bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of diffusion of plant metabolites from polyethylene glycol hydrogels using free volume theory
Authors: Natesan Pooja Vardhini , Banerjee Shib Sundar , Arunachalakasi Arockiarajan , Swaminathan Ramakrishnan
Published: March 2023

The present work aims to comprehensively analyze the diffusion of plant metabolites from the polyethylene glycol (PEG) hydrogels for controlled release applications. For this study, a mathematical model based on free volume theory has been utilized to simulate the diffusion of low molecular weight plant metabolites. The results demonstrate that the mesh size of the crosslinked network, thereby the diffusion coefficient of the natural compound can be computed using the current framework. The proposed model has also been validated using the experimental data. The diffusion period has been observed to vary within a wide range of 3.42 h for Cinnamaldehyde to 49.25 h for Grandinin. An empirical parametric relationship between the diffusion time and molecular weight of both the hydrogels and natural compounds is established. It appears that the reported modeling approach will be clinically useful for improving the design of the sustained drug delivery systems.
Adventure-Based Cognitive Behavioral Intervention for Hong Kong University Students: A Randomized Controlled Study
Authors: Pan Jia-Yan , Zhuang Xiaoyu
Published: March 2023

Purpose: This study developed and evaluated an adventure-based cognitive behavioral intervention (aCBI) program to respond to the higher education mental health crisis in Hong Kong. Methods: The aCBI program was delivered in the form of a 13-week general education (GE) course and was evaluated at pre-, post-, and 3-month follow-up. A total of 544 undergraduate students who experienced psychological distress were randomized to either the aCBI group (n = 197) or the wait-list control group (WLC) (n = 347). Results: Compared with their WLC counterparts, the aCBI participants showed significantly stronger improvements in psychological distress, perceived stress, positive and negative emotions, and resilience at the posttest and 3-month follow-up. Positive and negative thoughts and sense-making coping partially mediated the treatment effects of aCBI. Conclusions: The aCBI program shows promise for inclusion in higher education curriculums to bridge the mental health service gaps for Chinese university students.
Becoming Experts in Their Own Treatment: Child and Caregiver Engagement With Burn Scar Treatments
Authors: Killey Jessica , Simons Megan , Prescott Sarah , Kimble Roy , Tyack Zephanie
Published: March 2023

Children who experience a severe burn injury not only require acute medical care but may also need ongoing rehabilitation. To mitigate the potential long-term consequences of scarring and the impact of scarring on their everyday lives, children may be expected to use a variety of time-consuming and multi-component non-invasive scar treatments (such as pressure garments and silicone gels). These treatments may pose unique challenges for children and their caregivers. With limited research previously addressing how Australian children navigate the use of scar treatments at home, this study aimed to develop a grounded theory of children and their caregivers’ engagement with non-invasive burn scar treatments. Using a constructivist grounded theory approach, interviews were completed with 20 caregivers and 7 children, and a theory of children and their caregivers becoming experts in the use of non-invasive burn scar treatments was developed. Through persistence and flexibility, they continued to develop expertise. Engaging with scar treatments was an evolving process over time for children with burns and their caregivers. Theoretical categories identified included ‘making it work’, ‘finding the balance’ and ‘seeking reassurance’ and highlighted the remarkable strengths and adaptability of children and their caregivers. Through trial and error, children and their caregivers developed their own unique strategies for engaging with scar treatments. These insightful results may inform the development of interventions to support children and their caregivers’ day-to-day engagement with non-invasive burn scar treatments and guide health professionals recommending these treatments.
A Configurational Approach to Investigating the Relationship Between Organizational Culture and Organizational Effectiveness Using Fuzzy-Set Analysis
Authors: Puppatz Martin , Wang Mo , Deller Jürgen
Published: March 2023

The theoretical literature on organizational culture strongly emphasizes the multifacetedness of the construct. Nevertheless, empirical research has tended to focus on independent culture dimensions rather than applying a holistic perspective that conceives organizational culture as a complex collective. We addressed this issue by investigating configurations of organizational culture using fuzzy set qualitative comparative analysis (fsQCA) within organizational units of two organizations. Across the two samples (1170 employees in 89 work units of a financial service provider and 998 employees in 49 work units of a fashion retailer), results indicated that culture dimensions do not operate in isolation, but jointly work together in achieving different effectiveness outcomes. The results further suggested that several cultural configurations can be equally effective in reaching the same outcome, and that a clan culture is most relevant for achieving low employee turnover, while a market-oriented culture is most relevant for achieving financial effectiveness. With respect to more specific configurations of cultural elements, the results showed some congruencies, but were mixed overall. The discussion focuses on theoretical implications and future directions for applying configurational, set-theoretic approaches to analyzing organizational culture.
Reverse four-throw technique for pupilloplasty
Authors: Narang Rhea , Narang Priya
Published: March 2023

Purpose

To describe Reverse four-throw (RFT) technique for pupilloplasty.

Methods

The technique involves making a single pass through the anterior chamber that helps achieve a posteriorly directed suture knot. A single arm 9-0 polypropylene suture attached to long arm needle engages the iris defects with the tip of the needle piercing the iris tissue from the posterior surface and emerging from the anterior aspect. The suture end is passed from the loop with four throws taken consecutively in the same direction that create a self-sealing and self-retaining lock like single-pass four-throw technique but with the difference that the knot slides on the posterior surface of the iris tissue.

Results

The technique was performed in 9 eyes and the suture-loop easily slided along the posterior surface of iris tissue. The iris defect was well approximated in all the cases and the suture knot or suture tail was not visible in the anterior chamber. Anterior segment optical coherence tomography depicted smooth iris configuration with no suture extrusion in the anterior chamber.

Conclusions

The RFT technique provides an effective measure to seal the iris defect with the absence of knot in AC.
Performance of McDonald 2017 multiple sclerosis diagnostic criteria and evaluation of genetic ancestry in patients with a first demyelinating event in Argentina
Authors: Marrodan Mariano , Piedrabuena Maria Agustina , Gaitan Maria Ines , Fiol Marcela P , Ysrraelit Maria Celica , Carnero Contentti Edgar , Lopez Pablo Adrian , Peuchot Veronica , Correale Jorge
Published: March 2023

Background:

Information on performance of multiple sclerosis (MS) diagnostic criteria is scarce for populations from Latin America, Asia, or the Caribbean.

Objective:

To assess performance of revised 2017 McDonald criteria as well as evaluate genetic ancestry in a group of MS patients from Argentina experiencing a debut demyelinating event.

Methods:

Demographic and clinical characteristics, cerebrospinal fluid (CSF), and magnetic resonance imaging (MRI) findings and new T2 lesions were recorded at baseline and during relapses. Diagnostic accuracy in predicting conversion to clinically defined MS (CDMS) based on initial imaging applying revised 2017 criteria was evaluated and genetic ancestry-informative markers analyzed.

Results:

Of 201 patients experiencing their first demyelinating event (median follow-up 60 months), CDMS was confirmed in 67. We found 2017 diagnostic criteria were more sensitive (84% vs 67%) and less specific (14% vs 33%) than 2010 criteria, especially in a group of patients revised separately, presenting positive oligoclonal bands (88% vs 8%). Genetic testing performed in 128 cases showed 72% of patients were of European ancestry and 27% presented genetic admixture.

Conclusion:

2017 McDonald criteria showed higher sensitivity and lower specificity compared with 2010 criteria, shortening both time-to-diagnosis and time-to-treatment implementation.
‘I cringe at the slave portions’: How fans of Gone with the Wind negotiate anti-racist criticism
Authors: van den Haak Marcel , Plate Liedeke , Bick Selina
Published: March 2023

In recent years an increasing number of cultural products have come under fire for moral or political reasons, such as racist or sexist content, in the mainstream (White) public sphere. An outstanding example is the classic 1939 film Gone with the Wind ( GWTW), which is loved by many but also strongly criticised for glorifying the American Antebellum South and ignoring the inhumanity of slavery. This case study explores how fans of the film (and the novel on which it was based) negotiate their appreciation of GWTW and these controversial issues. Using an open-ended survey and follow-up interviews, we explore two dominant narratives among the film's predominantly White fans: one that fiercely defends the film against criticism and one that expresses increased feelings of ambivalence and awkwardness. Thus, we add a more self-reflective and dynamic approach to scholarship on cultural taste, audience reception, and fan studies.
Investigating the efficacy of prescribed labeling practices: Conceptualizing persons with disabilities
Authors: Granata Nicolette , Lane Jonathan D.
Published: March 2023

Advocates for the use of specific labels to describe persons with disabilities presume that these labels fundamentally shape lay conceptions of persons with disabilities, and are thus critical targets for intervention. In two studies ( N = 285) we test this presumption, by presenting participants with descriptions of persons with disabilities that use either person-first labels or condition-first labels; disability diagnoses were either made at birth or during the teenage years. For each description, participants judged how essential (consistent, deeply-rooted, broadly-ramifying) physical, sensory, or cognitive disability symptoms (Study 1) or diagnoses (Study 2) are to that person. Across both studies, participants judged disabilities to be equally essential to persons regardless of how they were labeled; this was robust whether diagnoses were made earlier or later in life. Although there may be other points of influence, these labels, which are primary targets of advocacy groups, do not seem to influence psychological essentialism of disabilities.
Inverting resolution: accounting for the planetary cost of earth observation
Authors: Cornford Stephen
Published: March 2023

This article uses the resolutional relationship between digital image and planetary surface in satellite remote sensing as a lens through which to view the reliance of visual culture on mineral resources. While most studies of resolution in satellite imaging have focused on visibility and invisibility, the author argues that the equivalence between pictorial and geographic space in its cm/pixel specification offers an opportunity to consider the physical relationship between the two. The proposed inversion enables the satellite and its transmitted images to be understood as contingent upon an unsustainably extractive industrial model. The article then traces the material trajectory in geophysical prospecting applications of remote sensing, identifying a recursive loop in which images are used to produce minerals that are used to produce images. The potential geopolitical impact of this circularity is then assessed with regard to an example of future remote sensing emissions governance.

In this, and many other climate-critical applications, remote sensing potentially plays a vital role, yet its instrumental gaze tends to shape the earth as an informational resource whose mineral reserves should be capitalized upon. Ultimately, the author’s aim is not to denounce earth observation as ecologically untenable, but to propose that we find a measure with which to assess the planetary impact of the various aspects of industrialized visual culture. Conceiving of resolution not as a measure of pictorial space but of the terrestrial cost of producing, consuming, distributing and permanently storing digital images might enable a more relational understanding of image and ground, pixels and planet. Accounting for the inverse resolution of an image could bring the deep temporal costs of digital visual culture into focus.
A hands-on guide to conducting field experiments using mobile applications
Authors: Khenfer Jamel
Published: March 2023

Researchers must increasingly account for growing expectations from scientific journals to infuse their work with real-world significance through field experiments. However, field experiments often require researchers to have access to substantial resources or a network that includes nonacademic partners willing to provide those resources. This article aims at overcoming those barriers by providing researchers with the tools they need to conduct randomized field experiments delivered to participants through mobile applications, given limited resources. The method presented herein takes advantage of the facilitated access to user data made possible by computing and development platforms such as Google’s Firebase. While the programming tools required to collect and analyze the data may feel intimidating, this article provides step-by-step instructions and illustrates the procedure with a case study experiment.
Hindcast of oil spill pollution in the East China Sea in January 2018
Authors: Nguyen Thi-Hong-Hanh , Hou Tien-Hung , Pham Hai-An , Tsai Chia-Cheng
Published: March 2023

In this study, an integrated model is developed for studying the Sanchi oil spill event, which occurred in the East China Sea in January 2018. The results of the Advanced Research Weather Research and Forecasting model (WRF-ARW) as well as the Princeton Ocean Model (POM) are used for meteorological forecasting and the hydrodynamic simulations, respectively. These data are adopted as inputs for the OpenOil, a sub-module of OpenDrift, for the oil spill model. Some reference experiments are examined for short-term hindcast. The satellite image is used to validate the numerical result. The oil slicks of the satellite image and the numerical result are of similar shapes. Quantitatively, the simulated oil slick and that from the satellite image are located closely and have similar dimensions of 56 km by 34 km and 54 km by 29 km, respectively. It is found that the accurate results can be obtained by the proposed integrated model with the high-frequency (hourly) and high-spatial-resolution data as inputs, and the wind drift factor has to be added. The long-term 1-month simulation showed that most of the oil particles would move to the northeast of the sinking location and be trapped by the Kuroshio current.
CDMTNet: a novel transfer learning model for the loosening detection of mechanical structures with threaded fasteners
Authors: Huang Jiayu , Liu Jianhua , Gong Honghui , Gong Hao , Deng Xinjian
Published: March 2023

In mechanical systems, various threaded fasteners are widely used to connect separated components. Loosening occurs frequently due to exposure to harsh working environments, especially vibration environments. Loosening detection can eliminate hidden dangers in advance, and its importance cannot be overemphasized. Ultrasonic detection methods based on machine learning have become popular. However, a proposed machine learning model in a published paper is only suitable for a specific mechanical structure with threaded fasteners; the generality of this type of model is poor. In addition, existing models are well-trained based on abundant labeled data. The labeled data are commonly sparse in practical engineering applications, and it is labor-consuming to obtain these data. This paper presents the creation of a generalized detection model suitable for different threaded connection structures based on transfer learning and the exploitation of a small amount of labeled data for model training and accurate loosening detection. A transfer learning network named the cross-domain matching-mix transfer network (CDMTNet) suitable for different mechanical structures was proposed to transfer the knowledge in a source structure to a target structure. The CDMTNet consists of a feature extraction module, a feature disentangling module, and a classification module. The matching-mix method for data augmentation was proposed to finely train the CDMTNet by exploiting only a small amount of labeled data in the target structure. Two different mechanical structures with threaded fasteners (i.e., a lap joint and a globe-cone joint) were tested in the experiment. Their detection accuracies were both greater than 0.8. The results indicated that our method had wide application potential in engineering.
A novel time domain-based multiple breathing crack diagnosis technique using Quadratic-Teager Kaiser Energy (Q-TKE)
Authors: Prawin J.
Published: March 2023

This paper presents a generalized time domain-based multiple breathing crack localization technique in beams with an unknown number of cracks based on Quadratic-Teager Kaiser Energy (Q-TKE) using vibration data. Localization of multiple breathing cracks is a highly challenging inverse problem, as all these breathing cracks (more than two) might be in a similar state (either opening or closing state) at any particular time instant or in contrasting states (while some breathing cracks are opening, others are in closing state) during vibration. The level of nonlinearity of vibration response is strongly dependent not only on each crack size and location but also on the application of driving force along the cracked beam. The concept of varied input frequency excitation sources is employed in the present work for multiple breathing crack identification over the tedious traditional approach of varying input force application positions. The major advantage of using Q-TKE in the present work is that it can reliably isolate and extract the very low-amplitude nonlinear sensitive components (superharmonics and intermodulation) being buried in the total response and enhance them in the time domain signal itself. Investigations have been carried out by varying the number, spatial locations, and also intensities of the breathing cracks. Sensitivities associated with measurement noise and also with limited sensors is also investigated. The results of both numerical and experimental investigations carried out in this paper concluded that the proposed Q-TKE can effectively localize closely spaced or sparsely spaced (i.e., spatially far apart) multiple cracks in the beam. The proposed Q-TKE approach is data-driven, works with limited sensors, and does not need reference healthy state measurements.
Fibrin Glue Sac Filling for Preventing Type II Endoleak, Short-Term Outcomes of a Prospective Randomized Controlled Trial
Authors: Chen Yonghui , Zhang Lei , Liu Zongwei , Bi Jiaxue , Niu Fang , Zhang Xiaoxing , Lu Qingsheng , Dai Xiangchen
Published: March 2023

Objective:

Type II endoleak (T2EL) worsens the long-term results of endovascular aneurysm repair (EVAR). How to prevent T2ELs remains controversial. This study aimed to evaluate the efficacy and safety of fibrin glue sac filling (FGSF) to prevent T2ELs after EVAR.

Methods:

A prospective randomized controlled trial was conducted. Patients were randomly divided into group A (standard EVAR + FGSF) and group B (standard EVAR). The follow-up plans included outpatient or telephone consultation at 1 and 3 months and computed tomography (CT) angiography at 6 months, 1 year, and once a year after EVAR.

Results:

A total of 64 abdominal aortic aneurysm (AAA) patients were randomized to the 2 groups. All patients were followed up for more than 6 months. The 2 groups showed similar baseline characteristics. The rate of T2ELs on immediate angiography in group A (9.6%) was significantly lower than that in group B (33.3%, p=0.033). Moreover, the sac area change was significantly reduced in group A at 6 months after EVAR (p=0.021). However, T2EL incidence was similar at the 6-month (p=0.055) and 1-year (p=0.057) follow-ups, and AAA diameter change was also similar at 1 year. There were similar operation times, radiation doses, severe adverse events (SAEs), and reinterventions between the 2 groups.

Conclusion:

Fibrin glue sac filling could prevent short-term type II endoleaks and promote AAA shrinkage after 6 months. The FGSF procedure is swift and straightforward; however, patients are at risk of bowel ischemia, especially after previous bowel resections or concomitant superior mesenteric artery (SMA) disease.

Clinical Impact

Standard endovascular aneurysm repair (EVAR) couldn’t prevent type II endoleak (T2EL). In this study, we found fibrin glue sac filling (FGSF) could prevent T2EL and promote AAA shrinkage in a short term. And the FGSF procedure is easy, it will be a useful supplement to standard EVAR for clinicians. And FGSF might have potential usefulness on ruptured aneurysms, although without direct evidence.Fibrin glue is often used to hemostasis and tissue adhesion in surgical patients and burn patients, we firstly carry out a randomized controlled study and prove that fibrin glue sac filling could prevent T2EL and promote sac remodeling.
A Nominal Group Technique Study of Patients Who Identify as Black or African American and Access to Renal Transplantation
Authors: Nonterah Camilla W. , Utsey Shawn O. , Gupta Gaurav , Wilkins Sawyer , Gardiner Heather M.
Published: March 2023

Introduction: Completion of the renal transplant evaluation has been associated with several barriers for patients who identify as Black or African American. This study sought to prioritize barriers to and motivators of completing the renal transplant evaluation. Methods/Approach: Semi-structured interviews and focus groups with a nominal group technique were used to generate priority scores. Transplant professionals (N = 23) were recruited from 9 transplant centers in the Mid-Atlantic, Mid-Western, and Southeastern parts of the United States. Black or African American identifying renal patients (N = 30) diagnosed with end-stage kidney disease were recruited from 1 transplant center in the Mid-Atlantic region. Findings: Priority scores were created to assess the quantitative data of participant rankings of top barriers and motivators. The most significant barriers identified by both patients and transplant professionals comprised financial constraints, insurance issues, difficulty navigating the healthcare system, transportation difficulties, and multiple health problems. Facilitators consisted of family/social support, transplant education, patient navigators, comprehensive insurance, and physician repertoire and investment. A qualitative description of the ranked factors resulted in themes classified as intrapersonal, health, socioeconomic, transplant-specific healthcare, and general healthcare. Conclusion: These findings provided vital information to transplant centers nationwide about assessing the influences of renal transplant evaluation completion. Achieving equity in access to transplantation for Black or African American renal patients requires multilayered approaches.
Cancer Stem Cell and Hepatic Stellate Cells in Hepatocellular Carcinoma
Authors: Quiroz Reyes Adriana G. , Lozano Sepulveda Sonia A. , Martinez-Acuña Natalia , Islas Jose F. , Gonzalez Paulina Delgado , Heredia Torres Tania Guadalupe , Perez Jorge Roacho , Garza Treviño Elsa N.
Published: March 2023

Hepatocellular carcinoma (HCC) is the most common liver cancer. It is highly lethal and has high recurrence. Death among HCC patients occur mainly due to tumor progression, recurrence, metastasis, and chemoresistance. Cancer stem cells (CSCs) are cell subpopulations within the tumor that promote invasion, recurrence, metastasis, and drug resistance. Hepatic stellate cells (HSCs) are important components of the tumor microenvironment (TME) responsible for primary secretory ECM proteins during liver injury and inflammation. These cells promote fibrogenesis, infiltrate the tumor stroma, and contribute to HCC development. Interactions between HSC and CSC and their microenvironment help promote carcinogenesis through different mechanisms. This review summarizes the roles of CSCs and HSCs in establishing the TME in primary liver tumors and describes their involvement in HCC chemoresistance.
Protocols to Prevent Transmission of the Hantavirus Pulmonary Syndrome: Three Case Studies
Authors: Martinez-Kilgore Jo Anne
Published: March 2023

The goal of the paper is to explain the risk posed by rodent contaminated materials and environments to cultural heritage professionals, to provide sound information from professional literature and reputable sources, to offer standardized protocols gleaned from these sources, and to view the protocols through case studies from three projects. By spelling out the affinity that rodents have for historic sites, museum collections, archives holdings, records repositories, library collections, and cultural heritage infrastructure it will be clear the risk is paramount. By making clear the widespread habitat of rodents that can spread viruses the case is made for wide adoption of protocols. Diverse professionals, working in conservation and allied fields, can utilize information in this paper as a starting point in planning projects to assess, handle, and treat rodent impacted items, storage areas, and sites.
Multi-objective optimization of the hollow shaft direct drive motor
Authors: Wang Zhaoguo , Gong Jingyu , Liu Bei
Published: March 2023

Surface permanent magnet synchronous motor (SPMSM) is widely used in low-speed and high torque permanent magnet synchronous motor. A multi-objective optimization method of hollow shaft direct drive motor (HSDDM) for double direct drive feed system (DDFS) is proposed in this paper. Several dimensions of HSDDM are considered in the proposed design procedure including pole embrace, thickness of magnet, eccentric distance, and air gap length. A multi-objective optimization model is established to minimize cogging torque, maximize efficiency, and minimize the magnet weight. The Optimized Latin hypercube sampling (OLHS) is used to design the experimental samples, and the sampling results are calculated by the finite element method (FEM). The Kring approximate model is established according to the sampling results. Based on the established approximate model, NSGA II multi-objective genetic algorithm is used to optimize the HSDDM. Compared with that before optimization, the efficiency after optimization is increased by 4.08%, the cogging torque is reduced by 86.78%, and the magnet weight is reduced by 20.24%. Eventually, the integration of NSGA-II and FEM provides an effective approach to obtain the optimal design of HSDDM.
Barrymore's Gun: Gender and Genre Potential in The Blood Red Knight (1810)
Authors: Johnson Daniel
Published: March 2023

This article closely examines William Barrymore's equestrian melodrama The Blood Red Knight; or, The Fatal Bridge (1810). While the play uses a vague medievalist setting, such associative conventions to the medieval romance are upended when the play's heroine shoots and kills the villain during the knight's mounted battle. While contemporary reviewers and theatre historians today have been largely fascinated by the use of live horses on stage, the gunshot makes The Blood Red Knight an outlier worthy of further study. I argue that the firing of Barrymore's gun creates a moment of disruptive potentiality where melodrama's complex and ambivalent politics are negotiated before the audience witnessing the play's concluding spectacle. In this largely overlooked moment, histories of gender and violence as well as romantic convention are disrupted, demonstrating the radical potential available to melodrama during its early stages of development.
Volumetric differences of thalamic nuclei in children with trisomy 21
Authors: Wagner Matthias W , Bernhard Nirit , Mndebele Gopolang , Vidarsson Logi , Ertl-Wagner Birgit B
Published: March 2023

Objectives

Histological studies have shown alterations of thalamic nuclei in patients with Down syndrome (DS). The correlation of these changes on MRI (magnetic resonance imaging) is unclear. Therefore, this study investigates volumetric differences of thalamic nuclei in children with DS compared to controls.

Methods

Patients were retrospectively identified between 01/2000 and 10/2021. Patient inclusion criteria were: (1) 0–18 years of age, (2) diagnosis of DS, and (3) availability of a brain MRI without parenchymal injury and a non-motion-degraded volumetric T1-weighted sequence. Whole thalamus and thalamic nuclei ( n = 25) volumes were analyzed bilaterally relative to the total brain volume (TBV). Two-sided t-tests were used to evaluate differences between groups. Differences were considered significant if the adjusted p-value was <0.05 after correction for multiple hypothesis testing using the Holm-Bonferroni method.

Results

21 children with DS (11 females, 52.4%, mean age: 8.6 ± 4.3 years) and 63 age- and sex-matched controls (32 females, 50.8%, 8.6 ± 4.3 years) were studied using automated volumetric segmentation. Significantly smaller ratios were found for nine thalamic nuclei and the whole thalamus on the right and five thalamic nuclei on the left. TBV was significantly smaller in patients with DS ( p < 0.001). No significant differences were found between the groups for age and sex.

Conclusions

In this exploratory volumetric analysis of the thalamus and thalamic nuclei, we observed statistically significant volumetric changes in children with DS. Our findings confirm prior neuroimaging and histological studies and extend the range of involved thalamic nuclei in pediatric DS.
A de novo chromosome 9p duplication in a female child with short stature and developmental delay
Authors: Tkemaladze Tinatin , Bregvadze Kakha , Papiashvili Nikoloz , Gagua Sopio , Abzianidze Elene
Published: March 2023

Chromosome 9p duplication, also known as a partial trisomy 9p, is a rare chromosome abnormality due to a duplication of the partial short arm of chromosome 9. More than 200 cases are reported in the literature. Major clinical findings include short stature, developmental delay, intellectual disability, and characteristic facial dysmorphic features. The most common origin of this syndrome is malsegregation of a parental reciprocal translocation. Only about 25 cases are reported as de novo in the literature, the rest being inherited from asymptomatic balanced carrier parents. We report an additional new case of de novo partial trisomy 9p in an 8-year-old girl, and describe her clinical manifestations and diagnostic testing results.
Reuse of the paramedian forehead flap pedicle: A case report
Authors: Immaneni Supriya , Harvey David T , Delgado Francisco
Published: March 2023

The paramedian forehead flap is an axial flap which utilizes vascular support from the supratrochlear artery to repair extensive nasal defects. Adverse outcomes including flap necrosis, infection, alar rim pull, and poor cosmesis can be seen with this flap. We report an 85-year-old woman with chronic obstructive pulmonary disease who underwent a staged paramedian forehead flap repair with a cartilage inlay complicated by moderate left alar rim necrosis and pedicle notching. In this patient, we were able to salvage the original pedicle and reposition it to achieve a satisfactory functional and cosmetic outcome.
Budd-Chiari syndrome and extensive inferior vena cava thrombosis treated with sequential interventional radiology and transjugular intrahepatic portosystemic shunting: A case report from Kenya
Authors: Kuka Werimo Pascal , Nduati Paul Kareithi , Mwirigi Anne , Opio Christopher K
Published: March 2023

Budd-Chiari syndrome is a rare disease characterized by the obstruction of hepatic venous outflow. Stepwise treatment options aimed to relieve obstruction and prevent complications of Budd-Chiari syndrome are medical therapy, interventional recanalization, and surgery. Aggressive interventions for complicated Budd-Chiari syndrome are placement of a transjugular intrahepatic portosystemic shunt, surgical shunting, or liver transplantation. Although literature suggests differences in the presentation and management between Europe and Asia, cases documenting successful use of stepwise management of Budd-Chiari syndrome in Sub-Saharan Africa are scarce. A 47-year-old male on treatment for chronic hepatitis B presented with abdominal pain and distension for 2 weeks and findings of gross ascites without stigmata of chronic liver disease. Laboratory investigations performed showed anemia, elevated transaminases, coagulopathy, and renal dysfunction. Abdominal ultrasound and computed tomography abdominal scan revealed filling defects in intrahepatic veins and inferior vena cava extending to bilateral renal and external iliac veins. Extensive workup for thrombophilia and myeloproliferative disorders was negative. The diagnosis was hepatic dysfunction secondary to inferior vena cava obstruction due to a thrombus in the setting of extensive inferior vena cava thrombosis, and heparin was initiated. However, due to lack of recanalization with anticoagulation, we performed aspiration thrombectomy, balloon angioplasty, and local thrombolysis. Transjugular intrahepatic portosystemic shunt procedure was subsequently done due to hepatic venous congestion and refractory ascites. He was discharged on oral anticoagulation. Imaging exams performed 4 months later showed patent inferior vena cava and transjugular intrahepatic portosystemic shunt, good flows in the portal vein and resolution of ascites.
Well-being in the Workplace: A Book Club Among Health Care Workers During the COVID-19 Pandemic
Authors: Kelsey Elizabeth A. , West Colin P. , Fischer Karen M. , Croghan Ivana T.
Published: March 2023

Introduction/Objectives:

A culture of joy in the workplace supports well-being, but less is known about the effect of a shared experience on well-being and burnout in a health care setting. This pilot study investigated personal well-being and occupational burnout among primary care staff who participated in a 3-month virtual book club.

Methods:

In December 2021, health care workers from a primary care practice were invited to participate in a 3-month virtual book club. Participants were emailed a preintervention survey with questions regarding well-being and burnout, the pandemic’s influence on emotional health, and demographic information. The book club met virtually every month from January 2022 through March 2022. After the March 2022 book club meeting, a paired postintervention survey was sent to participants with additional questions regarding their participation in the book club. Well-being and burnout were measured with the 11-point Well-Being Index, and the pandemic’s influence on emotional health was assessed with the 64-point Pandemic Emotional Impact Scale.

Results:

Of 12 book club participants, 9 participants (6 physicians and 3 nurses) completed surveys before and after the intervention. Postintervention improvement in the median score of the Pandemic Emotional Impact Scale was significant (7 points, P = .04). Although Well-Being Index results uniformly favored improved well-being after book club participation, the median improvement of 1 point was not significant ( P = .69).

Conclusions:

Social connection through a virtual workplace activity such as a book club may contribute to well-being and may decrease occupational burnout.
Prevalence of Shoulder and Elbow Overuse Injuries Among Competitive Overhead Youth Athletes in Singapore
Authors: Lau Rachel , Mukherjee Swarup
Published: March 2023

Background:

There is a dearth of information related to shoulder and elbow overuse injuries in Asian overhead youth athletes.

Purpose:

To determine the prevalence and severity of shoulder and elbow overuse injuries, as well as their associated factors, among competitive overhead youth athletes in Singapore.

Study Design:

Descriptive epidemiology study.

Methods:

Participants completed a survey consisting of 4 multiple-choice questions and 1 open-ended question. Data on sex, age, playing experience, and weekly training hours were also collected. Separate injury severity scores (range, 0-100, with higher scores indicating greater severity) for the shoulder and elbow were tabulated from the responses to the multiple-choice questions. The association between participant characteristics and presence of shoulder and elbow overuse injuries was determined using the chi-square test. Crude odds ratios (ORs) and 95% CIs were also calculated.

Results:

532 overhead youth athletes (age, 12-18 years) responded, of which 434 responses were included for analysis. Badminton, cricket, softball, swimming, and volleyball were some of the sports studied. The prevalence of shoulder and elbow overuse injuries was 31.3% and 9.2%, respectively. The respective severity scores were 30.4 ± 14.4 and 38.4 ± 22.4. Age was associated with the presence of both shoulder ( P = .016) and elbow ( P = .037) overuse injuries. Years of experience was associated with the presence of substantial elbow injuries ( P = .049). Weekly training hours was associated with the presence of shoulder ( P = .016) and substantial shoulder ( P = .020) injuries. Being older (15-18 years) increased the odds of shoulder (OR, 1.65; 95% CI, 1.10-2.49) and elbow (OR, 2.04; 95% CI, 1.03-4.01) overuse injuries. Having >8 years of experience increased the odds of substantial shoulder (OR, 2.71; 95% CI, 1.01-7.29) and substantial elbow (OR, 3.92; 95% CI, 1.01-15.24) overuse injuries. Training >11 hours per week increased the odds of shoulder overuse injuries (OR, 2.64; 95% CI, 1.31-5.30).

Conclusion:

Shoulder overuse injuries were more prevalent, but elbow injuries tended to be of greater severity among competitive overhead youth athletes in Singapore. Coaches working with older and experienced youth athletes, especially those training >11 hours per week, should be cognizant of the risk of shoulder and elbow overuse injuries.
The emperor, the lion and the peacock: Monuments and contested state sovereignty in contemporary Ethiopia
Authors: Regassa Asebe Debelo , Emmenegger Rony
Published: March 2023

As a first project launched after his nomination as Ethiopia’s new prime minister in 2018, Abiy Ahmed renovated the Imperial Palace in Ethiopia’s political center, Addis Ababa to turn it into a heritage site of significance for nation-state building. This project was widely interpreted as a sign for the end of authoritarian rule and political tensions in the country. In this paper, we scrutinize the monumentalization inside the palace as an assemblage of of mythical figures – political rulers and animals. In our focus are different statues, which we interpret in the context of Ethiopia’s political history of authoritarian rule, the politics of history, and ongoing ethno-nationalist contestations. On that basis, we demonstrate the strategic significance for Abiy Ahmed of articulating these mythical figures in his attempt to substantiate his sovereignclaim—especially in the context of his regime’s sever legitimacy crisis. Our analysis reveals the palace as a site of cultural and political significance in the broader context of ongoing ethno-nationalist struggles about nation-state authority, representation, legitimacy and history. It contributes to an inherently political understanding of developments of monuments and their significance for state sovereignty, hegemony, and authoritarian rule in Africa and beyond.
Grab it and change it, it’s yours: Affect, attitude and politics in 1970s Northern Irish punk music
Authors: Smith Rachel , Banfield Janet
Published: March 2023

This paper argues for incorporation of attitude into geographical work on affect. We do so through an engagement with affect in musical experiences and adopting as our focus punk music in Northern Ireland during the 1970s. Through a combination of lyrical analysis and in-depth interviews with some of those involved in the punk scene in Northern Ireland at that time, we find that affective responses to musical experiences can be translated into attitude, shifting from intentional expression, e.g., through clothing or demeanour, to habituation and pre-reflective persistence at the level of the everyday, extending the duration of affect and interweaving the cognitive and pre-reflective. Further, through our emphasis on the temporalities of affect, our focus on punk music in Northern Ireland at the height of the Troubles identifies the attitudinal prefiguration of an anarchist utopia. However, due to the habituation of attitude, this political aspect becomes invisible to and unacknowledged by those exhibiting and instantiating it. This paper extends the affective moment into durable attitudinal dispositions, unsettles rigid notions of separation between the cognitive and pre-reflective, questions the radical openness of affect in the face of the regulatory power of attitude, provides theoretical insights into punk as instantiating an attitudinal form of utopia, and contributes to growing engagement with the political potential of affect.
Unusual pattern of herpetic optic neuropathy: a case report and literature review of the pathophysiology of herpetic uveitis
Authors: Helal Rehab Sabry , Abu Sbeit Rami , Al-Baker Zamzam Mohammed
Published: March 2023

Herpetic uveitis is a relatively common type of intraocular inflammation with a broad spectrum of manifestations ranging from mild anterior uveitis to rapidly progressing vision threatening necrotizing retinitis. Posterior herpetic uveitis presents with different clinical patterns within a spectrum depending presumably on the immune status of the patient. Systemic steroid use for viral uveitis without prior antiviral coverage is inappropriate and can lead to dramatic sequelae. Here, we report an unusual case of herpetic optic neuropathy in the contra lateral eye of a patient with acute retinal necrosis after improper use of oral steroids.
NT-proBNP change is useful for predicting weaning failure from invasive mechanical ventilation among postsurgical patients: a retrospective, observational cohort study
Authors: Zheng Yingying , Luo Zujin , Cao Zhixin
Published: March 2023

Background

To evaluate the predictive value of N-terminal prohormone B-type natriuretic peptide (NTproBNP) for weaning failure among patients undergoing major surgeries during spontaneous breathing trial (SBT), compared to traditional weaning parameters.

Methods

The observational cohort study retrospectively included postsurgical patients who received IMV and underwent a 2 h SBT. According to weaning outcome, NTproBNP level at initiation (NTproBNP1) and at end of 2 h SBT(NTproBNP2), the ΔNTproBNP%, RSBI and MV were compared between weaning failure and weaning success group. Multiple logistical regression and ROC curve were used to evaluate the capability of NTproBNP to predict weaning failure.

Results

Out of the 323 included postsurgical patients, 45 (13.9%) patients had failed weaning. The ΔNTproBNP% was a better predictor for weaning failure (AUC 0.744;95%CI,0.693–0.791) than NTproBNP1(AUC 0.639; 95%CI,0.580–0.694)), NTproBNP2(AUC 0.742, 95%CI,0.688–0.792) and other traditional weaning index such as RSBI (AUC 0.651; 95%CI, 0.597–0.703) and MV (AUC 0.552; 95%CI,0.496–0.607). The cutoff value of ΔNTproBNP% for predicting weaning failure was 23.3% with the sensitivity75.76% and specificity73.38%. The multiple logistic regression analysis found that ΔNTproBNP%>23.3% was an independent predictor of weaning failure.

Conclusion

ΔNTproBNP% may be a useful marker for predict weaning failure for postsurgical patients, and it’s better to be more careful to withdraw from invasive mechanical ventilation for those postsurgical patients with ΔNTproBNP% >23.3%. The corresponding interventions to optimize cardiac function should be actively given to these patients.
The prognostic role of the AST/ALT ratio in hepatocellular carcinoma patients receiving thermal ablation combined with simultaneous TACE
Authors: Wang Feihang , Gao Shanshan , Wu Mengfei , Zhao Danyang , Sun Huiyi , Yav Sothea , Chen Yi , Zhang Zihan , Yang Minjie , Dong Yi , Wang Jianhua , Wang Xiaolin , Yan Zhiping , Liu Lingxiao
Published: March 2023

Background

To evaluate the prognostic value of the pre-treatment aspartate transaminase (AST)/alanine transaminase (ALT) ratio in hepatocellular carcinoma (HCC) patients receiving radiofrequency ablation (RFA)/microwave ablation (MWA) combined with simultaneous TACE.

Methods

The data for 117 patients were retrospectively analyzed in this study. The endpoint of prognosis was overall survival (OS). The Youden index was used to choose the optimal cut-off value of the pre-treatment AST/ALT ratio for OS prediction. Univariate and multivariate analyses were used to identify independent risk factors, then integrated to establish the nomogram.

Results

The AST/ALT ratio cut-off value for OS prediction was 0.89, and patients with a higher AST/ALT ratio had poorer OS. The median OS for the high-value AST/ALT group was not reached, while the median OS for the low-value AST/ALT group was 48.5 months (P = 0.0047). The univariate and multivariate analysis showed that AST/ALT ratio, AFP, and tumor numbers were independent prognostic indicators for OS. The integrated nomogram showed higher predictive accuracy for OS (C-index 0.674, 95%CI: 0.600–0.748).

Conclusions

The preoperative AST/ALT ratio could be a prognostic indicator for HCC patients receiving thermal ablation combined with simultaneous TACE.
Esophageal anthracosis occurred after treatment of esophageal tuberculosis secondary to mediastinal tuberculous lymphadenitis: a rare case report
Authors: Cheng Weixin , Zhou Xinxin , Lu Miaomiao , Jin Xi , Ji Feng
Published: March 2023

Background

Anthracosis is a disease generally considered to be in the lungs resulting from exposure to industrial dust in the workplace. Esophageal anthracosis is a fairly rare phenomenon and shows a strong correlation with tuberculosis. Moreover, esophageal involvement in tuberculosis is also rare. We here present an extremely rare case in which follow-up gastroesophageal endoscopy revealed a mass with a sunken, black area in the center and raised ring-like pattern in the surrounding mucosa resembling malignant melanoma. Uncovering the patient’s tuberculosis history finally avoided a misdiagnosis or overtreatment.

Case presentation

A 67-year-old male patient was admitted to the hospital due to “repeated chest pain for 1 month”. Endoscopic ultrasonography and contrast-enhanced CT scans revealed a mass adjacent to the esophageal wall with unclear boundaries. Aspiration biopsy confirmed that esophageal tuberculosis was caused by nearby mediastinal tuberculous lymphadenitis. After a standard anti-tuberculosis treatment regimen, the patient achieved a favorable prognosis. The follow-up gastroesophageal endoscopy showed a sunken black lesion with elevated peripheral mucosa replacing the original tuberculous mass, which was thought to be anthracosis, a disease that rarely occurs in the esophagus.

Conclusion

The diagnosis of tuberculosis should be taken into consideration when a submucosal mass appears in the middle part of the esophagus. Endoscopic ultrasonography can effectively contribute to a definite diagnosis. Moreover, this is the first case of esophageal anthracosis observed only 1 year after the treatment of tuberculosis, indicating esophageal anthracosis can be a short-term disease. The traction of the reduction of tubercular mediastinal lymph nodes after anti-tuberculosis treatment may create a circumstance for pigmentation or dust deposition.