bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability of a New Arthroscopic Discoid Lateral Meniscus Classification System: A Multicenter Video Analysis
Authors: Lee R. Jay , Nepple Jeffrey J. , Schmale Gregory A. , Niu Emily L. , Beck Jennifer J. , Milewski Matthew D. , Finlayson Craig J. , Joughin V. Elaine , Stinson Zachary S. , Pace J. Lee ,   PRiSM Meniscus Research Interest Group, Albright Jay , Carsen Sasha , Chambers Hank , Nault Marie-Lyne , Schlechter John A. , Stavinoha Tyler J. , Tompkins Marc , Wilson Philip L. , Heyworth Benton E.
Published: March 2022

Background:

The discoid lateral meniscus (DLM) is one of the most common congenital anomalies of the knee. The pathomorphology of DLM varies. Current classification systems are inadequate to describe the spectrum of abnormality.

Purpose:

A study group of pediatric orthopaedic surgeons from 20 academic North American institutions developed and tested the reliability of a new DLM classification system.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

After reviewing existing classifications, we developed a comprehensive DLM classification system. Four DLM features were evaluated: meniscal width, meniscal height, peripheral stability, and meniscal tear. Stepwise arthroscopic examination using anteromedial and anterolateral viewing portals was established for evaluating these features. Three senior authors who were not observers selected 50 of 119 submitted videos with the best clarity and stepwise examination for reading. Five observers performed assessments using the new classification system to assess interobserver reliability, and a second reading was performed by 3 of the 5 observers to assess intraobserver reliability using the Fleiss κ coefficient (fair, 0.21-0.40; moderate, 0.41-0.60; substantial, 0.61-0.80; excellent, 0.81-1.00).

Results:

Interobserver reliability was substantial for most rating factors: meniscal width, meniscal height, peripheral stability, tear presence, and tear type. Interobserver reliability was moderate for tear location. Intraobserver reliability was substantial for meniscal width and meniscal height and excellent for peripheral stability. Intraobserver agreement was moderate for tear presence, type, and location.

Conclusion:

This new arthroscopic DLM classification system demonstrated moderate to substantial agreement in most diagnostic categories analyzed.
Promethazine Downregulates Wnt/β-Catenin Signaling and Increases the Biomechanical Forces of the Injured Achilles Tendon in the Early Stage of Healing
Authors: Sakaguchi Takefumi , Ohkawara Bisei , Kishimoto Yasuzumi , Miyamoto Kentaro , Ishizuka Shinya , Hiraiwa Hideki , Ishiguro Naoki , Imagama Shiro , Ohno Kinji
Published: March 2022

Background:

Wnt/β-catenin signaling suppresses the differentiation of cultured tenocytes, but its roles in tendon repair remain mostly elusive. No chemical compounds are currently available to treat tendon injury.

Hypothesis:

We hypothesized that the inhibition of Wnt/β-catenin signaling would accelerate tendon healing.

Study Design:

Controlled laboratory study.

Methods:

Tendon-derived cells (TDCs) were isolated from rat Achilles tendons. The right Achilles tendon was injured via a dermal punch, while the left tendon was sham operated. A Wnt/β-catenin inhibitor, IWR-1, and an antihistamine agent, promethazine (PH), were locally and intramuscularly injected, respectively, for 2 weeks after surgery. The healing tendons were histologically and biomechanically evaluated.

Results:

The amount of β-catenin protein was increased in the injured tendons from postoperative weeks 0.5 to 2. Inhibition of Wnt/β-catenin signaling by IWR-1 in healing tendons improved the histological abnormalities and decreased β-catenin, but it compromised the biomechanical properties. As we previously reported that antihistamine agents suppressed Wnt/β-catenin signaling in human chondrosarcoma cells, we examined the effects of antihistamines on TDCs. We found that a first-generation antihistamine agent, PH, increased the expression of the tendon marker genes Mkx and Tnmd in TDCs. Intramuscular injection of PH did not improve histological abnormalities, but it decreased β-catenin in healing tendons and increased the peak force and stiffness of the healing tendons on postoperative week 2. On postoperative week 8, however, the biomechanical properties of vehicle-treated tendons became similar to those of PH-treated tendons.

Conclusion:

IWR-1 and PH suppressed Wnt/β-catenin signaling and improved the histological abnormalities of healing tendons. IWR-1, however, compromised the biomechanical properties of healing tendons, whereas PH improved them.

Clinical Relevance:

PH is a candidate repositioned drug that potentially accelerates tendon repair.
Challenges and limitation of wearable sensors used in firefighters’ protective clothing
Authors: Shakeriaski Farshad , Ghodrat Maryam
Published: March 2022

This review aims to present recent improvements and existing challenges in the design of wearable sensors used in the firefighters’ protective clothing. Wearable sensors are generally used directly on the body or placed on wearable items to monitor data for the safety of firefighters. Recently, wearable sensors have attracted much attention from researchers and experts. Most investigations have addressed novel designs for wearable sensors to enhance firefighters’ safety measures and reduce the risk of exposure to fires. This article is an attempt to review design limitations of wearable sensors for future developments and improve existing shortcomings. The growing body of knowledge focused on the application of wearable technology to monitor firefighters’ activity, health, and body temperature. In the following, we have discussed the trials of the design of the existing sensors. Finally, moisture and radiation as common exterior parameters in fire events are discussed which received less attention and have major impact on the performance of firefighters’ wearable sensors.
Female combatants and rebel group behaviour: Evidence from Nepal
Authors: Mehrl Marius
Published: March 2022

Recent research examines when and why women join rebel groups as combatants. However, we are only beginning to understand how their presence affects rebel group behaviour and conflict dynamics more generally. I address this gap by analysing how women's participation influences two dimensions of rebel behaviour: their relationship to civilians and their fighting performance. I argue that a greater number of female rebels decreases civilian victimization, but also reduces rebel combat performance. I test these propositions using time-varying district-level data from the Nepalese civil war. The results support both expectations. These findings increase our understanding of the effects of women's participation in civil war.
Emerald City? The case for situational capital in advancing our understanding of Irish immigrants’ attachment to New York City as place
Authors: Maye-Banbury Angela
Published: March 2022

This paper explores the relevance of social capital in shaping Irish immigrants’ reconstructions of their attachment to New York City (NYC) as place. Using extracts from Irish immigrants’ previously unpublished oral histories, I make the case for situational capital, a multi-faceted and dynamic place-based resource which connects people in situ by virtue of their literal and metaphorical positionality. The coalescence of individual and collective memories, including childhood memories, underpinned the network of social relationships which fuelled interviewees’ quest to recreate and reimagine a sense of ‘home’ both in NYC and Ireland. The resultant situational capital created by these relationships fostered a reflexive and sustained attachment to place which served to advance the cumulative economic, cultural, political and social prosperity of Irish men and women individually and collectively over time and space. Situational capital was also instrumental in advancing opportunities for Irish men and women and altering the physical characteristics of neighbourhoods. It shaped the genius loci of NYC as reconstructed by those interviewed pivoting around the fluid and ambiguous notion of real and imagined ‘home.’
Non-somatic Suffering in Palliative Care: A Qualitative Study on Patients’ Perspectives
Authors: Daneault Serge , Azri Mehdi , Ummel Deborah , Vinit Florence , Côté Andréanne , Leclerc-Loiselle Jérôme , Laperle Philippe , Gendron Sylvie
Published: March 2022

Objectives: Suffering is intimately linked to the experience of illness, and its relief is a mandate of medicine. Advances in knowledge around terminal illness have enabled better management of the somatic dimension. Nevertheless, there is what can be called “non-somatic” suffering which in some cases may take precedence. Inspired by Paul Ricoeur's thinking on human suffering, our aim in this qualitative study was to better understand the experience of non-somatic suffering. Methods: Semi-structured interviews were conducted with 19 patients. The results were qualitatively analyzed following a continuous comparative analysis approach inspired by grounded theory. Results: Three key themes synthesize the phenomenon: “the being enduring the suffering”, “the being whose agency is constrained”, and “the being in relationship with others.” The first describes what patients endure, the shock and fears associated with their own finitude, and the limits of what can be tolerated. The second refers to the experience of being restricted and of mourning the loss of their capacity to act. The last describes a residual suffering related to their interactions with others, that of loneliness and of abandoning their loved ones, two dimensions that persist even when they have accepted their own death. Conclusions: Non-somatic suffering can be multifarious, even when minimized by the patient. When evaluating suffering, we must keep in mind that patients can reach a “breaking point” that signals the state of unbearable suffering. In managing it, we probably need to make more room for family and friends, as well as a posture of caring based more on presence and listening.
Reconceptualising Sense of Place: Towards a Conceptual Framework for Investigating Individual-Community-Place Interrelationships
Authors: Erfani Goran
Published: March 2022

While sense of place has been increasingly used in planning literature over the last five decades, its conceptualisation varies by discipline and theoretical orientation, with disjointed elements. This study develops a three-theme conceptual framework articulating individual-community-place interrelationships by critically reviewing the literature on sense of place and place-based constructs of attachment, identity, and satisfaction. Theorising the interactions in-between contributes to theoretical debates on sense of place and developing conceptual clarity to understand the planning context, processes, and outcomes, informing decision- and policy-making. It also facilitates the analysis and synthesis of complex narratives in qualitative studies of people-place relations.
Parents’ Self-reported Changes in Concern About Children’s Bullying—Fall ConsumerStyles and Estilos Surveys, United States, 2020
Authors: Mercado Melissa C. , Wang Jing , Mercer Kollar Laura M.
Published: March 2022

Bullying is a type of youth violence and an adverse childhood experience that can result in trauma and have immediate and long-term consequences for all involved. It can happen at school or elsewhere — including online entertainment and social and learning environments. Some children are at increased risk for bullying victimization, such as those targeted because of their racial/ethnic background or cultural identity. This study assessed U.S. parents and caregivers’ self-reported changes in concern about their children’s involvement in bullying during Fall 2020 compared to the prior year, which was marked by extraordinary historical circumstances (e.g., COVID-19 pandemic, heightened awareness of racial inequities, schools transitioning to virtual learning). Secondary analyses of data from the 2020 Fall ConsumerStyles and Estilos online panel surveys — designed to be representative of U.S. adults overall and U.S. Hispanic adults, respectively — were conducted. Differences by children’s type of school attendance (i.e., physically at school or not) and parents’ sociodemographic characteristics were explored. While findings suggest that U.S. parents’ concern for their children being bullied during Fall 2020 compared to the prior year did not change, significant differences were found by the children’s type of school attendance and the parents’ race/ethnicity — with increased concern among parents of children who physically attended school, non-Hispanic Black parents and Hispanic parents. Among parents who reported being less concerned during Fall 2020 about their children being bullied compared to the prior year, not being physically at school is noted as the main reason why. Parents who reported being more concerned frequently noted racism as the reason why. It is imperative to understand what parents think about bullying, to best inform efforts to support their key role in bullying prevention.
Life of the Party: Social Networks, Public Attention, and the Importance of Shocks in the Presidential Nomination Process
Authors: Stiles Elizabeth A. , Swearingen Colin D. , Seiter Linda M.
Published: March 2022

We examine the effects of shocks on the invisible Presidential primary in the United States. First, we build on existing models using an algorithm simulating social network shocks. Findings show that positive shocks significantly aid the lead candidate’s chances of winning in the invisible primary. Negative shocks, however, are less detrimental to a lead candidate than positive shocks are helpful, as the leader is often able to survive a negative shock and still emerge victorious. Broad empirical tests demonstrate the importance of shocks as well. Beyond the importance of shocks, findings also suggest that Presidential candidate success in the invisible primary owes more to public- than elite-driven factors.
Redistributive Solidarity? Exploring the Utopian Potential of Unconditional Basic Income
Authors: Petersen Linea M. , Just Sine N. , Husted Emil
Published: March 2022

Using unconditional basic income (UBI) as its empirical prism, this article offers new impetus to the foundational debate within critical theory as to whether and how redistribution and recognition can relate productively to each other. We explore the possibility of redistributive solidarity, arguing that unconditional and universal redistribution may be a means of furthering the recognition of different subjectivities that are not solely defined by their productive relations of labor. Seeing such redistributive solidarity as a potential but not necessary outcome of UBI, we develop a typology of existing UBI experiments that divide these according to whether they seek to affirm or transform the current social order based on principles of growth or degrowth. Surveying these four types of UBI, we find that the envisioned form of economic redistribution shapes the potential for social recognition. While the relationship is one of utopian potential rather than causal necessity, UBI may indeed enable redistributive solidarity.
Holistic Psychosocial Approaches in the Care of Hispanic Victims of Trauma: An Overview
Authors: Goldin Deana , Maltseva Tatayana , Scaccianoce Monica , Brenes Francisco
Published: March 2022

The collapse of the Champlain Towers South (CTS), a condominium in Miami, Florida, left a diverse group of survivors and healthcare clinicians tasked with finding ways of coping with the disaster. Within seconds, the CTS collapse became a global tragedy due to the coastal neighborhood's rich international mix of residents. Although this tragedy impacted communities across globe, a large population of Hispanic victims lived in CTS that were deeply affected. Culturally adaptive interventions and holistic healthcare for Hispanic individuals are highly relevant because Hispanic Americans represent one of the fastest growing demographic groups in the United States. To reach, engage, and address the needs of Hispanic victims, this article provides an overview of psychosocial factors that influence Hispanic victims with trauma and discusses holistic psychotherapeutic approaches in nursing care that can be applied to improve victims’ well-being. Culture is an important consideration in health; therefore, this article highlights and operationalizes culturally tailored holistic nursing care that draws from the physical, mental, emotional, and spiritual dimensions of health and well-being that can be used in clinical settings with Hispanic clients who have experienced trauma.
Spiritual Wellbeing and Quality of Life among Hemodialysis Patients in Jordan: A Cross-Sectional Correlational Study
Authors: Musa Ahmad S. , Elbqowm Osama , AlBashtawy Mohammed , Al Qadire Mohammad I. , Suliman Mohammad , Tawalbeh Loai I. , Alkhawaldeh Abdullah , Batiha Abdul-Moni’m
Published: March 2022

Purpose: Nursing research studies investigating the relationship between spiritual wellbeing and health-related quality of life are lacking among Arab hemodialysis patients in Jordan or any other Arab country. The purpose of this study was to explore the associations between spiritual wellbeing, its religious and existential wellbeing dimensions, and health-related quality of life among Jordanian Muslim hemodialysis patients. Design: A cross sectional, quantitative correlational study. Methods: A convenience sample of 150 Jordanian hemodialysis patients completed a structured, self-administered questionnaire. Descriptive, bivariate, and multivariate regression models were used. Findings: The Jordanian hemodialysis patients had a moderate level of spiritual wellbeing and religious wellbeing, a low level of existential wellbeing, and a poor health-related quality of life. The findings revealed a significant moderate positive correlation between the spiritual wellbeing and its dimensions, and health-related quality of life. The existential wellbeing was the strongest predictor, with a large, positive, and significant effect after controlling for other spiritual, demographic and medical-related variables. Conclusion: Overall, the study suggests Jordanian hemodialysis patients use their religious and spiritual beliefs and practices as a coping mechanism, especially as sources of satisfaction, peace, comfort, strength and support, to help improve their health-related quality of life.
The influence of tool quality on the machining of additive manufactured and powder metallurgy titanium alloys
Authors: Ma Junhui , Tran Tanny , Gali Olufisayo A. , Riahi Reza A.
Published: March 2022

This study was carried out to investigate the impact the quality of the drill bits has on the machining behavior of additive manufacturing (AM) and powder metallurgy (PM) titanium alloys. Therefore, commercially available drill bits which typically reflect two extremes of drill bit quality were selected. The performance of coated carbide twist drills, typically recommended for the drilling of wrought titanium alloys was compared with that of high-speed steel (HSS) drills. The average torque value, specific cutting energy (SCE), and tool wear were used to evaluate the drilling performance of AM and PM titanium alloys. The results of drilling tests revealed the application of the coated carbide drill resulted in lower torque and SCE values, less flank wear, and lower build-up-edge (BUE) compared with the uncoated HSS drill bits for AM fabricated titanium alloys. However, the carbide drill appeared to offer negligible improvement over the uncoated HSS drill when employed with the PM fabricated titanium alloy. In spite of the improvement in the drilling performance offered by the carbide drills for the AM titanium alloy, TiB intermetallic particles (part of the AM titanium microstructure) contributed to the damage of the coated carbide drill which would limit the drill lifetime.
Toward a cylinder pressure signals-based active synthesis algorithm for engine sound
Authors: Xie Liping , Liu Zhien , Lu Chihua , Zhu Yawei , Song Weizhi
Published: March 2022

The active sound design (ASD) technology is one of the most flexible methods to achieve the diverse design of automobile sound, in which the active sound synthesis algorithm is essential. However, in previous works, the discontinuity phenomena always appear in the synthesized sound. Thus, a new method of active engine sound synthesis based on cylinder pressure signals is proposed in this paper for the sound synthesis algorithm of ASD technique. Firstly, the index matrix of sound grains is constructed based on the periodicity of engine cylinder pressure signal. Then the frame length and frame shift are defined by tracing the time step of Revolutions Per Minute (RPM) of engine, and the hamming window function is constructed to extract sound grains. Subsequently, the overlap-and-add (OLA) method is used to realize the synthesis of engine sounds with different durations. In addition, the code program of proposed algorithm is written and the ASD prototype system is built respectively to synthesize the engine sounds. Finally, a similarity evaluation metric is defined to verify the effectiveness of proposed algorithm. The results show that our algorithm not only restitutes the main features of original sound, but also satisfies both the real-time feedback on the driving status and the continuity of synthesized sound. It contributes to the development of real-time ASD engineering for automobiles.
Investigating the potential energy savings of MVHR in automotive HVAC systems
Authors: Champion Victoria , Allen Antony , Wigston Jonathan
Published: March 2022

The environmental impact of ICEVs (internal combustion engine vehicles) have led to increasing numbers of EVs (electric vehicles) and plug-in hybrid vehicles being developed. However, current HVAC (heating, ventilation and air conditioning) systems can heavily impact energy consumption, reducing EV range. MVHR (mechanical ventilation with heat recovery) is an approach to minimise the HVAC energy consumption currently used in buildings to meet the Passivhaus building standard and can be used for both heating and cooling. In this work a MATLAB Simulink model and a road load model are used to quantify potential energy reduction and corresponding range savings from an automotive MVHR HVAC system. The model is calibrated against data from the industry sponsor for a baseline non-MVHR vehicle. The results show a 74.3%–94.9% HVAC energy consumption and corresponding range savings of a mean average of 8.8%–11.0% range savings over the baseline case without MVHR, and a corresponding 0.5%–2.5% range increase over the industry sponsor’s vehicle’s range under certification conditions. The work concludes that the application of MVHR technology to automotive cases is beneficial.
Optimization of Micro Gas Turbine Based Hybrid Systems for Remote Off-grid Communities
Authors: Basmadjian Nareg , Yun Sean , Hong Zekai
Published: March 2022

Inherent fuel flexibility of micro gas turbine (MGT) makes the engine a promising energy solution to remote Canadian communities that are not connected to the North American electricity grid, where bio-oils derived from locally available bio-mass may be utilized to meet local power and heat demands to reduce fossil fuel consumption. The switch to bio-oils enabled by MGTs reduces not only carbon footprints but also operating expenses due to high transportation costs of fossil fuels. However, MGT efficiencies are greatly reduced at partial loads. This work investigates the feasibility of addressing MGT efficiency drops at partial loads by incorporating MGT with a Battery Energy Storage System (BESS) to form a hybrid system so that the MGT can be operated at near full power at all times for better efficiencies. In this study, a daily power demand profile of a typical Canadian household is adopted for optimizing battery size and MGT operating strategies. By optimizing MGT daily start time and the engine's threshold partial load factor, the specific fuel consumption and battery size can be minimized for a specific number of households on a micro-grid supported by the MGT-based hybrid power system.
Early Holocene palaeoceanographic and glaciological changes in southeast Greenland
Authors: Andresen Camilla S , Sha Longbin , Seidenkrantz Marit-Solveig , Dyke Laurence M , Jiang Hui
Published: March 2022

Sediment core ER11-16 from Køge Bugt in Southeast Greenland is used to assess early Holocene palaeoceanographic changes and sediment rafting from icebergs calved from the large outlet glaciers in the area. Diatom analysis reconstructs variability in surface water temperature, salinity and sea-ice concentrations, and benthic foraminiferal assemblages is used to reconstruct subsurface ocean conditions. We report Holocene Thermal Maximum in Southeast Greenland during the early Holocene (at least since onset of the record 9100 cal yr BP) until around 4500 cal yr BP, which contrasts with a delay until the mid-Holocene of the Holocene Thermal Maximum in South and Southwest Greenland. The early Holocene warming in Southeast Greenland was caused by a combination of high solar insolation and a weakened subpolar gyre, both of which served to warm the Irminger Current waters subducting onto the shelf. At the same time, the surface temperature was relatively high and sea-ice cover in the polar surface waters of the East Greenland Current was relatively low. High levels of iceberg rafting occurred in Køge Bugt during the early Holocene, synchronously with these warm oceanic temperatures. This is attributed to an increase in iceberg production from the extensive, but retreating, Greenland Ice Sheet. The warm surface conditions were interrupted by a marked and short-lived increase in sea ice around 8200 years ago, providing the first evidence of this global cold episode in Southeast Greenland. After 4500 cal. yr BP, sea-ice cover increased with an expansion of the East Greenland Current, suppressing the inflow of warmer subsurface Irminger Current water to the Southeast Greenland shelf. We relate this oceanic shift to the decreased Northern Hemisphere summer solar insolation. Multi-centennial variability is observed in the grain size spectrum of iceberg rafted debris; a finding we interpret in the context of palaeoceanographic changes.
Journal and disciplinary variations in academic open peer review anonymity, outcomes, and length
Authors: Thelwall Mike
Published: March 2022

Understanding more about variations in peer review is essential to ensure that editors and reviewers harness it effectively in existing and new formats, including for mega-journals and when published online. This article analyzes open reviews from the MDPI suite of journals to identify commonalities and differences from a simplistic quantitative perspective, focusing on reviewer anonymity, review length, and review outcomes. The sample contained 45,385 first round open reviews from published standard journal articles in 288 MDPI journals classified into one or more Scopus disciplinary areas (Health Sciences; Life Sciences; Physical Sciences; Social Sciences). The eight main findings include substantial differences between journals and disciplines in review lengths, reviewer anonymity, review outcomes, and the use of attachments. In particular, Physical Sciences journal reviews tended to be stricter and were more likely to be anonymous. Life Sciences and Social Sciences reviews were the longest overall. Signed reviews tend to be 15% longer (perhaps to be more careful or polite) but gave similar decisions to anonymous reviews. Finally, reviews with major revision outcomes tended to be 68% longer than reviews with for minor revision outcomes, except in a few journals. In conclusion, signing reviews does not seem to threaten the validity of peer review outcomes and authors, editors, and reviewers of multidisciplinary articles should be aware of substantial field differences in what constitutes an appropriate review.
Assisted dying before the ECtHR: General rules for national regulations
Authors: Loos Sien
Published: March 2022

National regulatory frameworks for assisted dying vary from an absolute ban to rather liberal, albeit conditional, approaches to the practice of assisting patients in terminating their lives. jurisdictions that take a restrictive stance towards assisted dying emphasize the ‘absolute’ nature of the right to life, whereas states that exhibit a more permissive regime put more emphasis on the right to respect for private life, including in particular the right to self-determination at the end of life. Although the European Court of Human Rights uses the margin of appreciation in such a way as to avoid taking a normative stance on the issue of assisted dying, its case law comprises general rules that have to be complied with when regulating assisted dying. This article examines the reasoning of the Court in cases concerning assisted dying and discusses these rules as they apply to countries that have in place restrictive or permissive assisted dying regimes. This human rights framework will become increasingly important as more and more jurisdictions are introducing or considering legislation on assisted dying. Against this background, this article aims at providing insight into what is expected of national regulations, from a human rights perspective, in the context of assisted dying.
COVID-19-related anxieties: Impact on duty to care among nurses
Authors: Ley Cathaleen A , Cintron Christian M , McCamant Karen L , Karpman Mitchell B , Meisenberg Barry R
Published: March 2022

Background

Duty to care is integral to nursing practice. Personal obligations that normally conflict with professional obligations are likely amplified during a public health emergency such as COVID-19. Organizations can facilitate a nurse’s ability to fulfill the duty to care without compromising on personal obligations.

Research Aim

The study aimed to explore the relationships among duty to care, perception of supportive environment, perceived stress, and COVID-19-specific anxieties in nurses working directly with COVID-19 patients.

Research Design

The study design was a cross-sectional descriptive study using an online survey. It was conducted at an ANCC Magnet® designated 385-bed acute care teaching hospital located in a suburban area.

Participants and Research Context

Included in this study were 339 medical surgical nurses working directly with COVID-19 patients during the early phase of the pandemic.

Ethical Considerations

The study was reviewed by the institution’s clinical research committee and determined to be exempt. A survey invitation letter with a voluntary implied consent agreement was sent to participants with a description of the research study attached to the anonymous survey.

Results

Nurses with specific COVID-19-related anxieties were more likely to agree that it was ethical to abandon the workplace during a pandemic.

Conclusions

Organizations can and ought to mitigate the negative effects of COVID-19 on duty to care in future pandemics and healthcare emergencies by incorporating several recommendations derived from this study.
Effects of Early Palliative Care in Advanced Cancer Patients: A Meta-Analysis
Authors: Shih Hsiu-Hua , Chang Hsiu-Ju , Huang Tsai-Wei
Published: March 2022

Objective: Advanced cancer patients often suffer from a reduced quality of life (QoL) and cancer-related symptoms. Early palliative care may improve their QoL and symptom severity. Methods: We conducted a meta-analysis of the effects of early palliative care on QoL, symptom severity, and other outcomes in advanced cancer patients, and searched PubMed, Embase, CINAHL, MEDLINE, and the Cochrane Library databases for potential randomized controlled trials (RCTs). The primary outcome was QoL. The secondary outcomes were symptom intensity and functional well-being (Trial Outcome Index, TOI). The study protocol has been registered and approved by PROSPERO (CRD42020164047). Results: We obtained 12 RCTs enrolling 2980 participants. Compared with the usual care, early palliative care significantly improved QoL at ≤ 3 months (SMD = .16, 95% CI = .05–.27) and when treated more 3 months (SMD = .26, 95% CI = .11–.40). Compared with usual treatment, patients who received early palliative care exhibited a significant reduction in symptom intensity when treated more than 3 months (SMD = .18, 95% CI = .06–.31) and in TOI ≤ 3 months (SMD = .28, 95% CI = .11–.45). Conclusions: Early palliative care improves QoL, symptom intensity, and TOI in advanced cancer patients. We recommend introducing early palliative care for advanced cancer patients as the approach provides additional clinical benefits compared with usual care.
Determinants of Location of Death: A Secondary Analysis Utilizing Multinomial Logistic Regression
Authors: Cypher Mackenzie , Axman Linnea M
Published: March 2022

Statement of Problem: A discrepancy exists between where people would like to die and what actually occurs. More research about the factors influencing the location of death is required. Sources of Data and Research Design: Multinomial logistic regression was used to examine a sample taken from the fourth round of data collection performed by the National Health and Aging Trends Study conducted in 2014. Conclusions Reached: Census location, age, dementia, and use of hospice were found to have a statistically significant ( P < .05) influence on the location of death ( P = .000). The results suggest that the use of hospice increased the odds of dying at home (OR = 17.467, CI = 7.43–41.063) and in a nursing home (OR = 34.334, CI = 12.444–94.727) as compared to dying in the hospital. Further research is required on the topic of geographic location and place of death.
A Novel and Practical Protocol for Three-Dimensional Assessment of Alveolar Cleft Grafting Procedures
Authors: Stoop Celine C. , Janssen Nard G. , ten Harkel Timen C. , Rosenberg Antoine J. W. P.
Published: March 2022

Objective

To evaluate the reproducibility and accuracy of a new, easy-to-use volumetric assessment of the alveolar cleft.

Design

Twelve cone-beam computed tomography (CBCT) datasets of patients with a unilateral cleft lip, alveolus, and palate were evaluated by two investigators. Residual alveolar cleft calcified volume one year after surgery was analyzed by using standardized landmarks to determine the borders of the cleft defect and semi-automatically segment the alveolar cleft defect.

Results

The Dice-coefficient between observers for the segmented preoperative alveolar cleft defect was 0.81. Average percentage of residual alveolar cleft calcified material was 66.7% one year postoperatively.

Conclusions

This study demonstrates a reliable and practical semi-automatic three-dimensional volumetric assessment method for unilateral clefts using CBCT.
Three-dimensional Analysis of Factors Related to the Effective Alveolar Molding in Presurgical Infant Orthopedics: Findings From a Pilot Study
Authors: Fujimoto Mai , Mano Mikiko , Sasaki Au , Hasegawa Hiroya , Suzuki Masaharu , Nojiri Naoko , Minami Yuri , Tokioka Kazuyuki , Suda Naoto
Published: March 2022

Objective

Presurgical infant orthopedics (PIO) reduces the severity of the original cleft and burden on patients and their parents, provides better esthetics and function, and enables surgeons to achieve better surgical repair. To reduce the alveolar cleft width and to predict treatment difficulty using PIO, various measures were examined in pretreatment cast models.

Design

Retrospective case-control pilot study.

Patients

The patients were 22 infants with non-syndromic unilateral cleft lip and palate (UCLP), and cast models of these infants were used.

Methods

After PIO using passive plates, infants with UCLP were divided into two groups: contact group (12 cases with close proximity of the greater and lesser segments) and non-contact group (10 cases without proximity of segments). The two groups were compared, and variables related to the proximity between alveolar clefts were examined.

Results

There was no significant difference in age at PIO initiation between the two groups. However, the treatment duration was significantly longer in the non-contact group than in the contact group. Among the 13 variables, the initial lateral deviation of the nasal septum was significantly larger in the contact group than in the non-contact group. A significant positive correlation was observed between the initial lateral deviation of the nasal septum and reduction of the alveolar cleft width by PIO.

Conclusion

Initial lateral deviation of the nasal septum is a predictive factor for the proximity between alveolar segments in infants with UCLP at the PIO.
Application of a Novel Nasal Clip for Nostril Retention After Primary Unilateral Cleft Rhinoplasty
Authors: Zhang Shiming , Yang Chao , Wu Min , Yin Jiayi , Zeng Ni , Shi Bing , Huang Hanyao
Published: March 2022

Objective

This study aimed to investigate the outcomes of using a novel nasal clip designed for nostril retention after primary unilateral cleft rhinoplasty.

Design

This is a retrospective study.

Setting

Department of Cleft Lip and Palate in a stomatological hospital.

Patients

A retrospective study was conducted on 57 patients who had a unilateral complete cleft lip without cleft palate and underwent primary surgical repair.

Interventions

The patients were categorized into 3 groups: the group in which the conventional nasal retainer was used, that in which the nasal clip was used, and the control group in which no postoperative nasal retainer was used. The nasal retainer or our nasal clip was applied 7 days after primary surgical repair and kept in the nostrils of children from 6 to 12 months.

Main Outcome Measures

Noses underwent photogrammetry preoperatively, postoperatively, and at follow-up. The nose was also subjectively scored at the follow-up.

Results

The nasal retainer and the nasal clip significantly minimized relapse as determined by nasal tip deviation. The nasal clip sustained nasal symmetry, as determined by the postoperative nostril width ratio, better than did the conventional retainer. After 6 to 12 months, the nasal clip achieved better columellar morphology and a more symmetric nasal base than did the conventional nasal retainer. Statistical differences in subjective scores between the control and nostril retention groups were noted.

Conclusion

The application of the novel nasal clip after primary unilateral cleft rhinoplasty preserves nasal morphology and reduces postoperative relapse without the need for adhesive tape.
New Challenges in the Differential Diagnosis of High-Grade Triple-Negative Breast Cancer and Serous Carcinoma
Authors: Puzyrenko Andrii , Cortina Chandler S , Jorns Julie M
Published: March 2022

While screening has improved early detection of primary breast cancers, it may also identify metastasis to the breast in rare instances. High-grade carcinomas identified on breast screening may have non-specific morphology and immunoprofiles, making distinction from metastasis problematic. High-grade carcinomas frequently lose expression of specific tumor markers. New evidence specifically challenges GATA3/PAX8 exclusivity in the differential diagnosis of high-grade triple-negative breast cancer and high-grade serous carcinoma of müllerian origin. This case series provides a careful and detailed review of immunohistochemistry interpretation, with focus on PAX8, and the potential pitfalls in making a definitive pathological diagnosis, which is essential in determining oncological treatment options.
Flexural vibration of multistep rotating Timoshenko shafts using hybrid modeling and optimization techniques
Authors: Soheili Saeed , Abachizadeh Mahdi
Published: March 2022

In this paper, the flexural vibration of uniform and non-uniform rotating shafts based on the Timoshenko beam theory is investigated. Considering shear deformation and gyroscopic effects to build an exact framework of a solution, the fourth-order differential equation of vibration is solved by an analytical method. The overall transfer matrix of the system formed by a series of flexible distributed in addition to lumped elements is achieved. The results obtained by the distributed lumped modeling technique (DLMT) are verified with other techniques. The damped frequencies obtained by the hybrid modeling method for a multistep gas turbine rotor system using the Euler–Bernoulli and Timoshenko beam theories are compared with the results of the transfer matrix method (TMM). It is shown that the presented method provides highly accurate results, while with no compromise, it can be simply and effectively employed for complex systems. It is also shown how the Hooke and Jeeves and the ant colony optimization (ACO) besides the direct enumeration method can be applied to obtain the damped natural frequencies of complicated vibrational systems such as the gas turbine rotors. The comparison between the frequency and damping ratio values obtained by the optimization and direct enumeration methods shows less than 1% error for different cases.
Queer Literacies: Queer Objects, Disorientation, and Sponsors of Literacy
Authors: Potter Troy
Published: March 2022

Since the 1990s, there have been increasing calls to “queer” curricula in order to challenge gender and sexuality norms. In this article, I develop a model of queer literacies that understands queer to encompass anti-normative ways of being and recognizes the agentic potential of queer objects to disorient individuals and spaces. I challenge educators to become sponsors of queer literacies in order to disrupt a range of normative ideologies and open up future possibilities in which difference is acknowledged and accepted. I conclude the article by illustrating how a queer object, Shaun Tan's picture book Cicada (2018), might be read using a queer literacies approach to promote critical literacy, social justice, and well-being.
Hitch suture assisted tuck in Tenon's Patch Graft for management of Corneal Perforations
Authors: Bafna Rahul Kumar , Kalra Nidhi , Rathod Aishwarya , Asif Mohamed Ibrahime , Lata Suman , Parmanand Kumar , Kaur Navpreet , Kittur Amogh Shreekant , Shakkarwal Chetan , Roop Prakhyat , Agarwal Rinky , Agarwal Tushar , Sharma Namrata
Published: March 2022

Purpose

To describe a novel modification of tuck-in Tenon's patch graft (TPG) using temporary horizontal mattress sutures and fibrin glue to hitch the graft in the management of corneal perforations.

Design

Ambispective interventional case series.

Methods

Modified technique of autologous TPG was used to seal corneal perforations measuring 3–5 mm, using horizontal mattress sutures to hitch the graft in a lamellar pocket, followed by application of fibrin glue. The horizontal mattress sutures were removed after the reformation of the anterior chamber. The primary outcome measure was a well formed anterior chamber in the post-operative period and the secondary outcome was epithelization time.

Results

The surgery was performed in 22 eyes. The mean age was 43.86 ± 16.02 (26–66) years, with 14 males and eight females. The etiologies of corneal perforation included dry eye (n = 10), neurotrophic keratitis (n = 6), trauma (n = 2), chemical injury (n = 2) and exposure (n = 2). The mean size of the perforation with the thinned-out area was 4.3 mm (range 3–5 mm). The mean duration of epithelialization was 14.31 ± 2.63 days (7–21 days). No intraoperative complications were observed. All eyes had a well-formed anterior chamber in the immediate postoperative period. Postoperatively, two eyes had graft pseudoectasia due to a thick graft and supra tenon haemorrhage each; one eye each had graft thinning with the formation of pseudopterygium and graft melting.

Conclusion

Tenon's patch graft, along with the use of temporary horizontal mattress sutures and fibrin glue, is an effective modification of the technique for managing corneal perforations measuring 3–5 mm.
New mechanism for epithelial ingrowth after small incision lenticule extraction: Vertical epithelial gas breakthrough
Authors: de Rojas Silva Mª Victoria , Tobío Ruibal Adrián
Published: March 2022

A 41-year-old man underwent SMall Incision Lenticule Extraction (SMILE) to treat myopia in both eyes. The femtosecond procedure was uneventful but a paracentral epithelial blister appeared during the dissection of the anterior plane of the lenticule in the right eye. The posterior surface of the lenticule was dissected without any complication. The surgery of the left eye was uneventful. In the postoperative period, he developed a paracentral epithelial ingrowth in his right eye, exactly underneath the site where the epithelial blister had been noted during the dissection of the lenticule. This induced irregular astigmatism, severely affecting his visual acuity. The decision of surgical treatment was made. After the de-epithelialization of an area of 6mm around the ingrowth, the SMILE incision was opened, and the epithelial ingrowth was dissected and removed from the interface. One month later, uncorrected visual acuity was 20/20, no epithelial ingrowth was observed at the interface, and only the edge of the former ingrowth was barely visible in slit lamp examination. No recurrence was observed. We hypothesize that a vertical epithelial gas breakthrough created a fistula between the interface and the epithelium, forming a pathway for the epithelial cells and giving rise to epithelial ingrowth.
Long-term follow-up of bilateral ectasia after laser–assisted Small-Incision Lenticule Extraction (SMILE) with known risk factors
Authors: Goupillou Paul , Boutillier Guillaume , Naguszewski Dominique , Muraine Marc
Published: March 2022

Purpose

To report the long-term follow-up of bilateral ectasia after laser–assisted small-incision lenticule extraction (SMILE) with known risk factors

Case Report

We report the case of a 23-year-old woman. Preoperative refraction was – 7.25 −2.00 × 20 in the right eye and −7.25 −1.50 × 155 in the left eye. Maximal keratometry was 47.32 diopters and 48.37 diopters, respectively, which was a contraindication to Laser Assisted In Situ Keratomileusis (LASIK) and a SMILE was proposed in 2015. One year after surgery, ectasia developed in the left eye and crosslinking (CXL) was performed. Two years after surgery, ectasia also developed in the right eye and CXL was also performed, leading to stabilization in both eyes five years after surgery.

Conclusions

Known contraindications for LASIK are also contraindications for the performance of refractive surgery with SMILE. CXL is an efficient treatment of post-SMILE corneal ectasia.
Ideology, doxa and critical reflexive learning: The possibilities and limits of thinking that ‘diversity is good’
Authors: Morillas Miguel , Romani Laurence
Published: March 2022

How can managers reach a critical position from which to develop more responsible management practices? The literature suggests that the answer lies in critical reflexive learning, explaining how reflexivity can detach individuals from the grip of harmful ideologies. We challenge this premise, according to which critical reflexive learning and ideology are counterposed, arguing instead that they need to be studied as intertwined. We build on the organizational ethnography of a firm promoting inclusive and responsible management, studying a programme for recruitment of highly skilled migrants. Exploring managerial learning achieved through this programme, we show how critique, reflexivity and learning are closely linked to the ideological system of beliefs that naturalizes the organizational order: the organizational doxa ‘Diversity is good’. This work makes the following three contributions to literature on critical reflexive learning: it stresses the currently overlooked interconnection between critical reflexivity and ideology, it shows how an ideological expression (doxa) both induces and simultaneously bounds managers’ engagement with critique, and it argues for the counterintuitive possibility that critique and change can be achieved through doxa. We answer our opening question – how to reach critique and responsible change – somewhat provocatively; through the adoption of a new ideology.