bluuebunny/crossref_metadata_2025 huggingface dataset:
Practical correlation for thermal resistance of 45° sloped-enclosed airspaces with upward heat flow for building applications
Authors: Saber Hamed H
Published: April 2021

Assessing the energy performance of building components with enclosed airspaces requires accurate determination of the thermal resistance ( R-value) of the airspaces. The R-value of enclosed airspace depends on its size and orientation, direction of heat transfer through the airspace, and temperatures and emissivities of all surfaces that define the airspace. In previous studies, practical correlations were developed to determine the R-values for vertical enclosed airspaces, horizontal enclosed airspaces with upward heat flow and downward heat flow, and 30° and 45° sloped-enclosed airspaces with downward heat flow. However, to the authors’ best knowledge, there is no such practical correlations available to determine the R-values for wide ranges of dimensions and operating conditions for 30° and 45° sloped-enclosed airspaces with upward heat flow. This paper focused on the thermal performance of 45° sloped-enclosed airspaces with upward heat flow, and the predicted R-values were compared with the R-values provided in ASHRAE Handbook of Fundamentals at different conditions. The dependence of the R-value on the aspect ratio of the enclosed airspaces was also investigated. As well, considerations were given to quantify the potential increase in the R-value of enclosed airspace when a thin sheet having different values of emissivity on both sides was placed in the middle of the airspace. The results showed that depending on the value of the effective emittance and the thickness of the airspace, the R-value could be tripled by incorporating thin a sheet in the middle of the enclosed airspace. Finally, practical correlation were developed to determine the effective R-values of 45° sloped-enclosed airspaces with upward heat flow for wide ranges of aspect ratio, temperature difference across the airspace, mean temperature, and effective emittance. The results showed that the calculated R-values using this correlation were in good agreement with the predicted R-values.
Sexual dimorphic role of the glucocorticoid receptor in chronic muscle pain produced by early-life stress
Authors: Green Paul G , Alvarez Pedro , Levine Jon D
Published: April 2021

Fibromyalgia and other chronic musculoskeletal pain syndromes are associated with stressful early life events, which can produce a persistent dysregulation in the hypothalamic-pituitary adrenal (HPA) stress axis function, associated with elevated plasm levels of corticosterone in adults. To determine the contribution of the HPA axis to persistent muscle hyperalgesia in adult rats that had experienced neonatal limited bedding (NLB), a form of early-life stress, we evaluated the role of glucocorticoid receptors on muscle nociceptors in adult NLB rats. In adult male and female NLB rats, mechanical nociceptive threshold in skeletal muscle was significantly lower than in adult control (neonatal standard bedding) rats. Furthermore, adult males and females that received exogenous corticosterone (via dams’ milk) during postnatal days 2–9, displayed a similar lowered mechanical nociceptive threshold. To test the hypothesis that persistent glucocorticoid receptor signaling in the adult contributes to muscle hyperalgesia in NLB rats, nociceptor expression of glucocorticoid receptor (GR) was attenuated by spinal intrathecal administration of an oligodeoxynucleotide (ODN) antisense to GR mRNA. In adult NLB rats, GR antisense markedly attenuated muscle hyperalgesia in males, but not in females. These findings indicate that increased corticosterone levels during a critical developmental period (postnatal days 2–9) produced by NLB stress induces chronic mechanical hyperalgesia in male and female rats that persists in adulthood, and that this chronic muscle hyperalgesia is mediated, at least in part, by persistent stimulation of glucocorticoid receptors on sensory neurons, in the adult male, but not female rat.
Household chaos, maternal stress, and maternal health behaviors in the United States during the COVID-19 outbreak
Authors: Kracht Chelsea L , Katzmarzyk Peter T , Staiano Amanda E
Published: April 2021

Objectives:

Household chaos, including disorder, noise, and crowding within the home, is a risk factor for poor mental and physical health. Household chaos may act upon maternal behaviors of physical activity and sleep, potentially via higher stress. The purpose of this study is to evaluate the relationships among household chaos, maternal stress, and maternal physical activity and sleep, and identify barriers to home organization during the COVID-19 outbreak.

Methods:

A cross-sectional study using an online survey of 1721 mothers of preschoolers (ages = 3.0–5.9 years) in the United States was conducted in May 2020 during COVID-19 stay-at-home orders and early reopening. Mothers reported demographic characteristics, household chaos, stress, physical activity and sleep, and barriers to home organization during the outbreak. Mediation models were conducted among household chaos, stress, and physical activity and sleep with adjustment for covariates.

Results:

About half of mothers were middle income (48.2%), employed full-time prior to the outbreak (59.1%), and met the physical activity (47.7%), and sleep guideline (49.7%, 7–9 h/day). Household chaos and stress were both negatively related to physical activity and sleep. For every 1 unit increase in mother’s current stress, mothers were 11% (95% confidence interval = 6% to 16%) less likely to meet the physical activity guideline and 19% (95% confidence interval = 14% to 23%) less likely to meet the sleep guideline. Household chaos was positively related to stress. Stress partially mediated the relationship between household chaos and physical activity and sleep. Virus concerns, occupational changes (i.e. teleworking), and lack of childcare were barriers to home organization.

Conclusion:

During the COVID-19 outbreak, many mothers had poor sleep and physical activity, which was associated with household chaos and stress. Opportunities to promote order at the individual, household, and community level may result in beneficial mental and physical health in mothers of young children during the COVID-19 outbreak and beyond.
Suture osteosynthesis in the bony reconstruction of thumb duplication
Authors: Chew Ee Ming , Wong Kenneth Pak Leung , Chan Christopher Mao Sheng , Teoh Lam Chuan
Published: April 2021

Metacarpal osteotomies are done to correct deviation deformity in thumb duplication. We describe a suture-only technique of metacarpal osteosynthesis, without using K-wires. Thirteen Flatt Type IV thumbs and five Wassel Type VII thumbs were reconstructed with this technique. The median follow-up was 23 months. After osteotomy, the metacarpal bone fragments were sutured together with 5-0 polyglactin or 4-0 polydioxanone sutures. Metacarpal fragment displacement was not observed on postoperative radiographs obtained at 1 and 2 weeks. Bony union was achieved at 6 weeks without loss of alignment. The metacarpophalangeal joint alignment was anatomical (≤5° deviation) in eight cases. The mean pre- and postoperative metacarpophalangeal joint alignments were 27° and 9°, respectively. The 11 patients who were available for grading with the Japanese Society for Surgery of the Hand Score were assessed as good. Complete internalization of the bony fixation eliminates infections associated with exposed K-wires without compromising the overall outcome.

Level of evidence: IV
Effect of COVID-19 pandemic on the workflow of endoscopy units: an international survey
Authors: Resál Tamás , Bor Renáta , Szántó Kata , Fábián Anna , Rutka Mariann , Sacco Marco , Ribaldone Davide Guiseppe , Molander Pauliina , Nancey Stephane , Kopylov Uri , Vavricka Stephan , Drobne David , Lukas Milan , Farkas Klaudia , Szepes Zoltán , Molnár Tamás
Published: April 2021

Introduction:

The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to healthcare. Staff and patients are at increased risk during an examination or intervention, so certain restrictions ought to be introduced. Hence, we aimed to measure the effect of the pandemic on endoscopy units in real-life settings.

Methods:

This was an observational, cross-sectional, questionnaire-based study, carried out between 7 April and 15 June 2020. Responds came from many countries, and the participation was voluntary. The survey contained 40 questions, which evaluated the effect of the COVID-19 pandemic on the endoscopy units and assessed the infection control.

Results:

A total of 312 questionnaires were filled, 120 from Hungary, and 192 internationally, and 54 questionnaires (17.3%) were sent from high-risk countries; 84.9% of the gastroenterologists declared that they read the European Society of Gastrointestinal Endoscopy (ESGE) statement, while only 32.1% participated in any advanced training at their workplace. Overall, 92.1% of gastroenterologists realized risk stratification, and 72.1% claimed to have enough protective equipment. In 52.6% of the endoscopy units, at least one endoscopist had to discontinue the work due to any risk factor, while 40.6% reported that the reduced staff did not affect the workflow. Gastroenterologists considered that the five most important examinations both in low and high-risk patients are the following: lower/upper gastrointestinal (GI) bleeding with hemodynamic instability, endoscopic retrograde cholangiopancreatography (ERCP) in obstructive jaundice, foreign body in the esophagus, ERCP in acute biliary pancreatitis, and iron deficiency anemia with hemodynamic instability, which correlates well with the ESGE recommendation. Significant correlation was found in the usage of the necessary protective equipment in high-risk patients depending on the countries ( p < 0.001).

Conclusions:

The survey found weak correlation in preliminary training depending on countries; nevertheless, in Hungary during the examined period, endoscopists considered the recommendations more strictly than in other countries. Although many physicians left the endoscopy lab, the workflow was not affected, probably due to the reduced number of examinations.
Open reduction of pediatric lateral condyle fractures: a systematic review
Authors: Eckhoff Michael D , Tadlock Josh C , Nicholson Tyler C , Wells Matthew E , Garcia EStephan J , Hennessey Theresa A
Published: April 2021

Introduction

Lateral condyle fractures are the second most common pediatric elbow fracture. There exist multiple options for internal fixation including buried K-wires, unburied K-wires, and screw fixation. Our study aims to review the current literature and determine if fixation strategy affects outcomes to include fracture union, postoperative range of motion, and need subsequent surgery.

Methods

A systematic review of Pubmed, MEDLINE, and EMBASE databases was performed. Included articles involve pediatric patients with displaced lateral condyle fractures treated with internal fixation that reported outcomes to include union rates and complications.

Results

Thirteen studies met inclusion criteria for a total of 1299 patients (472 buried K-wires, 717 unburied K-wires, and 110 screws). The patients’ average age was 5.8 ± 0.6 years, male (64%), and had 16.3 months of follow-up. No differences in union and infection rates were found. Unburied K-wires had the shortest time to union and the greatest elbow range of motion postoperatively.

Conclusions

Our systematic review demonstrates similar outcomes with union and infection rates between all fixation techniques. Unburied K-wires demonstrated a shorter time to union and the greatest postoperative range of motion. Additionally, unburied K-wires may be removed in clinic, decreasing the cost on the healthcare system.

Evidence

Level 3.
Using Institutional Ethnography to Bridge the Gap and Develop eHealth Communications for Patient Transitions in British Columbia
Authors: Atwood Kristin
Published: April 2021

Communication during patient transitions is difficult in a fragmented health care system. eHealth technologies are often seen as a panacea, but a large proportion of eHealth projects fail, primarily because of human, not technological, elements. To combat this tendency, concepts derived from institutional ethnography were applied to create an electronic communications solution, which enabled careful mapping of communications gaps; their consequences; and the diverse needs of multiple health care providers. Institutional ethnography allowed researchers to trace social relations across locations in the health system and determine how action could be coordinated to ensure that family physicians were informed of patients’ acute care encounters, while simultaneously strengthening relations between clinicians and information technology workers. As a result, an automated electronic notification system was piloted, evaluated, and spread to more than 92 percent of community physicians in one region of British Columbia, Canada, improving communication between providers and enhancing patient care.
The Relationships between Coronal Plane Alignments and Patient-Reported Outcomes Following High Tibial Osteotomy: A Systematic Review
Authors: Tawy Gwenllian , Shahbaz Hamza , McNicholas Michael , Biant Leela
Published: April 2021

Objective

This systematic review aimed to determine whether coronal angular corrections correlate with patient reported outcomes following valgus-producing high tibial osteotomy (HTO).

Design

Ovid MEDLINE, Embase, and Web of Science were systematically searched. Studies that reported hip-knee-ankle angles (HKA) or femorotibial angles (FTA), and the Oxford Knee Score (OKS), visual analogue scale (VAS) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), or EQ-5D before and after valgus-producing HTO were eligible. Correlation analyses were performed where appropriate to investigate the relationships between variables. PROSPERO ID: CRD42019135467.

Results

This study included 39 articles including 50 cohorts. VAS was reported in 22 studies, OKS in 9, KOOS in 12 and EQ-5D in 2. The HKA angle was corrected from 7.1° ± 1.7° varus to 2.3° ± 1.7° valgus at final follow-up. The FTA changed from 3.0° ± 2.0° varus to 7.7° ± 1.3° valgus. Outcome scores improved with clinical and statistical significance postoperatively. Spearman correlations for nonparametric data revealed greater changes in knee alignment were moderately associated with larger improvements in VAS scores ( r = 0.50). Furthermore, those who experienced greater changes in alignment showed larger improvements in the KOOS Activity and Quality of Life domains ( r = 0.72 and r = 0.51, respectively).

Conclusion

On average, patients did not achieve the “ideal correction” of 3° to 6° valgus postoperatively. Nevertheless, statistical and clinical improvements in patient-reported outcome measure scores were consistently reported. This suggests that the “ideal correction” may be more flexible than 3° to 6°.
“We’re not treated equally as Indigenous people or as women”: The perspectives and experiences of Indigenous women in Australian public relations
Authors: Clark Treena , Dodson Shannan , Guivarra Nancia , Widders Hunt Yatu
Published: April 2021

This paper argues that the public relations sphere needs to have better understanding and more representation and acknowledgment of Indigenous women’s contemporary experiences and contributions. Indigenous Australian women experience multiple oppressions, such as Eurocentric and patriarchal control and, within the broader areas of Indigenous, women’s, and feminist public relations scholarship, their voices are largely absent. To address these issues, this paper, based on Indigenous women’s standpoint theory and an Indigenous yarning method, presents the narratives of five Aboriginal and Torres Strait Islander women employed in public relations. These narratives reflect experiences of marginalization by the Australian mainstream culture of whiteness and patriarchy; they also suggest the incidence of work induced mental distress for the women participants. This study of female Indigeneity within public relations aims to promote understanding of intersectional identities, the long-term effects of whiteness and racism, and may suggest how public relations can play a role in decolonizing efforts.
Evaluation and management of elbow injuries in the adolescent overhead athlete
Authors: Looney Austin M , Rigor Paolo D , Bodendorfer Blake M
Published: April 2021

With an increased interest in youth sports, the burden of overhead throwing elbow injuries accompanying early single-sport focus has steadily risen. During the overhead throwing motion, valgus torque can reach and surpass Newton meters (N m) during the late cocking and early acceleration phases, which exceeds the tensile strength (22.7–33 N m) of the ulnar collateral ligament. While the ulnar collateral ligament serves as the primary valgus stabilizer between and degrees of elbow flexion, other structures about the elbow must contribute to stability during throwing. Depending on an athlete’s stage of skeletal maturity, certain patterns of injury are observed with mechanical failures resulting from increased medial laxity, lateral-sided compression, and posterior extension shearing forces. Together, these injury patterns represent a wide range of conditions that arise from valgus extension overload. The purpose of this article is to review common pathologies observed in the adolescent overhead throwing athlete in the context of functional anatomy, osseous development, and throwing mechanics. Operative and non-operative management and their associated outcomes will be discussed for these injuries.
The development of a digital intervention to increase influenza vaccination amongst pregnant women
Authors: Parsons Joanne E , Newby Katie V , French David P , Bailey Elizabeth , Inglis Nadia
Published: April 2021

Objective

Pregnant women and unborn babies are at increased risk of complications from influenza, including pneumonia, yet in the UK, uptake of flu vaccination amongst this population remains <50%. Pregnant women hold beliefs about risks of flu and efficacy of vaccination that consistently predict them to decline vaccination. This study aimed to develop a theory and evidence-based intervention addressing these beliefs to promote flu vaccine uptake.

Methods

The intervention was developed by behavioural scientists, pregnant women, midwives, clinicians and Public Health professionals, informed by Intervention Mapping. Six predefined steps were performed in line with Intervention Mapping.

Results

The intervention is an animation addressing beliefs about risks of flu and efficacy of vaccination. Preliminary testing using qualitative methodology indicates the information within the animation is appropriate, and the animation is acceptable to pregnant women.

Conclusions

This is the first known intervention for pregnant women, aiming to increase flu vaccination through addressing risk and efficacy appraisals. It has been implemented within seasonal flu vaccination campaigns during 2018/19 and 2019/20 within one geographically and ethnically diverse area of the UK.
Creation of a specific and separated pediatric intra-hospital pathway in primary level hospitals during the era of COVID-19
Authors: Manfredi Marco , Ragni Pietro , Gargano Giancarlo
Published: April 2021

Every new pandemic forces us to start new specific behaviors both in the civil life and within the hospitals trying to contain the spreading of the infection and preserve the more fragile people. In this regard, at the debut of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic, our Local Health Agency had drastically modified every clinical and organizational pathways in order to limit the diffusion of the infection as well as to maintain a good quality of care and preserve healthcare workers. We report how we have modified the usual pediatric intra-hospital pathways in our primary level hospital to avoid mixing children with suspected and non-suspected symptoms of SARS-CoV-2 infection. Before every hospitalization, regardless of symptoms, each child and him/her parent/caregiver are undergone to rapid antigenic and molecular swab to rule out a SARS-CoV-2 infection; hence, positive patients are transferred to Pediatric Unit of third level hospital equipped by a Pediatric COVID Intensive Unit. We think the healthcare behaviors described in this manuscript can help to reduce the intra-hospital spreading of SARS-CoV-2, although children seem to have a minimal role in the dissemination, but we cannot let down your guard. Simultaneously we observed that the overall children requiring inpatient pediatric evaluation and hospitalization have dramatically decreased from the beginning of pandemic.
Chinese Faculty Members at Japanese Universities: Who Are They and Why Do They Work in Japan?
Authors: Huang (黄福涛) Futao , Chen (陈丽兰) Lilan
Published: April 2021

Purpose:

The purpose of this study is to identify the key aspects of the demographic characteristics and motivations of Chinese faculty at Japanese universities.

Design/Approach/Methods:

Main methods include an analysis of relevant data from a national survey of full-time international faculty in Japan in 2017 and results from semi-structured interviews with several full-time Chinese faculty hired in different Japanese universities.

Findings:

This study suggests that, compared to the average level of international faculty, there are larger numbers of female Chinese faculty, greater numbers of Chinese professors, Chinese doctoral degree holders, Chinese faculty in engineering, and larger numbers of them being engaged in research rather than teaching. Further, this study argues that the most important reasons for Chinese faculty to work in Japanese universities are academic or professional reasons, followed by their fondness for Japanese life and culture and their agreement with better living conditions in Japan than in China.

Originality/Value:

It is the first time that the key characteristics of full-time Chinese faculty at Japanese universities and their motivations to come to Japan are investigated and discussed based on both quantitative and qualitative methods.
Diagnosing and Treating Chronic Pain: Are We Doing This Right?
Authors: Carnago Lisa , O’Regan Amy , Hughes Jaime M.
Published: April 2021

The diagnosis, treatment, and management of chronic pain is complex, nuanced, and challenging in primary care settings. These challenges often give rise to internal provider conflicts around appropriate management strategies, perhaps avoiding diagnosis all together. Factors that contribute to internal provider conflict include knowledge, responsibility, and uncertainties surrounding chronic pain management. This piece acknowledges the complexity and competing priorities of chronic pain management from a provider perspective. We advocate for coordinated and committed care of patients with chronic pain and a sense of shared responsibility among providers to adequately address patient needs.
Can Social Media Predict Soccer Clubs’ Stock Prices? The Case of Turkish Teams and Twitter
Authors: Tanaltay Altuğ , Langroudi Amirreza Safari , Akhavan-Tabatabaei Raha , Kasap Nihat
Published: April 2021

Finance literature in sports focuses on three main methods of stock price prediction in soccer: based on match results, pre-match expectations, or match importance. For pre-match expectations, betting odds is commonly used as the indicator of investors’ sentiments. We propose to include Twitter data as another indicator of this variable, and analyze the links among soccer match results, sentiments, and stock returns of the four major Turkish soccer teams. Our results show that social media can be a strong indicator of pre-match expectations and investors’ sentiments in stock price prediction.
Early Childhood Education: Academic and Behavioral Benefits of Prekindergarten Educational Programming
Authors: Nold James , De Jong David , Moran James , Robinson Derrick , Aderhold Frederick
Published: April 2021

State-funded prekindergarten educational programming for all children is a rarity in the United States. Five states offer no financial support to fund prekindergarten educational programming, and the majority offer partial funding. Only three states provide universally funded prekindergarten educational programming. The purpose of this study is to examine some of the benefits of prekindergarten educational programming to identify reasons to expand the programs and subsequently enroll, at the very least, all economically eligible children. The study analyzed the results of attendance, behavior reports, and test scores to evaluate the academic and behavioral success of six cohorts of students in Grades K–5. All students studied qualified for educational programming support at the level of 100% poverty. The two studied groups are those students who attended the prekindergarten educational programming and those students who did not attend prekindergarten educational programming. The study revealed statistically significant results predominately with behavior and more specifically with office referrals. Students who attended prekindergarten educational programming received fewer office referrals at a statistically significant level compared with those students who did not attend the prekindergarten programming. Academically, the overall results of the data showed that those students who completed prekindergarten educational programming outscored their counterparts who did not attend prekindergarten but not at a statistically significant level. Studies showing the benefits of prekindergarten educational programming may motivate local and state officials to support funding to ensure that at a minimum, all students who qualify based on poverty will have the opportunity to attend prekindergarten educational programming.
Differences in Clinical Indicators of Diabetes, Hypertension, and Dyslipidemia Among Workers Who Worked Long Hours and Shift Work
Authors: Kang EunKyo
Published: April 2021

Background

Many studies have reported an association between overwork, shift work, and chronic disease. However, there is little research on the influence of working hours and shift work and management of chronic diseases. The objective of this retrospective study was to examine the association between working hours, shift work type in workers with hypertension, diabetes, and dyslipidemia.

Methods

Among 18,513 hourly wageworkers from the Korea National Health and Nutrition Examination Survey, 4,313 with hypertension, diabetes, and hyperlipidemia were selected. An analysis of covariance with general linear modeling was used to estimate group differences in clinical indices of chronic diseases according to weekly working hours and types of shift work, both unadjusted and adjusted for gender, age, education, marital status, household income, and medication usage.

Findings

Clinical indicators were worse in workers with diabetes (differences in HbA1c = 0.15%; fasting blood glucose = 4.84 mg/dL), hypertension (differences in diastolic blood pressure = 1.2 mmHg), or dyslipidemia (differences in total cholesterol = 3.3 mg/dL) who worked for more than 40 hours/week compared with workers who worked less than 40 hours per week. Clinical indicators in workers with diabetes and hypertension were worse in shift workers, including evening and night shifts, relative to those who did not work shiftwork.

Conclusions/Application to Practice

Working more than 40 hours per week and shift work were negatively associated with adverse clinical indicators among workers with chronic diseases. To improve the health of workers with chronic diseases, these findings suggest that adjustment of working hours and shift work may be warranted.
The Associations Between Internalized Racism, Racial Identity, and Psychological Distress
Authors: Willis Henry A. , Sosoo Effua E. , Bernard Donte L. , Neal Aaron , Neblett Enrique W.
Published: April 2021

Internalized racism, or the acceptance of negative stereotypes about one’s own racial group, is associated with psychological distress; yet, few studies have explored the longitudinal impact of internalized racism on the psychological well-being of African American emerging adults. Furthermore, racial identity’s role as a protective factor in the context of internalized racism remains unclear. This study examined the longitudinal impact of internalized racism on psychological distress (depressive and anxiety symptoms) and the moderating role of racial identity beliefs among 171 African American emerging adults. Full cross-lagged panel models revealed no main effects of internalized racism beliefs on psychological distress. However, several racial identity beliefs moderated the relationship between internalized racism beliefs and changes in psychological distress over a year later. Initial levels of alteration of physical appearance, internalization of negative stereotypes, and hair change internalized racism beliefs were related to subsequent psychological distress, but only for those with certain levels of racial centrality, private regard, public regard, and assimilationist, humanist, and nationalist ideology beliefs. These findings suggest that, over time, internalized racism and racial identity beliefs can combine to influence the psychological well-being of African American emerging adults.
Biomechanical Comparison of an All-Inside Meniscal Repair Device Construct Versus Pullout Sutures for Arthroscopic Transtibial Repair of Posterior Medial Meniscus Root Tears: A Matched-Pair Cadaveric Study
Authors: Vertullo Christopher J. , Cadman Joseph , Dabirrahmani Danè , Appleyard Richard
Published: April 2021

Background:

Meniscus root repairs are important for restoring knee function after a complete meniscus root tear. Various suturing patterns have been proposed for the root repair. The 2-simple-stitches (TSS) method is currently the preferred technique, as it is simplest to perform and allows the least displacement of the meniscus root.

Purpose:

To compare the biomechanical properties of a posterior medial meniscus transtibial root repair consisting of an all-inside meniscal repair device (AMRD) construct with the TSS pullout suture pattern.

Study Design:

Controlled laboratory study.

Methods:

Ten pairs of cadaveric medial menisci were prepared with 1 of the 2 constructs. The constructs were randomized between pairs. All constructs were subjected to preloading with 2 N for 10 seconds and then cyclic loading from 5 N to 20 N for 1000 cycles at a frequency of 0.5 Hz. Subsequently, the menisci were loaded to failure at a rate of 0.5 mm/s. All loads were applied in-line with the circumferential meniscal fibers near the posterior medial meniscal horn.

Results:

The mean yield load and stiffness were similar for both constructs. The elongation after cyclic loading was greater for the AMRD. The displacement at both yield load and ultimate failure were also higher for the AMRD. The ultimate failure load of the AMRD was also significantly higher. During load to failure, the mode of failure in the AMRD was heterogeneous. All the TSS constructs failed by suture cutout.

Conclusion:

Posterior medial meniscus root repairs using both the AMRD and TSS constructs have elongation under the biomechanically acceptable threshold of 3 mm. The stiffness and yield loads indicate similar mechanical properties of the constructs. However, the significantly higher elongation for the AMRD leaves the TSS method as the preferred option for transtibial repairs. Despite this, the AMRD construct may still represent a viable alternative to the TSS suture pattern, comparable to alternative suture patterns with similar limitations.

Clinical Relevance:

The AMRD construct may represent a viable alternative to the TSS suture pattern.
Differences in Passive Shoulder Range of Motion Between Baseball Players With Neurogenic Thoracic Outlet Syndrome and Matched Healthy Controls
Authors: Garrison J. Craig , Hannon Joseph P. , Conway John E.
Published: April 2021

Background:

Neurogenic thoracic outlet syndrome (nTOS) is becoming more recognized as a diagnosis in the throwing athlete. Currently, there is limited information on the clinical presentation and development of nTOS in baseball players.

Purpose:

To compare passive shoulder range of motion (ROM) and anatomic humeral retrotorsion (HRT) of baseball players diagnosed with nTOS with a group of healthy, matched controls.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 53 adolescent baseball players diagnosed with nTOS (age, 17.2 ± 2.3 years; height, 180.9 ± 10.1 cm; weight, 80.0 ± 13.3 kg) were compared with 53 healthy baseball players (age, 17.2 ± 2.4 years; height, 183.9 ± 9.0 cm; weight, 83.8 ± 11.5 kg). Participants were measured for shoulder internal rotation (IR) and external rotation (ER) ROM and HRT. All measurements were taken bilaterally, and the differences (throwing to nonthrowing arm) were used to calculate mean values for glenohumeral internal rotation difference, glenohumeral external rotation difference (GERD), total rotational motion difference (TRMdiff), and anatomic humeral retrotorsion difference. Group comparisons were made between the nTOS and control players using multivariate analysis of variance, and descriptive comparisons were made with independent t tests.

Results:

There were no significant differences between groups in age, height, weight, or years of experience. Players in the nTOS group had significantly less throwing arm ER compared with controls (103.4° ± 10.4° vs 109.6° ± 7.5°, respectively; P = .001) and GERD (3.0° ± 9.2° vs 8.8° ± 9.2°, respectively; P = .002). TRMdiff was significantly greater in nTOS (–11.1° ± 11.1°) than in controls (–3.7° ± 9.4°) ( P < .001).

Conclusion:

In the current study, adolescent baseball players diagnosed with nTOS were evaluated with shoulder ROM differences when compared with a matched healthy cohort. A loss of throwing arm ER appeared to be the main factor behind shoulder ROM changes in the nTOS group.
Towards a systemic-dialogical model of therapy
Authors: Bertrando Paolo , Lini Claudia
Published: April 2021

Bakhtin-inspired ideas that led to the emergence of dialogic therapies are usually considered as incompatible with other, more traditional models. This article presents a possible integration of dialogical ideas, with their acceptance of uncertainty and disorder, within a systemic understanding, where the emergence of systemic patterns is recognised. Through a comparison with the open dialogue approach, the article aims at clarifying the difference between a pure dialogical and a systemic-dialogical perspective, that is seen as more fitting with the contextual complexity of the world of today. The model of practice is illustrated by a case supervision example.
Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service
Authors: Kozlowska Kasia , McClure Georgia , Chudleigh Catherine , Maguire Ann M , Gessler Danielle , Scher Stephen , Ambler Geoffrey R
Published: April 2021

This prospective study examines the clinical characteristics of children ( n = 79; 8.42–15.92 years old; 33 biological males and 46 biological females) presenting to a newly established, multidisciplinary Gender Service in New South Wales, Australia, and the challenges faced by the clinicians providing clinical services to these patients and their families. The clinical characteristics of the children were comparable to those described by other paediatric clinics providing gender services: a slight preponderance of biological females to males (1.4: 1); high levels of distress (including dysphoria about gender), suicidal ideation (41.8%), self-harm (16.3%), and suicide attempts (10.1%); and high rates of comorbid mental health disorders: anxiety (63.3%), depression (62.0%), behavioural disorders (35.4%), and autism (13.9%). The developmental stories told by the children and their families highlighted high rates of adverse childhood experiences, with family conflict (65.8%), parental mental illness (63.3%), loss of important figures via separation (59.5%), and bullying (54.4%) being most common. A history of maltreatment was also common (39.2%). Key challenges faced by the clinicians included the following: the effects of increasingly dominant, polarized discourses on daily clinical practice; issues pertaining to patient and clinician safety (including pressures to abandon the holistic [biopsychosocial] model); the difficulties of untangling gender dysphoria from comorbid factors such as anxiety, depression, and sexual abuse; and the factual uncertainties present in the currently available literature on longitudinal outcomes. Our results suggest the need to bring into play a biopsychosocial, trauma-informed model of mental health care for children presenting with gender dysphoria. Ongoing therapeutic work needs to address unresolved trauma and loss, the maintenance of subjective well-being, and the development of the self.
The Evolution of the Definition and Diagnosis of Barrett Esophagus: A Historical Perspective
Authors: Chandrasoma Parakrama
Published: April 2021

Historical definitions of Barrett esophagus (BE) have depended on 2 beliefs: the esophagus is a squamous lined tube and the stomach is a columnar lined sac. Norman Barrett, in 1957, recognized that columnar lining in the tubular esophagus was reflux-induced metaplasia of squamous epithelium, leading to the present definition of BE. Recent evidence that gastric overdistension results in acid exposure of distal esophageal squamous epithelium, causing progressive columnar metaplasia, damage to the lower esophageal sphincter, and dilatation of the abdominal esophagus. This is presently mistaken at endoscopy for proximal stomach. The future definition of BE will likely include intra-sphincteric BE.
Beyond Seattle: WATS and Advanced Imaging in Barrett’s Esophagus
Authors: Anandasabapathy Sharmila , Mansour Nabil M.
Published: April 2021

Barrett’s esophagus is the sole known precursor for esophageal adenocarcinoma. Endoscopic surveillance for Barrett’s esophagus is recommended to help identify and manage dysplasia, with the ultimate goal being prevention or early detection of esophageal adenocarcinoma. The current standard of care for endoscopic surveillance for Barrett’s esophagus, the Seattle protocol, has many drawbacks. Methods to overcome these disadvantages have been an active area of research. This review will focus on some of the technologies to help improve dysplasia surveillance in Barrett’s esophagus, including advanced endoscopic imaging, artificial intelligence, and wide-area transepithelial sampling with computer-assisted 3D analysis (WATS-3D).
Cancer Prevention in Patients with GERD and Barrett’s Esophagus: Surgery
Authors: Oelschlager Brant K. , Carrera Ceron Rocio E.
Published: April 2021

Barrett’s esophagus (BE) is an acquired pre-malignant condition that is the result of chronic damage to the esophagus mucosa caused by reflux. Gastroesophageal reflux disease (GERD) and BE are major risks factors for esophageal adenocarcinoma. Effective treatment for BE should control GERD symptoms but these patients frequently presents with other associated conditions that makes management more challenging. Laparoscopic antireflux surgery (LARS), restoring the gastroesophageal barrier, is a very effective treatment of patients with BE, but its role in cancer prevention remain controversial. There is strong evidence that surgery can promote regression, but less so for reducing progression. The aim of this article was to review the current role of antireflux surgery in preventing progression to dysplasia or cancer in patients with BE and GERD.
State of the Art: Management of Barrett’s Esophagus Related Dysplasia and Neoplasia—Which Patient and What Therapy?
Authors: Dhaliwal Lovekirat , Iyer Prasad G.
Published: April 2021

Endoscopic eradication therapy (EET) is safe and effective in the management of Barrett’s esophagus (BE) related dysplasia and early adenocarcinoma. EET includes endoscopic resection of the visible lesions followed by ablation to eradicate the residual Barrett’s epithelium. Techniques available for endoscopic resection include cap-based endoscopic mucosal resection and endoscopic submucosal dissection. Ablative therapies such as RFA, cryoablation and APC are used for the eradication of dysplastic BE and to prevent progression to EAC. Complete remission of intestinal metaplasia is the goal of EET. Post-treatment endoscopic surveillance is recommended to detect recurrence of metaplasia/dysplasia, mostly at the gastroesophageal junction.
Cancer Prevention in Patients with GERD and Barrett’s Esophagus—Medicine
Authors: Scarpignato Carmelo , Wang David H.
Published: April 2021

Gastro-esophageal reflux disease (GERD) and Barrett’s esophagus are risk factors for esophageal adenocarcinoma (EAC). Chemoprevention is an attractive strategy, more effective than identifying early disease. Since acid reflux can lead to increased cell proliferation, decreased apoptosis, production of reactive oxygen species, DNA damage, and esophageal production of proinflammatory and pro-proliferative cytokines, proton pump inhibitors (PPIs) alone, or in combination with COX-inhibition, are the most suitable chemopreventive agents. Other compounds (statins, metformin, and selected nutraceuticals) cannot currently be recommended. Data are strong enough to warrant PPI treatment of virtually all patients with Barrett’s esophagus, although the best regimen has not yet been defined.
Personalized Approach to the Management of Barrett’s Esophagus, Perspectives from Gastroenterology
Authors: Schnoll-Sussman Felice
Published: April 2021

Despite the rich literature and large number of guideline and consensus statements the management of patients with Barrett’s Esophagus (BE) remains controversial and demands careful thought when face-to-face with a patient. The approach to screening, individualized risk assessment and treatment depends on the scope of your practice, your access to technology, pathology and a multidisciplinary team. I am an interventional endoscopist with a specialized referral practice in foregut disease. In this article I discuss how I approach a patient with suspected or known Barrett’s Esophagus.
Reflux Control After Barrett’s Esophagus Ablation
Authors: Mittal Sumeet K. , Baboli Komeil Mirzaei , Bremner Ross M.
Published: April 2021

Esophageal adenocarcinoma (EAC) is difficult to treat and carries a poor prognosis. Barrett’s esophagus, which develops from long-standing gastroesophageal reflux disease, is the only known precursor to EAC. Endoscopic eradication therapy is a major advancement in the treatment of dysplastic Barrett’s esophagus and early EAC; however, failure to eradicate disease and a high rate of recurrence with risk of progression currently remain unacceptably high with the use of acid suppressive medication for reflux. Herein, we describe the physiology of gastroesophageal reflux and review the current literature on endoscopic eradication therapy for Barrett’s esophagus. We summarize that antireflux surgery for reflux control as an adjunct to endoscopic eradication therapy may decrease the need for multiple endoscopic sessions (to achieve eradication), decrease the risk for recurrence/progression, and potentially decrease the need for surveillance.
Mechanical properties and dissipation energy of carbon black/rubber composites
Authors: Chollakup Rungsima , Suethao Supitta , Suwanruji Potjanart , Boonyarit Jirachaya , Smitthipong Wirasak
Published: April 2021

The effects of carbon black on the properties of rubber composites were studied in order to explore their value in producing low rolling resistance truck tires. Carbon black with different grades, N330 (coarser grade of 26–30 nm) and N220 (finer grade of 20–25 nm), was used as a reinforcing agent of natural rubber. The effects of different ratios of carbon black N330 at 40, 45, 50 and 55 parts per hundred rubber (phr) and N220 at 30, 35, 40 and 50 phr were investigated. Rubber composites with N220 had greater rubber/carbon black interaction than those with N330. The Mooney viscosity of rubber composite increased when the carbon black ratio increased. After vulcanisation of rubber, the samples were characterised by dynamic mechanical analysis, tensile strength and heat build-up. The results showed that the strength of rubber composites increased with increasing carbon black ratios. Interestingly, at the same bound rubber level, rubber composites with N220 presented lower dissipation energy, heat build-up and better mechanical properties than those with N330. This study indicated that reinforcement with an optimum amount of carbon black N220 would improve several desirable characteristics of rubber composites when used in low rolling resistance truck tires.
Extracellular vesicles shed by follicular lymphoma B cells promote polarization of the bone marrow stromal cell niche
Authors: Dumontet Erwan , Pangault Céline , Roulois David , Desoteux Matthis , Léonard Simon , Marchand Tony , Latour Maelle , Legoix Patricia , Loew Damarys , Dingli Florent , Dulong Joelle , Flecher Erwan , Coulouarn Cédric , Cartron Guillaume , Fest Thierry , Tarte Karin
Published: April 2021

Follicular lymphoma (FL) originates in the lymph nodes (LNs) and infiltrates bone marrow (BM) early in the course of the disease. BM FL B cells are characterized by a lower cytological grade, decreased proliferation, and a specific phenotypic and subclonal profile. Mesenchymal stromal cells (MSCs) obtained from FL BM display a specific gene expression profile (GEP), including enrichment for a lymphoid stromal cell signature, and an increased capacity to sustain FL B-cell growth. However, the mechanisms triggering the formation of the medullar FL permissive stromal niche have not been identified. In the current work, we demonstrate that FL B cells produce extracellular vesicles (EVs) that can be internalized by BM-MSCs, making them more efficient to support FL B-cell survival and quiescence. Accordingly, EVs purified from FL BM plasma activate transforming growth factor β–dependent and independent pathways in BM-MSCs and modify their GEP, triggering an upregulation of factors classically associated with hematopoietic stem cell niche, including CXCL12 and angiopoietin-1. Moreover, we provide the first characterization of BM FL B-cell GEP, allowing the definition of the landscape of molecular interactions they could engage with EV-primed BM-MSCs. This work identifies FL-derived EVs as putative mediators of BM stroma polarization and supports further investigation of their clinical interest for targeting the crosstalk between BM-MSCs and malignant B cells.