bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Adjustment Model for Preserved Health Status in Patients With Heart Failure and Reduced Ejection Fraction: The CHAMP-HF Registry
Authors: Tran Andy T. , Fonarow Gregg C. , Arnold Suzanne V. , Jones Philip G. , Thomas Laine E. , Hill C. Larry , DeVore Adam D. , Butler Javed , Albert Nancy M. , Spertus John A.
Published: October 2021

Background:

Health status outcomes are increasingly being promoted as measures of health care quality, given their importance to patients. In heart failure (HF), an American College of Cardiology/American Heart Association Task Force proposed using the proportion of patients with preserved health status as a quality measure but not as a performance measure because risk adjustment methods were not available.

Methods:

We built risk adjustment models for alive with preserved health status and for preserved health status alone in a prospective registry of outpatients with HF with reduced ejection fraction across 146 US centers between December 2015 and October 2017. Preserved health status was defined as not having a ≥5-point decrease in the Kansas City Cardiomyopathy Questionnaire Overall Summary score at 1 year. Using only patient-level characteristics, hierarchical multivariable logistic regression models were developed for 1-year outcomes and validated using data from 1 to 2 years. We examined model calibration, discrimination, and variability in sites’ unadjusted and adjusted rates.

Results:

Among 3932 participants (median age [interquartile range] 68 years [59–75], 29.7% female, 75.4% White), 2703 (68.7%) were alive with preserved health status, 902 (22.9%) were alive without preserved health status, and 327 (8.3%) had died by 1 year. The final risk adjustment model for alive with preserved health status included baseline Kansas City Cardiomyopathy Questionnaire Overall Summary, age, race, employment status, annual income, body mass index, depression, atrial fibrillation, renal function, number of hospitalizations in the past 1 year, and duration of HF (optimism-corrected C statistic=0.62 with excellent calibration). Similar results were observed when deaths were ignored. The risk standardized proportion of patients alive with preserved health status across the 146 sites ranged from 62% at the 10th percentile to 75% at the 90th percentile. Variability across sites was modest and changed minimally with risk adjustment.

Conclusions:

Through leveraging data from a large, outpatient, observational registry, we identified key factors to risk adjust sites’ proportions of patients with preserved health status. These data lay the foundation for building quality measures that quantify treatment outcomes from patients’ perspectives.
Two‐Thumb Technique Is Superior to Two‐Finger Technique in Cardiopulmonary Resuscitation of Simulated Out‐of‐Hospital Cardiac Arrest in Infants
Authors: Cioccari Giani , Sica da Rocha Tais , Piva Jefferson Pedro
Published: October 2021

Background

To compare the 2‐finger and 2‐thumb chest compression techniques on infant manikins in an out‐of‐hospital setting regarding efficiency of compressions, ventilation, and rescuer pain and fatigue.

Methods and Results

In a randomized crossover design, 78 medical students performed 2 minutes of cardiopulmonary resuscitation with mouth‐to‐nose ventilation at a 30:2 rate on a Resusci Baby QCPR infant manikin (Laerdal, Stavanger, Norway), using a barrier device and the 2‐finger and 2‐thumb compression techniques. Frequency and depth of chest compressions, proper hand position, complete chest recoil at each compression, hands‐off time, tidal volume, and number of ventilations were evaluated through manikin‐embedded SkillReporting software. After the interventions, standard Likert questionnaires and analog scales for pain and fatigue were applied. The variables were compared by a paired
t
‐test or Wilcoxon test as suitable. Seventy‐eight students participated in the study and performed 156 complete interventions. The 2‐thumb technique resulted in a greater depth of chest compressions (42 versus 39.7 mm;
P
<0.01), and a higher percentage of chest compressions with adequate depth (89.5% versus 77%;
P
<0.01). There were no differences in ventilatory parameters or hands‐off time between techniques. Pain and fatigue scores were higher for the 2‐finger technique (5.2 versus 1.8 and 3.8 versus 2.6, respectively;
P
<0.01).

Conclusions

In a simulation of out‐of‐hospital, single‐rescuer infant cardiopulmonary resuscitation, the 2‐thumb technique achieves better quality of chest compressions without interfering with ventilation and causes less rescuer pain and fatigue.
China-Taiwan Threats of Force and the Paradox of the ‘Nuclear Weapons Principle’
Authors: Helmersen Sondre Torp
Published: October 2021

The People’s Republic of China (‘China’) has adopted legislation threatening to invade the Republic of China (‘Taiwan’) if the latter declares independence. Threats of force are prohibited by the UN Charter Article 2(4) and equivalent customary international law. This article proceeds along two apparently contradictory strands. On the one hand, the prohibition probably does not apply to non-State entities such as the Republic of China. One the other hand, the ICJ stated in the Nuclear Weapons opinion that ‘if the use of force itself in a given case is illegal […] the threat to use such force will likewise be illegal’. If the Republic of China declares independence it will become a State, making a PRC invasion illegal. Therefore, the PRC’s current threats should also be illegal. The best way to resolve this apparent paradox is to say that the ICJ’s ‘Nuclear Weapons principle’ must be nuanced.
China’s Humanistic Zhong-Yong Approach to Educational Partnerships for International Development in Post-Covid-19: Confucian and Ubuntu Perspectives on Confucius Institutes and Classrooms in Africa
Authors: Li Jun
Published: October 2021

Based on broad observations of the development of Confucius Institutes and Classrooms in Africa over a decade, this article focuses on educational partnerships between Chinese and African educational institutions and their implications for international development, as they relate to international development in the era of post-Covid-19. The author identifies the Confucian Zhong-Yong approach to educational partnerships through Confucius Institutes and Classrooms in Africa, a pragmatic model for educational development centered on Confucianism. Three core characteristics of Confucian educational partnerships – demand-driven, ethics-based and pragmatic – are seen as the key to the success of such partnerships. Reflecting on Ubuntu from a Confucian perspective, the author concludes that China’s humanistic Zhong-Yong approach to partnerships has a unique potential to re-envision education for international development in ways that may be of interest to such international developmental agencies as the Asian Infrastructure Investment Bank, the World Bank, and the United Nations.
The End of the Middle East’s Unipolar Era
Authors: Mousavian Seyed Hossein , Ameri Salman
Published: October 2021

This Policy Insight article argues that a growing security partnership between Russia, Iran, China, Turkey, Iraq, and Syria (rictis) will push the Middle East into an era of bipolarity. The paper demonstrates that rictis has significant convergence on regional security issues, and that these interests are distinct from those held by the American Security Camp, a collection of states that include the United States, Saudi Arabia, Israel, and the United Arab Emirates. The paper also argues that rictis has military and energy advantages that allow it to confront the American Camp’s regional dominance. Our analysis demonstrates how rictis might help deter unilateralism and democratize regional decision-making.
On the diurnal cycle of rainfall and convection over Lake Victoria and its catchment. Part 1: Rainfall and Mesoscale Convective Systems
Authors: Nicholson Sharon E. , Hartman Adam T. , Klotter Douglas A.
Published: October 2021

This article examines the diurnal cycle of lake-effect rains over Lake Victoria and of rainfall in the surrounding catchment. The analysis focuses on four months, which represent the two wet seasons (April and November) and the two dry seasons (February and July). Lake-effect rains are strongest in April, weakest in July. In all cases there is a nocturnal rainfall maximum over the lake and a daytime maximum over the catchment, with the transition between rainfall over the lake and over the catchment occurring between 1200 and 1500 LST. During the night the surrounding catchment is mostly dry. Conversely, little to no rain falls over the lake during the afternoon and early evening. In most cases the maximum over the lake occurs at either 0600 or 0900 LST and the maximum over the catchment occurs around 1500 to 1800 LST. The diurnal cycle of Mesoscale Convective Systems (MCSs) parallels that of over-lake rainfall. MCS initiation generally begins over the catchment around 1500 LST and increases at 1800 LST. MCS initiation over the lake begins around 0300 LST and continues until 1200 LST. While some MCSs originate over the highlands to the east of the lake, most originate in situ over the lake. Maximum MCS activity over the lake occurs at 0600 LST and is associated with the systems that initiate in situ.
The Digital Dilemma: Perspectives From Otolaryngology Residency Applicants on Social Media
Authors: Patro Ankita , Landeen Kelly C. , Stevens Madelyn N. , Cass Nathan D. , Haynes David S.
Published: October 2021

Objective:

To evaluate the impact of otolaryngology programs’ social media on residency candidates in the 2020 to 2021 application cycle.

Methods:

An anonymous survey was distributed via Otomatch, Headmirror, and word of mouth to otolaryngology residency applicants in the 2021 Match. Survey items included demographics, social media usage, and impact of programs’ social media on applicant perception and ranking. Descriptive statistics were performed, and responses based on demographic variables were compared using Fisher’s exact and Mann-Whitney U tests.

Results:

Of 64 included respondents, nearly all (61/64, 95%) used Facebook, Instagram, and/or Twitter for personal and/or professional purposes. Applicants (59/64, 92%) most commonly researched otolaryngology residency programs on Instagram (55/59, 93%) and Twitter (36/59, 61%), with younger ( P = .023) and female ( P = .043) applicants being more likely to engage with programs on Instagram. Program accounts were most helpful in showcasing program culture (50/59, 85%) and highlighting its location (34/59, 58%). Nearly one third (19/59, 32%) reported that social media impacted their rank list. Age, gender, reapplication, home program status, or time taken off before and/or during medical school did not significantly influence social media’s usefulness in the application cycle.

Conclusion:

Social media platforms like Instagram and Twitter are frequently used by applicants to assess otolaryngology residency programs. Programs’ social media accounts effectively demonstrate program culture and affect applicants’ rank lists. As social media usage continues to rise in the medical community, these findings can help otolaryngology residency programs craft a beneficial online presence that aids in recruitment, networking, and education.
A Brief History of the Discovery of Amelogenin Nanoribbons In Vitro and In Vivo
Authors: Bai Y. , Bonde J. , Carneiro K.M.M. , Zhang Y. , Li W. , Habelitz S.
Published: October 2021

Without evidence for an organic framework, biological and biochemical processes observed during amelogenesis provided limited information on how extracellular matrix proteins control the development of the complex fibrous architecture of human enamel. Over a decade ago, amelogenin nanoribbons were first observed from recombinant proteins during in vitro mineralization experiments in our laboratory. In enamel from mice lacking the enzyme kallikrein 4 (KLK4), we later uncovered ribbon-like protein structures that matched the morphology, width, and thickness of the nanoribbons assembled by recombinant proteins. Interestingly, similar structures had already been described since the 1960s, when enamel sections from various mammals were demineralized and stained for transmission electron microscopy analysis. However, at that time, researchers were not aware of the ability of amelogenin to form nanoribbons and instead associated the filamentous nanostructures with possible imprints of mineral ribbons in the gel-like matrix of developing enamel. Further evidence for the significance of amelogenin nanoribbons for enamel development was stipulated when recent mineralization experiments succeeded in templating and orienting the growth of apatite ribbons along the protein nanoribbon framework. This article provides a brief historical review of the discovery of amelogenin nanoribbons in our laboratory in the context of reports by others on similar structures in the developing enamel matrix.
Predicting and Evaluating Treatment Response: Evidence Toward Protracted Response Patterns for Severely Impacted Students With Dyslexia
Authors: Middleton Anna E. , Farris Emily A. , Ring Jeremiah J. , Odegard Timothy N.
Published: October 2021

Great strides have been made in the development of effective methods of instruction for children with dyslexia. However, individual response to treatment varies, and weaknesses persist for some students with dyslexia despite otherwise effective instruction. Continued efforts are needed to support the prospective identification of poor response, particularly in routine intervention settings. The current study addressed whether indicators of dyslexia risk as outlined by hybrid diagnostic models predict response in children who received Tier 3 dyslexia intervention in their schools. The program’s efficacy has been previously documented in remediating reading abilities in children with dyslexia. Data were examined from 115 elementary-age children who received routine Tier 3 dyslexia intervention in their schools. Logistic regression revealed powerful effects of preintervention fluency and gender in predicting response, with weaker effects of decoding and rapid naming. Attention-deficit/hyperactivity disorder status also played a role in predicting response. Phonological awareness and listening-reading comprehension discrepancy did not predict response. Profile analyses indicated near- and far-transfer of skill for the adequate response group, whereas growth in the poor response group was limited to near-transfer. Findings support a continuum of severity that may be associated with less robust growth and generalization over the course of the intervention.
Tearing behaviors of polytetrafluoroethylene coated fabric under uniaxial in-plane tearing tests
Authors: Zhang Xubo , Wu Minger , Bao Han
Published: October 2021

This study conducts alternative-basic-angle trapezoidal tearing and single-edge notch tearing tests on a polytetrafluoroethylene coated woven fabric, where the two methods are related through the basic angle of a trapezoid. The tearing process and failure modes are carefully examined, and load–displacement curves and tearing strength are analyzed. The tearing process comprises three stages, which are distinguished photographically or in different load–displacement curve sections. Corresponding to these stages, failure modes can be classified into three parts with varying extension directions. The effect of the basic angle is clearly illustrated. As the angle increases, three stages and parts appear in sequence; the tearing strength increases, but the larger one changes from weft to warp. The relationship between the tearing process and tearing strength is described. The three stages correspond to the increase in tearing strength, occurrence of the maximum tearing strength, and failure. Because the single-edge notch tearing method is more complex and important, it is the method that is studied mainly. Digital image correlation equipment is used to observe the strain distribution at the crack section. Moreover, the applications of four frequently used models are investigated. The results indicate that Thiele’s empirical formula offers the best simulation among the three tearing strength prediction models, and the theoretical stress distribution model also provides good simulation. Furthermore, a numerical simulation is conducted. The critical tearing strength and load–displacement curves before tearing initiates acquired through the simulation and test agree well. All results may provide basic data for future improvements in design theories.
Electric conductivity and surface potential distributions in carbon fiber reinforced composites with different ply orientations
Authors: Han Chaofeng , Sun Baozhong , Gu Bohong
Published: October 2021

The electric conductivity and surface potential distributions of carbon fiber laminated panels with different ply orientations have been investigated. We found that the unidirectional (UD) lamina has higher conductivity along the carbon fiber direction than the perpendicular direction, and equipotential contours also show different gradients along the two directions. The cross-ply (CP) and quasi-isotropic (QI) laminates have the mixed effects of the UD lamina electric conductivity and ply orientations, while the surface potential distributions mostly depend on the surface lamina direction. The conductivity along the thickness direction depends on each lamina and inter-laminar bonding. A finite element analysis model was also developed to show the effect of ply orientation on potential distribution. The CP and QI laminates with 0° surface ply have uniform potential distributions and isotropic electricity behaviors. The results could be used to monitor damage locations and design electric composite materials.
Changes of color and antibacterial characteristics of knitted fabrics dyed with reactive dyes after treatment with a nanocomposition of silver and carboxymethyl starch
Authors: Bektursunova Ainur , Botabayev Nurzhan , Yerkebay Gani , Nabiev Donyor
Published: October 2021

Changes in the color characteristics of knitted fabrics after bactericidal finishes were studied by the colorimetric method. Antibacterial activity was tested with regard to gram-negative bacterium E. coli and gram-positive bacterium S. aureus.

The strongest color changes due to the presence of Ag NPs were observed on samples dyed with lighter shades, where the color difference was mainly caused by the change in lightness and brightness. After treatment with silver NPs, the colors in samples dyed with Navy K-EN and Black NN are deepened, that is, the color intensity increases many times and the reflection coefficient decreases. Due to this effect, darker color tones can be achieved using less dye.

The dyed knitted fabrics modified with Ag-carboxymethyl starch (AgCMS) NPs exhibited excellent antibacterial properties regardless of the dye color used. The dyeing did not affect the antibacterial activity of fabrics modified with AgCMS nanocomposites. The research on the resistance of the dyed knitted fabrics treated with nanocomposite AgCMS solution to washing showed the preservation of a sufficiently high antimicrobial activity, slightly decreasing only after the 10th wash in a washing solution. This is proved by exceptional resistance to washing of knitted fabrics modified with AgCMS.

The results of the research allow one to solve the problem of expanding the range of antibacterial products and special clothes by treating textile materials with silver and carboxymethyl starch NPs.
The cities we need: Towards an urbanism guided by human needs satisfaction
Authors: Cardoso Rodrigo , Sobhani Ali , Meijers Evert
Published: October 2021

This article proposes moving beyond the tyranny of economic imperatives towards a human needs-based framework to assess cities and envision their development. Existing calls for such a transition lack a foundation able to capture the various dimensions of human life in cities, which can be provided by the concept of human needs. We ask whether cities deliver satisfiers that make them good places to cater for the full range of human needs in a similar way to how they cater for economic needs. The article develops a framework that allows us to address that question. We show how the main debates in human needs theory are illustrated by urban phenomena, and search for a human needs model which is able to advance those debates and tackle the problem specifically in cities. Then we highlight the specifically urban aspects of needs satisfaction processes and construct a table of indicators to assess how cities fare in that respect, ensuring global comparability as to whether, as well as local contextualisation as to how, needs are satisfied.
Laguerre-Gramian-based structure-preserving model order reduction for second-order form systems
Authors: Dai Liu , Xiao Zhi-Hua , Zhang Ren-Zheng , Jiang Yao-Lin
Published: October 2021

A new structure-preserving model order reduction technique based on Laguerre-Gramian for second-order form systems is presented in this article. The main task of the proposed approach is to use the Laguerre polynomial expansion of the matrix exponential function to obtain the approximate low-rank decomposition of the Gramians for the equivalent first-order representation of the original second-order form system. The approximate balanced system is generated by a balancing transformation which is directly computed from the expansion coefficients of impulse responses in the space spanned by Laguerre polynomials, without computing the full Gramians for the first-order representation. Then, the reduced second-order model is constructed by truncating the states with small approximate Hankel singular values (HSVs). The above method has a disadvantage that it may unexpectedly result in unstable systems although the original one is stable. Therefore, modified reduction procedure combined with the dominant subspace projection method is presented to alleviate the limitation. Finally, two numerical experiments are provided to demonstrate the effectiveness of the algorithms.
Evaluation of a Graduated Exposure Procedure to Teach Extended Mask Wearing in Various Settings to Children With Autism
Authors: Ertel Hallie M. , Wilder David A. , Hodges Ansley C.
Published: October 2021

During the COVID-19 outbreak, the Center for Disease Control (CDC) recommended that everyone 2 years and older wear a face mask while in a community setting. However, children with autism may be reluctant to wear a mask, particularly for extended durations. In the current study, we implemented a graduated exposure procedure to teach mask wearing for a minimum of 1 hour in an early intensive behavioral (EIBI) intervention clinic to three children diagnosed with autism. We subsequently probed mask wearing, and if necessary implemented the graduated exposure procedure, in each participant’s home and in a mock physician’s office. Finally, we collected probe data on mask wearing in another community setting and 1 month post-treatment maintenance data in the EIBI clinic. During baseline, participants wore masks for 0 second to 5 minutes. After treatment, all participants wore the mask for at least 1 hour in each setting, with maintenance probes indicating 4 to 5 hour mask tolerance.
Literature and Madness: Madness in the Baroque Theatre and the Theatre of Artaud
Authors: Foucault Michel
Published: October 2021

This article has been translated into English by Nancy Luxon and published with permission. Michel Foucault, La littérature et la folie [La folie dans le théâtre baroque et le théâtre d'Artaud], in Folie, langage, littéature, eds. H.-P. Fruchaud, D. Lorenzini, & J. Revel, pp. 89–109 © Librairie philosophique J. Vrin, Paris, 2019. www.vrin.fr Requests for re-use of La littéature et la folie [La folie dans le théâtre baroque et le théâtre d'Artaud] should be directed to Librairie philosophique J. Vrin, Paris. Literature and madness dominate Michel Foucault’s early writings in the 1960s, and indeed much of his career. In this text, Foucault considers the relation between madness, language, and silence; the difficult frontier between language and literary convention; and the experience of madness within language. He moves from a meditation on madness, to a rare commentary on theatre, stagecraft, and Artaud, and finishes by considering literature’s capacity for rupture. ‘Literature and Madness’ is a translation of a text written by Foucault in the 1960s, and recently published in Folie, langage, littérature, ed. Henri-Paul Fruchaud, Daniele Lorenzini and Judith Revel (Paris: Vrin, 2019, 89–109). This version includes a translator’s introduction by Nancy Luxon and was given a distinct subtitle to distinguish it from a similar lecture with the same title in that volume.
Insufficiency of ventral hippocampus to medial prefrontal cortex transmission explains antidepressant non-response
Authors: Papp Mariusz , Gruca Piotr , Lason Magdalena , Litwa Ewa , Solecki Wojciech , Willner Paul
Published: October 2021

Background:

There is extensive evidence that antidepressant drugs restore normal brain function by repairing damage to ventral hippocampus (vHPC) and medial prefrontal cortex (mPFC). While the damage is more extensive in hippocampus, the evidence of treatments, such as deep brain stimulation, suggests that functional changes in prefrontal cortex may be more critical. We hypothesized that antidepressant non-response may result from an insufficiency of transmission from vHPC to mPFC.

Method:

Antidepressant non-responsive Wistar Kyoto (WKY) rats were subjected to chronic mild stress (CMS), then treated with chronic daily administration of the antidepressant drug venlafaxine (VEN) and/or repeated weekly optogenetic stimulation (OGS) of afferents to mPFC originating from vHPC or dorsal HPC (dHPC).

Results:

As in many previous studies, CMS decreased sucrose intake, open-arm entries on the elevated plus maze (EPM), and novel object recognition (NOR). Neither VEN nor vHPC–mPFC OGS alone was effective in reversing the effects of CMS, but the combination of chronic VEN and repeated OGS restored normal behaviour on all three measures. dHPC–mPFC OGS restored normal behaviour in the EPM and NOR test irrespective of concomitant VEN treatment, and had no effect on sucrose intake.

Conclusions:

The synergism between VEN and vHPC–mPFC OGS supports the hypothesis that the antidepressant non-responsiveness of WKY rats results from a failure of antidepressant treatment fully to restore transmission in the vHPC–mPFC pathway.
Lesion human leukocyte antigen-E is associated with favourable prognosis for patients with oesophageal squamous cell carcinoma
Authors: Xu Yong-Fu , Du Xue-Feng , Li Zhen-Yu , Fang Zhe-Ping , Zhang Fa-Biao
Published: October 2021

Objective

To investigate the clinical significance of human leukocyte antigen (HLA)-E levels in oesophageal squamous cell carcinoma (ESCC).

Methods

The levels of HLA-E immunostaining in ESCC lesions and 47 corresponding adjacent normal tissues were measured using immunohistochemistry. The correlation between the levels of immunostaining and clinical parameters was analysed.

Results

This study analysed 110 paraffin-embedded primary tumour lesions and 47 case–controlled paracancerous tissues that were surgically resected from 110 patients with ESCC. Positive immunostaining for HLA-E was observed in 88.2% (97 of 110) of ESCC lesions and 29.8% (14 of 47) of normal oesophageal tissues. There was no correlation between HLA-E immunostaining in ESCC lesions and clinicopathological characteristics such as lymph node metastasis, tumour–node–metastasis stage and differentiation grade. Kaplan–Meier survival analysis revealed a significantly better prognosis in patients with higher levels of HLA-E immunostaining than in those with lower levels of HLA-E immunostaining; overall survival was 28.6 months (95% confidence interval [CI], 23.2, 34.0) versus 15.3 months (95% CI, 11.5, 19.1), respectively. Furthermore, multivariate analysis showed that the HLA-E level was an independent prognostic factor in patients with ESCC.

Conclusion

A higher level of HLA-E immunostaining was associated with favourable survival in patients with ESCC.
Further Evidence That People Rely on Egocentric Information to Guide a Cursor to a Visible Target
Authors: Crowe Emily M. , Bossard Martin , Karimpur Harun , Rushton Simon K. , Fiehler Katja , Brenner Eli
Published: October 2021

Everyday movements are guided by objects’ positions relative to other items in the scene (allocentric information) as well as by objects’ positions relative to oneself (egocentric information). Allocentric information can guide movements to the remembered positions of hidden objects, but is it also used when the object remains visible? To stimulate the use of allocentric information, the position of the participant’s finger controlled the velocity of a cursor that they used to intercept moving targets, so there was no one-to-one mapping between egocentric positions of the hand and cursor. We evaluated whether participants relied on allocentric information by shifting all task-relevant items simultaneously leaving their allocentric relationships unchanged. If participants rely on allocentric information they should not respond to this perturbation. However, they did. They responded in accordance with their responses to each item shifting independently, supporting the idea that fast guidance of ongoing movements primarily relies on egocentric information.
A High-Sensitivity International Knee Documentation Committee Survey Index From the PROMIS System: The Next-Generation Patient-Reported Outcome for a Knee Injury Population
Authors: Tenan Matthew S. , Robins Richard J. , Sheean Andrew J. , Dekker Travis J. ,   MOTION Collaborative, Bailey James R. , Bharmal Husain M. , Bradley Matthew W. , Cameron Kenneth L. , Burns Travis C. , Freedman Brett A. , Galvin Joseph W. , Grenier Eric S. , Haley Chad A. , Hurvitz Andrew P. , LeClere Lance E. , Lee Ian , Mauntel Timothy , McDonald Lucas S. , Nesti Leon J. , Owens Brett D. , Posner Matthew A. , Potter Benjamin K. , Provencher Matthew T. , Rhon Daniel I. , Roach Christopher J. , Ryan Paul M. , Schmitz Matthew R. , Slabaugh Mark A. , Tucker Christopher J. , Volk William R. , Dickens Jonathan F.
Published: October 2021

Background:

Patient-reported outcomes (PROs) measure progression and quality of care. While legacy PROs such as the International Knee Documentation Committee (IKDC) survey are well-validated, a lengthy PRO creates a time burden on patients, decreasing adherence. In recent years, PROs such as the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function and Pain Interference surveys were developed as computer adaptive tests, reducing time to completion. Previous studies have examined correlation between legacy PROs and PROMIS; however, no studies have developed effective prediction models utilizing PROMIS to create an IKDC index. While the IKDC is the standard knee PRO, computer adaptive PROs offer numerous practical advantages.

Purpose:

To develop a nonlinear predictive model utilizing PROMIS Physical Function and Pain Interference to estimate IKDC survey scores and examine algorithm sensitivity and validity.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

The MOTION (Military Orthopaedics Tracking Injuries and Outcomes Network) database is a prospectively collected repository of PROs and intraoperative variables. Patients undergoing knee surgery completed the IKDC and PROMIS surveys at varying time points. Nonlinear multivariable predictive models using Gaussian and beta distributions were created to establish an IKDC index score, which was then validated using leave-one-out techniques and minimal clinically important difference analysis.

Results:

A total of 1011 patients completed the IKDC and PROMIS Physical Function and Pain Interference, providing 1618 complete observations. The algorithms for the Gaussian and beta distribution were validated to predict the IKDC (Pearson = 0.84-0.86; R2 = 0.71-0.74; root mean square error = 9.3-10.0).

Conclusion:

The publicly available predictive models can approximate the IKDC score. The results can be used to compare PROMIS Physical Function and Pain Interference against historical IKDC scores by creating an IKDC index score. Serial use of the IKDC index allows for a lower minimal clinically important difference than the conventional IKDC. PROMIS can be substituted to reduce patient burden, increase completion rates, and produce orthopaedic-specific survey analogs.
An overview on the progress and development of modified sulfonated polyether ether ketone membranes for vanadium redox flow battery applications
Authors: Thiam Baye Gueye , El Magri Anouar , Vaudreuil Sébastien
Published: October 2021

Vanadium redox flow batteries (VRFB) are among the most promising approaches to efficiently store renewable energies. In such battery type, Nafion is commonly used as membrane material but suffers from high vanadium crossover and cost. These drawbacks negatively influence the widespread commercial application of VRFBs. Alternative membrane materials with high performance and low cost are thus being developed to address these shortfalls. Among those, possible materials for the VRFB membrane is sulfonated polyether ether ketone (SPEEK), which recently attracted considerable attention due to its low cost, combined with mechanical and chemical stability, and ease of preparation. This review summarizes the research activities related to the development of SPEEK-based membranes for VRFB applications and gives an overview of the properties of PEEK and its sulfonated form. A critical analysis on the challenges of SPEEK-based membranes is also discussed.
‘We Ought to Be Professionals’: Strategies of Intrapersonal and Interpersonal Emotion Regulation of Emergency Medical Services Professionals in Confrontation With the Death of a Newborn in Simulated Task
Authors: Uhrecký Branislav , Gurňáková Jitka , Marcinechová Denisa
Published: October 2021

Managing one’s own and others’ emotions is a necessary part of emergency medical services (EMS) professionals’ work. For that reason, we explored their emotion regulation strategies in a simulated task which focused these skills. Short semistructured interviews were conducted with 48 EMS professionals immediately after completing the task. They described their experience during this task as distressing on a manageable level. Emergent emotion regulation strategies are largely in line with established theoretical frameworks, but their specification is unique and offers new insights. Focusing on the task along with emotional distancing is a crucial combination employed by many EMS professionals. Pre-existing cognitive frames also help with processing of emotional stimuli. Among interpersonal strategies, allowing the relatives of a deceased child to cope with their grief was the most typical reaction. However, attempts to distract them or positively reframe their situation were also present, along with few other strategies.
Cost of Cleft Team Care at an Academic Children’s Hospital
Authors: Lee Jennifer , Skolnick Gary B. , Naidoo Sybill D. , Scheve Sibyl , Grellner Cheryl , Snyder-Warwick Alison , Patel Kamlesh B.
Published: October 2021

Background

The financial burden of cleft-craniofacial team care is substantial, and high costs can hinder successful completion of team care.

Solution

Collaboration with multiple stakeholders including providers, insurers, and patient guardians, as well as hospital administrators, is critical to increase patient retention and improve final clinical outcomes.

What We Do That is New

At our cleft and craniofacial center, charges for a team care visit fall into one of three categories—hospital fees, professional fees, or external fees. There are four types of hospital fees depending on (1) whether the patient is new or returning, and (2) whether the patient saw ≤4 or ≥5 providers. To further elucidate the financial burden (out-of-pocket costs) directly borne by families of children with cleft lip and/or palate, we conducted a retrospective review of billing records of team care visits made between September 2019 and March 2020. Out-of-pocket costs for a single team care visit (on a commercial insurance plan) ranged from $4 to approximately $1220 and had a median (IQR) of $445 ($118, $749).
Intra-Articular Synovial Fluid With Hematoma After Ankle Fracture Promotes Cartilage Damage In Vitro Partially Attenuated by Anti-Inflammatory Agents
Authors: Allen Nicholas B. , Abar Bijan , Danilkowicz Richard M. , Kraus Virginia B. , Olson Steven A. , Adams Samuel B.
Published: October 2021

Background:

Intra-articular ankle fracture (IAF) causes posttraumatic osteoarthritis (PTOA), but the exact mechanism is unknown. Proinflammatory mediators have been shown to be present in the synovial fluid fracture hematoma (SFFH) but have not been linked to cartilage damage. The purpose of this study was to determine if the SFFH causes cartilage damage and whether this damage can be attenuated by commercially available therapeutic agents.

Methods:

Synovial fluid was obtained from 54 IAFs and cultured with cartilage discs from the dome of fresh allograft human tali and randomly assigned to one of the following groups: (A) control—media only, (B) SFFH from days 0 to 2 after fracture, (C) SFFH from days 3 to 9, (D) SFFH from days 10 to 14, (E) group B + interleukin 1 receptor antagonist (IL-1Ra), and (F) group B + doxycycline. The cartilage discs underwent histological evaluation for cell survival and cartilage matrix components. The spent media were analyzed for inflammatory mediators.

Results:

Cartilage discs cultured with SFFH in groups B, C, and D demonstrated significantly increased production of cytokines, metalloproteinases (MMPs), and extracellular matrix breakdown products. Safranin O staining was significantly decreased in group B. The negative effects on cartilage were partially attenuated with the addition of either IL-1RA or doxycycline. There was no difference in chondrocyte survival among the groups.

Conclusion:

Exposure of uninjured cartilage to IAF SFFH caused activation of cartilage damage pathways evident through cartilage disc secretion of inflammatory cytokines, MMPs, and cartilage matrix fragments. The addition of IL-1Ra or doxycycline to SFFH culture partially attenuated this response.

Clinical Relevance:

IAFs create an adverse intra-articular environment consisting of significantly increased levels of inflammatory cytokines and MMPs able to damage cartilage throughout the joint. These data suggest that the acute addition of specific inflammatory inhibitors may decrease the levels of these proinflammatory mediators.
Primary Thrombophilia XVI: A Look at the Genotype of the Sticky Platelet Syndrome Phenotype
Authors: García-Villaseñor Elizabeth , Bojalil-Álvarez Lorena , Murrieta-Álvarez Iván , Cantero-Fortiz Yahveth , Ruiz-Delgado Guillermo J. , Ruiz-Argüelles Guillermo J.
Published: October 2021

The sticky platelet syndrome (SPS) was described by Mammen in 1983. Since then, scientists in several countries have identified the condition and published cases or series of patients, thus enabling the description of the prevalence of the inherited condition, its salient clinical features, and the treatment of the disease. The diagnosis of the SPS phenotype requires fresh blood samples and special equipment which is not available in all coagulation laboratories. In the era of molecular biology, up to now it has not been possible to define a clear association of the SPS phenotype with a specific molecular marker. Some molecular changes which have been described in platelet proteins in some persons with the phenotype of the SPS are here discussed. Nowadays, the SPS phenotype may be considered as a risk factor for thrombosis and most cases of the SPS developing vaso-occlussive episodes are the result of its coexistence with other thrombosis-prone conditions, some of the inherited and some of them acquired, thus leading to the concept of multifactorial thrombophilia. Ignoring all these evidence-based concepts is inappropriate, same as stating that the SPS is a nonentity simply because not all laboratories are endowed with adequate equipment to support the diagnosis.
Cerebral Abnormalities in Spina Bifida: A Neuropathological Study
Authors: Paschereit Fabienne , Schindelmann Kim Hannah , Hummel Michael , Schneider Joanna , Stoltenburg-Didinger Gisela , Kaindl Angela M
Published: October 2021

Introduction

Spina bifida (SB) is the most common neural tube defect in humans. Here, we analyzed systematically the neuropathological findings of the brain in SB cases.

Methods

79 cases with SB aperta (SBA) and 6 cases with SB occulta (SBO) autopsied at the Charité Neuropathology from 1974 to 2000 were re-evaluated retrospectively. For this, case files and spinal cord as well as brain sections were studied.

Results

While no brain malformations were detected in SBO cases, 95% of SBA cases had brain malformations. Main brain anomalies identified were hydrocephalus (71%), Chiari II malformation (36%), heterotopia (34%), other cerebellar anomalies (36%), gyrification defects (33%), and ependymal denudation (29%). Hydrocephalus was observed as early as gestational week 17 and was highly associated to Chiari II and ependymal denudation. In 55% SBA was accompanied by further anomalies not primarily affecting the CNS.

Conclusion

We confirm using neuropathologic methods brain malformations in most SBA but none in SBO cases. In addition to our previous radiologic study, we now demonstrate the high prevalence of cerebellar malformations and cerebral heterotopias in SBA. The early detection of hydrocephalus and Chiari II malformation in fetuses raises the question whether these arise parallel rather than in strict temporal sequence.
The Increase of Online Journalism in Nepal
Authors: Mahaseth Harsh , Qureshi Shifa
Published: October 2021

In the past two decades, Nepal has gone through revolutionary changes in the traditional model and the online or digital model of journalism, progressively adapting to contemporary global trends in news-making. Both models are developing and show greater participation of the people. However, these two models have certain pros and cons, which make them preferable to other models in terms of accessibility, low price, reliability and enforceability. This article plans to offer a hypothetical reflection on the emergence of online journalism in Nepal. At the same time, the article discusses how traditional media has evolved over time and the impact of digital media on the working of traditional media. This article also argues that, to ensure the best and positive use of the internet and related technologies for communication, Nepal needs to develop an online media policy. Consequently, the author concludes that both models do not run contrary to each other and can work together for greater results.
Molecular dynamics simulation of plastic deformation in polyethylene under uniaxial and biaxial tension
Authors: Zhang Yi , Qiao Liang , Fan Junming , Xue Shifeng , Jar PY Ben
Published: October 2021

Plastic deformation of polyethylene in uniaxial and biaxial loading conditions is studied using molecular dynamics simulation. Effects of tensile strain rates from 1 × 105 to 1 × 109 s−1, and mass density in the range of 0.923–0.926 g/cm3 on mechanical behaviour and microstructure evolution are examined. Two biaxial tensile deformation modes are considered. One is through simultaneous stretching in both the x and y directions and the other sequential stretching, firstly in the x-direction and then in the y-direction while strain in the x-direction remains constant. Tangent modulus and yield stress that are determined using the stress–strain curves from the molecular dynamics simulation show a strong dependence on the deformation mode, strain rate and mass density, and all are in good agreement with results from the experimental testing, including fracture behaviour which is ductile at a low strain rate but brittle at a high strain rate. Furthermore, the study suggests that the stress–strain curves under uniaxial tension and simultaneous biaxial tension at a relatively low strain rate contain four distinguishable regions, for elastic, yield, strain softening and strain hardening, respectively, whereas under sequential biaxial tension, stress increases monotonically with the increase of strain, without noticeable yielding, strain softening or strain hardening behaviour. The molecular dynamics simulation also suggests that an increase in the strain rate enhances the possibility of cavitation. Under simultaneous biaxial tension, with the strain rate increasing from 1 × 106 to 1 × 109 s−1, the molecular dynamics simulation shows that polyethylene failure changes from a local to a global phenomenon, accompanied by a decrease of the void size and increase of uniformity in the void distribution. Under sequential biaxial tension, on the other hand, the density of the cavities is clearly reduced.
Impact of cross-lapping angle and needling parameters on mechanical and functional properties of nonwoven air filter fabric
Authors: Mamuye Wondwossen , Ishtiaque SM , Roy Rupayan , Dixit Priyal
Published: October 2021

This research work investigated the influence of the cross-lapping angle in combination with punch density and stroke frequency on structural characteristics and properties of nonwoven fabric. An attempt has been made to change the cross-lapping angle by keeping the number of layers constant to maintain the same areal density of fabrics. The fibre orientation in the carded web was measured by using Lindsley and image analysis methods. Three variables, that is, cross-lapping angle, punch density and stroke frequency, were considered for the sampling plan to create a three-factor three-level Box–Behnken design. The properties such as mean flow pore size, bursting strength, filtration efficiency and pressure drop were evaluated and analysed in the light of fibre orientation in the carded web. It was concluded that the cross-lapping angle influenced the fibre orientation to a large extent; accordingly, the properties of nonwoven fabric were highly influenced by the fibre orientation.
Cases of Lower Extremity and Perianal Burns at the Burn Center in the Southeast Anatolia of Turkey
Authors: Yiğit Ebral , Yiğit Yasemin Demir
Published: October 2021

Introduction: In this study, the aim is to discuss the cases of lower extremity and perianal burns at the burn center in the southeast Anatolia of Turkey. Material and methods: A 4-year retrospective study was conducted on 775 patients who had been admitted to Gazi Yaşargil Training and Research Hospital Burn Centre with lower extremity and perianal burn injuries between January 2016 and January 2020. Results: Of the patients, 427 were male and 348 were female. Scald burns are most commonly affect the perianal and lower extremities. The right lower extremity was affected in 602 (77.7%) patients, the left lower extremity was affected in 574 (74.1%) patients and the perineum was affected in 70 (9.0%) patients. Most burn injuries occur in individuals between 0 to 4 years old, and the rate of burn injuries gradually decreases in individuals outside of this age range. No patient underwent colostomy for perianal burns. Conclusion: Early, aggressive and extensive debridement, in addition to adequate antimicrobial therapy, should be performed as the basis of treatment.
Neoliberal capitalism and misery of small peasantry and agricultural labourers in India
Authors: Singh Paramjit
Published: October 2021

This article argues that, till date, a single paradigm dominates the discourse on agrarian crisis and farmers’ movement against the anti-farmer dictates of the Indian state. There is a pressing need for the organic intellectuals of the masses to build an alternative discourse to examine the agrarian crisis and its roots. To this end, the present article reasons that the neoliberal resolution of the agrarian crisis that the authoritarian-corporate nexus has imposed on the farming community will produce mass dispossession and displacement in India. It exposes the misery of traditional consciousness that rules over the current farmers’ movement in India. The article concludes that the agrarian crisis which is actually a crisis of small farmers and agricultural labourers requires modern consciousness for egalitarian and long-term resolution.