bluuebunny/crossref_metadata_2025 huggingface dataset:
Proton-mediated reversible switching of metastable ferroelectric phases with low operation voltages
Authors: He Xin , Ma Yinchang , Zhang Chenhui , Fu Aiping , Hu Weijin , Xu Yang , Yu Bin , Liu Kai , Wang Hua , Zhang Xixiang , Xue Fei
Published: May 2023

The exploration of ferroelectric phase transitions enables an in-depth understanding of ferroelectric switching and promising applications in information storage. However, controllably tuning the dynamics of ferroelectric phase transitions remains challenging owing to inaccessible hidden phases. Here, using protonic gating technology, we create a series of metastable ferroelectric phases and demonstrate their reversible transitions in layered ferroelectric α-In
2
Se
3
transistors. By varying the gate bias, protons can be incrementally injected or extracted, achieving controllable tuning of the ferroelectric α-In
2
Se
3
protonic dynamics across the channel and obtaining numerous intermediate phases. We unexpectedly discover that the gate tuning of α-In
2
Se
3
protonation is volatile and the created phases remain polar. Their origin, revealed by first-principles calculations, is related to the formation of metastable hydrogen-stabilized α-In
2
Se
3
phases. Furthermore, our approach enables ultralow gate voltage switching of different phases (below 0.4 volts). This work provides a possible avenue for accessing hidden phases in ferroelectric switching.
Towards Novel HIV-1 Serodiagnostic Tests without Vaccine-Induced Seroreactivity
Authors: Lagatie Ole , Lauwers Dax , Singh Harvinder , Vanroye Fien , Stieh Daniel J. , Vingerhoets Johan , Lavreys Ludo , Oriol-Mathieu Valérie , Colón Will , Verhofstede Chris , Vercauteren Koen , Van den Bossche Dorien , Pau Maria Grazia
Published: May 2023

While the detection of HIV infection is accomplished by several methods, the most common are serological tests that detect host antibodies produced in response to viral infection. However, the use of current serological tests may present a significant challenge to the adoption of an HIV vaccine in the future because the antibodies to HIV antigens detected in currently available tests also tend to be included as antigens in the HIV vaccines in development.
Genetic features and kidney morphological changes in women with X-linked Alport syndrome
Authors: Di Hongling , Wang Qing , Liang Dandan , Zhang Jiahui , Gao Erzhi , Zheng Chunxia , Yu Xiaomin , Liu Zhihong
Published: May 2023

Background

X-linked Alport syndrome (XLAS) caused byCOL4A5pathogenic variants usually has heterogeneous phenotypes in female patients. The genetic characteristics and glomerular basement membrane (GBM) morphological changes in women with XLAS need to been further investigated.

Methods

A total of 83 women and 187 men with causativeCOL4A5variants were enrolled for comparative analysis.

Results

Women were more frequently carrying de novoCOL4A5variants compared with men (47% vs 8%, p=0.001). The clinical manifestations in women were variable, and no genotype–phenotype correlation was observed. Coinherited podocyte-related genes, includingTRPC6,TBC1D8B,INF2andMYH9, were identified in two women and five men, and the modifying effects of coinherited genes contributed to the heterogeneous phenotypes in these patients. X-chromosome inactivation (XCI) analysis of 16 women showed that 25% were skewed XCI. One patient preferentially expressing the mutantCOL4A5gene developed moderate proteinuria, and two patients preferentially expressing the wild-typeCOL4A5gene presented with haematuria only. GBM ultrastructural evaluation demonstrated that the degree of GBM lesions was associated with the decline in kidney function for both genders, but more severe GBM changes were found in men compared with women.

Conclusions

The high frequency of de novo variants carried by women indicates that the lack of family history tends to make them susceptible to be underdiagnosed. Coinherited podocyte-related genes are potential contributors to the heterogeneous phenotype of some women. Furthermore, the association between the degree of GBM lesions and decline in kidney function is valuable in evaluating the prognosis for patients with XLAS.
Early autoimmunity and outcome in virus encephalitis: a retrospective study based on tissue-based assay
Authors: Liu Ding , Lin Pei-Hao , Li Hui-Lu , Yang Jie , You Yong , Yang Xiao , Jiang Li-Hong , Ma Cai-Yu , Xu Lu-Fen , Zhang Qing-Xia , Liao Sha , Chen Han , Yue Jia-Jia , Lu Yu-Ying , Lian Chun , Liu Yin , Wang Zhan-Hang , Ye Jin-Long , Qiu Wei , Shu Ya-Qing , Wang Hai-Yang , Liu Hong-Li , Wang Yue , Duan Chun-Mei , Yang Huan , Wu Xiu-Ling , Zhang Lu , Feng Hui-Yu , Chen Huan , Zhou Hou-Shi , Xu Qian-Hui , Zhao Gui-Xian , Ou Teng-Fei , Wang Jin-Liang , Lu Yu-Hua , Mao Zhi-Feng , Gao Cong , Guo Jun , Zhang Hong-Ya , Chen Sheng , Li Jing , Long You-Ming
Published: May 2023

To explore the autoimmune response and outcome in the central nervous system (CNS) at the onset of viral infection and correlation between autoantibodies and viruses.

Methods

A retrospective observational study was conducted in 121 patients (2016–2021) with a CNS viral infection confirmed via cerebrospinal fluid (CSF) next-generation sequencing (cohort A). Their clinical information was analysed and CSF samples were screened for autoantibodies against monkey cerebellum by tissue-based assay. In situ hybridisation was used to detect Epstein-Barr virus (EBV) in brain tissue of 8 patients with glial fibrillar acidic protein (GFAP)-IgG and nasopharyngeal carcinoma tissue of 2 patients with GFAP-IgG as control (cohort B).

Results

Among cohort A (male:female=79:42; median age: 42 (14–78) years old), 61 (50.4%) participants had detectable autoantibodies in CSF. Compared with other viruses, EBV increased the odds of having GFAP-IgG (OR 18.22, 95% CI 6.54 to 50.77, p<0.001). In cohort B, EBV was found in the brain tissue from two of eight (25.0%) patients with GFAP-IgG. Autoantibody-positive patients had a higher CSF protein level (median: 1126.00 (281.00–5352.00) vs 700.00 (76.70–2899.00), p<0.001), lower CSF chloride level (mean: 119.80±6.24 vs 122.84±5.26, p=0.005), lower ratios of CSF-glucose/serum-glucose (median: 0.50[0.13-0.94] vs 0.60[0.26-1.23],
p
=0.003), more meningitis (26/61 (42.6%) vs 12/60 (20.0%), p=0.007) and higher follow-up modified Rankin Scale scores (1 (0–6) vs 0 (0–3), p=0.037) compared with antibody-negative patients. A Kaplan-Meier analysis revealed that autoantibody-positive patients experienced significantly worse outcomes (p=0.031).

Conclusions

Autoimmune responses are found at the onset of viral encephalitis. EBV in the CNS increases the risk for autoimmunity to GFAP.
Acute respiratory failure-related excess mortality in pediatric sepsis
Authors: Keim Garrett , Percy Andrew G , Himebauch Adam S , Hsu Jesse Y , Christie Jason D , Yehya Nadir
Published: May 2023

Excess mortality risk imparted by acute respiratory failure in children is unknown. We determined excess mortality risk associated with mechanically ventilated acute respiratory failure in pediatric sepsis. Novel ICD10-based algorithms were derived and validated to identify a surrogate for acute respiratory distress syndrome to calculate excess mortality risk. Algorithm-identified ARDS was identified with specificity of 96.7% (CI 93.0 − 98.9) and sensitivity of 70.5% (CI 44.0 – 89.7). Excess risk of mortality for ARDS was 24.4% (CI 22.9 – 26.2). Development of ARDS requiring mechanical ventilation imparts modest excess risk of mortality in septic children.
Weak gravitational lensing by an ESTGB black hole in the presence of a plasma
Authors: Li Qian , Zhang Yu , Lin Zhi-Wen , Li Qi-Quan , Sun Qi
Published: May 2023

This paper is devoted to studying the weak-field gravitational lensing properties of a 4D ESTGB black hole, which is surrounded by the plasma medium. The effects of the magnetic charges and the three plasma distribution models in the deflection of light around a 4D ESTGB black hole are investigated in detail. We find that the uniform plasma leads to a larger deflection of light rays in comparison with the singular isothermal sphere (SIS), the non-singular isothermal sphere (NSIS) models. Moreover, the deflection angle increases slightly as the absolute value of the magnetic charge decreases. Finally, we analyze the total magnification of image due to weak gravitational lensing around the black hole. The result shows that the presence of a uniform plasma medium remarkably enhances the total magnification whereas the non-uniform plasma reduces the total magnification.
Breast Masses Segmentation: A Framework of Skip Dilated Semantic Network and Machine Learning
Authors: Zahoor Saliha , Shoaib Umar , Lali Ikram Ullah
Published: May 2023

Many medical specialists used Computer Aided Diagnostic (CAD) systems as a second opinion to detect breast masses. The poor visualization of mass images makes it difficult to identify precisely. To segment the lesions from the mammograms is a difficult task due to different shapes, sizes, and locations of the masses. The motivation of this study is to develop a method that can segment breast mass lesions from mammogram images. The objective is to perform the segmentation of the breast mass mammogram images more precisely at an early stage. Breast mass segmentation is always a basic requirement in computer-aided diagnosis systems. In this study segmentation of the masses abnormalities from the mammogram images is performed by using the Skipping Dilated semantic segmentation approach. The study uses class weights and Dilation factor using semantic Convolutional Neural Network (CNN). It overcomes the class misbalance in tumors and background class, that affect the mean Intersection over Union (MIOU), and weighted-IOU (WIOU) by using class weights. Secondly, dilation convolution magnifies the receptive field exposure that enriches the convolutional operation with context attentiveness. Two public datasets of mammography INbreast and CBIS-DDSM are used. The WIOU of Skipping Dilated Semantic CNN for INbreast is 98.51% and CBIS-DDSM is 94.82% achieved.
Enhancing Electrochemical Performance of Zinc-Air Batteries Using Freeze Crosslinked Carboxymethylcellulose-Chitosan Hydrogels as Electrolytes
Authors: Bósquez-Cáceres María Fernanda , Bejar José , Álvarez-Contreras Lorena , Tafur Juan P.
Published: May 2023

Zinc-air batteries (ZABs) are devices of great interest as a replacement option for subsequent technologies to lithium-ion batteries. Still, the need for suitable electrolyte materials limits their application in commercial devices. In this study, a green hydrogel composed of chitosan and carboxymethylcellulose was synthesized with the use of citric acid as a chemical crosslinker, physical freezing-thawing, and freezing-drying strategies. Physicochemical, thermal, and electrochemical characterizations were performed to study the effects of the proposed synthesis’ on the performance of the hydrogels for the desired application. The obtained hydrogels showed a porous morphology that was doped with a 12 M KOH solution. Adequate complexation of K+ cations and the polymer chains was observed. The resulting membranes showed an enhanced ionic conductivity of 0.39 S cm‒1, attributed to the pores and channels generated by the crosslinking strategies, contributing to the pathways for ions to move easily. In addition, the temperature dependence of the conduction mechanism was confirmed in the temperature range of 0 °C to 70 °C. The electrolytes were employed in ZABs prototypes, achieving a maximum power density of 117 mW cm‒2 and a specific capacitance of 1899 mAh g‒1. The presented results show the promising properties of these hydrogels as electrolytes for green storage devices.
O-linked N-acetylglucosamine modification is essential for physiological adipose expansion induced by high-fat feeding
Authors: Nakamoto Akiko , Ohashi Natsuko , Sugawara Lucia , Morino Katsutaro , Ida Shogo , Perry Rachel J. , Sakuma Ikki , Yanagimachi Tsuyoshi , Fujita Yukihiro , Ugi Satoshi , Kume Shinji , Shulman Gerald I. , Maegawa Hiroshi
Published: May 2023

We evaluated the role of O-GlcNAcylation in adipose tissue in diet-induced obesity using adipose tissue-specific Ogt knockout mice. We found that O-GlcNAcylation in adipose tissue is essential for healthy fat expansion and that Ogt-FKO mice exhibit severe fibrosis upon long-term overnutrition. O-GlcNAcylation in adipose tissue may regulate de novo lipogenesis and free fatty acid efflux to the degree of overnutrition. We believe that these results provide new insights into adipose tissue physiology and obesity research.
Biochemical Evaluation by Confirmatory Tests after Unilateral Adrenalectomy for Primary Aldosteronism
Authors: Murasawa Shingo , Kageyama Kazunori , Usutani Mari , Asari Yuko , Kinoshita Noriko , Nakada Yuki , Watanuki Yutaka , Takayasu Shinobu , Daimon Makoto
Published: May 2023

Primary aldosteronism (PA) is the most common cause of endocrine hypertension. Unilateral PA can be cured using unilateral adrenalectomy (Adx). PA surgery outcome (PASO) criteria, which include clinical and biochemical outcomes, have been proposed to evaluate PA cure after Adx. However, clinical outcomes are often inconsistent with biochemical outcomes. In addition, although confirmatory tests are included as endpoints of biochemical outcomes in the PASO criteria, their clinical usefulness has not yet been established. We evaluated clinical parameters and confirmatory test results before and after Adx in 16 patients with PA and assessed the usefulness of the confirmatory tests. The following were the clinical outcomes after Adx: 37.5% complete success, 62.5% partial success, and 0% absent success. The ratio of biochemical complete success was as follows: 69% aldosterone/renin ratio and basal plasma aldosterone concentration, 19% as assessed by the captopril challenge test, 47% as assessed by the saline infusion test, 30% as assessed by the furosemide upright test, and 100% urine aldosterone. Of these, biochemical complete success was judged in four cases by aldosterone/renin ratio and basal plasma aldosterone concentration, one case by captopril challenge test, five cases by saline infusion test, and one case by furosemide upright test. Although clinical outcomes and urine aldosterone levels improved after Adx, confirmatory tests failed to improve in some cases. The current criteria are not considered useful for biochemical evaluation after Adx. To determine whether additional treatment with mineralocorticoid receptor antagonists is required, more accurate biochemical criteria should be established after Adx.
Biochemical and Microbiological Characteristics of Fresh Sardines (Sardinella maderensis) from the Exclusive Economic Zone of Mauritania Waters
Authors: Tolba Bah Abba , Tejedor-Junco María Teresa , El Mahmoud Hamed Mohmed Salem , Santana-Del Pino Angelo , Ould Brahim Hamoud , Zamel Mohamed Lemine Cheikh , Vadel Salihi Ahmedou Mohamed
Published: May 2023

Mauritania acquired the status of a lower-middle-income country in 2014. Economic development has relied primarily on fishing and mining. Fish is an important element in achieving adequate nutrition in these countries. But foodborne chemical and microbial hazards that may be present in fish are a major concern. The purpose of this study was to evaluate the microbiological and biochemical properties of fresh sardines (Sardinella maderensis). Totally, 135 samples were collected when boats arrived at the landing site and at the four main market sites. Microbiological and biochemical parameters were tested. Samples taken just after the arriving of the boats, almost always met quality standards. But when samples were taken on the markets, a high proportion of samples showed values of microbiological parameters higher than permissible limits. TVBN and TMA that result from the degradation of fish proteins, exceeded the authorized values in approximately 20% of the samples. Our findings suggest that postharvest contamination is the main health risk. Ensuring the cold chain, improving hygienic conditions in markets, and training vendors in food safety are the main challenges to be faced to reduce public health risks.
Antidepressant Use and Lung Cancer Risk and Survival: A Meta-analysis of Observational Studies
Authors: Lee Eunkyung , Park Yongho , Li David , Rodriguez-Fuguet Alice , Wang Xiaochuan , Zhang Wen Cai
Published: May 2023

Recent preclinical studies have linked antidepressants (AD) to their potential anticancer effects in multiple cancers, but the impact on lung cancer remains unclear. This meta-analysis examined the associations between ADs and lung cancer incidence and survival. The Web of Science, Medline, CINAHL, and PsycINFO databases were searched to identify eligible studies published by June 2022. We conducted a meta-analysis using a random-effects model to compare the pooled risk ratio (RR) and 95% confidence interval (CI) in those treated with or without ADs. Heterogeneity was examined using Cochran Q test and inconsistency I2 statistics. The methodologic quality of the selected studies was assessed using the Newcastle-Ottawa Scale for observational studies. Our analysis, including 11 publications involving 1,200,885 participants, showed that AD use increased lung cancer risk by 11% (RR = 1.11; 95% CI = 1.02–1.20; I2 = 65.03%; n = 6) but was not associated with overall survival (RR = 1.04; 95% CI = 0.75–1.45; I2 = 83.40%; n = 4). One study examined cancer-specific survival. Subgroup analysis showed that serotonin and norepinephrine reuptake inhibitors (SNRIs) were associated with an increased lung cancer risk by 38% (RR = 1.38; 95% CI = 1.07–1.78; n = 2). The quality of selected studies was good (n = 5) to fair (n = 6). Our data analysis suggests that SNRIs were associated with an elevated risk of lung cancer, raising concerns regarding the use of AD treatment in patients vulnerable to lung cancer. The effects of ADs—particularly SNRIs—and their interplay with cigarette use and lung cancer risk in vulnerable patients merits further study.

Significance:

In this meta-analysis of 11 observational studies, we found evidence of a statistically significant association between the use of certain ADs and lung cancer risk. This effect merits further study, particularly as it relates to known environmental and behavioral drivers of lung cancer risk, such as air pollution and cigarette smoke.
Insurreição na garganta: (re)existência no corpo de Elza Soares
Authors: Moreli Lígia Moreira , Mello Christine
Published: May 2023

Este artigo reflete, a partir da ideia de ativismo micropolítico defendida por Suely Rolnik, estudos sobre feminismo negro, de Lélia Gonzalez, e memória, performance e agência de corpos negros, de Leda Maria Martins, sobre a dimensão de insurgência presente na trajetória de Elza Soares e como a estética política presente em seu trabalho, com especial destaque a partir do álbum A mulher do fim do mundo (2015), tem reverberado no Brasil contemporâneo, ecoando como voz coletiva especialmente em movimentos antirracistas e feministas.
Transcranial Doppler After Successful Endovascular Revascularization and Hospitalization Outcomes
Authors: Del Brutto Victor J. , Sambursky Jacob A. , Krementz Nastajjia A. , Gondal Faisal J. , Gardener Hannah E. , Cabrera Frank , Cabrera Yosdely , Saleh Velez Faddi , Romano Jose G. , Koch Sebastian
Published: May 2023

Background

Almost half of large‐vessel occlusion strokes have unfavorable outcomes despite successful endovascular therapy. We aim to investigate whether postrevascularization cerebral hemodynamics, determined by transcranial Doppler (TCD), associate with hospitalization outcomes in this population.

Methods

The current observational cohort study analyzed 155 patients with successfully revascularized anterior circulation large‐vessel occlusion stroke (mean age, 68.3±15.4 years; 55% women) who had TCD within 48 hours from endovascular therapy. TCD parameters (mean flow velocity, peak systolic velocity, and pulsatility index) were recorded at the ipsilateral middle cerebral artery, and blood flow signals were categorized using the Thrombolysis in Brain Ischemia grades into normal (grade 5), stenotic (grade 4), or dampened (grade ≤3). Hospitalization outcomes comprised favorable discharge modified Rankin Scale score (0–2), favorable discharge destination (home or acute inpatient rehabilitation), and in‐hospital mortality. Logistic regression models adjusted for age, initial National Institutes of Health Stroke Scale score, and Alberta Stroke Program Early CT [Computed Tomography] Score were fit to determine TCD findings in association with study outcomes.

Results

Abnormal TCD‐derived blood flow was found in 54 (35%) cases, including 35 (23%) with Thrombolysis in Brain Ischemia grade 4 and 19 (12%) with Thrombolysis in Brain Ischemia grade ≤3. Overall, 31% had favorable discharge modified Rankin Scale score, 65% had favorable destination, and 14% died. Thrombolysis in Brain Ischemia grade ≤3 was associated with lower likelihood of both favorable discharge modified Rankin Scale score (adjusted odds ratio [OR], 0.09 [95% CI, 0.01–0.81]) and favorable destination (adjusted OR, 0.22 [95% CI, 0.07–0.71]). Mean flow velocity and peak systolic velocity were not associated with study outcomes. Conversely, increased pulsatility index was inversely associated with favorable destination (adjusted OR, 0.34 [95% CI, 0.13–0.87]).

Conclusions

TCD after successful endovascular therapy identified abnormal blood flow in one‐third of cases. Dampened flow and markers of increased microvascular resistance were associated with unfavorable hospitalization outcomes. TCD could provide valuable prognostic information in this population and identify potential therapeutic targets.
Spontaneous Resolution of 2 High Flow Cervical Vertebral Arteriovenous Fistulas
Authors: Zeineddine Hussein A. , Dawes Bryden H. , Mullarkey Matthew P. , Martinez‐Gutierrez Juan Carlos , Chen Peng Roc
Published: May 2023

Cervical vertebral arteriovenous fistula is a rare entity that is typically managed with endovascular techniques. We describe 2 consecutive cases of spontaneous obliteration of high flow cervical vertebral arteriovenous fistulas following angiography. Our cases pose an interesting natural history course, and we review the role of angiography in the unusual phenomenon of spontaneous obliteration of vascular malformations. These 2 cases bring forward the possibility of conservative management in such lesions.
The diagnostic utility of IgG index and oligoclonal bands for multiple sclerosis in a neurology hospital patient population
Authors: Shaw Francesca , Chadwick Carrie
Published: May 2023

Background

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system. Diagnosis is based on the 2017 revised McDonald criteria. Unmatched oligoclonal bands (OCB) within the CSF (i.e. positive OCB) can substitute for dissemination in time by magnetic resonance imaging (MRI). Simonsen et al. (2020) claimed a raised (>0.7) immunoglobulin G (IgG) index could replace OCB status. This study aimed to establish the diagnostic utility of IgG index for MS in the population served by The Walton Centre NHS Foundation Trust (WCFT) a neurology and neurosurgery hospital, and to derive a population-based IgG index reference interval.

Methods

OCB results from the laboratory information system (LIS) were collated from November 2018 to 2021. Final diagnosis and medication history was obtained from the electronic patient record. Exclusions were made based on age (<18 years) at the time of lumbar puncture (LP) disease-modifying treatment prior to LP, unknown IgG index and unclear OCB patterns.

Results

935 of 1101 results remained following exclusions. 226 (24.2%) had a diagnosis of MS, 212 (93.8%) were OCB positive and 165 (73.0%) had a raised IgG index. The diagnostic specificity of a raised IgG index was calculated at 90.3% compared to 86.9% for positive OCB. 386 results with negative OCB were used to establish the IgG index reference interval (0.36–0.68) at 95th percentiles.

Conclusion

This study provides evidence that IgG index should not replace OCB in the diagnosis of MS. >0.7 is an appropriate cut-off to define a raised IgG index for the patient population.
Girls under surveillance: Engaging Zimbabwean parents on young people’s sexual health
Authors: Bhana Deevia , Matswetu Vimbai
Published: May 2023

Background:

Parents play an important role in shaping young people’s sexual lives and behaviours with implications for their current and future sexual and reproductive health. This study examined the perspectives of rural Zimbabwean parents on young people’s sexual health.

Design:

Semi-structured individual interviews were conducted with 19 (6 men and 13 women) participants.

Setting:

Interviews were conducted in a rural district in Zimbabwe.

Method:

Semi-structured interviews were conducted with Community Field Officers who were the parents or caregivers of teenage learners in two rural secondary schools. Transcripts were coded and thematic analysis conducted by reading, re-reading, interpretation and reflection on the coded texts.

Results:

Parents approached the question of young people’s sexual health by placing young women’s sexuality under surveillance and regulation. Puberty and female bodily changes triggered concern about heterosexual relationships informed by protectionist and moralising discourses. Abstinence and self-control were promoted as expectations for female sexuality based on cultural norms concerning purity and female virginity. Female sexual purity provided a claim to status, was differentiated from other forms of femininity and was an important cultural and economic resource. In a context of economic precarity, the institutions of marriage and bride wealth, whereby female virginity status is valued, provide opportunities for future economic security and reinforce cultural norms concerning respectability.

Conclusion:

Working with parents to address the ways in which gender and cultural norms operate within the local social and economic context is vital to understand the enduring processes by which young female sexuality is placed under surveillance while reinforcing gender inequalities.
Percutaneous versus surgical approach to aortic valve replacement with coronary revascularization: A systematic review andmeta‐analysis
Authors: Guo Yujian , Zhang Wei , Wu Haibo
Published: May 2023

Objective

The optimal treatment of patients with severe aortic stenosis (AS) and complex coronary artery disease (CAD) remains controversial. We conducted a meta-analysis to investigate outcomes of transcatheter aortic valve replacement (TAVR) with percutaneous coronary intervention (PCI) versus surgical aortic valve replacement (SAVR) with coronary artery bypass grafting (CABG).

Methods

We searched PubMed, Embase, and Cochrane databases from its inception up to 17 December 2022 for studies that assessed TAVR + PCI versus SAVR + CABG in patients with AS and CAD. The primary outcome was perioperative mortality.

Results

Six observational studies including 135,003 patients assessing TAVI + PCI ( n = 6988) versus SAVR + CABG ( n = 128,015) were included. Compared to SAVR + CABG, TAVR + PCI was not significantly associated with perioperative mortality (RR, 0.76; 95% CI, 0.48–1.21; p = 0.25), vascular complications (RR, 1.85; 95% CI, 0.72–4.71; p = 0.20), acute kidney injury (RR, 0.99; 95% CI, 0.73–1.33; p = 0.95), myocardial infraction (RR, 0.73; 95% CI, 0.30–1.77; p = 0.49), or stroke (RR, 0.87; 95% CI, 0.74–1.02; p = 0.09). TAVR + PCI significantly reduced the incidence of major bleeding (RR, 0.29; 95% CI, 0.24–0.36; p < 0.01) and length of hospital stay (MD, −1.60; 95% CI, −2.45 to −0.76; p < 0.01), but increased the incidence of pacemaker implantation (RR, 2.03; 95% CI, 1.88–2.19; p < 0.01). At follow-up, TAVR + PCI was significantly associated with coronary reintervention (RR, 3.17; 95% CI, 1.03–9.71; p = 0.04) and a reduced rate of long-term survival (RR, 0.86; 95% CI, 0.79–0.94; p < 0.01)

Conclusions

In patients with AS and CAD, TAVR + PCI did not increase perioperative mortality, but increased the rates of coronary reintervention and long-term mortality.
Three Generations of Free Colored Women in St. Croix. 1750–1850
Authors: Sundsback Kariin Catharina
Published: May 2023

This paper explores the lives and agency of three generations free colored women on St. Croix, an island in the Danish-Norwegian West-Indies from the period 1760–1850. Different social strategies these women adopted in finding and defining their identities in a racially prejudiced society and how their social networks and family bonds affected their choices and lives have been studied. By applying a combination of prosopography and microhistory, new insights, and perspectives of free colored women's agency is gained. This paper suggests that free women of color were resourceful and independent and consciously employed complex social practices to climb the social ladder.
Atypical Shoulder Instability Patterns in Adolescents Following Traumatic Anterior Shoulder Dislocation
Authors: Cannamela Peter , Cutler Holt , Sohn Garrett , Wyatt Charles , Wilson Philip L. , Ellis Henry B.
Published: May 2023

Background:

Traumatic anterior shoulder instability is common in the adolescent athlete, and when it is untreated, the recurrence rate is high. Atypical lesions—such as anterior glenoid periosteal sleeve, humeral glenohumeral ligament, and insertional tendon avulsions—may occur within this population, and accurate diagnosis and appropriate lesion management are key to treatment success.

Purpose:

To evaluate the age, skeletal immaturity, bone loss, and uncommon soft tissue lesions as correlates of posttraumatic anterior shoulder instability lesion patterns in an adolescent population.

Study Design:

Cross-sectional study, Level of evidence, 3.

Methods:

Consecutive patients ≤18 years of age (160 shoulders) treated within a single institution for traumatic anterior shoulder instability between June 2013 and June 2021 were reviewed. Demographics, injury mechanism, radiographic and magnetic resonance imaging of lesions, the presence of any bone loss, operative findings, and physeal status were recorded. An overall 131 shoulders met the inclusion criteria. Instability lesion type was analyzed categorically by age <15 or ≥15 years; individual age was assessed for correlation with any bone loss present. Atypical lesions—anterior labral periosteal sleeve avulsion, humeral avulsion of the glenohumeral ligament, subscapularis avulsion—were assessed for correlations with age, open physeal status, and the presence of any bone loss.

Results:

An overall 131 shoulders (mean, 15.3 years; range, 10.5-18.3) were identified for this study: 55 in patients <15 years old and 76 in patients ≥15 years old. Bony injuries such as Bankart and Hill-Sachs lesions were more common in the ≥15-year-old group ( P = .044 and P = .024, respectively). Bony Bankart injuries were found at a rate of 18.2% in the <15-year-old group, as compared with 34.2% in the ≥15-year-old group ( P < .05). Anterior labral periosteal sleeve avulsions were more common in the <15-year-old group (n = 13 [23.6%] vs n = 8 [10.5%]; P < .044), as were all atypical lesions combined (n = 23 [41.8%] vs n = 13 [17.1%]; P < .0018].

Conclusion:

In this series of anterior shoulder instability in children and adolescents, instability lesions varied significantly by age. Bone loss was associated with older age at presentation, and atypical lesions were more common in patients <15 years of age. Treatment teams should be aware of less common soft tissue injuries in this young age group and ensure careful review of adequate imaging for proper diagnosis and treatment in these younger patients.
Abolishing labour in the 21st century
Authors: Netzer Amos
Published: May 2023

The concept of abolition of labour ( Aufhebung der Arbeit) appeared in some of Marx’s posthumously published works. Few of his notable successors highlighted this concept as key to opposing the Fordist stage of capitalism. Marcuse viewed this stage as a new peak in the repression of imagination and free instincts, bound to ‘the performance principle’. However, the rise of neo-liberalism presents unforeseen challenges to the criticism of labour. While the Keynesian welfare state is collapsing, its universal services are commodified and inequality rates are skyrocketing – some factors of the abolition of labour are surprisingly uplifted. This article will examine the evolution of some factors of abolition of labour that thrive with the spread of neo-liberalism and the erosion of other vital factors; we will elucidate the diminishing role of Marcuse’s performance principle, unravel the reality principle replacing it and discuss the relevance of the concept ‘abolition of labour’ today.
Early Identification of Cognitive Impairment: Utility of the Mini-Cog in Non-Clinical Settings
Authors: Brown Maria Teresa , Brangman Sharon A. , Smith Nancy H.
Published: May 2023

While we currently cannot cure Alzheimer’s disease or change the course of the disease, there are advantages to early detection. Routine, evidence based, brief cognitive screens offer destigmatized opportunities for diagnosis and improve the possibility of early identification of cognitive impairment. This community-based participatory research project evaluated the use of the Mini-Cog™ instrument to detect cognitive impairment in vulnerable community-dwelling older adults when administered by trained social services providers. Over 9 months, a case manager screened 69 clients ages 65 to 94 (mean 74.67) who met inclusion criteria for the pilot; 84.1% were female, 53.6% were Black, 26% were living with undetected cognitive impairment. Although participants agreed to Mini-Cog™ screening, two-thirds with Mini-Cog™ scores indicating cognitive impairment refused referrals for further evaluation. Future interventions should reduce stigma by educating the public about dementia and engaging members of racial and cultural communities in outreach.
Stratified Reproduction, Hysterectomy, and the Social Process of Opting into Infertility
Authors: Becker Andréa
Published: May 2023

Shifting cultural norms transform the uses and meanings of medical practices, and, in turn, medical practices have the capacity to alter social relations. In this article, I use hysterectomy as a case for understanding how reproductive health practices are constrained by and contribute to notions of gender, race, and stratified reproduction. Hysterectomy is regularly performed yet understudied and has been transformed by both technological advances and shifting norms in gender and reproduction. I draw on 100 in-depth interviews with individuals who had, want, or are considering hysterectomy to treat chronic reproductive health conditions or as gender-affirming care for trans and gender-nonbinary (TGNB) individuals. These comparative groups shed insight across three gender groups (cis women, trans men, nonbinary) as well as across race. Findings show divergent patient–provider interactions ranging from physician support to provider coercion to gatekeeping. Similarly, the data reveal that hysterectomy evokes a wide range of reactions—from delight to neutrality to grief. These distinct reactions and interactions map on to gender, race, and ethnicity, revealing persistent reproductive stratification by social positionality. Bringing together feminist science and technology studies with intersectional theories of the body and reproductive justice, I show how stratified reproduction operates when gender identities vary and introduce the concept of opting into infertility.
Workplace Happiness Levels in Business Process Outsourcing Organizations
Authors: Roy Rituparna , Konwar Juthika
Published: May 2023

The notion of happiness is in the limelight since the word ‘happiness’ is placed on the global development agenda. Happiness has dragged the attention of many researchers in various fields but when we talk about organizations only a few researchers are shedding the light on the concept of Workplace Happiness (WPH). Business Process Outsourcing (BPO) is one of the flourishing sectors of India. The literature reported that BPO employees are facing psychological and physical problems due to prolonged working hours and odd shift timings. And this is a matter of concern for every Business Process Outsourcing Organizations (BPOs). Here, certain questions are developed like; what parameters are being used to measure the WPH in BPOs, and how WPH can be measured. Therefore, this article is designed to explore WPH in the context of BPOs of Eastern India.
Exploring Primary Healthcare Experiences and Interest in Mobile Technology Engagement Amongst an Urban Population Experiencing Barriers to Care
Authors: Pakhomova Tatiana E. , Nicholson Valerie , Fischer Matthew , Ferguson Joanna , Moore David M. , Salters Kate , Lester Richard T. , Kremer Hayden , Dawydiuk Nicole , Barrios Rolando , Parashar Surita
Published: May 2023

Mobile phone–based engagement approaches provide potential platforms for improving access to primary healthcare (PHC) services for underserved populations. We held two focus groups (February 2020) with residents ( n = 25) from a low-income urban neighbourhood (downtown Vancouver, Canada), to assess recent healthcare experiences and elicit interest in mobile phone–based healthcare engagement for underserved residents. Note-based analysis, guided by interpretative description, was used to explore emerging themes. Engagement in PHC was complicated by multiple, intersecting personal-level and socio-structural factors, and experiences of stigma and discrimination from care providers. Perceived inadequacy of PHC services and pervasive discrimination reported by participants indicate a significant and ongoing need to improve client–provider relationships to address unmet health needs. Mobile phone–based engagement was endorsed, highlighting phone ownership and client–provider text-messaging, facilitated by non-clinical staff such as peers, as helpful to strengthening retention and facilitating care team connection. Concerns raised included reliability, cost, and technology and language accessibility.
An Enhanced Audiologic Protocol for Early Identification of Conductive Hearing Loss in Patients with Cleft Palate
Authors: Ellis Elizabeth West , Smetak Miriam R. , Alving-Trinh Alexandra , Golinko Michael , Phillips James D. , Belcher Ryan H.
Published: May 2023

Objective

To characterize the onset and prevalence of conductive hearing loss (CHL) in pediatric patients with cleft palate (CP) prior to palatoplasty with an enhanced audiologic protocol.

Design

Retrospective cohort study

Setting

Multidisciplinary cleft and craniofacial clinic at a tertiary care center.

Patients

Patients with CP who received audiologic workup pre-operatively. Patients with bilateral permanent hearing loss, expiration prior to palatoplasty, or no pre-operative data were excluded.

Interventions

Patients with CP born February 2019 to November 2019 who passed newborn hearing screening (NBHS) received audiologic testing at 9 months of age (standard protocol). Patients born December 2019 to September 2020 underwent testing prior to 9 months of age (enhanced protocol).

Main Outcome Measures:

Age of identification of CHL in patients after implementation of the enhanced audiologic protocol.

Results

The number of patients who passed their NBHS in the standard protocol (n = 14, 54%) and the enhanced protocol (n = 25, 66%) did not differ. Infants who passed their NBHS, but demonstrated hearing loss on subsequent audiologic testing did not differ between enhanced (n = 25, 66%) and standard cohort (n = 14, 54%). Of patients who passed NBHS in the enhanced protocol, 48% (n = 12) had CHL identified by 3 months, and 20% (n = 5) by 6 months of age. With the enhanced protocol, patients who did not undergo additional testing post NBHS significantly dropped from 44.9% (n = 22) to 4.2% (n = 2) ( P < .0001).

Conclusion

Even with passed NBHS, CHL is still present for infants with CP pre-operatively. Earlier and more frequent testing for this population is recommended.
Multiple Identities in High Reliability Organizations: A Case Study
Authors: Vaz Samir L. , Maia Gabriela X. , Nelson Reed E. , Henriqson Éder
Published: May 2023

It is generally accepted that consensus about the features of the “high reliability” identity allow organizations performing hazardous activities to act in an error-free manner. This work challenges this assumption, providing evidence of multiple identities in a High Reliability Organization. We conducted an inductive case study in a large oil and gas producer, whose top executives emphasized safety as a central and distinctive feature of the company. Our analysis was based on extensive data: presentations, interviews, observation, and conversations. The results permit us to describe two organizational identities of safety on offshore oil platforms: “controlling” and “caring.” We found that managers and workers interpreted safety both as imposing “strict sanctions” and possessing “meaningful value.” They expressed the organizational identity through varying forms of antinomies: authoritative versus respectful interactions and resisting versus adapting actions. These dynamics of identity help us better understand the organizational process of “becoming” highly reliable.
Effectiveness of Proximal Landing Zone 1 and 2 Thoracic Endovascular Aortic Repair for Type B Aortic Dissection by Comparing Outcomes With Thoracic Arch Aneurysm
Authors: Kudo Tomoaki , Kuratani Toru , Sawa Yoshiki , Miyagawa Shigeru
Published: May 2023

Purpose:

Hybrid thoracic endovascular aortic repair (TEVAR) for aortic arch aneurysms is a minimally invasive procedure with improved results. This study aimed to clarify the effectiveness and expand the possibilities of zone 1 and 2 landing TEVAR for type B aortic dissection (TBAD) using our treatment strategy.

Methods:

This retrospective, single-center, observational cohort study included 213 patients (TBAD, n=69; thoracic arch aneurysm [TAA], n=144; median age, 72 years; median follow-up period, 6 years) from May 2008 to February 2020. The following conditions were satisfied before performing zone 1 and 2 landing TEVAR: TBAD; proximal landing zone (LZ): diameter <37 mm, length >15 mm, and nondissection area, proximal stent-graft: size ≤40 mm and oversizing rate: 10% to 20%, and TAA; proximal LZ: diameter ≤42 mm and length >15 mm, proximal stent-graft: size ≤46 mm and oversizing rate: 10% to 20%. Of the 69 patients in the TBAD group, 34 (49.3%) had patent false lumen (PFL), and 35 (50.7%) had false lumen partial thrombosis (FLPT), including ulcer-like projections. Emergency procedures were performed in 33 (15.5%) patients.

Results:

There were no significant differences in the in-hospital mortality (TBAD: 1.5% vs TAA: 0.7%, p=0.544) or the in-hospital aortic complications (TBAD: n=1 vs TAA: n=5, p=0.666). Retrograde type A dissection was not observed in the TBAD group. The aortic event-free rates at 10 years were 89.7% (95% confidence interval [CI]: 78.7%–95.3%) and 87.9% (95% CI: 80.3%–92.8%) in the TBAD and TAA groups, respectively (log-rank p=0.636). In the TBAD group, the early and late outcomes were not significantly different between the PFL and FLPT groups.

Conclusion:

Satisfactory early and long-term results were obtained with zone 1 and 2 landing TEVAR. The TBAD cases had the same good results as the TAA cases. Using our strategy, we especially might reduce complications and be an effective treatment for acute complicated TBAD.

Clinical Impact

This study aimed to clarify the effectiveness and expand the possibilities of zones 1 and 2 landing TEVAR for type B aortic dissection (TBAD) using our treatment strategy. Satisfactory early and long-term results in the TBAD and thoracic arch aneurysm (TAA) groups were obtained with zones 1 and 2 landing TEVAR. The TBAD cases had the same good results as the TAA cases. Using our strategy, we especially might reduce complications and be an effective treatment for acute complicated TBAD.
Single antiplatelet regimen in flow diverter treatment of cerebral aneurysms: The drug matters. A systematic review and meta-analysis
Authors: Ma Yihui , Madjidyar Jawid , Schubert Tilman , Thurner Patrick , Barnaure Isabelle , Kulcsar Zsolt
Published: May 2023

Background

Hemorrhagic and thromboembolic complications (TECs) are the main concerns in the endovascular treatment of intracranial aneurysms using flow diverter devices (FDs). The clinical demand for single antiplatelet therapy (SAPT) is increasing especially with the development of devices with lower thrombogenicity profile. However, the safety of SAPT is not well established.

Objective

To analyze the safety and efficacy of SAPT in terms of ischemic and hemorrhagic complications in patients undergoing FDs treatment for cerebral aneurysms.

Methods

A systematic literature search and meta-analysis were conducted in PubMed, Ovid MEDLINE, Ovid Embase, and Web of Science from January 2010 until October 2022. Twelve articles which reported SAPT and data on hemorrhagic, TECs, and mortality following FDs treatment were included.

Results

Overall, the 12 studies involved 237 patients with 295 aneurysms. Five investigated the safety and efficacy of SAPT in 202 unruptured aneurysms. Six studies focused on 57 ruptured aneurysms. One study included both ruptured and unruptured aneurysms. Among the 237 patients, prasugrel was most often used as SAPT in 168 cases (70.9%), followed by aspirin in 42 (17.7%) patients, and by ticagrelor in 27 (11.4%). Overall, the hemorrhagic complication rate was 0.1% (95% CI 0% to 1.8%). The TEC rate was 7.6% (95% CI 1.7% to 16.1%). In the subgroup analysis, the TEC rates of prasugrel monotherapy of 2.4% (95% CI 0% to 9.3%) and ticagrelor monotherapy of 4.2% (95% CI 0.1% to 21.1%) were lower than of aspirin monotherapy 20.2% (95% CI 5.9% to 38.6%). The overall mortality rate was 1.3% (95% CI 0% to 6.1%).

Conclusion

According to the available data, SAPT regimen in patients undergoing FDs treatment for cerebral aneurysms has an acceptable safety profile, especially with the use of ADP-receptor antagonists.
Clarifying rupture: An authors’ reply
Authors: Mahanty Sango , Milne Sarah , Barney Keith , Dressler Wolfram , Hirsch Philip , To Phuc Xuan
Published: May 2023

In our article, ‘Rupture: Towards a Critical, Emplaced, and Experiential View of Nature-Society Crisis’, we advocated for contextually rich and critical understandings of environmental crises and their catalytic effects. This authors’ reply responds to four commentaries whose authors raise helpful questions and insights. We first review the spatial and temporal connections between specific rupture episodes and ongoing processes of extraction and exploitation. We then discuss how the impacts of rupture disproportionately fall to those with the smallest contribution to the crisis. Third, we clarify how our contextually rich view of rupture differs from planetary analytics such as the Anthropocene. In terms of rupture's effects, we agree with comments that rupture does not simply represent a politics of hope but can strengthen authoritarian interests. Finally, we clarify what it means to ‘put rupture to work’.
Practitioner-Implemented Video Prompting on Vocational Skills of Students With Significant Intellectual and Developmental Disabilities
Authors: Sun Xiaoning , Brock Matthew E.
Published: May 2023

Video prompting (VP) is an evidence-based practice, but few studies have included teachers and paraeducators as implementers. We adopted one of the single-case designs (multiple probe design) to evaluate the effectiveness of teacher and paraeducator-implemented VP on vocational skills for four high school students with significant intellectual and developmental disabilities. Experimental effects were demonstrated for all four students, but only two students met the mastery criterion. Individualized adaptations (i.e., priming, more frequent reinforcement) enabled two students to make further progress. The two students who met the mastery criterion maintained their performance after 2 weeks. These findings add to growing evidence that teachers and practitioners can effectively implement VP and suggest that individualized adaptations may be needed for some students with significant disabilities.