bluuebunny/crossref_metadata_2025 huggingface dataset:
Padrões alimentares de adultos brasileiros em 2008–2009 e 2017–2018
Authors: Antunes Anna Beatriz Souza , Cunha Diana Barbosa , Baltar Valéria Troncoso , Steluti Josiane , Pereira Rosangela Alves , Yokoo Edna Massae , Sichieri Rosely , Marchioni Dirce Maria
Published: January 2022

OBJETIVOS Identificar padrões alimentares entre adultos brasileiros a partir dos Inquéritos Nacionais de Alimentação (INA) 2008–2009 e 2017–2018, verificando, nesse último período, a aderência aos padrões de acordo com fatores sociodemográficos e regiões brasileiras. MÉTODOS Foram analisados dados do primeiro de dois dias de consumo alimentar de adultos (19–59 anos de idade) entrevistados nos INA 2008–2009 (n = 21.630) e 2017–2018 (n = 28.901). Os padrões alimentares foram derivados por análise fatorial exploratória a partir de 19 grupos de alimentos, considerando a complexidade do desenho amostral. Para o INA 2017–2018, os escores fatoriais foram avaliados de acordo com sexo, faixa etária, região, renda per capita e escolaridade. RESULTADOS Foram identificados três padrões nos dois inquéritos: (1) “tradicional”, caracterizado por arroz, feijão e carnes; (2) “pães e manteiga/margarina”, caracterizado por pães, óleos e gorduras (incluindo margarina/manteiga) e, em 2008–2009, café e chás; e (3) “ocidental”, caracterizado por refrigerantes e pizzas e salgados, além de farinhas e massas e doces em 2017–2018. O padrão “tradicional” teve maior aderência entre homens, moradores da região Centro-Oeste e indivíduos com ensino fundamental incompleto. Para o padrão “pães e manteiga/margarina”, observou-se maior aderência entre o sexo masculino, indivíduos com idade entre 40 e 59 anos, da região Sudeste e com renda entre 1 e 2 salários-mínimos per capita. Indivíduos do sexo masculino, com idades entre 19 e 39 anos, da região Sul, com renda per capita maior que dois salários-mínimos e escolaridade igual ou maior que o ensino fundamental foram os que apresentaram maior adesão ao padrão “ocidental”. CONCLUSÃO Os padrões alimentares identificados em 2008–2009 e 2017–2018 foram similares, com manutenção do padrão “tradicional”, que inclui arroz, feijão e carnes. A adesão aos padrões varia de acordo com sexo, faixa etária, região, renda per capita e escolaridade.
A new subgenus of Epeorus and its five species from China (Ephemeroptera: Heptageniidae)
Authors: Zhenxing Ma , Changfa Zhou
Published: January 2022

A new subgenus, Siniron subgen. n., is established for five Chinese species of Epeorus Eaton, 1881 to recognize their distinct difference from other subgenera: 1) in nymphs, tergalius I widely expanded anteriorly while tergalius VII curved but unfolded, well developed paired spines on abdominal terga; 2) in adults, unique coloration of wings, penis with distinct median titillators. Among them, nymphal stages of four previously known species, E. (S.) sinensis (Ulmer, 1925), E. (S.) dayongensis Gui & Zhang, 1992, E. (S.) herklotsi (Hsu, 1936b) and E. (S.) ngi Gui, Zhou & Su, 1999, are described for the first time and imaginal stages are also re-described. The fifth species, which has apically pigmented hind wings in imago and protuberances on pronotum in nymph, is described as a new species E. (S.) tuberculatus sp. n. All these species can also be delimited by COI sequences. In addition, their distribution in China is provided.
Impact of teacher encouragement on children’s consumption and non-eating behaviour in a Wisconsin elementary school vegetable snack programme
Authors: Chinchanachokchai Sydney , Jamelske Eric M , Vernon Erin
Published: January 2022

Objective:

Schools participating in the US Department of Agriculture (USDA) Fresh Fruit and Vegetable Programme (FFVP) serve more fruit than vegetables and tend not to implement activities designed to increase consumption. This research examines the impact of teacher encouragement on consumption of raw vegetables served through a non-FFVP elementary school snack programme.

Method:

Twelve teachers and 217 children in Grades K–3 were randomly assigned to one of three conditions. One condition served as the control group (no encouragement), while the other two conditions represented intervention groups (moderate and high encouragement). Three vegetables were served eight times each with teachers in both intervention conditions providing encouragement for the first six servings of each vegetable. All encouragement was discontinued during the final two servings of each vegetable. Average consumption and non-eating behaviour were analysed using differences in means, ordinary least squares and logistic regression analysis.

Results:

Moderate and high teacher encouragement significantly increased children’s consumption of vegetables compared to the control group. Both encouragement conditions also significantly reduced the likelihood of non-eating behaviour. The positive encouragement impacts were found to persist in the short term even when teacher encouragement had ceased, especially for the high encouragement condition.

Conclusion:

This study provides evidence that relatively low-cost teacher encouragement can decrease non-eating behaviour and increase children’s consumption of vegetable snacks served in elementary schools. This suggests that schools participating in the FFVP could see benefits from serving more vegetables and implementing encouragement activities. Moreover, these results could be informative to non-FFVP schools in implementing their own vegetable snack programme.
The Safer Culture Framework: An Application to Healthcare Based on a Multi-Industry Review of Safety Culture Literature
Authors: Kilcullen Molly P. , Bisbey Tiffany M. , Ottosen Madelene J. , Tsao Kuojen , Salas Eduardo , Thomas Eric J.
Published: January 2022

Background

Errors and preventable harm to patients remain regrettably common and expensive in healthcare. Improvement requires transforming the culture of the healthcare industry to put a greater emphasis on safety. Safety culture involves holding collective attitudes, values, and behaviors that prioritize safety. The Safer Culture framework, previously established through a narrative review of literature in multiple industries, provides a consensus on what impacts safety culture, how it manifests in behavior, and how it influences safety-related outcomes.

Methods

Through a theoretical review, we validate, refine, and provide nuance to this framework for the development of safety culture in healthcare contexts. To accomplish this, we conceptually map existing dimensions pulled through the literature onto our Safer Culture framework.

Results

A total of 360 articles were reviewed. We present specific elements for each dimension in our framework and apply the dimension to healthcare contexts.

Conclusion

We provide an evidence-based and comprehensive framework that can be used by patient safety leaders and researchers to guide the evaluation of safety culture and develop interventions to foster patient safety culture and improve patient safety outcomes.
A Synthesis of the Conceptualization and Measurement of Implementation Fidelity in Mathematics Intervention Research
Authors: Bos Samantha E. , Powell Sarah R. , Maddox Steven A. , Doabler Christian T.
Published: January 2022

In intervention studies, high rates of implementation fidelity are important markers of a study’s success; however, the definition of implementation fidelity is both complex and dynamic. In this synthesis, we examined the dimensions of implementation fidelity measured and reported in 99 studies in which researchers utilized a mathematics intervention for elementary students (i.e., Grades 1–5). We examined implementation fidelity following recommendations made by Dane and Schneider (1998), O’Donnell (2008), and DeFouw et al. (2009) to capture a comprehensive representation of the implementation fidelity data collected and reported within mathematics intervention studies. We organized our conceptualization of implementation fidelity into four overarching categories and nine dimensions within those categories: intervention design (i.e., theories of change and logistics), fidelity of implementor (i.e., adherence, quality of delivery, dosage, and implementor knowledge or experience), student engagement, and treatment analysis (i.e., treatment differentiation and analysis of implementation fidelity). Overall, findings indicate many author teams reported adherence data and dosage data, but significantly fewer studies reported quality of delivery data, student engagement data, or treatment differentiation data. In addition, author teams were more likely to report at least one form of logistics, such as implementor support, than theories of change. Implications for research and practice are discussed.
Where Do We Go From Here? The Survival and Recovery of Black-Owned Businesses Post-COVID-19
Authors: Lahr Darcelle , Adams Ashley , Edges Alec , Bletz Jillian
Published: January 2022

Given the direct relationship between business ownership and economic vibrancy within communities of color, this research explores a tailored approach for addressing persistent race-based economic disparities inhibiting business ownership in communities of color. While significant evidence exists regarding the need for access to capital, education, and the market to improve the sustainability of businesses of color, this research demonstrates the need for an additional component (the “Fourth Dimension”) to spur the development of thriving, socially oriented Black-owned business communities. We envision the “Fourth Dimension” comprising a collaborative, community-oriented social growth strategy for small Black-owned businesses implemented through enhanced and deliberate cooperative, community-supported market engagement.
Impact of meningeal uptake and partial volume correction techniques on [18F]MK-6240 binding in aMCI patients and healthy controls
Authors: Mertens Nathalie , Michiels Laura , Vanderlinden Greet , Vandenbulcke Mathieu , Lemmens Robin , Van Laere Koen , Koole Michel
Published: January 2022

[18F]MK-6240 is a second-generation tau PET-tracer to quantify neurofibrillary tangles in-vivo. However, individually variable levels of meningeal uptake induce spill-in-effects into the cortex, complicating [18F]MK-6240 PET quantification. Group SUVR differences between age-matched HC subgroups with varying extracerebral uptake (EC-low/mixed/high), and between aMCI and each HC subgroup were assessed without and with partial volume correction (PVC). Both Müller-Gartner (MG-)PVC and region-based voxelwise (RBV-)PVC, with the latter also correcting for extracerebral spill-in-effects, were implemented. Between HC groups, where no differences are to be expected, HC EC-high showed spill-in differences compared to HC EC-low when no PVC was applied while for MG-PVC, differences were reduced and, for RBV-PVC, no statistically significant differences were observed. Between aMCI and HC, cortical SUVR differences were statistically significant, both without and with PVC, but modulated by the varying meningeal uptake in HC subgroups when no PVC was applied. After applying PVC, correlations to clinical parameters improved and effect sizes between HC and aMCI increased, independent of the HC-subgroup. Therefore, appropriate PVC with correction for extracerebral spill-in-effects is recommended to minimize the impact of varying meningeal uptake on cortical differences between HC and aMCI.
A Procedure for Eliciting Women’s Preferences for Breast Cancer Screening Frequency
Authors: Grayek Emily , Yang Yanran , Fischhoff Baruch , Schifferdecker Karen E. , Woloshin Steven , Kerlikowske Karla , Miglioretti Diana L. , Tosteson Anna N. A.
Published: January 2022

Background

We evaluate the construct validity of a proposed procedure for eliciting lay preferences among health care policy options, suited for structured surveys. It is illustrated with breast cancer screening, a domain in which people may have heterogeneous preferences.

Methods

Our procedure applies behavioral decision research principles to eliciting preferences among policy options expressed in quantitative terms. Three-hundred women older than 18 y without a history of breast cancer were recruited through Amazon MTurk. Participants evaluated 4 screening options for each of 4 groups of women, with varying risk of breast cancer. Each option was characterized by estimates of 3 primary outcomes: breast cancer deaths, false alarms, and overdiagnosis resulting in unnecessary treatment of cancers that would not progress. These estimates were based on those currently being developed by the Breast Cancer Surveillance Consortium. For each risk group, participants stated how frequently they would wish to receive screening, if the predicted outcomes applied to them.

Results

A preregistered test found that preferences were robust enough to be unaffected by the order of introducing and displaying the outcomes. Other tests of construct validity also suggested that respondents generally understood the task and expressed consistent preferences. Those preferences were related to participants’ age and mammography history but not to measures of their numeracy, subjective numeracy, or demographics. There was considerable heterogeneity in their preferences.

Conclusions

Members of the public can be engaged more fully in informing future screening guidelines if they evaluate the screening options characterized by the expected health outcomes expressed in quantitative terms. We offer and evaluate such a procedure, in terms of its construct validity with a diverse sample of women.

Highlights

A novel survey method for eliciting lay preferences for breast cancer screening is proposed and evaluated in terms of its construct validity. Participants were generally insensitive to irrelevant task features (e.g., order of presentation) and sensitive to relevant ones (e.g., quantitative estimates of breast cancer risk, harms from screening). The proposed method elicits lay preferences in terms that can inform future screening guidelines, potentially improving communication between the public and policy makers.
Don’t Waste a Crisis: COVID-19 and Marketing Students’ Self-Regulated Learning in the Online Environment
Authors: Meshram Kanika , Paladino Angela , Cotronei-Baird Valeria S.
Published: January 2022

This research examines the extent to which a crisis situation, such as the COVID-19 pandemic, affects marketing students’ self-regulated learning (SRL) and grade expectations. Data were collected from 841 undergraduate marketing students and analyzed using the Hayes process macro to test the proposed framework. The results show direct and significant effects of SRL and its substrategies (goal setting, environmental structuring, and time management) on students’ grade expectations. However, help-seeking and self-evaluation strategies do not have a direct effect on students’ grade expectations. Instead, the analysis shows that the comparative appraisal of grades mediates these effects. In addition, crisis impact moderates the relationship of goal setting, time management, and self-evaluation with students’ grade expectations. These results advance the understanding of SRL and self-determination theory by showing how a radical disruption can transform students’ learning and, in turn, affect their perceptions of performance outcomes. This research contributes to the pandemic pedagogy by suggesting not only that marketing educators should be upskilled in the use of technology but also that they should develop curriculum design and pedagogical strategies that support SRL and work to devise appropriate curricula that help marketing students become independent learners.
Developing a Theory of Two Latent Soft Skills Progress Variables using the BEAR Assessment System: Validity Evidence for the Internal Structure of the Social Evaluative in the Workplace Instrument
Authors: Jolin Jerred , Wilson Mark
Published: January 2022

In this article, we report on the development of two latent soft skills progress variables using the Berkeley Evaluation and Assessment Research (BEAR) Assessment System (BAS). The Social Evaluative Reasoning in the Workplace (SER-W) instrument uses comic strip scenarios to depict interactions between employees and customers in entry-level workplace settings. We designed items to elicit evidence of student ability to: (a) identify salient customer social cues, which we term the social cue detection (SPU) variable, and, (b) justify an evaluation on the outcome of the situation depicted in the scenarios. We refer to this as the evaluative inference (EI) variable. Research from the field of autism spectrum disorder was used to develop a theory for building social complexity into the SER-W comic strip scenarios, by manipulating the type, frequency, and co-occurrence of the social cues presented in the scenarios. A unidimensional and multidimensional extension of the Rasch partial credit model were fit to the data. Model comparisons provide empirical support for our hypothesized two-dimensional structure, in which the SPU and EI variables are modeled as separate dimensions. These results are considered in terms of the evidence for the validity of the internal structure of the SER-W dimensions they provide. The article concludes with examples of the practical implications that progress variable research can have on soft skills curriculum development and assessment in the field of special education.
Late-Holocene paleomagnetic secular variation records from Lake Turkana, East Equatorial Africa
Authors: Lund Steve , Platzman Ellen , Scholz Chris
Published: January 2022

We have carried out a paleomagnetic study of three piston cores collected from Lake Turkana. The goal is to recover a Holocene paleomagnetic secular variation (PSV) record for this lake and to correlate it with other Holocene PSV records from the East Africa Rift Valley (EARV). All three cores were sampled with u-channels and magnetic measurements of magnetic susceptibility, the natural remanence (NRM), and two artificial remanences, anhysteretic remanence (ARM) and saturation isothermal remanence (SIRM), were made on them. The remanences were routinely step-wise demagnetized and measured at 10 mT steps up to 60 mT. The NRMS had a simple pattern of demagnetization with a characteristic direction (ChRM) removed between 10 and 60 mT. ARM and SIRM demagnetization indicated that the magnetic grains were relatively soft with median destructive fields (MDF) less than 30 mT. We interpret the magnetic grains to be multi-domain (silt-sized) magnetite/titanomagnetite. The resulting magnetic records of all three cores could be correlated. A chronology for these cores was determined from four radiocarbon dates on core 4P. We also estimated the sediment ages by correlating the PSV to two other well-dated PSV records from the same region, Lakes Malawi and Victoria. PSV age estimation indicates that the radiocarbon dates are about 500 year too old; a correction for that offset causes three of the four radiocarbon ages to become consistent with the PSV age estimates. The final composite Lake Turkana PSV record for the last ~4000 years is the highest resolution directional record of PSV (~200 cm/ky) ever to be recovered from Africa.
Experiences of Preservice Music Teachers at Minority Serving Institutions
Authors: Bryant Robert L.
Published: January 2022

The purpose of this study was to explore the experiences of preservice minority music teachers at Minority Serving Institutions (MSIs). Six undergraduate music education majors at two MSIs classified as Historically Black Colleges & Universities (HBCUs) completed field observations as a part of their music education requirements. I conducted individual interviews with each participant to uncover how preservice music teachers who attend MSIs describe their experiences as they matriculate through a music education program. Data were analyzed and coded to generate three themes: (a) stressful demands of the music education major, (b) immersion in school settings develops confidence, and (c) critical faculty mentoring and peer support. The experiences of preservice music teachers at MSIs are shared along with implications and recommendations for future research.
Numerical analysis on seismic behavior of beam-column joint with different cement-based materials
Authors: Li Xiaoqin , Ding Jie , Zhang Tian , Wen Wenlu , Wei Changfan
Published: January 2022

Under cyclic loading conditions, the ductility of frame beam-column joints, which can be evaluated by the displacement ductility coefficient ( μ), is strongly affected by the axial load ratio ( n). Due to the high toughness of engineering cementitious composites (ECCs), the normal concrete can be replaced giving better joint ductility. However, the limit values of n for reinforced ECC (R-ECC) joints have not been clarified. Therefore, T- and cross-shaped reinforced concrete (RC) and R-ECC joint finite element models were established and analyzed under n values. The results indicated that the seismic performance of the joints, including μ, equivalent damping coefficient ( ξ eq), and secant stiffness ( K i) were strongly dependent on n. μ and ξ eq became inversely proportional to n when n was over 0.5. The RC and R-ECC joint ductile failure could occur when n was in the range of 0.3–0.7 and 0.3–0.9, respectively. The joint brittle failure occurred in RC and R-ECC joints when n was over 0.7 and 0.9, separately. Under the same n and load history, the maximum value of μ of R-ECC joints increased by 33.7% and 27.9% for T- and cross-shaped joints separately compared to that of RC joints. It is suggested that the n values for RC and R-ECC joints should not exceed 0.7 and 0.9, respectively.
Impact of spexin on metabolic diseases and inflammation: An updated minireview
Authors: Türkel İbrahim , Memi Gülsün , Yazgan Burak
Published: January 2022

Spexin (SPX) is a 14 amino acid length peptide hormone which was discovered using bioinformatic tools. It is extensively expressed in central and peripheral tissues and secreted into circulation in response to metabolic stress. Recent studies revealed that SPX acts as a multifunctional peptide in various metabolic processes such as body weight, food intake, energy balance, glucose and lipid metabolism, lipid storage, salt–water balance, and arterial blood pressure. Endogenous SPX is sensitive to metabolic changes, and circulating levels of SPX have been shown to be reduced in chronic diseases such as obesity, diabetes, and insulin resistance. Moreover, in fish and rodent models, systemic SPX treatment has positive effects on metabolism including reduced food intake, fat mass, lipid accumulation, and inflammation, improved insulin sensitivity, energy expenditure, and organ functions which are underlying mechanisms in diseases. Taken together, these findings suggest that SPX is a potential drug target for the development of new pharmacological strategies to cure metabolic diseases. This review focuses on metabolo-protective properties of SPX and discusses novel insights into the biology and mechanism of SPX in the pathogenesis of diabetes, obesity, non-alcoholic fatty liver disease, metabolic syndrome, polycystic ovary syndrome, cardiovascular diseases, and kidney diseases, which are considerable global health problems.
Extracranial Internal Carotid Artery Aneurysm in Pregnancy
Authors: S Prakash Prajwala , Wong Chi Julian Leung , Chan Shiao-Yng , Sidhu Harvinder Raj Singh , Vijayan Sannasi Vikram , Tiwari Alok
Published: January 2022

Isolated extracranial internal carotid artery aneurysms (EICAAs) are rare, accounting for only about .4–4% of all peripheral artery aneurysms. We present a case of an EICAA in a young pregnant patient. To our knowledge, this is the first case being reported of a true EICAA during pregnancy in a multiparous woman. A 25-year-old pregnant patient presented with a pulsatile left neck swelling. Radiological investigations and subsequent surgery during the first trimester confirmed a true saccular left ICA with a maximum diameter of 3.5 cm. She was treated with aneurysm excision and primary anastomosis. She did not have any underlying diseases predisposing to an EICAA. She has been well for 3 years post procedure. It has been postulated that pregnancy could lead to aneurysm development through multiple mechanisms, including hemodynamic, hormonal, and other physiologic changes of pregnancy. Aggressive treatment with surgical intervention is advocated because of the risk of cerebral ischemic complications associated with non-operative treatment, and because satisfactory long-term outcomes can be achieved from surgery.
Evidence of Potential Discriminatory HIV Pre-Exposure Prophylaxis (PrEP) Prescribing Practices for People Who Inject Drugs Among a Small Percentage of Providers in the U.S.
Authors: Pleuhs Benedikt , Mistler Colleen B. , Quinn Katherine G. , Dickson-Gomez Julia , Walsh Jennifer L. , Petroll Andrew E. , John Steven A.
Published: January 2022

Introduction:

A large percentage of people who inject drugs (PWID) are living with HIV. Yet, rates of HIV pre-exposure prophylaxis (PrEP) use among PWID remain low. Stigma surrounding substance use and PWID have been identified as potential barriers to PrEP. This study examined healthcare providers’ concerns regarding PWID and willingness to prescribe PrEP to PWID.

Methods:

An online, cross-sectional survey of a diverse group of healthcare providers in the 10 U.S. cities with the greatest HIV prevalence was conducted between July 2014 and May 2015. Participants responded to a patient vignette of a PWID and asked to indicate whether the patient would be a candidate for PrEP and why via free-response text. Descriptive statistics are reported using frequency measures. Bivariate analyses were conducted using chi-squared comparisons and logistical regression.

Results:

Survey data from 480 providers were included in analyses. Of the 480 responses, 85.5% were classified as PrEP aware, while 14.2% were PrEP unaware. Additionally, 82.6% indicated the patient would be a good candidate for PrEP, 4.4% believed the patient was not a good candidate for PrEP, and 13% were unsure. Among those who were unsure or would not prescribe PrEP (n = 84), open-ended responses indicated lack of knowledge (42.9%), concern about adherence (27.4%), concern about cost (4.8%), and bias (7.1%) as the primary reasons.

Conclusions:

Although the majority of providers in this study did not demonstrate bias against PWID, our study found that limited PrEP knowledge and bias are barriers to PrEP prescription among PWID for some providers. Interventions are needed that increase PrEP awareness of CDC guidelines and reduce implicit bias among providers.
Conceptualizing and Assessing the Competitiveness of Slow Tourism Destinations: Evidence From the First Accredited Cittàslow in China
Authors: Tu Wei , Zhou Li , Haobin Ben Ye , Yan Qi
Published: January 2022

Characterized with in-depth interactions and self-reflections, slow tourism has been gaining growing popularity in recent years thanks to the importance attached to quality of life and self-actualization of tourists in the post modern era, which has all been necessitated by the challenges wrought by the Covid-19 pandemic. In response to the current research lacuna of competitiveness analyses of specialized small-scale destinations, this study comprehensively proposes and empirically evaluates the competitiveness of slow tourism destinations as indicated by the values perceived by the slow tourists, and explores the mechanism of competitiveness of slow tourism destinations with investigation of the interrelationships between competitiveness and tourist attitude, consumption emotion and behavioral intentions through Structural Equation Modeling (SEM). The Gaochun District, which was the first accredited Cittàslow in China, was selected as the research site. Findings yielded four major competitiveness dimensions of community ambiance and service, tourist, and comprehensive management, cultural resources and values and natural resources and protection, and confirmed that perceived values are positively related to attitude, consumption emotion, and behavioral intentions. In addition to offering a valid scale measuring the competitiveness of slow tourism destinations, this study suggests the integration of cultural components in better planning and management of slow tourism destinations.
“I Can be Unapologetically Who I Am”: A Study of Friendship Among Black Undergraduate Women at PWIs
Authors: Leath Seanna , Mims Lauren , Evans Khrysta A. , Parker Ti’Asia , Billingsley Janelle T.
Published: January 2022

The current study explores Black undergraduate women’s friendships using in-depth interview data from 47 women (18–24 years) attending predominantly white institutions (PWIs) in the United States. Drawing on consensual qualitative research methods, we considered the nature and importance of Black female friendships among Black undergraduate women. We identified the following themes: (a) friendship as a tool to mitigate bias and discrimination; (b) affinity groups as a gateway to friendship; and (c) friendship as a way to navigate intersectional identity development. Two subthemes within the final theme highlighted how Black female friends (1) affirmed their self-image; and (2) honored their unique, intersectional experiences. Our findings demonstrate how Black female friendships are “homeplaces” for Black undergraduate women, particularly in regards to identity development during emerging adulthood. We discuss how friendships with other Black women offer unique forms of support during Black undergraduate women’s journeys in PWI environments that may challenge their wellbeing.
Is First Metatarsal Shortening Correlated with Clinical and Functional Outcomes Following the Lapidus Procedure?
Authors: Nishikawa Danilo Ryuko , Duarte Fernando A. , Saito Guilherme H. , Fenelon Emanoel Jefferson A. , Prado Marcelo P.
Published: January 2022

Category:

Bunion; Midfoot/Forefoot

Introduction/Purpose:

Lapidus procedure (LP) is a powerful technique to correct hallux valgus (HV) deformities, with good long-term outcomes. However, postoperative complications may arise, as undercorrection of the deformity, nonunion, elevation and shortening of the first metatarsal (M1). The objective of this study was to correlate M1 shortening with transfer metatarsalgia, and clinical and functional outcomes in patients who underwent the LP.

Methods:

a retrospective review of 29 patients (36 feet) who were submitted to the LP for HV correction was performed. The average follow-up was 20 months. M1 length was analyzed using the Relative First Metatarsal Length (RML) measurement (Figure 1). When M1 shortens in relation to the second metatarsal, the RML measurements increase. The intermetatarsal angle (IMA) and hallux valgus angle (HVA) were also measured. Clinical and functional analyses were based on the VAS for pain, AOFAS, LEFS and SF-12 health survey. SF-12 is divided into physical and mental health composite scales (PCS-12 and MCS-12, respectively). Transfer metatarsalgia diagnosis was based on the clinical exam. Radiographic, clinical and functional measurements were compared using paired Wilcoxon signed-rank test and Student t test. Interobserver reliability of RML measurements was calculated using Intraclass Correlation Coefficients (ICC). A linear regression was performed to assess the correlation between RML and the clinical and functional questionnaires.

Results:

There was a significant M1 shortening of 2.28mm after the LP (p<.001), with mean preoperative RML of 3.06 mm and mean postoperative of 5.34 mm (Table 1). No patient developed transfer metatarsalgia. Intraclass Coefficient Correlation (ICC) of the RML measures showed a excellent reliability of 0.94 and 0.98 in the pre- and postoperative setting, respectively. IMA and HVA presented significant improvements (p<.001) (Table 1). Clinical and functional improvements were observed in all questionnaires applied, except in the MCS-12 (Table 2). In the linear regression, RML was inversely correlated to LEFS (p=<.05), which means that LEFS scores increased as RML measurements decreased (Table 3). There was no significant correlation with the other questionnaires.

Conclusion:

The present study demonstrated that M1 shortening led to a decreased LEFS following the LP. Comparative studies with prospective design and larger populations are required to assess the role of M1 shortening on clinical and functional outcomes.
Comparison of Medial and Dorsal Approach for Talonavicular Fusion: A Cadaver Study
Authors: Patch David A. , Andrews Nicholas A. , Torrez Timothy. , Sutherland Charles R. , Harrelson Whitt , Agarwal Abhinav , Shah Ashish
Published: January 2022

Category:

Basic Sciences/Biologics; Hindfoot; Other

Introduction/Purpose:

Talonavicular (TN) joint arthrodesis is a common procedure for end stage arthritis. There are two common operative approaches used to expose the TN joint for articular preparation, the medial and dorsal. Classically, the medial approach has been the preferred method of TN joint fusion, but recent arguments have been made for the use of the dorsal approach. Articular surface preparation is a key tenant required for any joint fusion. To date no physical preparation studies have been done to compare the two approaches in terms of articular surface preparation.

Methods:

Ten fresh frozen cadaver specimens were obtained. Fluoroscopic radiographs were used to rule out any pre-existing pathology of the talonavicular joint. Specimens were assigned to receive either a dorsal or medial operative approach to the talonavicular joint. After joint preparation, the talonavicular joint was disarticulated and the amount of articular surface preparation was recorded using ImageJ software.

Results:

A total of 8 male and 2 female specimens were utilized with an average age of 64.5 +- 13.1. The dorsal approach had a higher average percentage of talar, navicular, and total talonavicular joint surface prepared. When examining joint surface area preparation regardless of approach used, the talar head was significantly less prepared than the navicular. The inter-observer correlation coefficient was excellent for both navicular and talar surface area prepared.

Conclusion:

The amount of articular surface preparation in the dorsal approach was consistently higher on average. Given the high rate of nonunion in isolated talonavicular and triple arthrodesis, surgeons should be aware that the dorsal approach may offer an increased amount of articular surface preparation. Our study adds to the growing body of evidence supporting the investigation and use of the dorsal approach when attempting talonavicular arthrodesis.
Influence of Medical Marijuana on Mesenchymal Stromal Cell Osteogenesis: An in Vitro Study
Authors: Shang Jiangyinzi , Hogan MaCalus V. , Cain Jarrett D. , Lin Hang , Alexander Peter G. , Yan Alan Y.
Published: January 2022

Category:

Basic Sciences/Biologics; Basic Sciences/Biologics; Sports; Other

Introduction/Purpose:

Recently, purposes of medicinal marijuana including analgesia and reduction in inflammation. The active component activates the CB1 and CB2 receptors, thus mimicking the action of endogenous cannabinoids. CB1 and CB2 are important regulators of bone metabollism. In particular, endocannabinoid signaling has shown to regulate proliferation and differentiation of MSCs and the activities of osteoblasts and osteoclasts. Cannabinoids may be prescribed to patients suffering bone fractures involving prolonged immobilization and discomfort. Thus, there is an important need to understand more completely the role of cannanbinoid signaling in fracture healing. In this study, we examine the influence of a synthetic cannabinoid agonist, Win-55,212-2 (Win) on adult, human MSC-derived osteoblast activity. Cell viability and osteogenic phenotype were assessed by MTS assay, RT-PCR, and alizarin red staining.

Methods:

With an IRB approved protocol, MSCs were isolated from healthy human bone marrow and expanded to the passage five for experimentation. Cells were then plated at 5,200 cells/cm2 (6-well plate) and osteogenically stimulated for 21 days before treatment with increasing concentrations of Win (0.01, 0.1, or 1 µM) for an additional 48 hours. The MTS assay was employed to determine the half-maximal (50%) inhibitory concentration (IC50) at different time points. The cell phenotype was assessed by real-time PCR and alizarin red staining.

Results:

We first used the MTS assay (for metabolism and proliferation) to test 7 doses of Win-55, from 0.001µM up to 5 µM and determined that the human osteoblast IC50 of Win-55 over 1-7 days of exposure was ~ 1.5 µM (Figure 1), a dose slightly lower than concentrations found to affect chondrocytes in a previous study. At 1µM Win-55, RT-PCR revealed that the expression of inflammatory cytokines IL-1beta and TNF-alpha was significantly reduced, while that of IL-6 and COX2 was unchanged. The expression of most osteogenic markers was unchanged by Win, but we did observe significant increases in BMP2, RUNX2 and OPN (Figure 2). Alizarin Red staining revealed increased calcium deposition and mineralization in the presence of 1µM Win, corroborating the RT-PCR results (Figure 3).

Conclusion:

Win-55,212-2 may be beneficial to osteogenesis. 1 µM Win enhanced the osteoblastic phenotype over control, untreated MSC-derived osteoblasts, reduced inflammatory mediators and increased calcium deposition and mineralization. This suggests that cannabidiol treatment might lead to improvements in fracture healing and provide a novel therapeutic option for the bone regeneration. Future studies are aimed at characterizing the CB-1 and CB-2 signaling associated with the changes observed here and the effects of Win on MSC-derived osteoblasts in the context of inflammation.
Safe and Effective Tendoscopy around the Ankle with A 2-mm Diameter Operative System
Authors: Stornebrink Tobias , Stufkens Sjoerd A. , Appelt Daniel , Wijdicks Coen A. , Kerkhoffs Gino
Published: January 2022

Category:

Arthroscopy; Basic Sciences/Biologics

Introduction/Purpose:

To assess whether 2-mm-diameter operative tendoscopy of the tibialis posterior, peroneal, and Achilles tendons was safe and effective in a cadaveric model.

Methods:

A 2-mm-diameter arthroscopic system was used to perform a tendoscopic procedure in 10 nonpaired, freshfrozen, human ankles. Standard tendoscopic portals were utilized. Visual examination and operative reach with tailored tendoscopic instruments within the tendon sheaths were recorded and documented. Adhesiolysis and vincula resections were performed. After dissection, distances between portal tracts and neurovascular structures were measured and the tendons were inspected for signs of iatrogenic damage.

Results:

The entire tendon sheath and tendon of the tibialis posterior, peroneus brevis, and Achilles tendons were visualized and reached with tailored operative instruments. The proximal part of the peroneus longus tendon was visible and reachable from proximally up to the cuboid bone distally. Adhesiolysis and vincula resections were successfully performed in all specimens. The mean distances between portal tracts and local neurovascular structures ranged between 9.4 and 19.2 mm and there were no cases of contact. None of the tendons showed signs of iatrogenic damage.

Conclusion:

Two-millimeter-diameter operative tendoscopy provided safe and effective visualization and operative reach of the tibialis posterior, peroneal, and Achilles tendons.
Third generation cephalosporin-resistant Klebsiella pneumoniae thriving in patients and in wastewater: what do they have in common?
Authors: Rocha Jaqueline , Ferreira Catarina , Mil-Homens Dalila , Busquets Antonio , Fialho Arsénio M. , Henriques Isabel , Gomila Margarita , Manaia Célia M.
Published: January 2022

Background

Klebsiella pneumoniae are ubiquitous bacteria and recognized multidrug-resistant opportunistic pathogens that can be released into the environment, mainly through sewage, where they can survive even after wastewater treatment. A major question is if once released into wastewater, the selection of lineages missing clinically-relevant traits may occur. Wastewater (n = 25) and clinical (n = 34) 3rd generation cephalosporin-resistant K. pneumoniae isolates were compared based on phenotypic, genotypic and genomic analyses.

Results

Clinical and wastewater isolates were indistinguishable based on phenotypic and genotypic characterization. The analysis of whole genome sequences of 22 isolates showed that antibiotic and metal resistance or virulence genes, were associated with mobile genetic elements, mostly transposons, insertion sequences or integrative and conjugative elements. These features were variable among isolates, according to the respective genetic lineage rather than the origin.

Conclusions

It is suggested that once acquired, clinically relevant features of K. pneumoniae may be preserved in wastewater, even after treatment. This evidence highlights the high capacity of K. pneumoniae for spreading through wastewater, enhancing the risks of transmission back to humans.
Factors associated with C-reactive protein testing when prescribing antibiotics in general practice: a register-based study
Authors: Sydenham Rikke Vognbjerg , Hansen Malene Plejdrup , Justesen Ulrik Stenz , Pedersen Line Bjørnskov , Aabenhus Rune Munck , Wehberg Sonja , Jarbøl Dorte Ejg
Published: January 2022

Background

The use of C-reactive protein (CRP) tests has been shown to safely reduce antibiotic prescribing for acute respiratory tract infections (RTIs). The aim of this study was to explore patient and clinical factors associated with the use of CRP testing when prescribing antibiotics recommended for RTIs.

Methods

A nation-wide retrospective cross-sectional register-based study based on first redeemed antibiotic prescriptions issued to adults in Danish general practice between July 2015 and June 2017. Only antibiotics recommended for treatment of RTIs were included in the analysis (penicillin-V, amoxicillin, co-amoxicillin or roxithromycin/clarithromycin). Logistic regression models were used to estimate odds ratios for patient-related and clinical factors on performing a CRP test in relation to antibiotic prescribing.

Results

A total of 984,149 patients redeemed at least one antibiotic prescription during the two-year period. About half of these prescriptions (49.6%) had an RTI stated as the indication, and a CRP test was performed in relation to 45.2% of these scripts.

Lower odds of having a CRP test performed in relation to an antibiotic prescription was found for patients aged 75 years and above (OR 0.82, 95CI 0.79–0.86), with a Charlson Comorbidity Index of more than one (OR 0.93, 95CI 0.91–0.95), unemployed or on disability pension (OR 0.84, 95CI 0.83–0.85) and immigrants (OR 0.91, 95CI 0.88–0.95) or descendants of immigrants (OR 0.90, 95CI 0.84–0.96). Living with a partner (OR 1.08, 95CI 1.07–1.10), being followed in practice for a chronic condition (OR 1.22, 95CI 1.18–1.26) and having CRP tests performed in the previous year (OR 1.78, 95CI 1.73–1.84) were associated with higher odds of CRP testing in relation to antibiotic prescribing.

Conclusions

Differences were observed in the use of CRP tests among subgroups of patients indicating that both sociodemographic factors and comorbidity influence the decision to use a CRP test in relation to antibiotic prescriptions in general practice. Potentially, this means that the use of CRP tests could be optimised to increase diagnostic certainty and further promote rational prescribing of antibiotics. The rationale behind the observed differences could be further explored in future qualitative studies.
Non-cardiovascular findings on chest CT angiography in children with congenital heart disease: How important are they?
Authors: Nordjoe Yaotse Elikplim , Aubin Igombe Suzanne Rita , Chat Latifa
Published: January 2022

Background

There are only a few publications about the non-cardiovascular findings in children with congenital heart diseases explored by chest CT angiography. The purpose of our study is to evaluate the prevalence of non-cardiovascular findings on chest CT angiographies in children with congenital heart disease and to raise awareness about their importance among the radiologists.

Methods

We retrospectively reviewed the 272 chest CT angiographies performed in our pediatric radiology department between January 2017 and march 2021 and extracted the data of the 180 patients positive for a congenital heart disease. Then from that pool, we sorted out the non-cardiovascular findings into significant and non-significant in regard of their relevance or not in the patient’s management.

Results

Non-cardiovascular lesions were found in 58% (105/180) of our patients, and 49% (88/180) of them presented at least one significant non-cardiac lesion. Lung and airways abnormalities were found in 41% (74/180) of the cases, representing the majority of the non-cardiovascular findings. Syndromic associations were found in 17% (28/180) of our patients, including 14 cases of heterotaxic syndrome.

Conclusion

Non-cardiovascular findings are common in children with congenital heart disease. Reporting these associated lesions is a requisite for an optimal therapeutic management of these children. Radiologists should never forget that a Chest CT angiography in children is first and foremost a chest CT.
The incidence, risk factors and outcomes of acute kidney injury in critically ill patients undergoing emergency surgery: a prospective observational study
Authors: Hu Linhui , Gao Lu , Zhang Danqing , Hou Yating , He Lin Ling , Zhang Huidan , Liang Yufan , Xu Jing , Chen Chunbo
Published: January 2022

Background

Without sufficient evidence in postoperative acute kidney injury (AKI) in critically ill patients undergoing emergency surgery, it is meaningful to explore the incidence, risk factors, and prognosis of postoperative AKI.

Methods

A prospective observational study was conducted in the general intensive care units (ICUs) from January 2014 to March 2018. Variables about preoperation, intraoperation and postoperation were collected. AKI was diagnosed using the Kidney Disease: Improving Global Outcomes criteria.

Results

Among 383 critically ill patients undergoing emergency surgery, 151 (39.4%) patients developed postoperative AKI. Postoperative reoperation, postoperative Acute Physiology and Chronic Health Evaluation (APACHE II) score, and postoperative serum lactic acid (LAC) were independent risk factors for postoperative AKI, with the adjusted odds ratio (ORadj) of 1.854 (95% confidence interval [CI], 1.091–3.152), 1.059 (95%CI, 1.018–1.102), and 1.239 (95%CI, 1.047–1.467), respectively. Compared with the non-AKI group, duration of mechanical ventilation, renal replacement therapy, ICU and hospital mortality, ICU and hospital length of stay, total ICU and hospital costs were higher in the AKI group.

Conclusions

Postoperative reoperation, postoperative APACHE II score, and postoperative LAC were independent risk factors of postoperative AKI in critically ill patients undergoing emergency surgery.