bluuebunny/crossref_metadata_2025 huggingface dataset:
Postoperative complications and disposition for vascular surgery
Authors: Jeon Andy , Nagappan Leena
Published: March 2023

Among all surgical specialties, vascular surgery has the greatest proportion of patients with unplanned admissions to the intensive care unit postoperatively. Therefore, current clinical pathways for the postoperative management of vascular surgery patients may need to be revised. We aimed to compare the prevalence of postoperative deterioration in the high and standard risk cohorts of patients through several markers: medical emergency team activations and unplanned intensive care unit admissions. This was a single-centre, retrospective cohort study of all vascular surgical patients, emergency and elective, between 1 January and 31 December 2020 at Fiona Stanley Hospital, a tertiary hospital located in Perth, Western Australia. Patients ( n = 680) were risk stratified using the surgical outcome risk tool into standard-risk (30-day mortality risk <5%; n = 475, 69.9%) and high-risk (30-day mortality risk ≥5%; n = 205, 30.1%). There were 43 unplanned intensive care unit admissions (6.3%) in total. Furthermore, surgical outcome risk tool 5% or greater risk patients were approximately eight times more likely to experience an unplanned intensive care unit admission compared with their surgical outcome risk tool less than 5% risk counterparts (relative risk 7.65, 95% confidence interval 3.84–15.21). There were 87 medical emergency team calls (12.8%) in total. In addition, surgical outcome risk tool 5% or greater risk patients were approximately five times more likely to experience a medical emergency team activation than their surgical outcome risk tool less than 5% risk counterparts (relative risk 5.15, 95% confidence interval 3.37–7.86). Our findings highlight the need for a revision of the inpatient journey for surgical outcome risk tool 5% or greater risk vascular patients, given their increased rates of unfavourable postoperative outcomes such as unplanned intensive care unit admission and medical emergency team activation. Ideally this can be addressed through appropriate postoperative triage, thus allowing this vulnerable population group early access to higher acuity care.
Resurfacing Dignity as a Tool for the Unionization of African American Lower-Tier Workers
Authors: Young Alford A.
Published: March 2023

Selected lower-tier occupational sectors were defined as essential during the early phase of the Covid crisis. Accordingly, that period provided an opportunity to explore whether certain African American lower-tier workers might have acquired a greater sense of dignity and value for their work. By drawing from the author's earlier research on low-income African Americans and a recent study of such workers, this essay explores how considerations of value and dignity in the workplace during early Covid inform about the prospects for organizing such lower-tier workers for union participation.
Characterizing the Differences in Descriptions of Violence on Reddit During the COVID-19 Pandemic
Authors: Li Lifang , Neubauer Lilly , Stewart Robert , Roberts Angus
Published: March 2023

Concerns have been raised over the experiences of violence such as domestic violence (DV) and intimate partner violence (IPV) during the COVID-19 pandemic. Social media such as Reddit represent an alternative outlet for reporting experiences of violence where healthcare access has been limited. This study analyzed seven violence-related subreddits to investigate the trends of different violence patterns from January 2018 to February 2022 to enhance the health-service providers’ existing service or provide some new perspective for existing violence research. Specifically, we collected violence-related texts from Reddit using keyword searching and identified six major types with supervised machine learning classifiers: DV, IPV, physical violence, sexual violence, emotional violence, and nonspecific violence or others. The increase rate (IR) of each violence type was calculated and temporally compared in five phases of the pandemic. The phases include one pre-pandemic phase ( Phase 0, the date before February 26, 2020) and four pandemic phases ( Phases 1–4) with separation dates of June 17, 2020, September 7, 2020, and June 4, 2021. We found that the number of IPV-related posts increased most in the earliest phase; however, that for COVID-citing IPV was highest in the mid-pandemic phase. IRs for DV, IPV, and emotional violence also showed increases across all pandemic phases, with IRs of 26.9%, 58.8%, and 28.8%, respectively, from the pre-pandemic to the first pandemic phase. In the other three pandemic phases, all the IRs for these three types of violence were positive, though lower than the IRs in the first pandemic phase. The findings highlight the importance of identifying and providing help to those who suffer from such violent experiences and support the role of social media site monitoring as a means of informative surveillance for help-providing authorities and violence research groups.
Psychosocial Factors Associated With Physical Activity Among Low-Income Overweight or Obese Mothers with Young Children
Authors: Chang Mei-Wei , Gunther Carolyn , Militello Lisa K. , Wegener Duane T. , Lin Chyongchiou J.
Published: March 2023

Purpose

Investigate the associations between psychosocial factors and physical activity.

Design

Secondary data analysis utilizing baseline data of a large-scale community-based randomized controlled lifestyle behavior intervention.

Setting

The Special Supplemental Program for Women, Infants, and Children in Michigan, USA.

Subjects

Low-income overweight or obese mothers with young children (N = 740, 65% response rate).

Measures

Survey data were collected via phone interview. Predictors included self-efficacy, autonomous motivation, emotional coping, and social support. Self-reported leisure physical activity was the outcome variable. Covariates were age, race, smoking, employment, education, body mass index, and postpartum status.

Analysis

A multiple linear regression model was applied.

Results

Self-efficacy ( β = .32, 95% CI = .11, .52, P = .003) and autonomous motivation ( β = .10, 95% CI = .03, .17, P = .005) were positively associated with physical activity. However, emotional coping and social support were not associated with physical activity.

Conclusion

Future research should examine the longitudinal association of key psychosocial factors with physical activity.
How State Educational Agency Coordinators Navigate Logics of Local Control in Standards Implementation
Authors: Hodge Emily M. , Salloum Serena J. , Benko Susanna L.
Published: March 2023

State educational agency content coordinators commonly experience tensions in their professional roles related to distinct sets of beliefs, or logics, about who “should” control what students learn: the state bureaucracy, the local community, or the broader profession. Using an institutional logics frame and drawing on interviews with coordinators for English/language arts representing about a third of U.S. states, we illustrate how individuals navigate these competing traditions of decision-making. Multiple logics shaped coordinators’ perceptions of their job responsibilities and goals, as well as the actions they felt were possible for them to take in creating and providing resources, communicating those resources to local stakeholders, and providing professional development. More consistent messaging to coordinators about the types of outreach the state views as acceptable would better support high-quality literacy instruction.
Validation of a Novel Clinical Dyspnea Scale – A Retrospective Pilot Study
Authors: Kalluri Meena , Cui Ying , Wang Ting , Bakal Jeffrey A.
Published: March 2023

Objective: to examine the validity of a novel dyspnea scale, Edmonton Dyspnea Inventory in idiopathic pulmonary fibrosis (IPF). Methods: Edmonton Dyspnea Inventory (EDI), is a clinical instrument to measure dyspnea severity with activities of daily living, exercise and rest using a numeric rating scale (0 -10). Consecutive IPF patients (2012-2018) with baseline MRC and EDI were included. To validate EDI, psychometric analysis was conducted. Correlations between EDI, MRC and lung function were examined. Group-based trajectory modeling was used to group patients based on dyspnea severity. Net Reclassification Improvement (NRI) was calculated to assess the improvement in 1-year mortality prediction by adding trajectory groups to MRC grade. Results: 100 consecutive IPF patients were identified; mean age 73 years (SD = 9) and 65% males; 73% were in MRC grades ≥3. Item analysis showed all 8 EDI components have excellent discrimination power with ability to differentiate patients with varying dyspnea severity. EDI has good internal consistency (Cronbach α = .92). Exploratory factor analysis showed a one-factor solution with loadings from .66 to .89 suggesting 8 EDI components measured essentially one dimension of dyspnea. All EDI components were correlated with MRC and some with lung function. Modeling data identified three EDI dyspnea severity groups with differing mortality ( P = .009). The addition of EDI dyspnea severity groups to the MRC score improved 1-year mortality prediction (NRI = .66; 95% CI, .18-1.14). Conclusions: EDI is a valid dyspnea instrument, correlated with MRC and lung function. It can categorize IPF patients into 3 dyspnea severity groups associated with increased mortality. Key Message: We describe the development of a novel scale, Edmonton Dyspnea Inventory, that facilitates measurement of dyspnea severity in the context of daily activities in patients with IPF. The results indicate that the new instrument is valid and correlated to MRC. It identifies 3 categories of severity not recognized by MRC with impact on mortality. Knowledge of dyspnea severity can help triage patients and assign appropriate therapies.
Case of nivolumab-induced delayed adrenal insufficiency during the treatment of renal cell carcinoma
Authors: Yonezawa Ryo , Takata Eriko , Yamadera Shiho , Sunaga Tomiko
Published: March 2023

Introduction

Nivolumab is an immune checkpoint inhibitor used to treat advanced renal cell carcinoma (RCC). Adrenal insufficiency has been reported as an adverse event associated with nivolumab. We report a case of adrenal insufficiency that occurred more than 1 year after the initiation of nivolumab while patient was still receiving treatment.

Case Report

The patient was a 90-year-old Japanese woman. Fatigue and decreased cortisol levels were observed after 15 courses of nivolumab.

Management & Outcome

The symptoms improved with the initiation of oral hydrocortisone 30 mg once a day. Nivolumab was not resumed, and the patient is still under outpatient observation.

Discussion

This is the first report of RCC with adrenal insufficiency occurring more than 1 year after the initiation of the nivolumab regimen. Symptoms of adrenal insufficiency are similar to those of cancer progression. When symptoms of fatigue occur in patients receiving nivolumab, adrenal insufficiency should be suspected, regardless of the duration from nivolumab initiation.
Examination of Factors Associated With Informal Caregivers’ Reactions to Different Problem Behaviors Among Persons With Alzheimer’s Disease
Authors: Shi Junrong , Scott Cathy
Published: March 2023

Problem behaviors among persons with Alzheimer’s Disease (AD) have a significant impact on caregivers. However, caregivers’ subjective reaction to the problem behaviors better predicts the caregiving outcomes than the objective frequency of problem behaviors. With a sample recruited from community agencies serving Alzheimer’s Disease (AD) caregivers (n = 108), this study examined the effect of various factors on the caregivers ’reaction to different types of problem behaviors, including demographics, caregivers’ knowledge about the AD, and resilience level, controlling for the frequency of problem behaviors and other caregiving context factors. Caregivers’ reaction to problem behaviors was measured by the Revised Memory and Behavior Problem Checklist. Findings indicated that African American caregivers had a lower level of reactions to disruptive ( B = −3.956; p < .01) and depressive behaviors ( B = −2.443; p < .05) than white caregivers, but not for memory-loss problems. Age, being spousal caregivers, and knowledge of AD only affected reactions to memory-loss problems but not for other types of behaviors. No effects were observed for personal resilience. Intervention should be tailored to the varied needs of family caregivers to deal with problem behaviors among people with AD to delay institutionalization. More training/resources at the skill level over the information-only caregiver intervention should be promoted.
Cervical Transformation Zone Segmentation and Classification based on Improved Inception-ResNet-V2 Using Colposcopy Images
Authors: Dash Srikanta , Sethy Prabira Kumar , Behera Santi Kumari
Published: March 2023

The second most frequent malignancy in women worldwide is cervical cancer. In the transformation(transitional) zone, which is a region of the cervix, columnar cells are continuously converting into squamous cells. The most typical location on the cervix for the development of aberrant cells is the transformation zone, a region of transforming cells. This article suggests a 2-phase method that includes segmenting and classifying the transformation zone to identify the type of cervical cancer. In the initial stage, the transformation zone is segmented from the colposcopy images. The segmented images are then subjected to the augmentation process and identified with the improved inception-resnet-v2. Here, multi-scale feature fusion framework that utilizes 3 × 3 convolution kernels from Reduction-A and Reduction-B of inception-resnet-v2 is introduced. The feature extracted from Reduction-A and Reduction -B is concatenated and fed to SVM for classification. This way, the model combines the benefits of residual networks and Inception convolution, increasing network width and resolving the deep network’s training issue. The network can extract several scales of contextual information due to the multi-scale feature fusion, which increases accuracy. The experimental results reveal 81.24% accuracy, 81.24% sensitivity, 90.62% specificity, 87.52% precision, 9.38% FPR, and 81.68% F1 score, 75.27% MCC, and 57.79% Kappa coefficient.
Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease and COVID-19: A Systematic Review
Authors: Mirmosayyeb Omid , Ghaffary Elham Moases , Dehghan Mohammad S. , Ghoshouni Hamed , Bagherieh Sara , Barzegar Mahdi , Shaygannejad Vahid
Published: March 2023

Background

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an uncommon neurological disease affecting the central nervous system (CNS). Numerous neurological disorders, including multiple sclerosis (MS), neuromyelitis optica spectrum disorder (NMOSD), acute transverse myelitis (ATM), and MOGAD, have been reported following the COVID-19 infection during the current COVID-19 pandemic. On the other hand, it has been suggested that patients with MOGAD may be at greater risk for infection (particularly in the current pandemic).

Objective

In this systematic review, we gathered separately 1) MOGAD cases following COVID-19 infection as well as 2) clinical course of patients with MOGAD infected with COVID-19 based on case reports/series.

Methods

329 articles were collected from 4 databases. These articles were conducted from inception to March 1st, 2022.

Results

Following the screening, exclusion criteria were followed and eventually, 22 studies were included. In 18 studies, a mean ± SD time interval of 18.6 ± 14.9 days was observed between infection with COVID-19 and the onset of MOGAD symptoms. Symptoms were partially or completely recovered in a mean of 67 days of follow-up. Among 4 studies on MOGAD patients, the hospitalization rate was 25%, and 15% of patients were hospitalized in the intensive care unit (ICU).

Conclusion

Our systematic review demonstrated that following COVID-19 infection, there is a rare possibility of contracting MOGAD. Moreover, there is no clear consensus on the susceptibility of MOGAD patients to severe COVID-19. However, obtaining deterministic results requires studies with a larger sample size.
Students’ need satisfaction and frustration profiles: Differences in outcomes in physical education and physical activity-related variables
Authors: Burgueño Rafael , García-González Luis , Abós Ángel , Sevil-Serrano Javier
Published: March 2023

Grounded in self-determination theory, the objectives of the present research were to identify latent profiles based on need-based experiences in physical education (PE), and to examine differences in outcomes in PE (i.e. motivation, experiences, and oppositional defiance) and outside of PE (i.e. physical activity intention, moderate-to-vigorous physical activity, and meeting physical activity recommendations) across the identified profiles. A purposive sample of 1062 secondary PE students (526 boys and 536 girls; Mage  = 14.15, SD = 1.51) participated in this cross-sectional study. Results from latent profile analysis revealed four need satisfaction and frustration profiles: “high need satisfaction–low need frustration”; “moderate need satisfaction–low need frustration”; “moderate need satisfaction–moderate need frustration”; and “low need satisfaction–high need frustration.” For outcomes in PE, the “high need satisfaction–low need frustration” profile was the most adaptive, while the “low need satisfaction–high need frustration” profile obtained the most maladaptive pattern of outcomes. The “moderate need satisfaction–low need frustration” profile was more adaptive than the “moderate need satisfaction–moderate need frustration” profile, although both were similar in experiences and oppositional defiance. For outcomes outside of PE, the “high need satisfaction–low need frustration” profile scored highest, while no differences were obtained among the three remaining profiles. These results provide further insight into the importance for PE teachers not only to support students’ need satisfaction, but also to minimize need frustration, in obtaining the most optimal pattern of outcomes in PE, as well as a more active lifestyle among students.
Cross-cultural, transnational or interdisciplinary? Eric Wittkower’s psychosomatic medicine and transcultural psychiatry in historical context
Authors: Hennig Christina , Delille Emmanuel , Müller Thomas
Published: March 2023

This article traces the career, scientific achievements, and emigration of the Berlin-born physician, psychoanalyst, and psychosomatic researcher Eric Wittkower. Trained in Berlin and practicing internal medicine, he became persecuted by the Nazi regime and, after fleeing Germany via Switzerland, continued his professional career in the United Kingdom, where he turned to psychosomatic medicine and worked in the service of the British Army during World War II. After two decades of service in the UK, Wittkower joined McGill University in Canada. His increasingly interdisciplinary work contributed to the establishment of the new research field of transcultural psychiatry. Finally the paper provides a detailed history of the beginning of the section of transcultural psychiatry at the Allan Memorial Institute.
Citizen science at the roots and as the future of forensic genetic genealogy
Authors: Granja Rafaela
Published: March 2023

Forensic genetic genealogy is an emergent forensic technology that employs databases used by citizens to upload genetic data voluntarily to search for criminal suspects and/or unidentified individuals. Considering a wide view of the roots of forensic genetic genealogy, in this article, I draw on publicly available interviews with key stakeholders in the field, media articles, and companies’ statements to analyze how this technology is both grounded and based upon citizen science. That is, a type of science to which citizens actively, voluntarily, and consentingly contribute in various forms. On the one hand, I show how the emergence of forensic genetic genealogy is mainly based upon the work of individuals with a personal interest in genetic genealogy, who are heavily invested in constructing their own and others’ family trees. That is, citizens from various educational backgrounds and professional activities who became an untapped source of valuable expertise for forensic science because of their prolific experience in conducting genetic genealogy. On the other hand, I argue that the current situation of forensic genetic genealogy is also highly dependent on citizens’ interest and willingness to upload genetic data into publicly accessible genealogy databases and voluntarily deciding to make them available to law enforcement searches. Perceiving citizen science as being at the roots and as the future of forensic genetic genealogy has important implications for the forensic epistemic culture and the protection of citizens’ rights that must be considered in the development and implementation of such technology.
A systematic literature review of cognitive exchange in higher degree visual art education
Authors: Heaton Rebecca , Chan Lai Kuan Shannon
Published: March 2023

This literature review paper presents ways cognitive exchange occurs in higher degree visual art education. It also attempts to demystify concerns regarding the value and presence of cognitive exchange in art education, this is because cognitive exchange is not considered in art education with the same breadth or depth as in higher education. Cognitive exchange research in higher degree visual art education is limited but there has been a surge in interest about cognitive functioning in higher education. It is therefore timely to consider how cognitive exchange is understood across visual art practices at this level. This paper presents a two phased systematic review, where cognitive exchange literature in the higher degree context is considered alongside such literature in art education. Four spaces: the individual, social, pedagogic, and policy orientated are discussed to present cognitive exchange practices in higher degree visual art education. The spaces and forms of cognitive exchange profiled, provide a knowledge contribution to disciplines that intersect with the arts and humanities. This is because they mobilize where and how cognitive exchange forms, they present opportunities and uses for cognitive exchange and help suggest ways to support its growth.
Towards digital twins for heritage buildings: A workflow proposal
Authors: Noronha Pinto de Oliveira e Sousa Marcela , Correa Fabiano Rogerio
Published: March 2023

There has been a recent interest in the field of digital heritage to advance historic building information modeling (HBIM) towards digital twins (DT). This paper investigates the potential and limitations of HBIM use as DTs through a systematic mapping of literature (SML). The conclusions were applied in an incremental and low-code workflow to model historic buildings aiming at achieving a trade-off between a high degree of parametrization and a high degree of geometric accuracy. The proposed workflow is illustrated through a parametric script developed with visual programming in Grasshopper for Rhino 3D to model historic columns from profiles. VisualARQ for Rhino 3D is used to convert the script into a BIM object that uses profiles, automatically extracted from a point cloud acquired with 3D laser scanning, as an initial shape. This results in a simpler workflow to achieve more accurate HBIM models that could be leveraged in DT simulations.
The Close Relationship Between Metabolic Syndrome and Hormone Receptor-Positive Early-Stage Breast Cancer
Authors: Ozveren Ahmet , Ridvanogullari Donger Melis , Motor Sedat , Bulut Gulcan
Published: March 2023

Objective:

The primary aim of the current study was to investigate the frequency of metabolic syndrome (MS) in early-stage breast cancer patients. Additionally, clinicopathological factors, such as anthropometric measurements and hormonotherapy, were examined for their roles as potential confounders of MS in these patients.

Patients and Methods:

In this retrospective cross-sectional study, all patients diagnosed with early breast cancer were included. Patients were divided into 2 groups with respect to MS diagnosis. Peripheral blood samples were obtained, clinical data were recorded, and body mass index (BMI) was calculated.

Results:

The study was completed with a total of 207 patients of which 128 (61.8%) had MS. MS was more frequent hormone receptor positive subgroup and in recipients of adjuvant hormonotherapy. The comparison of patients with and without MS revealed significant differences in age, BMI and estrogen/progesterone receptor status. There were no significant differences between groups in terms of cancer stage, inflammatory markers, basal insulin and LDL levels, and tumor markers.

Conclusion:

MS appears to be rather widespread among women with early-stage breast cancer, and lifestyle changes, which can improve obesity-related adverse outcomes, should be more emphasized in clinical practice.
Risk Awareness and Demographic Characteristics Associated With the Use of Sexual Enhancement Supplements Among University Staff: A Cross-Sectional Study in the United Arab Emirates
Authors: Jairoun Ammar Abdulrahman , Saleh Al-Hemyari Sabaa , Shahwan Moyad , Saeed Balsam Qubais , Godman Brian , Kurdi Amanj , Zyoud Samer H. , Ibrahim Baharudin
Published: March 2023

Sexual enhancement supplements (SESs) that have illegal additions of pharmaceuticals or analogues pose a significant health risk, particularly with long-term usage. When supplements are adulterated with phosphodiesterase type 5 (PDE-5) inhibitors, dosages can vary widely and there may be an increase in adverse effects and drug–drug interactions which cannot be avoided. Consequently, there is a need to evaluate the public risk awareness toward SES and the associated adverse events as well as explore significant factors associated with knowledge and risk awareness. A cross-sectional community-based study was conducted among University male students and staff at Ajman University, United Arab Emirates (UAE), using a self-administered survey via a web-based electronic link to explore key issues. A total of 1,101 male subjects participated in the study and completed the questionnaire. Four hundred and thirty-three(39.3%) (95% confidence interval [CI]: 33.2–44.5) participants reported using SES products. Of these, 137 (31.6%) [95% CI: 28.6–37.2] experienced adverse effects from SES product use. SES use was more prevalent among participants aged 60 to 69 years (odds ratio [OR]: 2.94; 95% CI: 1.63–5.28), diabetic patients (OR: 2.61; 95% CI: 1.75–3.90), hypertension patients (OR: 2.12; 95% CI: 1.45–3.1), and those overweight or obese (OR: 1.84; 95% CI: 1.44–2.35). This study indicates that SES is a popular practice among the UAE university staff and students. However, there is a need to implement risk awareness programs to raise public awareness regarding SES use and safety. Regulatory bodies are encouraged to provide additional advice on the proper use and possible risks of consuming SES.
Effect of structural parameters and load states on PTRB’s load distribution
Authors: Zheng Shicheng , Fu Yongling , Wang Deyi , Liu Ziyu , Pan Junlin , Chen Juan
Published: March 2023

The planetary thread roller bearing (PTRB), as a new type of ball bearing, has the advantages of high-power density, no need to be used in pairs or combinations, and the ability to carry axial-radial combined load and bidirectional axial load. Its load distribution characteristics serve as the basis for building PTRB’s performance models, such as dynamic load rating, static load rating, and friction torque. In this paper, PTRB’s structure and the transmission paths of force were briefly introduced, and the elastic deformation of the threaded roller, inner ring, and outer ring was analyzed on the basis of the Hertz theory and Hooke’s law. Next, the methods for calculating the compressive deformation of shaft when PTRB was under different load states were presented. In view of the nonlinear relation between force and elastic deformation as well as the compatibility equation, the theoretical model of PTRB’s load distribution was set up accordingly. There was a discrepancy between the variation trends and values of load distribution under four axial load states, with a larger load distribution coefficient at the contact point closer to the flange. With the increase of load from 10 to 30 kN, the increase rates of the axial and radial load distribution coefficients were ≯1.2%, so that the load distribution coefficient could be approximately deemed as an inherent characteristic of PTRB. Within the value range of each structural parameter, the variation of the pitch diameter of threaded roller had the most significant effect on axial load distribution coefficient, with a variation rate of 7%; the variation of the number of threaded rollers had a significant effect on radial load distribution coefficient, with a variation rate of 37%; the variation of the remaining structural parameters had a minimal effect on load distribution coefficient, with a variation rate of ≯3%. When a follow-up optimization design is conducted on the performance of PTRB with a fixed dimension, and the contact angle, number of thread teeth per roller, and pitch diameter of threaded roller are deemed as design variables, the load distribution coefficient can be set as a constant value, and the number of threaded rollers can be set as the maximum value to simplify the optimization design process of PTRB’s performance and improve the optimization design efficiency.
Pareto front generation for integrated drive-train and structural optimisation of a robot manipulator conceptual design via NSGA-II
Authors: Gulec Musa Ozgun , Ertugrul Seniz
Published: March 2023

Due to the complexity of the process, there is no single solution for determining the motors, gearboxes and structures of a robot manipulator according to the desired dynamic performance while minimising both the deflections in the structure during the dynamic motion and total robot weight. The solution of this integrated drive-train and dynamic structural optimisation problem is generalised for three degrees of freedom (DOF) robot manipulator via Non-Dominated Sorting Genetic Algorithm II (NSGA-II) to obtain the Pareto front of any desired robot manipulator overall conceptual design, including motors, gearboxes and thicknesses of the links. A flexible body dynamic simulation model was created in the MATLAB Simmechanics environment. The flexible bodies were defined via lumped parameter estimation method, which allows observation of the deflections in links during the dynamic motion. A library containing technical data related to motors and gearboxes was created to be utilised in the optimisation algorithm. The method accelerates the time-consuming iterative process for obtaining optimum conceptual design solutions for a dynamic system and allows for easy modification of design parameters and constraints. It also makes the algorithm suitable for different types of dynamic system designs.
Professional support and re-entry preparedness among prisoners
Authors: Pasma Amanda J , Van Ginneken Esther , Palmen Hanneke , Nieuwbeerta Paul
Published: March 2023

Multiagency support is considered crucial in the successful resettlement of prisoners. Various prison-based and community-based professionals should each play a part in supporting prisoners through the gate regarding employment, housing, financial problems, healthcare or valid identification issues. Yet, little is known about the actual contribution of this support to a better perceived re-entry preparedness among prisoners. To examine the association between professional support and re-entry preparedness, the current study uses self-reported data from 1442 soon-to-be-released prisoners across 26 Dutch institutions. We include general satisfaction with support, and satisfaction with the specific instrumental support received, and compare prisoners who did and did not have reintegration needs prior to imprisonment. Support was positively related to re-entry preparedness for prisoners who had needs prior to imprisonment, and instrumental support from community-based professionals showed the most robust results. The implications and future recommendations are discussed.
Adherence to oral hormonal therapy in advanced prostate cancer: a scoping review
Authors: Fleshner Neil E. , Alibhai Shabbir M. H. , Connelly Kim A. , Martins Ilidio , Eigl Bernhard J. , Lukka Himu , Aprikian Armen
Published: March 2023

Background:

Orally administrated agents play a key role in the management of prostate cancer, providing a convenient and cost-effective treatment option for patients. However, they are also associated with adherence issues which can compromise therapeutic outcomes. This scoping review identifies and summarizes data on adherence to oral hormonal therapy in advanced prostate cancer and discusses associated factors and strategies for improving adherence.

Methods:

PubMed (inception to 27 January 2022) and conference databases (2020–2021) were searched to identify English language reports of real-world and clinical trial data on adherence to oral hormonal therapy in prostate cancer using the key search terms ‘prostate cancer’ AND ‘adherence’ AND ‘oral therapy’ OR respective aliases.

Results:

Most adherence outcome data were based on the use of androgen receptor pathway inhibitors in metastatic castration-resistant prostate cancer (mCRPC). Self-reported and observer-reported adherence data were used. The most common observer-reported measure, medication possession ratio, showed that the vast majority of patients were in possession of their medication, although proportion of days covered and persistence rates were considerably lower, raising the question whether patients were consistently receiving their treatment. Study follow-up for adherence was generally around 6 months up to 1 year. Studies also indicate that persistence may drop further with longer follow-up, especially in the non-mCRPC setting, which may be a concern when years of therapy are required.

Conclusions:

Oral hormonal therapy plays an important role in the treatment of advanced prostate cancer. Data on adherence to oral hormonal therapies in prostate cancer were generally of low quality, with high heterogeneity and inconsistent reporting across studies. Short study follow-up for adherence and focus on medication possession rates may further limit relevance of available data, especially in settings that require long-term treatment. Additional research is required to comprehensively assess adherence.
The EU’s foreign direct investment screening mechanism two years after implementation
Authors: Riela Stefano
Published: March 2023

Foreign direct investment (FDI) is widely welcomed as it can improve the standard of living in the recipient country. However, depending on the target sector and/or the nationality of the investor, FDI may pose a risk to national security; this is why some countries have adopted screening procedures. Since 2020 the European Commission has coordinated its member states in screening FDI, but not all EU members have national screening mechanisms in place. Moreover, those mechanisms that do exist are not homogenous, for example, in their identification of protected sectors. This incompleteness and heterogeneity are weaknesses that undermine the security of the EU due to the high level of integration within the single market.
The effect of fine-particle size and extrafine particle size inhaled corticosteroid in reducing airway resistance in asthmatic patients
Authors: Abdul Hamid Mohamed Faisal , Ahmad Asyraf , Mohamad Jailaini Mas Fazlin , Soelar Shahrul Aiman , Nik Abeed Nik Nuratiqah , Hau Ng Boon , Azmel Azat Azrai , Ban Andrea
Published: March 2023

Background

Bronchial asthma is characterised by chronic inflammation of both large and small airways. Extra-fine formulation of inhaled corticosteroid (ICS) can achieve a higher peripheral lung deposition leading to improved asthma control. We investigated the effect of extra-fine and fine particle size inhaled ICS with airway resistance and severity of symptoms in asthmatic patients.

Methods

Prospective interventional study of outpatient asthmatics in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Subjects were grouped based on pre-existing inhalers; extra-fine and fine inhaled corticosteroid (ICS)/long acting beta agonist (LABA). Crossover was at week 7 and treatment regime continued for 7 weeks. Subjects were assessed at week 0, 6 and 13 using asthma control test (ACT) score, forced expiratory volume in 1 s (FEV1) and impulse oscillometry (IOS) Inhaler technique was assessed periodically.

Results

Thirty-four subjects were recruited. Median asthma duration was 20 years. Twenty subjects (58%) in fine ICS/LABA and 14 (42%) in extra-fine ICS/LABA group. Thirty-one subjects were analysed before crossver. There was a significant improvement of FEV1 in the extra-fine ICS/LABA group (1.7 ± 0.47 to 1.88 ± 0.5; p = 0.01). ACT score reduced significantly in extra-fine ICS/LABA group (23 ± 5 to 21 ± 4; p = 0.04) at week 0–6. Week 7–13 showed a significant improvement of ACT score (16.5 ± 3 to 20 ± 3; p = 0.01) and FEV1 (1.71 ± 0.96 to 1.81 ± 1.02: p = 0.01) in extra-fine ICS/LABA. There was no significant difference in (IOS) parameters between the groups.

Conclusion

There was an improvement of FEV1 and ACT score with extra-fine ICS/LABA with no benefit in airway resistance.
Numerical study of a near-field explosion using arbitrary Lagrangian–Eulerian mapping technique
Authors: Hung Cheng-Wei , Tsai Ying-Kuan , Chien Li-Kai , Pi Sheng-Jung
Published: March 2023

This study adopted the LS-DYNA mapping algorithm to implement a numerical simulation of a near-surface burst and steel plate non-contact explosion experiments. The rationality and reliability of the mapping technique used in the numerical simulation were validated by a comparison between the experiments and the numerical simulation. The findings showed that the numerical simulation result was consistent with the experimental blast attenuation, meaning the numerical mapping technique could effectively enhance the simulation accuracy and could reflect the experimental blast wave propagation.
Vulvar lichen planus–induced vulvovaginal stenosis: A case report and review of the literature
Authors: Chow Meghan R , Gill Navjeet , Alzahrani Fatmah , Schuurmans S Nan , Dytoc Marlene T
Published: March 2023

The authors report a case of vulvar lichen planus–induced vulvovaginal stenosis along with a review of the current literature. The authors outline a case of a patient with biopsy-proven vulvar lichen planus who subsequently developed a vulvovaginal stenosis. Treatment was initiated with clobetasol ointment, oral prednisone, later transitioned to oral methotrexate and clobetasol, and then switched to acitretin. Collaboration with the patient’s family physician and the hypertension clinic has been sought to remove medications associated with lichenoid reactions from the patient’s regimen. Review of literature was conducted through Ovid MEDLINE. Only six cases of vulvar lichen planus–induced vulvovaginal stenosis had been found, suggesting the relative rarity of this severe disease presentation. The patient has achieved control with her current regimen, as well as some clinical improvement of the resulting vaginal stenosis. Vulvovaginal stenosis can be induced by vulvar lichen planus, and its management requires a multimodal and multidisciplinary approach.
Antecedents to Following Brands on Facebook and Instagram with Moderating Role of User Experience
Authors: Manzoor Amir
Published: March 2023

This study empirically examines the antecedents to users’ intention to follow brands on the two most popular social media platforms, that is, Facebook and Instagram. Using the existing body of knowledge, a conceptual model was developed. Users appear to follow brands on Facebook and Instagram for different gratifications. The findings show that consumers who utilize social media platforms to follow brands perceive their usage as convenient and fruitful. Second, social circle pressure has a great impact on users in social media engagement with brands. Lastly, advertisers should design social media campaigns that provide value to consumers.
Paper 02: Is There a Benefit of Sling Immobilization After Open Latarjet Surgery for Anterior Shoulder Instability™ A Randomized Control Trial
Authors: Goetti Patrick , Martinho Tiago , Bothorel Hugo , Lädermann Alexandre
Published: March 2023

Objectives:

Recurrent traumatic anterior shoulder instability occurs most commonly in young to middle-aged male athletes. The Latarjet procedure was reported to enable early return to sport compared to capsulolabral repair. Recent research has highlighted the negative effect of immobilization on shoulder rehabilitation. However, only few studies evaluated different rehabilitation programs after open Latarjet and their potential impact on complication rates, stiffness and time to return to sport. The reported immobilization periods ranged from zero to three weeks, and different types of mobilization protocols were used. The aim of this study was to evaluate the benefit of sling immobilization after open Latarjet procedure for anterior shoulder instability. The hypothesis was that immediate self-rehabilitation without sling immobilization would result in improved functional scores at 6 months compared to patient wearing a sling for 3 weeks postoperatively.

Methods:

We randomized 72 patients with anterior shoulder instability scheduled for open Latarjet procedure into sling and no-sling groups. Two partially 1 cm apart threaded 4.0-mm cancellous screws were used to secure the graft. Both groups started the same immediate self-rehabilitation protocol. Patients were evaluated clinically using Rowe score, the Single Assessment Numeric Evaluation (SANE) instability score as well as visual analogue pain scale (VAS) preoperatively and at 1.5, 3, and 6 months. A computed tomography was performed at 6 months to evaluate graft healing.

Results:

Both groups had similar preoperative patient characteristics. Both groups had a significant improvement in Rowe score (from 38.8 ± 20.4 to 81.6 ± 17.8, p < 0.001), SANE instability score (from 42.5 ± 20.5 to 84.7 ± 13.2, p < 0.001) and VAS (from 27.7 ± 21.8 to 13.9 ± 16.1, p < 0.001) at 6 months postoperative. There was no difference in functional outcomes between the two groups at 6 months. Mean Rowe score was respectively 80.7 ± 15.9 and 82.6 ± 19.6 in the sling and no-sling group (p = 0.64). Mean SANE instability score was 83.7 ± 13.0 and 85.7 ± 13.6 (p = 0.53) and mean VAS 15.6 ± 14.8 versus 12.2 ± 17.5 (p = 0.38), for sling and no-sling group respectively. Finally, computed tomography evaluation revealed no significant differences regarding bone graft healing between both groups (p = 0.35).

Conclusions:

Both treatment groups resulted in excellent early functional outcomes. Absence of sling immobilization did not increase complication rates after open Latarjet. Sling immobilization seems therefore optional after open Latarjet procedure.
Paper 23: Outcomes Following Arthroscopic Removal of A Posteromedial Osteophyte and Risk of Future Ulnar Collateral Ligament Reconstruction
Authors: Paul Ryan , Zareef Usman , Hall Anya , Lencer Adam , Ciccotti Michael , Cohen Steven , Tjoumakaris Fotios , Thomas Stephen , Erickson Brandon
Published: March 2023

Objectives:

Despite successful return to sport (RTS) outcomes after posteromedial osteophyte resection, one possible consequence of removing this osteophyte is increased stress on the ulnar collateral ligament (UCL), leading to a UCL injury. It is currently unknown how often overhead athletes who have an isolated posteromedial osteophyte resection progress to require UCL reconstruction (UCLR). Therefore, the purpose of this study was to report outcomes following arthroscopic resection of posteromedial osteophyte in overhead athletes and determine if baseball pitchers who underwent arthroscopic posteromedial osteophyte resection for posteromedial impingement went on to require UCL surgery.

Methods:

All patients who underwent elbow arthroscopy from 2010-2020 were reviewed. Patients were included if they underwent isolated arthroscopic posteromedial osteophyte resection without concomitant UCL surgery, were overhead athletes at the onset of posteromedial impingement symptoms and had no history of prior elbow surgery. Primary outcomes included RTS rate, complications, subsequent shoulder and elbow injury/surgery and several patient-reported outcome measures (Kerlan-Jobe Orthopaedic Clinic score, Timmerman-Andrews Elbow score, Conway-Jobe score).

Results:

Overall, 36 overhead athletes were evaluated at 5.1 years post-operatively, including 28 baseball pitchers, 3 baseball catchers, 3 softball players, 1 tennis player, and 1 volleyball player. 77% of overhead athletes RTS and had a mean KJOC score of 70, with 89% of athletes having either an excellent (73%) or good (16%) Conway-Jobe score at long-term follow-up. Subsequent UCLR was required in 18% (n=5) of baseball pitchers at a median of 13 months post-op. Three of the five UCLR were performed shortly after posteromedial osteophyte resection (6, 7, and 13 months post-op), while the other two UCLRs were performed at 6.2 and 7.5 years post-op.

Conclusions:

Following arthroscopic posteromedial osteophyte resection, 77% of athletes were able to RTS. Baseball pitchers who undergo arthroscopic posteromedial osteophyte resection have an 18% risk of subsequent UCLR.
Paper 24: Osteochondritis Dissecans of the Capitellum of the Elbow: A Comparison of Non-Operative and Surgical Outcomes at Long-Term Follow-up
Authors: Braig Zachary , Uvodich Mason , Till Sara , Reinholz Anna , Morrey Mark , Sanchez-Sotelo Joaquin , O’Driscoll Shawn , Camp Christopher
Published: March 2023

Objectives:

Osteochondritis dissecans (OCD) of the humeral capitellum is an often painful condition that typically affects the adolescent athlete. There is little consensus on treatment and a scarcity of long-term outcomes data. The purpose of this study was to (1) report the long-term outcomes associated with both operative and non-operative management of capitellar OCD, (2) identify factors associated with failure of non-operative management, and (3) determine whether delay in surgery affects final outcomes.

Methods:

All patients diagnosed with OCD of the capitellum from 1995-2020 within a defined geographic cohort were included. Medical records, imaging studies, and operative reports were manually reviewed to record demographic data, treatment strategies, and outcomes. Surgical treatment was considered delayed if it occurred more than 6 months after symptom onset.

Results:

A total of 50 elbows with a mean follow-up of 9.4 years were included. Of these, 7 (14%) were treated non-operatively and never underwent surgery during follow-up, while 43 (86%) underwent surgical intervention: 27 had early surgery and 16 underwent delayed surgery after ≥ 6 months of non-operative treatment. When compared to non-operative management, surgical management resulted in superior MEPI scores (90 vs 83, p=0.05), decreased persistence of mechanical symptoms (9% vs 50%, p<0.01), and better elbow flexion (141° vs 131°, p=0.01) at long-term follow up. Older patients had a trend toward increased failure of non-operative management (p=0.06). The presence of an intra-articular loose body strongly predicted failure of non-operative management (p=0.01; OR 13). Plain radiography and MRI had poor sensitivities for identifying loose bodies (27% and 40%, respectively). Differences in outcomes following early versus delayed surgical management were not demonstrated.

Conclusions:

Patients with capitellar OCD initially treated nonoperatively failed nonoperative management 70% of the time. Elbows that did not undergo surgery had slightly increased symptoms and decreased functional outcomes compared to those treated surgically. In this cohort, the greatest predictors for failure of non-operative treatment were older age and presence of a loose body; however, an initial trial of non-operative treatment did not adversely impact the success of future surgery at long term follow-up. [Table: see text][Table: see text][Table: see text][Table: see text]