bluuebunny/crossref_metadata_2025 huggingface dataset:
Urban ecosystems assessment: An integrated approach to maintenance of habitats and their biodiversity
Authors: Semerdzhieva Lidiya , Borisova Bilyana
Published: December 2021

Natural habitats and their biodiversity are usually associated with protected areas, incompatible with direct anthropogenic influence. Is there a biodiversity in urban environment, what is the role of peri-urban areas to the provision of species richness and is their potential being properly utilized? These are current issues that deserve the attention of decision-makers because the human's need of natural environment in cities is expressed more intensely than in any previous period in history. Green and blue infrastructure elements, being part of the larger system of urban ecosystems, provide an essential and proven benefits to the city dwellers, like health improvement, opportunities for nature-based daily outdoor recreation, strengthening sense of place etc. The main objective of this research is to assess this part of the landscape elements in urban and peri-urban environment, which are most supportive to the maintenance of habitats and their biodiversity. Selected Functional urban area with center city of Burgas is choosen for a case study. The urban ecosystems are assessed in GIS environment with unified indicator (based on City Biodiversity Index approach) according to 5 criteria: hemeroby index, share of protected areas, fragmentation index, presence of water and species richness. The assessment is performed on two spatial levels: within Functional urban area by Urban Atlas spatial units and within urban core – by grid cells (local climate zones). The final higher scores identify areas that provide the greatest extent the maintenance of habitats and their biodiversity. The results could support the urban planning and help to optimize the link between the natural elements within the Functional urban areas, providing ecological, economic and social benefits to the regions through the enhancement of the urban ecosystem’s functions and their services.
Controverse sur la 5G
Authors: Chardel Pierre-Antoine , Frérot Olivier
Published: December 2021

Le développement de la 5G, qui favorise l’Internet des objets, s’appuie sur l’idée que le changement technologique est en général bénéfique. Des applications médicales peuvent en effet être pertinentes. Mais les oppositions soulevées invitent à un véritable débat démocratique. L’innovation technologique est indissociable d’une responsabilité éthique.
Sécurité des Systèmes d’Information de E-Démocratie : une obligation préalable ?
Authors: Février Rémy
Published: December 2021

Un management efficient de la sécurité des systèmes d’ information constitue une obligation préalable à un développement efficient de la E-Démocratie et notamment dans les collectivités territoriales qui en constituent le fer de lance. Notre étude exploratoire tend à montrer que, contrairement à l’ influence décisive que l’on prête généralement à la dimension technique, les facteurs les plus opérants relativement à la sécurisation d’un système d’information sont avant tout d’ordre organisationnel.
Investir la ville. Les stratégies patrimoniales des élites urbaines laïques d’Italie centrale (XI e -XIII e siècle)
Authors: Fulconis Maxime
Published: December 2021

Les stratégies patrimoniales et les investissements que réalisent les grands propriétaires laïcs dans les villes italiennes des xi e - xiii e  siècles n’ont pas encore fait l’objet d’études détaillées et précises, l’état actuel des archives orientant plutôt le chercheur vers les patrimoines et les stratégies des institutions ecclésiastiques. Pourtant, quelques parchemins de Viterbe, qui peuvent être mis en parallèle avec des documents d’autres villes d’Italie centrale, offrent l’opportunité de dresser un portrait assez précis de la morphologie du patrimoine urbain des élites, dont le profil évolue par ailleurs au cours de la période considérée. La documentation permet également d’évaluer la rentabilité des différents types d’investissements urbains et met en lumière la faible rentabilité économique des maisons dont l’usufruit était concédé à des tenanciers. Ce type d’investissement servait avant tout à constituer au sein des quartiers des clientèles à même de soutenir le grand propriétaire en cas de faide ou dans le cadre de votes à l’assemblée populaire. Enfin, le tènement familial représentait à la fois l’épicentre du patrimoine urbain, un objet d’investissement massif et un outil qui permettait d’afficher la puissance du propriétaire et de conforter son emprise sur ses voisins et ses clients. Ces stratégies d’investissements, qui incluent la pratique du prêt, contribuèrent ainsi à transformer l’économie, la société et le fonctionnement politique des villes d’Italie et marquèrent leur évolution. Elles permettent donc de mieux comprendre une période de transition au cours de laquelle, dans les villes, les structures sociales et politiques de matrice carolingienne laissent progressivement place aux institutions communales.
Élites politiques et aristocratie à Byzance (V e -XV e siècles)
Authors: Puech Vincent
Published: December 2021

L’Empire byzantin n’est pas gouverné par une noblesse car les titres de cour ne sont pas héréditaires. Il est même difficile de parler d’aristocratie car les élites byzantines constituent un groupe social ouvert. Entre le v e et le xv e  siècle, ces élites se caractérisent par une grande continuité, héritée de l’Empire romain tardif. L’empereur nomme à des dignités auliques et à des fonctions administratives, qui sont souvent achetées et procurent les plus grosses fortunes. Ce système de gouvernement est aussi marqué par la corruption et les relations de fidélité entre les hommes. L’appartenance familiale prédispose à l’occupation des postes de pouvoir, à la fois grâce aux réseaux sociaux et aux biens hérités. Des évolutions se manifestent néanmoins au cours du millénaire byzantin, sans que l’on puisse parler de « Moyen Âge grec ». Les élites de l’Antiquité tardive se renouvellent à une grande vitesse, même dans l’entourage impérial. Après le viii e  siècle apparaissent les noms lignagers transmissibles caractéristiques d’une aristocratie placée au sommet du groupe des élites et particulièrement spécialisée dans la guerre. À partir du xii e  siècle, les plus hautes dignités de cour sont réservées aux membres des dynasties impériales constituées par une politique matrimoniale. Au même moment se généralise au bénéfice de la plus haute aristocratie la dévolution des revenus à la source, sous le contrôle de l’empereur, qui distribuait jusqu’alors directement ses largesses.
Effects of low-cost agricultural technology package on income, cereal surplus production, household expenditure, and food security in the drylands of Mali
Authors: Sissoko Penda , Synnevag Gry , Aune Jens B.
Published: December 2021

This study assessed the effects of introducing a technology package consisting of seed priming and microdosing of mineral fertilizer on sorghum and pearl millet yield, cereal production, net value of cereal production, household expenditure, adoption rate of technology and household food security in the millet and sorghum producing areas in Mopti, Segou and Koulikoro regions of Mali. Three different surveys were undertaken to collect the data during the period from 2013 to 2015. The first survey assessed the farmers practices (360 households), the second survey assessed production, household expenditure and food security in the households (54 households) and the third survey assessed the adoption rates of the technologies (108 households). The surplus cereal production was in average 1155 kg/household for adopting households while non-adopting households had a surplus of only 196 kg/household. The monetary surplus increased from 31.2 Euro for non-adopting households to 215.6 Euro for adopting households. Households using the package spent 167.8 Euro on health, children's education, and other necessities while non-adopting households spent only 29.5 Euro. Furthermore, households using the package spent 55.9 Euro on fertilizer against close to zero for non-adopting households. Finally, the number of food insecure months were significantly reduced from 3.57 months for the adopting households to 1.24 months for non-adopting households. The technology package initiated positive development pathways characterized by increased production and income, surplus grain production, investments in livelihood assets and yield-enhancing technologies and improved food security. This link from technology introduction to improved food security is very important from a development perspective, but there is a lack of research that clearly demonstrate this effect in the drylands of West Africa. Future interventions to ensure a more broad-based development should focus on continued investment in yield-enhancing technologies, diversification of production to ensure better access to high quality food, strengthening the role of women, and building institutions to support farmers' livelihood and agency.
Constrained Ensemble Langevin Monte Carlo
Authors: Ding Zhiyan , Li Qin
Published: December 2021

The classical Langevin Monte Carlo method looks for samples from a target distribution by descending the samples along the gradient of the target distribution. The method enjoys a fast convergence rate. However, the numerical cost is sometimes high because each iteration requires the computation of a gradient. One approach to eliminate the gradient computation is to employ the concept of "ensemble." A large number of particles are evolved together so the neighboring particles provide gradient information to each other. In this article, we discuss two algorithms that integrate the ensemble feature into LMC, and the associated properties.

In particular, we find that if one directly surrogates the gradient using the ensemble approximation, the algorithm, termed Ensemble Langevin Monte Carlo, is unstable due to a high variance term. If the gradients are replaced by the ensemble approximations only in a constrained manner, to protect from the unstable points, the algorithm, termed Constrained Ensemble Langevin Monte Carlo, resembles the classical LMC up to an ensemble error but removes most of the gradient computation.
Monotonicity, convexity properties and inequalities involving Gaussian hypergeometric functions with applications
Authors: Han Ye-Cong ,   Department of Mathematics, Zhejiang Sci-Tech University, Hangzhou 310018, China, Cai Chuan-Yu , Huang Ti-Ren ,   Zhejiang Technical Institute of Economics, Hangzhou 310018, China
Published: December 2021

In this paper, we mainly prove monotonicity and convexity properties of certain functions involving zero-balanced Gaussian hypergeometric function $ F(a, b; a+b; x) $. We generalize conclusions of elliptic integral to Gaussian hypergeometric function, and get some accurate inequalities about Gaussian hypergeometric function.
PREVALÊNCIA DE PARALISIA CEREBRAL E OS TIPOS DE ÓRTESES MAIS USADAS PARA DEFORMIDADES NOS PÉS DE CRIANÇAS DA ASSOCIAÇÃO NORTE PARANAENSE DE REABILITAÇÃO - ANPR
Authors:   UNINGÁ-Centro Universitário Ingá, Freitas Itala backes de , Silva Thainá Caroline da , Dei Tos Débora ,   UNINGÁ- Centro Universitário Ingá, Fabiano Lilian Catarim ,   UNINGÁ- Centro Universitário Ingá
Published: December 2021

A Paralisia Cerebral (PC) é uma encefalopatia crônica, que atinge cerca de 1 a cada 1000 nascidos vivos no Brasil, ocasionando alterações cognitivas e motoras durante o desenvolvimento. Para portadores de PC são prescritos diferentes tipos de dispositivos que auxiliam durante o processo de reabilitação e proporcionam uma melhor qualidade de vida, como por exemplo as órteses de tornozelo e pé, que são indicadas para aprimoramento da marcha e adquirir independência, em especial para crianças que dispõem da deformidade em pé equino. Nosso estudo teve como objetivo verificar a prevalência de crianças frequentadoras da Associação Norte Paranaense de Reabilitação (ANPR) com diagnóstico de PC e que apresentam deformidade nos pés. Adicionalmente, também objetivou verificar o tipo de órtese usada por essas crianças e se fazem uso das mesmas. Para realização do estudo foi feito busca de dados nos prontuários das crianças frequentadoras da ANPR com diagnóstico de PC, contando com uma amostra de 30 alunos. O uso correto da órtese pode contribuir não apenas no tratamento, mas também na prevenção de deformidades, vale ressaltar que para obter seus benefícios, dever ser realizado a prescrição correta e a orientação aos seus cuidadores para fazer o uso no ambiente domiciliar.
Facebook as a Venue for Learning Writing Skills in English: A Survey Based on an ELT Experiment
Authors: Jayarathna Dilini
Published: December 2021

Facebook is a website that allows users who sign-up for free profiles, to connect online with friends, work colleagues, or strangers while providing prospects to share pictures, music, videos, and articles, as well as their thoughts and opinions with people they prefer. Considering its capacity to build networks out of various types of interest groups among young people, this study strives to investigate the utilization of a Facebook group as a platform for teaching and learning English as a Second Language (ESL). In the present experiment, a sample of 30 intermediate-level ESL learners joined with a Facebook group under the banner “Time for Writing” to learn paragraph writing in English for a period of six weeks. Throughout the period, the teacher presented the lesson material and instruction on paragraph writing via Facebook while assessing students’ writing along with constructive feedback in the same way. Moreover, the students employed the Facebook group to share their work with the entire group including the teacher, correct the work of their peers, and exchange their feedback on each other’s work. After the relevant period, the group of participants assembled in a traditional classroom situation, writing paragraphs by means of the paper-based method. Thus, they were facilitated to compare the Facebook environment and the traditional classroom environment and were expected to provide their feedback on the two types of ESL settings. The findings achieved through a review of their responses to the two respective pedagogical settings, online via social media and classroom with physical amenities and resources, reveal that learning via a Facebook group has benefits in terms of boosting confidence, intensifying motivation, and promoting connected learning, despite a few challenges concerned with distractions and technical problems. Moreover, the results suggest Facebook as an innovative learning setting that is appealing, motivating and full of social interactions which are incredible in comparison to traditional teaching practices. The findings of the study may help ESL educators in incorporating Facebook into their teaching repertoire.
Impact of Self-Awareness and Self-Management on Organizational Commitment to Change: A Study Based on Aviation Industry in Sri Lanka
Authors: Warnakula U. S. , Dhammika K. A. S. , Karunarathne R. A. I. C.
Published: December 2021

As organizations are operating in a turbulent environment, it is essential for them to change the existing practices and policies. Currently, the aviation sector in Sri Lanka needs to acclimatize to survive in their environment. Thus, this study aims to identify the impact of self-awareness and self-management on organizational commitment to change. Moreover, the study aims to examine the boundary conditions of the proposed relationship by examining the moderating effect of environmental dynamism, which received less attention in the extant literature. Researchers adopted post-positivism research philosophy, and the approach is deductive. Data were collected using a self-administrated questionnaire from 330 front-line employees in the aviation industry in Sri Lanka. PLS-SEM model was adopted to analyze the data, and the violating assumptions were tested. The results showed that self-awareness and self-management are positive and significant influences on organizational commitment to change, and environmental dynamism moderate these relationships. The key implication of this study is managing any critical times by inspiring their level of self-awareness and management to change the mindset of staff to cope with the organization change to enhance the commitment. The findings of the study are beneficial for potential aviation-related academies and partitioners.
Laminin Isoforms in Human Dental Pulp: Lymphatic Vessels Express Laminin-332, and Schwann Cell–Associated Laminin-211 Modulates CD163 Expression of M2-like Macrophages
Authors: Yoshiba Nagako , Edanami Naoki , Ohkura Naoto , Maekawa Tomoki , Takahashi Naoki , Tsuzuno Takahiro , Maeda Takeyasu , Tabeta Koichi , Izumi Kenji , Noiri Yuichiro , Yoshiba Kunihiko
Published: December 2021

Laminin, a basement membrane heterotrimeric glycoprotein composed of α/β/γ subunits, has important tissue-specific functions in the control of cellular behavior. Our recent study showed the colocalization of CD163+ M2-like macrophages with Schwann cells in human dental pulp, leading us to hypothesize that the laminin isoform of Schwann cells is associated with CD163 expression. The present study investigated the distribution of laminin isoforms in human dental pulp and the underlying mechanisms that affect macrophage phenotypes. Immunofluorescence analysis indicated that blood vessels were exclusively positive for laminin α4 and α5, whereas laminin α2 was associated with Schwann cells. Unexpectedly, laminin α3/laminin-332 (α3β3γ2) was detected on lymphatic vessels. In intact and carious teeth, CD163+ cells were associated with laminin α2, whereas CD206 single-positive cells were present inside, outside, and along blood vessels. In vitro incubation of THP-1 macrophages in plates coated with laminin-211/511 or its functionally analogous E8 fragments of α-chain (E8-α) indicated that cell shapes differed between macrophages grown on laminin-211/E8-α2 and macrophages grown on laminin-511/E8-α5. Laminin-211/E8-α2–coated plates upregulated CD163 expression, compared with laminin-511/E8-α5–coated plates. Integrin α3– and integrin α6–neutralizing Abs altered the shape of THP-1 macrophages and upregulated mRNA levels of CD206 and CD163 in macrophages grown on laminin-511; the neutralizing Abs did not affect macrophages grown on laminin-211. These findings suggest that laminin isoforms differentially regulate macrophage behavior via distinct integrin–laminin affinities. Of note, laminin-332 is expressed by pulpal lymphatic vessels, the existence of which has been debated; laminin-211 might have a role in maintaining CD163 expression on macrophages.
Mucosal Vaccination with Cyclic Dinucleotide Adjuvants Induces Effective T Cell Homing and IL-17–Dependent Protection against Mycobacterium tuberculosis Infection
Authors: Jong Robyn M , Van Dis Erik , Berry Samuel B , Nguyenla Xammy , Baltodano Alexander , Pastenkos Gabrielle , Xu Chenling , Fox Douglas , Yosef Nir , McWhirter Sarah M , Stanley Sarah A
Published: December 2021

Tuberculosis consistently causes more deaths worldwide annually than any other single pathogen, making new effective vaccines an urgent priority for global public health. Among potential adjuvants, STING-activating cyclic dinucleotides (CDNs) uniquely stimulate a cytosolic sensing pathway activated only by pathogens. Recently, we demonstrated that a CDN-adjuvanted protein subunit vaccine robustly protects against tuberculosis infection in mice. In this study, we delineate the mechanistic basis underlying the efficacy of CDN vaccines for tuberculosis. CDN vaccines elicit CD4 T cells that home to lung parenchyma and penetrate into macrophage lesions in the lung. Although CDNs, like other mucosal vaccines, generate B cell–containing lymphoid structures in the lungs, protection is independent of B cells. Mucosal vaccination with a CDN vaccine induces Th1, Th17, and Th1–Th17 cells, and protection is dependent upon both IL-17 and IFN-γ. Single-cell RNA sequencing experiments reveal that vaccination enhances a metabolic state in Th17 cells reflective of activated effector function and implicate expression of Tnfsf8 (CD153) in vaccine-induced protection. Finally, we demonstrate that simply eliciting Th17 cells via mucosal vaccination with any adjuvant is not sufficient for protection. A vaccine adjuvanted with deacylated monophosphoryl lipid A (MPLA) failed to protect against tuberculosis infection when delivered mucosally, despite eliciting Th17 cells, highlighting the unique promise of CDNs as adjuvants for tuberculosis vaccines.
Home-based unsupervised pulmonary rehabilitation program improves the respiratory disability in systemic sclerosis patients with dyspnea: an observational prospective study
Authors: Faverzani Silvia , Nocera Filippo , Crisafulli Ernesto , Marvisi Maurizio , Becciolini Andrea , Mosetti Federica , Di Donato Eleonora , Mozzani Flavio , Santilli Daniele , Scopelliti Giuseppe , Ariani Alarico
Published: December 2021

Dyspnea is a common symptom in Systemic Sclerosis (SSc) that considerably decreases patients’ quality of life (QoL). Pulmonary Rehabilitation (PR) mitigates dyspnea impact on daily activities. The aim of this study is to evaluate the effect on respiratory disability of home-based PR in SSc patients with dyspnea. In this observational prospective monocentric study, we screened all dyspneic SSc consecutive patients attending the Rheumatological day hospital in the University hospital of Parma from January 2019 and June 2019. The aim of our study was to understand if a PR unsupervised home-based program could improve respiratory disability in this specific population. Dyspnea was evaluated with the self-administered questionnaires modified Medical Research Council (mMRC) and  Saint George's Respiratory Questionnaire (SGRQ).Patients also filled in Short Form 36 (SF36) and the Modified-Health Assessment Questionnaire for SSc (HAQ-MOD). Health Professionals assessed and trained the patients and collected data before PR and at the end of the program. PR consisted in 5 weekly unsupervised sessions for 8 weeks. Wilcoxon test for paired data evaluated the changes after PR. p<0.05 was considered statistically significant. 46 SSc patients were included (43 female). Only 31 (29 female) performed PR as planned (Adherent Group-AG) while the others gave up within the first week (Non-Adherent Group-NAG). All SGRQ domains (Symptoms: from 30 to 18; p=0.0055; Activity: from 47 to 35, p=0.23; Impact from 29 to 25, p=0.044) and SGRQ total score (from 35 to 29; p=0.022) improved in AG. SGRQ scores did not change in NAG as well as SF36 and HAQ-MOD in both groups. The home-based PR program dramatically decreased the effect, frequency and severity of respiratory symptoms. Conversely, it slightly changed the activities causing breathlessness and dyspnea-related social functioning disturbances. PR appears to be a useful tool in treatment strategies aiming to achieve a QoL improvement in SSc patients.
Saudi Arabian real-life experience with biologic therapy in severe asthma
Authors: Eldaboussi Safwat , Qabil Ahmed , Lotfi Ahmed , Awad Amgad , Abdel Salam Eman , Alkhamis Abdullah , Abuelhassan Usama E.
Published: December 2021

Background: Severe asthma (SA) is a common health problem associated with increased morbidity and mortality and high medical costs. Biological therapies have emerged in recent decades as promising treatment options for patients with high type 2 (T2) SA. This retrospective observational study from Saudi Arabia aimed to investigate the effects of additional biologics therapy on reducing oral corticosteroid (OCS) consumption, frequency of asthma exacerbations, improvement in lung function, and asthma control.Methods: This multicenter observational study enrolled a cohort of 97 patients from Mach 2019 to February 2021. Outcomes of anti-IgE, anti-IL5/IL5R, and anti-IL4R therapies in severe type 2 asthma were recorded and analyzed in terms of number of exacerbations (emergency visits or hospitalizations required), asthma symptoms, and use of oral corticosteroids, blood eosinophil count, asthma control according to GINA classification, and FEV1 before and during biologic therapy.Results:  Ninety-seven patients were included in the analysis The mean age was 46.7±14.1 years, and 69.1% of them were female. The average duration of biological treatment was 16.4±6.8 months. At the time of data collection, the four biologic therapies reduced the exacerbation rate per year from 82/97 (84.5%) to 14/97 (14.4%) with a percent improvement of 83% from 2.9 per year in the year before biologic treatment to 1.6 per year (p<0.001). OCS was reduced from 75/97 (77.3%) to 10/97 (10.3%) for a percent improvement of 86.7%, and the average OCS dose decreased from 7.12 mg to 6.8 mg. Mean blood eosinophil count also decreased after biologic therapy from 750.5±498.5 to 188.0±122.4 cells/μl, most significant result achieved with benralizumab, and mean FEV1 improved from 59.0±12.9% to 76.0±10.2%, most significant result achieved with omalizumab.  ll patients had uncontrolled asthma before biologics therapy, but asthma control improved by 91.8% after treatment.Conclusions: Biologic as add-on therapy for high T2 SA was found to reduce asthma exacerbations, systemic glucocorticoid doses, and SA symptoms.
Use of Lifesaving Medications by Athletic Trainers
Authors: Hoffman Mark , Murphy Molly , Koester Michael C. , Norcross Emily C. , Johnson Sam T.
Published: December 2021

The athletic trainer's (AT's) emergency management skillset requires competency in the delivery of basic lifesaving medications. Some lifesaving medications have been a part of athletic training practice for decades, but that list has grown as ATs' practice settings have expanded, increasing the types of emergent conditions that the AT may have to treat. The 2020 Commission on Accreditation of Athletic Training Education (CAATE) curricular standards require that athletic training students be trained to administer the following: supplemental oxygen, nitroglycerine, low-dose aspirin, bronchodilators, epinephrine using an automated injection device, glucagon, and naloxone. Clinically, the conditions treated by these medications can be categorized as cardiac, respiratory, hypoglycemia, and anaphylaxis. All ATs should know the indications, contraindications, administration methods, and details of patient monitoring for each medication. Generally, these medications are safe and have clear indications for use and few contraindications. Although ATs are trained to administer these medications, they must consider state laws and local policies governing administration.
Proper Recognition and Management of Exertional Heat Stroke in a High School Cross Country Runner: A Validation Clinical Case Report
Authors: Garrett Bryanna , Lopez Rebecca , Szymanski Michael , Eidt Drew
Published: December 2021

A 14-year-old female high school cross country runner (height = 154 cm, mass = 48.1 kg) with no history of exertional heat stroke (EHS) collapsed at the end of a race. An athletic trainer (AT) assessed the patient, who presented with difficulty breathing then other signs of EHS (i.e. confusion, agitation). The patient was taken to the medical area, draped with a towel, and a rectal temperature (Tre) of 106.9°F(41.6°C) was obtained. The emergency action plan was activated and emergency medical services (EMS) were called. The patient was submerged in a cold-water immersion tub until EMS arrived (~15 minutes; Tre = 100.1°F; cooling rate: 0.41°F·min−1[0.25°C·min−1]). At the hospital, the patient received intravenous fluids, and urine and blood tests were normal. The patient was not admitted and returned to running without sequelae. Following best practices, AT's in secondary schools can prevent death from EHS by properly recognizing EHS and providing rapid cooling before transport.
Epidemiology of Overuse Injuries in US Secondary School Athletics From 2014–2015 to 2018–2019 Using the National Athletic Treatment, Injury and Outcomes Network Surveillance Program
Authors: Post Eric G. , Simon Janet E. , Robison Hannah , Morris Sarah N. , Bell David R.
Published: December 2021

Context

With 8 million annual US high school student-athletes, the epidemiology of sport-related injuries has garnered significant interest. The most recent studies examining overuse injury rates in high school sports were based on data from 2012 to 2013 and, therefore, may not reflect current overuse injury rates in high school sports.

Objective

To (1) determine overuse time-loss (TL) and non–time-loss (NTL) injury rates among high school student-athletes using National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP) data collected from 2014–2015 to 2018–2019 and (2) compare overuse injury rates based on student-athlete sex defined by whether it was a boys' sport or a girls' sport, the sport itself, and the injury location.

Design

Descriptive epidemiology study.

Setting

Online injury surveillance from 211 high schools (345 individual years of high school data).

Patients or Other Participants

Athletes who participated in secondary school–sponsored boys' or girls' sports.

Main Outcome Measure(s)

Boys' and girls' overuse injury data from the NATION-SP during the 2014–2015 to 2018–2019 school years were analyzed. Overuse injuries were identified using a combination of the reported injury mechanism and diagnosis. Time-loss injuries resulted in restriction from participation beyond the day of injury; NTL injuries did not result in restriction from participation beyond the day of injury or involved no lost time due to the injury. Injury counts, rates, and rate ratios (IRRs) were reported with 95% CIs.

Results

The total overuse injury rate was 5.3/10 000 athlete-exposures (AEs; 95% CI = 5.1, 5.7), the NTL overuse injury rate was 3.4/10 000 AEs (95% CI = 3.1, 3.6), and the TL overuse injury rate was 2.0/10 000 AEs (95% CI = 1.8, 2.2). The overuse injury rate was greater in girls' sports compared with boys' sports (IRR = 1.9; 95% CI = 1.7, 2.1). The highest rates of overuse injury were observed in girls' cross-country (19.2/10 000 AEs; 95% CI = 15.0, 24.2), girls' track and field (16.0/10 000 AEs; 95% CI = 13.5, 18.8), and girls' field hockey (15.1/10 000 AEs; 95% CI = 10.2, 21.6). Overuse injury rates were higher for the lower extremity than the upper extremity (IRR = 5.7; 95% CI = 4.9, 6.7) and for the lower extremity than the trunk and spine (IRR = 8.9; 95% CI = 7.3, 10.8).

Conclusions

Awareness of the overuse injury risk, as well as prevention and intervention recommendations, is necessary and should be specifically targeted at cross-country, field hockey, and track and field athletes.
Efficacy of perineural versus intravenous dexamethasone in prolonging the duration of analgesia when administered with peripheral nerve blocks: a systematic review and meta-analysis
Authors: Tan Elizabeth Sein Jieh , Tan Yan Ru , Liu Christopher Wei Yang
Published: December 2021

Background: Perineural dexamethasone has been regarded as a promising adjunct for prolonging the duration of nerve blocks. However, it is uncertain whether its effects are due to local effects on the nerves or from systemic absorption. This systematic review aimed to compare the duration of postoperative analgesia associated with perineural versus intravenous dexamethasone as an adjunct to peripheral nerve blocks. Methods: A total of 2,216 relevant academic articles were identified after a comprehensive search of PubMed, Embase, Scopus, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov from 1967 until 2020. All randomized controlled trials that compared perineural and intravenous dexamethasone as adjuncts to peripheral nerve limb blocks were included.Results: Fifteen randomized controlled trials (1,467 cases; 738 perineural dexamethasone, 729 intravenous dexamethasone) were eligible. The primary outcome (duration of analgesia) was significantly longer in the perineural than in the intravenous dexamethasone group (mean difference [MD]: 2.72 h, 95% CI [1.42, 4.01], P < 0.001). Perineural dexamethasone was also found to prolong the sensory block (MD: 3.45 h, 95% CI [1.36, 5.54], P = 0.001) and lower 24 h postoperative pain scores (MD: −0.74 h, 95% CI [−1.40, −0.07], P = 0.03).Conclusions: This review confirms the greater efficacy of perineural compared to intravenous dexamethasone in prolonging the analgesic duration of peripheral nerve blocks. However, the extent of prolongation was small and may not represent a clinically meaningful difference.
Intention of healthcare workers to accept COVID-19 vaccination and related factors
Authors: Galanis Petros , Vraka Irene , Fragkou Despoina , Bilali Angeliki , Kaitelidou Daphne
Published: December 2021

Considering medical and economic burden of coronavirus disease 2019 (COVID-19), a high COVID-19 vaccination coverage among healthcare workers (HCWs) is an urgent need. The aim of this systematic review and meta-analysis was to evaluate the intention of HCWs to accept COVID-19 vaccination and to identify related factors. We searched PubMed, MEDLINE, Scopus, Web of Science, ProQuest, CINAHL and medRxiv until July 14, 2021. The heterogeneity between results was very high; thus, we applied a random effects model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Twenty four studies, including 50 940 HCWs, met the inclusion criteria. The overall proportion of HCWs that intend to accept COVID-19 vaccination was 63.5% (95% confidence interval: 56.5%-70.2%) with a wide range among studies from 27.7% to 90.1%. The following factors were associated with increased HCWs' willingness to get vaccinated against COVID-19: male gender, older age, white HCWs, physician profession, higher education level, comorbidity among HCWs, vaccination against flu during previous season, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. The reluctance of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or refuse COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake.
Congenital cleft earlobe repair by triangular flap technique
Authors: Singh Kuldeep , Aggarwal Krittika , Beniwal Meenu
Published: December 2021

Introduction:

Congenital cleft earlobe is a common congenital deformity of earlobe. Various techniques have been described for its repair, but cosmetic deformity usually persists. We present our result using triangular flap repair for simple longitudinal cleft of earlobe.

Materials and Methods:

The procedure was done in five cases who presented between 2017 and 2020. The technique uses the same principles as in Randall-Tennison triangular flap repair for cleft lip.

Results:

Earlobes were near-symmetrical, postoperative scar minimal and patient satisfaction was very good in all cases. Ear piercing was done without any complications at least 6 months after surgery. After a follow-up of 1 year, no complications were noted.

Conclusions:

Triangular flap repair technique for cleft earlobe follows the principles of Randall-Tennison triangular flap repair for cleft lip. It provides very good results with esthetic contour, minimal scar with no complications in case of simple longitudinal cleft.
Automatic speech processing software – New sensitive tool for the assessment of nasality
Authors: Girish K.S. , Pushpavathi M. , Abraham Ajish K. , Vikram C. M.
Published: December 2021

Introduction:

Automatic speech processing (ASP) software is a nasality assessment tool. ASP studies focusing on investigating sentences to find nasality and correlating ASP scores with other objective assessment scores measuring nasality are scarce. Hence, the present study aimed at comparing the nasalance values of the ASP software with the nasometer in typically developing children (TDC) and children with repaired cleft palate (RCP) across different stimuli.

Methods:

Participants included 30 Kannada speaking TDC and 10 children with RCP (9–12 years). Speech stimuli (oral, nasal, and oronasal sentences) were recorded and the values were obtained from the ASP software as well as the nasometer. The following statistical tests were applied: mixed ANOVA, repeated measures ANOVA, paired samples t-test, independent samples t-test and Pearson's correlation.

Results:

Like nasometer, the nasalance values of ASP software were high for the nasal sentences followed by the oronasal sentences and the oral sentences, for both the populations. Higher nasalance values were found for children with RCP than for TDC across all the stimuli. Significant differences were found in nasalance values between the instruments in oral and oronasal sentences in TDC and nasal sentences and oronasal sentences in RCP. The nasalance values across the stimuli between nasometer and ASP software in both the groups showed no significant correlations.

Conclusions:

ASP software was successful in identifying nasalance in TDC and children with RCP. However, a major issue needs to be addressed concerning the dynamic range of the software and it has to be validated on a large number of populations.
The significance or insignificance of prematurely fused bilateral squamosal sutures
Authors: Deraje Vybhav , Tandon Anisha Sawkar
Published: December 2021

We report a case of a patient with premature fusion of bilateral squamous sutures and perform a literature review of similar cases. We have noted in our case and in other reports that bilateral squamous synostosis does not lead to significant clinical effects such as deformed shape of the skull or raised intracranial pressure.
Oro-facial clefts at a tertiary level hospital of eastern Nepal
Authors: Jaisani Mehul R. , Dongol Ashok , Acharya Pradeep , Yadav Anjani Kumar , Sagtani Alok , Pradhan Leeza , Jaisani Pallavi Vyas , Laverick Sean
Published: December 2021

Introduction:

There are only a few centers providing care to orofacial cleft patients across Nepal. However, no adequate data have been reported regarding the epidemiology, pattern, and association of cleft in children from eastern Nepal. The aim of the study was to study the epidemiological profile of cleft lip palate (CLP) patients reporting to the department of oral and maxillofacial surgery (OMFS) in Dharan, Eastern Nepal.

Materials and Methods:

Data retrospectively retrieved from the cleft registry in the department of OMFS were tabulated and entered into Microsoft Excel 2000. Data of all the diagnosed nonsyndromic orofacial cleft patients attending BP Koirala Institute of Health Sciences for treatment from August 2011 to August 2017 were used for the analysis. Incompletely filled records and syndromic cases were excluded.

Results:

Data of 220 orofacial clefts were analyzed which included 119 males and 101 females. Among these children with cleft, only 7 patients had direct family members and 18 patients had distant family members having the same condition. Among patients with CL (n = 151), left-sided CL (n = 85) was a more common presentation. Amongst patients with a cleft of the hard plate (n = 153), bilateral (n = 87) presentation was more common. A similar pattern was observed for cleft alveolus (n = 117) with the left side (n = 60) being common. In clefts affecting the soft palate (n = 192), complete cleft (n = 189) was a more common occurrence than incomplete. The majority of our patients had a CLP (n = 133) with isolated CL being the least commonly seen (n = 18).

Conclusion:

The majority of our patients had a CLP with isolated CL being the least common. This observation is in concordance with reports from other Caucasian and Asian populations both from developed and developing countries.
Esthetic outcome of cleft lip repair with the use of tissue adhesive as opposed to suture for skin closure – A retrospective comparative study
Authors: Rout Sunil Kumar , Panda Ritesh , Mallik Mainak
Published: December 2021

Background:

Suture removal in infants and children operated for cleft lip is one of the cumbersome task for the surgeons because of missing compliance. For this reason, tissue adhesives have gained popularity among the surgeons as well as the patients over the past two decades for skin wound closure. Although there are several published reports of case series using tissue adhesive for skin closure during cleft lip repair, very few have established its advantage over conventional suture technique.

Objective:

The objective of this study was to compare the esthetic outcome of skin closure in cleft lip repair with suture technique and tissue adhesive, with respect to the quality of scar.

Methodology:

A retrospective observational study was conducted by analyzing the photographic records of patients who underwent surgical repair of cleft lip between January 2015 and December 2017. The patients were divided into two groups, one for whom skin closure performed with 5-0 monofilament polyamide suture and the other with tissue adhesive. Esthetic outcome in terms of the quality of scar was assessed using a 5 point Likert's scale by 10 independent observers who remained blind of the surgeon performed the surgery, to reduce the assessor-related bias to minimum. The statistical analysis was performed using the SPSS version 27.0 and the difference between mean scores of both the groups was calculated.

Results:

A total of 70 patients were included in this study with 35 in each group. The mean follow-up period of adhesive and the suture group was 13.97 and 17.85 months, respectively. Overall mean of the total scores of the entire patient population was 3.92 (+/[FIGURE DASH]0.38). For the tissue adhesive group, the mean score was 3.88 (+/[FIGURE DASH]0.367) and for the suture group, the mean score was 3.96 (+/[FIGURE DASH]0.401). The difference between mean scores of individual parameters of both the groups as well as the difference between the overall mean scores of both the groups was not found to be statistically significant.

Conclusion:

The use of tissue adhesive for the closure of skin during cleft lip repair is as good as sutures, with respect to esthetic outcome of scar. Hence, any of these two techniques can be used for this purpose depending on the surgeon's preference.
Ayurveda approach to mucormycosis and other fungal infections
Authors: Karthik Kasimadom P. , Dileep Aparna , Rajagopala Shrikrishna , Mahapatra Arun K. , Dharmarajan Prasanth
Published: December 2021

Introduction:

Mucormycosis is an opportunistic angio-fungal infection that has resurfaced during the COVID-19 pandemic period due to multifarious reasons. Due to the limitations of current interventions associated with it, prevention is the recommended strategy. Ayurveda has a significant role to play in prevention, for which prior understanding of the condition in its own parlance is essential.

Materials and Methods:

Literature and research works from Ayurveda and Western biomedicine relevant to the subject were identified, screened, explored, and interpreted. The data obtained were grouped into three major criteria: etiological factors, disease patterns, and disease targets. These ideas were grouped to obtain a near-total picture of mucormycosis. A set of recommendations, including diet, regimen, single drugs, formulations, therapeutic procedures, and community-level interventions, were made on the basis of research evidence and textual indications.

Results and Discussion:

Mucormycosis is an exogenous condition that initially follows a common pathogenetic pattern, localizing at various sites to show diverging manifestations. Kapha and Pitta (especially in terms of Snigdha and Uṣna properties) play a major role in preventive and curative strategies in terms of food, regimen, medicine, and therapies.

Conclusion:

The current Ayurveda knowledge should be effectively used in diagnosing, staging, preventing, and rehabilitating the cases of mucormycoses. Their curative role as adjuvant and standalone therapies are to be subjected to further research.
Review of clinical and preclinical studies on Ayurveda drugs used in management of liver diseases
Authors: Sharma Bhavana , Sharma Meenakshi , Rai Shalini , More Anand B.
Published: December 2021

Introduction:

Liver disease has become a matter of public health concern. The worldwide prevalence of liver disease is rapidly increasing due to changes in our cultural and lifestyle norms. Western medicine is known to have serious adverse effects in patients with liver disease. Ayurveda is enriched with various herbo-mineral formulations and their efficacy and safety in treating liver disease has been evidenced in various forms of research. This potential of Ayurveda formulation can be utilized to treat liver disease. The present review is aiming at summarizing a well-organized and comprehensive analysis of various clinical and cell line studies using Ayurveda hepato-protective drugs.

Materials and Methods:

A thorough search was conducted in online databases of Google Scholar and PubMed on Ayurveda and modern drugs acting in liver disorders. Studies meeting our selection criteria were included and evaluated.

Observations and Results:

Eighty-six relevant articles were found, of which 55 were used in this review.

Conclusions:

Ayurveda drugs have been used for centuries in liver diseases of varied etiology. In this systematic analysis, a detailed description of reviewed studies on hepato-protective plants clearly indicates the efficacy and safety of widely used medicinal drugs used in alleviating chronic liver disease and that have an enormous potential to protect the liver from oxidative injury. It is inferred from the study that Ayurveda formulations can be used to combat various liver diseases both safely and efficiently.
Ayurveda interventions in management of chronic plaque psoriasis (Ekakushtha)
Authors: Sharma Meenakshi , Mandal Sisir Kumar , Kumar Anil
Published: December 2021

Psoriasis is a chronic inflammatory disease skin disease that is associated with different clinical phenotypes and that may show a variety of clinical manifestations such as interaction of genetic, and immunological and environmental factors. Plaque-type psoriasis (PP) is the most common form of psoriasis, occurring in 85%–90% of all cases. The classical symptoms of PP correspond to Ekakushtha in ayurveda, which is explained under Kushtha (skin) disease. The clinical sign and symptoms, dermatological examination, and previous history confirmed the case as “Plaque psoriasis.” According to classics, the case was diagnosed as Ekakushtha. Internal administration of decoction of drugs Punarnava, Manjistha, and Ushira, and Arogyavardhini Vati along with local application of 777 oil and Jivantyadi Yamaka was suggested to the patient initially for 1 month. After 1 month of treatment, there was a significant improvement in subjective assessment of itching, scaling, dryness, and erythema and PASI score, which was initially 43.6, was reduced to 5.2. Then along with above medication Mahatikta Ghrita was prescribed for 6 months. After 6 months of treatment, there was complete regression of all the symptoms and PASI score was found to be 0. In follow-up period even 10 months without medication, there were no signs of relapse. This case proved efficacy of ayurveda interventions in treating such cases where other systems of medicines have their own limitation.