bluuebunny/crossref_metadata_2025 huggingface dataset:
The Judgment
Authors: Janák Jiří
Published: June 2023

The article discusses different ancient Egyptian approaches to posthumous judgment and focuses on the motif of the Judgment of the Dead, both on its textual and pictorial attestations as it appears in the Book of the Dead tradition on papyrus and on other media. Apart from general themes and aspects of the concept in question, this article discusses and attempts to interpret individual motifs that are present in the visual representation of the judgment, mainly. In particular, the scene of weighing the heart, which is the main pictorial motif representing the Judgment of the Dead in the Book of the Dead, will be thoroughly analyzed.
Queer Culture(s)
Authors: Chernetsky Vitaly , McFadden Devin
Published: June 2023

The chapter provides an overview of the changes in conceptualizing the place of what scholars have termed gender and sexual dissent and its cultural representation in the context of Russian and Soviet society, and especially of the underground/non-conformist culture within it, highlighting the post-Stalin period as it traces continuities and breaks from the beginning of the twentieth century to the time of the collapse of the USSR. It contrasts the situation in the Soviet context with the evolving modern-era LGBTQ cultural networks in Western societies that have been studied much more extensively by historians, with emphasis on the problem of (in)visibility of queer culture within broader Soviet contexts. The core part of the chapter focuses on the case study of the writer Evgenii Kharitonov, the most influential and critically acclaimed queer figure within late Soviet-era underground culture.
Inequality and Stratification in Latin America
Authors: Salgado Mauricio , Castillo Javier
Published: June 2023

This chapter reviews current research on inequality, social stratification, and intergenerational mobility in Latin America. It is proposed that ascriptive factors such as gender and ethno-racial markers play a distinctive role that significantly affects the position individuals occupy in the status hierarchy. Besides the traditional mediating factors in the mobility process—such as educational achievement and occupational trajectory—the region also has particularities not observed in other places. On the one hand, average returns on schooling are higher in Latin America than in any other region of the world. On the other hand, Latin American labor markets are characterized by an enormous self-employed sector. This class is much larger and more heterogeneous in Latin America, giving rise to the notion of the “informal” sector. The chapter addresses some of the mechanisms bridging ascriptive characters and social origins with the mediating factors of social mobility.
The World of the Tamil Saṅgam Poetry
Authors: Devadevan Manu V.
Published: June 2023

This chapter introduces the Saṅgam poetry produced in the Tamil-speaking regions of southern India in the early centuries CE against its historical context. The emphasis is on the geopolitical milieu and the settlement geography, which were both undergoing profound and irreversible changes due to the transformation of existing pre-state chieftaincies into state-centred forms of political life sustained by an agrarian economy. It is argued that Saṅgam aesthetics is best understood in light of this transformation and that the recurring themes of melancholy and separation that mark the Saṅgam poetry constitute an aesthetics that the transformation has brought to life.
Treating Opioid Use During Pregnancy and Postpartum Life Phases
Authors: Jones Hendrée E.
Published: June 2023

This chapter reviews the screening, assessment, and treatment of pregnant and postpartum women and people with opioid use disorder. The historical and current status of opioid use among pregnant women and people is first reviewed. Next, the benefits and drawbacks of medically assisted withdrawal (“detoxification”) are presented. The risks and benefits for the birthing person, fetus, and child regarding using the opioid agonist medications methadone and both formulations of buprenorphine are discussed in the context of induction and stabilization during the perinatal period. This chapter also acknowledges that not every person with the capacity for pregnancy identifies as a woman. The chapter also embraces and respects every person’s gender expression, identity, and experience, and desires to be inclusive and helpful to anyone who needs care during the perinatal time.
Data in Historical Political Economy
Authors: Cirone Alexandra
Published: June 2023

Empirical data is essential for studies in historical political economy. The range of data is vast—scholars collect quantitative information from both primary and secondary sources, and the scope of data collection over time and space depends on the research study. Yet this chapter provides an overview of different types of quantitative historical data, commonly used in historical political economy: sociodemographic and population data, government or institutional records, geographic and spatial data, political data, economic data, ethnographic data, and civil society data. Research highlighted in this chapter serves as an introductory overview for scholars wishing to work with historical data.
The Cultural Niche
Authors: Boyd Robert
Published: June 2023

Humans are a different kind of animal. Our species has a bigger ecological range, cooperates on larger scales, and makes greater use of tools than any other vertebrate species. Many scholars argue that these novel features of human biology are the result of enhanced cognitive ability, especially the ability to create causal explanations of natural phenomena. An alternative hypothesis holds that cumulative cultural evolution has a central role, and that causal reasoning plays a secondary role. This chapter reviews this debate arguing that there are a range of models that differ about the role of causal reasoning, trial-and-error learning, and biased cultural learning. It then presents a laboratory study that indicates that cumulative cultural evolution can occur without causal understanding and an field study among Hadza hunter-gatherers that shows that the design of an essential foraging tool does not depend on a complete understanding of the costs and benefits of alternative designs.
Cultural Evolution of Ineffective Medicine
Authors: de Barra Mícheál
Published: June 2023

Until recently, cultural evolutionary processes rarely generated adaptive solutions to medical problems, and many commonplace treatments were more likely to harm than help. Indeed, medicine played a surprisingly limited role in life-expectancy extension until the late nineteenth century. This chapter reviews features of health and disease, and of cognition and cultural transmission, that might have impeded the evolution of effective medicine (or facilitated the persistence of maladaptive treatments). The beneficial effects of treatments are often subtle relative to changes resulting from immunological and other homeostatic processes: both noise and bias, therefore, make the search for effective treatments challenging. Moreover, biased communication of successful outcomes inflates the reputation of treatments and treatments grounded in intuitive but erroneous biological models that can be sustained irrespective of benefits. Finally, medical treatment can sometimes play an important role in signalling a legitimate need for care. These processes continue to influence medical practice.
Advances in single-cell metabolomics to unravel cellular heterogeneity in plant biology
Authors: Pandian Kanchana , Matsui Minami , Hankemeier Thomas , Ali Ahmed , Okubo-Kurihara Emiko
Published: June 2023

Single-cell metabolomics is a powerful tool that can reveal cellular heterogeneity and can elucidate the mechanisms of biological phenomena in detail. It is a promising approach in studying plants, especially when cellular heterogeneity has an impact on different biological processes. In addition, metabolomics, which can be regarded as a detailed phenotypic analysis, is expected to answer previously unrequited questions which will lead to expansion of crop production, increased understanding of resistance to diseases, and in other applications as well. In this review, we will introduce the flow of sample acquisition and single-cell techniques to facilitate the adoption of single-cell metabolomics. Furthermore, the applications of single-cell metabolomics will be summarized and reviewed.
Different music types affect mood, focus and work performance: exploring the potential of music as therapy with AI music
Authors: Padillah Raup , Hidayah Nur , Atmoko Adi
Published: June 2023

It is crucial in music therapy to select the right music type especially in the workplace. Exploring the potential of music as therapy and leveraging AI music for genre selection can unlock transformative possibilities in the workplace. The power of music as therapy with AI music and experience its positive impact on mood, focus and overall work performance.
Usefulness of electrocardiogram mA modulation during the electrocardiogram-gated CT scan in paediatrics with high heart rate for different helical pitch: a phantom-based assessment study
Authors: Masuda Takanori , Funama Yoshinori , Nakaura Takeshi , Sato Tomoyasu , Oku Takayuki , Gotanda Rumi , Arao Keiko , Imaizumi Hiromasa , Arao Shinichi , Ono Atsushi , Hiratsuka Junichi , Awai Kazuo
Published: June 2023

We investigated the effect of electrocardiographic (ECG) mA-modulation of ECG-gated scans of computed tomography (CTA) on radiation dose and image noise at high heart rates (HR) above 100 bpm between helical pitches (HP) 0.16 and 0.24. ECG mA-modulation range during ECG-gated CTA is 50–100 mA, the phase setting is 40–60% and the scan range is 90 mm for clinical data during HR for 90, 120 and 150 bpm. Radiation dose and image noise in Housfield units are measured for CT equipment during HR for 90, 120 and 150 bpm between HP 0.16 and 0.24. ECG mA-modulation, dose reduction ratio for HR 90, 120 and 150 bpm are 19.1, 13.4 and 8.7% at HP 0.16 and 17.1, 13.3 and 7.7% at HP 0.24, respectively. No significant differences were observed in image noise between both HP. Dose reductions of 8–24% are achieved with ECG mA-modulation during ECG-gated CCTA scan, which is beneficial even in high HR more than 100 bpm.
Mesenchymal Stem Cells-Derived Apoptotic Extracellular Vesicles (ApoEVs): Mechanism and Application in Tissue Regeneration
Authors: Zhu Yufan , Chen Xihang , Liao Yunjun
Published: June 2023

Mesenchymal stem cells (MSCs) are commonly used as a source for cellular therapy owing to their strong immunosuppressive and regenerative effects. However, MSCs undergo extensive apoptosis within a short period after transplantation. During apoptosis, MSCs generate several apoptotic extracellular vesicles (MSCs-ApoEVs). MSCs-ApoEVs are rich in miRNomes, metabolites, and proteomes. They are critical intercellular communication mediators that can exert different regulatory effects on recipient cells. MSCs-ApoEVs have been shown to promote regeneration in the skin, hair, bone, muscle, and vascular system, etc. This review describes the production, release, isolation, and functionality of ApoEVs in detail. Furthermore, we summarize the existing mechanisms of MSCs-ApoEVs used for tissue regeneration and evaluate the possible strategies for their clinical application.
Suicide Risk among University Students in Spain: Implications for Social Work
Authors: Reina-Aguilar Pastora , Díaz-Jiménez Rosa María , Caravaca-Sánchez Francisco
Published: June 2023

Suicide is a phenomenon that affects university students all over the world, and although vulnerability has been revealed in universities, there are still few studies that include large populations, a large number of universities and students pursuing different degrees. The study presented here aims to detect the risk of suicide in Spanish university students pursuing different areas of study. A total of 2,025 students from 16 Spanish universities and 17 degree programs completed an online questionnaire assessing support and suicide risk factors. The results indicate that 29.2 percent of the university students had experienced suicidal ideation in their lifetime. Logistic regression analysis showed that this risk was associated with depressive symptomatology and having suffered sexual violence. In contrast, self-esteem, life satisfaction, and perceived support were shown to be protective factors. Suicide risk affects one in three students. The present study includes particular implications for decision makers in the university community and other related governmental bodies, as well as for social work.
What causes transformation of the parasitic copepod? A new example of host switching in the family Anthessiidae (Cyclopoida) from Singaporean waters, with the proposal of a new genus
Authors: Uyeno Daisuke , Hashimoto Rina , Watanabe Hiromi K
Published: June 2023

Merlionia zeeae , a new species belonging to a new genus, is described as a member of the cyclopoid family Anthessiidae (Copepoda), based on both sexes collected off the coast of Singapore. The new species was found in the gill cavities of the longnosed stargazer, Ichthyscopus lebeck (Actinopteri: Perciformes: Uranoscopidae), although almost all members of the family are associated with molluscan hosts. However, this copepod is not similar to other genera of the family Anthessiidae due to possessing the following characters: the curved hook-like antenna, which is similar to that of the family Chondracanthidae in both sexes; the distal portion of the maxilla covered with numerous spinules; and the lack of the maxilliped in the female. Both maximum likelihood and Bayesian inferences using partial SSU (18S) ribosomal RNA genes strongly supported a monophyletic clade formed by the new genus, and three anthessiid genera in this study. However, it was not supported that Anthessiidae and Chondracanthidae are closely related. Therefore, the new genus is considered to be a highly transformed member of the former, and the chondracanthid-form antenna might therefore be a product of convergent evolution attributable to the host-switching event from molluscs to fishes.
Jumping continents and major host lineages: phylogeny and diversity of the enigmatic Cryptotropidae (Platyhelminthes: Digenea)
Authors: Tkach Vasyl V , Chermak Taylor P , Patitucci Kaylyn K , Greiman Stephen E , Thi Binh Tran , Olson Peter D
Published: June 2023

Members of several genera in the digenean superfamily Microphalloidea, namely Renschetrema, Rohdetrema, Cryptotropa, Cephalouterina and Pseudocryptotropa, are characterized by an unusual dorsal position of the genital atrium. In the absence of phylogenetic data, their systematic position has been unstable. In the most recent taxonomic revision of the Microphalloidea, they were housed in three different families. We studied the morphology and obtained DNA sequences of several microphallolideans with a dorsal genital pore, collected from vertebrates in Southeast Asia and South America. We used sequences of the nuclear 28S gene to infer a superfamily-level phylogeny and sequences of the mitochondrial cox1 gene for family-level phylogeny and species-level comparisons. Based on the combination of molecular phylogenetic data and morphological features, we restore the Cryptotropidae and synonymize the Renschetrematidae with the Cryptotropidae. We erect new genera Paracryptotropagen. nov. and Armadoatriumgen. nov., provide amended diagnoses of the Cryptotropidae and Renschetrema and provide keys to the identification of genera within the family. We resurrect the genus Novetrema, previously synonymized with Pseudocryptotropa, and remove Renschetrema indicum from Renschetrema. We describe four new species from lizards in Vietnam and birds in the Philippines and Peru. The unique morphological features and unusually broad host associations and geographical distributions of cryptotropids are discussed.
Eccrine Angiomatous Hamartoma with Atypical Localization Treated by Mohs Micrographic Surgery
Authors: D’Acunto Carmine , Riccioni Luca , Scarpellini Francesca , Purpura Valeria , Melandri Davide
Published: June 2023

Eccrine angiomatous hamartoma (EAH) is a rare hamartoma characterized by a benign proliferation of eccrine glands and vascular structures in the dermis. These tumors rarely regress spontaneously, so surgical excision of the involved tissue is required when pain or enlargement occurs. Here, the authors report the clinical case of a patient affected by an extremely painful EAH with the atypical localization at the last phalanx of the thumb of the right hand with involvement of nail matrix and nail bed. This report aims to emphasize the application of Mohs micrographic surgery for the treatment of painful EAH in a very difficult area at potential risk of amputation while preserving the maximum anatomical integrity and function of the damaged area. These results can pave the way for the use of Mohs micrographic surgery for very carefully selected benign neoplasms when their surgical removal is required.
Bone Turnover Markers in Patients With Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine
Authors: Sasaki Katsuyuki , Doi Toru , Inoue Tomohisa , Tozawa Keiichiro , Nakarai Hiroyuki , Yoshida Yuichi , Ito Yusuke , Ohtomo Nozomu , Sakamoto Ryuji , Nakajima Koji , Nagata Kosei , Okamoto Naoki , Nakamoto Hideki , Kato So , Taniguchi Yuki , Matsubayashi Yoshitaka , Okazaki Ken , Tanaka Sakae , Oshima Yasushi
Published: June 2023

Study Design.

A prospective, single-center, observational study.

Objective.

To explore the association between serum levels of bone turnover markers and ossification of the posterior longitudinal ligament (OPLL) in the thoracic spine.

Summary of Background Data.

The relationship between bone turnover markers, such as N-terminal propeptide of type I procollagen (PINP) or tartrate-resistant acid phosphate 5b (TRACP-5b), and OPLL has previously been examined. However, the correlation between these markers and thoracic OPLL, which is more severe than cervical-only OPLL, remains unclear.

Methods.

This prospective study included 212 patients from a single institution with compressive spinal myelopathy and divided them into those without OPLL (Non-OPLL group, 73 patients) and those with OPLL (OPLL group, 139 patients). The OPLL group was further subdivided into cervical OPLL (C-OPLL, 92 patients) and thoracic OPLL (T-OPLL, 47 patients) groups. Patients’ characteristics and biomarkers related to bone metabolism, such as calcium, inorganic phosphate (Pi), 25-hydroxyvitamin D, 1α,25 dihydroxyvitamin D, PINP, and TRACP-5b, were compared between the Non-OPLL and OPLL groups, as well as the C-OPLL and T-OPLL groups. Bone metabolism biomarkers were also compared after adjusting for age, sex, body mass index, and the presence of renal impairment using propensity score-matched analysis.

Results.

The OPLL group had significantly lower serum levels of Pi and higher levels of PINP versus the Non-OPLL group as determined by propensity score-matched analysis. The comparison results between the C-OPLL and T-OPLL groups using a propensity score-matched analysis showed that T-OPLL patients had significantly higher concentrations of bone turnover markers, such as PINP and TRACP-5b, compared with C-OPLL patients.

Conclusions.

Increased systemic bone turnover may be associated with the presence of OPLL in the thoracic spine, and bone turnover markers such as PINP and TRACP-5b can help screen for thoracic OPLL.
Single-level Anterior Cervical discEctomy and Fusion has Lower Five-year Revisions than Posterior Cervical Foraminotomy in a Large National Cohort
Authors: Jayaram Rahul H. , Joo Peter Y. , Gouzoulis Michael J. , Ratnasamy Philip P. , Caruana Dennis L. , Grauer Jonathan N.
Published: June 2023

Study Desig.

Retrospective cohort study using the 2010-2020 MSpine PearlDiver administrative dataset.

Objective.

To compare perioperative adverse events and five-year revisions for single-level ACDF versus PCF.

Summary of Background Data.

Cervical disc disease can often be treated surgically using single-level anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). Prior studies have suggested that posterior approaches provide similar short-term outcomes as ACDF; however, posterior procedures may have an increased risk of revision surgery.

Methods.

The database was queried for patients undergoing elective single-level ACDF or PCF (excluding cases performed for myelopathy, trauma, neoplasm, and/or infection). Outcomes including specific complications, readmission and reoperations were assessed Multivariable logistic regression was used to ascertain odds ratios (OR) of 90-day adverse events controlling for age, sex, and co-morbidities. Kaplan-Meier survival analysis was performed to determine 5-year rates of cervical reoperation in the ACDF and PCF cohorts

Results.

A total of 31,953 patients treated by ACDF (29,958, 93.76%) or PCF (1,995, 6.24%) were identified. Multivariable analysis, controlling for age, sex, and comorbidities, demonstrated that PCF was associated with a significantly greater odds of aggregated serious adverse events (OR 2.17, P<0.001), wound dehiscence (OR 5.89, P<0.001), surgical site infection (OR 3.66, P<0.001), and pulmonary embolism (OR 1.72, P=0.04). However, PCF was associated with significantly lower odds of readmission (OR 0.32, P<0.001), dysphagia (OR 0.44, P<0.001), and pneumonia (OR 0.50, P=0.004). At five years, PCF cases had a significantly higher cumulative revision rate compared to ACDF cases (19.0% vs. 14.8%, P<0.001).

Conclusions.

he current study is the largest to date to compare short-term adverse events and five-year revision rates between single-level ACDF and PCF for non-myelopathy elective cases. Perioperative adverse events differed by procedure, and it was notable that the incidence of cumulative revisions was higher for PCF. These findings can be used in decision making when there is clinical equipoise between ACDF and PCF.
Granulomatous Cheilitis Preceding Gastrointestinal Manifestations of Crohn's Disease
Authors: Eubanks Bianca N. , Seykora Caitlin M. , Bandino Justin P.
Published: June 2023

We describe a 20-year-old male with no significant medical history who presented with a 1-month history of painless upper and lower lip edema initially treated with antibiotics for suspected cellulitis before arriving to the clinic. After a failed response to that treatment, a lip biopsy was eventually performed and consistent with a diagnosis of granulomatous cheilitis. In addition to oral and topical corticosteroids and tacrolimus, the patient adopted the cinnamon- and benzoate-free diet with some improvement of his lip swelling. Persistent mild tachycardia led to a cardiology referral for further evaluation and sarcoidosis workup. A gastroenterology consult was placed to correlate his presentation with Crohn's disease. The cardiology workup was noncontributory, and the patient was ultimately diagnosed with Crohn's disease after evaluation with laboratory studies and colonoscopy. This case highlights the need to evaluate for Crohn's disease in patients who present with granulomatous cheilitis, even in the absence of gastrointestinal symptoms, and the potential benefit of incorporating a cinnamon- and benzoate-free diet in treatment.
A phase 1/2, open-label, parallel group study to evaluate the safety and pharmacokinetics of DARE-HRT1 (80 μg estradiol/4 mg progesterone and 160 μg estradiol/8 mg progesterone intravaginal rings) over 12 weeks in healthy postmenopausal women
Authors: Thurman Andrea , Hull M. Louise , Stuckey Bronwyn , Hatheway Jessica , Zack Nadene , Mauck Christine , Friend David
Published: June 2023

Objectives

Primary objectives were to evaluate the safety and systemic pharmacokinetics (PK) of DARE-HRT1, an intravaginal ring (IVR), which releases 17β2-Estradiol (E2) with progesterone (P4) for 28 days in healthy postmenopausal women.

Methods

This was a randomized, open-label, 2-arm, parallel group study in 21 healthy postmenopausal women with an intact uterus. Women were randomized (1:1) to either DARE-HRT1 IVR1 (E2 80 μg/d with P4 4 mg/d) or DARE-HRT1 IVR2 (E2 160 μg/d with P4 8 mg/d). They used the IVR for three 28-day cycles, inserting a new IVR monthly. Safety was measured by treatment emergent adverse events and changes in systemic laboratories and the endometrial bilayer width. Baseline adjusted plasma PK of E2, P4, and estrone (E1) was described.

Results

Both DARE-HRT1 IVR were safe. All treatment emergent adverse events were mild or moderate and were distributed similarly among IVR1 versus IVR2 users. Month 3 median maximum plasma (C
max) P4 concentrations were 2.81 and 3.51 ng/mL and C
max E2 was 42.95 and 77.27 pg/mL for IVR1 and IVR2 groups, respectively. Month 3 median steady state (C
ss) plasma P4 concentrations were 1.19 and 1.89 ng/mL, and C
ss E2 was 20.73 and 38.16 pg/mL for IVR1 and IVR2 users, respectively.

Conclusions

Both DARE-HRT1 IVRs were safe and released E2 in systemic concentrations, which were in the low, normal premenopausal range. Systemic P4 concentrations predict endometrial protection. Data from this study support further development of DARE-HRT1 for the treatment of menopausal symptoms.
Liver transplantation for unresectable colorectal liver metastasis
Authors: Chávez-Villa Mariana , Ruffolo Luis I. , Hernandez-Alejandro Roberto
Published: June 2023

Purpose of review

To summarize the current state of liver transplantation (LT) for unresectable colorectal liver metastases (uCRLM), and to address future directions.

Recent findings

The Norwegian secondary cancer (SECA) I and SECA II studies demonstrated that after LT the 5-year survival of a highly selected group of patients with uCRLM could be as high as 60% and 83%, respectively. After long-term follow-up, the 5- and 10-year survival was shown to be 43% and 26%, respectively. Furthermore, data has accumulated in other countries and a North American study reported a 1.5-year survival of 100%. In addition, steady growth has been demonstrated in the US, with 46 patients transplanted to date and 19 centers enrolling patients for this indication. Lastly, although recurrence is almost universal in patients with a high tumor burden, it has not been an accurate surrogate for survival, reflecting the relatively indolent nature of recurrence after LT.

Growing evidence has shown that excellent survival and even cure can be achieved in highly selected patients with uCRLM, with survival rates far superior than in patients treated with chemotherapy. The next step is to create national registries to standardize selection criteria and establish the optimal approach and best practices for incorporating LT for uCRLM into the treatment armamentarium.
Point-of-Care Ultrasound for the Diagnosis of Pediatric Foreign Body Ingestion
Authors: Niset Alexandre , Baert Jérome , Dupriez Florence
Published: June 2023

Purpose

Foreign body ingestion (FBI) is a frequent concern in emergency departments. Clinical guidelines recommend performing plain x-rays as the primary modality of diagnosis. Although point-of-care ultrasound (PoCUS) has increasingly been integrated into the daily practice of emergency medicine, it has been poorly investigated in the diagnostic approach for FBI.

This review aims to highlight the current state of PoCUS use for pediatric FBI.

The following research question was considered in this narrative review: Is PoCUS useful for FBI management?

Methods

A literature search was conducted to identify articles reporting PoCUS use for the management of FBI. All articles were assessed for quality by 2 reviewers.

Main Results

The 14 selected articles reported 52 FBI cases in which PoCUS successfully identified and located the ingested FB. Point-of-care ultrasound was used either as the primary imaging technique or after positive or negative x-ray findings. In 5 cases (9.6%), PoCUS was the only modality used for the diagnosis. Of these cases, 3 (60%) underwent a successful procedure to remove the FB and 2 (40%) received conservative treatment without complications.

Conclusions

This review suggests that PoCUS might be a reliable modality for the initial management of FBI. PoCUS can locate, identify, and evaluate the size of the FB in a wide range of materials and gastrointestinal locations. Point-of-care ultrasound could eventually become the go-to modality in the case of radiolucent FB, thus avoiding the use of radiation. Further studies are nevertheless required to validate PoCUS use for FBI management.
Pre-Injury Measures do not Predict Future Concussion Among Collegiate Student-Athletes: Findings from the CARE Consortium
Authors: Lempke Landon B. , Breedlove Katherine M. , Caccese Jaclyn B. , McCrea Michael A. , McAllister Thomas W. , Broglio Steven P. , Schmidt Julianne D. , Lynall Robert C. , Buckley Thomas A. ,   CARE Consortium Investigators
Published: June 2023

This prospective cohort study aimed to determine whether pre-injury characteristics and performance on baseline concussion assessments predicted future concussions among collegiate student-athletes. Participant cases (concussed = 2,529; control = 30,905) completed pre-injury: demographic forms (sport, concussion history, sex), Immediate Post-Concussion Assessment and Cognitive Test (ImPACT), Balance Error Scoring System (BESS), Sport Concussion Assessment Tool (SCAT) symptom checklist, Standardized Assessment of Concussion (SAC), Brief Symptom Inventory-18 item (BSI-18), Wechsler Test of Adult Reading (WTAR), and Brief Sensation Seeking Scale (BSSS). We used machine-learning logistic regressions with area under the curve (AUC), sensitivity, and positive predictive values (+PV) statistics for univariable and multivariable analyses. Primary sport was determined to be the strongest univariable predictor (AUC = 64.3% ± 1.4, sensitivity = 1.1% ± 1.4, +PV = 4.9% ± 6.5). The all-predictor multivariable model was the strongest (AUC = 68.3% ± 1.6, sensitivity = 20.7% ± 2.7, +PV = 16.5% ± 2.0). Despite a robust sample size and novel analytical approaches, accurate concussion prediction was not achieved regardless of modeling complexity. The strongest +PV(16.5%) indicated only 17 out of every 100 individuals flagged would experience a concussion. These findings suggest pre-injury characteristics or baseline assessmentshave negligible utilityfor predicting subsequent concussion. Researchers, healthcare providers, and sporting organizations therefore should not use pre-injury characteristics or baseline assessments for future concussion risk identificationat this time.
Naloxone-Prescribing Practices in a Freestanding Rehabilitation Hospital
Authors: Stone Shane N. , Curley Natalie , Sheth Manasi , Butler Christopher , Margolis Shana
Published: June 2023

Objective

The study aims to determine whether Physical Medicine & Rehabilitation physicians offer naloxone per the Centers for Disease Control and Prevention Guidelines to patients at the highest risk of complications from opioid treatment and whether there is a difference between inpatient and outpatient naloxone prescribing.

Design

A retrospective chart review on 389 adults (outpatient n = 166; inpatient n = 223) from May 4 to May 31, 2022, at an academic rehabilitation hospital. Prescribed medications and comorbidities were evaluated to determine whether Centers for Disease Control and Prevention criteria for offering naloxone were met and whether naloxone was offered.

Results

One hundred twenty-nine opioid prescriptions were written for 102 outpatients; 61 qualified for naloxone (morphine milliequivalent range = 10–1080, mean = 158.08). On inpatient, 68 patients received 86 opioid prescriptions; 35 qualified for naloxone (morphine milliequivalent range = 3.75–246, mean = 62.36). Overall, there was a significantly lower rate of opioid prescriptions for inpatients (30.49%) than outpatients (61.45%) (P < 0.0001), a nonsignificant lower rate of inpatient (51.47%) than outpatient (59.80%) “at-risk” prescriptions (P = 0.351), and a weakly significant lower rate of naloxone prescribing for inpatient (2.86%) than outpatient visits (8.20%) (P < 0.0519).

Conclusions

At this rehabilitation hospital, there was a low rate of naloxone prescribing by inpatient and outpatient providers, with a higher rate occurring in the outpatient than inpatient setting. More research is needed to understand this prescribing trend to determine potential interventions.
Condylar Resorption After Orthognathic Surgery: A Review of Risk Factors With a Proposed Algorithm of Treatment
Authors: AlMofreh AlQahtani Feras , Othman Ahmad , Elsayed Shadia , Jaber Mohamed , Kuriadom Sam
Published: June 2023

This study aimed to critically reanalyze systematic reviews of patients suffering from condylar resorption (CR) and summarize the current scientific pieces of evidence with a focus on a possible relationship between CR and orthognathic surgery (OS). The work followed the “Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol” guidelines and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42020168660). The search strategy produced 143 articles. After reading the abstracts, 113 articles were excluded, and the full-text articles in English of the remaining 30 studies were separately examined for eligibility by 2 authors, with 20 of them being excluded because they did not meet the inclusion criteria. Finally, 10 systematic reviews were processed for critical evaluation. Young female patients with a high mandibular plane angle, diminished posterior facial height, posteriorly inclined condylar neck, and a counter-clockwise jaw rotation, are more likely to develop CR after OS. The most common procedure associated with CR in the included systematic reviews was the bimaxillary OS followed by bilateral sagittal split osteotomy. Hence, extreme caution and surgical modification should be used in these high-risk conditions. There is still a need for more evidence on the risks of OS or iatrogenic factors during the fixation of various osteosynthesis devices because it is still inconclusive and requires further justification.
Association Between Maxillary Segmentation and Perioperative Complications in Le Fort I Osteotomy
Authors: Joseph Mia M. , Jain Nirbhay S. , DeLong Michael R. , Ozaki Wayne
Published: June 2023

The Le Fort I osteotomy is used to reposition the maxilla to correct numerous maxillofacial and occlusal deformities. The aim of this study was to delineate perioperative complication rates associated with Le Fort I osteotomy and determine whether the number of maxillary segments or bone grafting yielded increased complication rates. Patients undergoing Le Fort I osteotomy from 2012 to 2019 were identified from the multi-institution “National Surgical Quality Improvement Program” database using Current Procedure Terminology codes. The predictor variables of interest included maxillary segmentation defined as 1, 2, or 2 pieces and the presence or absence of bone graft. Perioperative complications were collected as the primary outcome variable, including superficial and deep space infections, wound dehiscence, airway complication, peripheral nerve injury, and hemorrhage. The secondary outcome variables included readmission and reoperation rate within the 30-day postoperative period. Complication rates were compared using multivariate analysis across groups stratified by the number of maxillary segments and inclusion of bone grafting. Of the 532 patients that met the inclusion criteria, 333 (63%) underwent 1-piece, 114 (21%) 2-piece, and 85 (16%) 2-piece Le Fort I osteotomy procedures. A total of 48 patients exhibited complications (9%), with hemorrhage (2.3%) being the most common complication observed. The number of maxillary segments was not a significant predictor of perioperative complications (P = 0.948) nor was the use of bone grafting (P = 0.279).
The FSHD jigsaw: are we placing the tiles in the right position?
Authors: Salsi Valentina , Vattemi Gaetano Nicola Alfio , Tupler Rossella Ginevra
Published: June 2023

Purpose of review

Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common myopathies, involving over 870,000 people worldwide and over 20 FSHD national registries. Our purpose was to summarize the main objectives of the scientific community on this topic and the moving trajectories of research from the past to the present.

Recent findings

To date, research is mainly oriented toward deciphering the molecular and pathogenetic basis of the disease by investigating DUX4-mediated muscle alterations. Accordingly, FSHD drug development has been escalating in the last years in an attempt to silence DUX4 or to block its downstream effectors. Breakthroughs in the field include the awareness that new biomarkers and outcome measures are required for tracking disease progression and patient stratification. The need to develop personalized therapeutic strategies is also crucial according to the phenotypic variability observed in FSHD subjects.

We analysed 121 literature reports published between 2021 and 2023 to assess the most recent advances in FSHD clinical and molecular research.
Smaller is better in competition for space
Authors: Senthilnathan Athmanathan
Published: June 2023

Body size is a prominent morphological trait which affects many aspects of an organism’s life. Although large body size is generally considered to be advantageous, ecologists have wondered about the benefits of being small. Many studies of body size depend on the metabolic theory of ecology since body size is an irremovable part of an organism’s energy budget. Body size is also a spatial quantity and therefore is linked to spatial processes. Here, I show that competition for space leads to a benefit of being small and hence selects for increasingly smaller body size. I build a deterministic population dynamics model and a stochastic model of birth, death and dispersal in a population of individuals with two different body sizes and show that only the smaller individuals survive. I also extend the population dynamics model to continuously varying body sizes and include a stabilizing natural selection for an intermediate body size. I find that the intrinsic advantage of smaller body size in competition for space can only be overcome when natural selection for a large body size is sufficiently strong. Overall, my results point to a novel benefit of being small.
Adaptive significance of affiliative behaviour differs between sexes in a wild reptile population
Authors: Delmé C. , Jackson N. , Class B. , Strickland K. , Potvin D. A. , Frère C. H.
Published: June 2023

In recent years, we have begun to appreciate that social behaviours might exhibit repeatable among-individual variation. Such behavioural traits may even covary and have critical evolutionary implications. Importantly, some social behaviours such as aggressiveness have been shown to provide fitness benefits, including higher reproductive success and survival. However, fitness consequences of affiliative behaviours, especially between or among sexes, can be more challenging to establish. Using a longitudinal behavioural dataset (2014–2021) collected on eastern water dragons (
Intellagama lesueurii
), we investigated whether various aspects of affiliative behaviour (i) were repeatable across years, (ii) covaried with each other at the among-individual level, and (iii) influenced individuals' fitness. In particular, we considered affiliative behaviours towards opposite-sex and same-sex conspecifics separately. We found that social traits were repeatable and covaried with each other similarly for both sexes. More notably, we found that male reproductive success was positively correlated with the number of female associates and the proportion of time spent with females, while females’ reproductive success was not correlated with any of the measured social behaviour metrics. Overall, these findings suggest that selection may be acting differently on social behaviour of male and female eastern water dragons.
Comparison the outcomes of blunt trauma with penetrating traumatic popliteal artery injury repair in Southwest of Iran
Authors: Azadvar Alireza , Mousavi Seyed Masood , Tork Hossein Minaie , Sherafatmand Shaghayegh , Ghaedamini Hossein
Published: June 2023

Introduction

Popliteal artery injuries (PAI) one of the most severe peripheral vascular damages may lead to movement impairment or amputation. This study aimed to compare the repair results of popliteal artery injury due to blunt trauma with penetrating trauma in patients referred to the Vascular Surgery Center in Southwest Iran.

Methods

This was a descriptive and retrospective study. The statistical population was all patients with vascular trauma referred to the Southwest Trauma Center of Iran in 2020. The sampling method was census. The data collection tool was a checklist containing demographic information, medical information, vascular information, Functional Independence Measure (FIM) Score, and Mangled Extremity Severity Score (MESS). Statistical analyses were conducted using SPSS24 (IBM Inc., Chicago, IL, USA). The Chi-Square test, Fisher Exact Test, and independent T-test were used.

Results

63.1 % of participants had penetrating trauma. 10.6 % of participants needed limb fasciotomy (26.3 % in the penetrating trauma group VS 1.7 % in the blunt trauma group). The amputation rate was 8.8 % in the penetrating trauma group VS 12 % in the blunt trauma. There was a significant difference between the two groups in terms of organ fasciotomy (P=0.035), type of PAI(P=0.018), and fracture (P=0.007). MESS Score (P<0.001), FIM Score (P<0.001), time of discharge (P<0.001), and Arterial condition (P<0.001).

Conclusion

Popliteal artery trauma is uncommon. Tthe results showed that the complication of penetrating PAI include organ fasciotomy (type of fracture, MESS Score, FIM Score, time of discharge, Arterial condition) in the southwest of Iran were significantly more than the blunt type. It is necessary to investigate additional studies with a larger sample size and extended duration.
Coping mechanisms of students with mental disorders at Busitema University, an exploratory qualitative study at Mbale and Busia campuses
Authors: Kagoya Enid Kawala , Mpagi Joseph , Waako Paul , Muhwezi Martha R L , Namaganda Agnes , Nsubuga Allan.G. , Atala Christine Etoko , Okello Francis , Okibure Ambrose , Kibuuka Ronald , Wandera Ernest , Ndamanywa Kalisiti , Kirabira Joseph
Published: June 2023

Background

Over the past years, Ugandan universities have been grappling with mental health issues among students. The prevalence of mental disorders was up to 60% among undergraduate students in Uganda. This trend has been observed at many universities as mental health issues pose significant academic and social problems for many students. This study aimed to explore the coping mechanisms used by students with mental disorders at Busitema University.

Methods

Forty-two key informant interviews were conducted among students diagnosed with mental disorders based on Mini International Neuropsychiatric Interview. All the interviews followed a well-structured interview guide which was developed by the research team. All participants consented during the study. All interviews were audiotaped and recordings were later subjected to verbatim transcription. Each transcript was read several times by the research team. Thematic analysis was done following a deductive approach. Nvivo software was used to support the coding and grouping of codes.

Results

The study revealed several key coping strategies embraced by students experiencing mental health issues at the two campuses. Five themes emerged during the data analysis which included Alcohol and substance use, Use of sedatives, social and personal initiatives, seeking counselling services, withdrawal and confrontation and faith healing. A lot of subthemes emerged as indicated in table (2). Among the many were resorting to drug, alcohol and substance use, withdrawal, confrontations, witchcraft, engaging in co-curricular activities and other social events, abortions, seeking counselling and other forms of psychosocial support.

Conclusions

In the face of increasingmental health challenges among university students, their coping strategies amidst such situations need to be looked through and given much attention. Some are self-thought-through strategies while others are university-led interventions. There is a need to reinforce the good coping mechanisms and counter the bad ones for the betterment of the mental health status of these students.
Measuring Quality-of-Care in Treatment of Children with Attention-Deficit/Hyperactivity Disorder: A Novel Application of Natural Language Processing
Authors: Pillai Malvika , Posada Jose , Gardner Rebecca M. , Hernandez-Boussard Tina , Bannett Yair
Published: June 2023

Objective

To develop and validate a novel application of natural language processing (NLP) techniques to measure pediatrician adherence to evidence-based guidelines in the treatment of young children with attention-deficit/hyperactivity disorder (ADHD).

Materials and Methods

We extracted structured and free text data from electronic health records of all office visits (2015-2019) of children aged 4-6 years seen in a community-based primary healthcare network in California, who had ≥1 visits with an ICD-10 diagnosis of ADHD. Two pediatricians manually annotated clinical notes of the first ADHD visit for 423 patients. Inter-annotator agreement was assessed for recommendation for first-line behavioral treatment; Disagreements were reconciled. The BioClinical Bidirectional Encoder Representations from Transformers (BioClinical-BERT) was used to identify mentions of behavioral treatment recommendations using a 70/30 train/test split. Following an error analysis and threshold selection, we completed external (temporal) validation by deploying the model on 1,020 unannotated notes representing other ADHD visits and well-care visits; all positively classified notes and 5% of negatively classified notes were annotated.

Results

Of 423 included patients, 313 (74%) were male, 268 (63%) were privately insured; 138 (33%) were white; 61 (14 %) were Hispanic. The BERT model of first ADHD visits achieved F1=0.78, precision=0.84, and recall=0.72. Following threshold selection, temporal validation on notes from other visits achieved F1=0.80, recall=0.92 and precision=0.7.

Conclusion

Deploying a machine learning algorithm on a large and variable set of clinical notes accurately captured pediatrician adherence to guidelines in treatment of children with ADHD. This approach can be used to measure quality-of-care at scale and improve clinical care for various chronic medical conditions.