bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-World Moderate-to-Severe Hidradenitis Suppurativa: Decrease in Disease Burden With Adalimumab
Authors: Gulliver Wayne , Alavi Afsaneh , Wiseman Marni C. , Gooderham Melinda J. , Rao Jaggi , Shayesteh Alam Maryam , Papp Kim A. , Desjardins Olivier , Jean Christine
Published: March 2022

Background

Real-world knowledge of the burden of hidradenitis suppurativa (HS) on patients remains limited.

Objectives

To measure the impact of adalimumab on moderate-to-severe HS patients’ health-related quality of life (HRQoL) and work productivity.

Methods

In 23 Canadian centres, 138 adults with moderate-to-severe HS requiring a change in ongoing therapy were treated with adalimumab for up to 52 weeks as per the physician’s practice. Patient-reported outcome measures (PROMs) were obtained at baseline, weeks 24 and 52 to measure overall HRQoL, HS severity, levels of anxiety and depression, impact and symptoms of HS, work productivity and activity impairment. A post-hoc analysis further explored the PROMs by abscess and inflammatory nodule (AN) count at baseline (≤5, low; 6–10, medium; ≥11, high).

Results

From baseline to weeks 24 and 52, all PRO overall scores improved significantly ( P ≤ .0023). The number of patients reporting “good disease control” and “complete disease control” increased from 9.7% to 66.4% over 52 weeks. The score in Health Utility Index Mark 3 (HUI3) pain attribute meaningfully decreased over 52 weeks (mean difference ≥.05). The HS symptoms skin “tenderness” and “itchiness” improved the most. Work productivity loss and activity impairment improved by approximately 20% over 52 weeks. Disease burden improved more in 24 week responders with low and medium AN counts at baseline than in those with high AN count or in 24 week nonresponders.

Conclusion

At week 24 and maintained at week 52 in a real-world setting, adalimumab meaningfully improved HRQoL, work productivity, and activity impairment in moderate-to-severe HS patients.
The doge worth 88 billion dollars: A case study of Dogecoin
Authors: Nani Albi
Published: March 2022

In the modern financial system, the ability to create money is in the hands of a few central institutions. Blockchain networks, and by extension cryptocurrencies, were created with the promise of giving that power to users. The most well-known example of a blockchain technology achieving such decentralization is Bitcoin, but its popularity has arguably been matched by an alternative-currency named Dogecoin. Unlike other cryptocurrencies, which have marketed themselves on differentiating technical features, Dogecoin’s allure likely stems from its cultural roots as a meme. Where cryptocurrency is typically regarded as a difficult topic to grasp, the introduction of Doge’s (2013) most popular meme, into the crypto-space increased crypto’s accessibility to new participants. Consequently, Dogecoin exists in two economies: the financial economy and the cultural meme economy, with the latter having unprecedented tangible impacts on the former. Dogecoin’s unique cultural significance provides an example of how blockchain can succeed in promoting alternative money systems. At its peak in 2021, Dogecoin achieved a market capitalization of $88 billion. Where analysis of the Dogecoin phenomenon is lacking in the current literature, we will fill that gap with a case study of Dogecoin. By studying Dogecoin as a combination of money and meme, we can further our understanding of how to better promote social finance initiatives through the virality of memes.
Methodological reflections on Foucauldian analyses: Adopting the pointers of curiosity, nominalism, conceptual grounding and exemplarity
Authors: Hansen Magnus Paulsen , Triantafillou Peter
Published: March 2022

This article seeks to provide a set of pointers for methodological reflections on Foucauldian-inspired analyses of the exercise of power. Michel Foucault deliberately eschewed methodological schemata, which may be why so little has been written on the methodological implications of his analyses. While this article shares the premise that we should refrain from a standardized methodology, it argues that providing broad pointers for analyses informed by the critical ambition and conceptual framework offered by Foucault is both desirable and possible. The article then offers some reflections and general guidelines on how to strengthen the methodological quality of Foucauldian analyses. We argue that the quality of Foucauldian-inspired analysis of modern power may gain from methodological reflections around four pointers: curiosity, nominalism, conceptual grounding and exemplarity.
“My mother is not newsworthy”: Framing missingness in Israel
Authors: Katz Ori
Published: March 2022

This research explores the processes of framing civilian (as opposed to military-related) missingness in Israel. The people who have been left behind, and particularly the missing persons’ loved ones, seek to frame missingness stories in such a way as to make them newsworthy. However, civilian missingness lacks both cultural scripts and an end to the stories. Thus, I argue, those left behind must use meta-narratives to assert the newsworthiness of these stories. Based on narrative ethnography, I explore two kinds of framings that are used, both reflecting an acceptance of the life/death dichotomy. The first framing (“the child of us all”), is collective in form, and derives from stories with a wide cultural resonance such as cases of missing soldiers. The second framing (“it can happen to anyone”), which highlights individualism, borrows from a common framing of missing persons in the US, particularly about missing young white women. Ultimately, both framings generally fail to achieve wide resonance in Israel. Together with the failure to achieve an ontological solution, I argue, missingness might then be constructed as a stable category. This category has the potential to be a subversive one, creating new cultural scripts that challenge meta-narratives as well as the distinction between life and death.
Development of a checklist to assess COVID-19 information on orthodontic webpages
Authors: Keshtgar Safoora , Hodges Samantha , Owaise Sharif Mohammad
Published: March 2022

Objective:

To create a COVID-19 information checklist and critique all available webpages of hospitals with an orthodontic department in England.

Design:

Cross-sectional analysis.

Setting:

World Wide Web.

Methods:

A 16-item COVID-19 webpage checklist was developed using up-to-date COVID-19 government advice, and the General Dental Council Principles of Ethical Advertising. Presence of advice on managing orthodontic appliance breakages, information on outpatient appointment changes and video consultations was also assessed. The checklist was used to undertake a cross-sectional analysis of all available webpages of hospitals with an orthodontic department in England between September 2020 to October 2020.

Results:

A total of 61 webpages were assessed. Of them, 95% had a COVID-19 section on the homepage, including advice on the use of face coverings during hospital visits. Only 18% of websites provided information on orthodontic appliance care and breakages. Four orthodontic department websites stated the department was closed during this study. The mean update interval of the webpages was six weeks (range = 1–28 weeks). Only one webpage fully conformed with the COVID-19 checklist.

Conclusion:

Availability and completeness of COVID-19 information on webpages of hospitals with an orthodontic department varied, which may be due to the absence of a formal COVID-19 information webpage checklist. The checklist produced in this research may prove valuable to encourage uniform patient support and positive patient experience across orthodontic services. Principles behind the development of the checklist could be adopted during prolonged service disruptions to ensure optimal patient communications. The checklist is equally applicable to primary and secondary care settings.
Laypeople’s interpretation of, and preference for, orthodontic images
Authors: Berry Lauren , Jones Adam , Barber Sophy
Published: March 2022

Background:

Good communication is fundamental to provision of information and patient engagement in orthodontic treatment. Images can be used to support verbal and written information, but little is known about how laypeople interpret orthodontic images.

Objective:

To explore laypeople’s understanding and preferences for images (clinical photographs and medical illustrations) relating to orthodontic diagnoses and treatments.

Design:

Cross-sectional survey.

Setting:

UK.

Population:

Laypeople aged ⩾16 years.

Methods:

Participants were recruited through social media to complete an online questionnaire containing six pairs of images (clinical photograph and medical illustration) relating to orthodontic diagnoses and treatment. Photographs were selected from a bank with input from laypeople, then a matching medical illustration was created. Images were presented with questions relating to interpretation, preferences and reasons for preferences.

Results:

A total of 898 people completed the questionnaire. Interpretation of images by laypeople was variable and, in some cases, normal intra-oral features and image orientation caused confusion. A combination of photograph and illustration were preferred for images representing diagnosis (by 41%–50% participants), whereas the illustration alone or both photograph and illustration together was preferred for explaining treatment (43%–48% and 35%–44%, respectively). Photographs were liked for their realism and relatability, while illustrations were often found to be clearer. Arrows aided participants’ understanding of the images, but annotations were requested to further improve the value of images. Only 26% of participants reported having previously been shown dental images, but 96% felt they would be helpful to support verbal and written information.

Conclusion:

Laypeople may not interpret orthodontic images in the way that professionals expect, and unfamiliar intra-oral features may distract people from the intended focus of the image. A combination of photographs and illustrations together may improve the usefulness of images, alongside annotation or explanation.
A non-invasive system to manage impacted teeth associated with a large dentigerous cyst
Authors: Maltoni Manuela , Maltoni Ivano , Santucci Giorgia , Guiducci Daniela , Cremonini Francesca , Lombardo Luca
Published: March 2022

A male patient aged 11 years presented a large dentigerous cyst in the lower left quadrant associated with retained deciduous lower lateral incisor and canine and impacted, unerupted corresponding permanent ones. The treatment consisted in marsupialisation and placement of a modified lingual arch that held a tube for decompression used for irrigation of the cystic cavity in a comfortable way for the patient and for the clinician.

The same lingual arch was later used as an anchorage method for traction of the retained teeth. The final records showed complete resolution of the cyst and retained teeth were successfully Aligned into the oral cavity.
Why Do We Only Get Anime Girl Avatars? Collective White Heteronormative Avatar Design in Live Streams
Authors: Brett Noel
Published: March 2022

With live streaming rising in popularity, many people stream the creation of 3D avatars However, many of these avatars end up following a similar output: a hyper-feminized anime girl. Why is this? What are the social and technological processes constructing these avatars? To answer these questions, I propose that human (streamer and audience) and non-human (streaming platform and 3D modeling software) participants interact to produce the cultural experience of the live stream, re-producing common heteronormative, cisgendered, and racialized tropes about bodies and desirable avatars. And so, I take as my object of study the interaction that happens when all of these participants merge, forming what I call a white heteronormative assemblage. I argue that this assemblage is collective, relational, and self-reinforcing. Analyzing the relations between human and non-humans participants helps us turn our analytical lens away from media content or streamer motive, and instead toward the restrictive outcomes of such interactions.
Significant in-Vitro and in-Vivo Antimicrobial and Antibiofilm Activity of Colloidal Silver Nanoparticles (cAgNPs) in Chronic Diabetic Foot Ulcers
Authors: Singh Aradhana , Sharma Swati , Banerjee Tuhina , Pratap Arvind , Shukla Vijay Kumar
Published: March 2022

Infection is a foremost challenge in the cases of wound care, especially in cases of chronic wounds. The present study was conducted to determine the antimicrobial and antibiofilm activity of the colloidal silver nanoparticles (cAgNPs) on Gram positive organisms and to evaluate the in-vivo response of cAgNPs on patients of chronic diabetic foot ulcers (DFUs). cAgNPs were tested against selected Gram-positive organisms like methicillin-sensitive and resistant Staphylococcus aureus (MSSA, MRSA), Enterococcus faecalis and vancomycin resistant enterococci (VRE) using microbroth dilution assay to estimate minimum inhibitory/bactericidal concentration (MIC/MBC). Biofilm inhibition capacity and time kill assay was performed. Further, the in-vivo response of topical application of cAgNPs was evaluated on patients of DFUs. The susceptibility testing demonstrated the MIC and MBC values of the cAgNPs ranging from 0.5μg/ml to 1.0 μg/ml and 1.0 μg/ml to 8 μg/ml against the tested organisms respectively. The cAgNPs showed inhibition of biofilm formation in the low, medium and high biofilm producers by 91%, 83% and 75% respectively at the highest concentration (52ppm). The time kill kinetics showed significant reduction in the number of viable cells (p < 0.0001). Significant reduction in microbial load (p = 0.0062) and in the number of moderate to strong biofilm producing organisms (p = 0.0069) after treatment with cAgNPs was seen. cAgNPs exhibited significant in-vitro bactericidal and bacteriostatic activity against MRSA, MSSA and VRE respectively along with anti-biofilm activity. Additionally, cAgNPs showed significant reduction in microbial load of the chronic DFUs.
Individuals with Chronic Mild-to-Moderate Traumatic Brain Injury Exhibit Decreased Neuromuscular Complexity During Gait
Authors: Acuña Samuel A. , Tyler Mitchell E. , Thelen Darryl G.
Published: March 2022

Background

Synergy analysis provides a means of quantifying the complexity of neuromuscular control during gait. Prior studies have shown evidence of reduced neuromuscular complexity during gait in individuals with neurological disorders associated with stroke, cerebral palsy, and Parkinson’s disease.

Objective

The purpose of this study was to investigate neuromuscular complexity during gait in individuals who experienced a prior traumatic brain injury (TBI) that resulted in chronic balance deficits.

Methods

We measured and analyzed lower extremity electromyographic data during treadmill and overground walking for 44 individuals with residual balance deficits from a mild-to-moderate TBI at least 1 year prior. We also tested 20 unimpaired controls as a comparison. Muscle synergies were calculated for each limb using non-negative matrix factorization of the activation patterns for 6 leg muscles. We quantified neuromuscular complexity using Walk-DMC, a normalized metric of the total variance accounted for by a single synergy, in which a Walk-DMC score of 100 represents normal variance accounted for. We compared group average synergy structures and inter-limb similarity using cosine similarity. We also quantified each individual’s gait and balance using the Sensory Organization Test, the Dynamic Gait Index, and the Six-Minute Walk Test.

Results

Neuromuscular complexity was diminished for individuals with a prior TBI. Walk-DMC averaged 92.8 ± 12.3 for the TBI group during overground walking, which was significantly less than seen in controls (100.0 ± 10.0). Individuals with a prior TBI exhibited 13% slower overground walking speeds than controls and reduced performance on the Dynamic Gait Index (18.5 ± 4.7 out of 24). However, Walk-DMC measures were insufficient to stratify variations in assessments of gait and balance performance. Group average synergy structures were similar between groups, although there were considerable between-group differences in the inter-limb similarity of the synergy activation vectors.

Conclusions

Individuals with gait and balance deficits due to a prior TBI exhibit evidence of decreased neuromuscular complexity during gait. Our results suggest that individuals with TBI exhibit similar muscle synergy weightings as controls, but altered control of the temporal activation of these muscle weightings.
A novel two-dimensional reversible data hiding scheme based on high-efficiency histogram shifting for JPEG images
Authors: He Ben , Chen Yi , Zhou Yonghui , Wang Yongrong , Chen Yanli
Published: March 2022

In recent years, reversible data hiding technology has been widely used in JPEG images for special purposes such as file management and image authentication. Histogram shifting is one of the most popular techniques for achieving reversible data hiding technology. However, invalid shifting in histogram shifting limits the performance of existing reversible data hiding schemes. Therefore, we propose a two-dimensional histogram shifting-based reversible data hiding scheme in this article to improve the performance of marked JPEG images in terms of visual quality and file size. In the proposed histogram shifting method, only the coefficient pairs containing two non-zero quantized discrete cosine transform coefficients are changed for embedding data. Specifically, the coefficient pairs with at least one quantized discrete cosine transform coefficient valued −1 or +1 are shifted and the rests leave room for embedding data. With our proposed reversible data hiding scheme, the number of invalid shifting pixels is reduced so that it improves the performance of marked JPEG images. The experimental results show that the proposed method achieves a higher peak signal-to-noise ratio and has a lower increase in file size than state-of-art methods.
Collection tree-oriented mesh routing optimization for extending the lifetime of wireless sensor networks
Authors: Yuan Li-Yong , Lin Fei-Long
Published: March 2022

Routing optimization in wireless sensor networks facilitates to reduce the overhead of the maintaining of wireless sensor networks and extend the lifetime of wireless sensor networks. Collection tree-based routing protocol, which does not require route discovery, has been widely used for low overheads of calculation and storage. However, with collection tree-based routing protocol, some nodes easily become the bottleneck points and quickly run out of the energy. To deal with this drawback, this article proposes a collection tree-oriented mesh routing strategy with cooperatively consuming the residual energy among the neighboring sensor nodes. The collection tree-oriented mesh routing is formulated into a linear programming problem with the purpose to maximize the network lifetime. By solving the optimization problem, the optimal mesh routing and data forwarding scheme is derived. Experimental simulations show that the proposed collection tree-oriented mesh routing optimization strategy can extend the network lifetime by more than 20%.
Giant Cell Tumor of the Triquetrum: Clinical Case and Literature Review
Authors: Calderon Adrià , Martínez-Ruiz Amalia , Subirà-i-Álvarez Teresa , Oraa Luis , Llorens Xavi , Mora José Maria
Published: March 2022

Giant cell tumor (GCT) is a benign, locally aggressive neoplasm with little incidence at the carpal bone level. We present a case of pyramidal bone GCT that required open biopsy for diagnosis. As a definitive treatment, en bloc resection of the pyramidal bone and luno-capitate arthrodesis were performed to avoid frequent relapses of these neoplasms and ensure proper functionality of the anatomical segment.
Comparing the Radiologic and Functional Outcome of Radial Shortening Versus Capitate Shortening in Management of Kienböck’s Disease
Authors: Mazhar Farid Najd , Motaghi Paniz , Kooshesh Mohammad Reza , Mahmoudinasab Omid
Published: March 2022

Background:

Kienböck’s disease is the avascular necrosis of the lunate bone. There is no consensus on the treatment strategy to avoid joint deterioration. This trial is conducted to compare the functional and radiological outcomes of radial shortening and capitate shortening techniques, in patients with avascular necrosis of lunate.

Methods:

Patients with a confirmed diagnosis of Kienböck’s disease who met the inclusion criteria were randomly divided into radial shortening and capitate shortening groups and treated by allocated technique. Physical examination and radiologic evaluations were performed before and 6 and 12 months after the operation.

Results:

A total of 52 patients (52 wrists) of stage II or III Kienböck’s disease were assessed for eligibility, 12 patients in the radial shortening group, and 17 patients remained until the end of the study. Patients in both groups achieved a satisfactory outcome, with no report of postoperative complications. None of the outcome measures, ranges of motion, grip, and pinch strengths were significantly different between the groups. The outcome was not considerably different in patients with positive or negative ulnar variances who were treated by capitate shortening technique.

Conclusions:

The capitate shortening technique which is performed through a smaller incision, and takes less time as compared with radial shortening can be advantageous for patients with stage II or III Kienböck’s disease regardless of the ulnar variance. This method can be as effective as classical methods such as radial shortening in improving clinical and functional symptoms after surgery while causing fewer complications.
Impact of COVID-19 on the Work, Health, and Quality of Life of Brazilian Hand Surgeons
Authors: Cagnolati Amanda Favaro , Andrade Fernanda Ruiz , Mandarano-Filho Luiz Garcia , Mazzer Nilton , Barbieri Cláudio Henrique , Chen Neal C.
Published: March 2022

Background:

To evaluate the impact of coronavirus disease 2019 (COVID-19) on the clinical practice, health, and quality of life of Brazilian hand surgeons when only essential services and emergency procedures were being provided.

Method:

A questionnaire of 50 questions was sent to members of the Brazilian Society of Hand Surgery addressing work and life routines before the pandemic and during the initial quarantine period from April to August 2020.

Results:

Two hundred ten hand surgeons answered the questionnaire; 55.2% lived in the southeast region and worked in the capital and metropolitan regions, in both the private and public systems. Thirty-eight percent of the sample had other sources of income besides medicine, and due to a drop of 50% or more in the volume of consultations and surgeries, one-third had to apply for financial loans or access personal savings, and 69% made financial cuts in their domestic and life routines. More than 40% gained weight and stopped doing physical activities, while 20% lost weight and started physical activities. Approximately 30% were diagnosed with COVID-19, 92% of whom had mild symptoms and quarantined at home, and 89% had psychological symptoms such as anxiety, fear, insecurity, and insomnia.

Conclusions:

Coronavirus disease 2019 had a significant impact on the lives of Brazilian hand surgeons by drastically reducing the number of consultations and surgical procedures, generating not only financial difficulties but also changes in the exercise routine, changes in body weight, associated psychological symptoms, and changes in the family/life routine.
Validation of a Smartphone-Based Institutional Electronic Data Capture System for Thumb Carpometacarpal Joint Arthroplasty
Authors: Chughtai Morad , Scollan Joseph P. , Emara Ahmed K. , Jin Yuxuan , Evans Peter J. , Shapiro David B. , Styron Joseph F.
Published: March 2022

Background:

The Orthopaedic Minimal Data Set (OrthoMiDaS) Episode of care (OME) is a prospectively collected database enabling capture of patient and surgeon-reported data in a more efficient, comprehensive, and dependable manner than electronic medical record (EMR) review. We aimed to assess and validate the OME as a data capture tool for carpometacarpal (CMC) arthroplasty compared to traditional EMR-based review. Specifically, we aimed to: (1) compare the completeness of the OME versus EMR data; and (2) evaluate the extent of agreement between the OME and EMR data-based datasets for carpometacarpal (CMC) arthroplasty.

Methods:

The first 100 thumb CMC arthroplasties after OME inception (Febuary, 2015) were included. Blinded EMR-based review of the same cases was performedfor 48 perioperative variables and compared to their OME-sourced counterparts. Outcomes included completion rates and agreement measures in OME versus EMR-based control datasets.

Results:

The OME demonstrated superior completion rates compared to EMR-based retrospective review. There was high agreement between both datasets where 75.6% (34/45) had an agreement proportion of >0.90% and 82.2% (37/45) had an agreement proportion of >0.80. Over 40% of the variables had almost perfect to substantial agreement (κ > 0.60). Among the 6 variables demonstrating poor agreement, the surgeon-inputted OME values were more accurate than the EMR-based review control.

Conclusions:

This study validates the use of the OME for CMC arthroplasty by illustrating that it is reliably able to match or supersede traditional chart review for data collection; thereby offering a high-quality tool for future CMC arthroplasty studies.
The One-Bone Forearm: A Review
Authors: Multani Iqbal , Xu Joshua , Manji Jamil , Lawson Richard D. , Graham David J. , Sivakumar Brahman S.
Published: March 2022

The one-bone forearm (OBF) is a salvage technique that may be used to correct global forearm instability secondary to osseous defects. This study aims to provide an overview of the contemporary literature regarding the OBF. A literature review was conducted electronically across MEDLINE, Embase, and PubMed databases in May 2020. Studies were eligible for inclusion if published in the English language; detailed the use of the OBF procedure to correct forearm instability; and were original data studies reporting qualitative or quantitative outcomes. Thirty-four studies, describing a cohort of 210 patients undergoing 211 OBFs, were documented in the literature. The primary etiology necessitating the OBF was trauma, followed by genetic/congenital disorders and infections. Technically, the OBF was most frequently achieved via an end-to-end osteosynthesis with plate fixation. In total, 85.0% (154/182) of OBF were fused in neutral rotation or varying degrees of pronation. Union was achieved in more than 80.0% (174/211) of OBFs. The OBF is a feasible salvage technique that has been used for a wide spectrum of pathology, providing satisfactory outcomes in most cases.
Galangin reduces vascular endothelial cell dysfunction via Heme oxygenase-1 signaling
Authors: Qian Zhengyao , Suo Rong
Published: March 2022

Objective

As one of the independent risk factors for atherosclerosis (AS), oxidized low-density lipoprotein (ox-LDL) can trigger damage to the vascular intima and induce the expression of various adhesion molecules. This study aimed to explore the effects of galangin, an extract of galangal, on ox-LDL-induced vascular endothelial cells.

Methods

The effects of different concentrations of galangin or ox-LDL on the metabolic activity of vascular endothelial cells were determined using the CCK8 assay. Afterward, the role of galangin in the expression levels of inflammatory factors was assessed using RT-qPCR and Western blotting. In addition, the influences of galangin on apoptosis and endothelial-mesenchymal transition (EndMT) were also evaluated. Through molecular docking, the Heme oxygenase-1 (HO-1) signaling pathway was proposed, and then the effects of the HO-1 signaling pathway on the regulatory roles of galangin were evaluated.

Results

In this study, galangin was found to effectively increase the metabolic activity of ox-LDL-induced cells in a concentration-dependent manner. In addition, galangin was found to reduce ox-LDL-induced cell inflammation, apoptosis, and EndMT. Moreover, galangin could combine with HO-1 and regulate the HO-1 signaling pathway. The effects of galangin on cells were shown to be through the HO-1 signaling pathway.

Conclusion

To sum up, galangin reduced ox-LDL-induced inflammation, apoptosis, and EndMT of vascular endothelial cells via regulating the HO-1 signaling pathway.
The practice of menstrual hygiene management and associated factors among secondary school girls in eastern Ethiopia: The need for water, sanitation, and hygiene support
Authors: Hussein Jemal , Gobena Tesfaye , Gashaw Tigist
Published: March 2022

Background:

During menstruation, school girls face obstacles connected to menstrual hygiene management in schools. Due to their monthly period, up to 20% of girls miss school globally, and one in ten will drop out entirely. Three hundred thirty-five million girls attended school without access to running water or soap. In Ethiopia, 67% of girls have no access to education on puberty and menstrual health; menstrual hygiene management continues to be one of the major problems among school girls. Thus, context-specific assessment of the practice may be useful in developing customized intervention approaches. Thus, the objective of the study was to assess practices of menstrual hygiene management and associated determinants among secondary school girls in East Hararghe, Ethiopia from 1 to 30 December 2020.

Methods:

A school-based cross-sectional survey was undertaken with 486 randomly selected female students. Data were collected by pretested self-administered questionnaire. Descriptive statistical tests and multivariate logistic regression were used to describe the study variables and to examine the association. Statistical package for social science version 23 was used for data analysis, and a p-value of 0.05 was considered as a cut-off point for statistical significance.

Results:

Of the total, 328 (68%) of the study participants practiced appropriate menstrual hygiene. Besides, 350 (72.6%) had a good level of understanding about menstrual hygiene. A higher level of knowledge (adjusted odds ratio = 2.12, 95% confidence interval = 1.28, 3.53), a greater wealth indexed family (adjusted odds ratio = 7.14, 95% confidence interval = 3.98, 12.88), earning permanent pocket money (adjusted odds ratio = 0.495, 95% confidence interval = 0.299, 0.821), and being in grade level (11–12) (adjusted odds ratio = 3.45, 95% confidence interval = 1.75, 4.501) were significant predictors of the good menstrual hygiene practice.

Conclusion:

One-third of the school girls had poor menstrual hygiene practices which may affect their school performance and the reproductive health. Hence, tailored menstrual hygiene information should be given to school girls and parents. Besides, efforts ought to be made for the provision of affordable sanitary materials in schools.
Assessing coaches’ basic psychological need satisfaction and need frustration: preliminary validation from a multidimensional approach
Authors: Pulido Juan Jose , López-Gajardo Miguel Angel , Díaz-García Jesús , Tapia Miguel Ángel , Leo Francisco M.
Published: March 2022

The purpose of this study was to adapt and validate the Basic Psychological Needs in Exercise (BPNES) and the Psychological Need Thwarting Scale (PNTS) to merge both measures and create a specific scale for the coaching context. Two studies were conducted. In Study 1, three sports psychologist experts adapted two instruments to analyze the coaches’ psychological needs on a single and multidimensional scale. Also, the content validity and comprehension of the scale were evaluated by 37 coaches ( Mage = 33.03 ± 10.65; work experience = 8.79 ± 6.57 years). In Study 2, we tested other psychometric properties (i.e. confirmatory factor analysis, reliability, and concurrent validity) of the final version of the scale with 352 coaches ( Mage = 32.88 ± 11.14; work experience = 8.03 ± 8.18 years) from four collective sports (soccer = 227; basketball = 69; handball = 43; and volleyball = 13). We tested a first-order six-factor solution of CBPN-Q and an H-CFA by including two second-order latent factors of need satisfaction and need frustration. The first-order six-factor solution obtained a better fit to the model than the H-CFA solution. The standardized factor loadings were positively significant and higher than.47. An adequate internal consistency was also obtained, and the concurrent validity of the scale was calculated with the types of motivation. These findings provide a valid and reliable scale to measure need satisfaction and need frustration in the field of coaching.
An anti-inflammatory bundle may help avoid opioids for low-risk outpatient procedures
Authors: Dbeis Rachel , Assani Khadij , Fadaee Negin , Huynh Desmond , Khader Ali , Towfigh Shirin
Published: March 2022

Background

Currently, over half of drug overdose deaths are due to opioids. Opioid alternatives may be prescribed to help curb the opioid epidemic. However, little is known about their efficacy for acute postoperative pain.

Methods

We studied patients who underwent low-risk outpatient surgery. Perioperatively, all patients were started on an anti-inflammatory bundle consisting of multimodal pain remedies. Opioids were available to the patients postoperatively. Pain scores and opioid use were recorded.

Results

Over 18 months, 120 patients underwent low-risk outpatient surgery and all used the anti-inflammatory bundle. All patients had a significant decrease in postoperative pain scores (p = 0.001). There was no significant difference in postoperative pain scores between those who followed the anti-inflammatory bundle alone and those who also used opioids (mean 2.2 vs 3.1/10). Twenty-five (21%) patients were using opioids preoperatively and 50 (42%) postoperatively. Of those using opioids preoperatively, six (24%) patients used the anti-inflammatory bundle alone and avoided opioids postoperatively.

Conclusions

For 58% of our patients, an anti-inflammatory bundle alone provided adequate pain control after a low-risk outpatient operation, such as hernia repair. Our practice uses the anti-inflammatory bundle for all patients. Our goal is to reduce both the need for opioids and the surgeon’s contribution to the opioid epidemic.
Establishing a COVID-secure site for elective surgery during the COVID pandemic: An observational study
Authors: Phelan Liam , Digne-Malcolm Holly , Hassett Dominic , Naumann David N , Dilworth Mark P , Bowley Douglas M
Published: March 2022

Introduction

Maintaining timely and safe delivery of major elective surgery during the COVID-19 pandemic is essential to manage cancer and time-critical surgical conditions. Our NHS Trust established a COVID-secure elective site with a level 2 Post Anaesthetic Care Unit (PACU) facility. Patients requiring level 3 Intensive Care Unit admission were transferred to a non-COVID-secure site. We investigated the relationship between perioperative anaesthetic care and outcomes.

Materials and methods

All consecutive patients undergoing major surgery at the COVID-secure site between June and November 2020 were included. Patient demographics, operative interventions and 30-day outcomes were recorded. Multivariate logistic regression was used to determine the odds ratio of outcomes according to PACU length of stay and the use of spinal or epidural anaesthesia, with age, sex, malignancy status and American Society of Anesthesiologists grade as independent co-variables.

Results

There were 280 patients. PACU length of stay >23h was associated with increased 30-day complications. Epidural anaesthesia was associated with PACU length of stay >23h, increased total length of stay, increase hospital transfer and 30-day complications. Two patients acquired nosocomial COVID-19 following hospital transfer.

Discussion

Establishing a separate COVID-secure site has facilitated delivery of major elective surgery during the COVID-19 pandemic. Choice of perioperative anaesthesia and utilisation of PACU appear likely to affect the risk of adverse outcomes.
Unusual presentation of atraumatic insufficiency pelvic fractures unmasking pregnancy-related osteoporosis: A case report
Authors: Hourston George JM , Bardos Andrea , Stohr Kuldeep
Published: March 2022

We describe the case of a young 27-year-old Caucasian female who presented in the third trimester of her first pregnancy with sudden and severe suprapubic and left-sided hip pain without history of trauma. She was eventually diagnosed with two insufficiency fractures of the pelvis. The underlying diagnosis was pregnancy-related osteoporosis. Her baby was delivered successfully at term, with an elective caesarean section. The diagnosis was eventually made using a magnetic resonance imaging scan. Pregnancy-related osteoporosis is relatively rare, and cases of patients presenting with insufficiency fractures of this condition are rarer still. Our case raises the importance of considering this diagnosis in females in the later stages of pregnancy, with severe sudden hip or pelvis pain. The patient gave informed written consent for the publication of this case.
Effect of positive end expiratory pressure on atelectasis in patients undergoing major upper abdominal surgery under general anaesthesia: A lung ultrasonography study
Authors: Nair Parvathy Ramachandran , Ramachandran Rashmi , Trikha Anjan , Anand Rahul Kumar , Rewari Vimi
Published: March 2022

Postoperative pulmonary complications vary in major upper abdominal surgery. The objective of this study was to assess the effect of positive end expiratory pressure on the incidence of atelectasis in patients undergoing major upper abdominal surgery under general anaesthesia using lung ultrasound. The patients were randomised into receiving either no positive end expiratory pressure (Group I) or positive end expiratory pressure of 5cm H2O (Group II). Lung ultrasound was performed at various time points – baseline, 10 minutes, 2 hours after induction, during closure of skin and 30 minutes post extubation. The lung aeration as assessed by Total Modified Lung Ultrasound Score was worse in the Group I as compared to the Group II at 2 hours post induction. Driving pressure in Group II was significantly reduced compared to Group I. Application of positive end expiratory pressure, as minimal as 5cm H2O, as a single intervention, helps in significantly reducing the Total Modified Lung Ultrasound Score after a duration of more than 2 hours and also attaining low driving pressures during intraoperative mechanical ventilation.
Adopting the day surgery default in the provision of lumbar discectomy and decompressive surgery
Authors: Paluch Anthony J , Matthews Alexander H , Mullins Sophie , Vanstone Ross J , Woodacre Timothy
Published: March 2022

Introduction

Provision of day case spinal procedures in the UK is below expected standards and there is a need for the creation of guidance and patient pathways to address this. Here we present a day case lumbar discectomy protocol and evaluate its impact at our institution.

Methods

A new pathway (incorporating defined selection criteria, patient education, anaesthetic protocol and discharge prescriptions) was implemented for all suitable patients within a single surgeon’s cohort. Day case rates for lumbar discectomy were compared before and after implementation. Patient feedback was collated using a patient-reported experience measure.

Results

Eighteen of 23 patients selected as suitable via the pathway successfully underwent day surgery, leading to an increase in lumbar discectomy day case rates from 25% to 69% at our institution. Nearly all patients were satisfied with their experience, although a significant proportion felt provision of postoperative analgesia could be improved.

Conclusion

We present a day surgery pathway for lumbar discectomy that is safe and effective. This could be more widely implemented to increase day case rates.
Predictive factors of postoperative acute pain in laparoscopic inguinal hernia repair in men: A single-centre retrospective study in Japan
Authors: Nishikawa Masashi , Fukuda Taeko , Okazaki Masaya
Published: March 2022

Introduction

Laparoscopic inguinal hernia repair has significantly reduced the incidence of postoperative acute and chronic pain compared to open repair, but it remains problematic. This study’s purpose was to retrospectively identify predictive factors of acute pain after laparoscopic inguinal hernia repair.

Methods

We reviewed the medical records of 193 patients. After excluding atypical cases and female patients, 156 patients were analysed. Factors affecting rescue analgesic requirements were investigated via multivariable logistic regression analysis. Independent variables included age, body mass index, analgesics used during surgery and surgical factors (unilateral/bilateral, primary/recurrent). The degree of postoperative pain and the hospital stay duration after surgery were also investigated.

Results

Of the 156 patients, 40 (25.6%) required rescue analgesics. Patients under 60 years of age were about seven times more likely to need rescue analgesics than patients over 80 years of age. Primary surgery patients were about 5.5 times more likely to need rescue analgesics than recurrent surgery patients. The maximum verbal rating scale score was less than 3 in 89% of patients. All patients were discharged by two days postoperatively.

Conclusion

Laparoscopic inguinal hernia repair results in less postoperative acute pain. However, analgesia management should be considered prudently for younger patients and primary surgery patients.
Caregiver burden in cystic fibrosis: a systematic literature review
Authors: Daly Conor , Ruane Philip , O’Reilly Karl , Longworth Louise , Vega-Hernandez Gabriela
Published: March 2022

Background:

Cystic fibrosis (CF) affects more than 80,000 people worldwide, having a considerable impact on the quality of life of patients and their caregivers, who assist patients with time-consuming treatment regimens. Despite this, a review of the available evidence has not been previously undertaken. This systematic literature review aimed to identify the humanistic and economic burdens of CF on caregivers.

Methods:

A systematic literature review was conducted, in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Publications reporting outcomes for the caregivers of people with CF, including utility data, health status, and occupational impact, were reviewed. Sources searched were Embase (OvidSP), Medline (PubMed), the Cochrane Database of Systematic Reviews, and the Epistemonikos database, from 2010 to March 2020. A subsequent search with updated terms identified articles up to April 2020. Electronic searches were supplemented by hand searches to capture all relevant literature.

Results:

A total of 889 articles reporting humanistic burden and 310 reporting economic burden were identified. Following full-text screening by two independent reviewers, 72 articles were included in the review, of which 65 and 17 reported data on humanistic and economic burdens, respectively, with 10 reporting on both. The reviewed literature covered several outcomes and identified multiple key findings: greater disease severity is associated with the reporting of greater caregiver burden and lower utility scores of quality of life; reduced patient lung function is associated with increased caregiver depression and anxiety; and caregiving causes significant occupational impact, with pulmonary exacerbations decreasing caregiver productivity by up to a third compared with the patient being in a ‘well’ state.

Conclusion:

Findings from this systematic literature review highlight the substantial humanistic and economic burdens borne by the caregivers of people with CF. Future research would help to further inform on the link between disease severity and caregiver burden.
Gastroenterology team members’ knowledge and practices with fertility therapy for women with inflammatory bowel disease
Authors: Laube Robyn , Liu Eleanor , Li Ying , Leong Rupert W. , Limdi Jimmy , Selinger Christian
Published: March 2022

Introduction:

Fecundity may be reduced in women with active inflammatory bowel disease (IBD) or prior IBD-related surgery, and these women may require assisted reproductive technology (ART). There are no guidelines for women with IBD to outline referral criteria for ART.

Methods:

We performed a prospective, multicentre, international questionnaire of gastroenterologists, gastroenterology trainees, and IBD nurses. The primary outcome was to establish clinical practices and fertility therapy referral patterns among gastroenterology team members. We hypothesised that the lack of knowledge and awareness may delay or prevent initiation of fertility consultation referrals.

Discussion:

Of 182 participants, most had never initiated a referral for fertility therapy (69.8%), and of respondents who do initiate referrals, 50% wait until the patient has been unsuccessfully attempting conception for 12 months. Participants were significantly more likely to initiate a fertility therapy referral if they believed ART was effective ( p = 0.038), not impeded by IBD-related surgery ( p = 0.053), and if they had access to a dedicated IBD-pregnancy clinic ( p = 0.027). Superior pregnancy knowledge was predictive of a greater likelihood of fertility therapy referrals ( p = 0.037). All participants thought they had inadequate knowledge about ART in IBD, and 96.2% expressed desire to improve their knowledge.

Conclusion:

Gastroenterology team members infrequently initiate referrals for fertility therapy consultation in women with IBD, increasing their risk of remaining childless. Implementation of dedicated IBD pregnancy clinics and targeted education programmes to increase awareness of ART in women with IBD might increase referral rates and reduce infertility.