bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal Microvascular Density and Perfusion during an Insulin-Induced Hypoglycemia Episode: A Warning Call
Authors: González-Saldivar Gerardo , González-González José Gerardo , Chow David Robert , Mohamed-Hamsho Jesús , González-Cortés Jesús Hernan , Sánchez-García Adriana , Rodríguez-Gutiérrez René
Published: October 2023

Aim. To evaluate retinal vascular perfusion and density by optical coherence tomography angiography (OCTA) before, during, and after hypoglycemia in individuals with diabetes mellitus with or without diabetic retinopathy (DR). Methods. A focused clinical history was performed, followed by an ophthalmological examination to document retinopathy status. OCTA was performed at baseline, at hypoglycemia, and at glucose normalization. Eye tracking and eye alignment devices on the platform were used to obtain a macular thickness cube (512 × 128) and vascular perfusion and density protocols of 3 × 3 mm. Retinal vascular reactivity was analyzed with superficial plexus vascular perfusion and density protocols on OCTA. Results. Fifty-two participants encompassing 97 eyes fulfilled the eligibility criteria. Their mean age was 42.9 ± 15.1 years (range, 22 to 65), and 20 (38.2%) were men. We found a statistically significant difference in vascular perfusion and density when comparing all groups at baseline. The controls had higher vascular perfusion and density values than the cases. Vascular perfusion and density were significantly reduced in all groups during the hypoglycemia episode, except for vascular density in DR cases. Conclusion. Acute hypoglycemia significantly alters the retinal vascularity in DM patients with and without DR, suggesting that repeated episodes of acute hypoglycemia could exacerbate retinopathy in the long term.
Etiology of Primary Cerebellar Intracerebral Hemorrhage Based on Topographic Localization
Authors: Incontri Diego , Marchina Sarah , Andreev Alexander , Wilson Mitchell , Wang Jia-Yi , Lin David , Heistand Elizabeth C. , Carvalho Filipa , Selim Magdy , Lioutas Vasileios-Arsenios
Published: October 2023

BACKGROUND:

Cerebellar intracerebral hemorrhage (cICH) is often attributed to hypertension or cerebral amyloid angiopathy (CAA). However, deciphering the exact etiology can be challenging. A recent study reported a topographical etiologic relationship with superficial cICH secondary to CAA. We aimed to reexamine this relationship between topography and etiology in a separate cohort of patients and using the most recent Boston criteria version 2.0.

METHODS:

We performed a retrospective analysis of consecutive patients with primary cICH admitted to a tertiary academic center between 2000 and 2022. cICH location on brain computed tomography/magnetic resonance imaging scan(s) was divided into strictly superficial (cortex, surrounding white matter, vermis) versus deep (cerebellar nuclei, deep white matter, peduncular region) or mixed (both regions). Magnetic resonance imaging was rated for markers of cerebral small vessel disease. We assigned possible/probable versus absent CAA using Boston criteria 2.0.

RESULTS:

We included 197 patients; 106 (53.8%) were females, median age was 74 (63–82) years. Fifty-six (28%) patients had superficial cICH and 141 (72%) deep/mixed cICH. Magnetic resonance imaging was available for 112 (57%) patients (30 [26.8%] with superficial and 82 [73.2%] with deep/mixed cICH). Patients with superficial cICH were more likely to have possible/probable CAA (48.3% versus 8.6%; odds ratio [OR], 11.43 [95% CI, 3.26–40.05];
P
<0.001), strictly lobar cerebral microbleeds (51.7% versus 6.2%; OR, 14.18 [95% CI, 3.98–50.50];
P
<0.001), and cortical superficial siderosis (13.8% versus 1.2%; OR, 7.70 [95% CI, 0.73–80.49];
P
=0.08). Patients with deep/mixed cICH were more likely to have deep/mixed cerebral microbleeds (59.2% versus 3.4%; OR, 41.39 [95% CI, 5.01–341.68];
P
=0.001), lacunes (54.9% versus 17.2%; OR, 6.14 [95% CI, 1.89–19.91];
P
=0.002), severe basal ganglia enlarged perivascular spaces (36.6% versus 7.1%; OR, 7.63 [95% CI, 1.58–36.73];
P
=0.01), hypertension (84.4% versus 62.5%; OR, 3.43 [95% CI, 1.61 to −7.30];
P
=0.001), and higher admission systolic blood pressure (172 [146–200] versus 146 [124–158] mm Hg,
P
<0.001).

CONCLUSIONS:

Our results suggest that superficial cICH is strongly associated with CAA whereas deep/mixed cICH is strongly associated with hypertensive arteriopathy.
Examining Academics' Perspectives on Weber's Bureaucracy Approach
Authors: YEMENİCİ Aysun Devrim , TANYOLU Mehmet Can
Published: October 2023

This study examines the university's bureaucratic structure where the academics are located based on Max Weber's bureaucracy approach. It is aimed to determine how academicians perceive the understanding of bureaucracy in universities and to make it more effective and efficient. Phenomenological research design, one of the qualitative research methods, was used in the research. Semi-structured interviews were conducted with 27 academics working at universities in different regions of Turkey, and information on the bureaucratic structure of the academicians was obtained. Content analysis, one of the qualitative data analysis techniques, was used to analyze the data. It has been observed that academicians have different opinions on bureaucracy. It has been reached that bureaucratic structures can have positive and negative consequences. As a result, it is thought that the study will contribute to the maintenance or improvement of the functioning of bureaucratic structures.
Generalized Low-Rank Update: Model Parameter Bounds for Low-Rank Training Data Modifications
Authors: Hanada Hiroyuki , Hashimoto Noriaki , Taji Kouichi , Takeuchi Ichiro
Published: October 2023

In this study, we have developed an incremental machine learning (ML) method that efficiently obtains the optimal model when a small number of instances or features are added or removed. This problem holds practical importance in model selection, such as cross-validation (CV) and feature selection. Among the class of ML methods known as linear estimators, there exists an efficient model update framework, the low-rank update, that can effectively handle changes in a small number of rows and columns within the data matrix. However, for ML methods beyond linear estimators, there is currently no comprehensive framework available to obtain knowledge about the updated solution within a specific computational complexity. In light of this, our study introduces a the generalized low-rank update (GLRU) method, which extends the low-rank update framework of linear estimators to ML methods formulated as a certain class of regularized empirical risk minimization, including commonly used methods such as support vector machines and logistic regression. The proposed GLRU method not only expands the range of its applicability but also provides information about the updated solutions with a computational complexity proportional to the number of data set changes. To demonstrate the effectiveness of the GLRU method, we conduct experiments showcasing its efficiency in performing cross-validation and feature selection compared to other baseline methods.
Additions to Peroneutypa (Diatrypaceae, Xylariales): Introducing P. nayariophyti sp. nov. and new host associations of P. scoparia from northern Thailand
Authors: AFSHARI NAGHMEH , FARIAS ANTONIO R. G. DE , SILVA NIMALI INDEEWARI DE , BHUNJUN CHITRABHANU S. , LUMYONG SAISAMORN
Published: October 2023

Fungi are essential to forest functioning and biodiversity. This research elaborates on the study of the morphology and phylogeny of Peroneutypa species in Thailand. We introduce Peroneutypa nayariophyti as a novel saprobic species from the dead wood of Nayariophyton zizyphifolium (Malvaceae) and a new record of P. scoparia with three new host associations on Dalbergia cana, Afzelia zylocarpa (Fabaceae), and Microcos paniculata (Malvaceae) in Doi Tung National Park, Chiang Rai, Thailand. The morphology of the two taxa was compared with related taxa based on features such as ascomasta, peridium, asci, and ascospores. Their position in Peroneutypa is also supported by the phylogeny of the internal transcribed spacer (ITS) region and the β-tubulin (tub2) dataset.
A new endemic species of Macropsychanthus (Leguminosae: Papilionoideae) from the Brazilian Atlantic Forest
Authors: FONSECA-CORTÉS ANDRÉS , CARDOSO DOMINGOS BENÍCIO OLIVEIRA SILVA , SNAK CRISTIANE , QUEIROZ LUCIANO PAGANUCCI DE
Published: October 2023

The Brazilian Atlantic Forest is a world’s remarkable biodiversity hotspot, seriously endangered by urbanization, industrialization, and agricultural expansion. More than a thousand species of legumes (Leguminosae) occur in the Atlantic Forest, with a record of 443 endemic species. Here, we describe Macropsychanthus ruschii, a new species narrowly endemic from a pristine Atlantic Forest area in the Espírito Santo state, eastern Brazil. This species is uniquely characterized by its inflorescences up to 15 cm and uncommon pink petals. A molecular phylogenetic analysis of nuclear ribosomal (ETS and ITS) and plastid (trnK/matK) DNA sequence data strongly resolves the new species within a clade that exclusively diversified in the Atlantic Forest. This result reinforces the importance of focusing more efforts to conserve and promote biodiversity research in this taxonomically and evolutionarily rich Brazilian phytogeographic domain.
Aspidistra albovillosa (Asparagaceae), a new species from Guangxi, China
Authors: DING TAO , PAN BO , LIN CHUN-RUI
Published: October 2023

Aspidistra albovillosa, a new species of Asparagaceae from Guangxi, southern China, is described and illustrated. The new species is similar to A. ovatifolia, but differs by the appendages at the base of the perianth lobes are purplish red, sometimes white and slightly rolled upwards at apex, tube adaxially with white villous densely, stigma upper surface yellowish white, slightly undulate and 6 (or 8) lobed at margin. The new species is currently known only from the Karst areas in central Guangxi. Colour plates of the two similar species and line drawing are provided for comparison.
Ubiquitous Sea Surface Temperature Anomalies Increase Spatial Heterogeneity of Trade Wind Cloudiness on Daily Time Scale
Authors: Chen Xuanyu , Dias Juliana , Wolding Brandon , Pincus Robert , DeMott Charlotte , Wick Gary , Thompson Elizabeth J. , Fairall Chris W.
Published: October 2023

The impact of weak submeso- to mesoscale SST anomalies on daily averaged trade cumulus cloudiness is investigated using satellite observations that have been validated against shipboard measurements from the Atlantic Tradewind Ocean–Atmosphere Mesoscale Interaction Campaign (ATOMIC). Daily spatial SST anomalies are identified from GOES–POES Blended SST analysis within a 10° × 10° region during January and February 2020. Daily averaged cloud fraction and 10-m neutral wind from satellite observations and reanalysis are composited over the identified SST features, using a common coordinate system based on the near-surface background wind directions. Composites of satellite cloud fraction show a statistically significant increase of cloudiness over the SST warm core with a reduction of cloudiness away from it. These responses are largely the same but with opposite signs over SST cold anomalies, suggesting that spatial heterogeneity in SST can locally imprint on daily cloud fraction. Composites of daily 10-m wind speed and wind convergence anomalies from both satellite and reanalysis show that surface wind speed is increased over SST warm anomalies, implying enhanced turbulence over warmer SSTs. Correspondingly, the surface convergence anomalies in these composites are located around the maximum downwind SST gradient, offset downwind from the cloudiness anomalies. These results indicate that the response of daily cloudiness to these SST anomalies is more likely generated by spatial variability of surface-driven turbulence and surface fluxes rather than that of surface or boundary layer convergence.
Geopsychiatry and geography: A response
Authors: Philo Chris , Callard Felicity , McGeachan Cheryl , Parr Hester
Published: October 2023

Background:

This contribution responds to three articles (we refer to all three as ‘editorials’) concerning something called ‘geopsychiatry’.

Aims:

To evaluate claims made in these editorials for ‘geopsychiatry’ as a new field of inquiry at the interface between geography and psychiatry.

Method:

Close critical reading of two editorials in the International Journal of Social Psychiatry – entitled ‘Geographical determinants of mental health’ and ‘Political determinants of mental health’ – and one in the International Review of Psychiatry – entitled ‘What is geopsychiatry?’

Results:

While this geopsychiatry initiative is to be applauded, disquiet can be expressed about the almost complete neglect of a pre-existing domain of inquiry – ‘mental health geography’ or ‘the geography of mental health’ – that has long been researched by academic geographers and cognate scholars. Key trajectories in this field can be identified and related to the proposed foci for geopsychiatry.

Conclusions:

The hope is voiced that future developments in geopsychiatry will proceed in dialogue with the literature and practitioners of mental health geography.
An epidemiological survey on personality disorder in Andalusia (the PISMA-ep PD study)
Authors: Muñoz-Negro José Eduardo , Gutiérrez Blanca , Rivera Margarita , Molina Esther , González Díez Manuel , Jabalera Ruz Paula , Cervilla Jorge A.
Published: October 2023

Background:

Despite a significant clinical and social burden, there is a relative scarcity of epidemiological studies on Personality Disorder (PD).

Aim:

To determine the current prevalence of PD and the psychosocial correlates associated with this in the Andalusian population.

Method:

We carried out a cross-sectional population mental-health survey in Andalusia, southern Spain. Thus, 4,518 randomly selected participants were interviewed following sampling using different standard stratification levels. We used the Spanish version of the SAPAS to estimate PD prevalence. In addition, a full battery of other instruments was utilized to explore global functionality, childhood abuse, maltreatment, threatening life events, personality traits (neuroticism, impulsivity and paranoia), medical and psychiatric comorbidities, family history of psychological problems and other potential risk factors for PD.

Results:

PD prevalence (10.8%; 95% CI [9.8, 11.7]) and ran two different multivariate models for PD. We obtained the highest PD prevalence in those affected by any mental disorder plus those reporting having suffered childhood abuse, particularly sexual abuse. Additional potential risk factors or correlates of PD identified were: younger age, lower levels of functioning, less social support, poorer general health, having suffered maltreatment, threatening life events, higher suicidal risk scores and higher levels of both neuroticism and impulsivity.

Conclusions:

This study reports PD prevalence and risk correlates in consonance with similar findings reported in other Western populations. However, longitudinal studies are needed to elicit a more thorough group of prospective determinants of PD.
Learning While Black: Racial and Educational Challenges of Black Students
Authors: Joseph Ruby , Thomas LaTosha , Vatalaro Angela , Anderson Rene , Akiwumi Fenda , Briscoe Richard
Published: October 2023

Learning while Black: racial and educational challenges of Black students, is based on a qualitative study focused on the educational experiences of high school seniors, undergraduate and graduate students. Focus groups with students from the three targeted groups revealed that Black students experience several challenges: (1) inadequate student, faculty and teacher representation, (2) inadequate mentoring, (3) isolation, (4) overt racism/microaggressions, (5) inadequate information regarding resources, and (6) mental health issues. This study operationalizes these barriers using students’ lived experiences and quotes. Students also provide insight on possible solutions for addressing racial and educational challenges including hiring Black faculty, and mental health counselors, increasing diversity, racial and cultural training for students, staff, and faculty, and providing mentoring, financial and other resources for Black students. Predominately White institutions can create safer, more inclusive environments for Black students by utilizing these strategies. Students’ resiliency and strengths can also play an important role in implementing these strategies to reduce educational disparities.
Verbalizing visual characterizations of race in the audio description of Netflix
Authors: Abu Tair Sausan , Haider Ahmad S , Alkhawaldeh Malik
Published: October 2023

This article examines the description of race in the audio description (AD) of Netflix through the lens of political correctness to determine any bias, whether intentional or not. It analyzes the wording of English AD incidents where characters are described in several series and films available on Netflix. Passing, Kipo, and Squid Game were selected because their cast and characters were diverse or consisted mainly of minorities. The findings showed that although Netflix aims to minimize bias in the AD provided on its platform, some subtle biases are still present; some of these may even be unintentional. When it comes to labels, no offensive terms were ever used; however, some efforts to avoid offensive language resulted in the descriptions being too ambiguous. The study concludes that since language cannot be separated from its pragmatics, the choice in wording can create a problematic area for the scriptwriter.
How Do People Process Different Representations of Statistical Information? Insights into Cognitive Effort, Representational Inconsistencies, and Individual Differences
Authors: Tiede Kevin E. , Gaissmaier Wolfgang
Published: October 2023

Background

Graphical representation formats (e.g., icon arrays) have been shown to lead to better understanding of the benefits and risks of treatments compared to numbers. We investigate the cognitive processes underlying the effects of format on understanding: how much cognitive effort is required to process numerical and graphical representations, how people process inconsistent representations, and how numeracy and graph literacy affect information processing.

Methods

In a preregistered between-participants experiment, 665 participants answered questions about the relative frequencies of benefits and side effects of 6 medications. First, we manipulated whether the medical information was represented numerically, graphically (as icon arrays), or inconsistently (numerically for 3 medications and graphically for the other 3). Second, to examine cognitive effort, we manipulated whether there was time pressure or not. In an additional intervention condition, participants translated graphical information into numerical information before answering questions. We also assessed numeracy and graph literacy.

Results

Processing icon arrays was more strongly affected by time pressure than processing numbers, suggesting that graphical formats required more cognitive effort. Understanding was lower when information was represented inconsistently (v. consistently) but not if there was a preceding intervention. Decisions based on inconsistent representations were biased toward graphically represented options. People with higher numeracy processed quantitative information more efficiently than people with lower numeracy did. Graph literacy was not related to processing efficiency.

Limitations

Our study was conducted with a nonpatient sample, and the medical information was hypothetical.

Conclusions

Although graphical (v. numerical) formats have previously been found to lead to better understanding, they may require more cognitive effort. Therefore, the goal of risk communication may play an important role when choosing how to communicate medical information.

Highlights

This article investigates the cognitive processes underlying the effects of representation format on the understanding of statistical information and individual differences therein. Processing icon arrays required more cognitive effort than processing numbers did. When information was represented inconsistently (i.e., partly numerically and partly graphically), understanding was lower than with consistent representation, and decisions were biased toward the graphically represented options. People with higher numeracy processed quantitative information more efficiently than people with lower numeracy did.
Characterization of Canine Gingival-Derived Mesenchymal Stem Cells and Their Exosomes
Authors: Ji Yikuan , Jiang Wenkang , Zeng Fulan , Zou Daofu , Li Shaofang , Zhang Xianying , Zhu Qiong , Liang Quanming , Li Meidi , Li Dongsheng
Published: October 2023

Mesenchymal stem cells (MSCs) can be isolated from numerous tissues and have the potential for self-renewal and multidirectional differentiation. Evidence is accumulating which suggests that MSCs are also present in the gingival tissue. This study aimed to evaluate the feasibility of collecting, purifying, and amplifying gingival-derived MSCs (GMSCs) from canine gingiva and to obtain GMSC-derived exosomes (GMSC-exo). GMSCs were isolated and cultured; furthermore, cellular immunofluorescence demonstrated that GMSCs possess characteristic MSC markers, and in vitro differentiation was induced, indicating that GMSCs can differentiate into multiple lineages. GMSC-exo was successfully extracted from GMSCs supernatant and found that they exhibit the typical characteristics of exosomes as analyzed by transmission electron microscopy, nanoflow analysis, and western blotting. GMSC-exo promoted the proliferation and migration of Madin–Darby canine kidney cells. It was concluded that canine gingiva is a good source of MSCs. Additionally, GMSC-exo is a potentially promising cell-free therapeutic tool for the treatment of canine gingival diseases.
The resilient public library: Understand and reflect on own practice
Authors: Lindén Magnus , Isberg Catharina , Westrup Ulrika , Lidén Alina
Published: October 2023

This article describes, discusses, and evaluates an educational program aimed at building resilience in public libraries. The program focuses on personal and organizational resilience and builds upon four themes: trust, stress and uncertainty, group identity, and character strenghts. Eighty-seven Swedish public library professionals participated in it. A mixed-method approach was used to study how the program supported employees in discussing and reflecting on resilience, as well as how they experienced what the program had given them in terms of knowledge and insights. Two main results are addressed; (i) the value of an educational program lies both in its power to make employees jointly discuss and reflect on their own roles and situations and in library-management using this information to change the organization, and (ii) staff gaining new insight and knowledge from the program experienced improvements in a number of outcomes related to the content of the program. Overall, this study implies that locally designed educational programs facilitate both personal and organizational resilience at public libraries.
“I Get It, I’m Sick Too”: An Autoethnographic Study of One Researcher/Practitioner/Patient With Chronic Illness
Authors: Ciotti Sarah
Published: October 2023

This autoethnographic research utilizes reflexivity as a method to explore my self-experience of Lyme disease while holding co-occurring identities as a researcher, health professional, and mother. Awareness of self is central in psychotherapy so that therapists do not adversely impact their clients. This is similar for researchers who are ethically required to acknowledge and reduce any potential risk(s) of harm to their participants. In this study, I describe and systematically analyze my experiences as a patient with symptom-persistent Lyme disease, contextualized through co-occurring identities as a mother, a regulated (mental) health professional, and a scholar investigating the embodied experience of being a Lyme disease patient in the Canadian context. The central research question guiding this study is: “What are my experiences with symptom-persistent Lyme disease?” The results of this study suggest reflexivity is an important practice in both health research and healthcare. Relationships with health professionals have a significant impact on patients’ healthcare experiences, and engaging in reflexive practice may improve the responsivity of healthcare professionals toward patients’ needs and embodied experiences and serve as a check on pre-existing power relations in healthcare. Further, this research contributes to the current academic knowledge on symptom-persistent Lyme disease by offering a reflexive representation of my experiences as a researcher who is also a health professional and a patient within the Canadian healthcare system. Representations of patients’ experiences are critical in advancing health research and ensuring equitable care for patients. Autoethnography offers important insights into patients’ disease experiences.
“It's Like Being a Parent at Work”: Antiviolence Frontline Work, Boundaries, and Intimacy During COVID-19
Authors: Schwarz Corinne , Welch Leigh
Published: October 2023

COVID-19 profoundly shaped how service providers in the antiviolence sector interact with clients, coworkers, and community stakeholders. In addition to stressors inherent in antiviolence work, service providers negotiated new, challenging social distancing and remote communication strategies. In this paper, we analyze interviews with 23 antiviolence workers in the US Great Plains region, focusing on participants’ descriptions of workplace boundaries and intimacy. We demonstrate how COVID-19 both expanded and contracted public/private boundaries and formal/informal connections in antiviolence workers’ daily experiences. Pandemic conditions revealed the pressing need for frontline workers to exercise discretion over levels of intimate engagement with coworkers and clients.
Preoperative Sildenafil in Pediatric Patients Undergoing Congenital Heart Surgeries: A Systematic Review and Meta-Analysis
Authors: Fikri Yusuf Ananda , Mulia Eka Prasetya Budi , Nugroho Faris Wahyu
Published: October 2023

Background. Pulmonary hypertension (PH) is a common complication of congenital heart disease (CHD). With early surgical intervention, outcomes have improved over the last two decades. Persistent PH, however, may still occur following surgery. Sildenafil has been shown to be beneficial for postoperative pulmonary hypertensive crises. The role of preoperative sildenafil in controlling postoperative PH is poorly elucidated. This study aimed to evaluate the effect of preoperative sildenafil on pediatric patients undergoing congenital heart surgeries. Methods. A comprehensive literature search was conducted in scientific databases. We included randomized controlled trials which assessed the effect of preoperative sildenafil in pediatric patients with CHD undergoing repair surgeries. Primary outcomes were pre- and postoperative differences in mean pulmonary arterial pressure (mPAP) and mean pulmonary artery/aortic pressure ratio (PA/Ao ratio). Results. Four studies (n = 233) were retained for the final analysis. Dose of sildenafil ranged from .3 to .5 mg/kg every 4-6 hours via oral/nasogastric route, with timing of administration varied from 1 to 2 weeks before surgery. Compared to controls, preoperative sildenafil was associated with greater reduction in postoperative mPAP (MD –5.02; 95% CI [–8.91, –1.13]) and mean PA/Ao ratio (MD –.11; 95% CI [–.17, –.06]). Shorter CPB time, ICU length of stay, and duration of mechanical ventilation were also observed in the sildenafil group. Conclusion. Preoperative sildenafil is beneficial in reducing PAP, thereby reducing the risk of postoperative PH crisis. Further studies are warranted to identify the optimal dosage and timing of administration of sildenafil in CHD patients prior to surgery.
Children as songwriters: The social-emotional benefits of songwriting in the elementary grades
Authors: Dweck Julienne
Published: October 2023

Songwriting has been used in music therapy for decades to help address trauma, alleviate depression and build confidence in both children and adults. With components that great music education models point to—composition, agency, collaboration, and means for self-expression, songwriting seems to be a useful tool for music educators as well. Yet, songwriting is rarely found in a general music educators’ curriculum in a substantial way. This study investigates the stories of eight students who engaged in a robust songwriting program in their elementary school years (children aged 6–12 – referred to as middle childhood). The students share their experiences with songwriting in detail and leave us wondering why songwriting has not been incorporated as an integral part of music education curricula and how this can be changed.
Primary results of the SAVAL randomized trial of a paclitaxel-eluting nitinol stent versus percutaneous transluminal angioplasty in infrapopliteal arteries
Authors: van Overhagen Hans , Nakamura Masato , Geraghty Patrick J , Rao Sid , Arroyo Max , Soga Yoshimitsu , Iida Osamu , Armstrong Ehrin , Nakama Tatsuya , Fujihara Masahiko , Ansari Mohammad M , Mathews Santhosh J , Gouëffic Yann , Jaff Michael R , Weinberg Ido , Pinto Duane S , Ohura Norihiko , Couch Kara , Mustapha Jihad A
Published: October 2023

Background:

Effective and durable options for infrapopliteal artery revascularization for patients with chronic limb-threatening ischemia (CLTI) are limited.

Methods:

The SAVAL trial is a prospective, multicenter, randomized trial of patients with CLTI and infrapopliteal artery lesions with total lesion length ⩽ 140 mm, stenosis ⩾ 70%, and Rutherford category 4–5 assigned 2:1 to treatment with the SAVAL self-expandable paclitaxel drug-eluting stent (DES) or percutaneous transluminal angioplasty (PTA) with an uncoated balloon. The primary effectiveness endpoint was primary vessel patency (i.e., core lab-adjudicated duplex ultrasound-based flow at 12 months in the absence of clinically driven target lesion revascularization or surgical bypass of the target lesion). The primary safety endpoint was the 12-month major adverse event (MAE)-free rate; MAEs were defined as a composite of above-ankle index limb amputation, major reintervention, and 30-day mortality. The endpoints were prespecified for superiority (effectiveness) and noninferiority (safety) at a one-sided significance level of 2.5%.

Results:

A total of 201 patients were enrolled and randomly assigned to treatment ( N = 130 DES, N = 71 PTA). Target lesion length was 68.1 ± 35.2 mm for the DES group and 68.7 ± 49.2 mm for the PTA group, and 31.0% and 27.6% of patients, respectively, had occlusions. The 12-month primary patency rates were 68.0% for the DES group and 76.0% for the PTA group (Psuperiority = 0.8552). The MAE-free rates were 91.6% and 95.3%, respectively (Pnoninferiority = 0.0433).

Conclusion:

The SAVAL trial did not show benefit related to effectiveness and safety with the nitinol DES compared with PTA in infrapopliteal artery lesions up to 140 mm in length. Continued innovation to provide optimal treatments for CLTI is needed. (ClinicalTrials.gov Identifier: NCT03551496)
Does the media (also) keep the score? Media-based exposure to the Russian-Ukrainian war and mental health in Portugal
Authors: Castro Marta , Aires Dias Joana , Madeira Luis
Published: October 2023

The Russian-Ukrainian war (RUW) is responsible for extensive individual suffering and a socio-economic impact on the world and is reshaping global affairs. Many studies have focused on direct exposure to conflict and several public health policies have been devised. Nonetheless, indirect exposure through media has received minimal attention and there is limited evidence that mental health symptoms and disorders may arise as a result. We explored the role of voluntary or involuntary media-based exposure to the RUW on individuals’ mental health including stress symptoms, coping strategies, daily functioning, and worries across demographic variables. In our sample, subjects with involuntary and higher amount of exposure seem to have higher stress symptoms. Also, those who had previous ruminations on war issues could be at risk of developing more post-traumatic stress symptoms. Therefore, media appears to be a conduit that spreads negative consequences of community trauma beyond directly affected communities.
Relational parenthood in addiction recovery
Authors: Ruisniemi Arja , Itäpuisto Maritta , Kuusisto Katja
Published: October 2023

Aims: The purpose of this research was to elicit how parents attending family-focused substance abuse treatment construct their parenthood in relation to other people. Design: Relational parenthood of addiction treatment attendees is scrutinised from seven thematic interviews carried out in a community-based inpatient substance abuse treatment unit in Finland. The core analytical concept of the research is relationality. The data were first content coded via Atlas.ti22 and the relations and codes classified into the five following parenthood types emerging from the data: (1) worn-out; (2) coping; (3) ambivalent; (4) changing; and (5) supported. Content codes and parenthood types were cross-tabulated to ascertain how these types are emphasised in different relationships. Results: Worn-out and coping parenthood types emerged in the closest relationships, mostly with their own children and the other parent. Ambivalent parenthood was present in all relations as expressions of inner conflict, which can lead to changing parenthood. Changing parenthood emerged in relation to interviewees’ own children as an empowering experience. It also emerged in relation to other people as readiness to accept help. Supported parenthood was most often found in relation to significant others and professionals, presumably due to the context of the interviews. Conclusion: The parenthood types illustrate how parenting changes over time, which is also an important part of social identity change in recovering from addiction. In treatment, it is extremely important to understand the different sides of parenthood and to use the information to strengthen clients’ parenthood.
“On WhatsApp I say what I want”: Messaging apps, diaspora communities, and networked counterpublics in the United States
Authors: Trauthig Inga K , Woolley Samuel C
Published: October 2023

Critical scholars have assessed conceptualizations of “the public sphere” with a focus on contestation and plurality for several years. Recent studies comment on how specific social media platforms lend themselves to the creation of networked (counter)publics. This study advances related understandings by outlining how diaspora communities in the United States use encrypted messaging apps (EMAs) to create networked counterpublics. We leverage data from 71 interviews with diaspora community members alongside conceptualizations from Fraser, Squires, Baym, and boyd. We outline how these digital groups are veiled from the wider public by design, language, and perception. We explain how they rely on humor and multimediality for the interpretation of political developments. This is critical to hypothesis generation and future work, as the inherent subversiveness of encrypted communication could nurture potentials for democratic inclusiveness against the backdrop of multiplicity.
The Futures Triangle: Origins and Iterations
Authors: Inayatullah Sohail
Published: October 2023

This article presents a genealogy of the Futures Triangle. The method's evolution is explained. Problems, iteration and benefits are presented. The Futures Triangle is a simple method to map three competing factors: the pull of the future, the push of the present, and the weight of history. It can be used as a stand-alone futures method or in conjunction with other methods such as Emerging Issues Analysis, Causal Layered Analysis, or Scenarios.
Effectiveness of intravesical glycosaminoglycans in the treatment of recurrent urinary tract infections: Systematic review and meta-analysis
Authors: Contreras-García Ricardo , García-Perdomo Herney Andrés
Published: October 2023

Objective:

The objective of the study was to determine the efficacy of glycosaminoglycans in bladder instillation compared with placebo or other forms of prophylaxis in women with recurrent urinary tract infections (UTIs).

Methods:

A search strategy was performed in the Cochrane central register, Embase, and Medline until October 2020, along with manual searches and reference-list checking. Randomised and nonrandomized studies in women with recurrent UTIs who received hyaluronic acid (HA) or HA plus chondroitin sulfate (CS) were included. A random-effects model was applied to the pooled results. The risk of bias was evaluated using the Cochrane RoB 2 bias tool for clinical trials and MINORS for nonrandomized studies. The quality of the evidence was evaluated by the GRADE method.

Results:

One randomised study and eight nonrandomized studies were included. All evaluated HA or HA plus CS. HA or HA plus CS decreased the average UTI patient-years (mean difference (MD) = −2.62; 95% confidence interval (CI) = −4.00 to −1.23), increased the time to recurrence (MD = 145.70; 95% CI = 61.57 to 229.83), and improved symptoms and quality of life as evaluated through the total pelvic pain and urgency/frequency score (MD = −6.08; 95% CI = −7.68 to −4.48) and the visual analog scale (MD = −4.79; 95% CI = −5.55 to −4.03). There was high heterogeneity in the results, a high risk of bias in the one randomised study, and a low quality of evidence according to GRADE. The number of included studies was low.

Conclusion:

The application of HA or HA plus CS in intravesical instillation is associated with fewer UTI recurrences and improved symptoms and quality of life. The quality of the evidence provided by the studies is limited, so more studies of higher quality are needed to yield definitive conclusions.

Level of evidence:

Not applicable
A systematic review of randomised clinical trials – The safety of vaginal hormones and selective estrogen receptor modulators for the treatment of genitourinary menopausal symptoms in breast cancer survivors
Authors: Hussain Ishrat , Talaulikar Vikram Sinai
Published: October 2023

Therapies utilised in breast cancer management have been found to induce or worsen the genitourinary symptoms of menopause (GSM), a group of physical symptoms associated with the systemic loss of estrogen. These symptoms are often undertreated due to concerns surrounding cancer recurrence, especially when considering treatments with possible pro-estrogenic effects. As breast cancer prognosis continues to improve, clinicians are increasingly focussing on managing these symptoms amongst survivors. This systematic review primarily aimed to determine the risk of breast cancer recurrence amongst survivors using vaginal hormones and selective estrogen receptor modulator therapies recommended for use in GSM in the United Kingdom amongst currently published randomised clinical trials (RCTs). The secondary aim was to determine whether these RCTs demonstrated a significant rise in serum estrogen levels following the use of these therapies. A literature search revealed three RCTs suitable for assessment, two evaluating vaginal estrogen and one evaluating vaginal DHEA treatment. Our review determined that amongst published RCTs, no studies have aimed to assess for breast cancer recurrence; however among the studies observing for serious adverse effects of vaginal estrogen preparations, none have reported an increased incidence. Furthermore, these studies did not report a persistent or significant increase in serum estrogen levels following the use of vaginal estrogen products and low concentration (3.25 mg/day) DHEA gel. Larger RCTs studying commonly used vaginal preparations and selective estrogen receptor modulator treatments for GSM over longer follow-up periods will be vital to better assess the risk of breast cancer recurrence in survivors receiving these treatments.
‘Blockchain for good’: Exploring the notion of social good inside the blockchain scene
Authors: Semenzin Silvia
Published: October 2023

One of the most intriguing discussions concerning blockchain technology revolves around its potential to ‘do good’. Consequently, numerous projects and institutions are showing interest in the capacity of blockchain to impact the social sphere positively. However, so far, very little literature has addressed the fundamental notion of ‘good’ that underlies its implementation or explores its connection to social justice theories. This article aims to analyse the narratives that surround the use of blockchain for social good and to compare them with traditional concepts that are significant in social justice theories, such as distribution and recognition. Results show that the selected informants involved in the blockchain scene tend to frame social good in rational, mathematical, and often competitive terms. This tendency contributes to the reinforcement of a neoliberal imaginary that neglects to address structural inequalities as relevant issues. Instead, it envisions social justice as an avenue for generating value, enhancing meritocracy, and ensuring technical accountability, echoing Silicon Valley's aspirations to ‘change the world’.
A Phenomenological Inquiry of College Engineering Students with Low-Income and Economic Marginalization: Implications for High School Counselors
Authors: Cogburn Bethani , Saunders Rachel , Griffith Lane , Galloway Stephanie , Lewis Wendy , Foxx Parikh Sejal , Tempest Brett , Lewis Chance
Published: October 2023

The purpose of this transcendental phenomenological qualitative study was to describe the precollege interactions of undergraduate engineering students with low-income and economic marginalization (LIEM). Our analysis yielded three major themes regarding precollege interactions: (a) family and kinship as a source of motivation, (b) educators as encouragers, and (c) building bridges with professionals. We discuss the importance of these findings within the community cultural wealth framework, highlighting important considerations and implications for school counselors.
Relationship of Chronic Ankle Instability With Foot Alignment and Dynamic Postural Stability in Adolescent Competitive Athletes
Authors: Maeda Noriaki , Ikuta Yasunari , Tsutsumi Shogo , Arima Satoshi , Ishihara Honoka , Ushio Kai , Mikami Yukio , Komiya Makoto , Nishikawa Yuichi , Nakasa Tomoyuki , Adachi Nobuo , Urabe Yukio
Published: October 2023

Background:

Competitive adolescent athletes should be aware of the early signs of chronic ankle instability (CAI) and the connection between the condition and performance.

Purpose:

To investigate whether CAI is related to foot alignment and morphology as well as dynamic postural stability after a jump landing among adolescent competitive athletes with and without a history of a lateral ankle sprain and CAI.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Between July 2020 and August 2021, adolescent competitive athletes (N = 85; n = 49 boys; n = 36 girls) were classified into 3 groups using Cumberland Ankle Instability Tool (CAIT) scores: healthy athletes (n = 55), coper athletes (n = 19), and athletes with CAI (n = 11). Results of foot alignment assessments involving the leg-heel angle (LHA) and navicular height, intrinsic foot muscle morphology, dynamic postural stability index (DPSI), and other parameters were compared among the 3 groups. The relationship between the CAIT score and the LHA and dynamic postural stability and instability were examined using multiple linear regression.

Results:

Compared with the healthy group, the CAI group had a significantly greater LHA (8.73°± 3.22° vs 6.09°± 3.26°; P < .05), higher DPSI (0.336 ± 0.046 vs 0.298 ± 0.035), and higher vertical stability index (0.303 ± 0.048 vs 0.264 ± 0.037; P < .05 for all). Multiple regression analysis showed that the LHA (β = −0.228; P = .033) and DPSI (β = −0.240; P = .025) were significantly associated with the CAIT score .

Conclusion:

Valgus rearfoot alignment and poorer dynamic postural control were associated with CAI among adolescent athletes.
Simultaneous Arthroscopic Rotator Cuff Repair and Glenoid Microfracture in Active-Duty Military Patients Younger Than 50 Years: Outcomes at Midterm Follow-up
Authors: Green Clare K. , Scanaliato John P. , Sandler Alexis B. , Adler Adam , Dunn John C. , Parnes Nata
Published: October 2023

Background:

While concomitant full-thickness rotator cuff tears and glenoid osteochondral defects are relatively uncommon in younger patients, military patients represent a unique opportunity to study this challenging injury pattern.

Purpose/Hypothesis:

To compare the outcomes of young, active-duty military patients who underwent isolated arthroscopic rotator cuff repair (ARCR) with those who underwent ARCR plus concurrent glenoid microfracture (ARCR+Mfx). It was hypothesized that ARCR+Mfx would produce significant improvements in patient-reported outcome measures.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a retrospective analysis of consecutive active-duty military patients from a single base who underwent ARCR for full-thickness rotator cuff tears between January 2012 and December 2020. All patients were <50 years and had minimum 2-year follow-up data. Patients who underwent ARCR+Mfx were compared with those who underwent isolated ARCR based on the visual analog scale (VAS) for pain, Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion.

Results:

A total of 88 patients met the inclusion criteria for this study: 28 underwent ARCR+Mfx and 60 underwent isolated ARCR. The mean final follow-up was 74.11 ± 33.57 months for the ARCR+Mfx group and 72.87 ± 11.46 months for the ARCR group ( P = .80). There were no differences in baseline patient characteristics or preoperative outcome scores between groups. Postoperatively, both groups experienced statistically significant improvements in all outcome scores ( P < .0001 for all). However, the ARCR+Mfx group had significantly worse VAS pain (1.89 ± 2.22 vs 1.03 ± 1.70; P = .05), SANE (85.46 ± 12.99 vs 91.93 ± 12.26; P = .03), and ASES (86.25 ± 14.14 vs 92.85 ± 12.57; P = .03) scores. At the final follow-up, 20 (71.43%) patients in the ARCR+Mfx group and 53 (88.33%) patients in the ARCR group were able to remain on unrestricted active-duty military service ( P = .05).

Conclusion:

Concomitant ARCR+Mfx led to statistically and clinically significant improvements in patient-reported outcome measures at the midterm follow-up. However, patients who underwent ARCR+Mfx had significantly worse outcomes and were less likely to return to active-duty military service than those who underwent isolated ARCR. The study findings suggest that ARCR+Mfx may be a reasonable option for young, active patients who are not candidates for arthroplasty.