bluuebunny/crossref_metadata_2025 huggingface dataset:
The Context of the 2018–20 “Protracted” El Niño Episode: Australian Drought and Terrestrial, Marine, and Ecophysiological Impacts
Authors: Allan Rob , Stone Roger , Gergis Joëlle , Baillie Zak , Heidemann Hanna , Caputi Nick , D’Arrigo Rosanne , Pudmenzky Christa
Published: June 2023

A “protracted” El Niño episode occurred from March–April 2018 to April–May 2020. It was manifested by the interlinked Indo-Pacific influences of two components of El Niño phases. Positive Indian Ocean dipoles (IODs) in 2018 and 2019 suppressed the formation of northwest cloud bands and southern Australia rainfall, and a persistent teleconnection, with enhanced convection generated by positive Niño-4 region sea surface temperature (SST) anomalies and strong subsidence over eastern Australia, exacerbated this Australian drought. As with “classical” El Niño–Southern Oscillation (ENSO) events, which usually last 12–18 months, protracted ENSO episodes, which last for more than 2 yr, show a similar pattern of impacts on society and the environment across the Indo-Pacific domain, and often extend globally. The second half of this study puts the impact of the 2018–20 protracted El Niño episode on both the Australian terrestrial agricultural and marine ecophysiological environments in a broader context. These impacts are often modulated not only by the direct effects of ENSO events and episodes, but by interrelated local to region ocean–atmosphere interactions and synoptic weather patterns. Even though the indices of protracted ENSO episodes are often weaker in magnitude than those of major classical ENSO events, it is the longer duration of the former that poses its own set of problems. Thus, there is an urgent need to investigate the potential to forecast protracted ENSO episodes, particularly when the mid-2020 to current 2022 period has been experiencing a major protracted La Niña episode with near-global impacts.

Significance Statement

The major 2018–20 Australian drought and its terrestrial and marine impacts were caused by a “protracted” El Niño episode, exacerbated by global warming. Indo-Pacific ocean–atmosphere interactions resulted in a persistent positive western Pacific Niño-4 sea surface temperature anomaly during the period 2018–20 and positive Indian Ocean dipoles (IODs) in 2018 and 2019. These suppressed rainfall across eastern Australia and limited northwest Australian cloud band rainfall across southern Australia. Australian agricultural and ecophysiological impacts caused by protracted El Niño–Southern Oscillation (ENSO) episodes permeate, overstress, and expose society, infrastructure, and livelihoods to longer temporal-scale pressures than those experienced during shorter “classical” ENSO events. Thus, there is an urgent need to investigate the potential to forecast protracted ENSO episodes.
Evaluating Equating Methods for Varying Levels of Form Difference
Authors: Sun Ting , Kim Stella Yun
Published: June 2023

Equating is a statistical procedure used to adjust for the difference in form difficulty such that scores on those forms can be used and interpreted comparably. In practice, however, equating methods are often implemented without considering the extent to which two forms differ in difficulty. The study aims to examine the effect of the magnitude of a form difficulty difference on equating results under random group (RG) and common-item nonequivalent group (CINEG) designs. Specifically, this study evaluates the performance of six equating methods under a set of simulation conditions including varying levels of form difference. Results revealed that, under the RG design, mean equating was proven to be the most accurate method when there is no or small form difference, whereas equipercentile is the most accurate method when the difficulty difference is medium or large. Under the CINEG design, Tucker Linear was found to be the most accurate method when the difficulty difference is medium or small, and either chained equipercentile or frequency estimation is preferred with a large difficulty level. This study would provide practitioners with research evidence–based guidance in the choice of equating methods with varying levels of form difference. As the condition of no form difficulty difference is also included, this study would inform testing companies of appropriate equating methods when two forms are similar in difficulty level.
Heating of thick continuous glass fiber reinforced thermoplastic plates via embedded metal mesh networks
Authors: Gayton James T , Davids William G , Haller James C , Duffy Jordan , Sheltra Cody , Lopez-Anido Roberto A , Dagher Habib J , Lapp Justin L
Published: June 2023

A method is proposed to locally heat areas of thick (>25.4 mm) continuous glass fiber reinforced thermoplastic (C-FRTP) composites with embedded wire mesh resistive heating elements. Four test specimens including 10.6 cm wide nichrome mesh heating elements embedded in C-FRTP laminates were fabricated and used for heating trials, showing that the composite can be locally heated to near the thermoplastic forming temperature over its entire thickness in less than 1 hour. The heating trials were simulated using a purpose-built finite difference model to investigate detailed temperature distributions. The simulations show that the internal resistive heating elements are capable of locally increasing the temperature of the composite with negligible effect on the adjacent material. Heating efficiency is between 73% and 77%, with temperature differences in the z-direction at peak temperatures less than 35°C. Temperature uniformity can be improved by longer heating times and more heating elements. The local heating method does not cause deconsolidation of the part. The heating method was also experimentally assessed on a more complex cross-section laminate with varying thickness and a foam core using stainless steel mesh heating elements. Results from the first heating tests were applied to the experimental assessment of the more complex laminate to reduce z-direction temperature differences. Numerical simulation of the heating of the foam core laminate showed a z-direction temperature range of 15.5°C. The results of this study show that embedded resistive heating is a cost-effective and simple method for heating a local portion of a thick fiber reinforced thermoplastic composite.
Prolonged Grief in Times of Lockdown During the COVID-19 Pandemic
Authors: von Blanckenburg Pia , Seifart Carola , Ramaswamy Annette , Berthold Daniel , Volberg Christian
Published: June 2023

This study aimed to estimate the prevalence of prolonged grief (PG) during the COVID-19 pandemic and to analyze associated variables. 142 family members of patients who died during the lockdown at a hospital were surveyed 6 months after the death. Prolonged grief, depression and anxiety, grief rumination, and loss-related variables were captured. Logistic regression analyses were conducted to detect the associated variables of PG symptoms. Prolonged grief was present in 44.4% of the bereaved. 76.2% of the relatives reported feeling distressed due to visitor restrictions, and the majority of them were unable to bid farewell to their family member at the time of death. Pastoral or psychological care was also lacking. Low education ( p < 0.001), emotional closeness ( p = 0.007), loss of a spouse ( p < 0.001), inability to bid farewell after death ( p = 0.024), feeling of threat due to the pandemic ( p < 0.001), depression ( p = 0.014), and anxiety ( p = 0.028) were significantly associated with prolonged grief.
Design of tunnel steel arch looping manipulator with multiple actuators in limited space
Authors: He Yuanfu , Yang Mei , Xu Zhen , Li Shenyuan , Zhang Bowen
Published: June 2023

In order to overcome the low efficiency, high labor intensity and high risk of steel arch support operations in tunnel boring machines, a steel arch looping manipulator with multiple actuators was designed. Firstly, in order to simplify the complex design requirements of the manipulator, an exponential product model was established to analyze the influence of each single joint on the end output, and the manipulator was decomposed into different modules. The design is carried out separately, layer by layer, in the order of actuator—trunk module—branch module. Then, the optimal manipulator is obtained considering the limited space, equivalent flexibility, and joint control accuracy requirements. Finally, a prototype of the steel arch looping manipulator was manufactured and the feasibility of the manipulator was verified by experiments. The design method can provide a reference for the design of multi-actuator manipulator configuration in limited space.
Analysis of the influence of surgical robot drilling parameters on the temperature of skull drilling based on Box–Behnken design
Authors: Liu Zhenzhong , Yao Zhancheng , Jiang Wenyu , Wang Jutao
Published: June 2023

It is easy to cause thermal damage to the bone tissue when the surgical robot performs skull drilling to remove bone flaps, due to the large diameter of the drill bit, the large heat-generating area, and the long drilling time. Therefore, in order to reduce the thermal damage during the robot-assisted skull drilling process, the relationship between the drilling parameters and the drilling temperature during the skull drilling was studied in this paper. Firstly, a dynamic numerical simulation model of the skull drilling process was established by ABAQUS, and a temperature simulation plan for skull drilling was designed based on the Box–Behnken method. Then according to the simulation results, a quadratic regression model of drill diameter, feed rate, drill speed, and drilling temperature was established by using the multiple regression method. By analyzing the regression model, the influence of drilling parameters on the drilling temperature was clarified. Finally, the bone drilling experiment was carried out, and the error percentage was lower than 10.5% through the experiment to verify the reliability of the conclusion, and a safety strategy was proposed to ensure the safety of the surgical drilling process based on this experiment.
The lonely activist: On being haunted
Authors: Emejulu Akwugo , Bassel Leah
Published: June 2023

In our six-nation comparative research project examining how women of colour activists in London, Paris, Berlin, Brussels, Copenhagen and Madrid organise and mobilise against austerity, against the far right and for migrants’ rights, we found activists experiencing intense feelings of loneliness in their work. Emotional turmoil in activist spaces is to be expected since activists are mobilised to action precisely because of the deeply felt emotions about a particular social problem. However, we argue that activists’ loneliness is a structural alienation born out of the operation of white supremacy, patriarchy, classism, queerphobia, ableism and xenophobia not only in wider society but especially in activist spaces. Women of colour activists are made lonely by the unspoken power relations effectuated through emotions. In trying to negotiate the feeling rules of their activist spaces, we argue that much of women of colour’s emotion work is doomed to failure because many activist spaces are constituted by taken for granted dominations to which many women of colour activists are unable and unwilling to reconcile their feelings.
Monetizing Failure: Fyre Fraud, Social Media, and the Normalization of Crisis
Authors: Hoerl Kristen E. , Kelly Casey Ryan
Published: June 2023

This essay analyzes the social media rebranding of the infamous Fyre Festival, a disastrous and fraudulent music concert that went viral in 2017. The posthumous life of the ill-fated festival illustrates the unique confluence of neoliberal crisis and the entrepreneurial logics of social media that enable failed entrepreneurs to exploit their own abject spectacles of fraud and unethical business practices into lucrative opportunities. By looking at how three individuals deeply involved in planning Fyre Fest monetized the media spectacle surrounding the festival's failure through unrelenting spin, ironic self-branding, and the commodification of kitsch, we show how the emerging character of a socially mediated failure industry that revels not only in failure but in the unprincipled nature of risk-taking in the current economy. We conclude by reflecting how the entrepreneurial discourses in the aftermath of the festival are indicative of evolving entrepreneurial logics that normalize the detached and ironic enjoyment of neoliberal spectacles.
Effect of External Shocks on the Predictability of Remittance Flows From Developed Countries
Authors: Gnangnon Sèna Kimm
Published: June 2023

The present analysis has explored the effect of external shocks on the predictability of remittance outflows, by relying on an unbalanced panel of 24 developed countries over the period from 1996 to 2020. The indicator of predictability of remittance outflows for a given country in a given year is the deviation of the remittance outflows (as a share of gross domestic product) from its trend. Results are obtained by means of the within-fixed effects estimator, and indicate that external shocks reduce the predictability of remittance outflows, with a larger negative effect on the positive predictability of these capital outflows than on the negative predictability of these capital outflows. The negative effect of external shocks on the predictability of remittance outflows operates through the economic growth channel, with the magnitude of this negative effect being higher in countries with low economic growth rates. Finally, external shocks reduce the predictability of remittance outflows in countries that experience a decline in migrant inflows. This finding has implications for the economic and development prospects of migrants’ countries of origin.

JEL Classification: F24, F43, O11
Challenges and opportunities for improvement when people with an intellectual disability or serious mental illness also need palliative care: A qualitative meta-ethnography
Authors: Ashok Nivedita , Hughes Daniel , Yardley Sarah
Published: June 2023

Background:

People with diagnoses of intellectual disability or serious mental illness have higher mortality rates due to physical comorbidities; better understanding is needed to guide best practice in provision of palliative care for these populations.

Aims:

To identify multivoiced perspectives, drawn from lived experience of: what works, and what does not, in palliative care for people with intellectual disability or serious mental illness; challenges in, and opportunities to improve, palliative care.

Design:

A systematically constructed qualitative meta-ethnography. Protocol published (PROSPERO: CRD42021236616).

Data sources:

MEDLINE, PsychINFO, CINAHL PLUS and Embase used without date limitations. Papers published in English, containing qualitative data on palliative care provision for people with a diagnosis of intellectual disability or serious mental illness were included. Global five-point strength score applied for relevance/quality appraisal.

Results:

Familiarity (of location, people and/or things) is important for good palliative care. Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common. Adapting training for palliative care staff to address concerns and beliefs about mental illness is one of the methods that helps avoid diagnostic overshadowing. Proactive identification of service arrangements to meet needs of persons with personality, psychotic, delusional and bipolar affective disorders will help optimise care.

Conclusions:

Evidence, including the voices of people with intellectual disability or serious mental illness is urgently needed to guide efforts to improve their access to and experience of palliative care. More evidence is especially needed to understand, develop and implement best practice for people with psychosis, bipolar affective disorder, mania and personality disorder.
Case Study on the Relationship Between Socio-Demographic Characteristics and Work-from-Home Behavior Before, During, and After the COVID-19 Pandemic
Authors: Kong Xiaoqiang , Li Zihao , Zhang Yunlong , Chen Xun , Das Subasish , Sheykhfard Abbas
Published: June 2023

Many studies have explored the impact of the COVID-19 pandemic on work-from-home (WFH) behavior from different perspectives. However, it is rare to find studies focusing on how the newly adopted WFH practices will affect commuting patterns in the post-pandemic era. This study defines two mediation factors to capture the perceptions of pandemic severity and work environment at home and further investigates their impacts on future WFH adoption. This study utilizes a comprehensive survey and a path analysis method known as structural equation modeling (SEM) to explore the association between demographic factors, perception of COVID-related issues, and WFH behavior before, during, and after the pandemic. The results show that motherhood negatively affected WFH experiences in the before, during, and after periods of the pandemic. It was also found that being forced to WFH and mixing the working environment with their children made mothers less likely to WFH in the post-pandemic era. The results also show that older workers are less appreciative of the WFH approach and are less likely to continue to WFH in the post-pandemic era. The findings also confirmed the association between WFH during and after the pandemic with other factors, such as age and education. The positive or negative experiences with WFH during the pandemic will significantly shape workers’ decisions on continuing to WFH in the post-pandemic era. These findings could help transportation agencies understand the impacts of these factors on the choices of WFH during and, more importantly, after the pandemic era.
Disruption of everyday life in times of crises – explanatory factors of well-being among students during COVID-19
Authors: Thomassen Bjørn , Ejrnæs Anders , Nobel Trine Cosmus , Nyland Jensen Ida Marie , Sørensen Pelle Korsbæk
Published: June 2023

This article examines explanatory factors behind well-being among Danish students during the COVID-19 crisis. The empirical analyses are based on a two round panel survey among students at Roskilde University in Denmark. Using fixed effect regression and random effect regression our results show that, amongst the variables included in the analysis, the level of self-assessed structure in everyday life has the strongest positive effect on the self-assessed level of well-being. We briefly discuss this finding which is supported by qualitative data from the survey. The article concludes that the major changes in everyday life, caused by the COVID-19 crisis and societal lockdown, for example, isolation, virtual classes etc., makes it more difficult to draw upon internalized habits and navigate socially, which may contribute negatively to well-being. Conceptually, the article calls for a deeper engagement with the role of everyday life structure and its effects on well-being at a more general level.
Hydrogels provide microenvironments to mesenchymal stem cells for craniofacial bone regeneration: Review
Authors: Liu Xiaojie , Fang Tao , Shi Ting , Wang Yun , Liu Guanying
Published: June 2023

The anatomical and physiological architecture of the craniofacial bone is intricate. Hence, the exact management of osteogenesis is necessary for the regeneration of the deficiencies that present in this area. Stem-based tissue engineering approaches, as opposed to conventional surgical intervention, induce bone growth with minimal postoperative risk and expense. Mesenchymal stem/stromal cells (MSC)‘s pluripotent differentiation potential, anti-inflammatory and immunomodulatory properties underpin its versatility as a therapeutic agent in bone tissues. Inspired by the native stem cell niche, hydrogels are preferred choices to mediate cells and adapt to 3-D environment because of their outstanding swelling capabilities and similarity to natural extracellular matrices (ECMs). Due to their remarkable biocompatibility and capacity for stimulating bone regeneration, bone regeneration hydrogels have also received a great deal of interest. This review explores the opportunities of MSC based regenerative skeletal therapies, introduces the application of hydrogel scaffolds as artificial bone microenvironments for stem cells to explore its usage in craniofacial bone tissue engineering.
“What Does It Take to Succeed Here?”: The Belief That Success Requires Brilliance Is an Obstacle to Diversity
Authors: Muradoglu Melis , Arnold Sophie H. , Leslie Sarah-Jane , Cimpian Andrei
Published: June 2023

Why are some fields and occupations more diverse than others? In this review, we describe a conceptual framework—the field-specific ability beliefs (FAB) model—that provides a promising answer to this question. This model proposes that gender and racial/ethnic imbalances in a field or occupation result in part from the confluence of two beliefs: (a) the belief that success in that context requires high levels of intellectual ability (“brilliance”) and (b) the cultural stereotype that associates intellectual ability with (White) men more than other groups. We describe the FAB model and detail evidence for it, including evidence that the beliefs at its core are present even among children. We conclude by highlighting open questions.
Agricultural Producer Markets in the Maldives: How Poor Market Connectivity Between Farmers and the Markets can be Enhanced
Authors: Van Driessche Paul Arthur
Published: June 2023

In 2018, a multisite case study investigated the agricultural challenges faced by Maldivian farmers and farming stakeholders. The study interviewed a total of 373 farmers and stakeholders from 51 islands across 15 atolls. In their own words, farmers and stakeholders identified factors in macro and micro levels agricultural systems that are related to poor connectivity between farmers and the markets. This research article conducts a deeper investigation into these factors using the Ecological Systems Theory. In this investigation, the data clearly reveal that any efforts towards market connectivity resolution must address the individual within the context of the greater, extrinsic challenges present in the interrelated systems of farming in the Maldives. While the individual is placed at the smallest level of a greater system, and the interconnections of the larger systems are great in impact, the individual is ultimately the decision maker on what and how things work, and how effective they will be. In this article, five recommendations are identified to enhance farmers’ connectivity to markets. This first-person perspective of smallholder farmers is an essential contribution to understanding what measures are needed to address connectivity challenges between Maldivian farmers and the markets they would like to supply.
Salvianolate Ameliorates Renal Damage Induced by C-BSA in Membranous Nephropathy Rats Through Inhibiting Hypercoagulable State and Alleviating Podocyte Injury
Authors: Chen Wenjun , Tan Jinchuan , Chen Suzhi , Yang Fengwen , Yan Huiming , Duo Huiling , Zhou Huijie
Published: June 2023

Background

Membranous nephropathy (MN), one of the primary pathogenic forms of adult nephrotic syndromes, frequently coexists with hypercoagulability and hyperviscosity. MN is prone to thrombosis, embolism, and other complications, leading to the accelerated occurrence of glomerulosclerosis and renal fibrosis. Therefore, it is particularly important to promote blood circulation and remove stasis through anticoagulant therapy. Salvianolate (SAL) is a Chinese patent anticoagulant commonly used in clinical practice to promote blood circulation and remove blood stasis. SAL plays an important role in alleviating urinary protein and renal pathological damage in MN patients.

Objectives

In the present study, we aimed to investigate the kidney-protective effect of SAL on MN in a rat model.

Materials and Methods

The rat model of MN was established by tail vein injection of cationic bovine serum albumin (C-BSA). After the treatment, urinary proteins, hypercoagulable state index (fibrinogen (Fib), D dimer (D-D)), hepatic and renal functions, renal pathology, and podocyte marker proteins were analyzed to explore the renal protective effect of SAL on MN rats and its underlying mechanism.

Results

In the modeled rats, we discovered a significant rise in urinary protein, a hypercoagulable state, and hypoproteinemia. Additionally, the expressions of Wilms’ tumor protein 1 (WT-1), podocalyxin (PCX), and vascular endothelial growth factor (VEGF) in renal tissues were significantly downregulated, indicating remarkable pathological damage to podocytes and renal tissues in MN rats. The expressions of the above-mentioned indices could be greatly reversed by SAL, which could also regulate the hypercoagulable state and suppress podocyte damage and renal pathological harm.

Conclusion

Our results suggested that the renal protective effect of SAL on C-BSA-induced MN was related to its ability to inhibit hypercoagulable states, upregulate the expressions of WT-1, PCX, and VEGF in the renal tissue, and repair podocyte injury.
Schisandrin A Suppresses Inflammation in DSS-induced IBD Mice and H2O2-induced MODE-K Cells through Wnt/β-Catenin Signaling
Authors: Xu Hong , Chen Xi , Li Xinlei , Dou Deqiang , Xu Zhili
Published: June 2023

Background

Schisandrin A (SchA) has multiple pharmacological features, and inflammatory bowel disease (IBD) represents a common digestive system disease mainly characterized by inflammation.

Objectives

To assess the anti-inflammatory effects and the mechanism of SchA in mice with enteritis and in MODE-K cells representing in vivo and in vitro models of inflammation.

Materials and Methods

DSS-induced IBD mouse models and MODE-K cells (an in vitro model of the intestine) were used to assess the effects of SchA on IBD inflammation and to determine the related signaling pathways.

Results

Our data showed that SchA exerted anti-inflammatory effects by reducing the general clinical symptoms and the pathological damage to the colonic mucosa in mice with IBD and by promoting the migration of H2O2-induced MODE-K cells, inhibiting apoptotic death, and reducing the release of inflammatory factors. Moreover, SchA downregulated Wnt/β-catenin in both enteritis mice and H2O2-induced cells.

Conclusion

SchA inhibits inflammation in DSS-induced IBD mice and H2O2-induced MODE-K cells by repressing Wnt/β-catenin signaling.
PD-L1 Expression in Ampullary Adenocarcinoma
Authors: Siddiqui Saima Haleem , Kumari Niraj , Mishra Shravan , Radha Paturu , Mohindra Samir , Singh Rajneesh K , Krishnani Narendra
Published: June 2023

Introduction

Ampullary adenocarcinoma is a rare neoplasm often treated by the complex Whipple's procedure. Several histological factors predict poor prognosis including pancreatobiliary morphology, presence of lymphovascular, perineural invasion and local or distant metastasis. Systemic therapy with gemcitabine, 5-fluorouracil regimens are given with variable benefits. Immunotherapy checkpoint inhibitors have shown beneficial anti-tumor effects in several carcinomas, the most remarkable being in non-small cell lung cancer. Administration of these novel drugs is based on immunohistochemical expression (which may or may not be indicative of response to therapy) along with meticulous decision making by the multidisciplinary team. Immunohistochemistry (IHC) is an effective means of immune marker demonstration and has been used in various tumor types for predictive and prognostic purposes.

Methods

PD-L1 IHC (clone E1L3N) was applied in 101 cases of ampullary adenocarcinoma. Tumor infiltrating lymphocytes were also evaluated. The immunoreactivity was assessed and categorized into following staining thresholds: <1%, <5%, <10% and ≥10% for tumor cells (membranous and/or cytoplasmic staining pattern), and 5% and 10% cut-offs for immune cells.

Results

We found that at a 10% cut-off, 73.3% (74/101) patients were men ( P  =  .006) older than 50 years of age ( P < .001) presenting with a tumor measuring <3 cm ( P  =  .001). It was significantly associated with intestinal differentiation ( P  =  .004) and grade 1 tumors ( P  =  .001). Twelve patients presented with recurrence as well ( P  =  .03).

Conclusion

In the context of ampullary adenocarcinoma, this study highlights the positivity observed with the PD-L1 IHC clone E1L3N at different thresholds, with the particularly stronger associations being evident at a 10% cut-off.
Multiverse, Feminist Materialist Relational Time, and Multiple Future(s): (Re)configuring Possibilities for Qualitative Inquiry
Authors: Fairchild Nikki
Published: June 2023

Critical feminist materialist theorizing opens up possibilities for enacting different ways of knowledge making. In this article, I connect feminist materialist inquiry with time and temporality to develop a line of inquiry to reimagine the nature of multiple future(s). Employing theorizing developed by Francesca Ferrando, Karen Barad, and Donna Haraway, and thinking with the concepts of Multiverse, spacetimemattering, and agential cuts, I develop the concept of feminist materialist relational time as a methodological possibility for inquiry. Using examples from my own and others’ scholarship, I propose that feminist materialist relational time articulates ways in which affirmative and transversal ethico-onto-epistemologies can reconsider power, mattering, enactment, and exclusions, creating multiple future(s) for qualitative inquiry. I argue that the entanglement of past/present/future as events and forces in flux highlights the multiplicity of temporality where past/present/future are now, then, immanent, processual, always already in the making, and formed of intra-acting bodies.
Confessional critiques: Parrhesia and avowal in contemporary anti-racist discourses
Authors: Boland Tom , Moore-Ponce Jody
Published: June 2023

Confessional critiques proliferate in contemporary culture, remodelling critical politics as self-purification. Within Foucault’s work, critique is associated with resistance to power and subjectification, whereas confession appears a technique of disciplinary and pastoral power. However, genealogy creates hybrids, and herein we observe how critique and confession are entangled in contemporary social justice discourses, focusing empirically on contemporary anti-racist texts. These critique their imagined readers and society more generally, demanding confessions, castigating denials and exhorting interminable purificatory self-work. This analysis draws from Foucault’s genealogies of parrhesia and avowal, through his latter works on the problem of ‘truth-telling’ and how it forms subjects, even by critique. Recognising this historical hybridisation of critique and confession within discourses such as anti-racism may help to clarify the political stakes of critique.
Benchmarking a Center of Excellence in Vascular Surgery: Using Acute Physiology and Chronic Health Evaluation II to Validate Outcomes in a Tertiary Care Institute
Authors: Laczynski DJ , Gallop J , Sicard GA , Sidawy AN , Rowse JW , Lyden SP , Smolock CJ , Kirksey L , Quatromoni JG , Caputo FJ
Published: June 2023

Objective

The Society of Vascular Surgery (SVS) has made it a top priority to implement verification of vascular “centers of excellence”. Our institutional aortic network was established in 2008 in order to standardize care of patients with suspected acute aortic pathology. The implementation and success of this program has been previously reported. We sought to use our experience as a benchmark for which to develop prognostic modeling to quantify clinical status upon admission and help predict outcomes. Our objective was to validate the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system using a cohort of aortic emergencies transferred by an organized transfer network.

Method

This was a retrospective, single institution review of patients transferred through an institutional aortic network for acute aortic pathology from 2017-2018. Demographics, comorbidities, aortic diagnosis, APACHE II score, as well as 30-day mortality were recorded. Associations with 30-day mortality were evaluated using two-sample t-tests, ANOVA models, Pearson chi-square tests and Fisher exact tests. Receiver operating characteristic (ROC) curves were fit overall and by pathology to predict 30-day mortality by Apache II total score.

Results

There were 395 consecutive transfers were identified. The mean age was 64.7 years. Diagnoses included Type A Dissection (n = 134), Type B (n = 81), Aortic Aneurysm (n = 122), and PAU/IMH (n = 27). Mean APACHE II score on arrival was 12. Overall there were 53 deaths (13.4%) in the cohort. Patients that died had significantly higher Apache II total scores (11.3 vs 16.5, P < .001). The area under the receiver operator characteristic (ROC) curve (AUC) was .66 for the full cohort, indicating a poor clinical prediction test.

Conclusion

APACHE II score is a poor predictor of 30-day mortality in a large transfer network accepting all aortic emergencies. The authors believe further refining a prognostic model for diverse population will not only help in predicting outcomes but to objectively quantify illness severity in order to have a basis for comparison among institutions and verification of “centers of excellence”.
Dispensing mifepristone for medical abortion in Canada: Pharmacists’ experiences of the first year
Authors: Zusman Enav Z. , Munro Sarah , Norman Wendy V. , Soon Judith A.
Published: June 2023

Background:

Mifepristone for medical abortion was first dispensed by community pharmacists in Canada directly to patients in January 2017. We asked about pharmacists’ experiences over their first year dispensing mifepristone in order to evaluate the frequency of the new practice and assess availability in urban/rural pharmacies.

Methods:

From August to December 2019, we invited 433 community pharmacists who had completed a baseline survey at least 1 year prior to participate in a follow-up online survey. We summarized categorical data using counts and proportions and conducted a qualitative thematic analysis of open-ended responses.

Results:

Among 122 participants, 67.2% had dispensed the product, and 48.4% routinely stocked mifepristone. Pharmacists reported a mean of 26 and median of 3 (interquartile range, 1, 8) mifepristone prescriptions filled in their pharmacies in the previous year. Participants perceived that the benefits of making mifepristone available in pharmacies included increased abortion access for patients ( n = 115; 94.3%), reduced pressure on the health care system ( n = 104; 85.3%), increased rural and remote abortion access ( n = 103; 84.4%) and increased interprofessional collaborations ( n = 48; 39.3%). Few participants reported challenges to maintaining adequate stock of mifepristone, but these challenges included low demand ( n = 24; 19.7%), short expiry dating ( n = 12; 9.8%) and drug shortages ( n = 8; 6.6%). The overwhelming majority, 96.7%, reported that their communities did not resist the provision of mifepristone by their pharmacy.

Interpretation:

Participating pharmacists reported many benefits and very few barriers to stocking and dispensing mifepristone. Both urban and rural communities responded positively to enhanced access to mifepristone in their community.

Conclusions:

Mifepristone is well accepted by pharmacists within the primary care system in Canada.
Experimental study on hygrothermal properties of recycled aggregate concrete
Authors: Sui Xuemin , Cui Haoran , Yang Pinggang , Xu Biao , Huang Hua
Published: June 2023

Recycled aggregate concrete has great significance from the environmental protection perspective. However, the current research findings on its hygrothermal properties are sparse. In this study, the apparent density, thermal conductivity, mass moisture content, water vapor permeability coefficient, water absorption coefficient, and liquid water diffusion coefficient of recycled aggregate concrete were determined by experimental methods. The effect of temperature and humidity on thermal conductivity was also studied. Furthermore, the fitting relations of the thermal conductivity of recycled aggregate concrete with the two variables of temperature and relative humidity were presented. The isothermal moisture absorption curve and the fitting relationship of water vapor permeability coefficient with relative humidity were also developed. The results indicate that the thermal conductivity of the eight recycled concrete specimens in the dry state at 25°C ranges from 0.994 to 1.242 W/(m·K). The thermal conductivity increases with the increase in temperature. When the temperature rises from 25°C to 35°C, the thermal conductivity of recycled aggregate concrete increases by 3.8%–13.5%. With the increase of relative humidity, the thermal conductivity of recycled aggregate concrete shows an increasing trend, followed by a steady state, and finally the increasing trend, showing a cubic function relationship between them. When the relative humidity increases from 0% to 95%, the thermal conductivity increases by about 20%. The mass moisture content and the water vapor permeability coefficient increase with relative humidity. The results of this study can provide basic information for the study on the heat and moisture transfer of recycled aggregate concrete, and enhance the database of hygrothermal properties of building materials.
Effect of Age and Sex on Psychological Readiness and Patient-Reported Outcomes 6 Months After Primary ACL Reconstruction
Authors: Milewski Matthew D. , Traver Jessica L. , Coene Ryan P. , Williams Kathryn , Sugimoto Dai , Kramer Dennis E. , Kocher Mininder S. , Micheli Lyle J. , Yen Yi-Meng , Christino Melissa A.
Published: June 2023

Background:

Successful return to sport after anterior cruciate ligament (ACL) reconstruction (ACLR) can be affected by a patient’s physical and psychological state throughout the rehabilitation process.

Purpose:

To prospectively compare differences in patients at 6 months after primary ACLR with the ACL–Return to Sport after Injury (ACL-RSI), International Knee Documentation Committee (IKDC) or pediatric (Pedi)-IKDC, Hospital for Special Surgery Pediatric Functional Activity Brief Scale (Pedi-FABS), and Patient-Reported Outcomes Measurement Information System–Psychological Stress Experiences (PROMIS-PSE) scores.

Study Design:

Prospective cohort study; Level of evidence, 2.

Methods:

Patients enrolled were 8 to 35 years old who underwent primary ACLR and had their 6-month follow-up appointments between December 2018 and March 2020. Patients were divided into 3 age groups as follows: (1) preadolescents (10-14 years); (2) adolescents (15-18 years); and (3) adults (>18 years). Outcomes on the ACL-RSI, IKDC/Pedi-IKDC, Pedi-FABS, and PROMIS-PSE were compared according to age group, graft type (hamstring, patellar tendon, quadriceps, or iliotibial band autograft), and sex.

Results:

A total of 176 patients (69 male, 107 female), with a mean age of 17.1 ± 3.1 years were included in the study. The mean ACL-RSI scores were significantly different among age groups (preadolescents, 75 ± 18.9; adolescents, 61.5 ± 20.4; and adults, 52.5 ± 19.8 [ P < .001]) and graft types ( P = .024). The IKDC and PROMIS-PSE scores were also significantly different among age groups ( P < .001 and P = .044, respectively) and graft types ( P = .034 and P < .001, respectively), with the iliotibial graft and the younger age group performing the best. There was no significant difference in the Pedi-FABS either by age group ( P = .127) or graft type ( P = .198). Female patients had lower ACL-RSI scores and higher (worse) scores on PROMIS-PSE than their male counterparts ( P = .019 and P < .001, respectively), with no sex-based differences on IKDC or Pedi-FABS scores. The ACL-RSI and IKDC were positively correlated (Spearman r = 0.57; P < .001), while the ACL-RSI and PROMIS-PSE were negatively correlated (Pearson r = –0.34; P < .001).

Conclusion:

This study suggests that psychological profiles and subjective perceptions of knee function 6 months after ACLR may vary in patients of different ages and between the sexes. Preadolescent patients had better scores on a majority of patient-reported outcomes compared with adolescent and adult patients.
Relationship Between Mechanoreceptors in the Posterior Cruciate Ligament and Patient Age or Osteoarthritis Severity
Authors: Chen Jinlong , Chen Shirong
Published: June 2023

Background:

Mechanoreceptors in the posterior cruciate ligament (PCL) can produce proprioception, which is an important reason why patients choose cruciate-retaining total knee arthroplasty (TKA). The number of mechanoreceptors in the PCL of patients with knee osteoarthritis (OA) is unknown.

Purpose:

To provide a theoretical basis for estimating the number of mechanoreceptors in the PCL by evaluating the relationship between this number and patient age or OA severity.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

An overall 28 PCLs from patients with knee OA were collected at the time of TKA and grouped according to patient age (group A, 60-69 years [n = 8]; group B, 70-79 years [n = 12]; group C, ≥80 years [n = 8]) and OA based on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (group I, ≤80 [n = 8]; group II, 81-120 [n = 10]; group III, >120 [n = 10]). Hematoxylin and eosin and S-100 immunohistochemical staining were performed on the slices near the tibial attachment of the PCL, and the number of mechanoreceptors in each slice was counted. Multifactor analysis of variance was used to evaluate the relationship between the number of mechanoreceptors and patient age or WOMAC score.

Results:

The number of mechanoreceptors (mean ± SD) in groups A, B, and C was 24.00 ± 15.19, 30.92 ± 11.41, and 23.38 ± 11.39, respectively, with no significant between-group differences. The number of mechanoreceptors in groups I, II, and III was 43.50 ± 4.99, 25.00 ± 5.27, and 15.20 ± 5.61, with significant differences between groups I and II, groups I and III, and groups II and III ( P < .001 for all).

Conclusion:

In patients with knee OA, age had no significant effect on mechanoreceptor count, but the number of mechanoreceptors in the PCL decreased significantly with higher (worse) WOMAC score. These findings suggest that in patients of any age with high WOMAC scores, there may be little value as it relates to knee proprioception in performing a PCL-retaining TKA.
Arthroscopic Onlay Biceps Tenodesis Utilizing 2 Knotless All-Suture Anchors
Authors: Jawanda Harkirat S. , Jackson Garrett R. , Dasari Suhas P. , Kaplan Daniel J. , Brusalis Christopher M. , Verma Nikhil N.
Published: June 2023

Background:

Tenodesis is an effective surgical technique for the management of a pathologic long head of the biceps tendon. Tenodesis is performed with either an onlay (tendon opposed to cortical surface) or inlay (tendon docked into a reamed intra-cortical tunnel). Both techniques can be performed either from a subpectoral location, which is typically done through an open approach, or from a suprapectoral location, which is performed arthroscopically. The arthroscopic suprapectoral approach, when compared with its subpectoral counterpart, has been shown to report similar patient outcomes and complication rates.

Indications:

Arthroscopic suprapectoral biceps tenodesis is most commonly indicated in patients undergoing surgical treatment with anterior shoulder pain and biceps tendonitis, often associated with concomitant pathology. Less common indications include patients with superior labrum anterior and posterior tears as well as biceps tendon subluxation or dislocations. Patients with ruptured proximal biceps tendons are contraindicated, as the tendon is typically too distal for arthroscopic management.

Technique Description:

The biceps tendon is identified arthroscopically within the bicipital groove, just proximal to the pectoralis major tendon superior border. Suprapectoral tenodesis is then performed utilizing 2 knotless suture anchors for fixation.

Results:

Patient-reported outcomes following arthroscopic suprapectoral tenodesis in the literature have been found to be excellent with minimal complications. Despite current literature being inconclusive regarding the optimal site of fixation, the arthroscopic procedure minimizes the risk of infection, cosmetic deformity, and neurovascular injury that is seen in the open approach. In addition, the use of onlay fixation has traditionally avoided the risk of humeral fracture that is seen with inlay fixation.

Discussion/Conclusion:

This arthroscopic onlay suprapectoral tenodesis has the benefit of a time-efficient and easily reproducible technique that safely minimizes the risk of humeral fracture or neurovascular injuries. This technique historically has provided a strong fixation with excellent patient-reported outcomes.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Loss of Vision Outcome for Allergic Fungal Sinusitis: Case Report and Literature Review
Authors: Alhussien Ahmed , Alghulikah Abdulrahman , Albaharna Hussain , Alserhani Abdulrahman , Alromaih Saud , Aloulah Mohammad
Published: June 2023

Visual loss is a rare manifestation of allergic fungal rhinosinusitis (AFRS). We report a case of an adult male who was diagnosed with AFRS and who presented during the COVID-19 pandemic lockdown with sudden-onset complete vision loss and a lack of recovery after surgical and medical management. We reviewed the literature on reported cases of AFRS complicated by visual loss to identify factors associated with visual outcomes. We found 50 patients who were diagnosed with acute visual loss due to AFRS, with an average age of 28 ± 14 years. Complete and partial recovery after surgical intervention were reported in 17 and 10 cases, respectively. However, the absence of vision improvement was reported in 14 of the cases. Early diagnosis and prompt intervention can return vision back to normal. However, delayed presentation, complete loss of vision, and acute onset of visual loss are associated with worse outcomes.
Exploring the Phases and Measuring the Effectiveness of Social Innovations Waved During Coronavirus (COVID-19) Pandemic: Implications from India
Authors: Ali Esrafil , Malik Madhusmita , Satpathy Sharvani
Published: June 2023

Drawing on the social innovation process adapted by Van de Ven et al. (2008), we studied the different phases of social innovations in terms of ideation, development and scaling that waved during the pandemic of COVID-19. We also measured the effectiveness of the innovations on different parameters in fighting the Coronavirus when it was at its peak in the first wave. In this article, we also postulated how the various innovations impacted social life. A total of 24 innovations were explored and studied using the qualitative content analysis method. Data were analyzed using the Maxqda software (version Pro 2020). Results revealed that most of the innovations were implemented with new and latest technologies and they had developed using optimum resources. Further, it was noticed that most of the innovations had achieved the scaling and implementation phase in managing the COVID crisis.