bluuebunny/crossref_metadata_2025 huggingface dataset:
Mother Nature: An initial exploration of new potential for attachment theory
Authors: Jenkins Matthew
Published: February 2022

Objective

This study aims to postulate new theory regarding attachment theory and its relationship to the natural world via an analysis of the existing literature regarding environmental and ecological psychology alongside what is known about attachment theory. Additionally, it draws on wider literature (including folklore) pertaining to anthropology and nomadic societies as well as indigenous societies with reference to New Zealand.

Conclusions

Although merely an introductory overview, there is convincing evidence to support a case that our relationship with nature is of paramount importance for human well-being and wider societal well-being and that this relationship has been corrupted via the developed world and progressive disconnect from nature. This disconnect could be categorised through the lens of attachment theory whereby an insecure attachment has subsequently developed. This insecure attachment predisposes us, as a species, to neglect, denigrate and commodify the natural world which, in turn, is giving rise to climate change and its own psychological sequelae. However, discrepancies such as trauma arising from natural disasters suggest a more nuanced approach is needed as our relationship with nature is not entirely without danger, and, as such, there remain significant gaps when unifying this under the umbrella of attachment theory without further research/extrapolation of its importance.
Longitudinal Predictors of Mother- and Child-Report of Maternal Support Following Child Sexual Abuse
Authors: Rancher Caitlin , Are Funlola , Goodrum Nada M. , Smith Daniel W.
Published: February 2022

Maternal support is theorized as a critical predictor of children’s recovery from sexual abuse. However, following disclosure, several factors may cause maternal support to fluctuate over time. This study examined the effects of hypothesized risk factors, mother’s relationship to the perpetrator and maternal psychological distress, as well as protective factors, maternal belief of disclosure, lower levels of child blame, and mother–child relationship quality, as predictors of change in maternal support over a 9 month period. Mothers ( Mage = 38.42, SD = 8.99) and their children ( Mage = 11.57, SD = 2.69; 85% female), recruited from a child advocacy center following sexual abuse disclosure, completed measures of maternal support. Mothers reported on their relationship to the perpetrator, psychological distress, belief of disclosure, child blame, and mother–child relationship quality. On average, mother- and child-reports of maternal support were stable across time. Belief of disclosure and child blame predicted mother- and child-report of maternal support. Psychological distress and mother–child relationship quality predicted change in mother-report, but not child-report of maternal support. Researchers and clinicians should consider potential fluctuations in maternal support in assessment and intervention following child sexual abuse.
The Impact of Psychosocial Stress from Life Trauma and Racial Discrimination on Epigenetic Aging—A Systematic Review
Authors: Lim Sungju , Nzegwu Dumebi , Wright Michelle L
Published: February 2022

Purpose

The purpose of this review was to explore the effects of psychosocial stress from life trauma and racial discrimination on epigenetic aging.

Design

A systematic review of the last 10 years was conducted using four databases: PubMed/MEDLINE, Web of Science, PsychInfo, and CINAHL.

Methods

Articles were identified using the following terms: ([(DNA methylation) AND (epigenetic clock)] OR [(DNA methylation) AND (epigenetic age)]) AND (discrimination OR trauma)). Original research articles published in English measuring life trauma, post-traumatic stress, experience of discrimination, and epigenetic clocks or aging were analyzed using PRISMA guidelines.

Results

Ten articles met inclusion criteria. The study sample size ranged from 96 to 1163 and most study populations had a mean age under 50 and included predominantly White male participants. One study identified accelerated epigenetic aging associated with discrimination using Hannum’s clock; 33% of studies evaluating life trauma reported epigenetic age acceleration using GrimAge or Horvath’s clock; 25% of studies evaluating childhood trauma reported epigenetic age acceleration using Horvath’s clock; and 71% of studies assessing post-traumatic stress observed epigenetic age acceleration with all clocks, while one study reported deceleration using Horvath’s clock.

Conclusions

The experiences of life trauma, post-traumatic stress, and discrimination may be associated with accelerated epigenetic aging that can be consistently detected using different epigenetic clocks. Additional studies inclusive of diverse populations and other psychosocial stressors are needed.

Relevance

Nursing scholars and other health scientists who utilize epigenetic age acceleration to assess health risks may need to consider including psychosocial stressors in their studies as covariates.
Assessment of Lacrijet monocanalicular intubation for congenital nasolacrimal duct obstruction
Authors: Hamed Azzam Shirin , Hartstein Morris , Dolmetsch Angela , Mukari Abed
Published: February 2022

Purpose

To assess the success rate and complications of Lacrijet monocanalicular stent (FCI S.A.S, Paris, France) intubation in children treated for congenital nasolacrimal duct obstruction (CNLDO).

Methods

Retrospective review study which included children with CNLDO that were intubated with Lacrijet monocanalucilar silicone tube.The Lacrijet tube remained in place for 11–15 weeks post operatively and was removed in the clinic with topical anesthesia. Operative time was recorded for each case. All children were evaluated using the following parameters preoperatively and postoperatively: tear meniscus height, Fluorescein dye disappearance test (FDDT), and MUNK score.

Results

The study included 20 eyes with mean age of 26.25 ± 11.25 months. 17 eyes (85%) had undergone probing previously. Mean operation time of Lacrijet intubation was 8.5 min (95% CI 7.04–9.95). Mean follow-up period was 204.65 ± 105.27 days. Lacrijet intubation resulted in statistically significant improvements in tear meniscus height ( P < .001), FDDT ( P < 0.001), and MUNK score ( P < 0.001) in all children. Two different sizes of Lacrijet intubations were used. Complete success was obtained in all cases. No complications were observed.

Conclusions

Lacrijet lacrimal intubation has a high rate of success, shortens surgical time and has a low rate of complications in children with CNLDO.
Fifteen years of central catheter applications and outcomes in intensive care patients: A single-center pediatric experience
Authors: Silahli Musa , Kesim Çağrı
Published: February 2022

Background:

To investigate the clinical outcome of central line placement in the pediatric age group and to evaluate the risk factors for central line-associated bloodstream infection (CLABSI).

Methods:

We retrospectively examined the outcomes and CLABSI risk factors of pediatric patients aged 0–17 years admitted to intensive care units who had central catheters placed between January 2005 and December 2020.

Results:

Of the 2718 catheter admissions, 1502 catheter admissions were eligible for the regression and other outcome analyses. Fifty-seven percent of the study group were umbilical artery and vein catheters and 43% were other central catheter admissions, including ultrasound-guided catheter admissions. Logistic regression analysis showed us that right internal jugular vein (RIJV) (OR = 1.5, 95% CI = 1.15–2.02, p = 0.030) was the insertion site and ultrasound-guided interventional radiology catheter placement was the technique (OR = 1.7, 95% CI = 1.07–2.90, p = 0.024), duration of catheter stay (OR = 1.07, 95%CI = 1.06–1.08, p < 0.001), catheter placement in patients older than 2 years (OR = 2.42, 95% CI = 1.69–3.45, p < 0.001), were risk factors for CLABSI.

Conclusion:

Although CLABSI has variable risk factors, the most important risk factor seems to be the length of catheter stay.
Moral Exposures, Public Appearances: Contested Presences of Non-Normative Sex in Pandemic Berlin
Authors: Probst Ursula , Schnepf Max
Published: February 2022

Since its reunification, Berlin has regained its reputation as a sexually liberal European metropolis, offering spaces and infrastructures for non-normative sex to become present in the cityscape. However, with the advent of the COVID-19 pandemic in Germany and the concomitant measures to contain its spread, sexual practices and their open display have become highly contested and subject to increased regulation. In this article, we attend to sex work and casual sex among gay men, who, both historically and at present, have been placed under particular public scrutiny and moralised (health) governance. Yet, non-normative sex did not vanish from the city during the pandemic, but (re-)appeared in the form of both moralising media exposure and politically motivated public appearances. Attending to the intersections and divergences within these shifting presences of casual gay sex and sex work, we highlight how the biopolitical governance of pandemic sex has been evaded, contested and incorporated into efforts to normalise certain sexual activities. We therefore conclude that the pandemic had ambivalent effects on non-normative sexual practices in Berlin. It contributed to a further politicisation in the fight for their place in the city and to the (re-)emergence of normative assumptions about the respectable sexual subject for and within communities centred around non-normative sexual practices.
Thermohydrodynamic lubrication analysis of misaligned journal bearing considering surface roughness and couple stress
Authors: Zhu Shaoyu , Zhang Xiangjun
Published: February 2022

The modified average Reynolds equation for friction pairs with arbitrary three-dimensional rough surfaces lubricated by couple stress fluid is derived by the average flow method. And the performance parameters under the effect of couple stress, surface roughness, journal misalignment, and thermal effect are obtained with the finite difference numerical method. The surface roughness factor plays an important role even though the nominal eccentricity ratio is small. With the increase of the nominal eccentricity ratio, the greater values of the couple stress parameter, the greater values of performance parameters except for the dimensionless maximum oil film temperature and the dimensionless friction power. With the increase of the degree of misalignment, the greater values of the couple stress parameter, the greater the dimensionless maximum average film pressure, the dimensionless load capacity, and the dimensionless misalignment moment. As the value of the couple stress parameter is increased, the greater values of the dimensionless surface roughness, the greater values of the performance parameters except for the dimensionless side leakage. This research can widely use in various forms of friction pairs such as thrust bearings, sliding bearings, piston ring-cylinder liners.
A model to predict the short-term turbulent indoor dispersion of small droplets and droplet nuclei released from coughs and sneezes
Authors: Pallares Jordi , Fabregat Alexandre
Published: February 2022

We propose a simple model to predict the short-term indoor turbulent dispersion of the aerosol cloud produced by violent expiratory events. Once the air injection ceases, the turbulent jet transitions to a thermal puff that progressively decays due to viscous effects. According to recent literature, the expelled liquid droplets of saliva and sputum smaller than 20–30 μm in diameter stay afloat within this decaying turbulent puff. In contrast, droplets larger than 100 μm tend to leave the puff following quasi-ballistic trajectories and landing on the floor at relatively short times after release. The model presented here is capable of providing good estimates for the shape and dimensions of the cloud composed of the lighter fraction of droplets as a function of the intensity and the duration of the flow injection and the density difference between the exhaled and the ambient air. Predictions agree with Direct Numerical Simulations and experiments reported in the literature. This model can be used as an operational tool to determine the short-term spatial range of expelled droplets and provides realistic initial conditions for simulations of long-term dispersion of pathogen-laden clouds in indoor environments with forced and natural ventilation.
Early initiation of thromboembolic prophylaxis in critically ill trauma patients with high-grade blunt liver and splenic lacerations is not associated with increased rates of failure of non-operative management
Authors: Moore Kerry , Barton Cassie A , Wang Yuxuan , Ran Ran , Chi Albert , Rowell Susan , Schreiber Martin
Published: February 2022

Background

Non-operative management (NOM) is the current standard of care of hemodynamically stable patients with traumatic blunt solid abdominal organ injuries. Guidelines do not define the optimal timing of initiation of venous thromboembolism (VTE) prophylaxis in this population, and fear of failure of NOM may lead to delayed initiation of prophylaxis specifically in patients with high-grade injuries.

Methods

This was a single-center, retrospective study of patients with high-grade (AAST grades ≥3) blunt liver and splenic lacerations presenting to our level 1 trauma center between January 2010 and October 2017. Patients were divided into groups based on timing of low-molecular weight heparin (LMWH) initiation for VTE prophylaxis. The primary outcome was rate of failure of NOM, defined as the need for interventional radiology or surgical intervention for management of abdominal organ bleeding. Secondary outcomes included rates of VTE, lengths of ICU and hospital stay, and in-hospital mortality.

Results

A total of 207 patients with high-grade blunt liver and splenic injuries undergoing an initial attempt at NOM were identified. The distribution of grades 3, 4, and 5 liver and splenic injuries were similar across all groups. Overall, 55.5% of patients received LMWH during their index admission. Early administration of LMWH was not associated with a statistically significant increased risk of failure of NOM ( p = 0.054). Rates of VTE and in-hospital mortality were similar.

Conclusions

Early initiation of VTE prophylaxis was not associated with an increased rate of failure of NOM in patients with high-grade blunt abdominal organ injuries in patients who survived 24 h post-admission and did not require massive transfusion; however, the study was likely underpowered to detect a difference among groups due to small sample size.
Fostering habits of care: Reframing qualitative data sharing policies and practices
Authors: Weller Susie
Published: February 2022

This article argues that navigating the formalized, regulated and institutionalized data sharing landscape is challenging for researchers tasked with making qualitative data available for re-use. Archiving empirical material has progressively become a requirement enshrined in the policies of UK research institutions. Yet, how qualitative researchers feature – as data (co)creators and curators – within a process governed largely by quantitative data management strategies remains undocumented. Using examples from the ESRC Timescapes initiative, this article argues that to advance ethical practice in qualitative secondary analysis (QSA), data sharing policies and practices need to be re-framed to respect, value and care for the particularities of qualitative data and the emotional, intellectual and temporal investments made by qualitative researchers working in an increasingly pressurized Higher Education (HE) environment. Accordingly, ideas from the ethics of care literature are employed to propose areas where ‘habits of care’, attuned to the needs of qualitative researchers and data, can be fostered.
Observational evaluative conditioning is sensitive to relational information
Authors: Kasran Sarah , Hughes Sean , De Houwer Jan
Published: February 2022

Social learning represents an important avenue via which evaluations can be formed or changed. Rather than learning slowly through trial and error, we can instead observe how another person (a “model”) interacts with stimuli and quickly adjust our own behaviour. We report five studies ( n = 912) that focused on one subtype of social learning, observational evaluative conditioning (OEC), and how it is moderated by relational information (i.e., information indicating how a stimulus and a model’s reactions are related). Participants observed a model reacting positively to one stimulus and negatively to another, and were either told that these reactions were genuine, faked, or opposite to the model’s actual feelings. Stimulus evaluations were then indexed using ratings and a personalised Implicit Association Test (pIAT). When the model’s reactions were said to be genuine, OEC effects emerged in the expected direction. When the model’s reactions were said to be faked, the magnitude of self-reported, but not pIAT, effects was reduced. Finally, stating that the model’s reactions were opposite to his actual feelings eliminated or reversed self-reported effects and eliminated pIAT effects. We consider how these findings relate to previous work as well as mental-process theories.
Endovascular treatment for acute basilar artery occlusion: A multicenter randomized controlled trial (ATTENTION)
Authors: Tao Chunrong , Li Rui , Zhu Yuyou , Qun Sen , Xu Pengfei , Wang Li , Zhang Chao , Liu Tianlong , Song Jianlong , Sun Wen , Wang Guoping , Baxter Blaise , Qureshi Adnan , Liu Xinfeng , Nogueira Raul G , Hu Wei
Published: February 2022

Background and hypothesis:

Recently, two multicenter randomized controlled trials (RCT) failed to show a significantly beneficial effect of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO). However, both trials suffered from equipoise issues which may have hindered the validity of the trial results. Therefore, additional RCT studies are needed to explore the potential benefit of EVT in patients presenting with BAO.

Study design:

ATTENTION is an investigator-initiated, multicenter, prospective, randomized, controlled clinical trial with open-label treatment and blinded outcome assessment (PROBE) of EVT versus best medical management (BMM). The primary effect parameter is a modified Rankin Score of 0–3 at day 90.

Discussion:

ATTENTION will provide evidence for the efficacy and safety of EVT in stroke patients within 12 h after BAO.

Trial registration:

ClinicalTrials.gov NCT04751708
IMproving Physical ACtivity after stroke via Treadmill training (IMPACT) and self-management: A randomized trial
Authors: Brauer Sandra G , Kuys Suzanne S , Ada Louise , Paratz Jennifer D
Published: February 2022

Aim:

To determine if treadmill training embedded in self-management education commencing during stroke inpatient rehabilitation results in more physical activity than usual gait training.

Method:

A prospective, parallel-group, randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis involving 119 stroke survivors undergoing rehabilitation who were able to walk independently was undertaken. The experimental group undertook treadmill training (40–60% heart rate reserve) and self-management education for 30 min, three times a week for 8 weeks, and the control group undertook the same amount of usual gait training. Outcomes were measured at baseline (Week 0), on completion of the intervention (Week 8), and beyond the intervention (Week 26). The primary outcome was physical activity measured as steps/day using an activity monitor. Secondary outcomes were walking ability, cardiorespiratory fitness, cardiovascular risk, depression, self-efficacy, perception of physical activity, participation, and quality of life.

Results:

After 8 weeks, the experimental group took 1436 more steps/day (95% confidence interval (CI) = 229 to 2643) than the control group. By 6 months, they took 871 more steps/day (95% CI −385 to 2129) than the control group. There was no difference between groups in any other outcome.

Conclusion:

In individuals undergoing rehabilitation after stroke, 8 weeks of treadmill training embedded in self-management resulted in more physical activity than usual gait training and this was largely maintained at 6 months, despite little effect on walking or cardiorespiratory fitness, suggesting the self-management was responsible.
Syphilis and ischemic stroke: Old question revisited by a nationwide cohort study
Authors: Chang Shu-Han , Kao Chih-Hsiang , Hung Chih-Hsin , Chou Mei-Chia , Yip Hei-Tung , Hung Yao-Min , Chang Renin , Cheng-Chung Wei James
Published: February 2022

Background and purpose:

In the era of easily available antibiotic use, this study provides epidemiological evidence for a re-examination of the relationship between syphilis and ischemic stroke (IS).

Methods:

Patients aged 18 years and older with newly diagnosed syphilis were included (n = 1585) from 2000 to 2012, and participants without syphilis in the control group (n = 6340) were matched by propensity score (age, sex, index year, insured amount, urbanization, seasons, and comorbidities). The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of IS. Five different Cox regression models, sensitivity analyses, and negative control were conducted to test our findings.

Results:

In all, 1585 patients (1055 (66.56%) men; mean (SD) age, 49.59 (20.32) years) had syphilis, and 3.8% had new-onset IS. The syphilis group had a higher risk of IS than the controls (adjusted HR, 1.35; 95% CI, 1.01–1.80; p value < 0.05) after full adjustment. Serial sensitivity analyses yielded consistent results.

Conclusion:

Syphilis patients have higher risk of IS, and our data raise the question of implementation of prophylactic treatment for IS.
Validating the Cambridge Protocol: Reliability of Hip Muscle Strength Measurements Using a Motorized Dynamometer and Electromyography
Authors: Memarzadeh Arman , Morrison Andrew Paul , Merzbach Viviane , Ferrandino Michael , Arora Arvind , Claydon-Mueller Leica S. , Khanduja Vikas
Published: February 2022

Background:

Muscle weakness is common after injury in athletes and in the presence of hip pathology. It will cause abnormal hip biomechanics and can predict future injury. However, objective measurement of hip muscle strength is difficult to perform accurately and reliably. Therefore, it is challenging to determine when an athlete has returned to preinjury levels of strength. In addition, there is currently no standardized method of obtaining measurements, which prevents the data being compared or shared between research centers.

Purpose:

The purpose of this study is to comprehensively assess the inter- and intraobserver reliability of our standardized muscle strength measurement protocol.

Study Design:

Descriptive laboratory study.

Level of Evidence:

Level 3, inception cohort study.

Methods:

A total of 16 healthy male volunteers (age = 28.3 ± 7.9 years) were recruited. Those with a previous history of hip injuries or disorders were excluded. These volunteers underwent strength testing according to the Cambridge Protocol on 4 separate occasions, performed by 2 independent assessors. Maximal voluntary contractions, fatigue torque fluctuations, and electromyography measurements were recorded. Intra- and interobserver reliability was assessed using intraclass correlation coefficient (ICC).

Results:

Good-to-excellent correlation was seen for both intra- and interobserver reliability across almost all hip movements for maximal contractions: ICC ranged 0.78 to 0.93 and 0.78 to 0.96, respectively. The standard error of the mean for all hip movements was also extremely low at 2% to 3%.

Conclusion:

The Cambridge Protocol is a highly reliable method for objective measurement of hip muscle strength. We recommend future studies use this protocol, or the principles underpinning it, to enable data sharing and comparison across different studies.

Clinical Relevance:

This is a description and analysis of hip muscle strength measurement. If widely used, it will allow for accurate and objective strength assessment and closer monitoring of hip injuries and pathology.
De novo brain AVM following radiotherapy for cerebral cavernous malformation in a child: A 15-year clinical course
Authors: Matsoukas Stavros , Bageac Devin V , DeLeacy Reade , Berenstein Alejandro , Fifi Johanna T
Published: February 2022

Multiple de novo brain arteriovenous malformations (bAVM) have been reported in the literature, raising questions about the contended purely congenital nature of these lesions. We present the 15-year course of a pediatric patient, who initially presented at age 5 with a thalamic cavernous malformation and was treated with radiosurgery, and then subsequently developed a thalamic de novo bAVM immediately adjacent to the initial lesion location, discovered 2 years later. Treatment of the bAVM entailed two transarterial embolizations and one radiosurgery session which ultimately led to complete angiographic resolution. Finally, this patient’s course was complicated by intraparenchymal hemorrhage and acute obstructive hydrocephalus, and further imaging revealed two newly formed cavernous malformations, also associated with the initial lesion’s location, that have remained stable since their formation. This case likely represents the second-hit model for the formation of vascular malformations, as sparsely supported by the current literature. According to this, genetically aberrant, yet quiescent, brain areas might promote the de novo formation of vascular malformations after brain injury, including radiation.
Virtual Care Access and Health Equity during the COVID-19 Pandemic, a qualitative study of patients with chronic diseases from Canada
Authors: Chan-Nguyen Sophy , Ritsma Benjamin , Nguyen Lisa , Srivastava Siddhartha , Shukla Garima , Appireddy Ramana
Published: February 2022

Objectives

The COVID-19 pandemic has led to the widespread uptake of virtual care in Canada; however, virtual care may also create new barriers to health care. The purpose of this paper was to explore patient perceptions and concerns around virtual care access.

Methods

Between February and April 2020, we conducted semi-structured interviews with participants from four chronic disease clinics (stroke, epilepsy, amyotrophic lateral sclerosis, obstetrics medicine) in a mid-sized academic hospital in Southern Ontario, Canada. Consecutive sampling was done by including the patients receiving virtual care in those months. Caregivers were invited to participate in the event that patients were unable to participate in the interview. Thematic analysis was employed to identify overarching themes, and codes were reviewed and refined using a consensus process.

Results

We interviewed 31 participants (27 patients, four caregivers) that had taken part in virtual care. Our findings suggested that the COVID-19 pandemic served to isolate participants and had negatively impacted their access to health care. However, virtual care did provide a safe avenue for patients to receive care and served as a reassuring option during the pandemic. Low technological literacy and access were identified as barriers to virtual care. Greater awareness and patient engagement is needed in future research to improve access.

Conclusion

Certain populations can be disproportionately affected by differential access to virtual care. Future studies should examine how social determinants intersect to impact virtual health care access in different patient populations.
Apparent diffusion coefficient signature of ischemic tissue predicts neurological progression in isolated pontine infarcts
Authors: Oge Dogan Dinc , Topcuoglu Mehmet A. , Arsava Ethem Murat
Published: February 2022

Background

Early neurological deterioration is encountered in up to a third of patients with isolated pontine infarcts. A limited number of clinical and imaging features have been suggested as predictors of neurological progression in this setting. In this study, we assessed whether quantitative apparent diffusion coefficient (ADC) measurements within the ischemic pontine region could be used as a radiomic feature to forecast clinical deterioration.

Methods

We calculated the mean ADC value of ischemic voxels within the ischemic region and normalized them to the contralateral non-ischemic tissue (relative ADC, rADC) in patients with isolated pontine infarcts. This imaging signature was then compared among patients with neurological progression (n = 21) and a propensity matched cohort of non-progressors (n = 42), together with other clinical and imaging features in bivariate and multivariate statistical models.

Results

The rADCmean was significantly lower among patients with progression ( p = 0.008). Female gender and extension of the ischemic lesion to the ventral pontine surface were other features significantly associated with progression. The association between rADCmean and progression persisted in multivariate models with an odds ratio of 13.7 (95% CI 2.6–72.8; p = 0.002) for progression among patients with rADCmean ≤ 0.67 in their ischemic tissue. The probability for worsening was 80% among patients who had an ischemic lesion extending to the ventral pontine surface with a mean rADC ≤ 0.67.

Conclusion

The mean rADC value within the ischemic lesion is closely related with early neurological deterioration in patients with isolated pontine infarcts.
Technique for Arthroscopic Transtibial Medial Meniscus Posterior Root Repair
Authors: Lynch Danny , Duerr Robert A.
Published: February 2022

Background:

Medial meniscus posterior root tears (MMPRT) can lead to significant pain, functional limitations, and osteoarthritis (OA). Biomechanically, MMPRT has been shown to be equivalent to total meniscectomy in terms of peak contact pressure in the medial compartment. Transtibial repair of a meniscus root tear has also been shown to restore hoop stresses and reduced peak contact pressure to the normal intact state. Clinically, root repair was shown to reduce rates of OA progression and need for total knee arthroplasty when compared with nonoperative treatment or partial meniscectomy for MMPRT.

Indications:

Medial meniscus posterior root repair is indicated in patients with a symptomatic MMPRT who are appropriate surgical candidates: age ≤65 years, body mass index ≤40 kg/m2, <5° varus alignment, no more than Kellgren-Lawrence grade 2 changes, and willing and able to undergo the demanding postoperative rehabilitation program.

Technique Description:

This surgical technique video demonstrates our preferred technique for arthroscopic transtibial medial meniscus posterior root repair using a case example in a commonly encountered patient. The repair is completed using a 3 simple suture triangle configuration with 2 tibial tunnels to create a broad footprint for healing.

Results:

There are a number of case series and comparative studies published with good clinical outcomes using similar transtibial medial meniscus posterior root repair techniques. In short-term follow-up of 18 patients at a mean of 10.5 months post-operatively, we have demonstrated improvements in pain and functional status with a 16.7% clinical failure rate and 11% rate of conversion to arthroplasty.

Discussion:

In this surgical technique video, we review the anatomy of the native medial meniscus posterior root and the biomechanical and clinical consequences of a MMPRT. We highlight important technique pearls and pitfalls to avoid failures and complications during the surgical demonstration. Finally, we review postoperative rehabilitation guidelines and clinical outcomes within the existing literature. In patients with MMPRT, transtibial repair provides a safe and reliable technique to achieve healing of the medial meniscus posterior root and return patients to full activities with reduced risk of OA progression.
Efficacy and safety of Z-substances in the management of insomnia in older adults: a systematic review for the development of recommendations to reduce potentially inappropriate prescribing
Authors: Scharner Vincenz , Hasieber Lukas , Sönnichsen Andreas , Mann Eva
Published: February 2022

Background

Z-drugs are usually prescribed as first line pharmacological therapy for insomnia. However, the benefits and risks of Z-drugs may differ for older adults. This systematic review investigated the available evidence on the efficacy and safety of Z-drugs in the management of insomnia in older adults.

Methods

The Cochrane database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed/MEDLINE and EMBASE were searched for systematic reviews, meta-analyses, controlled interventional and observational studies using a pre-formulated search term. The target population was older adults (≥65 years old) with insomnia. Studies were included if they reported efficacy and/or safety outcomes of the use of Z-drugs for the management of insomnia compared to placebo, usual or no treatment, or other pharmacological agents.

Results

Eighteen studies were included (8 interventional and 10 observational studies). In short-term interventional studies, Z-drugs were similarly or better efficacious in improving both sleep and daytime parameters than placebo or other pharmacological treatments, while showing good results on measures of safety. However, in longer-term observational studies, Z-drugs significantly increased the risk for falls and fractures in comparison to no treatment or melatonin agonists.

Conclusions

Analyzing the evidence from short-term interventional studies, Z-drugs appear effective and safe for treatment of insomnia in older adults, but they may have unfavorable side effects when used for longer periods of time. We, therefore, recommend discontinuing Z-drugs, principally because of the high risk for falls and fractures. Nonetheless, quality and quantity of evidence are low. Due to the scarcity of data, especially concerning drug dependence after longer periods of treatment and due to the significantly increased risk for falls and fractures, further studies are needed to evaluate the benefit-risk profile of Z-drugs use in older patients, particularly for long-term use.
Mental well-being during stages of COVID-19 lockdown among pregnant women and new mothers
Authors: Overbeck Gritt , Rasmussen Ida Scheel , Siersma Volkert , Kragstrup Jakob , Ertmann Ruth Kirk , Wilson Philip
Published: February 2022

Background

Pregnancy and early motherhood are sensitive times where epidemic disease outbreaks can affect mental health negatively. Countries and health care systems handled the pandemic and lockdowns differently and knowledge about how the COVID-19 pandemic affected the mental well-being of pregnant women and new mothers is limited and points in different directions.

Aim

To investigate symptoms of anxiety and depression in a population of pregnant women and new mothers in various stages of infection pressure and lockdown during the first 15 months of the COVID-19 pandemic in Denmark.

Methods

The study population was nested an inception cohort of women recruited in their first trimester of pregnancy. Data about mental health of the woman were obtained in relation to pregnancy and child development (first trimester, 8 weeks postpartum and 5 months postpartum), and data were analysed cross-sectionally according to calendar time (periods defined by infection rate and lock-down during the COVID-19 pandemic).

Results

No differences in reported levels of depressive symptoms between the six examined time periods of the pandemic were observed. Specifically, symptoms remained unchanged after the first lock-down. No major changes in anxiety symptoms were observed in relation to increased infection pressure or lockdowns, but a small increase was observed during the second lockdown in women 8 weeks postpartum.

Conclusion

No clear change in mood among pregnant women was seen between during the stages of COVID-19 pandemic in Denmark.
Assessment of different thresholds of birthweight discordance for early neonatal outcomes: retrospective analysis of 2348 twin pregnancies
Authors: Ye Shaoxin , Fan Dazhi , Li Pengsheng , Chen Gengdong , Rao Jiaming , Zhang Huishan , Zhou Zixing , Feng Jinping , Luo Caihong , Guo Xiaoling , Liu Zhengping , Lin Dongxin
Published: February 2022

Background

The optimal threshold of birthweight discordance (BWD) remains controversial. This study aimed to evaluate the associations between BWD at different thresholds and early neonatal outcomes and to assess their predictive accuracy.

Methods

This was a retrospective cohort study using a birthweight data with the chorionicity information of 2348 liveborn twin pairs at a gestational age of ≥26 weeks, from 2012 to 2018. The percentage of BWD was calculated by dividing the actual birthweight difference by the weight of the larger twin and multiplying by 100. Outcomes of interest included neonatal intensive care unit (NICU) admission, neonatal respiratory distress syndrome (NRDS), ventilator support and a composite outcome combining major morbidities and neonatal death. Logistic regression models were performed to estimate the association between neonatal outcomes and BWD with different thresholds (≥15.0%, ≥20.0%, ≥25% and ≥ 30%). Generalized estimated equation (GEE) models were used to address intertwin correlation. Restrictive cubic spline (RCS) models were established to draw the dose-response relationship between BWD and the odds ratios of outcomes. Clustered receiver operating characteristic (ROC) curve analyses were performed to assess the predictive accuracy.

Results

Of 2348 twin pairs, including 1946 dichorionic twin pairs and 402 monochorionic twin pairs, BWD was significantly associated with NICU admission, regardless of the thresholds used. The incidence of NRDS, ventilator support and the composite outcome were significantly higher when a threshold of ≥20% or greater was chosen. The dose-response relationship showed nonlinear growth in the risk of adverse neonatal outcomes with increasing BWD. ROC analyses showed a low significant AUROC of 0.569 (95% CI: 0.526–0.612) for predicting NICU admission but no significant AUROCs for predicting other outcomes. A BWD of ≥30% provided a moderate increase in the likelihood of NICU admission [positive likelihood ratio (LR+) = 5.77].

Conclusion

Although BWD is independently associated with adverse neonatal outcomes, it is not a single predictor for neonatal outcomes given the weak discriminative ability to predict neonatal outcomes. A cutoff of 30% is more practical for risk stratification among twin gestations.
Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study
Authors: Pradhan Nousheen Akber , Ali Sumera Aziz , Roujani Sana , Ali Ammarah , Hussain Syed Shujaat , Rizwan Samia , Ariff Shabina , Saleem Sarah , Siddiqi Sameen
Published: February 2022

Introduction

Pakistan is facing a challenging situation in terms of high newborn mortality rate. Securing pregnancy and delivery care may not bring a substantial reduction in neonatal mortality, unless coupled with the provision of quality inpatient care for small and sick newborns and young infants (NYIs). We undertook this study to assess the availability and quality of newborn care services provided and the readiness of inpatient care for NYIs in Pakistan.

Methods

We conducted a cross-sectional study across Pakistan from February to June 2019, using a purposive sample of 61% (23) of the 38 sick newborn care units at public sector health care facilities providing inpatient care for small and sick NYIs. We interviewed facility managers and health care providers by using structured questionnaires. We observed facility infrastructure and relevant metrics related to the quality of inpatient care such as types of infant care units and essential equipment, drugs, staffing cadre and facility management practices, quality assurance activities, essential services for small and sick NYI care, discharge planning, and support, quality of NYIs care record, and health information system.

Results

Of the 23 facilities assessed, 83% had newborn intensive care units (NICUs), 74% reported Special Care Units (SCUs), and only 44% had Kangaroo Mother Care (KMC) Units. All facilities had at least one paediatrician, 13% had neonatologists and neonatal surgeons each. Around 61 and 13% of the facilities had staff trained in neonatal resuscitation and parental counseling, respectively. About 35% of the facilities monitored nosocomial infection rates, with management and interdisciplinary team meetings reported from 17 and 30% of the facilities respectively preceding the survey. Basic interventions for NYIs were available in 43% of the facilities, only 35% of facilities had system in place to monitor nosocomial infections for NYI care. Most (73%) of reviewed records of NYIs at 1–2 days had information on the birth weight, temperature recording (52%), while only a quarter (25%) of the observed records documented danger signs. Mechanism to support discharge care by having linkages with community workers was present in 13% of the facilities, while only 35% of the facilities have strategies to promote adherence after discharge. Majority (78%) of facilities reported monitoring any newborn/ neonatal care indicators, while none of the sub-units within facilities had consolidated information on stillbirths and neonatal deaths.

Conclusion

The study has demonstrated important gaps in the quality of small and sick NYI inpatient care in the country. To avert neonatal mortality in the country, provincial and district governments have to take actions in improving the quality of inpatient care.
Comparison of bone mineral density according to domains of sedentary behavior in children and adolescents
Authors: Christofaro Diego Giulliano Destro , Tebar William Rodrigues , Saraiva Bruna Thamyres Ciccotti , da Silva Gabriela Caroline Rodrigues , dos Santos Amanda Barbosa , Mielke Gregore Iven , Ritti-Dias Raphael Mendes , Mota Jorge
Published: February 2022

Background

Somatic maturation and the age at onset of puberty are closely related to bone mineral density (BMD), and are potential confounders of the associations between physical activity, sedentary behavior (SB) and BMD in adolescents. Thus the aim was compare BMD at different anatomical sites according to different domains of SB.

Methods

The sample consisted of 88 young people (54 boys and 34 girls; 9.5 ± 1.5 years). The self-reported SB was measured by the time spent on TV, computer, video game and smartphone. BMD at each location and throughout the body was assessed by DEXA. Physical activity was assessed by a questionnaire. The comparison of the different types of BMD sites according to the SB levels for each screen device and the total SB were analyzed by Covariance Analysis (ANCOVA).

Results

Whole-body BMD was higher in young people with low total SB (Total BMD = 0.957 ± 0.042) than in those with moderate (Total BMD = 0.921 ± 0.053) and high SB (Total BMD = 0.929 ± 0.051) (p-value = 0.011). Children and adolescents with low total SB had higher BMD legs (0.965 ± 0.056) than young people with high total SB (BMD legs = 0.877 ± 0.209), but this relationship was attenuated when the analyzes were adjusted for physical activity (p-value = 0.068).

Conclusion

Adolescents with high sedentary behavior tend to have lower whole body bone mineral density than those with low sedentary behavior.
The association between physical activity and mental health during the first year of the COVID-19 pandemic: a systematic review
Authors: Marconcin Priscila , Werneck André O. , Peralta Miguel , Ihle Andreas , Gouveia Élvio R. , Ferrari Gerson , Sarmento Hugo , Marques Adilson
Published: February 2022

Introduction

The Coronavirus disease-19 (COVID-19) pandemic affected countries worldwide and has changed peoples’ lives. A reduction in physical activity and increased mental health problems were observed, mainly in the first year of the COVID-19 pandemic. Thus, this systematic review aims to examine the association between physical activity and mental health during the first year of the COVID-19 pandemic.

Methods

In July 2021, a search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included cross-sectional, prospective, and longitudinal study designs and studies published in English; outcomes included physical activity and mental health (e.g., depressive symptoms, anxiety, positive and negative effects, well-being).

Results

Thirty-one studies were included in this review. Overall, the studies suggested that higher physical activity is associated with higher well-being, quality of life as well as lower depressive symptoms, anxiety, and stress, independently of age. There was no consensus for the optimal physical activity level for mitigating negative mental symptoms, neither for the frequency nor for the type of physical activity. Women were more vulnerable to mental health changes and men were more susceptive to physical activity changes.

Conclusion

Physical activity has been a good and effective choice to mitigate the negative effects of the COVID-19 pandemic on mental health during the first year of the COVID-19 pandemic. Public health policies should alert for possibilities to increase physical activity during the stay-at-home order in many countries worldwide.
‘You’re setting a lot of people up for failure’: what formerly incarcerated women would tell healthcare decision makers
Authors: Norris Whitney K. , Allison M. Kathryn , Fradley Marley F. , Zielinski Melissa J.
Published: February 2022

Background

Incarcerated women have a higher prevalence of health problems than the general population; however, little is known about their perspectives on the healthcare they receive. Here, we conducted semi-structured interviews with women who had been incarcerated (n = 63) which asked what they would tell healthcare decision-makers about their experiences of healthcare in prisons and the community post-incarceration if provided the opportunity. All participants had a history of sexual violence victimization and had at least one period of incarceration in a community corrections center in Arkansas due to the goals of the larger study from which data were drawn.

Results

Four themes arose when participants were asked what they would tell people who make decisions about community healthcare: 1) the healthcare system is not working (52%; n = 33), 2) have compassion for us (27%; n = 17), 3) recognize that we have specific and unique needs (17%; n = 11), and 4) the transition from incarceration is challenging and requires more support (22%; n = 14). Three themes arose when we asked participants what they would tell people who make decisions about healthcare in prisons: 1) we had experiences of poor physical healthcare in prison (44%; n = 28), 2) more specialty care is needed in prison (49%; n = 31), and 3) healthcare providers treat women in prison poorly (37%; n = 23).

Conclusions

Our findings underscore the need for systemic changes including greater oversight of prison-based healthcare services, enhanced access to medical subspecialties in prisons, and healthcare provider training on the unique needs of incarcerated and previously incarcerated women. Polices that expand healthcare access are also likely to benefit formerly incarcerated women given the challenges they experience seeking community-based care.