bluuebunny/crossref_metadata_2025 huggingface dataset:
The neuropolitical imaginaries of cognitive warfare
Authors: Ördén Hedvig
Published: October 2024

The concept of cognitive warfare is currently gaining ground in the policy discussion and in academic research as a way of conceptualizing the ‘weaponization of the neurosciences’. Introducing the Science and Technology Studies-inspired concept of ‘neuropolitical imaginaries’ and assessing discussions on cognitive warfare launched by the NATO Innovation Hub in 2017, this article explores how the contemporary turn to the brain sciences in defense and security reimagines politics. The article argues that seeing the human mind as increasingly vulnerable to external interference redefines the nature of human agency by giving precedence to the skilful ‘cartographer’ employing neuroscientific techniques and methods for persuasion. This emerging vulnerability of the human mind reshapes security into a zero-sum game for ‘cognitive superiority’, making brain science scholars authorities in security. Finally, speaking to the literature on security expertise and science in security, the article argues that the envisaged arms race for cognitive superiority gives rise to a neurosecurity dilemma: as the neurosciences becomes entangled with security, neuroscientific practices simultaneously arise as a core vulnerability, making their work conditional upon compliance with security practices.
Albert Sharman (1903–1970): Gynaecologist, inventor and teacher
Authors: Collins Kenneth
Published: October 2024

Albert Sharman was a Glasgow-born and based gynaecologist who pioneered research into infertility and the diagnosis of pregnancy using new techniques of investigation and treatment, many of his own design. His Fertility Clinic, opened in 1931, was the first in Britain, and became a model for those that followed. Working at Glasgow's Royal Samaritan Hospital for Women, he published widely in the medical press, especially the British Medical Journal and the Lancet, and he authored and co-edited several books, some aimed at a medical audience while others sought to explain complex issues surrounding puberty, fertility and the menopause to the general public.
Hell yes? Enthusiastic consent as a legal standard for sexual consent
Authors: Bennett Theodore
Published: October 2024

Australian laws around sexual consent have recently begun to shift towards ‘yes mean yes’ standards of affirmative consent. This article examines whether Australian laws should go further and adopt ‘enthusiastic yes’ standards of enthusiastic consent. This article begins by explaining enthusiastic consent and highlighting its strengths as a model of consent, before outlining both the practical and conceptual objections to its use within law. Ultimately, this article finds that whilst enthusiastic consent should not be used as a legal standard for sexual consent in Australia, it nonetheless remains a valuable tool for thinking about sexual consent in non-legal areas such as ethics and education.
Past Bullying Experiences and Depression in College Students: A Moderated-Moderation Model of Parental Monitoring and Family Support
Authors: Park Yangjin , Thor Pa , Park Yanghyun , Yang Sejung , Kim Jinwon , Lee Jeoung Min
Published: October 2024

This study examined the association between past bullying victimization and college students’ depressive symptoms, which included mediation (self-esteem) and moderated-moderation (parental monitoring and family support) analysis. This study sample ( n = 362) was collected from South Central and Midwest colleges in the United States. Previous K–12 bullying victimization had a positive association with later life depression among college students which was partially explained by lowered self-esteem. Only a moderate or low level of parental monitoring in the context of high family support buffered the negative impact of past bullying victimization on college students’ depression. However, with low family support, parental monitoring rather increased depression. The transitional period to college life may require restructuring family relationships, and parents excessively monitoring their emerging adult child may not be ideal for mental health among college students who experienced bullying victimization.
Three-Dimensional Animated Videos Improve Caregiver Craniosynostosis Education
Authors: Zhu Katherine J. , Chen Jonlin , Heron Matthew J. , Bai Yunong , Roy Sayantika , Feitelberg Jacob , Kumar Sahana , Li Yukang , Jackson Eric M. , Yang Robin
Published: October 2024

Background: Craniosynostosis management involves various surgical options early in a patient's life. Nevertheless, few three-dimensional (3D) tools exist to help caregivers comprehend craniosynostosis anatomy and surgical options. This study aims to assess the efficacy of 3D animated videos for enhancing craniosynostosis education in caregivers. Methods: We created 3D animated videos describing anatomy and surgical options (eg, fronto-orbital advancement, posterior vault reconstruction) for three craniosynostosis diagnoses: bicoronal, metopic, and sagittal. In a cross-sectional survey, caregivers rated their understanding of craniosynostosis on 10-point Likert-scales, labelled anatomic sutures, and answered true/false general (eg, “The sutures have fused too early”) and diagnosis-specific (eg, “The distractors are not removed after surgery”) craniosynostosis knowledge questions. Respondents were then shown an animated video and asked the same set of questions after watching the video. Results: A total of 69 craniosynostosis caregivers (mean age 35 years, 73% Caucasian, 64% female) completed the survey. After watching the video, caregivers self-rated their understanding of craniosynostosis as significantly higher (mean score difference: 2.62, P < .01). Caregivers also scored significantly higher on the general and diagnosis-specific knowledge questions (mean score difference: 1.27, P < .01). Conclusions: Our findings indicate that our animated videos improved caregiver craniosynostosis understanding and knowledge. These findings may inform how surgeons approach future caregiver craniosynostosis education.
Spanish Terms for Cleft Lip Within the United States
Authors: Munday John H. , Brinton Fujiki Robert , Thibeault Susan L.
Published: October 2024

To examine Spanish terms used for “cleft lip” within the United States. Perceived acceptability of these terms was also considered.

An online survey was distributed to Spanish-speaking medical interpreters, clinicians, and parents of children with cleft lip. Survey questions probed demographics, language use, preferred term for “cleft lip,” and perceived acceptability of terms for cleft lip.

There were 158 respondents. Significant differences were observed with profession ( P < .001) as 62.5% of medical providers used labio hendido, while 71.8% of interpreters preferred labio leporino. Perceived acceptability of terms was consistent with the term use patterns reported by respondent groups. Significant differences were also observed with geographical region ( P = .001) as 90% of respondents from the Northeast United States employed labio leporino, compared to 60% to 70% of respondents from other regions.

Selection and perception of Spanish terms for “cleft lip” may differ across regions and professions. Cleft teams should invite stakeholders to discuss what terms best suit their community.
Study of thermal stress deformation in hybrid 3D printing and milling process of PEEK material
Authors: Sun Haoyi , Cheng Xiang , Dong Ruichun , Liu Huanbao , Zheng Guangming , He Lei , Wang Wenbo , Tan Kun
Published: October 2024

Hybrid manufacturing can enable rapid production of personalized artificial bones that are made of Polyether-ether-ketone (PEEK) by integrating 3D printing and milling. A main challenge, however, is the thermal stress deformation that arises from the fused deposition process, leading to warping and shrinkage. As a result, the fabrication accuracy is significantly diminished. This work aims to address this challenge by investigating the thermal stress deformation behavior of PEEK in hybrid manufacturing. The main contributions of this work, therefore, include the development of a model for this thermal deformation behavior, and the identification of key parameters such as cross-section length ( Ls), printed layer thickness ( Lh), and current workpiece height ( He). Further, experiments are conducted based on response surface methodology (RSM) to explore the relationships between temperature variation rate (Δ T), end surface height difference (Δ S), and length shrinkage rate (Δ L) with critical hybrid processing parameters. Optimal parameter combinations are then identified. Our experiments demonstrate that the proposed methods effectively reduce the effects of warping and shrinkage.
Selective Adaptation of the RNR Model in China’s Juvenile Criminal Justice System: Balancing Rehabilitation and Risk Management
Authors: HE Chengchen
Published: October 2024

The risk-need-responsivity (RNR) model is widely used to understand criminal behavior and guide interventions to reduce recidivism. However, its implementation in China’s juvenile justice system has not been extensively explored. This research critically examines China’s adaptation of the RNR model, noting differences from the original framework. While China emphasizes rehabilitation, its juvenile justice system prioritizes stability and risk prevention. By employing participant observation, interviews, and document analysis, this study suggests that China’s selective adaptation of the RNR model supports rehabilitation rhetoric in juvenile justice while maintaining the state’s role in risk management and promoting social stability.
Restoring the question of culture: identity, essence and the unknowability of difference
Authors: Rose Mitch
Published: October 2024

Throughout the 20th century the question of culture was a central pillar of social scientific thought. From Durkheim to Levi-Strauss, from Stuart Hall to Dennis Cosgrove, the question of culture and cultural difference was a touchstone for understanding the structures, norms and expectations that organised society. Yet, today the concept has disappeared from the academic landscape, including geography, where it is absorbed into other debates and terms, or discarded as an antiquated essentialist construct. Despite pressing political debates about culture wars, identity politics, cultural appropriation and nativism, there seems to be little interest in discussing, debating, much less theorising, the concept of culture as a credible explanatory tool. The aim of this lecture is two-fold: first it explores what has been lost by forsaking the question of culture (in geography and elsewhere); and second, it endeavours to reframe the question of culture in terms that emancipate it from the problem of difference. Indeed, at its heart, I argue that while geographers commonly study difference as an obvious empirical fact of life, emerging and receding at various scales, the nature of difference itself is unknowable. Yet rather than seeing this as an obstacle to theorising culture, the lecture uses it as an invitation to think culture differently: culture not as an explanation for difference but as an elucidation of the phenomenon of claiming difference. The lecture will focus on explaining this distinction and how it fundamentally changes the question of culture. The plenary lecture explores and develops arguments examined in my forthcoming monograph, Dreams of Presence: a Geographic Theory of Culture (University of Toronto Press, 2024).
How Do Alternative Gendered Linguistic Forms Affect Response Behavior in Surveys?
Authors: Neuert Cornelia E.
Published: October 2024

Using masculine forms in surveys is still common practice, with researchers presumably assuming they operate in a generic way. However, the generic masculine has been found to lead to male-biased representations in various contexts. This article studies the effects of alternative gendered linguistic forms in surveys. The language forms are evaluated on three dimensions: comparability, response behavior, and response effort. The results suggest that, compared to masculine-only forms, the use of gender-fair forms does not impair comparability and does not result in detrimental response behavior for most items.
Polymer Everolimus-Eluting Stent as Bailout Stenting for Below-the-Knee Artery Repair in Patients with Critical Limb-Threatening Ischemia: A Real-World National Registry
Authors: Sebbag William , Sauguet Antoine , Demicheli Thibault , Declemy Serge , Lecorvec Tom , Brunet Jérôme , Della Schiava Nellie , Sobocinski Jonathan , Steinmetz Eric , Goueffic Yann
Published: October 2024

Objectives:

Percutaneous old balloon angioplasty is still the preferred treatment for the treatment of below-the-knee (BTK) arteries in chronic limb-threatening ischemia (CLTI). In the case of a suboptimal angioplasty result, a bailout stenting is required. So far, few data are available to assess the outcomes of bailout stenting after BTK angioplasty. This study aims to investigate the 1-year efficacy and safety after implantation of a polymer everolimus-eluting stent (PEES) as bailout stenting for BTK repair in patients with CLTI in a real-world setting.

Design:

This was a national multicenter prospective observational study.

Methods:

Patients with CLTI (Rutherford 4 to 6) BTK lesions (including P3) and requiring a bailout PEES due to dissection, thrombosis, or residual stenosis ≥30% after angioplasty were included. The freedom of a major adverse limb event at 12 months of the target limb was the primary endpoint.

Results:

XIENCE assessed 106 limbs (CLTI, 96.2%; chronic total occlusion, 2.8%) in 106 patients (mean age 77.1 years; males, 71.7%; diabetes mellitus, 66.9%; chronic kidney failure, 36.8%) with CLTI undergoing PEES stenting as a bailout for BTK lesions. Bailout stenting was required after 75.5% and 26.4% of residual stenosis and dissection, respectively. The mean diameter and length of the PEES were 3 mm and 3.4 ± 0.5 cm, respectively. At 1 year, the freedom of a major adverse limb event was 79.6% (95% CI, 71.5%-88.7%), the major amputation rate was 6.2% (95% CI, 1.3%-11%), and the target revascularization rate was 14.9% (95% CI, 6.5%-22.5%).

Conclusions:

In CLTI patients with BTK lesions, PEES stenting showed safety and efficacy as bailout stenting for BTK arterial lesions. This confirms the need for PEES stenting in a real-world practice.

Clinical Impact

The XIENCE study introduces the PEES as an effective bailout stenting option for patients with CLTI undergoing BTK revascularization, particularly for lesions under 4 cm. The study focuses on real-world cases where POBA alone is insufficient, demonstrating that PEES significantly improves outcomes by enhancing limb salvage and reducing the need for major amputations. For clinicians, this innovation offers a precise, size-adaptable solution, especially in cases where bailout stenting is required for short, focal lesions, improving both clinical and procedural results.
A Randomized Clinical Trial Study on the Prevention Strategy and Early Detection of Ulcer Recurrence in Patients with Type 2 Diabetes Mellitus Using the Risk of Recurrence Ulcer Tool
Authors: Haryanto Haryanto , Sari Yunita , Panjaitan Elveria , Juminar Juminar , Armstrong David
Published: October 2024

This study aimed to evaluate the effectiveness of prevention strategies and detect the risk level of recurrence. A randomized controlled trial (RCT) was conducted. Sixty participants were split into two groups: an intervention group consisting of 30 individuals and a control group also with 30 participants. For the intervention group, education and guidance on foot examination, foot care, dietary habits, exercise, and stress management were provided for 1 to 1.5 h each month. However, the control group only received standard care and education through a pamphlet at baseline. The both groups, the baseline risk level of ulcer recurrence score was assessed using INDIFURUTO (Indonesian Diabetic Foot Ulcer Recurrence Assessment Tool). The follow-up period was three months. A General Linear Model (GLM) repeated measures (ANCOVA) analysis was employed to compare the quality of life and risk level between the two groups at baseline and third follow-up. Risk factors for recurrence score in the intervention group significantly decreased after 3 months. These included improvements in mobility ( P = .04), anxiety/depression ( P < .001), EuroQol Visual Analogue Scale score ( P = .004), and INDIFURUTO score ( P = .004). The combination of preventive strategies could reduce the risk of recurrence ulcer and improve the quality of life.

Trial registration number

ClinicalTrials.gov Identifies: NCT06434922.
Ceratonia Siliqua L: A Natural Compound with Big Impact on Male Reproductive System
Authors: Firouzabadi Amir Masoud
Published: October 2024

Herbal products with antioxidant properties have gained attention for their potential impact on male reproductive health. One such botanical, Ceratonia siliqua (commonly known as carob), has been empirically used by infertile men in Iran and Turkey. Carob, a pod-bearing tree native to the Mediterranean, exhibits promising therapeutic potential for various aspects of male reproductive health. Carob consumption may positively affect sperm count, motility, and morphology in infertile men. The proposed mechanisms involve antioxidant activity, improved blood flow, and enhanced energy production within sperm. Carob’s richness in antioxidants like polyphenols and flavonoids might counteract oxidative stress, a major contributor to sperm dysfunction. Carob may influence male sex hormones by potentially stimulating testosterone production and inhibiting estrogen conversion. While carob demonstrates promise as a natural supplement for male fertility, more robust research is necessary to solidify its therapeutic role. This exploration could pave the way for the development of novel dietary or nutraceutical interventions to address male infertility. While preliminary research suggests positive effects on sperm health and potential hormonal influence, robust clinical trials are needed to solidify carob’s therapeutic efficacy. This exploration paves the way for future research on carob as a natural supplement and potentially opens doors for novel dietary or nutraceutical interventions to address male infertility.
Does the experience of the endoscopic vein harvester matter to the quality of the vein conduit: A critical thematic literature review
Authors: Kay Michael , Abouelela Youssef , Raaj Sam , Krishnamoorthy Bhuvaneswari
Published: October 2024

Coronary artery bypass graft surgery remains the golden standard surgical option for multiple vessel disease. Harvesting the long saphenous vein using endoscopic vein harvesting requires advanced surgical skills dexterity, but the lack of a national standardised training programme allows for variance in the learning curve and the quality of the vein during the learning cycle is unknown. A search of bibliographic databases: CINHAL Plus, Embase, Pubmed and the Cochrane register for randomised controlled trials identified 11 articles eligible for review. The themes emerging were learning curve-associated injuries to the long saphenous vein, intimal wall remodelling of the long saphenous vein and incidence of graft patency rates. Harvesting practitioners with less than 100 cases of experience inflict more conduit injuries leading to endothelial remodelling and narrowed vein grafts at the six-month point resulting in lumen loss. Practitioners with more than 100 cases demonstrated reduced learning curve-related injuries on the conduit. Adopting a formalised structured training programme such as the Manchester Endoscopic Learning Tool has shown to reduce endothelial injury to the long saphenous vein minimising early vein graft failure during the learning cycle.
Phytochemical Components, Hindering Abilities on Cell Proliferation, Cell Migration and Three-Dimensional Spheroids’ Formation Capacity of Micromeria fruticosa Infusion
Authors: Abdallah Samer , Abu-Reidah Ibrahim , Mousa Ahmed
Published: October 2024

Objectives

The objective of this study was to investigate the potential anti-cancer effects of Micromeria fruticosa plant infusion on uterine cervix cancer cells, aiming to explore its potential as an alternative or supportive therapeutic approach to conventional treatments.

Methods

Micromeria fruticosa plant infusion was prepared and administered to uterine cervix cancer cells in vitro. Various assays were conducted to assess its impact on cell migration, proliferation, and tumorigenicity. Additionally, the phytochemical composition of the infusion was analyzed by using LC-MS to identify major functional compounds.

Results

The study revealed that Micromeria fruticosa plant infusion exhibited significant anti-migratory, anti-proliferative, and anti-tumorigenic effects on uterine cervix cancer cells. Analysis of the infusion identified several major functional phytochemicals, which likely contribute to its anticancer properties.

Conclusion

This research suggests that Micromeria fruticosa plant infusion possesses promising anti-cancer properties against uterine cervix cancer cells. The identified phytochemicals present in the infusion highlight its potential as a source of functional ingredients with anticancer effects. These findings support further exploration of Micromeria fruticosa as a potential therapeutic agent in both nutraceutical and pharmaceutical applications, offering new avenues for the development of alternative or supportive treatments for cervical cancer.
Unraveling the Antidiabetic Effect of Alternantera brasiliana (L.) Kuntze: A Combined in Vitro and in Vivo Approach
Authors: Faloye Kolade O. , Famuyiwa Funmilayo G. , Olanudun Esther A. , Ayoola Marcus D. , Ayoade Peter T. , Ugwo Jeremiah P. , Obaidullah Ahmad J. , Alotaibi Jawaher M. , Akinniyi Ganiyu , Famuyiwa Samson O.
Published: October 2024

Background of the study

This study established the antidiabetic efficacy of Alternantera brasiliana in vitro and in vivo, identified the most active fraction and profiled the chemical constituents of the most active fraction.

Methodology

The leaf of A. brasiliana was air-dried, pulverized and extracted with methanol and evaluated for its α-amylase activity at different concentrations using in vitro method. The in vivo antidiabetic activity of the extract and glibenclamide was evaluated in glucose loaded and streptozotocin-induced diabetic rats using various doses, while the most active partitioned fraction was identified using glucose loaded method followed by identification of its chemical constituents through GC-MS analysis.

Results

The extract elicited good α-amylase inhibitory potential with IC50 = 0.45 mg/mL. Also, the 50 mg/kg dose demonstrated the highest percentage blood glucose level reduction and significantly ( P > 0.05) comparable to glibenclamide (5 mg/kg) from 0.5 to 4 h. The streptozotocin-induced antidiabetic assay showed that the 50 mg/kg demonstrated better activity than glibenclamide (5 mg/kg) and was significantly comparable on days 10 and 14. The aqueous methanol fraction was the most active fraction with 53% blood glucose level reduction at 4 h. The secondary metabolite profiling identified 30 chemical compounds whereby 1H-Indole-2-carboxylic acid, 6-(4-ethoxyphenyl)-3-methyl-4-oxo-4,5,6,7-tetrahydro-, isopropyl ester, Benzo[h]quinoline, 2,4-dimethyl-, thymol and 13,5-trioxane as the major constituents.

Conclusion

The antidiabetic activity demonstrated by the A. brasiliana extract established its antidiabetic efficacy
Medium- to Long-term Outcomes of Fasciotomy for Chronic Exertional Compartment Syndrome: A 6-Year Mean Follow-up Study
Authors: Moore Michael , Lezak Bradley , Berzolla Emily , Hughes Andrew , Seidenberg Julian , Kaplan Daniel , Strauss Eric , Jazrawi Laith
Published: October 2024

Background:

Operative treatment of chronic exertional compartment syndrome (CECS) with fasciotomy is effective for symptomatic resolution, but outcomes at medium- to long-term follow-up are unclear.

Hypothesis:

Patients will have favorable satisfaction at medium- to long-term follow-up and a high return to sport (RTS) rate after fasciotomy for treatment of CECS.

Study Design:

Cross-sectional.

Level of Evidence:

Level 3.

Methods:

Retrospective review of patients who underwent fasciotomy for treatment of CECS from 2010 to 2021. Outcomes were assessed using Tegner Activity Scale, symptom resolution, patient satisfaction, return to activities, and EQ-5D-5L survey.

Results:

Fifty patients (23 male and 27 female) were included. Mean age at time of surgery was 29.0 ± 11.6 years with mean follow-up 6.0 ± 2.3 years (range, 2.6-10.9). Tegner activity scores at final follow-up were improved compared with symptom onset (mean, 5.2 vs 3.3; P < 0.01). Increased preoperative symptom duration correlated with decreased RTS (β = -0.447; P = 0.01) and return to work (RTW) (β = -0.572; P = 0.01). Patients with a previous psychiatric diagnosis (n = 15) had lower rates of RTS (β = -0.358; P = 0.03) and RTW (β = -0.471, P = 0.02). Mean time to RTS was 5.5 ± 6.1 months. Mean visual analogue scale satisfaction rate was 74.4; 36 (72.0%) patients would be willing to have their fasciotomy again. Patients with fasciotomy of 1 to 2 compartments had higher Tegner score at final follow-up ( P = 0.02) than those who had fasciotomy of >3 compartments; 19 (38.0%) patients reported experiencing paresthesia after their operation. No patients experienced major complications.

Conclusion:

Medium- to long-term outcomes of patients with CECS treated with fasciotomy demonstrated high satisfaction levels and high RTS rate. However, rate of minor complications including paresthesia, swelling, and cramping was high.
Effectiveness of Injury Prevention Program Using a Global Systems Approach on High-Risk Movement Mechanics for Noncontact ACL Injury
Authors: Sheikhi Bahram , Letafatkar Amir , Hadadnezhad Malihe , Hogg Jennifer
Published: October 2024

Background:

Injury prevention training using a global systems approach was designed to develop integrated trunk-lower extremity neuromuscular control using whole-body, rotational forces about the vertical Z-axis during simulated sports movements.

Hypothesis:

Compared with traditional hip-focused exercises, injury prevention training using a global systems approach could improve kinetic and kinematic measures related to anterior cruciate ligament injury.

Study Design:

Controlled laboratory study.

Level of Evidence:

Level 3.

Methods:

A total of 39 male and female athletes received 6 weeks of either global systems approach (n = 20), or hip-focused strengthening, balance, and plyometrics training (n = 19) exercises. Before and after the training program, participants performed a single-leg vertical drop jump task on their dominant leg. Peak vertical ground-reaction forces (GRFs), peak knee abduction, internal rotation moments, peak hip flexion, hip adduction, knee flexion, knee abduction, contralateral pelvic drop, and lateral trunk flexion angles were assessed. Biomechanical data were compared between the 2 groups using a random-intercept linear mixed-models analysis.

Results:

A significant group × time interaction effect was found for vertical GRFs ( P = 0.01; change difference relative to baseline: 4.5%), knee abduction moment ( P = 0.01; 14.8%), hip adduction ( P < 0.01; 16.7%), knee abduction ( P < 0.01; 13.8%), contralateral pelvic drop ( P < 0.01; change difference: 26.6%), and lateral trunk flexion ( P = 0.04; 20.37%) angles, favoring the global systems approach group after 6 weeks of training.

Conclusion:

Participants who trained using the global systems approach had significantly decreased lateral trunk flexion, hip adduction, knee abduction and contralateral pelvic drop angles, peak vertical GRFs, and peak knee abduction moment during a single-leg vertical drop jump compared with participants who trained with hip-focused exercises.

Clinical Relevance:

Incorporating additional external resistance at the proximal trunk results in improved biomechanics compared with conventional hip-focused exercises.
Adult Education Program Implementers’ Understanding and Usage of Strategy Policy Documents in Addis Abab City Administration, Ethiopia
Authors: Tadesse Million
Published: October 2024

This study was targeted to assess adult education program implementers’ understanding towards adult education policy documents and usage of the documents in Addis Ababa City Administration. In order to guide the study qualitative method was applied. Accordingly, qualitative data was gathered using interview and document analysis. Qualitative data like views of respondents and result gained from document analysis were discussed by narrating the evidences/responses in words. As the findings of this study reveals, majority of adult education program implementers lack understanding about the policy documents of adult education sector; there is no established and sustainable awareness creation system and capacity building program for newly employed and other personnel; non-existence an established structure to lead adult education program according to the designed strategy documents are some of the results of the research. In order to overcome the challenges mentioned above adult education implementing organizations have to launch continuous professional development (CPD) program for implementers of adult education program. Consequently, implementers of the program can get first-hand information on the policy documents on one hand and they can also upgrade their profession on the other hand.
Effects of Preoperative Cervical Range of Motion on Clinical Outcomes Following Posterior Decompression: A Multicenter Study of Patients With Cervical Ossification of the Posterior Longitudinal Ligament
Authors: Okubo Toshiki , Nagoshi Narihito , Kono Hitoshi , Nojiri Kenya , Fukuda Kentaro , Ikegami Takeshi , Tsuji Takashi , Horiuchi Yosuke , Iga Takahito , Takeda Kazuki , Ozaki Masahiro , Suzuki Satoshi , Matsumoto Morio , Nakamura Masaya , Watanabe Kota , Ishii Ken , Yamane Junichi
Published: October 2024

Study Design

Retrospective multicenter study.

Objectives

To investigate the impact of preoperative cervical range of motion (ROM) on clinical outcomes after posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL).

Methods

We analyzed data from 156 patients with cervical OPLL who underwent posterior decompression and were followed for at least 2 years. Patients were divided into two groups based on preoperative gap ROM, which was a novel indicator representing the difference between flexion and extension ROM: the gROM <0° and >0° groups, and their outcomes were compared.

Results

There were no significant differences in patient demographics or surgical details between the gROM <0° and >0° groups. The gROM <0° group exhibited less lordosis in C2-7 angles before and after surgery compared to the gROM >0° group. Cervical ROM significantly decreased following posterior decompression regardless of whether preoperative gROM was <0° or >0°. Meanwhile, the incidence of perioperative complications was similar between the two groups. Furthermore, both groups showed significant improvement in Japanese Orthopaedic Association (JOA) scores postoperatively; however, there were no significant group differences in JOA scores, recovery rates, or visual analog scale for neck pain between the two groups at the preoperation and final follow-up.

Conclusions

The incidence of perioperative complications and postoperative clinical outcomes were comparable regardless of the magnitude of preoperative cervical gROM. Although cervical ROM decrease postoperatively, posterior decompression for cervical OPLL can offer favorable clinical outcomes irrespective of the preoperative cervical ROM magnitude, consequently.
Patient-Reported Outcomes After Arthroscopic Superior Capsule Reconstruction With an Acellular Porcine Dermal Xenograft for Irreparable Rotator Cuff Tears
Authors: Ilg Ansgar , Kaiser René , Schneider Stefan , Hollander Karsten , Holz Johannes
Published: October 2024

Background:

Currently, there is no consensus on the adequate management of irreparable rotator cuff tears. Arthroscopic superior capsule reconstruction (SCR) seems to be an alternative treatment option.

Purpose/Hypothesis:

The purpose of this study was to evaluate patient-reported outcomes up to 2 years after the treatment of irreparable rotator cuff tears with SCR using an acellular porcine dermal xenograft. It was hypothesized that SCR treatment with an acellular porcine dermal xenograft would not result in a significant clinical improvement or pain relief in patients with irreparable rotator cuff tears if the xenograft fails.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 26 consecutive patients with irreparable rotator cuff tears were enrolled in the study between 2015 and 2019. All patients underwent SCR with acellular porcine dermal xenograft. Patient-reported outcome measures including visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the Veterans RAND 12- Item Health Survey (VR-12), and the Single Assessment Numeric Evaluation (SANE) were followed up for 2 years. For statistical analysis, the 1-way analysis of variance was used to compare means for VAS, ASES, VR-12, and SANE results between pre- and posttreatment. Magnetic resonance imaging (MRI) records were obtained at 1 year postoperatively to evaluate graft integrity.

Results:

In total, 22 patients were included in the patient-reported outcomes with 4 being lost at final follow-up. The mean VAS score decreased from 4.2 ± 2.5 to 1.0 ± 1.4 ( P < .001) from pretreatment to 2 years postoperatively. The mean ASES – index score improved significantly from 47.7 ± 15.3 to 86.4 ± 12.9 ( P < .001) and the SANE score improved from 34.0 ± 20.4 to 77.3 ± 20.2 ( P < .001). In addition, a clinically important difference in the patients’ quality of life was achieved, as shown by the mean changes in the VR-12 physical (+4.3) and mental scores (+9.3). Based on postoperative MRI, the dermal graft on the humeral side was intact in 15 (68.2%) patients after surgery.

Conclusion:

Our arthroscopic SCR with an acellular porcine dermal matrix showed significant and continuous improvement in pain and clinical scores up to a 2-year follow-up in patients with irreparable rotator cuff tears, even with structural graft failure. However, further studies and evaluation of larger patient groups are needed to evaluate the long-term effect of this procedure.
Tapping into Efficient Learning: An Exploration of the Impact of Sequential Learning on Skill Gains and Learning Curves in Central Venous Catheterization Simulator Training
Authors: Tzamaras Haroula , Brown Dailen , Moore Jason , Miller Scarlett R.
Published: October 2024

OBJECTIVE

Medical residents learn how to perform many complex procedures in a short amount of time. Sequential learning, or learning in stages, is a method applied to complex motor skills to increase skill acquisition and retention but has not been widely applied in simulation-based training (SBT). Central venous catheterization (CVC) training could benefit from the implementation of sequential learning. CVC is typically taught with task trainers such as the dynamic haptic robotic trainer (DHRT). This study aims to determine the impact of sequential learning on skill gains and learning curves in CVC SBT by implementing a sequential learning walkthrough into the DHRT.

METHODS

103 medical residents participated in CVC training in 2021 and 2022. One group ( N = 44) received training on the original DHRT system while the other group ( N = 59) received training on the DHRTsequential with interactive videos and assessment activities. All residents were quantitatively assessed on (e.g. first trial success rate, distance to vein center, overall score) the DHRT or DHRTsequential systems.

RESULTS

Residents in the DHRTsequential group exhibited a 3.58 times higher likelihood of successfully completing needle insertion on their first trial than those in the DHRT only group and required significantly fewer trials to reach a pre-defined mastery level of performance. The DHRTsequential group also had fewer significant learning curves compared to the DHRT only group.

CONCLUSION

Implementing sequential learning into the DHRT system significantly benefitted CVC training by increasing the efficiency of initial skill gain, reducing the number of trials needed to complete training, and flattening the slope of the subsequent learning curve.
Vitamin D association with systemic sclerosis and its clinical features: A systematic review, meta-analysis, and meta-regression
Authors: Dhaouadi Tarak , Riahi Awatef , Ben Abdallah Taïeb , Gorgi Yousr , Sfar Imen
Published: October 2024

Objectives:

The aim of this review was to summarize existing data on the contribution of Vitamin D level and/or deficiency/insufficiency to systemic sclerosis susceptibility and its clinical features.

Methods:

An electronic literature search for eligible studies among all papers published prior to 30 June 2024 was conducted through PubMed, EMBASE, Web of science, and Scopus databases. Meta-analyses estimating pooled raw mean differences, odds ratios, and Pearson r together with subgroup analyses and meta-regressions were performed for the association of Vitamin D with susceptibility to systemic sclerosis and disease presentation.

Results:

Combined analysis revealed a significant decrease in Vitamin D level in systemic sclerosis patients comparatively to healthy controls, with raw mean differences 95% CI = −11.68 [−15.43 to −7.92] ng/mL, p < 1 E-10. Likewise, Vitamin D insufficiency (Vitamin D < 30 ng/mL) and deficiency (<10 ng/mL) were significantly associated with systemic sclerosis; odds ratios 95% CI = 3.58 [2.59–4.95], p < 1 E-10 and odds ratios 95% CI = 7.67 [3.97–14.83], p < 1 E-10, respectively. Moreover, decreased Vitamin D level was significantly associated with interstitial lung disease occurrence (raw mean differences 95% CI = −3.61 [−6.93 to −0.3], p = 0.003), while Vitamin D deficiency was associated with increased systolic pulmonary arterial pressure, raw mean differences (95% CI = 4.17 [1.44–6.89], p = 0.003). Besides, Vitamin D level was negatively correlated with the modified Rodnan skin score, r (95% CI = −0.26 [−0.44 to −0.08], p = 0.004). Conversely, Vitamin D level was significantly increased in systemic sclerosis patients with cutaneous calcinosis, raw mean differences (95% CI = 4.18 [1.07–7.28], p = 0.008).

Conclusion:

This meta-analysis showed that decreased Vitamin D level was associated with susceptibility to systemic sclerosis, interstitial lung disease occurrence, increased systolic pulmonary arterial pressure, and higher modified Rodnan skin score. Conversely, calcinosis was found to be associated with increased Vitamin D level.

Registration:

This review has been registered on PROSPERO: CRD42024565045, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024565045
Pyrocarbon Hemi-Shoulder Arthroplasty Provides Satisfactory Outcomes Following Prior Open Latarjet
Authors: Lajoinie Louis , Garret Jérôme , van Rooij Floris , Saffarini Mo , Godenèche Arnaud
Published: October 2024

Purpose

To assess the clinical and radiographic outcomes, at a minimum follow-up of 4 years, following HSA using pyrocarbon in patients that had prior open Latarjet.

Methods

The authors retrieved the records of 61 consecutive patients that underwent HSA with a pyrocarbon humeral head at 2 centers between December 2013 and October 2019. Eight patients (9 shoulders) had undergone previous Latarjet procedures without other surgical antecedents. Patients underwent radiological assessment, and clinical assessment including Constant score, Subjective Shoulder Value (SSV), and pain on VAS. Finally, range of motion was assessed, including active forward elevation and external rotation.

Results

The initial cohort of 9 shoulders, comprised 1 woman and 7 men (1 bilateral), aged 52.5 ± 5.2 at their index HSA, which was performed 27.7 ± 9.3 years following their prior Latarjet procedure. One shoulder required conversion to reverse shoulder arthroplasty, 3 years after HSA. The remaining 8 shoulders were assessed at 6.1 ± 1.6 years (range, 4-8) after the index HSA. Glenoid erosion only progressed in 1 shoulder from mild to moderate. The Constant score was 79.6 ± 12.7, pain on VAS was 1.0 ± 2.1, and SSV was 80.0 ± 25.6. The active forward elevation improved from 96°±41° to 151°±29°, and external rotation from 11°±17° to 32°±8°.

Conclusion

Patients that underwent HSA using pyrocarbon heads following prior Latarjet had satisfactory clinical scores, and glenoid erosion only progressed in 1 patient. Furthermore, only 1 patient required conversion to RSA. The clinical relevance is that HSA using pyrocarbon heads is a safe treatment and grants satisfactory clinical outcomes in patients with prior Latarjet.

Level of Evidence

Level III, retrospective comparative study
Combination Dornase and Alteplase for Intra-abdominal Drain, Abscess, and Hematoma Clearance: A Retrospective Case Series
Authors: Schultz Michelle , Patel Jasmine , Olsen Megumi , Nordbeck Sarah
Published: October 2024

Background:

Since the advent of the MIST2 trial, the combined instillation of dornase and alteplase has become an effective nonsurgical treatment option for empyema and pleural fluid collection. Percutaneous drainage of abdominal abscesses and fluid collections, rather than open surgical treatment, also has become commonplace. The are several case reports and studies on the use of fibrinolytics to drain abdominal fluid collections but no literature reporting use of both alteplase and dornase for abdominal administration.

Objective:

We present a case series from an academic medical center where dornase therapy was added to fibrinolytic therapy to treat intra-abdominal fluid collections, hematoma, and abdominal drainage catheters with low output.

Methods:

This is an institutional review board-approved retrospective case series of 13 patients who underwent combination use of alteplase and dornase via intra-abdominal route. The primary objective was to assess for increased drain output, reduction in size of the fluid collection, and adverse events.

Results:

Many patients had improved drain output after dornase-alteplase therapy. One patient had significant bleeding complications.

Conclusions:

All patients were discharged alive from the hospital. Clinical success was difficult to define due to variable goals of therapy. Further data are needed to establish the safety and efficacy of this practice, especially compared with intra-abdominal alteplase alone. Patients in our series generally received larger doses of alteplase than in prior studies due to use of dosing modeled on the MIST2 trial. Based on the limited experience of our study, we recommend holding therapeutic anticoagulation during the administration of intra-abdominal dornase-alteplase.
IGF1R signaling in perinatal mesenchymal stem cells determines definitive hematopoiesis in bone marrow
Authors: Lou Qi , Jiang Kaizheng , Wang Xiaoqi , Pan Yuan , Qiu Guo , Wu Binghuo , Yuan Lisha , Xie Siyu , Chen Jian , Xu Quanhui , Zhao Meng , Jiang Linjia
Published: October 2024

Abtract

During the transition from embryonic to adult life, the sites of hematopoiesis undergo dynamic shifts across various tissues. In adults, although bone marrow (BM) becomes the primary site for definitive hematopoiesis, the establishment of the BM niche for accommodating hematopoietic stem cells (HSCs) remains incompletely understood. Here, we reveal that perinatal BM mesenchymal stem cells (BMSCs) exhibit highly activated insulin-like growth factor 1 receptor (IGF1R) signaling compared with adult BMSCs (aBMSCs). Deletion of Igf1r in perinatal BMSCs (pBMSCs) hinders the transition of HSCs from the fetal liver to the BM in perinatal mice and disrupts hematopoiesis in adult individuals. Conversely, the deletion of Igf1r in aBMSCs, adipocytes, osteoblasts, or endothelial cells does not affect HSCs in the BM. Mechanistically, IGF1R signaling activates the transcription factor nuclear factor of activated T cells c1 in pBMSCs, which upregulates CXCL12 and other niche factors for HSC retention. Overall, IGF1R signaling in pBMSCs regulates the development of the BM niche for hematopoiesis.
A phase 1 study of the amino acid modulator pegcrisantaspase and venetoclax for relapsed or refractory acute myeloid leukemia
Authors: Liu Yuchen , Bollino Dominique R. , Bah Osman M. , Strovel Erin T. , Le Tien V. , Zarrabi Jinoos , Philip Sunita , Lapidus Rena G. , Baer Maria R. , Niyongere Sandrine , Duong Vu H. , Dougherty Christine C. , Beumer Jan H. , Caprinolo Katherine D. , Kamangar Farin , Emadi Ashkan
Published: October 2024

Glutamine dependency has been shown to be a metabolic vulnerability in acute myeloid leukemia (AML). Prior studies using several in vivo AML models showed that depletion of plasma glutamine, induced by long-acting crisantaspase (pegcrisantaspase [PegC]) was synergistic with the B-cell lymphoma-2 (BCL-2) inhibitor venetoclax (Ven), resulting in significantly reduced leukemia burden and enhanced survival. Here, we report a phase 1 study of the combination of Ven and PegC (VenPegC) for treating adult patients with relapsed or refractory AML, including patients who had previously received Ven. The primary end points were the incidence of regimen-limiting toxicities (RLTs) and the maximum tolerated dose (MTD). Twenty-five patients received at least 1 PegC dose with Ven, and 18 efficacy-evaluable patients completed at least 1 VenPegC cycle; 12 (67%) had previously received Ven. Hyperbilirubinemia was the RLT and occurred in 60% of patients treated with VenPegC; 20% had grade ≥3 bilirubin elevations. MTD was determined to be Ven 400 mg daily with biweekly PegC 750 IU/m2. The most common treatment-related adverse events of any grade in 25 patients who received VenPegC included antithrombin III decrease (52%), elevated transaminases (36%-48%), fatigue (28%), and hypofibrinogenemia (24%). No thromboembolic or hemorrhagic adverse events or clinical pancreatitis were observed. The overall complete remission rate in efficacy-evaluable patients was 33%. Response correlated with alterations in proteins involved in messenger RNA translation. In patients with RUNX1 mutations, the composite complete remission rate was 100%. This study was registered at www.ClinicalTrials.gov as #NCT04666649.