bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Learning-Based Optimization Algorithm for Enterprise Personnel Identity Authentication
Authors: Chen Tiejun
Published: June 2022

Enterprise strategic management is not only an important part of enterprise work, but also an important factor to deepen the reform of management system and promote the centralized and unified management of enterprises. Enterprise strategic management is to study the major problems of survival and development of enterprises in the competitive environment from the overall and long-term point of view. It is the most important function of senior leaders of modern enterprises. Starting from the characteristics of the recognition object, this paper analyzes the individual differences of biometrics through intelligent face image recognition technology to identify biometrics, which can be used to identify different individuals. This paper studies the main problems of personnel identity authentication in the current enterprise strategic management system. Based on identity management and supported by face image recognition technology, deep learning, and cloud computing technology, the personnel management model of the management system is constructed, which solves the problems of personnel real identity authentication and personnel safety behavior control. Experiments show that the model can simplify the workflow, improve the operation efficiency, and reduce the management cost. From the perspective of enterprise system development, building a scientific enterprise strategic management system is of great significance to improve the scientific level of enterprise system management.
A Deep Coordination Graph Convolution Reinforcement Learning for Multi-Intelligent Vehicle Driving Policy
Authors: Si Huaiwei , Tan Guozhen , Zuo Hao
Published: June 2022

With the growing up of Internet of Things technology, the application of Internet of Things has been popularized in the field of intelligent vehicles. Therefore, more artificial intelligence algorithms, especially DRL methods, are more widely used in autonomous driving. A large number of deep reinforcement learning (RL) technologies are continuously applied to the behavior planning module of single-vehicle autonomous driving in early. However, autonomous driving is an environment where multi-intelligent vehicles coexist, interact with each other, and dynamically change. In this environment, multiagent RL technology is one of the most promising technologies for solving the coordination behavior planning problem of multivehicles. However, the research related to this topic is rare. This paper introduces a dynamic coordination graph (CG) convolution technology for the cooperative learning of multi-intelligent vehicles. This method dynamically constructs a CG model among multiple vehicles, effectively reducing the impact of unrelated intelligent vehicles and simplifying the learning process. The relationship between intelligent vehicles is refined using the attention mechanism, and the graph convolution RL technology is used to simulate the message-passing aggregation algorithm to maximize the local utility and obtain the maximum joint utility to guide coordination learning. Driving samples are used as training data, and the model guided by reward shaping is combined with the model of the free graph convolution RL method, which enables our proposed method to achieve high gradualness and improve its learning efficiency. In addition, as the graph convolutional RL algorithm shares parameters between agents, it can easily build scales that are suitable for large-scale multiagent systems, such as traffic environments. Finally, the proposed algorithm is tested and verified for the multivehicle cooperative lane-changing problem in the simulation environment of autonomous driving. Experimental results show that our proposed method has better value function representation in that it can learn better coordination driving policies than traditional dynamic coordination algorithms.
A Young Boy with Brittle Hair
Authors: Tootoonchi Nassim , Azhari Vahideh , Razavi Zahra , Seraji Shadab , Kianfar Nika , Mahmoudi Hamidreza , Daneshpazooh Maryam
Published: June 2022

Trichothiodystrophy (TTD) is a rare multisystem disorder with an autosomal recessive mode of inheritance. TTD presentations vary from only hair abnormalities like brittle, fragile hair to physical and mental retardation. Mutations of DNA repair genes have been identified as responsible for the disease. A 5-year-old boy presented with sparse, short, and brittle hair to our clinic. He was born to consanguineous parents. Trichoscopy and light microscopy revealed broken hairs with no specific shaft defect. Due to the inaccessibility of the polarized microscopy, a bedside technique was employed. We used a polarized dermatoscope and a mirror in order of achieving transillumination of the hair shafts, which revealed striking bright and dark bands. These bands are referred to as “tiger tail,” which is the pathognomonic sign of TTD. Subsequent polarizing microscopy also confirmed the clinical diagnosis. This highlighted a feasible method for observing the tiger tail, which expanded the known clinical diagnostic tools of TTD.
Acute Chest Pain as an Infusion Reaction to Vedolizumab
Authors: Levartovsky Asaf , Yavzori Miri , Fudim Ella , Kopylov Uri , Ben-Horin Shomron , Ungar Bella
Published: June 2022

Vedolizumab-associated adverse effects, including infusion reactions, are generally uncommon. Less than 5% of patients experience an infusion-related reaction. We report a 67-year-old male with ulcerative colitis under prolonged maintenance therapy who presented with recurring chest pain occurring immediately after consecutive vedolizumab infusions. Medical workup of possible etiologies for chest pain were investigated and excluded. Vedolizumab drug trough levels were negative, accompanied by high detectable levels of anti-vedolizumab antibodies. These findings demonstrate an uncommon case of an infusion reaction to vedolizumab infusion.
Lung Adenocarcinoma Harboring Triple Rare EGFR Exon 18 Mutations Rapidly Developed Resistance to Multiple Therapies
Authors: Liu Yuyao , Wu Yuanqiang , Wu Fang , Hu Chunhong
Published: June 2022

There is no standard therapy for nonsmall-cell lung cancer harboring rare coexistent EGFR mutations. Here, we report a female patient who was diagnosed as lung adenocarcinoma with three mutations of G724S, E709K, and V689I in exon 18. The patient responded to, but also showed rapid development of resistance to multiple therapies, including a second-generation EGFR-TKI of afatinib, a platinum-based doublet chemotherapy, and a multiple target TKI of anlotinib. As such, she ended up with a short overall survival time. Further research is required to understand the resistance mechanism(s) of these complex gene mutations.
The Long and Winding Road to Clinical Xenotransplantation: A Personal Journey
Authors: Cooper David K.C.
Published: June 2022

Background: The recent clinical pig-heart transplant carried out at the University of Maryland in Baltimore is hopefully the first of many xenotransplants that will resolve the problem of the lack of availability of organs from deceased human donors. I offer my personal recollections of how xenotransplantation research has progressed since the mid-1980s, when the pig-to-nonhuman primate (NHP) organ transplant model was established. Summary: Initially, hyperacute rejection or early antibody-mediated rejection was almost uniform. Among the milestones that were subsequently achieved are (i) the introduction of the first genetically engineered pigs that expressed a human complement regulatory protein, CD55, which was associated with prolonged graft function, extending to several weeks; (ii) the observation that conventional immunosuppressive therapy did not prevent an adaptive immune response, whereas the administration of an agent that blocked the CD40/CD154 T-cell costimulation pathway was successful in this respect; (iii) the identification of the major pig carbohydrate xenoantigen as galactose-α1,3-galactose (Gal), followed by gene editing to delete its expression, and the demonstration of prolonged survival of organs from these pigs in NHPs; (iv) the resolution of coagulation dysfunction between a pig and primate by the introduction of genes for human coagulation regulatory proteins; (v) the recognition of a prolonged systemic inflammatory response to a xenograft and its suppression either by drug therapy or by further gene editing, and (vi) identification of two pig “non-Gal” xenoantigens and the production of triple-knockout (TKO) pigs. However, although many humans do not have antibodies against TKO pig cells, all Old World NHPs do have antibodies against these cells. This has provided an unexpected new barrier to testing TKO pig organ transplants in NHPs. Key Messages: The optimal gene-edited pig for clinical xenotransplantation may be one with 10 genetic manipulations. A pig with this genetic background provided the heart for the recent first clinical xenotransplant. In view of the current barrier to progress in the TKO pig-to-NHP model, the time has surely come when we need to consider moving from the laboratory to the clinic. Selection of patients for the first clinical trials is briefly discussed.
Political Activism in Pentecostal Charismatic Evangelical Churches and the 2019 Elections in South Africa
Authors: Frahm-Arp Maria
Published: June 2022

This article examines the public messages of the leaders of six Pentecostal Charismatic Evangelical Churches (PCE) in South Africa during the six months leading up to the 2019 presidential elections in that country. All six leaders presented themselves as knowledgeable about politics and as having solutions to ‘fix’ the political corruption and the failing economy that plagued South Africa in 2019. In this analysis it becomes apparent that the leaders had different attitudes to and understanding of politics and political activism. Some strongly advocated political activism among their members, others merely encouraged their members to vote on election day, while a third group did not directly mention politics or voting and did not endorse any form of political activism among the members of their churches. Four reasons explain these differences: (a) the theology of the different churches and their respective understandings of the relationship between faith/spirituality and politics, (b) the PCE leader’s personal perceptions of politics in South Africa, (c) the leaders’ own status as a South African citizen or foreign national, and (d) the socioeconomic situation of the different churches and their members.
Word stress at utterance-final position
Authors: Silber-Varod Vered , Amir Noam
Published: June 2022

This study investigates the realization of the two most common word-level stress patterns in Hebrew, final and penultimate, at utterance-final position. Twenty-six disyllabic words that form minimal pairs, which differ only in their stress pattern, were embedded in 52 sentences. The mean values of three acoustic parameters—duration, F0, and intensity—were measured for vowels of the target words. Findings show that duration is significantly longer at stressed vowels, similar to previous findings on words at utterance-mid position. Lower intensity is assigned to the utterance-final vowels regardless of the stress pattern, but the degree of lowering does depend on the stress pattern. Finally, lower F0 values are found in the utterance-final vowels, but the degree of lowering is similar to both stress patterns. We conclude that duration is the main cue at the prosodic word level, while F0 is used by Hebrew speakers to cue higher prosodic units.
Giving or Receiving Gifts?
Authors: Fields C. Ryan
Published: June 2022

The severity of difficulties surrounding Paul’s use of Psalm 68:18 in Ephesians 4:8 is well known. I argue that Ephesians 4:8 is best understood as an instance of Paul quoting Psalm 68:18 against a broader canonical backdrop, putting the themes of Psalm 68 in dialogue with other portions of the OT (especially Numbers 8) while engaging in typological and christological reflection on the nature of the church as a diversely gifted community. I make this argument by evaluating seven major interpretive options for understanding Paul’s use of the OT here. I then assess the two most promising options by examining Psalm 68 in its relation to Judges 5 and Numbers 8 and by investigating the extent to which these canonical co-texts might have informed Paul’s appropriation of the psalm, concluding that more attention should be given to the possibility that Paul is engaged in a christological reading of Numbers 8.
First record of subgenus Thao Tsuneki, 1982 (Hymenoptera: Crabronidae: Crabronini) from India: a new subspecies and a key to all subspecies of Crossocerus (Thao) nitidicorpus Tsuneki
Authors: SAINI VARUN , DEY DEBJANI
Published: June 2022

The subgenus Thao Tsuneki, 1982 of the genus Crossocerus Lepeletier de Saint Fargeau and Brullé, 1835 is recorded for the first time from India. A new subspecies viz., Crossocerus (Thao) nitidicorpus indicus, (India: Uttarakhand) is described. A key to all subspecies in the subgenus Thao is provided.
Improving Probabilistic Quantitative Precipitation Forecasts Using Short Training Data through Artificial Neural Networks
Authors: Ghazvinian Mohammadvaghef , Zhang Yu , Hamill Thomas M. , Seo Dong-Jun , Fernando Nelun
Published: June 2022

Conventional statistical postprocessing techniques offer limited ability to improve the skills of probabilistic guidance for heavy precipitation. This paper introduces two artificial neural network (ANN)-based, geographically aware, and computationally efficient postprocessing schemes, namely, the ANN-multiclass (ANN-Mclass) and the ANN–censored, shifted gamma distribution (ANN-CSGD). Both schemes are implemented to postprocess Global Ensemble Forecast System (GEFS) forecasts to produce probabilistic quantitative precipitation forecasts (PQPFs) over the contiguous United States (CONUS) using a short (60 days), rolling training window. The performances of these schemes are assessed through a set of hindcast experiments, wherein postprocessed 24-h PQPFs from the two ANN schemes were compared against those produced using the benchmark quantile mapping algorithm for lead times ranging from 1 to 8 days. Outcomes of the hindcast experiments show that ANN schemes overall outperform the benchmark as well as the raw forecast over the CONUS in predicting probability of precipitation over a range of thresholds. The relative performance varies among geographic regions, with the two ANN schemes broadly improving upon quantile mapping over the central, south, and southeast, and slightly underperforming along the Pacific coast where skills of raw forecasts are the highest. Between the two schemes, the hybrid ANN-CSGD outperforms at higher rainfall thresholds (i.e., >50 mm day−1), though the outperformance comes at a slight expense of sharpness and spatial specificity. Collectively, these results confirm the ability of the ANN algorithms to produce skillful PQPFs with a limited training window and point to the prowess of the hybrid scheme for calibrating PQPFs for rare-to-extreme rainfall events.
Genital Gender Affirming Surgery
Authors: Li Virginia Y. , Demzik Alysen , Snyder Liem , Ogunleye Adeyemi A. , Wang Annmarie , Figler Bradley D.
Published: June 2022

Genital gender affirming surgery is an effective treatment for gender dysphoria in transgender individuals. Optimization of medical and mental health conditions, including coordination with a patient’s entire care team, is essential. Feminizing procedures include vaginoplasty (creation of female genitalia with a vaginal canal) and vulvoplasty (creation of female genitalia with a short or absent vaginal canal). Masculinizing procedures include metoidioplasty (construction of male genitals via local tissue rearrangement) and phalloplasty (creation of a phallus from extra-genital tissue). We aim to provide an overview of genital gender affirming surgery for providers who are interested in learning more about genital gender affirming surgery.
Feasibility and Safety of Laparoscopic Placement of Peritoneal Dialysis Catheter Using Percutaneous Endoscopic Gastrostomy Device
Authors: Tsunematsu Masashi , Sugita Kazuya , Odaira Hironori , Ikegami Toru , Washida Naoki , Suzuki Yutaka
Published: June 2022

We developed a novel technique of peritoneal dialysis (PD) catheter placement using an existing device originally utilized to insert a percutaneous endoscopic gastrostomy tube. We investigated the feasibility and safety of the procedure. This study included 21 consecutive patients who underwent laparoscopic placement of PD catheter between August 2021 and December 2021. We retrospectively investigated the clinical variables and perioperative results. The laparoscopic procedure was successfully performed in all patients. The duration of surgery was 21 (18-37) minutes. All patients could start PD within the seventh postoperative day. However, 1 patient had peri-catheter leakage due to exit-site infection. There were no patients with catheter migration, catheter obstruction, peritonitis, procedure-related death, and withdrawal of PD. The laparoscopic placement PD catheter using percutaneous endoscopic gastrostomy device was feasible and safe. (128 words)
Pediatric Antibiotic Prescribing and Utilization Practices for RTIs at Private Urgent Care Centers
Authors: Mannix Mary Kathryn , Vandehei Thor , Ulrich Emily , Black Thomas A. , Wrotniak Brian , Islam Shamim
Published: June 2022

Data on pediatric antibiotic prescribing and utilization practices at urgent care centers (UCC) remain limited. In this study, an electronic medical record–based review of UCC encounters for respiratory tract infections (RTI) of patients belonging to one mid-sized pediatric practice was performed. Antibiotic prescribing and guideline adherence were compared between UCCs that were staffed exclusively by pediatric-trained providers to those staffed otherwise. Of a total of 457 RTI visits, 330 (72%) occurred at the pediatric UCC. Across all bacterial RTIs, 82% of encounters at the pediatric UCC were guideline-adherent versus 59% at nonpediatric UCCs ( P < .001). At nonpediatric UCCs, pharyngitis was the most common RTI encounter diagnosis (40%), and full streptococcal management guideline adherence was 41%. While 93% of RTI-UCC encounters for <2 years were at pediatric UCCs, the majority of children >10 presented to nonpediatric UCCs. RTI guideline education to UCCs should be a focus of ambulatory stewardship efforts.
Maxwell-Wagner-Sillars interfacial polarization in dielectric spectra of composite materials: Scaling laws and applications
Authors: Samet Mariem , Kallel Ali , Serghei Anatoli
Published: June 2022

An experimental and theoretical investigation of the scaling laws governing the phenomenon of Maxwell-Wagner-Sillars interfacial polarization in composite materials in dependence on morphology, volume fraction, orientation of fillers, form factor and the presence of interphases is presented in the current study. By considering the complex dielectric function of the matrix and of the fillers, the dielectric spectra are calculated in the frequency range from 107 Hz to 10-2 Hz and compared to dielectric measurements by Broadband Dielectric Spectroscopy, carried out in the frequency range from 107 Hz to 0.5Hz and between -90oC and 150oC. The characteristic frequencies of the global dielectric response are reported to strongly vary with the conductivity value of the conductive phase, while a much weaker dependence is observed upon varying the volume fraction, the form factor and the orientation of fillers. The value of permittivity at low frequency does not change with the conductivity value, whereas a significant variation is observed in dependence on the composite morphology, form factor, orientation of fillers and presence of interfaces with different gradients of properties. Two possible applications of our analysis are reported: (i) measuring the conductivity of materials without employing a direct electrical contact between the electrodes and the sample and (ii) discriminating different phenomena of electrical polarization in complex materials by analyzing the scaling laws. Our study delivers thus a useful and necessary analysis of the dielectric behavior of composite materials, where interfacial polarization effects play a major role.
Violent Political Protest: Introducing a New Uppsala Conflict Data Program Data Set on Organized Violence, 1989-2019
Authors: Svensson Isak , Schaftenaar Susanne , Allansson Marie
Published: June 2022

This article presents the Uppsala Conflict Data Program (UCDP) “Violent Political Protest” (VPP) data set: a new –standalone- category of organized violence, which complements, and is compatible with, UCDP’s three categories of organized violence: one-sided violence, non-state, and state-based conflict. It consists of violent political protests, with at least 25 casualties during a year, in which informally organized civilians challenge states over governmental or territorial issues. We describe the data collection process, and demonstrate the data’s use with empirical analyses. Violent political protest is present globally, but most prevalent in the Middle East and Africa, and increasingly common over time. Violent political protest frequently co-occurs with state-based conflicts, but rarely due to conflict escalation. We explore if this is due to shared contexts, and find that gender inequality increases the likelihood of VPP onset, similar to state-based conflicts. Finally, we identify avenues for future research, including using VPP to assist in a more precise and complete analysis of organized violence.
Understanding the Performance Effects of “Dark” Salesperson Traits: Machiavellianism, Narcissism, and Psychopathy
Authors: Satornino Cinthia B. , Allen Alexis , Shi Huanhuan , Bolander Willy
Published: June 2022

People with the personality traits of Machiavellianism, narcissism, and psychopathy (i.e., the “dark triad”) are prevalent in the sales profession. Yet research into sales performance drivers tends to focus on positive personality traits. The authors examine the dark triad's effect on salesperson performance and reveal some conditioning factors that influence these links. A longitudinal study that pairs surveys and objective performance data from a national insurance agency reveals the complex effects of dark triad traits on performance over time. Another study, based on data from a direct sales organization and employing social network analysis, relies on partial least squares structural equation modeling to determine the role that the social structure plays in conditioning the relationship between dark triad traits and performance. The results yield insights into both the challenges and the opportunities that dark traits present for managers and scholars.
Is the liberal order on the way out? China’s rise, networks, and the liberal hegemon
Authors: Larson Deborah Welch
Published: June 2022

Recent criticisms by leaders and scholars have raised questions about prospects for survival of the liberal world order as well as the relationship between American hegemony and order. The three books discussed in this essay have similar diagnoses of problems in the liberal order but differ in their prognoses. Yan’s Leadership and the Rise of Great Powers offers an alternative model for leadership of the world order – humane authority. Cooley and Nexon’s Exit from Hegemony maintains that US hegemony is gone for good and the liberal world order is unraveling due to the rise of great power challengers, changing behavior by smaller states, and anti-liberal transnational movements. Ikenberry’s World Safe for Democracy argues that current problems are due to attempted global extension of the liberal order. The liberal order should be restored to its original purpose of providing a protective environment for liberal democracies. All three books emphasize the role of domestic political governance and moral values in contributing to global leadership.
Constitutional Struggles and the Court in Indonesia’s Turn to Authoritarian Politics
Authors: Wiratraman Herlambang P
Published: June 2022

Indonesia’s politics has changed dramatically during Jokowi’s administration. Numbers of scholars argued this situation turns to a ‘new model of authoritarianism’ or declining democracy. The situation is generally referred to as the strengthening of authoritarian politics. Meanwhile, in such situation, the role of the judiciary is the key to balancing power in authoritarian politics. However, in reality, efforts to encourage constitutional struggle through the judiciary will easily reverse the situation to lose its independence. The court could play a significant role in authoritarian politics. This phenomenon has been called the ‘judicialisation of authoritarian politics’. This article dissects how the process of authoritarian political institutionalisation through law and the courts has occurred in the two decades after Suharto’s reforms. Then it examines how civil society changes and the democracy movement have made it possible to advance constitutional rights in the context of Indonesia’s cartel politics and the judicialisation of authoritarian politics. The legal argument for such judicial practice is that authoritarianism has been increasingly institutionalised, facilitating oligarchy networks in a cartelised political system, so that law and the judiciary merely work to strengthen the chain of impunity.
COVID Travel Bans, Citizenship and the Constitution: Do Australian Citizens Have a Constitutional Right of Abode?
Authors: Rangiah Priam
Published: June 2022

The words ‘the people’ of the States and of the Commonwealth appear throughout the Constitution, yet they have received little judicial attention. It remains unclear who constitutes ‘the people’ and what rights or freedoms membership of ‘the people’ entails. This essay explores these uncertainties, suggesting that ‘the people’ have an implied constitutional freedom to enter and remain in Australia without licence from the executive. Recognition of such an implied constitutional freedom would have important implications in the COVID-19 era for the validity of travel bans and restrictions, which exclude citizens from entering Australia on public health grounds.
‘A wedding through a piece of glass’: Transnational Tunisian family communication as driver of ICT adoption
Authors: Toumi Ikram
Published: June 2022

This study focuses on the role of ICT in transnational communication between family members, mainly between elderly parents and adult children living abroad. A semi-structured interview study ( N = 32) was conducted during Fall 2015 in three neighborhoods in the city of Sousse, Tunisia. In the study, Skype played a central role in the respondents’ transnational communication and a driving factor of technology adoption. Families used Skype to communicate with their migrant family members and virtually engage in family activities such as cooking and attending wedding events through the screens of their laptops, tablets, and mobile phones. In other words, Skype evolved from a simple online communication medium to a platform for a transnational family space; it assumes a Tunisian identity and essence stemming from the social practices and experiences of the Tunisian users and becomes shaped by their values and traditions.
Throat Symptoms Before and After Septal Surgery in Adults With Nasal Septum Deviation
Authors: Jafarov Sabuhi , İsazade Artoghrul , Bahçecitapar Melike , Büyüklü Adnan Fuat
Published: June 2022

Objective

To investigate subjective throat symptoms with the Qualities of Sore Throat Index (QuaSTI) in adults with nasal septum deviation.

Study Design

Prospective study.

Setting

Baskent University Ankara Hospital.

Methods

Group 1 included patients with septum deviation. Preoperative data were obtained through evaluation of subjective nasal obstruction with the NOSE (Nasal Obstruction Symptom Evaluation) and throat symptoms with the QuaSTI (group 1a). After 3 months, the same patient group was reevaluated with the NOSE and QuaSTI to obtain postoperative data (group 1b). Group 2 was formed of healthy volunteers with no nasal obstruction.

Results

The mean ± SD and median (range) values of the QuaSTI total score were 33.39 ± 29.50 and 18.5 (0‐90) in group 1a, 7.49 ± 4.31 and 7 (0‐18) in group 2, and 7.58 ± 9.24 and 4.50 (0‐49) in group 1b (group 1a vs 2, P < .001; group 1a vs 1b, P < .0001). A significant difference was determined between groups 1a and 2 with respect to the QuaSTI sensory score (26.58 ± 23.54 and 18 [0‐73] vs 6.51 ± 3.58 and 7 [0‐15], P < .001, respectively) and between groups 1a and 1b for the QuaSTI functional score (6.03 ± 6.62 and 3 [0‐20] vs 1.50 ± 2.47 and 0.50 [0‐13], P = .004). No significant difference was found between groups 1a and 2 in terms of the QuaSTI emotional score (P = .126).

Conclusion

Various persistent sensory and functional throat symptoms can be seen in patients experiencing nasal obstruction associated with septum deviation, and the majority of these symptoms recover after septal surgery.
Systematic Review of Endolymphatic Sac Tumor Treatment and Outcomes
Authors: Tang Joseph D. , Grady Anthony J. , Nickel Christopher J. , Ryan Lindsey E. , Malone Alexander , Canvasser Leah , Boyev Kestutis Paul
Published: June 2022

Objective

Endolymphatic sac tumors are rare neoplasms originating in the endolymphatic sac. Current literature is limited to case reports and small case series. The objective of this study was to systematically review the literature to better describe clinical presentation, treatment options, and outcomes in endolymphatic sac tumors.

Data Source

PubMed, Embase, and Cochrane Library.

Review Methods

A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines describing human endolymphatic sac tumors. Risk of bias was assessed using a validated critical appraisal checklist for case series. Studies without inclusion of individual patient characteristics, corresponding treatments, and outcomes were excluded. Heterogeneity of data precluded meta‐analysis.

Results

A total of 82 studies met inclusion criteria, and 253 discrete tumors were analyzed. A total of 23.4% of patients had von Hippel‐Lindau disease. Von Hippel‐Lindau‐associated tumors affected females to males in a 2.4:1 ratio. Patients with von Hippel‐Lindau disease displayed earlier average age at diagnosis compared to the sporadic cohort. Surgery was the primary treatment modality and was performed in 88.9% of cases. Adjuvant radiation therapy was employed in 18.7% of cases; 16.2% cases recurred, and 10.6% had progression of residual disease after treatment. Mean time to recurrence or progression was 53.1 ± 52.4 months with a range of 3 to 240 months.

Conclusion

Endolymphatic sac tumors require a high degree of suspicion for early diagnosis. Complete resection is the standard of care. No strong evidence supports routine use of adjuvant radiation therapy. Given the high rate of recurrence and wide‐ranging time to recurrence, long‐term follow‐up is necessary.
Caffeine intake in adults with cardiovascular diseases; A cross-sectional study
Authors: Bozkır Çiğdem , Tuğgüm Sergen , Kağan Nursena , Nizam Beydanur , Alpsoy Şeref
Published: June 2022

Background: Caffeine in the safe dose range has been associated with a reduction in the risk of chronic diseases. There is evidence that caffeine intake has both protective and negative effects on cardiovascular diseases. Aim: This study aimed to investigate caffeine intake in cardiovascular patients. Methods: The study sample was selected from individuals who applied to the Cardiology policlinic of Tekirdağ Namık Kemal University Hospital. A questionnaire was applied using face-to-face interview method to determine their demographic information, nutritional status and anthropometric measurements. Moreover, the nutritional status of the participants was determined by the Food Frequency Questionnaire and the type of cardiovascular disease was determined by a physician. The blood parameters of the sample for the last three months were questioned. The sample has been ninety people of whom fifty cardiovascular diseases (CVDs) were diagnosed and forty were non-diagnosed (ND). Results: The mean age of individuals (n = 90) was 43.2 ± 14.4. The BMI and waist circumference of the CVDs group were statistically significantly higher than the ND group (p < 0.001). While the total caffeine consumption of the ND group was 209.34 ± 143.85 mg/day, consumption of the CVDs group was 209.99 ± 196.76 mg/day. LDL cholesterol and total cholesterol did not show statistically significant difference between the two groups. However, HDL cholesterol was significantly higher in the ND group (p ≤ 0.001). Conclusion: Present results show that daily caffeine consumption may partially affect blood parameters associated with cardiovascular diseases, especially in the presence of coronary artery disease.
From ‘Selves’ to ‘One Another’: A Hospitable Proposal for a Post-Colonial Missions Paradigm of Interdependence
Authors: Howell Alan
Published: June 2022

The Three-Selves paradigm of establishing indigenous churches that are Self-Propagating, Self-Supporting, and Self-Governing (later including Self-Theologizing as a Fourth “Self”) has been influential in shaping the “end goal” of Protestant missions. While this paradigm oriented missions towards independence, that objective was still shaped by Colonial ideals. This paper proposes a shift from the goal of independent “Selves” to an interdependent posture of “One-Another-ing” (or “Belonging”) for hosts and guests. That proposal is framed by listening to the language of hospitality from the margins: a reading of oft-neglected texts (2 and 3 John) in the context of northern Mozambique, Africa.
Awake extracorporeal life support and physiotherapy in adult patients: A systematic review of the literature
Authors: Cucchi Marta , Mariani Silvia , De Piero Maria E , Ravaux Justine M , Kawczynski Michal J , Di Mauro Michele , Shkurka Emma , Hoskote Aparna , Lorusso Roberto
Published: June 2022

Objective

The Awake Extracorporeal Life Support (ECLS) practice combined with physiotherapy is increasing. However, available evidence for this approach is limited, with unclear indications on timing, management, and protocols. This review summarizes available literature regarding Awake ECLS and physiotherapy application rates, practices, and outcomes in adults, providing indications for future investigations.

Methods

Four databases were screened from inception to February 2021, for studies reporting adult Awake ECLS with/without physiotherapy. Primary outcome was hospital discharge survival, followed by Extracorporeal Membrane Oxygenation (ECMO) duration, extubation, Intensive Care Unit stay.

Results

Twenty-nine observational studies and one randomized study were selected, including 1,157 patients (males n = 611/691, 88.4%) undergoing Awake ECLS. Support type was reported in 1,089 patients: Veno-Arterial ECMO (V-A = 39.6%), Veno-Venous ECMO (V-V = 56.8%), other ECLS (3.6%). Exclusive upper body cannulation and femoral cannulation were applied in 31% versus 69% reported cases ( n = 931). Extubation was successful in 63.5% ( n = 522/822) patients during ECLS. Physiotherapy details were given for 676 patients: exercises confined in bed for 47.9% ( n = 324) patients, mobilization until standing in 9.3% ( n = 63) cases, ambulation performed in 42.7% ( n = 289) patients. Femoral cannulation, extubation and V-A ECMO were mostly correlated to complications. Hospital discharge survival observed in 70.8% ( n = 789/1114).

Conclusion

Awake ECLS strategy associated with physiotherapy is performed regardless of cannulation approach. Ambulation, as main objective, is achieved in almost half the population examined. Prospective studies are needed to evaluate safety and efficacy of physiotherapy during Awake ECLS, and suitable patient selection. Guidelines are required to identify appropriate assessment/evaluation tools for Awake ECLS patients monitoring.
Opportunities and Challenges When Using the Electronic Health Record for Practice-Integrated Patient-Facing Interventions: The e-Assist Colon Health Randomized Trial
Authors: Elston Lafata Jennifer , Shires Deirdre A. , Shin Yongyun , Flocke Susan , Resnicow Kenneth , Johnson Morgan , Nixon Ellen , Sun Xinxin , Hawley Sarah
Published: June 2022

Background

Even after a physician recommendation, many people remain unscreened for colorectal cancer (CRC). The proliferation of electronic health records (EHRs) and tethered online portals may afford new opportunities to embed patient-facing interventions within clinic workflows and engage patients following a physician recommendation for care. We evaluated the effectiveness of a patient-facing intervention designed to complement physician office-based recommendations for CRC screening.

Design

Using a 2-arm pragmatic, randomized clinical trial, we evaluated the intervention’s effect on CRC screening use as documented in the EHR (primary outcome) and the extent to which the intervention reached the target population. Trial participants were insured, aged 50 to 75 y, with a physician recommendation for CRC screening. Typical EHR functionalities, including patient registries, health maintenance flags, best practice alerts, and secure messaging, were used to support research-related activities and deliver the intervention to enrolled patients.

Results

A total of 1,825 adults consented to trial participation, of whom 78% completed a baseline survey and were exposed to the intervention. Most trial participants (>80%) indicated an intent to be screened on the baseline survey, and 65% were screened at follow-up, with no significant differences by study arm. One-third of eligible patients were sent a secure message. Among those, more than three-quarters accessed study material.

Conclusions

By leveraging common EHR functionalities, we integrated a patient-facing intervention within clinic workflows. Despite practice integration, the intervention did not improve screening use, likely in part due to portal-based interventions not reaching those for whom the intervention may be most effective.

Implications

Embedding patient-facing interventions within the EHR enabled practice integration but may minimize program effectiveness by missing important segments of the patient population.

Highlights

Electronic health record tools can be used to facilitate practice-embedded pragmatic trial and patient-facing intervention processes, including patient identification, study arm allocation, and intervention delivery. The online portal-embedded intervention did not improve colorectal cancer (CRC) screening uptake following a physician recommendation, likely in part because portal users tend to be already highly engaged with healthcare. Relying on patient portals alone for CRC screening interventions may not alter screening use and could exacerbate well-known care disparities.
Changes in Anatomic Risk Factors for Patellar Instability During Skeletal Growth and Maturation
Authors: Pruneski James , O’Mara Lauren , Perrone Gabriel S. , Kiapour Ata M.
Published: June 2022

Background:

Several anatomic risk factors have been identified in the pathogenesis of patellofemoral instability. The literature is sparce regarding how these anatomic risk factors change during skeletal growth and development.

Hypothesis:

The anatomic risk factors associated with patellar instability change significantly during skeletal growth and maturation with different patterns in male versus female patients.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Magnetic resonance imaging data from 240 unique, asymptomatic knees (7-18 years of age; 50% female) were used to measure patellar height (Caton-Deschamps index), lateral patellar tilt angle, trochlear height, trochlear groove depth, trochlear sulcus angle, and tibial tubercle–trochlear groove (TT-TG) distance. Linear regression was used to test the associations between age and anatomic findings. Two-way analysis of variance with Holm-Šídák post hoc test was used to compare anatomic characteristics between sexes in 3 age groups: prepubertal school-aged children (7-10 years old), early adolescents (11-14 years old), and late adolescents (15-18 years old).

Results:

Patellar height (female sex), lateral patellar tilt angle (male sex), and trochlear sulcus angle (both sexes) decreased with age ( P < .001). Trochlear height, depth, and TT-TG distance increased with age in both male and female participants ( P < .02). Male participants had a larger sulcus angle (by 5.3°± 1.6° at age 11-14 years) and greater trochlear height (by >5 mm across medial, central, and lateral regions at age 15-18 years) than age-matched female participants ( P < .01). We found no other sex-related differences in quantified anatomic features ( P > .1).

Conclusion:

The findings partially support our hypothesis indicating significant age-related changes in all quantified features, which were not different between male and female participants except for trochlear sulcus angle in early adolescence and trochlear height in late adolescence. In general, the majority of anatomic risk factors for patellar instability change with maturity in a direction that assists in reducing the risk of patellar instability and/or dislocation. The only outlier is the TT-TG distance, which increased by age, and in our oldest cohort of patients, the mean fell below the normal adult range. The current observations highlight the importance of age in the interpretation of risk for injury as well as the need for further studies to identify intrinsic and extrinsic factors that may result in abnormal development of these anatomic features during skeletal growth and maturation.
Effect of the Inverted V-Shaped Osteotomy on Patellofemoral Joint and Tibial Morphometry as Compared With the Medial Opening Wedge High Tibial Osteotomy
Authors: Kondo Eiji , Yabuuchi Koji , Joutoku Zenta , Matsubara Shinji , Iwasaki Koji , Matsuoka Masatake , Onodera Tomohiro , Momma Daisuke , Inoue Masayuki , Yagi Tomonori , Iwasaki Norimasa , Yasuda Kazunori
Published: June 2022

Background:

Recent studies have reported that medial opening wedge (OW) high tibial osteotomy (HTO) induces patella baja, resulting in degenerative changes in the patellofemoral joint. We have developed an inverted V-shaped (iV) HTO, which is classified as a neutral wedge osteotomy.

Hypotheses:

The study hypotheses were as follows: (1) patellar height, posterior tibial slope, and tibial length will not change between pre- and postoperative evaluations after iV-HTO; (2) the lateral shift ratio of the patella and the distance between the tibial tubercle and the trochlear groove may be significantly decreased after iV-HTO.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 191 patients (220 knees) who underwent HTO for medial osteoarthritis were enrolled retrospectively in this study: 107 knees underwent OW-HTO and 113 knees underwent iV-HTO. Clinical and radiological evaluations were performed before and at least 3 years after surgery.

Results:

Postoperatively, the mean Caton-Deschamps ratio was significantly decreased ( P < .0001) from 0.95 to 0.79 in the OW group, while there were no significant changes in the iV group. The mean posterior tibial slope was significantly increased ( P < .0001) from 8.5° to 10.5° in the OW group, while there were no significant differences in the iV group. Although the entire leg length was significantly increased ( P < .0003) in both groups after HTO, there were no significant differences in tibial length between the pre- and postoperative periods in the iV group. Regarding the congruity of the patellofemoral joint, the mean lateral shift ratio did not significantly change in the OW group, whereas it was significantly decreased ( P = .0012) from 11.5% to 8.8% in the iV group. The mean tibial tubercle–trochlear groove distance was significantly decreased ( P < .0001) from 12.8 to 9.7 mm in the iV group, while it was significantly increased in the OW group ( P < .0001). Concerning the clinical outcome, the Japanese Orthopaedic Association (JOA) and Lysholm knee scores at final follow-up (OW vs iV: JOA, 91.2 vs 90.1; Lysholm, 92.5 vs 89.0) were significantly increased ( P < .0001) as compared with the preoperative values (OW vs iV: JOA, 68.3 vs 66.8; Lysholm, 67.9 vs 61.0).

Conclusion:

Patellar height, posterior tibial slope, and tibial length did not change after the iV-HTO, while they were significantly changed after the OW-HTO. Although the preoperative degrees of varus knee and patellofemoral osteoarthritis were more severe in the iV group than the OW group, the iV-HTO led to altered patellofemoral joint congruity.
Multiple roles of ghrelin in breast cancer
Authors: Chen Yiding , Han Xuke , Wang Lan , Wen Qing , Li Liufu , Sun Lisha , Chen Qiu
Published: June 2022

Breast cancer is one of the most threatening malignant tumors in women worldwide; hence, investigators are continually performing novel research in this field. However, an accurate prediction of its prognosis and postoperative recovery remains difficult. The severity of breast cancer is patient-specific and affected by several health factors; thus, unknown mechanisms may affect its progression. This article analyzes existing literature on breast cancer, ranging from the discovery of ghrelin to its present use, and aims to provide a reference for future research into breast cancer mechanisms and treatment-plan improvement. Various parts of ghrelin have been associated with breast cancer by direct or indirect evidence. The ghrelin system may encompass the direction of expanding breast cancer treatment methods and prognostic indicators. Therefore, we compiled almost all studies on the relationship between the ghrelin system and breast cancer, including unacylated ghrelin, its GHRL gene, ghrelin O-acyltransferase, the receptor growth hormone secretagogue receptor, and several splice variants of ghrelin to lay the foundation for future research.
Getting news from social media influencers and from digital legacy news outlets and print legacy news outlets in seven countries: The “more-and-more” phenomenon and the new opinion leadership
Authors: Martin Justin D. , Sharma Krishna
Published: June 2022

Legacy news consumption was found to be a predictor of getting news from social media influencers (SMIs) among respondents in seven nationally representative samples in Arab countries (N = 5,166). Getting news from SMIs does not seem to be an “alternative” for persons disenchanted with legacy media; SMI news use may, itself, be a form of legacy news consumption. The results provide strong evidence of the more-and-more phenomenon first identified by Lazarsfeld et al.
Power with Presence: Connecting Theory and Knowledge to Nursing Practice
Authors: Carroll Karen
Published: June 2022

Theory and knowledge connect and constitute disciplinary-centered practice. Nursing theories and knowledge thus propel nursing practice through leading-following processes cocreated with and directed toward the betterment of persons, families, and communities amid changing social and healthcare contexts. In the article that follows, the Roy adaptation model provides a guiding light and structure to focus on emerging healthcare requisites expressed by persons and communities.
Ethics and Emerging Health Policy
Authors: Milton Constance L.
Published: June 2022

Following the tumultuous times of a pandemic, members of the healthcare disciplines, including nursing, face mounting priorities and ethical straight-thinking questions for policy development. The processes for developing ethical policies must acknowledge others’ health priorities and what matters to them instead of political agendas that dominate global thinking. An example of doing harm in healthcare is examined here as a priority leadership policy opportunity from a humanbecoming ethos understanding.