bluuebunny/crossref_metadata_2025 huggingface dataset:
Iatrogenic Inferior Vena Cava Resection Requiring Reconstruction
Authors: Alslaim Hossam , Chung Jane , Kruse Edward , Shukla Mrinal , Agarwal Gautam
Published: April 2021

This is a report of an iatrogenic inferior vena cava (IVC) segmental resection and reconstruction utilizing bovine pericardium. A 48-year-old female patient presented for a planned right nephrectomy by the urology service secondary to xanthogranulomatous pyelonephritis. This was complicated by inadvertent resection of an 8 cm segment of the infrarenal IVC. Postoperatively, the patient did not tolerate IVC ligation due to severe lower extremity edema. She then underwent reconstruction with a bovine pericardium conduit as an interposition graft. The post-operative course was complicated by pulmonary embolism requiring percutaneous intervention. This report addresses the utility of bovine pericardium for IVC reconstruction in an infected field.
Gender Differences and Their Influences on T2DM Self-Management Among Spanish-Speaking Latinx Immigrants
Authors: Smith-Miller Cheryl A. , Berry Diane C. , Miller Cass T.
Published: April 2021

Introduction:

Evidence suggests that gender may influence many aspects of type 2 diabetes (T2DM) self-management (SM) and we posit that limited English language–proficient Latinx immigrants face additional challenges.

Methods:

Instruments and semi-structured interviews were used to examine gender differences on health literacy, diabetes knowledge, health-promoting behaviors, diabetes, eating and exercise self-efficacy (SE), and T2DM SM practices among a cohort of limited English language–proficient Latinx immigrants. Statistical and qualitative analysis procedures were performed comparing males and females.

Results:

Thirty persons participated. Males tended to be older, have higher educational achievement, and more financial security than females. Physiologic measures tended worse among female participants. Health literacy and exercise SE scores were similar, but females scored lower on Eating and Diabetes SE. Forty-seven percent ( n= 9) of the women reported a history of gestational diabetes mellitus and a majority of men ( n = 7) cited difficulty with excessive alcohol.

Consumption:

Males appeared to receive more SM support compared to females. Females more frequently noted how family obligations and a lack of support impeded their SM. Work environments negatively influenced SM practices.

Conclusion:

Men and women have unique SM challenges and as such require individualized strategies and support to improve T2DM management.
Using a Culturally Proficient Leadership Lens to Effectively Serve Refugee Students
Authors: Brion Corinne
Published: April 2021

This teaching case study takes place in an American middle school and tells the story of Dorah, a refugee student from the Republic of Congo who experienced severe trauma. At Lincoln Middle School, the principal and her teachers encounter difficulties serving their refugee students adequately because of their lack of cultural proficiency. This case aims to help leaders in diverse contexts understand how to embrace and advocate for different cultures, beliefs, and norms to increase the cultural wealth of their communities. To achieve this goal, I provide a cultural proficiency model and a trauma-invested framework.
Intra-articular Distal Humerus Fractures: Parallel Versus Orthogonal Plating
Authors: Haglin Jack M. , Kugelman David N. , Lott Ariana , Belayneh Rebekah , Konda Sanjit R. , Egol Kenneth A.
Published: April 2021

Background: Dual-plating osteosynthesis is the standard treatment for Orthopedic Trauma Association (OTA)-type 13-C distal humerus fractures. However, optimal plate position is debated. Purpose: The purpose of this study was to evaluate dual-plate positioning following intra-articular distal humerus fracture repair by comparing outcomes between patients plated in parallel and those plated orthogonally following open-reduction, internal-fixation (ORIF) of intra-articular distal humerus fractures. Methods: All OTA-type 13-C intra-articular distal humerus fractures treated operatively at our institution over a 10-year period were reviewed. Clinical outcomes and complications were compared between those plated in parallel and those plated orthogonally. Data were analyzed using independent-samples t-tests, Mann-Whitney U tests, chi-square tests, and Fisher’s exact tests. Results: A total of 69 patients met inclusion criteria. Mean follow-up among this cohort was 19.3 months; 45 (64.8%) patients had orthogonal dual plating, and 24 (35.2%) had parallel plating. Groups did not differ with respect to demographics or duration of follow-up. Clinically, there were no significant differences in time to union, elbow arc of motion at any time point, or patient Mayo Elbow Performance Index (MEPI) scores at final follow-up. Furthermore, there were no differences in complications. Conclusion: Parallel and orthogonal plating following ORIF of distal humerus fractures with modern, contoured locking compression plates had similar outcomes in this study. This study represents the largest comparative series in the literature at the time of its writing. Both techniques may be considered when deciding on dual-plating technique for treating intra-articular distal humerus fractures.
A Meta-Analysis of the Efficacy of L-Carnitine/L-Acetyl-Carnitine or N-Acetyl-Cysteine in Men With Idiopathic Asthenozoospermia
Authors: Wei Guangzhu , Zhou Zhongbao , Cui Yuanshan , Huang Yongjin , Wan Zijin , Che Xuanyan , Chai Yumeng , Zhang Yong
Published: April 2021

The meta-analysis was performed to access efficacy of L-carnitine/L-acetyl-carnitine (LC/LAC) and N-acetyl-cysteine (NAC) in men with idiopathic asthenozoospermia. We researched PubMed, EMBASE, and Cochrane Library databases and references to related articles. Finally, seven articles including 621 patients were analyzed. The results indicated that LC/LAC and NAC had a considerable improvement in sperm motility ( p = .03 and p < .0001, respectively) and normal morphology ( p = .006, p = .0002, respectively) compared with the placebo group. Besides, NAC had a significantly greater increase in sperm concentration ( p < .00001) and ejaculate volume ( p = .002) compared with the placebo group, and there was no significant difference in LC/LAC. For the analysis of serum hormones, NAC had no obvious differences in improving the serum testosterone, luteinizing hormone, follicle-stimulating hormone, and prolactin compared with non-treatment group. Conclusively, LC/LAC and NAC showed a greater improvement in sperm motility and normal morphology. Moreover, NAC has a positive effect on sperm concentration and ejaculate volume, whereas no obvious effect was observed in serum hormones.
Optimal placement design for picking and packing in distribution centers
Authors: Rios John , Linfati Rodrigo , Morillo-Torres Daniel , Derpich Iván , Gatica Gustavo
Published: April 2021

An efficient distribution center (DC) is one that receives, stores, picks and packs products into new logistics units and then dispatches them to points of sale at the minimal operating cost. The picking and packing processes represent the highest operating cost of a DC, and both require a suitable space for their operation. An effective coordination between these zones prevents bottlenecks and has a direct impact on the DC’s operational results. In the existing literature, there are no studies that optimize the distribution of the picking and packing areas simultaneously while also reducing operating costs. This article proposes an integer nonlinear integer programming model that minimizes order preparation costs. It does so by predicting customer demand based on historical data and defining the ideal area for picking and packing activities. The model is validated through a real case study of seven clients and fifteen products. It achieves a [Formula: see text] reduction in operating costs when the optimal allocation of the picking and packing areas is made.
Meshing theory of axial arc tooth profile cylindrical worm drive
Authors: Liu Yunuo , Zhao Yaping , Chen Xinyuan , Li Gongfa
Published: April 2021

In this paper, the axial arc tooth profile cylindrical worm drive is proposed, whose worm is cut by turning tool. Due to the simple processing equipment, short manufacturing time and low cost, this kind of worm can replace the cylindrical worm ground by grinding wheel under some conditions. The meshing theory of the worm drive is founded comprehensively. Moreover, a movable orthogonal frame is established on the non-orthogonal parametric curves net helical surface. Based on the founded meshing theory, the simulating study on the meshing quality of the worm drive is performed systematically. The numerical outcome shows that the meshing quality of this worm drive is quite favorable, and the condition of forming lubricating oil film is excellent. The working orthogonal clearance of the turning tool is decreased with the increase of the worm thread number, which must be a positive value in the process of worm cutting. This explains that the number of the worm thread is ≤4.
Research on microwave heating performance of modified steel slag asphalt mixture
Authors: Song Yanfang , Wang Zhe , Zhou Yan , Hu Rong
Published: April 2021

Aiming at the change law of the flexural and tensile strength of the modified steel slag asphalt mixture during microwave heating, the results of this paper are as follows: the microwave heating process can achieve the recovery of the flexural and tensile properties of the modified steel slag asphalt mixture. The number of point bending failure tests continues to increase, and the recovery rate of bending and tensile properties of beams made of modified steel slag asphalt mixture will slowly decrease until the test piece is completely destroyed. The flexural and tensile strength of beams made by microwave heating asphalt mixture cannot be fully recovered, but different asphalt mixtures have different recovery effects. Compared with the ordinary basalt asphalt mixture, the steel slag asphalt mixture before modification has the same bending and tensile repair effect after microwave heating, while the modified steel slag asphalt mixture has the first bending and tensile repair effect after microwave heating increased by 23%.
Clinical features and outcomes after endovascular therapy for penetrating aortic ulcer and intramural hematoma
Authors: Jiang Xiaolang , Liu Yifan , Chen Bin , Jiang Junhao , Shi Yun , Ma Tao , Lin Changpo , Guo Daqiao , Xu Xin , Fu Weiguo , Dong Zhihui
Published: April 2021

Objectives

To identify the differences between clinical features and outcomes after endovascular therapy for penetrating aortic ulcer (PAU) and intramural hematoma (IMH).

Methods

From January 2009 to March 2020, patients who underwent endovascular therapy for PAU and IMH were enrolled. Information on patient demographics, presentation, PAU and IMH morphology, laboratory examination, and clinical follow-up information was collected and analyzed. Univariate analysis was performed to identify the differences between IMH and PAU, and Kaplan–Meier was used to calculate the cumulative survival rate and freedom from reintervention.

Results

A total of 114 patients were enrolled; 80 (70.2%) of them were diagnosed with PAU. Compared with PAU, patients with IMH were younger ( p = 0.006), more likely to be admitted emergently ( p = 0.001), had longer hospital stay ( p = 0.028), and had higher levels of C-reactive protein ( p = 0.030). Meanwhile, patients with IMH were more likely to be associated with hypertension ( p = 0.020) and pleural effusion ( p < 0.001) and less likely to have a history of acute coronary syndrome ( p = 0.019) and prior cardiovascular intervention ( p = 0.017). The five-year freedom from reintervention and cumulative survival rate were 94.2% (95% confidential interval, 88.9%–99.9%) and 87.8% (95% confidential interval, 79.5%–96.9%) in PAU patients and 89.6% (95% confidential interval, 75.8%–99.9%) and 85.1% (95% confidential interval, 68.0%–99.9%) in IMH patients, respectively. There was no significant difference in freedom from reintervention ( p = 0.795) or cumulative survival rate ( p = 0.817).

Conclusions

IMH appeared to occur in younger patients with hypertension and usually had an acute onset, while PAU was more likely to be found incidentally in older patients with atherosclerosis. Endovascular therapy was effective in both IMH and PAU patients with encouraging outcomes.
Investigating the triangle: The school principal’s role, term of office, and school improvement in Greece
Authors: Katsigianni Eleni A , Ifanti Amalia A
Published: April 2021

The aim of this study was to explore the role of school principals and their term of office in regard to school improvement. In particular, we investigated the convergences and divergences between the views of school principals in Greece and the findings of relevant international literature. To this end, we collected and analysed data from 66 school principals across 89 secondary state schools in Achaia, Greece, using an anonymous questionnaire. Survey data revealed that most participants assessed positively the contribution of essential aspects of international literature to school improvement. The same applied for the role and term of office of school principals in Greece, despite the factors that were acknowledged to limit their autonomy. More-qualified school principals appeared to have a more positive stance on assessment and human resource management. In contrast, novices had greater difficulty in managing priorities and tended to be more cautious at the prospect of being assessed. They also appeared to be more satisfied with the institution of term of office as per the Greek model. Conclusions on the implications are presented.
An operant temperature sensory assay provides a means to assess thermal discrimination
Authors: Isaacson Matthew , Hoon Mark A
Published: April 2021

Mouse behavioral assays have proven useful for the study of thermosensation, helping to identify receptors and circuits responsible for the transduction of thermal stimuli and information relay to the brain. However, these methods typically rely on observation of behavioral responses to various temperature stimuli to infer sensory ability and are often unable to disambiguate innocuous thermosensation from thermal nociception or to study thermosensory circuitry which do not produce easily detectable innate behavioral responses. Here we demonstrate a new testing apparatus capable of delivering small, rapid temperature change stimuli to the mouse’s skin, permitting the use of operant conditioning to train mice to recognize and report temperature change. Using this assay, mice that were trained to detect a large temperature change were found to generalize this learning to distinguish much smaller temperature changes across the entire range of innocuous temperatures tested. Mice with ablated TRPV1 and TRPM8 neuronal populations had reduced ability to discriminate temperature differences in the warm (>35°C) and cool (<30°C) ranges, respectively. Furthermore, mice that were trained to recognize temperature changes in only the cool, TRPM8-mediated temperature range did not generalize this learning in the warm, TRPV1-mediated range (and vice versa), suggesting that thermosensory information from the TRPM8- and TRPV1-neuronal populations are perceptually distinct.
Dexmedetomidine as an adjunctive analgaesic in the perioperative setting: A review of the literature
Authors: Reinert Justin P , Lang Andrew , Veronin Michael
Published: April 2021

Though arguably past the initial phase of the opioid epidemic, opioid-sparing or opioid-eliminating pain management regimens remain beneficial for patients and practitioners alike. Providing adequate analgaesia without relying on opioids is especially advantageous in the operative setting, as patients may be able to recover without deep levels of sedation or the need for a high amount of opioid medications. Despite being used primarily as a sedative over the past 20 years, dexmedetomidine, a centrally acting alpha2-agonist, possesses analgaesic properties, though its use has been limited by its well-described cardiovascular suppressive effects. The objective of this review was to determine the efficacy and safety of adjunctive dexmedetomidine for the purposes of analgaesia in the perioperative setting.
Mimetic rivalry in practice: The case of Kosovo
Authors: Hehir Aidan , Lanza Claudio
Published: April 2021

In this article, we advance a framework that highlights the relational nature of rivalry emergence and its ongoing manifestations, before illustrating this framework in practice through an analysis of the rivalry between Serbs and Albanians over the issue of Kosovo. We argue that the locus of rivalry lies in the inherently social character of human desire and the destructive reciprocity elicited by human mimetic behaviour. The manner in which rivals portray their plight, and legitimise their cause, is, we argue, a function of their desire to acquire that which they imagine the other has. As such, rather than adhering to the conventional view that rivalries are characterised by difference, we argue that rivals share a set of common goals/desires. Thus, though rivalries are characterised by mutual antipathy – and the attendant devotion to constructing self-serving myths – this is but a superficial manifestation of an underlying mimetic dynamic. To focus only on how myths are constructed and instrumentally employed, is not sufficient when seeking to explain the persistence of rivalries. Rather, we must understand the underlying desires the respective rivals seek to fulfill through the proliferation of these myths if we are to truly understand the nature of the rivalry.
Comorbidities Known to Affect Physical Function Negatively Impact Baseline Health-Related Quality-of-Life in Patients With Chronic Rhinosinusitis
Authors: Gill Amarbir S. , Ashby Shaelene , Oakley Gretchen M. , Steele Toby O. , Menjivar Dennis , Orlandi Richard R. , Alt Jeremiah A.
Published: April 2021

Background

Medical comorbidities are commonly encountered in chronic rhinosinusitis (CRS) and may impact both physical function and patient reported health-related quality-of-life (HRQOL). The functional comorbidity index (FCI) is designed to elucidate the role of comorbidities on functional prognosis. The objective of this study was to understand the impact of comorbidities known to impact physical function on baseline HRQOL using the FCI. Methodology: Patients meeting diagnostic criteria for CRS were prospectively enrolled in a cross-sectional study. Responses from the Sinonasal Outcomes Test-22 (SNOT-22), a measure of patient HRQOL, as well as the Lund-Kennedy and Lund-Mackay scores were recorded at enrollment. FCI was calculated retrospectively using the electronic medical record. Information was collected and compared for patients without (CRSsNP) and with nasal polyps (CRSwNP) using chi-square and t-tests. Spearman’s correlations, followed by multivariate regression analysis, were used to assess the association between FCI and SNOT-22 scores.

Results

One hundred and three patients met inclusion criteria for analysis. There were no significant differences in age, gender, and SNOT-22 scores between patients with CRSsNP and those with CRSwNP. FCI was significantly and independently associated with worse SNOT-22 scores ( P = .012). FCI did not correlate with endoscopy and computed tomography scores. The mean FCI for patients with CRSsNP and CRSwNP was 2.02 and 2.24, respectively, and did not differ significantly between the two cohorts ( P = .565).

Conclusions

Major medical comorbidities known to affect physical function are associated with worse SNOT-22 scores in patients with CRS as measured by the FCI.
Treatment of Patellofemoral Chondral Lesions Using Microfractures Associated with a Chitosan Scaffold: Mid-Term Clinical and Radiological Results
Authors: Calvo Rafael , Figueroa David , Figueroa Francisco , Bravo Jose , Contreras Martin , Zilleruelo Nicolas
Published: April 2021

Objective

To assess the clinical and radiological results of patellofemoral osteochondral lesions treated with microfractures associated with a chitosan scaffold.

Design

A retrospective observational analytical study was performed. Fifteen patients with full-thickness patellofemoral osteochondral lesions were included. Quantity and quality of the reparation cartilage was assessed with the MOCART 2.0 score on a postoperative magnetic resonance imaging (MRI), and clinical outcomes were evaluated with pre- and postoperative Kujala score tests. Shapiro-Wilk test for normality was applied as well as Wilcoxon’s signed rank test and Kruskal-Wallis H test for clinical scores within subjects and patella versus trochlea subgroups comparisons. Analysis of variance test was used for imaging subgroups comparison, with P < 0.05 defined as statistical significance.

Results

Mean follow-up was 33.36 months (range 24-60 months). Postoperative Kujala scores improved an average of 19 points compared with the preoperative state (SE = 17.6; P < 0.001). No statistical difference was found through the clinical location assessment ( P = 0.756), as well as the cartilage imaging assessment ( P = 0.756). The mean MOCART 2.0 scale was 67.67 (range 50-85).

Conclusions

Treating full-thickness patellofemoral osteochondral lesions with microfractures associated with a chitosan scaffold proved to be effective regarding defect filling and symptomatic improvement.
Positive predictive value and stroke workflow outcomes using automated vessel density (RAPID-CTA) in stroke patients: One year experience
Authors: Adhya Julie , Li Charles , Eisenmenger Laura , Cerejo Russell , Tayal Ashis , Goldberg Michael , Chang Warren
Published: April 2021

Purpose

Several new techniques have emerged for detecting anterior circulation large vessel occlusion by quantifying relative vessel density including RAPID-CTA, potentially allowing for faster triage and decreased time to mechanical thrombectomy. We present our one-year experience on positive predictive value of RAPID-CTA for the detection of large vessel occlusion in patients presenting with stroke symptoms and its effect on treatment time and clinical outcomes.

Materials and methods

Three hundred and ten patients presenting with stroke symptoms with relative vessel density <60% on RAPID-CTA were included (average age 70 years, 145 male, 165 female). Examinations were considered positive if there was evidence of large vessel occlusion or high grade stenosis. Computed tomography angiography to groin puncture time was calculated during one-year time intervals before and after RAPID-CTA installation. Ninety-day Modified Rankin Scale scores were obtained for patients in each cohort.

Results

Of the 310 patients, 270 had large vessel occlusion or high grade stenosis (87% positive predictive value), with 161 having large vessel occlusion. Using 45% relative vessel density threshold, 129/161 large vessel occlusion were detected (80% sensitivity) and 163/172 examinations were positive (95% positive predictive value). Computed tomography angiography to groin puncture time was significantly lower after deployment of RAPID-CTA (93 min vs 68 min, p<0.05). Average 90 day modified Rankin Scale score was lower in the RAPID-CTA group with a higher percentage of patients with functional independence, although the data was not statistically significant.

Conclusion

RAPID-CTA had high positive predictive value for large vessel occlusion with a 45% relative vessel density threshold, which could facilitate active worklist reprioritization. Time to treatment was significantly lower and clinical outcomes were improved after deployment of RAPID-CTA.
A qualitative study with orthopaedic surgeons on pain catastrophizing and surgical outcomes: shifting from a medical towards a biopsychosocial model of surgery
Authors: Dismore Lorelle , van Wersch Anna , Murty Aradhyula N , Swainston Katherine
Published: April 2021

Background:

Pain catastrophizing (PC) moderates surgical outcomes and behavioural interventions are recommended to optimise post-operative results. Less is known about surgeons’ experiences of providing care and their attitudes towards the use of interventions in practice.

Objective:

It is therefore invaluable to understand surgeons’ views on how best to support patients who may be at risk of suboptimal recovery. Eleven surgeons and three registrar orthopaedic practitioners took part in semi-structured interviews within a hospital setting. The surgical decision-making process, views of PC and the use of behavioural interventions in surgical practice were explored.

Results:

Thematic analysis identified five themes: pain expressions and pain behaviours affect the surgeons’ decision-making process, when pathologies and symptoms do not match, psychological factors pertaining to unsatisfactory outcomes, a service gap in surgical care and the acceptability of using a screening tool in surgical practice to identify patients at risk of suboptimal recovery.

Conclusion:

Orthopaedic surgeons face challenges in identifying who is likely to reach optimal versus suboptimal outcome. Surgeons are becoming increasingly aware of patient psychological distress being detrimental to outcomes, and they support the use of behavioural interventions to optimise post-operative outcomes or stop unnecessary treatments. The surgeons accept the use of a screening tool in surgical practice with better access to support services with input from allied health professionals. A screening tool may provide great utility for identifying at risk patients, to allow for modification of surgical patients care plans.
Use of item response theory to investigate disability-related questions in the National Health and Nutrition Examination Survey
Authors: Terman Samuel W , Burke James F
Published: April 2021

Objectives:

Accurately measuring disability is critical toward policy development, economic analyses, and determining individual-level effects of health interventions. Nationally representative population surveys such as the National Health and Nutrition Examination Survey provide key opportunities to measure disability constructs such as activity limitations. However, only very limited work has previously evaluated the item response properties of questions pertaining to limitations in National Health and Nutrition Examination Survey.

Methods:

This was a cross-sectional study. We included participants ⩾20 years old for the 2013–2018 National Health and Nutrition Examination Survey cycles. Activity limitations, and a smaller number of body function impairments or participation restrictions, were determined from interview questions. We performed item response theory models (a two-parameter logistic and a graded response model) to characterize discriminating information along the latent continuum of activity limitation.

Results:

We included 17,057 participants. Although each particular limitation was somewhat rare (maximally 13%), 7214 (38%) responded having at least one limitation. We found a high amount of discriminating information at 1–2 standard deviations above average limitation, though essentially zero discrimination below that range. Items had substantial overlap in the range at which they provided information distinguishing individuals. The ordinal graded response model including 20 limitations provided greater information than the dichotomous two-parameter logistic model, though further omitting items from the graded response model led to loss of information.

Conclusion:

National Health and Nutrition Examination Survey disability-related questions, mostly specifically activity limitations, provided a high degree of information distinguishing individuals with higher than average limitations on the latent continuum, but essentially zero resolution to distinguish individuals with low or average limitations. Future work may focus on developing items which better distinguish individuals at the “lower” end of the limitation spectrum.
Intralesional fenestration and corticosteroid injection for symptomatic Ledderhose disease of the foot: Two case reports
Authors: Flanagan George , Burt Nicola , Reilly Ian N
Published: April 2021

The description of corticosteroid injections as a treatment option for Ledderhose disease has received little attention in the literature and often only receives a passing comment in scientific papers. We present a short case series of two patients who underwent corticosteroid injection in combination with fenestration to treat painful Ledderhose disease nodules. Both patients had their lesions injected on two occasions. Significant reduction in pain and lesion volume was seen at 12 months post treatment. Our protocol combines fenestration with the use of triamcinolone acetonide (mixed with local anaesthetic) which we believe conveys further advantage over other steroid preparations or the corticosteroid infiltration alone.
Central odontogenic fibroma of simple type: An original observation
Authors: Oueslati Yassine , Belkacem Chebil Raouaa , Oualha Lamia , Mziou Zouha , Moatemri Ramzi , Sriha Badreddine , Douki Nabiha
Published: April 2021

Central odontogenic fibroma is an uncommon, benign, slow-growing intraosseous mesenchymal odontogenic tumour. It presents a diagnostic dilemma to the clinician and the pathologist because its clinical and radiological features resemble other odontogenic and/or non-odontogenic tumours, and the differential diagnosis is based on histological examination. In this report, we describe our experience with a case of a 23-year-old female patient with central odontogenic fibroma of the mandible that was diagnosed as ‘simple type’. Highlighting a subtype that was dropped from the last World Health Organization classification of head and neck tumours is important to accumulate more information about this lesion and to show its different features. Despite its rarity, central odontogenic fibroma should be included in the differential diagnosis of intrabony tumours of the jaws. These findings can better educate oral and maxillofacial surgeons about the unusual nature of this lesion, help establish a correct diagnosis and give the appropriate therapeutic management.
Longitudinal Coupling of Depression in Parent–Adolescent Dyads: Within- and Between-Dyads Effects Over Time
Authors: Griffith Julianne M. , Young Jami F. , Hankin Benjamin L.
Published: April 2021

In the present work, we evaluated reciprocal, within-dyads associations between parents’ and adolescents’ depressive symptoms across two independent samples ( N = 327 and N = 435 dyads; approximately 85% biological mothers) assessed every 3 months for 2 years (Study 1) to 3 years (Study 2). Results of random intercept cross-lagged panel models converged to support positive contemporaneous patterns of cofluctuation in parental and adolescent depression such that within-persons deviations in parental depression were associated with same-direction within-persons deviations in adolescent depression at the same time point. In contrast, within-persons fluctuations in parental depression did not prospectively predict within-persons fluctuations in adolescent depression, or vice versa, across the follow-up period. Results held across boys and girls, as well as dyads with and without a parental history of depressive disorder. Overall, findings advance knowledge by demonstrating that after accounting for between-persons/dyads variance, parental and adolescent depression demonstrate contemporaneous cofluctuations but do not demonstrate within-dyads reciprocity over time.
The Feasibility of 3D Intraoperative Navigation in Lateral Lumbar Interbody Fusion: Perioperative Outcomes, Accuracy of Cage Placement and Radiation Exposure
Authors: Urakawa Hikari , Sivaganesan Ahilan , Vaishnav Avani S. , Sheha Evan , Qureshi Sheeraz A
Published: April 2021

Study Design:

Retrospective cohort study.

Objectives:

To evaluate perioperative outcomes, accuracy of cage placement and radiation exposure in lateral lumbar interbody fusion (LLIF) using 3D intraoperative navigation (ION), compared to conventional 2D fluoroscopy only.

Methods:

The perioperative outcomes and accuracy of cage placement were examined in all patients who underwent LLIF using ION (ION group) or fluoroscopy only (non-ION group) by a single surgeon. The radiation exposure was examined in patients who underwent stand-alone LLIF.

Results:

A total of 87 patients with 154 levels (ION 49 patients with 79 levels/ non-ION 38 patients with 75 levels) were included. There were no significant differences in operative time (ION 143.5 min vs. non-ION 126.0 min, P = .406), time from induction end to surgery start (ION 31.0 min vs. non-ION 31.0 min, P = .761), estimated blood loss (ION 37.5 ml vs. non-ION 50.0 ml, P = .351), perioperative complications (ION 16.3% vs. non-ION 7.9%, P = .335) and length of stay (ION 50.6 hours vs. non-ION 41.7 hours, P = .841). No significant difference was found in the accuracy of cage placement ( P = .279). ION did not significantly increase total radiation dose (ION 51.0 mGy vs. non-ION 47.4 mGy, P = .237) and tended to reduce radiation dose during the procedure (ION 32.2 mGy vs. non-ION 47.4 mGy, P = .932).

Conclusions:

The perioperative outcomes, accuracy of cage placement and radiation exposure in LLIF using ION were comparable to those using fluoroscopy only. The use of ION in LLIF was feasible, safe and accurate and may reduce radiation dose to the surgeon and surgical team.
Effectiveness of a Gelatin–Thrombin Matrix Sealant (Floseal®) for Reducing Blood Loss During Microendoscopic Decompression Surgery for Lumbar Spinal Canal Stenosis: A Retrospective Cohort Study
Authors: Nomura Kazunori , Yoshida Munehito , Okada Motohiro , Nakamura Yosuke , Yawatari Kenichi , Nakayama Enshi
Published: April 2021

Study Design:

Retrospective cohort study.

Objectives:

To investigate the effectiveness and safety of a gelatin–thrombin matrix sealant (GTMS) during microendoscopic laminectomy (MEL) for lumbar spinal canal stenosis (LSCS).

Methods:

This study included 158 LSCS cases on hemostasis-affecting medication who underwent MEL by a single surgeon between September 2016 and August 2020. Patients were divided into 2 groups depending on whether GTMS was used (37 cases, Group A) or not (121 cases, Group B). Perioperative data related to bleeding or postoperative spinal epidural hematoma (PSEH) was investigated. Clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score for low back pain.

Results:

The mean intraoperative blood loss per level was greater in Group A (26.0 ± 20.3 g) than in Group B (13.6 ± 9.0 g), whereas the postoperative drainage volume was smaller in Group A (79.1 ± 42.5 g) than in Group B (97.3 ± 55.6 g). No revision surgeries for PSEH were required in Group A, while 2 (1.7%) revisions were required in Group B ( P = .957). The median JOA score improved significantly from the preoperative period to 1-year postoperatively in both Group A and B (total score, 16.0-23.5 and 17.0-25.0 points, respectively).

Conclusions:

The use of GTMS during MEL for LSCS may be associated with a reduction in postoperative drainage volume. The revision rate for PSEH was not affected significantly by the use of GTMS. Clinical outcomes (represented by the JOA score) were significantly improved after the surgery, regardless of GTMS use during MEL.
Brazilian Black Feminism in Rural and Urban Spaces
Authors: Rios Flavia , Maciel Regimeire
Published: April 2021

Brazilian Black feminism has changed and grown more influential and diverse in the past two decades. One of the major challenges is to understand what these changes mean for women’s agency in the different contexts in which they emerge, both rural and urban. To examine the transformations of Black feminism in Brazil, this article investigates three generations of activists over the periods of re-democratization, democratic expansion and crisis of democracy, bringing focus to Black women in the quilombola movement, young Black feminists on the Internet and intersectional feminism. The article analyses traditional and new activist networks that claim multiple identities for themselves, as well as public status as collective action strategies to seize traditional spaces for political activism, grounding themselves in feminism and anti-racism against the multiple forms of oppression in urban and rural spaces.
Neuromuscular Training Warm-up Prevents Acute Noncontact Lower Extremity Injuries in Children’s Soccer: A Cluster Randomized Controlled Trial
Authors: Hilska Matias , Leppänen Mari , Vasankari Tommi , Aaltonen Sari , Kannus Pekka , Parkkari Jari , Steffen Kathrin , Kujala Urho M. , Konttinen Niilo , Räisänen Anu M. , Pasanen Kati
Published: April 2021

Background:

Prevention of sports injuries is essential in youth, as injuries are associated with less future physical activity and thus greater all-cause morbidity.

Purpose:

To investigate whether a neuromuscular training warm-up operated by team coaches is effective in preventing acute lower extremity (LE) injuries in competitive U11-U14 soccer players.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

Twenty top-level U11 to U14 soccer clubs in Finland were randomized into intervention and control groups and assessed for 20 weeks. Participants included 1403 players (280 female, 1123 male; age range, 9-14 years): 673 players (44 teams) in the intervention group and 730 players (48 teams) in the control group. The intervention group team coaches were introduced to a neuromuscular training warm-up to replace the standard warm-up 2 to 3 times per week. The control teams were asked to perform their standard warm-up. Injury data collection was done via weekly text messages. The primary outcome measure was a soccer-related acute LE injury, and the secondary outcome measure was an acute noncontact LE injury.

Results:

A total of 656 acute LE injuries occurred: 310 in the intervention group and 346 in the control group. The overall acute LE injury incidence was 4.4 per 1000 hours of exposure in the intervention group and 5.5 per 1000 hours of exposure in the control group, with no significant difference between groups (incidence rate ratio [IRR], 0.82 [95% CI, 0.64-1.04]). There were 302 acute noncontact LE injuries: 129 in the intervention group (incidence, 1.8 per 1000 hours) and 173 in the control group (2.7 per 1000 hours). A significant reduction in acute noncontact LE injuries of 32% (IRR, 0.68 [95% CI, 0.51-0.93]) was observed in the intervention group compared with the control group. Furthermore, significant reductions in injury incidence in favor of the intervention group were seen in the subanalyses of acute noncontact LE injuries, leading to ≤7 days of time loss and fewer ankle and joint/ligament injuries.

Conclusion:

A neuromuscular training warm-up operated by team coaches was found to be effective in preventing acute noncontact LE injuries in children’s soccer, but this was not seen in all acute LE injuries.

Clinical Relevance:

We encourage children’s soccer coaches and health care professionals to implement neuromuscular training warm-up in youth sports.

Registration:

ISRCTN14046021 (ISRCTN registry).
Changes in Pediatric Sports Injury Presentation During the COVID-19 Pandemic: A Multicenter Analysis
Authors: Johnson Mitchell A. , Halloran Kenny , Carpenter Connor , Pascual-Leone Nicolas , Parambath Andrew , Sharma Jigyasa , Seltzer Ryan , Ellis Henry B. , Shea Kevin G. , Ganley Theodore J.
Published: April 2021

Background:

The current coronavirus 2019 (COVID-19) pandemic has prompted a multitude of public health response measures including social distancing, school cancellations, and cessation of organized sports.

Purpose:

To examine the impact of COVID-19 and corresponding public health measures on the characteristics of common pediatric musculoskeletal injuries associated with sports.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This was a multicenter retrospective cohort study comparing patients with sports injuries presenting to 3 geographically diverse level I pediatric trauma hospitals and outpatient orthopaedic surgery clinics in the United States during the COVID-19 pandemic and a prepandemic period at the same institutions. Patients were included if they presented for care between February 15 and July 15 in 2020 (pandemic cohort) or between March 15 and April 15 in 2018 and 2019 (prepandemic cohort).

Results:

Included were 1455 patients with an average age of 12.1 ± 4.5 years. When comparing patients presenting in 2018 and 2019 with those presenting in 2020, we observed a decrease in mean age during the pandemic (12.6 ± 4.0 vs 11.0 ± 5.2 years; P = .048). Additionally, a decrease in the proportion of injuries attributed to sports (48.8% vs 33.3%; P < .001) and those occurring at school (11.9% vs 4.0%; P = .001) was observed. The proportion of injuries attributable to clavicle fractures increased during the early stages of the pandemic (13.2% vs 34.7%; P < .001). There was no statistically significant delay to care in injuries presenting during the pandemic (41.5 ± 141.2 vs 19.23 ± 79.1 days; P = .175).

Conclusion:

Across 3 tertiary care institutions, patients were seen without significant delay during the pandemic. We observed a significant decline in pediatric musculoskeletal injuries associated with sports during the COVID-19 pandemic. This decrease has been accompanied by a shift in both injury type and mechanism.
Improving Transparency, Falsifiability, and Rigor by Making Hypothesis Tests Machine-Readable
Authors: Lakens Daniël , DeBruine Lisa M.
Published: April 2021

Making scientific information machine-readable greatly facilitates its reuse. Many scientific articles have the goal to test a hypothesis, so making the tests of statistical predictions easier to find and access could be very beneficial. We propose an approach that can be used to make hypothesis tests machine-readable. We believe there are two benefits to specifying a hypothesis test in such a way that a computer can evaluate whether the statistical prediction is corroborated or not. First, hypothesis tests become more transparent, falsifiable, and rigorous. Second, scientists benefit if information related to hypothesis tests in scientific articles is easily findable and reusable, for example, to perform meta-analyses, conduct peer review, and examine metascientific research questions. We examine what a machine-readable hypothesis test should look like and demonstrate the feasibility of machine-readable hypothesis tests in a real-life example using the fully operational prototype R package scienceverse.
Making Sense of Our Working Lives: The concept of the career imagination
Authors: Cohen Laurie , Duberley Joanne
Published: April 2021

This essay considers how the traditional concept of career retains its power in an age of contingency, short-termism and gig work. To answer this question, it introduces and explicates the concept of the ‘career imagination’. This concept has three key dimensions: perceptions of enablement and constraint, time and identity. Situated in the nexus of structure and agency, it is through our career imagination that we envisage and evaluate the progress of our working lives. Encapsulating continuity and change, our career imagination helps us to understand the enduring legitimacy of the traditional career as a yardstick by which to measure success, and the emergence of new possibilities.
Prothrombotic immune thrombocytopenia after COVID-19 vaccination
Authors: Tiede Andreas , Sachs Ulrich J. , Czwalinna Andreas , Werwitzke Sonja , Bikker Rolf , Krauss Joachim K. , Donnerstag Frank , Weißenborn Karin , Höglinger Günter , Maasoumy Benjamin , Wedemeyer Heiner , Ganser Arnold
Published: April 2021

We report 5 cases of prothrombotic immune thrombocytopenia after exposure to the ChAdOx1 vaccine (AZD1222, Vaxzevria) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients presented 5 to 11 days after first vaccination. The spectrum of clinical manifestations included cerebral venous sinus thrombosis, splanchnic vein thrombosis, arterial cerebral thromboembolism, and thrombotic microangiopathy. All patients had thrombocytopenia and markedly elevated D-dimer. Autoantibodies against platelet factor 4 (PF4) were detected in all patients, although they had never been exposed to heparin. Immunoglobulin from patient sera bound to healthy donor platelets in an AZD1222-dependent manner, suppressed by heparin. Aggregation of healthy donor platelets by patient sera was demonstrated in the presence of buffer or AZD1222 and was also suppressed by heparin. Anticoagulation alone or in combination with eculizumab or intravenous immunoglobulin (IVIG) resolved the pathology in 3 patients. Two patients had thromboembolic events despite anticoagulation at a time when platelets were increasing after IVIG. In summary, an unexpected autoimmune prothrombotic disorder is described after vaccination with AZD1222. It is characterized by thrombocytopenia and anti-PF4 antibodies binding to platelets in AZD1222-dependent manner. Initial clinical experience suggests a risk of unusual and severe thromboembolic events.
Treating lymphoma is now a bit EZ-er
Authors: Morin Ryan D. , Arthur Sarah E. , Assouline Sarit
Published: April 2021

Tazemetostat represents the first epigenetic therapy approved for the treatment of follicular lymphoma (FL). It inhibits the activity of the enhancer of zeste homolog 2 (EZH2) histone methyltransferase, the first of a multitude of epigenetic regulators that have been identified as recurrently mutated in FL and germinal center diffuse large B-cell lymphoma. In this review, we discuss the initial discovery and ongoing exploration of the functional role of EZH2 mutations in lymphomagenesis. We also explore the path from the preclinical development of tazemetostat to its approval for the treatment of relapsed FL, and potential future therapeutic applications. We discuss the clinical data that led to the approval of tazemetostat and ongoing research into the function of EZH2 and of tazemetostat in lymphomas that derive from the germinal center, which could increase the applicability of this drug in the future.
Cedazuridine/decitabine: from preclinical to clinical development in myeloid malignancies
Authors: Patel Anand A. , Cahill Kirk , Saygin Caner , Odenike Olatoyosi
Published: April 2021

Since the US Food and Drug Administration (FDA) approvals of parenteral decitabine and azacitidine, DNA methyltransferase inhibitors, otherwise referred to as DNA hypomethylating agents (HMAs), have been a mainstay in the treatment of higher-risk myelodysplastic syndromes. The development of oral HMAs has been an area of active interest; however, oral bioavailability has been quite poor due to rapid metabolism by cytidine deaminase (CDA). This led to the development of the novel CDA inhibitor cedazuridine, which was combined with an oral formulation of decitabine. Preclinical work demonstrated a pharmacokinetic and pharmacodynamic profile approximate to parenteral decitabine, leading to early-phase clinical trials of oral cedazuridine-decitabine (C-DEC) in myelodysplastic syndromes and chronic myelomonocytic leukemia (CMML). A combination of oral decitabine 35 mg with oral cedazuridine 100 mg was established as the recommended phase 2 dose. Phase 2 data confirmed bioequivalence of C-DEC when compared with parenteral decitabine, and a larger phase 3 trial has demonstrated similar results, leading to the FDA approval of C-DEC for use in intermediate/high-risk myelodysplastic syndrome (MDS) and CMML. This review will focus upon the current role of HMA therapy in MDS/CMML, preclinical and clinical development of C-DEC, and potential roles of oral HMA therapy in myeloid malignancies moving forward.