaluate the implementation of a spiritual care subject in a nursing program. 2. Secondly, to examine undergraduate nursing students’ perceptions of providing spiritual care within their holistic care practice. Background: Studies conducted internationally indicate many nurses feel inadequately prepared to provide holistic care inclusive of spiritual care due to insufficient spiritual care education. Design: Two phase, sequential explanatory mixed method design which comprised of a quantitative study followed by a qualitative study. Methods: The setting was an Australian faith-based university. Participants comprised of undergraduate nursing students who were enrolled in a spiritual care subject. Findings: Two study findings emerged: 1. Participants’ knowledge and practice of spiritual care were transformed by the spiritual care subject, and 2. The spiritual care subject broadened perceptions of spiritual care so participants viewed themselves more equipped to provide spiritual care in their holistic care provision. Conclusion: The spiritual care subject had an affirmative influence on participants’ perceptions of providing spiritual care within holistic care practice. The findings have implications for nurse educators to consider how spiritual care content can be included within undergraduate nursing curricula.
The Social Meanings of the Third Sector: How Action and Purpose Shape Everyday Understandings of “Nonprofit”
Authors: Child Curtis , Witesman Eva
Published: April 2022

How do nonspecialists of nonprofit practice, law, and scholarship conceptualize the third sector? This article explores the everyday meanings of nonprofit organization and action empirically by reporting on a survey-based exercise in which research participants coded statements describing qualitatively different interactions between various types of entities. The survey, drawing on Crawford and Ostrom’s grammar of institutions, allows for an examination of how lay observers make sense of the sectoral boundaries that occupy specialists’ attention. We find that research participants are less prone to code interactions consistently with the nominal sectors of the organizations presented to them and more inclined to code the interactions based on the types of actions organizations take and their rationale for those actions. We argue that understanding the everyday meaning of nonprofit has important implications for theory and practice.
Modeling rounded counts using a zero-inflated mixture of power series family of distributions
Authors: Mirkamali Sayed Jamal
Published: April 2022

This paper proposes an extension of zero-inflated models for analyzing rounded counting outcomes. A zero-inflated mixture of power series is proposed, and the EM algorithm is developed to estimate parameters. The accuracy of estimators is evaluated using a simulation study. The results of simulations show that the estimation procedure is successful and estimates are accurate. An application of our models for analyzing the number of cigarettes smoked per day of respondents for the American’s Changing Lives study is enclosed. The proposed model best fits the data and the relationships between rounded counts and other covariates revealed by proposed regression models.
Density of Cigarette Retailers Near Facilities for Children and Adolescents in Urban and Rural Areas in Indonesia: A Geospatial Analysis
Authors: Dewi Desak Made Sintha Kurnia , Puspikawati Septa Indra , Astutik Erni , Kusuma Dian , Melaniani Soenarnatalina , Sebayang Susy Katikana
Published: April 2022

The lack of regulation banning cigarette retailers near facilities for children and adolescents has made cigarettes easily accessible to youth in Indonesia. This study aimed to investigate the density of cigarette retailer near children and adolescent facilities in urban and rural areas in the country. We mapped all cigarette retailers and facilities for children and adolescents in Surabaya city (urban) and Banyuwangi district (rural) in East Java province. All types of facilities for children and adolescents and retailers visible from the streets in the study areas were mapped. We conducted geospatial analysis of the density of retailers to the facilities for children and adolescents in QGIS 2.8 and STATA 14. We found that the density of cigarette retailers was 81% higher in the areas within 100 m from the facilities for children and adolescents, compared with the areas within 100 to 250 m from facilities. We also found that the density of cigarette retailers within 100 m from facilities was 2.35 times higher in the rural setting, compared with the urban setting. Controlling cigarette retailers through zoning and licensing is urgently needed in Indonesia.
Population-Based Study on the Maternal-Newborn-Child Health Continuum of Care: Evidence From Lower-Middle-Income Countries in Southeast Asia
Authors: Andriani Helen , Rahmawati Nurul Dina , Fauzia Sifa , Kosasih Reynaldi Ikhsan
Published: April 2022

This article aimed to assess the relationships within the continuum of care for maternal, neonatal, and child health (MNCH) at four service levels, the utilization distribution, and its contributing factors in six lower-middle-income countries in Southeast Asia. It was based on data from the Demographic and Health Survey, a nationally representative and repeated cross-sectional survey, on 50 619 ever-married women aged 15-49 years. Only 21.9% of women (n = 10 252) obtained all four levels of continuing MNCH services. Women and husbands’ education and employment, parity, mass media consumption, and wealth quintiles were the strongest determinants for the continuation of care, apart from access to health care, decision-making autonomy in health care, and women’s age. Identifying populations that experience health inequalities, prominent policy intervention, and better health promotion and advocacy systems regarding pregnancy, delivery, and postnatal and immunization care might help to enhance maternal and child health and equity outcomes.
Inferior angle of scapula fractures: A retrospective case series
Authors: Alder-Price Angela Chang , Pilch Wiktor , Zhuang Clarence B , McLean James , Bain Gregory I
Published: April 2022

Background: Inferior angle of scapula fractures (IAS) are rare injuries that result from the periscapular shoulder muscles avulsing the inferior scapula tip. The aim of this study was to investigate the mechanisms of injury, investigations and treatment outcomes, as currently only case reports are available to guide management. Methods: Computered tomography (CT) images were reviewed to identify patients with an IAS fracture. Case notes were reviewed, and patients contacted to gather data relating to the injury, treatment and outcome. Results: Fourteen fractures were identified on CT. Five were missed on the initial radiograph. High energy fractures had an average age of 47.6 years, 90% were male. Low energy fractures had a mean age of 83.6 years 75% were female. All undisplaced fractures had a satisfactory outcome treated non-operatively. Three of six displaced fractures reported an unsatisfactory outcome with non-operative treatment. Subsequent surgical fixation resulted in resolution of symptoms. Conclusions: Inferior angle of scapula fractures are a rare injury that can result from high or low energy trauma. They are easy to miss on plain radiographs. Identification is important as displaced fractures can do poorly when treated non-operatively, but symptoms resolve with surgical fixation. Undisplaced fracture has a satisfactory outcome when treated non-operatively. Evidence: Level IV.
Speech-Language Pathologists’ Self-Reported Language Input and Recommendations During Early Intervention
Authors: Maltman Nell , Lorang Emily , Venker Courtney , Sterling Audra
Published: April 2022

This study examined the extent to which early intervention (EI) speech-language pathologists (SLPs) use and recommend language input strategies for caregivers of children with language delays and the child factors associated with these decisions. Participants included 213 SLPs who completed an online survey. Wilcoxon signed-rank tests, Friedman’s analyses of variance, and Spearman correlations were used to determine the extent to which EI SLPs used and recommended language input, child factors that influenced recommendations and input, and relationships between SLPs’ self-reported strategies and recommendations to caregivers. EI SLPs reported recommending expanding on child utterances more than other strategies. EI SLPs reported using grammatical input more than telegraphic input and recommended grammatical phrases as children made gains in spoken language. Language strategies used by SLPs inconsistently aligned with their recommendations to caregivers. Results underscore the importance of evaluating recommendations to caregivers in the context of EI.
Valproate: Not All Boxed Warnings Are Created Equal
Authors: Wartman Carolanne , VandenBerg Amy
Published: April 2022

Objective

Valproate has undergone significant changes in labeling to the boxed warnings associated with it. This review will analyze evidence regarding the valproate-boxed warnings for teratogenicity, hepatotoxicity, and pancreatitis, with a particular emphasis on the fetal risk.

Data Sources

A review of Pubmed, Cochrane Central Register, Google Scholar, manufacturer websites, and product labeling was performed from 1963 to February 2022, using the following search terms: valproate, valproic acid, depakote, teratogenicity, birth defects, fetal risk, hepatotoxicity, and pancreatitis. Relevant English-language studies and those conduced in humans were considered. Product labeling was also reviewed.

Data Synthesis

There is a significant fetal risk following in utero valproate exposure (risk of malformation development: 8.6% in 360 women in North America). Current labeling in the United States recommends co-prescribing effective contraception for women of childbearing age. The risk of hepatotoxicity and pancreatitis is much lower in the general population (1/20 000 and 1/40 000 patients, respectively) compared with those patients with certain risk factors who are taking valproate (1/500).

Conclusions

Overstated monitoring recommendations for the potential risk of hepatotoxicity and pancreatitis distracts from a much more common and severe risk of fetal harm. Clinicians must be diligent about discussing this risk with patients and documenting when this discussion occurs. Changes to the current recommendations for monitoring of the boxed warnings associated with valproate therapy should be considered, such as more stringent monitoring requirements for the inherent fetal risk. This could be accomplished through a Risk Evaluation and Mitigation Strategy program or through institution-based policies and procedures. In addition, monitoring recommendations for the risk of hepatotoxicity and pancreatitis should account for contributing risk factors.
From Values to Value: The Commensuration of Sustainability Reporting and the Crowding Out of Morality
Authors: van Bommel Koen , Rasche Andreas , Spicer André
Published: April 2022

Drawing on extensive case study evidence, this study unpacks sustainability reporting’s evolution from a moral values–based practice toward a financialized value–based one. We argue that this transition can be seen as a commensuration project. We examine the dynamics of this process and its implications for sustainability-related outcomes. We find that increased levels of commensuration have moved sustainability reporting away from an original emphasis on morality and values to a focus on strategic value creation for the firm. We theorize this process as a “crowding out of morality” that is enabled by a rigid cognitive framing of social and environmental issues (objectification) and the monetized coordination of relevant social interactions (marketization). We outline implications of our analysis for the scholarly debates on the institutionalization of sustainability reporting and commensuration.
High pulse pressure predicts primary arteriovenous fistula failure within 1 year
Authors: Wu Chung-Cheng , Hung Hao-Chien , Kao Tsung-Chi , Hsin Chun-Hsien , Yu Sheng-Yueh , Hsieh Hung-Chang , Ko Po-Jen
Published: April 2022

Background:

The arteriovenous fistula is the preferred access route for hemodialysis, although its high primary failure rate remains a clinical challenge. Multiple studies have attempted to determine the risk factors for primary arteriovenous fistula failure; however, none have identified pulse pressure as a potential predictive marker. High pulse pressure is a surrogate poor arterial compliance endpoint and leads to inferior cardiovascular outcomes. Our aim was to determine whether elevated pulse pressure indicates poor arteriovenous fistula maturation.

Methods:

We retrospectively reviewed 274 patients who underwent an arteriovenous fistula index operation between September 1, 2018 and May 31, 2019. Demographic, clinical data, and operative parameters were collected and analyzed. The maximum follow-up period was 365 days. Arteriovenous fistula failure was defined as the inability to achieve functional use during the follow-up period. We identified risk factors for arteriovenous fistula failure by performing a multivariate logistic regression analysis using backward elimination procedures.

Results:

A total of 274 patients were included in the study. The patients’ average age was 61.3 ± 14.0 years, approximately half of the patients ( n = 161, 58.8%) were male, and the majority had hypertension. At the end of the follow-up period, 68 (24.8%) had arteriovenous fistula failure. The proportion of patients with pulse pressure values of >60 mmHg was significantly higher in the failure group than in the maturation group (66.0% vs 80.9%; p = 0.021). A PP value of >60 mmHg (odds ratio = 2.25; 95% confidence interval = 1.14–4.42; p = 0.019) and coronary artery disease or myocardial infarction (odds ratio = 1.97; 95% confidence interval = 1.01–3.84; p = 0.045) were found to be independent risk factors for primary arteriovenous fistula failure.

Conclusions:

High pulse pressure is an independent risk factor for primary arteriovenous fistula failure.
Tribological aspects of tool wear during turning Ti-15Mo alloy with cemented tungsten carbide cutting inserts prepared with different surface finishes
Authors: Pivotto L.B. , Antonialli A.Í.S. , Ventura C.E.H.
Published: April 2022

Due to the low machinability of titanium alloys, which have been increasingly applied in medical and aerospace industries, several studies have been carried out focusing on the improvement of tool life in machining processes that involve such class of material. Aiming at contributing to the technological investigations and at expanding the knowledge on the phenomena involved in the tool-workpiece contact, this work presents tool wear results and a tribological analysis of the application of cemented tungsten carbide cutting inserts with different roughness characteristics in the edge and flank face as well as grinding marks (grooves) in the rake face in distinct directions. The inserts were prepared by plunge-face grinding and used in turning of a beta-titanium alloy (Ti-15Mo). Results showed that the insert with lower surface and edge roughness and with grooves in the rake face perpendicular to chip flow direction led to the lowest final flank wear value when the tool life criterion was achieved. Higher flank wear values were obtained for the rougher inserts, due to the greater edge chipping produced in grinding.
Effect of nano bentonite on direct yellow 50 dye removal; Adsorption isotherm, kinetic analysis, and thermodynamic behavior
Authors: Mahmoud Ahmed S.
Published: April 2022

Developing countries suffering from the toxicity of different industrial effluents especially dyes. This study successfully prepared and characterized nano-bentonite for anionic dye removal (DY 50). The prepared nanoparticles were characterized by X-Ray Diffraction (XRD), X-ray Fluorescence (XRF), Scanning Electron Microscope (SEM), EDAX analysis, FT-IR, and TGA and the obtained results indicated the formation of nanoparticles with an average size of 15 nm. The effect of different operating conditions was studied using different pH, dose, contact time, temperature, and initial DY 50 concentrations. The obtained results indicated that nano bentonite was able to adsorb about 78.3 and 100% for initial concentrations of 100±8.1 and 20 ±1.62 mg/L, respectively. The optimum removal conditions were observed at acidic media (pH 3) using sorbent material dosage 1 g/L for 45 min and 30°C. The adsorption isotherm, kinetic analysis, and thermodynamic behavior were studied by using linear equation form, and the adjusted R2 was compared to detect the preferred models. The adsorption isotherm indicated that heterogeneous, as well as multilayer adsorption, plays an important role in the removal of dye. Kinetic studies indicated the chemisorption interaction between sorbed and adsorbed molecules. Thermodynamic behavior indicated the reaction is exothermic with ∆H equal to −5.24 KJ/mol and ∆S equal −74.2 J/K.mol. Finally, this study strongly recommended using nano bentonite for DY 50 removal from an aqueous solution. The RSM relations show significant relations in all removal models with p-value <0.001. The ANN results indicated that the most effective operating conditions are the effect of nano bentonite dose followed by the pH effect.
The benefits of a home non-invasive ventilation retrieval service: Improved effectiveness and environmental sustainability in challenging times
Authors: Oakes Amy , Antoine-Pitterson Pearlene , Watson Alastair , Cooper Brendan G , Mukherjee Rahul
Published: April 2022

In the last 6 months, home non-invasive ventilation (NIV) services have faced several unanticipated challenges to their effectiveness and delivery as the result of a ‘perfect storm’ of the COVID-19 pandemic demands. We developed and delivered an innovative follow-up service, to support home NIV delivery, and improve cost-effectiveness and sustainability during COVID-19. Between Feb-2019 and Nov-2020, 92 post-acute patients were issued with home NIV; 25 (27%) out of the 92 patients had unused NIV machines successfully retrieved. The median (IQR) days of home NIV usage were 207 (98) for patients who had their machines returned. All the unused NIV machines retrieved were within the 5-year working life guaranteed by the manufacturer and were all redeployed after appropriate reconditioning and infection control measures. Without the home-visiting and recycling pilot, we would have relied on patients and families to return the unused machines. Given the expected disruption to NIV machine supply for at least the foreseeable 12–18 months, we feel it is important to get this important message out to other home NIV services urgently. Wider implementation of this novel approach could increase the availability of this vital resource and help meet the current demand on home NIV services.
Network Analysis of Endovascular Treatment Strategies for Femoropopliteal Arterial Occlusive Disease
Authors: Zhao Shenyu , Li Lingzhi , Cui Kaijun
Published: April 2022

Purpose:

Endovascular treatment of femoropopliteal arterial diseases remains controversial. We conducted a Bayesian network meta-analysis of randomized controlled trials aiming to investigate the efficacy differences between paclitaxel- or sirolimus-eluting stents, covered stents, drug-coated balloons, bare metal stents, and percutaneous transluminal angioplasty.

Method:

MEDLINE, Embase, Ovid, and other relevant online material were searched up to October 21, 2020. Primary endpoints were primary patency and target lesion revascularization at 6, 12, and more than 24 months.

Results:

Thirty-eight eligible trials included 6026 patients. In terms of primary patency, drug eluting stents were ranked as the most effective treatment based on the surface under the cumulative ranking curve values at 6 (80.6), 12 (78.4), and more than 24 months (96.5) of follow-ups. In terms of target lesion revascularization, drug eluting stents were ranked as the most effective treatment based on the surface under the cumulative ranking curve values at 6 (90.3), 12 (71.3), and more than 24 months (82.1) of follow-ups. Covered stents and bare metal stents had higher ranks in target lesion revascularization than those in primary patency. Sirolimus stents had a higher rank than paclitaxel stents.

Conclusion:

Drug eluting stents showed encouraging results in primary patency rates and freedom from target lesion revascularization at all phases of follow-up for femoropopliteal arterial diseases. Sirolimus stents appear to be more effective in femoropopliteal segment than paclitaxel stent.
Up-and-over access is not an optimal pathway for percutaneous catheter-directed thrombolysis in acute iliofemoral popliteal venous thrombosis
Authors: Li Fandong , Tang Dianjun , Guo Yanan , Yang Yanfei , Wang Fengchun , Wu Mengtao
Published: April 2022

Objective

To analyze the feasibility and results of up-and-over access (UOA) for catheter-directed thrombolysis (CDT) in acute iliofemoral popliteal venous thrombosis (IFPVT).

Methods

From June 2020 to June 2021, a total of 26 patients (26 lower limbs) undergoing CDT for IFPVT were included. According to the vascular access, the patients were divided into UOA group ( n = 11, 10 left limbs and 1 right limb) and ipsilateral popliteal vein (ILPV) ( n = 15, 15 left limbs) access group. The differences in preoperative characteristics and technical details between the two groups were compared.

Results

Patients in UOA group were older than those in ILPV access group (67.64 ± 4.11 years VS. 52.73 ± 15.63 years, p = .003). The BMI of UOA group was significantly higher than that of ILPV access group (26.03 ± 1.62 kg/m2 VS 24.71 ± 1.46 kg/m2, p = .039). There were significantly more patients with simultaneous three comorbidities in UOA group than in ILPV access group (45.5% vs. 0, p = .043). Compared with ILPV access group, the duration of operation and fluoroscopy of UOA group were significantly longer (20.64 ± 3.41 min vs. 10.20 ± 1.42 min, p < .001; 18.18 ± 2.99 min vs. 6.13 ± 0.92 min, p < .001), but the technical success rate was significantly lower (54.5% vs. 100%, p = .007). In UOA group, the operation-related complications occurred, including catheter straying into lateral sacral vein (9.1%), retroperitoneal hematoma (9.1%), and thrombus shedding into filter (9.1%).

Conclusion

The UOA may be attempted in patients who are unable to be prone, but this access is not an optimal pathway for CDT.
Designing Take-Back for Single Use Medical Devices: The Case of ReturpenTM
Authors: Mallick Pravin Kumar , Salling Kim Bang , Pigosso Daniela C. A. , McAloone Tim C.
Published: April 2022

Focus on take-back of waste products is currently enjoying increased importance, as attention on environmental sustainability and circular economy grows. Single-Use or Disposable Medical Devices (SUDs), which in homecare settings often end up in landfills or incineration, are currently subject to attention, regarding the potential to slow the flow of waste and seek new value creation possibilities. Via a descriptive single-case study of the “ReturpenTM”initiative—a collaborative take-back initiative launched in three municipalities in Denmark—characteristics are elicited, of the planning, launch, and implementation, of the first 6-month pilot of the ReturpenTMinitiative. ReturpenTMis a collaborative partnership of 15 public and private organizations and is adopting an end-to-end approach for its development and execution, including numerous professional workstreams. The pilot of the ReturpenTMachieved participation of 66 of the existing 73 pharmacies in 3 municipalities (90% participation rate), and an overall return rate of 13% for the used insulin pens, despite the limitations caused by the covid-19 pandemic. The return rates ranged from 10% to 15% in the 3 municipalities, and overall, the second quarter recovery (15%) was higher than the first quarter (11%). ReturpenTMdemonstrates how a workstream-based approach can provide a practical framework for the development and implementation of SUD take-back in a homecare setting. The case describes how the pharmaceutical industry is taking proactive measures to contribute to a more circular economy for disposable medical devices, including the infrastructure and ecosystem necessary to ensure a closed-loop system for medical devices.
The effectiveness of enterprise stent use on the treatment of intracranial atherosclerosis disease
Authors: Ari Oguz , Nas Omer F , Inecikli Mehmet F , Hakyemez Bahattin
Published: April 2022

Objective

To examine the clinical outcome of Enterprise stent in patients with severe and symptomatic intracranial atherosclerosis.

Material and method

Twenty-five patients who underwent Enterprise stenting between January 2012 and March 2019 were included in this study. Exclusion criteria were previous intracranial stenting and inadequate follow-up. Technical success rates of the procedures were recorded. Clinical outcome was evaluated with pre- and post-treatment modified Rankin Scale scores. The patients were monitored for 18 months clinically and for 14.3 months radiologically.

Results

The mean age of the 15 males and 10 females was 61.6 ± 8.19. Of these 25 patients, 6 (24%) were in the anterior system and 19 (76%) were in posterior system. The mean degree of pre-treatment stenosis was 86.4% ± 7 with the mean lesion length of 12.5 ± 7.5 mm. The residual stenosis rate was 23.8% ± 8.81. Technical success rate was 100%. There were two major complications within the first 30 days (8%). Late major complications (after 30 days) occurred in one case (4%). Stent restenosis was detected in two patients (8%). No intracranial bleeding or mortality was observed.

Conclusion

In this single-center study, we achieved high technical success and tolerable complication rates. Enterprise stent may be a good treatment alternative for severe intracranial stenosis especially in patients resistant to medical treatment when correct patient selection is made. However, further randomized controlled studies, including more cases should be carried out.
Improving Awareness of Workplace Opioid Use and Addiction Prevention: A Train-the-Trainer Approach
Authors: Persaud Eric , Weinstock Deborah , Landsbergis Paul
Published: April 2022

Background:

The National Institute of Environmental Health Sciences Worker Training Program developed instructor curriculum, a training tool, and materials to prepare trainees to conduct opioids workplace awareness training. Opioids and the Workplace Prevention and Response (OWPR) Train-the-Trainer (TTT) courses were held during three instructor-led online programs.

Methods:

The OWPR TTT was evaluated using an online pre- and posttest among registered participants, and an assessment of discussion among trainees during the training program.

Results:

A total of 31 pretests and 24 posttests were completed for the three TTT courses conducted. Quantitative and qualitative data complemented each other in supporting the conclusion that the training achieved intended objectives.

Conclusion/Applications to Practice:

The evaluation illustrated that the training was effective in increasing knowledge and confidence in conducting awareness training on opioid use and addiction prevention.
Computer Simulated Enhancement and Planning, Robotics and Navigation With Patient Specific Implants and 3-D Printed Cages
Authors: McAfee Paul C. , Cunningham Bryan W. , Mullinex Ken , Eisermann Lukas , Brooks Daina M.
Published: April 2022

Study Design:

This is a retrospective cohort study.

Objectives:

Pre and postop Measurement Testing. This is a retrospective study of 33 consecutive interbody spacers in 21 patients who underwent pre, intra, and postoperative measurement of the middle column to determine if this would lead to more precise restoration of middle column height and spacer fit. Scaled transparencies of the pre-operative simulation of angular correction and spacer geometry could be overlayed on the post-operative imaging studies.

Methods:

Multiple Observers Measurement Testing. 33 consecutive vertebral levels requiring interbody spacers for multilevel deformities had middle column height pre and post operatively measured by 3 blinded observers. The preoperative and postoperative measurements were compared using a linear regression analysis and Pearson product-moment correlation.

Results:

Pre and postop Measurement Testing: Thirty-three interbody devices in 21 patients had pre-operative planning, simulation of cage dimensions to determine the proper cage fit which would provide for the desired correction of foraminal height and sagittal balance parameters. The simulated preoperative plan overlayed the final post-operative radiograph and was a near-perfect match in 20 of 21 patients (95.2%). Multiple Observers Measurement Testing: A Pearson product-moment correlation was run between each individual’s pre-op and post-op middle column measurements. There was a strong, positive correlation between pre-operative and post-operative measurements, which was statistically significant ( r = 0.903, n = 33, P < 0.001).

Conclusions:

This consecutive series of 33 cases demonstrated the utility of measuring the preoperative middle column length in predicting the optimal height of the spacers, intervertebral disks, and posterior vertebral body height simultaneously restoring sagittal and coronal plane alignment.
Challenges and Complications in Freehand S2-Alar-Iliac Spinopelvic Fixation and the Potential for Robotics to Enhance Patient Safety
Authors: Arora Ayush , Berven Sigurd
Published: April 2022

Study Design:

Narrative Summary Review for Navigation & Robotics Focus Issue.

Objective:

To discuss the challenges and complications of S2-Alar-Iliac (S2AI) spinopelvic fixation using freehand techniques, and to introduce the utility of navigation & robotics to enhance patient safety.

Methods:

This study involved search of literature using the PubMed database, including retrospective clinical studies, anatomic reports, and surgical reports. The intention was to find literature that discussed complications regarding screw malfunction from manual S2AI placement, anatomical complexity of the sacroiliac joint, and outcomes of S2AI procedures conducted with robotic guidance systems.

Results:

The sacroiliac joint presents numerous complexities that can lead to challenges in free-hand placement of the S2-alar-iliac screw. Anatomic considerations of the S2AI screw involve close proximity to vital neurovascular structures, including: superior gluteal vessels, external iliac vessels, pudendal vessels, superior gluteal nerves, sciatic nerve, sympathetic chain ganglia, and pudendal nerves. The complications associated with manual S2AI screw installation include screw misplacement, breach of cortical bone, and injury to neurovascular structures. Robotic techniques for establishing S2AI screws involve greater accuracy of screw placement and reduced complications.

Conclusions:

Accurate placement of S2AI screws is compromised by variation in pelvic anatomy and by a pathway that traverses dense cortical bone of the sacroiliac joint. Accurate placement of S2AI screws is important for patient safety regarding neurovascular structures, and for effective, stable fixation across the SI joint. Robotic navigation of S2AI fixation offers significant utility in improving the accuracy of screw placement and patient safety.
Microleakage Evaluation of Expired and Non-expired Resin Composites and Bonding Agents: In Vitro Study
Authors: Çilingir Aylin , Dulger Kıvanç
Published: April 2022

Aim:

Although the shelf life is a key property of dental composites and bonding agents, these materials may often be used in simple procedures after expiration. In this study, the microleakage of two year expired and non-expired dental composites (Filtek Ultimate Universal A2 Enamel, 3M ESPE, USA, and Tetric N Ceram A2, Ivoclar Vivadent, Schaan, Liechtenstein) and a universal bonding system (Single Bond Universal, 3M ESPE, USA) was examined.

Materials and Methods:

In 40 freshly extracted human molars, two standardized Class II cavities (buccolingual and mesiodistal width of 3 mm and 4 mm, respectively) were prepared (80 cavity preparations). The teeth were thermocycled in distilled water for 1000 cycles in a 5°C to 55°C water bath. Next, the teeth and their apical foramens were coated with water resistant nail varnish, except for 1 mm around the restoration–tooth interface, and retained in a 1% methylene blue solution. After 24 h, the specimens were cut into two halves and analyzed using a stereomicroscope. Scanning electron microscopy images of two samples of the groups were obtained.

Results:

The Kruskal–Wallis test indicated no significant differences between the groups ( P < .05). The occlusal median scores were not significant ( P = .99). Moreover, the gingival median scores were not significant ( P = .48). No difference was found between the occlusal and gingival values in any group ( P > .05).

Conclusion:

These findings indicated that two-year-expired dental composites and bonding agent, which were maintained under proper conditions, do not have any significant difference in terms of the microleakage.
Leaving the PKK: Toward a process-oriented model of disengagement
Authors: Lafaye Caroline Guibet
Published: April 2022

While the involvement in terrorist organizations and social movements has generated a plethora of literature, little work exists on the exit from these two types of collectives. In order to grasp the plurality of factors involved in these processes, we based ourselves on an empirical sociological survey of 64 activists of the Partiya Karkerên Kurdistan (PKK). This party experienced a major wave of departures from the guerrilla movement in the early 2000s. The micro-sociological study of desistance trajectories make it possible to develop a relevant explanatory model of disengagement combining attention to diachronicity, the identification of micro-level turning points and meso-level windows of opportunity. After recalling the conditions under which the survey was carried out, we will show how desistance brings into play a certain relationship to time, key moments which, in the case of the PKK, concern not so much state repression as the internal dysfunctions of the party, as well as the “possibilities” that open up for the actors, either during moments of the party restructuraction or in civilian life.
The Hulk Hand!—In a Hemodialysis Patient
Authors: Prabhakaran Manoj , Mahapatra Himanshu Sekhar , Singh Amandeep , Patil Sanket , Gautam Abhisek
Published: April 2022

A 35-year-old gentleman who was on maintenance hemodialysis for last 20 months presented with progressive swelling of the left upper limb. Initially, he had right nontunneled internal jugular vein (IJV) catheter followed by left nontunneled IJV catheter through which he received dialysis for 2 months. Further, his left brachiocephalic fistula (BCF) was created 18 months back. Since then, he was on regular thrice weekly dialysis through BCF. He started developing swelling of the left upper limb 8 months after fistula creation, which was gradually increasing. Blood flow was found to be normal during dialysis, examination suggestive of entire left upper limb swelling with thick induration. Doppler showed dilated outflow veins with high flow without any narrowing/stenosis of veins. Computed tomography venography done showed left brachiocephalic vein stenosis. He was found to have mega-fistula secondary to central vein stenosis which was managed successfully being discussed in this case report. Undiagnosed occult central venous stenosis in the prearteriovenous fistula (AVF) construction can manifest in various ways; one of them is as mega-fistula. It is the generalized aneurysmal dilatation of the entire outflow vessels of an AVF. Management option for this condition is limited depending on the etiology, fistula flow has to be reduced either by banding of the vessel or by fistula closure. Assessment of central veins before AVF construction and regular access surveillance in dialysis patients may prevent complications like these.
Seismic performance of UHV composite post electrical equipment interconnected using a rigid bus with a sliding fitting
Authors: He Chang , Zhang Yue , Xie Qiang , Yang Zhenyu
Published: April 2022

To evaluate the influence of a rigid bus on the interconnected post electrical equipment with a sliding fitting, this article conducted shaking table tests on two full-scaled ±800 kV ultra-high voltage post insulators. Simplifying the rigid bus with a sliding fitting serving as a linear spring and damper allowed us to create a dynamic model of the stand-alone insulators and establish advanced two-piece interconnected post electrical equipment. Later, parametric analyses were carried out on the dynamic model. The results showed that the frequencies of the interconnected system were similar to those of the stand-alone counterparts if the dynamic characteristics of the two interconnected items were similar. The seismic responses of the interconnected system generally decrease compared with those of the stand-alone insulators. Thus, the seismic performance of the rigid bus interconnected electrical equipment system could qualify as having a stand-alone status if the dynamic characteristics of the equipment items are similar. The connection stiffness greatly affects the seismic responses of UHV composite post electrical equipment.
Optimization of melanin pigment production from the halotolerant black yeast Hortaea werneckii AS1 isolated from solar salter in Alexandria
Authors: Elsayis Asmaa , Hassan Sahar W. M. , Ghanem Khaled M. , Khairy Heba
Published: April 2022

Background

Melanins are one of the magnificent natural pigments synthesized by a wide range of microorganisms including different species of fungi and bacteria. Marine black yeasts appear to be potential prospects for the synthesis of natural melanin pigment. As a result, the goal of this research was to isolate a marine black yeast melanin-producing strain and improve the culturing conditions in order to maximize the yield of such a valuable pigment.

Results

Among five locally isolated black yeast strains, the only one that demonstrated a potent remarkable melanin pigment production was identified using ITS rDNA asHortaea werneckiiAS1. The extracted pigment’s physiochemical characterization and analytical investigation with Ultraviolet-Visible (UV) spectrophotometry, Fourier Transform-Infrared spectroscopy (FTIR), and Scanning Electron Microscope (SEM) confirmed its nature as a melanin pigment. The data obtained from the polynomial model’s maximum point suggested that CaCl2, 1.125 g/L; trace element, 0.25 ml/L; and a culture volume 225 mL/500 mL at their optimal values were the critical three elements impacting melanin production. In comparison with the baseline settings, the response surface methodology (RSM) optimization approach resulted in a 2.0 - fold improvement in melanin output.

Conclusions

A maximum melanin yield of 0.938 g/L proved the halotolerantH. werneckiiAS1 potentiality as a source for natural melanin pigment synthesis ‘when compared to some relevant black yeast strains’ and hence, facilitating its incorporation in a variety of pharmaceutical and environmental applications.
Exogenous proline mitigates toxic effects of cadmium via the decrease of cadmium accumulation and reestablishment of redox homeostasis in Brassica juncea
Authors: Wang Yuanduo , Tan Piaopiao , Chang Liang , Yue Zheming , Zeng Chaozhen , Li Mei , Liu Zhixiang , Dong Xujie , Yan Mingli
Published: April 2022

Background

As a vital osmoticum, proline has an important role in enhancing the tolerance of plants to environmental stress. It is unclear whether the application of exogenous proline can improve the tolerance of Brassica juncea to cadmium (Cd).

Results

This study investigated the effects of different concentrations of proline (20, 40, 60, 80, and 100 mg/L) under Cd stress at different times (0 d, 2 d, and 7 d) on the growth and physiology of B. juncea. Treatment with exogenous proline not only increased the content of proline in B. juncea but also alleviated Cd-induced seedling growth inhibition via the maintenance of higher photosynthetic pigment content and cell viability and a decrease in the content of Cd. Moreover, it increased the activities of antioxidant enzymes and the glutathione/glutathione disulfide ratio to reduce the accumulation of reactive oxygen species. Compared with other concentrations, 60 mg/L of exogenous proline was the most effective at mitigating Cd toxicity in B. juncea.

Conclusions

Exogenous proline treatment enhanced the tolerance to Cd via a decrease in Cd accumulation and reestablishment of the redox homeostasis in B. juncea.
Dynamical indicators in time series of healthcare expenditures predict mortality risk of older adults following spousal bereavement
Authors: Katsiferis Alexandros , Nielsen Pernille Yde , Jensen Majken K. , Westendorp Rudi G. J.
Published: April 2022

Background

The process of aging renders older people susceptible for adverse outcomes upon stress. Various indicators derived from complex systems theory have been proposed for quantifying resilience in living organisms, including humans. We investigated the ability of system-based indicators in capturing the dynamics of resilience in humans who suffer the adversity of spousal bereavement and tested their predictive power in mortality as a finite health transition.

Methods

Using longitudinal register data on weekly healthcare consumption of all Danish citizens over the age of 65 from January 1st, 2011, throughout December 31st, 2016, we performed statistical comparisons of the indicators ‘average’, ‘slope’, ‘mean squared error’, and ‘lag-1 autocorrelation’ one year before and after spousal bereavement, stratified for age and sex. The relation between levels of these indicators before bereavement and mortality hazards thereafter was determined by time to event analysis. We assessed the added value for mortality prediction via the time dependent area (AUC) under the receiver operating characteristic curve.

Results

The study included 934,003 citizens of whom 51,890 experienced spousal bereavement and 2862 died in the first year thereafter. Healthcare consumption is increased, more volatile and accelerating with aging and in men compared to women (all p-values < 0.001). All dynamic indicators before bereavement were positively related with mortality hazards thereafter (all p-values < 0.001). The average discriminative performance for the 1-year mortality risk of the model with only age as a predictor (AUC: 68.9% and 70.2%) was significantly increased with the addition of dynamical indicators (78.5% and 82.4%) for males and females, respectively.

Conclusions

Dynamic indicators in time series of health care expenditures are strong predictors of mortality risk and could be part of predictive models for prognosis after life stressors, such as bereavement.