bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple status signals in multinational teams: Implications of lingua franca proficiency and task expertise for informal leadership
Authors: Nguyen Thao P. H. , Bell Bradford S. , Yuan Y. Connie
Published: October 2024

Lingua franca proficiency and task expertise coexist in multinational teams as prominent status signals that are often relied upon to infer a member’s competence. These personal attributes, however, do not always suggest consistent information since those with lower lingua franca proficiency might be more expert at the task and vice versa. In examining their joint implications, we draw on status characteristics and expectation states theories to identify the signaling nature of each attribute. Unlike the categorically specific quality of task expertise, lingua franca proficiency possesses characteristics commensurate with both specific and diffuse signals: it represents a social group and, at the same time, carries valid information about performance for certain tasks. Using archival (Study 1) and experimental (Study 2) data, we explore how the hybrid nature of lingua franca proficiency shapes its interaction with task expertise and implications for subsequent leadership outcomes. We provide further evidence for the generalizability of our findings through a supplemental study that includes 18 interviews with current members of multinational teams across various organizations.
Prospective Adoptive Parent Psychological Evaluations: A Proposal for Required Content Areas
Authors: Wirta-Leiker Chaitra E.
Published: October 2024

Current psychological evaluation processes for prospective adoptive parents lack standardization, leading to inconsistent assessments, potential placement issues, and adverse effects on adopted children well into adulthood. This brief proposes a structured framework for evaluations that includes 10 essential content areas and highlights the risks of inconsistent criteria. By standardizing the content areas of such evaluations, a pathway to more effective and consistent adoption practices can be implemented to improve parent readiness and enhance the well-being of adopted individuals throughout their lifespan.
Effects of Automation Exposure and Non-Driving Related Tasks on Manual Driving Performance after Takeover of Manual Control
Authors: Dudley LeGrand E. , DeLucia Patricia R.
Published: October 2024

Prolonged exposure to an automated driving system (ADS) can lead drivers to acclimate to the ADS in maladaptive ways. For example, exposure to a conditional ADS that maintained a time headway of 0.3 s resulted in drivers adopting smaller time headways postautomation, which is attributed to behavioral adaptation. The current study investigated whether drivers adapt to an ADS’ performance over time and if this adaptation differs based on the duration of automation exposure (15 or 25 min) and the task performed during the automation (NDRT or driving-related task). A greater exposure to the automation did not lead drivers to adopt smaller time headways. Surprisingly, drivers who provided a higher evaluation of the automation adopted smaller time headways post-automation than drivers who provided a lower evaluation. Future research should explore the relationship between trust in ADS and driving behavior to guide the development of safer ADSs.
Predictive Models of Brake Reaction and Steering of Police Officers in Critical Driving Situations
Authors: Shahini Farzaneh , Nadri Chihab , Zahabi Maryam
Published: October 2024

Motor vehicle crashes involving police vehicles significantly impact law enforcement officer (LEO) safety, often occurring during high-risk maneuvers like pursuit driving and sudden lane changes. These incidents are exacerbated by LEOs’ interaction with in-vehicle technologies, including Mobile Computer Terminals. Advanced Driver-Assistance Systems (ADAS) could mitigate these risks, though existing ADAS algorithms are not tailored to the unique work demands. To address these challenges, our study develops predictive models for LEO braking and steering in critical situations, based on a driving simulator experiment with police officers. Both braking and steering models were constructed and identified as effective in predicting police officer braking response and steering. The models can be practically applied as part of ADAS systems to deliver warnings at appropriate times, adapting to police officer demands in critical driving situations. Study implications contribute to the wider body of knowledge on surface transportation, occupational safety, and the use of adaptive models.
Exploring the Impact of the β-Catenin Mutations in Hepatocellular Carcinoma: An In-Depth Review
Authors: Idrissi Yassine Alami , Rajabi Mohammad Reza , Beumer Jan H. , Monga Satdarshan P. , Saeed Anwaar
Published: October 2024

Liver cancer, primarily hepatocellular carcinoma, represents a major global health issue with significant clinical, economic, and psychological impacts. Its incidence continues to rise, driven by risk factors such as hepatitis B and C infections, nonalcoholic steatohepatitis, and various environmental influences. The Wnt/β-Catenin signaling pathway, frequently dysregulated in HCC, emerges as a promising therapeutic target. Critical genetic alterations, particularly in the CTNNB1 gene, involve mutations at key phosphorylation sites on β-catenin’s N-terminal domain (S33, S37, T41, and S45) and in armadillo repeat domains (K335I and N387 K). These mutations impede β-catenin degradation, enhancing its oncogenic potential. In addition to genetic alterations, molecular and epigenetic mechanisms, including DNA methylation, histone modifications, and noncoding RNAs, further influence β-catenin signaling and tumor progression. However, β-catenin activation alone is insufficient for hepatocarcinogenesis; additional genetic “hits” are required for tumor initiation. Mutations or alterations in genes such as Ras, c-Met, NRF2, and LKB1, when combined with β-catenin activation, significantly contribute to HCC development and progression. Understanding these cooperative mutations provides crucial insights into the disease and reveals potential therapeutic strategies. The complex interplay between genetic variations and the tumor microenvironment, coupled with novel therapeutic approaches targeting the Wnt/β-Catenin pathway, offers promise for improved treatment of HCC. Despite advances, translating preclinical findings into clinical practice remains a challenge. Future research should focus on elucidating how specific β-catenin mutations and additional genetic alterations contribute to HCC pathogenesis, leveraging genetically clengineered mouse models to explore distinct signaling impacts, and identifying downstream targets. Relevant clinical trials will be essential for advancing personalized therapies and enhancing patient outcomes. This review provides a comprehensive analysis of β-Catenin signaling in HCC, highlighting its role in pathogenesis, diagnosis, and therapeutic targeting, and identifies key research directions to improve understanding and clinical outcomes.
Implementing Visual Activity Schedules to Support Elementary Student Engagement
Authors: Tuck Kathleen N. , Chow Jason C. , Kim Gospel Y. , Malone Elisabeth J. , Smith Kelsey H.
Published: October 2024

Visual activity schedules (VASs) are an effective, efficient intervention designed to promote positive language and behavioral development for elementary students with and at risk for emotional and behavioral disorders (EBD). However, VAS design and implementation varies widely in the extant research, prohibiting the ease of implementation in classrooms. The purpose of this article is to provide systematic guidance for educators to design, plan, implement, and progress monitor VAS effectiveness for students with or at risk for EBD.
Domestic Zebra Bite Leading to Upper Extremity Amputation
Authors: Young Clayton , Levitin Howard , Bryant Holly
Published: October 2024

A man attacked by a pet zebra suffers multiple bite wounds to his right arm and generalized trauma after being dragged to the ground and pinned by the animal. He was transported to the emergency department (ED) by the local emergency medical service (EMS) with a tourniquet in place for nearly 60 min. The man's injuries included extensive soft tissue damage, an open fracture and dislocation of his right elbow, and a soft tissue injury to his right ear. His clinical course was complicated by severe necrosis of the soft tissue of the right forearm requiring transhumeral amputation just above the condyles. Ongoing infection and the development of phantom limb pain complicated his recovery.
Metabolic Reprogramming of Cancer-Associated Fibroblast in the Tumor Microenvironment: From Basics to Clinic
Authors: Zhou Lujia , Zhang Wenjie , Hu Xiaoxue , Wang Daorong , Tang Dong
Published: October 2024

Metabolic reprogramming occurs when tumor cells replenish themselves with nutrients required for growth to meet their metabolic needs. Cancer-associated fibroblasts (CAFs) are activated fibroblasts involved in building the c (TME) to promote tumor progression and metastasis. Metabolic reprogramming of CAFs can interact with cancer cells to generate metabolic crosstalk. Furthermore, CAF metabolic reprogramming has great potential as a new field of tumor treatment. This review summarizes the role of CAFs in TME and the mechanisms by which metabolic reprogramming of CAFs causes cancer progression and metastasis, demonstrating the great potential of CAF metabolic reprogramming in cancer chemotherapy and immunotherapy treatment. Furthermore, we provide an outlook for future CAF metabolic reprogramming for cancer treatment.
Maternal, Fetal, and Labour Outcomes of Dupilumab Use for Atopic Dermatitis During Pregnancy: A Systematic Review
Authors: Chopra Chirag R. , Sharma Mahak , Gill Mahtab S. , Del Balso Victoria , Sakka Noor , Abu-Hilal Mohannad
Published: October 2024

Atopic dermatitis is a chronic complex inflammatory disease that significantly impacts maternal well-being and quality of life during pregnancy, warranting effective therapeutic interventions that prioritize maternal health and fetal safety. Dupilumab is approved for moderate-to-severe atopic dermatitis, but limited data exist regarding its safety during pregnancy. We conducted a systematic review to review and analyze maternal, fetal, and labour outcomes in patients receiving dupilumab for atopic dermatitis during pregnancy. Comprehensive searches were conducted using databases including OVID, Scopus, and Web of Science, covering studies published until May 2024. Our search yielded 285 studies, of which 13 met the eligibility criteria. These studies included 68 patients with 69 pregnancies, revealing 58 live births and 11 spontaneous abortions. Dupilumab therapy was administered continuously throughout pregnancy in 22.2% of cases, while 77.8% received intermittent treatment. Maternal atopic dermatitis outcomes showed significant improvement in disease severity. Most pregnancies (86.3%) progressed without complications. Labour-associated outcomes varied, with 82.4% of women undergoing vaginal deliveries. The majority of births occurred at full term (82.5%), with a mean gestational age of 38.4 weeks. Fetal outcomes demonstrated a normal birth weight in 92.3% of cases, with no reported congenital defects. Our review suggests that dupilumab use during pregnancy is associated with improvement of atopic dermatitis and low or minimal risk of major adverse outcomes in treated patients or their newborns. Prospective studies with long-term follow-up are warranted to confirm the safety of dupilumab in this population.
Addressing thermal challenges in hydrodynamic bearings: A contemporary review of strategies and technologies
Authors: Bhat Junaid Ahmad , Harmain GA , Najar FA
Published: October 2024

Hydrodynamic bearings are integral components in various industrial sectors, including aerospace, defense technologies, and power generation units etc. Advancements in modern technology have driven the evolution of bearings to withstand the high temperatures, increased speeds, and additional load demands of contemporary operations. Some of the prime consequences of high temperatures include thermal deformation, misalignment, viscosity degradation, reduced oil film thickness, reduced load carrying capacity and premature failure due to bearing seizure. Researchers have rigorously addressed the persistent thermal challenges posed to hydrodynamic bearings, achieving significant advancements over the years. Key developments include innovative bearing pad designs, optimal materials, coating technologies, advanced computational software, novel lubrication methods, and efficient monitoring techniques. The introduction of materials with tailored properties such as high heat conductivity, high strength, and low-friction coatings has greatly enhanced bearing performance. Additionally, advanced computational software like ANSYS CFX, Fluent, and COMSOL, adaptive lubrication methods, and real-time temperature sensors have significantly improved the performance of critical systems, including hydro power plants. This review paper summarizes significant developments and investigations carried out to mitigate thermal effects in hydrodynamic bearings, and hence provides a comprehensive in depth details of the subject matter. Even though there has been a lot of progress in the field of hydrodynamic bearings, continuous research is important to tackle issues related to sustainability, industry-specific obstacles, developing technologies, and dynamic operating conditions.
New people, new policy: How personnel renewal in the party executive affects party policy change. The case of Austria
Authors: Kaltenegger Matthias , Müller Wolfgang C
Published: October 2024

The party organization literature has long acknowledged that changes in a party’s internal power structure bring about changes in leadership personnel. However, empirical assessments of how such personnel changes relate to party behavior are rare. We explore personnel renewal in the party executive as a driver of party policy change and argue that focusing on these processes provides for an encompassing perspective on the connection between intra-party power and party behavior. Building on the party change literature, we theorize on personnel renewal in the party executive as a potential stand-alone driver of party policy change as well as on its interplay with other explanatory factors and test empirical implications based on all major Austrian parties (1949–2019). Findings suggest that personnel renewal in the party executive has a profound effect on party policy and that these personnel changes are in part driven by party performance.
Differing relationships between parenting stress, parenting practices and externalising behaviours in autistic children
Authors: Suvarna Vedanta , Farrell Lara , Adams Dawn , Emerson Lisa-Marie , Paynter Jessica
Published: October 2024

There is limited literature on the association between parenting practices, parenting stress and externalising behaviours in autistic children. We investigated whether parenting practices mediate the association between parenting stress and externalising behaviours. Parents of school-aged autistic children ( n = 138) completed an online survey on parenting practices, parenting stress and child externalising behaviours. Higher levels of parenting stress were associated with higher levels of externalising behaviours. In contrast to prior literature, parenting practices were not associated with child externalising behaviours and did not have mediating effects on the association between parenting stress and child externalising behaviours. However, higher levels of parenting stress were associated with lower levels of mindful parenting and higher levels of permissive and authoritarian parenting practices. Together, findings suggest that targeting parenting stress can impact parenting practices. Limitations of the study are acknowledged including the cross-sectional design, which limits causality-based inferences, given parent–child associations could occur over time. Implications for research and clinical practice in designing parent-informed programmes focused on reducing parenting stress via parenting practices are discussed.

Lay abstract

There is much research on parenting stress and child behaviours of autistic children. However, researchers have rarely explored whether how parents raise their children (called ‘parenting practices’) links to parenting stress and child behaviours. This is important, as if we know which parenting practices lead to better outcomes, parents can be supported to use parenting practices that are most helpful to them and/or their child. We asked parents of school-aged children to complete a survey on parenting stress, parenting practices and child behaviours. We found that parents who reported being more stressed (i.e. high levels of parenting stress) reported their children showed more observable behaviours that others find challenging such as aggression. Parents who were more stressed also reported lower mindful parenting (i.e. a style of parenting characterised by being present, non-judgementally in the moment) and were more permissive (e.g. giving in) in their parenting. However, these parenting practices did not impact the link between parenting stress and child behaviours. Results suggest we should focus on ways to reduce parents’ stress, which could include changing parenting practices which is consistent with strengths-based, neurodiversity-affirming approaches.
‘The MRI-scan says it is completely normal’: Reassurance attempts in clinical encounters among patients with chronic musculoskeletal pain
Authors: Andersen Trine CB , Wilhelmsen Maja , Lian Olaug S
Published: October 2024

In clinical guidelines for patients with chronic musculoskeletal pain, reassurance is a key element. The purpose of reassuring patients is to change their views on their illness and, thereby, their actions. However, when symptoms persist without pathological findings, reassurance can be difficult to achieve. Drawing on observations of nineteen naturally occurring hospital consultations with chronic musculoskeletal pain patients, followed by individual interviews with both patients and clinicians, we study how they interact in relation to reassurance. Our main aim is to explore the ways in which clinicians explicitly attempt to provide reassurance, and how patients receive these attempts, before reflecting on facilitating and hindering factors for successful reassurance in relation to the sociocultural context in which their interaction takes place. Through a thematic analysis, four dominating elements of explicit reassurance were identified: (1) education through visualisation, (2) validation through technological findings, (3) validation through physical examination and (4) normalising pain. To gain a deeper understanding of the reassurance process, we then narratively explored dialogical extracts containing these elements. The analysis shows a potential lack of congruence between what patients experience, and the biomedical knowledge clinicians rely on. Despite employing a combination of affective and cognitive modes of reassurance, clinicians tend to build their final conclusions not on patients experiences but on biomedical knowledge, which is knowledge that holds epistemic primacy for themselves. In that sense, their efforts to reassure the patients might also be a way in which they seek to reassure themselves.
Unlocking the power of socially assistive robotic nurses in hospitals through innovative living lab methodology
Authors: Arioz Umut , Bratina Božidar , Mlakar Izidor , Plohl Nejc , Uran Suzana , Roj Igor Robert , Šafarič Riko , Šafran Valentino
Published: October 2024

Objectives: Pilot 5 utilizes AI and robotics to develop a robotic nurse assisting hospital staff in response to workforce shortages and rising care demands due to an aging population. This project aims to optimize resources, reduce errors, and improve patient satisfaction through personalized care. Methods: The Living Lab approach was implemented to split the study into sprints. The first split involves working with project partners and stakeholders to define the problem, brainstorm functionalities, and identify limitations (24 participants). The second split focuses on further requirement gathering, exploring real-world use cases, and considering ethical and privacy concerns (51 participants). Results: The project used iterative development cycles (5-8 months) to continuously improve the solution. Surveys revealed high satisfaction rates, with average scores of 4.0 and 3.6 for Sprints 1 and 2, respectively. Similarly, a team morale survey indicated a positive trend, with average scores of 7.6 and 8.18 for Sprints 1 and 2, respectively. Conclusion: Pilot 5 offers a promising solution to the evolving needs of modern hospitals. This study explores the integration of a social robotic system into nursing care to enhance quality and emphasizes stakeholder engagement, participatory design, and user-centered approaches in AI healthcare solutions.
An investigation on the mechanical, thermal and tribological properties of newly developed polyester composites made with Pistachio shell particles for industrial applications
Authors: Deo Chitta Ranjan , Mohapatra Deepak Kumar , Parimanik Soumya Ranjan , Lohar Kalyani
Published: October 2024

The drive for sustainability and addressing environmental concerns has led to the productive use of bio-waste. This research investigates the potential of pistachio (Pistacia vera) nut shell particles as a novel filler in polyester composites. The study explores the use of these nut shells as a reinforcing material in polyester-based composites to evaluate their mechanical and thermal properties. Pistachio shell particles (PSP) are mixed with polyester resin in varying weight fractions (0%, 1%, 3%, and 5%) to create a new type of composite. The impact of filler content, impingement angle and striking velocity on the erosive wear behavior of these composites are also studied. The mechanical results for the composites revealed that incorporating PSP filler resulted in the maximum rise in tensile (96.61%), impact strength (66.66%), micro-hardness (52.94%), under loading of 5 wt% of PSP filler. However, the composite with 3 wt% of PSP filler, resulted in the maximum rise of flexural strength (135.65%) and flexural modulus (45.28%). Results showed that, composites with 5 wt% of PSP filler exhibited superior erosive resistance. An optimal parameter setting is determined for minimum erosion rate and subsequently validated by conducting confirmation experiment as per Taguchi methodology. Different modes of material removal, wear craters and other qualitative attributes are examined by a scanning electron microscopy during erosion experiment of the samples. Thus, the utilization of agro/food wastes in the development of bio-based products holds significant potential and offers the possibility of replacing conventional materials in various industrial applications.
Unraveling gender differences in entrepreneurial exits: The role of human capital and family situation during an unprecedented crisis
Authors: Usero Belén , Hernández Virginia , Romaní Gianni
Published: October 2024

This study applies a gender role perspective to delve into disparities in entrepreneurial exit decisions during unprecedented crises such as the COVID-19 pandemic. The paper examines how human capital and family dynamics—encompassing family income and size—interact with evolving social roles and responsibilities. Using multinomial estimation techniques and Global Entrepreneurship Monitor survey data from Chile, our findings reveal that women entrepreneurs display a higher likelihood of business exits compared to their male counterparts. Further analysis with moderating variables shows that the gender coefficient is not significant and unveils a non-linear pattern tied to educational backgrounds. Specifically, women with elementary education are prone to discontinuing businesses due to the COVID-19 crisis, with a similar—though weaker—tendency observed among women with tertiary education. Women with medium education levels do not significantly differ from men in terms of business closures due to COVID-19. Additionally, family size disproportionately affects women, amplifying the likelihood of business exits during the COVID-19 crisis compared to men. The paper offers actionable insights for researchers and policymakers, emphasizing the pressing need to augment women's entrepreneurial resilience in the face of unforeseen crises.
Implementing Schwartz Rounds in children's social care: Enablers and barriers
Authors: Wilkins David , Thompson Sarah , Jones Rebecca , Bezeczky Zoe , Bennett Verity
Published: October 2024

Children's social care services can be a challenging place to work, with staff regularly reporting higher stress levels relative to the general population and other public sector settings. Thus, it is important to provide staff with good support. Previously, we completed a randomised controlled trial (RCT) of Schwartz Rounds (SRs) and reported a series of non-statistically significant differences between intervention and comparison groups. We also undertook a process evaluation, to identify enablers and barriers to the successful implementation of SRs in children's social care.

Findings

Compared with studies of SRs in healthcare settings, we identified several similar enablers, such as senior management buy-in and effective administrative support, and some similar barriers, such as high workloads and poor publicity. We also identified specific enablers and barriers for social care settings, including the synergy between existing practice models and SRs, the nature of trauma in social care compared with healthcare, and some related to the different nature of organisational and workload pressures.

Applications

Understanding the differences between SRs in healthcare and social care will be useful for local authorities who may want to support their staff via the provision of SRs. They should also be useful in any future definitive evaluation of SRs for social care by helping to maximise the possibility for a successful implementation.
Exploring participatory approach to community development projects in Africa: Toward an empowerment-participatory approach for sustainable development
Authors: Veta Oghenechoja Dennis
Published: October 2024

Applying the participatory approach alone to development projects has yet to lead to the active participation of the marginalized in African development projects. A qualitative phenomenological research design was utilized. The study purposively included six communities across Delta State, Nigeria, based on the presence of development projects. Eighteen participants with high incomes and above, and 18 participants with low incomes and below were included in the study using the snowball sampling technique. The total sample size for the study was 36. Unstructured interviews were used to collect data, which were thematically analyzed.

Findings

The findings, which are of significant importance, revealed that the studied communities benefited from town halls, open-stall markets, borehole water, roads, primary health care centers, primary schools, secondary schools, irrigations, electricity, and hospitals. The participants with low incomes and below indicated a low level of participation in the development projects due to poverty, lack of formal education, inadequate information, government interference, male domination, lack of interest, and discriminatory cultural practices. The participants with high incomes and above indicated a high level of participation believing that they were better positioned to participate in development-related matters in the communities.

Applications

The findings suggest a promising potential for change. There is a clear need for social work educators to adopt the empowerment-participatory approach into Nigerian social work curricula, and social work practitioners should apply it for active community participation, and sustainability in Nigerian and African development projects.
Traditional wellness therapy
Authors: Binkley Jason , Patterson Shane
Published: October 2024

This submission for the special issue of qualitative social work journal describes how the authors have implemented a Indigenous therapy model in Indigenous communities. The approach centers Indigenous worldviews with a focus on ceremony, trauma, and spirituality.
Improvement of temporal light artefact effects in commercial LED lamps
Authors: Mantela V , Nordlund R , Askola J , Kärhä P , Dekker P , Ikonen E
Published: October 2024

Temporal light modulation and its potential adverse visual effects on human observers, collectively known as temporal light artefacts (TLAs), have been limited by the European Union Ecodesign regulation. Limitations on two key TLA metrics, flicker and stroboscopic effect, were introduced in September 2021. This study analyses the impact of this regulation on commercial LED lamps by measuring multiple different consumer-grade LED E27 retrofit lamps by several manufacturers before and after the regulation. The lamps purchased after the Ecodesign regulation seem to favour a certain type of LED driver that provides the best TLA behaviour of all lamp types. The regulation, with respect to TLA, has resulted in the replacement of ill-behaving lamp types in the market by newer lamps with better TLA characteristics.
Visibility and annoyance of the phantom array effect varies with age and history of migraine
Authors: Miller NJ , Irvin L , Royer M , Strachan C
Published: October 2024

The phantom array effect (PAE) is a series of repeated images that may be perceived when a person moves their eyes in large saccades across a light source (or a specular reflection of that light source) that is modulating in output over time. Fifty-five people, including a group of 25 who experience migraine, evaluated the visibility and annoyingness of phantom arrays produced by 85 unique temporal light modulation waveforms (including sine, rectangular, complex and DC waveforms) generated using an LED placed against a black background. Those with migraine exhibited higher average visibility compared to those without migraine ( p = 0.019) and were relatively more sensitive at higher frequencies ( p < 0.001). Younger participants also found more stimuli to be visible ( p < 0.001). The threshold sensitivity function was similar to that developed for the phantom array visibility measure (PAVM), and PAVM was effective in predicting visibility ( R2 = 0.87 for the relevant region of PAVM < 3). While those in the migraine group did not report seeing the PAE more often in everyday life at a statistically significant level, they reported being more annoyed by it and having more unwanted physiological responses (headaches, eye fatigue and distraction/disorientation). Members of the migraine group were also more likely to have changed their behaviour in architectural spaces (such as leaving a restaurant with ‘flickering’ lights). In the four hours after completing the experiment, 64% of the migraine group (vs. 19% of the non-migraine group) reported experiencing discomfort or an adverse reaction. In particular, 41% reported experiencing a headache (vs. 8% for those in the non-migraine group).
Radiographic and Clinical Outcomes of First Tarsometatarsal Joint Arthrodesis With a Biplanar Locking Plate System Versus the Modified Lapidus Technique With Crossed-Screw Fixation: A Retrospective Multicenter Comparison
Authors: Fletcher Amanda N. , Droz Lindsey G. , Fuller Robert , Rajan Lavan , Zhu Jiaqi , Easley Mark E. , Nunley James A. , Cody Elizabeth A.
Published: October 2024

Background: Hallux valgus (HV) is recognized as a triplanar deformity. A biplanar locking plate (BLP) system corrects this deformity through first tarsometatarsal joint (TMTJ) arthrodesis, with specialized reduction tools and cutting guides. Yet the optimal surgical technique and fixation construct for first TMTJ arthrodesis remains controversial. Purpose: We sought to compare the BLP system with a modified Lapidus (ML) technique with crossed-screw fixation in terms of radiographic outcomes, complications, and reoperations. Methods: In this retrospective multicenter study, we identified a series of consecutive patients who underwent first TMTJ arthrodesis for HV with either the ML procedure at institution A or the BLP system at institution B. Patients 18 years of age with a minimum of 6 months of postoperative radiographs were included. There were 130 patients, 65 in each group, including 121 women (93.8%) with a median age of 58 years and mean radiographic follow-up of 7.1 months. Data included preoperative and postoperative HV angle (HVA), intermetatarsal angle (IMA), and tibial sesamoid position (TSP), plus complications and reoperations. Statistical testing included Mann-Whitney U, Wilcoxon signed rank, Fisher exact, McNemar, and multivariable regression. Results: After adjusting for confounding variables, the BLP system was associated with significantly greater improvements in postoperative IMA and HVA but not TSP. There were no significant differences in rates of complications (ML: 18.4%; BLP: 9.2%) or reoperations (ML: 4.6%; BLP: 7.7%). Conclusion: This retrospective multicenter review found that the BLP system was associated with greater improvement in radiographic HV parameters compared with the ML procedure using crossed-screw fixation. Clinical significance is unclear as complication and reoperation rates were similar between groups. Further study in this regard is warranted.
Cannabis-Related Disorders Are Associated with Increased Early Postoperative Opioid Prescriptions and Delayed Emergency Department Visits Following Open Carpal Tunnel Release
Authors: Humble Kirstin A. , Vatsia Sohrab K. , Monahan Peter F. , Taylor Kenneth F.
Published: October 2024

Background:

The effect of cannabis on pain management following open carpal tunnel release (CTR) surgery is unknown. The purpose of this study is to compare outcomes for patients with cannabis-related disorder (CRD) undergoing open CTR to a propensity-matched cohort of patients without CRD (no cannabis-related disorder [NCRD]).

Methods:

The TriNetX Research Network was queried to identify patients undergoing primary open CTR between January 2010 and December 2022. Patients with CRD were propensity matched to a NCRD cohort in a 1:1 ratio based on 7 characteristics. Rates of postoperative opioid prescriptions, emergency department (ED) services, and outpatient appointments were reported at 0-2, 2-6, and 6-12 weeks postoperatively.

Results:

A total of 925 CRD patients were propensity matched to 925 NCRD patients undergoing open CTR. Within 0-2 weeks postoperatively, CRD patients received significantly greater rates of opioid prescriptions compared to NCRD patients (30.9% and 25.6%, P = .011). No cannabis-related disorder (NCRD) patients presented for outpatient follow-up at significantly higher rates than CRD patients within 6 weeks postoperatively. CRD patients presented to the ED at significantly higher rates between 6 and 12 weeks postoperatively (11.0% vs. 8.0%, respectively, P = .027).

Conclusions:

Cannabis-related disorder (CRD) is associated with lower rates of outpatient follow-up but higher rates of postoperative opioid prescriptions and ED presentations following open CTR compared to a propensity-matched cohort of NCRD patients.

Level of Evidence:

Cohort Study; Level III.
Use of Onyx Frontier™ for intracranial stenting in stroke patients: A multicenter retrospective study
Authors: Chahine Ahmad , Morsi Rami Z. , Thind Sonam , Kass-Hout Omar , Becske Tibor , Khaldi Ahmad , Karar Lina , Baskaran Archit , Carrión-Penagos Julián , Desai Harsh , Kothari Sachin A. , Rana Rohini , Verhagen Metman Okker , Zakaria Jehad , Shah Atman P. , Paul Jonathan D. , Nathan Sandeep , Siegler James E. , Mendelson Scott J. , Mansour Ali , Hurley Michael C. , Prabhakaran Shyam , Gupta Rishi , Kass-Hout Tareq
Published: October 2024

Background

Acute ischemic stroke (AIS) due to intracranial atherosclerotic disease (ICAD) carries a high risk of recurrence despite aggressive medical management. The aim of our study is to present our initial experience with the Onyx Frontier™ balloon-mounted drug-eluting stent (Medtronic, Santa Rosa, CA) for AIS due to ICAD.

Methods

We conducted a multicenter retrospective cohort study describing the technical feasibility, safety, and performance of using the Onyx Frontier™ balloon-mounted drug-eluting stent in patients with acute intracranial vessel occlusion due to ICAD across three comprehensive stroke centers in the United States.

Results

We included 23 patients in our study (mean age 67.3 [10.7]; females: n = 13/23, 56.5%). Most patients were Black (n = 14/23, 60.9%). The most common site of vessel occlusion was the M1 branch of the middle cerebral artery (MCA) (n = 14/23, 60.9%), followed by the vertebrobasilar system (n = 5/23, 21.7%), and the internal carotid artery (n = 3/23, 13.0%). Treatment with the Onyx Frontier™ stent was associated with a final mTICI score ≥2b for 100% of patients, with no vessel perforations or distal embolization. None of the patients had any restenosis or re-treatment over a median follow-up of 3.5 months (interquartile range [IQR] 7.8). All cases required a single stent except for one, where two were deployed. Transfemoral access was used in most cases (n = 18/23, 78.3%), with one in-hospital death due to access site complication (n = 1/23, 4.3%).

Conclusions

This is the largest multicenter cohort study demonstrating the feasibility and safety of using the Onyx Frontier™ balloon-mounted zotarolimus-eluting stent to treat symptomatic AIS due to ICAD.
Carotid artery stenting for symptomatic carotid near occlusions: Feasibility, safety and outcome analysis
Authors: Çelebioğlu Emre Can , Dabus Guilherme , Bozer Uludağ Sena , Çetinkaya Ömer Arda , Ünal Sena , Bengisun Uğur , Eryılmaz Sadık , Sorgun Mine Hayriye , Doğan İhsan , Atmaca Şermin , Özçınar Evren , Meço Başak Ceyda , İnan Mustafa Bahadır , Togay Işıkay Canan , Akar Ahmet Rüçhan , Alaçayır İskender , Bilgiç Sadık
Published: October 2024

Introduction

Extracranial internal carotid stenosis (EICS) is a well-established cause of stroke. Carotid near-occlusion (CNO), either distally collapsed or not, is a rare sub-type of EICS with conflicting data regarding the necessity for treatment. The aim of this study is to evaluate the results of carotid artery stenting (CAS) for patients with symptomatic CNOs.

Material and methods

Institutional review board (I06-420-23) approval was obtained for this retrospective study. Consecutive data from January 2019 to January 2023 was obtained. Sixty-five patients underwent 66 procedures for symptomatic CNOs. Diagnosis of CNOs were made with DSA images. Treatment decisions were made by a multidisciplinary team. Patient data including age, gender, clinical presentation, affected side, complications (initial/ follow-up), and pre and post mRS scores were recorded and analyzed.

Results

There were 22 female and 43 male patients with symptomatic CNOs (mean age: 71.52 ± 9.32 years). The mean time from symptom-to-treatment was 3.91 weeks ± 3.74 weeks (ranging from 0 to 20 weeks). There were eight events recorded in the 30 days period after CAS; five (7.7%) were cerebral hyperperfusion syndrome (one causing haemorrhage) and three (4.5%) ischemic complications. Permanent neurologic deficit rate was 6% and 61 patients (94%) mRS scores were unchanged during last follow-up. Mean follow-up period was 22.94 ± 16.67 months (ranging from 0.5 to 60 months).

Conclusion

Our study demonstrated that in the complex population of patients with symptomatic CNOs, CAS is a feasible option with acceptable rate of permanent neurologic deficits. Further studies are needed to assess its safety and long-term efficacy.
A Funny Thing Happened on the Way to Studying Portuguese Ethnic Media in Montreal: ‘Autosiociobiographie,’ Sibling Relations, Brotherly Love and ‘Emotional Episodes’ in Research
Authors: Aguiar Luís L. M. , Bérubé Farrah , Teixeira Carlos , Aguiar Norberto
Published: October 2024

How does the dynamic of sibling relations affect researching and dissemination of research findings? How can we best capture the unfolding of this dimension in researching? We discuss these questions via the description of a community event where the siblings were directly implicated and an “emotional episode” arose leading to humor in one sense but also stress on the other as the younger sibling struggled to intervene and interrupt his older brother’s presentation. We discuss and analyze this “key emotional episode” by placing it in the cultural upbringing of the siblings involved in the study as well as co-authors’ reactions to the same episode. We conclude by stating the necessity to know your audience and the approach most conducive to fit the culture of community engagement. Further, we argue that in this time when so much emphasis is placed on team research, we know so much about the academic credentials and skills of our project team members, but little about their personal upbringing and how this can influence relationships and interpretations of findings.
Centenaries, museum audiences and discourses of commemoration: Remembering the First World War 2014–2018
Authors: Cubitt Geoffrey , Moody Jessica
Published: October 2024

This article explores public attitudes both to the First World War as a historic event and to its Centenary as a commemorative occasion. Through an analysis of exit interviews with visitors to two contrasting Centenary-related museum exhibitions in 2014 and 2018, we place these attitudes within the larger context of the War’s evolving meanings and representations in British society, and the immediate circumstances of the Centenary period. Our research reveals the varying levels of connectedness people express to the First World War and to wider cultural assumptions about the meanings and place of commemoration. This is expressed in sometimes specific and nuanced ways, but more often through a more repetitive symbolic vocabulary. We argue that it is the mechanism of the Centenary itself as a cultural process that facilitates the easy adoption of an established discourse of war – evoking tropes of sacrifice, futility, a duty to remember or learn lessons – and for referring to the War and its significance for today’s society.
BLU-945, a potent and selective next-generation EGFR TKI, has antitumor activity in models of osimertinib-resistant non-small-cell lung cancer
Authors: Lim Sun Min , Schalm Stefanie S. , Lee Eun Ji , Park Sewon , Conti Chiara , Millet Yves A. , Woessner Rich , Zhang Zhuo , Tavera-Mendoza Luz E. , Stevison Faith , Albayya Faris , Dineen Thomas A. , Hsieh John , Oh Seung Yeon , Zalutskaya Alena , Rotow Julia , Goto Koichi , Lee Dae-Ho , Yun Mi Ran , Cho Byoung Chul
Published: October 2024

Introduction:

Despite the availability of several epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), most patients with non-small-cell lung cancer (NSCLC) eventually develop resistance to these agents. Notably, EGFR_C797S mutations confer resistance to the third-generation EGFR-TKI osimertinib and no approved post-osimertinib targeted pharmacology options are currently available. BLU-945 is a novel, reversible, and orally available next-generation EGFR-TKI that selectively targets EGFR-activating ( EGFRm) and resistance mutations (including EGFR_C797S) with nanomolar potency while sparing wild-type EGFR in vitro.

Methods:

In vitro activity of BLU-945 as a single agent and in combination with osimertinib was tested in engineered EGFR-mutant cell lines as well as patient-derived cells and patient-derived organoids. In vivo activity was evaluated in osimertinib-resistant patient-derived xenograft mouse models. Three patient cases from the global, first-in-human, phase I/II SYMPHONY trial (NCT04862780) demonstrating the clinical efficacy of BLU-945 were reported.

Results:

In vitro BLU-945 demonstrated inhibited cell viability and growth of EGFR-mutant/osimertinib-resistant cell lines. BLU-945 demonstrated in vivo tumor shrinkage in osimertinib-resistant models of NSCLC (osimertinib second line: EGFR_L858R/C797S and third line: EGFR_ex19del/T790M/C797S and L858R/T790M/C797S) both as monotherapy and in combination with osimertinib. BLU-945 also demonstrated tumor shrinkage in patients from the SYMPHONY trial.

Conclusion:

Our findings demonstrate the preclinical and early clinical activity of BLU-945 in EGFRm NSCLC progressing on previous EGFR-TKIs.
A biopsy-based Immunoscore in patients with treatment-naïve resectable gastric cancer
Authors: Soeratram Tanya T. D. , Beentjes Isis , Egthuijsen Jacqueline M. P. , Mookhoek Aart , Lange Marilyne M. , Meershoek-Klein Kranenbarg Elma , Hartgrink Henk H. , van de Velde Cornelis J. H. , Ylstra Bauke , van Laarhoven Hanneke W. M. , van Grieken Nicole C. T.
Published: October 2024

Background:

The prognostic significance of T-cell densities in gastric cancer (GC) was previously demonstrated in surgical resection specimens. For prognosis or response prediction, it is preferable to identify biomarkers in pre-treatment biopsies; yet, its representativeness of the tumor immune microenvironment is unclear.

Objectives:

This study aimed to evaluate the concordance and prognostic value of T-cell densities in paired biopsies and resections.

Methods:

Paired diagnostic biopsies and surgical resections were available for 131 patients with resectable GC who were treated with surgery alone in the D1/D2 trial. T-cell markers such as CD3, CD45RO, CD8, FOXP3, and Granzyme B were assessed by immunohistochemistry and digitally quantified. Tumors were categorized into high and low subgroups for each marker. The concordance between biopsies and resections was determined for each marker with Cohen’s κ. To determine the prognostic value of T cells in biopsies, Cox regression was performed.

Results:

The concordance of T-cell high and low tumors was moderate for CD8 (κ = 0.58) and weak for other markers (κ < 0.3). CD8 and FOXP3 densities in biopsies were significantly associated with cancer-specific survival. Multivariable analysis showed that an Immunoscore incorporating CD8 and FOXP3 served as an independent prognostic marker (low vs high: hazard ratio 3.40, 95% confidence interval: 1.27–9.10; p = 0.015).

Conclusion:

Although the concordance in T-cell densities between biopsy and resection specimens is modest, a biopsy-based Immunoscore identified distinct biological subgroups with prognostic potential. To fully evaluate the prognostic performance of this biopsy Immunoscore, additional studies are warranted.
Tianxia Under the Sea: China’s Quest for Maritime History
Authors: Schmitz Frederik
Published: October 2024

This article examines how the Chinese political and academic discourses have constructed a narrative of China as a peaceful maritime power and the role that underwater archaeology has played in narrating China's rise. The ancient Chinese concept of tianxia (天下) is a central part of the Chinese elites’ discourse on maritime policy. This concept, translated as “all under heaven,” forms part of China's effort to produce historical statecraft using textual sources and underwater archaeological artefacts. In this narrative, the historical figure of Zheng He became a prominent representative of China's peacefulness, refuting concerns regarding the purposes of a more assertive Chinese foreign policy. Studying tianxia under the sea thus contributes to forming a better understanding of the production of narratives respecting China's rise. In particular, underwater archaeology is highlighted as an authoritative source of evidence underpinning and reinforcing narratives of China as an ancient and peaceful maritime nation.