bluuebunny/crossref_metadata_2025 huggingface dataset:
The multilingual children’s library as physical and metaphorical ‘space’ within the community: Practical and emotional considerations
Authors: Little Sabine , Murray Rebecca
Published: November 2022

Following the establishment of a multilingual children’s library section in Sheffield, England, this paper explores logistical and emotional considerations concerning the set-up and running of the library, and its role within the community. Adopting a case study approach, data are derived from book stock and borrowing statistics, feedback from multiple events (including multilingual storytelling and story writing events, and a reading scheme), as well as a library staff and a parent focus group. Data were analysed thematically according to logistical and emotional concerns, with subthemes – such as borrowing patterns, identity, belonging and physical and metaphorical ‘space’ being identified within the data. The research highlights shortcomings in cataloguing facilities, and in the way in which ‘successes’ are measured in library management and research, while adding significantly to our understanding of the contribution multilingual resources and events in public libraries makes to a community’s sense of identity and belonging. The notion of real and metaphorical ‘space’ for multilingualism as part of library provision forms a vital addition to the way libraries might consider their roles in diverse societies.
The ethics of sexual relationships between psychiatrists and trainee psychiatrists in the ‘me too’ era
Authors: Corderoy Amy
Published: November 2022

Objective

Since 2017, the structural dynamics that entrench rape culture, sexual harassment and exploitation have gained increased attention across the globe, particularly in regards to workplaces. This paper aims to review the current RANZCP guidelines and other literature pertaining to the ethics of sexual relationships between psychiatrists and trainees.

Conclusions

Such relationships involve significant power differentials, which may make them unethical on an individual level. A culture condoning such relationships may also disadvantage women in the workplace. The current RANZCP guidelines on relationships between supervisors and trainees may unfairly disadvantage trainees.
Achilles Tendon, Patellar Tendon, and Femoral Cartilage Thickness in Control vs Asymptomatic Flatfoot Young Adults
Authors: Taş Serkan , Aktaş Arda , Dikici Tahir Fatih , Çekok Fatma Kübra
Published: November 2022

Background:

Changes in lower extremity alignment in individuals with flatfoot may be associated with differences in morphology of the tendons or cartilage in lower extremities. The purpose of the present study was to investigate the potential association of flatfoot with the morphology of the Achilles tendon, patellar tendon, and femoral cartilage.

Methods:

This study was conducted with 40 participants with flatfoot (28 females, 12 males) and 40 participants with a normal foot posture (28 females, 12 males). The thickness of the Achilles tendon (at points 2 and 3 cm proximal to the superior aspect of the calcaneus), patellar tendon (at the inferior pole of the patella and 1 cm proximal of the inferior pole of the patella), and femoral cartilage (at the intercondylar area, medial condyle, and lateral condyle) was measured by an ultrasonography device.

Results:

The Achilles tendon thickness at 2 cm ( P = .009) and 3 cm ( P = .010) proximal of the superior aspect of the calcaneus was on average 4% to 6% lower in individuals with flatfoot compared with controls. The cartilage thickness at the intercondylar area ( P = .005) and medial condyle ( P = .018) was on average 8% to 12% greater in individuals with flatfoot; however, the cartilage thickness at the lateral condyle and patellar tendon thickness was similar in both groups.

Conclusion:

The results obtained suggest that foot posture is associated with the morphology of the Achilles tendon and femoral cartilage.

Level of Evidence:

Level III, diagnostic comparative study.
How party competition shapes ethnic parties’ positions on migration and immigration
Authors: Debus Marc , Schulte Felix
Published: November 2022

What positions do ethnic parties adopt on issues related to migration and immigration? We argue that, first, the specific characteristics of the party system – that is, if there are further ethnic parties that compete for votes, in particular among the same ethnic group – matter for the policy profile of ethnic parties on immigration policy. Secondly, we expect that the ideological position of an ethnic party should matter for their immigration policy position: ethnic parties with a more right-wing ideological profile should adopt more negative positions on immigration, in particular, if they face competition from another ethnic party. We use regression analysis and a manually coded sample of ethnic parties based on the Comparative Manifesto Project to test these assumptions. The empirical analysis provides support for our expectations: ethnic parties take more negative immigration positions if they compete with other parties among the same group of ethnic voters and the more the ethnic parties belong to the right wing of the ideological spectrum.
Cellular lattice cores of sandwich panels fabricated by additive manufacturing: Effect of dimensions and relative density on mechanical behaviour
Authors: Pereira Diogo , Alves Frederico PD , Reis Luis , Leite Marco , Deus Augusto M , Sardinha Manuel , Vaz M Fatima
Published: November 2022

Sandwich panels have a wide field of applications from aerospace to automotive industries. These panels are formed by a core and two layers, having the geometry of the core an important role in its mechanical properties. While the most common cores have hexagonal honeycomb structures, there is a recent trend to replace them with other cellular structures based on truss or lattice arrangements. Previous studies on modified atomic-based lattices reached the conclusion that modified body and face-centred parallelepiped, with vertical struts, denoted by the body- and face-centred parallelepiped with struts in z-axis, provided higher stiffness and absorbed energy with low weight, compared with the conventional design. These promising findings have motivated a further comprehensive investigation of this type of structure. The aim of the present study is to get the body- and face-centred parallelepiped with struts in z-axis structure that provides the highest stiffness and absorbed energy, in comparison with a previous work of the current authors, by changing its dimensions and relative density. To accomplish this purpose body- and face-centred parallelepiped with struts in z-axis lattices with three relative densities, namely, 0.25, 0.30 and 0.35 and with truss radii of 0.8, 0.92 and 1.1 mm were designed, respectively. Samples were printed by additive manufacturing of polylactic acid. The two face sheets (skins) and the core of the panel were manufactured altogether. The mechanical behaviour of the sandwich panels was assessed by three-point bending tests both experimentally and in numerical simulations with finite element analysis. A good correlation between experiments and numerical results was achieved. Simulation results revealed that the highest values of strength, stiffness and absorbed energy were obtained for the combination of the lowest relative density with the highest truss radius. A failure analysis revealed two failure modes, namely, cohesive failure and face sheet failure. Results indicate that the dimensions of the struts and the relative density affect the mechanical performance and the failure mode of the panels.
Towards A Deeper Understanding of the Relationship between Structural Reconfiguration Capacity, Technological and Non-technological innovations, and Firm Performance
Authors: Vo Thai Huy-Cuong , Hue Trinh Hoang Hong , Tran My-Linh
Published: November 2022

Small and medium-sized manufacturing enterprises, the backbone of the Southeast Asian economy, are struggling to operate and maintain profitable growth in the face of the COVID-19 epidemic. During the recovery process, technological and non-technological innovation is a major factor in enterprise efficiency and profitability. However, it is unclear what drives manufacturing enterprises to innovate in technological and non-technological approaches and how they choose to implement innovation to keep their businesses growing and successful. Therefore, to answer this issue, this research develops and empirically tests a model based on dynamic capabilities and innovative perspectives utilizing World Bank Enterprise Survey data from 789 manufacturing enterprises in Southeast Asian countries. The hierarchical regression model assists create prediction equations to test technological and non-technological innovation as the mediators of structural reconfiguration and innovation investment on firm performance. The results reveal that structural reconfiguration and innovation investment impact technological and non-technological innovation. Additionally, structural addition and investment in formal R&D have a moderated impact on technological innovation. Finally, firm performance may be boosted by organizational innovation.
Wicked Bodies: A Health and Well-Being Toolkit Addressing Eating Disorders Within LGBTQIA2S+ Communities
Authors: Joy Phillip , Ferlatte Olivier , Aston Megan , Minzloff Hannah , Hillis John
Published: November 2022

Wicked Bodies is a toolkit for addressing eating disorder in LGBTQIA2S+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, Two-Spirit, and other sexual and gender minority) communities, an increasing prevalent issue that can have serious consequences on the health and well-being for LGBTQIA2S+ people. The toolkit consists of a series of short films and a discussion guidebook that provide a template that can be used for engaging with LGBTQIA2S+ youth through a lens of compassion and cultural humility. Wicked Bodies does this by presenting the lived experiences of a diverse range of LGBTQIA2S+ individuals navigating sociocultural pressures, gender expectations, and peer-based ideals around body weight and shape. Feedback from three screening events revealed that Wicked Bodies has the potential to be transformative as a health promotion initiative.
Factors Associated with Infection Severity of Diabetic Foot Ulcers: A Cross-Sectional Study
Authors: Luo YiXin , Niu ShaoNa , Mai LiFang , Liu XingZhou , Yang Chuan
Published: November 2022

Background: Infection in the ulcerated foot is a foremost cause of morbidity, constituting the biggest proportion of hospitalization and amputation among patients with diabetic foot ulcers. Assessment of infection severity lays a foundation for making treatment decisions, for which the IDSA/IWGDF classification is recommended. Different factors may cause various severity of infection. However, few investigations have been conducted concerning factors associated with infection severity of diabetic foot ulcers. Objective: To investigate factors associated with infection severity of diabetic foot ulcers. Methods: This cross-sectional study involved 150 subjects hospitalized in the Department of Endocrinology of Sun Yat-sen Memorial Hospital in Guangdong Province between July 2020 and September 2021. The IDSA/IWGDF classification was adopted to assess ulcer infection severity. Demographic and disease information, laboratory reports, and ulcer assessment results were evaluated for an association with the infection severity. The generalized linear model was performed to conduct multivariate analyses of the factors associated with the severity of foot infection. Results: The prevalence of mild, moderate, and severe infected diabetic foot was 23.3%, 64.7% and 10.2%, respectively. The results of generalized linear models showed a correlation between Alb (OR = −1.74, 95%CI1.12-6.58, p = .023), CRP (OR = 2.13, 95%CI1.38-7.21, p = .014), PCT (OR = 2.01, 95%CI1.29-7.64, p = .013), microbial type (OR = 2.04, 95%CI1.43-7.83, p = .004) and ulcer infection severity. Conclusion: Alb, CRP, PCT and microbial type were among the factors influencing infection severity of diabetic foot ulcers.
Quxie Capsule Alleviates Colitis-associated Colorectal Cancer Through Modulating the Gut Microbiota and Suppressing A. fumigatus-induced Aerobic Glycolysis
Authors: Zhang Zhiyong , Chen Yuxi , Zheng Yaojun , Wang Lei , Shen Sunan , Yang Geliang , Yang Yufei , Wang Tingting
Published: November 2022

Aim:

Quxie capsule (QX), a compound of 21 kinds of Traditional Chinese Medicine (TCM) herbs, has been used to treat patients with metastatic colorectal cancer (mCRC) and could suppress the growth of colon cancer. However, the mechanisms of QX inhibiting colorectal cancer remain unclear. In current study, we attempted to determine the anti-colorectal cancer (CRC) effects of QX and the mechanisms of QX in alleviating colorectal cancer.

Methods:

A colitis-associated colon cancer (CAC) model was established by intraperitoneally injecting mice with AOM followed by 3 cycles of 2% DSS in water. During establishment of CAC model, we orally gavaged mice with QX. Hematoxylin and eosin (H&E) and immunohistochemistry were performed to assess lesion of the colonic tumors. The expression of pro-inflammatory cytokines in colonic tumors was measured by qPCR. The proportion of immune cells in colonic tumors was analyzed by flow cytometry. Internal transcribed spacer (ITS) sequencing and 16S rRNA gene sequencing were performed to detect intestinal microbiota. The expression of glycolytic related enzymes, lactate production, and extracellular acidification rate (ECAR) were used to assess the level of aerobic glycolysis.

Results:

QX markedly inhibited intestinal tumorigenesis by decreasing the expression of pro-inflammatory cytokines and the proportion of myeloid-derived suppressor cells (MDSCs), and increasing the proportion of CD8+ T cells in colon tumors. Fecal microbiota sequencing revealed that QX increased the relative abundances of intestinal symbiotic probiotics, such as, Lactobacillus, Bifidobacterium and Faecalibacterium genera. What’s more, opportunistic pathogens, Bacteroides genera and Aspergillus- Aspergillus fumigatus, exhibited remarkably reduced abundances in mice treated with QX compared with untreated CAC mice. Further experiments showed that QX significantly reduced glycolysis of colon tumor and suppressed A. fumigatus-induced glycolytic metabolism of colon cancer cells.

Conclusions:

QX alleviates the development of CRC at least in part through modulating intestinal microbiota and reducing A. fumigatus-induced aerobic glycolysis of colon cancer cells.
Design and Implementation of Taizhou Integrated Prostate Screening
Authors: Li Fei-Ping , Zhang Mei-Xian , Wang Li-Jun , Zhu Xiao-Liang , Sun Liang-Xue , Chen Zhi-Xia , Chen Wei-Ying , Liu Ding-Yi , Li Hai-Ping , Jiang Yu-Ying , Tung Tao-Hsin
Published: November 2022

A community-based prostate cancer screening program was conducted to assess the morbidity and associated factors for prostate cancer among the subpopulation of men aged ≥50 years in Taizhou, China. Taizhou Integrated Prostate Screening (TIPS) is a large, observational, population-based study of prostate cancer screening data based on serum prostate-specific antigen (PSA) concentrations. A pilot census of all male residents aged 50 years or older was conducted in Luqiao District, one of the field sites of the TIPS cohort in the city of Taizhou, Zhejiang. The interviewer-administered questionnaire evaluated demographic characteristics and environmental exposure factors. A total of 1,806 out of 3,516 participants completed the questionnaire. The overall prevalence of PSA ≥4 ng/mL was 11.5%, and included participants at low risk (9.2%), moderate risk (1.7%), and high risk (0.6%). Participants aged 60–69, 70–79, and ≥80 years had a 2.7-fold, 4.2-fold, and 6.5-fold higher risk of elevated PSA, respectively, in comparison with those aged 50 to 59 years ( p < .001). Eighteen patients were diagnosed with prostate cancer, of whom 11 (61.1%) underwent radical surgery. This community-based PSA screening program indicated the results for early detection of prostate cancer among men aged ≥50 years. Early screening and appropriate clinical therapy for the management of prostate cancer are essential in this subpopulation.
Development of natural coir/jute fibers hybrid composite materials for automotive thermal insulation applications
Authors: Veeraprabahar J , Mohankumar G , Senthil Kumar S , Sakthivel S
Published: November 2022

Thermal comfort property is closely related to the concept of thermal insulation and includes protection against heat. This research paper presents an experimental study on thermal insulation properties, for natural fiber composite materials: a natural fiber (Coir/Jute) with different blend proportions of raw materials mixed with rigid polyurethane foam as a binder. The natural fiber composite materials were characterized by both thermal resistance (Thermal Insulation Value TIV) and also in terms of heat transfer (thermal conductivity). Thermal insulation values were measured according to Lee’s disk method (ASTM C177). The influence of the structure of these materials on the thermal insulating properties was analyzed. The experimental results show the thermal resistance performances of natural fiber composites based on coir/jute fiber materials, thus promoting environmentally friendly solutions.
Impact of the Soundscape on the Physical Health and the Perception of Senior Adults in Senior Care Facilities
Authors: Mu Jingyi , Wu Yue , Wang Tian
Published: November 2022

Purpose:

To explore the impact of different acoustic stimuli of varying sound pressure levels on physical responses and the perception of senior adults.

Background:

Noise-related health problems have been gaining increased attention as studies have shown an association with negative impacts on physiological parameters resulting in cardiovascular morbidity and mortality. However, a gap in knowledge exists in exploring the impact of exposure to sound recordings in the actual environment on physiological measurements.

Methods:

Five acoustic stimuli were recorded in real life and 120 senior adults listened to them in a sound treated room to analyze the impacts of low-, middle-, and high-decibel sounds on their heart rate, blood pressure, and perception. The physical responses, heart rate, and blood pressure were measured during the sound exposure, and questionnaires were administered afterward.

Results:

Exposure to different sounds resulted in fluctuations and an inconsistent trend in heart rate, systolic pressure, and diastolic pressure. According to the physical measures and subjective evaluations, sport sounds and traffic noise were given the lowest rating for preference, while music was perceived as the most comfortable.

Conclusions:

A sound pressure level below 55–65 dB(A) correlates with increased comfort and less increase in heart rate and blood pressure. Senior adults with normal hearing preferred and were most comfortable with music, while those with severe hearing impairment preferred entertainment sounds the most.
Total Ankle Replacement Outcome in Patients With Inflammatory Versus Noninflammatory Arthritis: A Systematic Review and Meta-analysis
Authors: Mousavian Alireza , Baradaran Ashkan , Schon Lew C. , Daniel Joseph , Pedowitz David , Kachooei Amir R.
Published: November 2022

Background

The decision regarding total ankle replacement (TAR) is challenging in patients with inflammatory arthritis (IA) regarding more inferior bone quality, large bone cysts, and increased risk of infections. This systematic review and meta-analysis aimed to compare the functional outcome, revision rate, complication rate, and survival rate of TAR between IA (including rheumatoid arthritis [RA]) and noninflammatory arthritis (NIA) (primary and posttraumatic).

Methods

After reviewing the full texts, 30 articles fulfilled all inclusion criteria from 1985 until 2021, comparing TAR results. The eligible studies included 5508 patients, of whom 1565 patients had IA and 3943 patients had NIA. At the time of surgery, the average age was 58 years in the IA group and 63 in the NIA group. The average follow-up was 67.2 months in the IA group and 67 months in the NIA group. The outcome measures were the American Orthopaedic Foot and Ankle Society (AOFAS) score and the rate of complications, revisions, and survival.

Results

The mean final AOFAS score was 82 (95% confidence interval [CI]: 78-86) in the IA group and 83 (95% CI: 78-88) in the NIA group, with no significant difference. There was no significant difference in the mean preoperative to postoperative AOFAS score change between the IA and the NIA. The complication rate was 16% (95% CI: 9%-27%) in the IA group and 15% (95% CI: 8%-27%) in the NIA group with no significant difference. The revision rate was 12% (95% CI: 10%-15%) in the IA group and 13% (95% CI: 10%-18%) in the NIA group, which was significant (P = .04). There was no significant difference in the survival rate between IA and NIA.

Conclusion

Total ankle replacement is a safe procedure in inflammatory ankle arthritis, specifically in RA patients with relatively minor and major complications close to other reasons for ankle replacement.

Levels of Evidence:

Level IV: prognostic
Non-Invasive Treatments for Failed Back Surgery Syndrome: A Systematic Review
Authors: Papalia Giuseppe Francesco , Russo Fabrizio , Vadalà Gianluca , Pascarella Giuseppe , De Salvatore Sergio , Ambrosio Luca , Di Martino Sara , Sammartini Davide , Sammartini Emanuele , Carassiti Massimiliano , Papalia Rocco , Denaro Vincenzo
Published: November 2022

Study design

Systematic Review.

Objectives

The aim of this systematic review is to evaluate the efficacy of non-invasive procedures in relieving chronic pain due to Failed Back Surgery Syndrome (FBSS).

Methods

Since patients who suffered from FBBS are often non-responders to analgesics, we compared Visual Analogical Scale for low back and leg pain, Oswestry Disability Index, trial success rate, adverse events and complications between conservative treatment groups and control groups.

Results

The included studies were 15. Spinal Cord Stimulation (SCS) was performed in 11 trials; 4 studies assessed the efficacy of different epidural injections; one study evaluated repetitive Transcranial Magnetic Stimulation. All the studies reported back and leg pain relief after treatment with SCS, with a significant superiority in high frequences (HFS) group, compared to low frequences (LFS) group. Moreover, disability decreased with each non-invasive treatment evaluated. Epidural injections of steroids and hyaluronidase have shown controversial results. Adverse events were described in 7 studies: lead migration, hardware-related events, infection and incisional pain were the most reported. Finally, trial success rate showed better outcomes for HFS.

Conclusions

Our systematic review highlights the efficacy of conservative treatments in FBSS patients, with an improvement in pain scores and a decrease in disability index, especially after SCS with HFS. However, due to the lack of homogeneity among trials and population characteristics, further studies are needed to confirm the effectiveness of non-invasive interventions in patients affected by FBSS.
Use of Pro in Evaluating TAA and its Indications
Authors: Suri Yash
Published: November 2022

Category:

Ankle

Introduction/Purpose:

The indications for total ankle arthroplasty (TAA) have greatly expanded over the past decade. This rapid growth has been made possible with evidence-based medicine. Patient-reported outcomes (PROs) have been the primary outcome measure in many of these studies. To evaluate the quality of the evidence underlying expanded indications for TAA, we must first understand what PROs have been used in the evaluation of outcomes of TAA.

Methods:

The goal of this study was to conduct a systematic review of the literature from 2010 to 2021 capturing all studies of TAA to determine what PRO instruments were used, and what facets of TAA practice were studied. Studies reporting on outcomes and PROs following a TAA procedure were selected to review from the PubMed database between January 2010 and July 2021. Results from one hundred sixty-three studies were reviewed and pooled for analysis for this study.

Results:

After the evaluation of one hundred sixty-three studies, twenty-four separate PRO measures were identified in the literature. The PROs that were most reported in the literature from 2010 to 2021 were American Orthopedic Foot and Ankle Score (AOFAS) (49.1%), 36-Item Short Form Survey (SF-36) (40.5%), visual analog scale - pain (VAS) (35.6%), Ankle Osteoarthritis Scale (AOS) Questionnaire (17.8%), and Short Musculoskeletal Function Assessment (SMFA) (14.7%). The independent variables in these studies included a wide range of modifiable and unmodifiable patient factors such as age (27 studies), BMI (23 studies), smoking (8 studies), and preoperative coronal plane deformity (5 studies). A significant portion of the studies (41%) advocating for expanded indications did so based on the failure to find a difference in groups.

Conclusion:

The most commonly used PROs for TAA were AOFAS, SF-36, and VAS. The AOFAS score which had been the most commonly used PRO in 2009, is still today despite the determination in 2011 that it is not valid and there is a substantial risk for bias. Newer, validated PRO instruments, such as PROMIS, have not yet attained significant implementation in studies of TAA. The vast majority of the evidence supporting the expanded indications for TAA has come from studies with negative results. Caution should be exercised in interpreting these results and their study implications.
Ankle Temporizing External Fixation as a Risk for Sharp Exposure: A Common Occurrence
Authors: Swords Michael P. , Patel Jay , Kane Kevin
Published: November 2022

Category:

Trauma; Ankle

Introduction/Purpose:

External fixation is a common initial management strategy for complex ankle injuries. The purpose of this study was to evaluate external fixation frame constructs for risk of sharp exposure to the health care team at the receiving institution when patients were received in transfer for definitive care after an external fixator was applied at an outside institution.

Methods:

Patients with an ankle external fixator applied prior to transfer to the senior author over a 3 year period were included. Injuries represented- included pilon fractures, complex ankle fractures and other injuries with significant soft tissue swelling. External fixation constructs were evaluated for sharp pin ends when the patient was received in transfer. Frame constructs were assessed for pins that were cut resulting in sharp ends or pins that were never cut, resulting in an exposed sharp pin end. The location of sharp pins was recorded as a tibial shaft pin, foot pin, or calcaneal pin. calcaneal pins were recorded as either monolateral or transcalcaneal.

Results:

39 patients with ankle external fixation were received in transfer by the senior author over a 3- year period. 16/39 external fixation constructs had sharp pins that presented potential for injury at the receiving institution. Of the external fixation constructs with sharp pin ends 2/16 had tibial pins that were cut in a manner that resulted in a sharp pin end. 14/16 of the external fixation frames with sharp pin ends exposed were transcalcaneal pins where the leading sharp point was not cut after the pin was inserted through the calcaneus and the external fixator was assembled. No foot pins or monolateral calcaneal pins resulted in sharp pin ends.

Conclusion:

External fixation plays an important role in staged management of complex ankle injuries. All external fixation pins should be cut in a manner that results in blunt pin ends to reduce potential for injury to all members of the health care team. Pin cutters that result in blunt pin ends are commercially available and should be used to prevent potential sharp injury in all external fixation cases
Novel Dynamic Screw-Suture Stabilization System for Syndesmotic Repair Provides Better Anteroposterior Translation and Axial Tibiofibular Joint Stability: A Human Cadaveric Study
Authors: Swords Michael P. , Souleiman Firas , Zderic Ivan , Pastor Torsten , Gehweiler Dominic , Galie Jessica , Kent Todd J. , Gueorguiev Boyko , Tomlinson Matthew P. , Schepers Tim
Published: November 2022

Category:

Ankle; Basic Sciences/Biologics; Trauma

Introduction/Purpose:

The quest for optimal treatment of acute distal tibiofibular syndesmotic disruptions is still in full progress. Using suture-button repair devices is one of the dynamic stabilization options, however, they may not be always appropriate for stabilization of length-unstable syndesmotic injuries. Recently, a novel screw-suture repair system was developed to address such issues. The aim of this study was to investigate its performance in comparison to a suture-button stabilization of unstable syndesmotic injuries.

Methods:

Eight pairs of human cadaveric lower legs were CT scanned under 700 N single-leg axial loading in five foot positions - neutral, 15° external/internal rotation and 20° dorsi-/plantarflexion - in 3 different states: (1) pre-injured (intact); (2) injured, characterized by complete syndesmosis and deltoid ligaments cuts simulating pronation-eversion injury types III and IV as well as supination-eversion injury type IV according to Lauge-Hansen; (3) reconstructed, using a screw-suture (FIBULINK, Group 1) or a suture-button (TightRope, Group 2) implants for syndesmotic stabilization, placed 20 mm proximal to the tibia plafond/joint surface. Following, all specimens were: (1) biomechanically tested over 5000 cycles under combined 1400 N axial and +-15° torsional loading; (2) rescanned. Clear space (diastasis), anterior tibiofibular distance, talar dome angle and fibular shortening were measured radiologically from CT scans. Anteroposterior, axial, mediolateral and torsional movements at the distal tibiofibular joint level were evaluated biomechanically via motion tracking.

Results:

In each group clear space increased significantly after injury (p <= 0.004) and became significantly smaller in reconstructed compared with both pre-injured and injured states (p <= 0.041). In addition, after reconstruction it was significantly smaller in Group 1 compared to Group 2 (p < 0.001). Anteroposterior (AP) and axial movements were significantly smaller in Group 1 compared with Group 2 (p < 0.001, Figure). No further significant differences were identified/detected between the groups (p >= 0.113).

Conclusion:

Although both implant systems demonstrate ability for stabilization of unstable syndesmotic injuries, the screw- suture reconstruction provides better anteroposterior translation and axial stability of the tibiofibular joint and maintains it over time under dynamic loading. Therefore, it could be considered as a valid option for treatment of syndesmotic disruptions.
How I treat Elderly Patients with DLBCL in the frontline setting.
Authors: Lugtenburg Pieternella J , Mutsaers Pim G.N.J.
Published: November 2022

Diffuse large B-cell lymphoma (DLBCL) is an aggressive but potentially curable disease and is most common in older people. Rituximab-CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) is the standard of care for fit patients without cardiac contraindications. In each individual elderly patient the potential gains of treatment should be balanced against the risks of treatment related morbidity and mortality. A simplified comprehensive geriatric assessment or easily performed assessments such as gait speed and grip strength can be helpful to assess the fitness of an elderly patient. Pre-phase with corticosteroids, rigorous supportive care including G-CSF prophylaxis and careful monitoring can be important to prevent adverse events. In unfit elderly patients a dynamic dosing strategy is often applied. For very elderly patients (≥ 80 years) a dose reduced regimen (R-miniCHOP) is recommended. When anthracyclines are contraindicated, doxorubicin can be replaced by etoposide or gemcitabine. Most frail patients do not benefit from chemotherapy. Further progress can be expected from non-chemotherapy based therapies, such as bispecific antibodies, antibody-drug conjugates and immunomodulatory agents. This article provides an overview of first line treatment in elderly patients with DLBCL and our approach to the management of these challenging patients.
Supplementary suckling technique in infants less than 6 months of age with uncomplicated severe acute malnutrition: a prospective hospital-based study in armed conflict Yemen
Authors: Baazab Mohamed Salem Mohamed , Bilal Jalal Ali , Ba-Saddik Iman Ali , Arabi Ali Mohammed
Published: November 2022

Background

Globally 3.8 million of children under 6 month of age are severely wasted. In Yemen, around 20% of children under 6 months were affected by malnutrition during the armed conflict in the last 7 years. Supplementary suckling may reestablish exclusive breastfeeding in infant less than 6 months of age with Severe Acute Malnutrition (SAM). This study aimed to determine the outcomes of employing supplementary suckling technique in treatment of uncomplicated SAM infants in a conflict-affected community.

Methods

A prospective hospital-based study was carried out between January to April 19th, 2020 among randomly selected infants less than 6 months of age with SAM following breastfeeding failure. Infants’ anthropometric indices were daily measured and recorded. Supplementary sulking technique was used in management with high or low protein milk-based formula supplement. Outcome was recorded as cured, died, defaulter or in nonrecovery state.

Results

In this study 108 infants were enrolled with a median (IQR) age of 4 (2.5-5) years and a male: female ratio of 1.4:1. After treatment, 80.6% recovered to cure, 12% defaulters, 6% died, and 2% did not respond to treatment Thirty-four infants (38.8%) gained weight with significantly increased median weight and median weight-for-age z score. The median (IQR) duration of treatment was 9 (7.5-14) days. The means of age and weight-for-length z score were correlated (r = − 0.22, p = 0.025). Duration of treatment was a predictor of outcome (OR = 1.71, 95% CI = 0.05-0.62, p < 0.001).

Conclusion

Supplementary suckling technique for feeding infant with SAM aged less than 6 months had a positive impact on anthropometric indices with high cure rate. The younger the infant and the longer the duration of treatment, the better the outcome.
India's achievement towards sustainable Development Goal 6 (Ensure availability and sustainable management of water and sanitation for all) in the 2030 Agenda
Authors: Biswas Sourav , Dandapat Biswajit , Alam Asraful , Satpati Lakshminarayan
Published: November 2022

Background

Clean water and sanitation are global public health issues. Safe drinking water and sanitation are essential, especially for children, to prevent acute and chronic illness death and sustain a healthy life. The UN General Assembly announced the 17 Sustainable Development Goals (SDGs) and 169 targets for the 2030 Agenda on 25 September 2015. SDG 6 is very important because it affects other SDG (1, 2,3,5,11,14 and 15). The present study deals with the national and state-wise analysis of the current status and to access deficiency of India's achievement towards SDG 6 (clean water and sanitation for all) for the 2030 agenda based on targets 6.1, 6.2,6.4,6.6 from 2012 to 2020.

Materials and methods

Data of different indicators of SDG 6 are collected from different secondary sources—NSS 69th (2012) and 76th (2018) round; CGWB annual report 2016–2017 and 2018-2019; NARSS (2019–2020); SBM-Grameen (2020). To understand overall achievement towards SDG 6 in the 2030 agenda, the goal score (arithmetic mean of normalised value) has been calculated.

Major findings

According to NSS data, 88.7% of Indian households had enough drinking water from primary drinking water sources throughout the year, while 79.8% of households had access to toilet facilities in 2018. As per the 2019–2021 goal score for States and UTs in rural India based on SDG 6 indicator, SDG 6 achiever States and UTs (100%) are Sikkim, Himachal Pradesh, Andaman and Nicobar Islands.

Conclusion

Drinking water and sanitation for all ensure a healthy life. It is a matter of concern for the government, policymakers, and people to improve the condition where the goal score and indicator value of SDG 6 are low.
Preface for article collection “Thermal, dynamical, and chemical processes in our early Solar System”
Authors: Bouvier Audrey , Kimura Makoto , Lin Yangting , Ohtani Eiji , Sharp Thomas
Published: November 2022

Upper: Giant impact (Courtesy NASA/JPL-Caltech); chondrule, majorite in shocked enstatite (Courtesy Miyahara); Lower: Collision of planetesimals (Courtesy NASA/JPL-Caltech); Raman mapping of wadsleyite and ringwoodite in Peace River L6 (Courtesy Miyahara and El Goresy).
Intestinal tumor lesions leading to intussusception in children: a report of four cases and literature review
Authors: Cheikhrouhou Taycir , Chtourou Rahma , Ben Dhaou Mahdi , Mallouli Manel , Benkraiem Najoua , Kallel Rim , Ammar Saloua , Zitouni Hayet , Boudawara Tahya Sellami , Mhiri Riadh
Published: November 2022

Background

Intussusception is commonly idiopathic in children. Pathologic lead points (PLP) especially intestinal tumors (IT) are extremely rare. The diagnosis of intussusception secondary to pediatric IT is difficult due to the non-specific nature of symptoms. Its management remains a challenge. We report here four pediatric cases of intussusception secondary to IT lesions in order to analyze the clinical and therapeutic characteristics of this unusual condition.

Case presentations

Four children were diagnosed and operated in our center for intussusception secondary to IT during the period from February 2017 to February 2021. Patients’ demographics, clinical presentations, investigations, operative data, and postoperative outcome were recorded and analyzed. There were three girls and one boy. Ages ranged between 1 and 8 years (average of 5.5 years). Intermittent abdominal pain with acute exacerbation and vomiting were the main clinical signs. Radiologic investigations showed the intussusception in all cases but the tumor lead point was evident only during the surgical exploration in most cases. All patients underwent surgical treatment with intussusception reduction and mass removal. Pathological examination of these masses revealed: submucosal intestinal lipoma (1 case), hamartomatous polyposis (2 cases), and Burkitt’s lymphoma (1 case). For this last case, adjuvant chemotherapy was also needed. The postoperative period was uneventful in all cases.

Conclusion

Pediatric intussusception secondary to IT lesions is an unusual and challenging condition that requires high preoperative diagnostic suspicion, considerate intraoperative judgment, and appropriate postoperative follow-up for successful outcomes.

These tumors should be considered by the pediatric surgeons as possible PLP for recurrent intussusception, especially in older children. Surgeons should be familiar with the various treatment options, because the real cause of the intussusception is often accurately diagnosed by laparotomy.
Evaluating the implementation of a multidisciplinary lifestyle intervention for people with severe mental illness in sheltered housing: effectiveness-implementation hybrid randomised controlled trial
Authors: Smit Marij M. C. , Waal Elze de , Tenback Diederik E. , Deenik Jeroen
Published: November 2022

Background

Lifestyle interventions can improve health-related outcomes for people with severe mental illness (SMI), but few studies evaluate this potential in everyday settings. After a successful approach in routine inpatient mental healthcare (MULTI), we sought to replicate this multidisciplinary lifestyle-enhancing support in people with SMI living in sheltered housing (MULTI_sh).

Aims

To evaluate the effectiveness and implementation of MULTI_sh (trial registration: NCT03157557).

Method

In an effectiveness-implementation hybrid cluster-randomised controlled trial, six municipalities with sheltered housing facilities in The Netherlands were randomly assigned to MULTI_sh (n = 3) or treatment as usual (TAU, n = 3). After 12 months, we evaluated effects on metabolic health, sedentary behaviour/physical activity (ActiGraph GT3X+), quality of life (EuroQol 5D, WHOQoL-Bref) and psychopathology (Brief Psychiatric Rating Scale Expanded Version) using multiple regression, adjusting for baseline values and municipalities (intention to treat and per protocol). In addition, implementation fidelity and barriers/facilitators were evaluated (Measurement Instrument for Determinants of Innovation).

Results

Of 177 eligible patients, 74 (42%) could be included in the analyses. Health outcomes did not substantially improve with MULTI_sh (n = 45) compared with TAU (n = 29). MULTI_sh was not implemented as intended. Most patients and all healthcare professionals believed that patients’ lifestyle should be part of treatment, but implementation was primarily (in)directly hindered by organisational factors (e.g. staff shortages, complexity of participation, lack of time and difficulty getting patients involved).

Conclusions

MULTI_sh was not implemented as intended and no clinical health improvements were found. Organisations are decisive in the success or failure of the implementation of lifestyle interventions for people with SMI. More intensive implementation strategies on this level are warranted in sheltered housing.
Dissecting the In Vitro Efficacy of Octreotide and Cabergoline in GH- and GH/PRL-Secreting Pituitary Tumors
Authors: Gatto Federico , Feelders Richard A , van Koetsveld Peter M , Dogan Fadime , Neggers Sebastian J C M M , van der Lelij Aart-Jan , Amarù Jessica , Ferone Diego , Hofland Leo J
Published: November 2022

Context

Cabergoline (CAB) is an off-label medical therapy for acromegaly, overshadowed by first-generation somatostatin receptor ligands, eg, octreotide (OCT).

Objective

This was a head-to-head comparison between OCT and CAB in inhibiting growth hormone (GH) secretion in primary cultures of GH- and GH/prolactin (PRL)-secreting tumors; we also investigated the role of somatostatin (SST) and dopamine type 2 (D2R) receptor expression.

Methods

We evaluated the antisecretory effect of OCT and CAB, together with receptor mRNA expression, in 23 tumor cultures obtained from acromegaly patients referred to the Erasmus Medical Center (Rotterdam, The Netherlands). GH concentrations in cell culture media were determined after 72-hour OCT and CAB treatment (10 nM).

Results

OCT showed a slightly higher efficacy compared with CAB (GH decrease −39.5% vs −32.5%, P = 0.079). The effect of the 2 drugs was superimposable in GH/PRL co-secreting tumors (−42.1% vs −44.8%), where SST1 and D2R had a higher expression compared with the pure GH-secreting tumors (P = 0.020 and P = 0.026). OCT was more effective than CAB in 8/23 cultures, while CAB was more effective than OCT in 3/23 (CAB+ group). In CAB+ tumors, SST1 expression was higher compared with the other groups (P = 0.034). At receiver operating characteristic (ROC) curve analysis, SST1 and D2R discriminated between GH and GH/PRL co-secretion (AUC 0.856, P = 0.013; AUC 0.822, P = 0.024). SST1 was the best predictor of CAB response (≥50% GH reduction, AUC 0.913, P = 0.006; 80% sensitivity, 94% specificity).

Conclusion

OCT is 5% to 10% more effective than CAB in vitro. SST1 mRNA expression can represent a reliable marker of GH/PRL co-secreting tumors showing a preferential response to CAB treatment.
France's Great Indian Misadventure
Authors: Margerison Kenneth
Published: November 2022

The French interest in attacking the British in India during the American Revolution was promoted by a variety of individuals with experience and often personal interests on the subcontinent. These individuals convinced the naval minister, Antoine de Sartine, and his successor, Charles de la Croix, marquis de Castries, that the Indian princes were eager to liberate India from British tyranny and with French assistance would launch an uprising to achieve this goal. Both ministers became avid proponents of launching an attack on the British in India coinciding with French entrance into the American War. Initially opposed to this venture, the foreign minister, Charles Gravier, comte de Vergennes, ultimately came to see its value. The exaggerated predictions of a massive Indian revolt against the British never materialized. The difficulties of mounting a long-distance invasion and the tardy arrival of General Charles Joseph Patissier, marquis de Bussy-Castelnau, who did not reach India until after peace negotiations had begun, resulted in the failure of the French intervention.

L'intérêt des Français à attaquer les Britanniques en Inde pendant la Révolution américaine a été promu par une variété de personnes ayant de l'expérience et souvent des intérêts personnels sur le sous-continent. Ces individus ont convaincu le ministre de la Marine Sartine et son successeur Castries que les princes indiens désiraient libérer l'Inde de la tyrannie britannique et, avec l'aide de la France, lanceraient un soulèvement pour atteindre cet objectif. Les deux ministres devinrent de fervents partisans du lancement d'une attaque contre les Britanniques en Inde coïncidant avec l'entrée de la France dans la guerre américaine. Initialement opposé à cette entreprise, le ministre des Affaires étrangères Vergennes finit par en reconnaître la valeur. Les prédictions exagérées d'une révolte indienne massive contre les Britanniques ne se sont jamais matérialisées. Les difficultés d'organiser une invasion à longue distance et l'arrivée tardive de Bussy, qui n'arriva en Inde qu'après le début des négociations de paix, entraînèrent l’échec de l'intervention française.
Less Is More? Repartnering and Completed Cohort Fertility in Finland
Authors: Andersson Linus , Jalovaara Marika , Uggla Caroline , Saarela Jan
Published: November 2022

An extensive literature theorizes the role of repartnering for cohort fertility and whether union dissolution can be an engine for fertility. A large share of higher order unions are nonmarital cohabitations, but most previous studies on completed cohort fertility have analyzed only marital unions, and none have incorporated nonmarital cohabitations using population-level data. To analyze the relationship between the number of unions and cohort fertility for men and women, we use Poisson regression with Finnish register data to enumerate every birth, marriage, and cohabitation among the 1969–1972 birth cohorts at ages 18–46. We show that dissolutions of first cohabitations are the main pathway to repartnering and that most higher order unions are cohabitations. Nonmarital repartnering is a strong predictor of low fertility. In contrast, remarriage is positively associated with cohort fertility. Because the bulk of first-union dissolutions and higher order unions are nonmarital, repartnering is not an efficient engine for fertility at the aggregate level. Marriage and cohabitation are far from indistinguishable in a country often described as a second demographic transition forerunner.