bluuebunny/crossref_metadata_2025 huggingface dataset:
Why the Qualitative Health Research (QHR) Review Process Does Not Use Checklists
Authors: Morse Janice
Published: March 2021

Using checklists in manuscripts are perceived to indicate quality, transparency, and rigor. Generally, these checklists consist of a list of all of the strategies that may be used to ensure rigor and transparency. Beside each item, there is usually a box to check (or tick) to indicate whether a component is present, and a space on which to note the page each item is listed in the manuscript. Some of these forms also include space for the author to make brief comments to the reviewer. The intent is that the checklist guides the review process to ensure that all components are present in the article, and therefore, that the article is solid enough to publish.

However, these checklists consist only of technical/mechanical management of the creation and sorting of data. These lists ignore the value of the product of the research: They do not address the originality, the substance, the contribution, and the potential results to the actual topic—which is after all the purpose of the project itself.

Paradoxically, these checklist reviews are undermining the quality of qualitative inquiry. In seeking quality, the criteria for systematic reviews, clinical trials, and evidence have spilled over to represent quality criteria for all qualitative research. They are becoming commonplace for evaluating qualitative research by journal editors, directing the review process, and subsequent evaluation of the research. Of greatest concern is that checklists items are being used by authors themselves to represent their actual text (e.g., “data were saturated”), and the items for completing these forms are read by the reviewers and editors in lieu of reading the article itself (e.g., for signs of “saturation”). Furthermore, the use of these criteria by authors/researchers to guide the conduct of their research, yet meeting all these criteria, whether relevant or pertinent or necessary for their project, and may even invalidate the findings. In this way, these criteria are redefining processes of qualitative inquiry.
A Short Measure of Acceptability of Intimate Partner Violence Against Women: Development and Validation of the A-IPVAW-8 Scale
Authors: Martín-Fernández Manuel , Gracia Enrique , Lila Marisol
Published: March 2021

Attitudes of acceptability of intimate partner violence against women (IPVAW) are considered one of the main risk factors of this type of violence. The aim of this study is to develop and validate a short version of the acceptability of IPVAW scale, the A-IPVAW-8, for large scale studies where space and time are limited. A panel of experts were asked to assess item content validity. Two samples were recruited to assemble an 8-item short version of the scale using automated test assembly, and to reassess the psychometric properties of the A-IPVAW-8 in an independent sample. Results showed that the A-IPVAW-8 had adequate internal consistency (α = .72-.76, ω = .73-.81), a stable one-factor latent structure (comparative fit index [CFI] = 0.94, Tucker–Lewis index = 0.92, root mean square error of approximation = 0.077), validity evidences based on its relationships to other variables in both samples, and was also invariant across gender (ΔCFI < |0.02|). This study provides a short, easy-to-use tool to evaluate attitudes of acceptability of IPVAW for large scale studies.
Military Background and Gender Identity in Psychological Assessment Among College Students: Factorial Invariance of the Counseling Center Assessment of Psychological Symptoms–62 (CCAPS-62)
Authors: Ghosh Arpita , Niileksela Christopher R. , Janis Rebecca
Published: March 2021

The purpose of this study was to examine the factorial invariance of the Counseling Center Assessment of Psychological Symptoms–62 (CCAPS-62) across military background and gender identity. A sample of 2,208 military students and 2,208 nonmilitary students were chosen from a large database of university and college counseling centers. Using exploratory structural equation modeling, findings suggested the CCAPS-62 is mostly invariant across military background and gender identity. Only three item thresholds appeared to be noninvariant across groups. These results suggest comparisons of scores across military background and gender can be made. Latent mean differences across groups were also examined. After controlling for several background variables, there were some differences between males and females on subscales measuring depression, eating concerns, and generalized anxiety, but no differences between military and nonmilitary students. Implications for practice and future research are discussed.
Preadolescent Advanced Readers: Exploring Attitudes, Beliefs, and Behaviors
Authors: Walker April , Bower Janessa , Kettler Todd
Published: March 2021

Despite dedication of tremendous resources to developing literary proficiencies, advanced readers may remain an underserved and understudied population. This qualitative study included nine preadolescent participants aged 10–12 years who demonstrated reading comprehension abilities within the top 10% on a national normed achievement battery. The researchers gathered interview data from participants with corroborating evidence from their parents and their book club teacher. The grounded theory analyses found advanced readers to demonstrate superior reading comprehension and the ability to read entire books quickly. Participants reported positive attitudes toward reading in general and preferred out of school reading over the limiting structures of school reading. Some evidence supported a connection between reading and identity exploration through narrative imagination and empathetic relations to characters and narratives. Advanced readers may present cognitive characteristics, as well as behaviors and motivations that require differentiated learning designs.
Local Norms for Gifted and Talented Student Identification: Everything You Need to Know
Authors: Peters Scott J. , Makel Matthew C. , Rambo-Hernandez Karen
Published: March 2021

Conversations over who should be identified as gifted continue perpetually both within the field and in the popular media. In this article, we focus on the use of local norms as one approach to gifted identification that can increase the equity of advanced educational programs and services while also better achieving their stated purpose of providing additional challenge to those students who need it. In this article, we define local norms, explain their purpose, provide examples of schools that have used local norms, discuss common challenges, and provide a tutorial and external resources on how schools can begin to use local norms as part of their gifted identification process.
When Pictures Are Worth a 1,000 Words: Addressing Global Stereotypes With Dollar Street
Authors: Siegle Del
Published: March 2021

This article describes the Gapminders’ Dollar Street website that provides educators with a vehicle to debunk stereotypes about people from other countries and provides opportunities for their students to explore the role poverty plays in people’s lives.
Footfalls and heart-prints for Indigenous inclusion
Authors: Pio Edwina
Published: March 2021

Geographies of inclusion have largely been ignored in Management & Organization Studies (MOS), which tend to be encased within global white Western power over knowledge production. In this paper, I contribute to how non-Western contexts can serve as a counterpoint, yet avoid sharp dichotomies, concerning hegemonic Western discourse in geographies of inclusion. Through ethnography, I seek to provide some answers to the question: How does inclusion happen and how can it be theorised in non-Western contexts. Two central ideas of the paper are: 1. MOS can and should learn from non-Western contexts. Indigenous inclusion, specifically linked to Adivasis in India, illustrates how geographical contexts matter for theorising inclusion which can be enriched by examining non-Western contexts; and 2. Liberation theology through discernment and contemplative action, can provide insights and probe the possibilities of the nature of inclusion. I make no claim to a sole interpretation, rather I offer a guiding framework, grounded in an empirical contribution, for a nuanced understanding of Indigenous inclusion. My poignant hope is to invite other adaptations and traditions to further enrich and unveil understandings of geographies of inclusion for MOS.
Influence of slip-flow phenomenon on thermohydrodynamic behaviour of gas foil thrust bearings
Authors: Kumar Jitesh , Khamari Debanshu S , Behera Suraj K , Sahoo Ranjit K
Published: March 2021

Gas foil bearings are often used in high-speed turbomachinery such as turboexpanders and turbochargers due to their merits over simple gas-lubricated bearings. The merits of gas foil bearings include their ability to tailor dynamic parameters such as stiffness and damping. Gas foil bearings usually have low clearance and operate at a high rotational speed, which eventually leads to velocity slip at the solid–fluid interface. This article investigates the effect of slip flow on various parameters of gas foil thrust bearings. A numerical model is formulated to predict pressure, film thickness and temperature distribution of helium lubricated gas foil thrust bearing at high rotating speed. The Reynolds equation is modified by assuming first-order slip coupled with the structural (compliant) and energy equation. The temperature-dependent viscosity and density of the fluid are also considered in the Reynolds equation to predict the thermohydrodynamic behaviour of gas foil thrust bearings. The numerical model thus developed uses a finite-difference method and the Newton–Raphson method to solve the Reynolds equation,whereas the successive over-relaxation method is used to solve the energy equation. Various performance parameters are compared for slip and no-slip conditions for gas foil thrust bearings. The results show a considerable difference between the two phenomena. Also, the conventional Reynolds equation tends to overestimate the load-carrying capacity.
Outcomes of the paclitaxel-eluting Eluvia stent for long femoropopliteal lesions in Asian patients with predominantly chronic limb-threatening ischemia
Authors: Kum Steven , Ipema Jetty , Huizing Eline , Tan Yih K , Lim Darryl , Lok Ian YH , Hazenberg Constantijn EVB , Ünlü Çağdaş
Published: March 2021

The fluoropolymer-coated, paclitaxel-eluting Eluvia stent has shown promising results for the endovascular treatment of femoropopliteal artery lesions in patients with claudication. The aim of the current study was to evaluate efficacy and safety outcomes of the Eluvia stent for the treatment of long femoropopliteal lesions in Asian patients. This is a single-center, retrospective study. The primary endpoint was primary patency at 1 year. Secondary outcomes were 30-days complication rate, technical success, 1-year freedom from clinically driven target lesion revascularization (CD-TLR), limb salvage, survival, amputation-free survival (AFS), wound healing, and clinical improvement. A total of 64 patients with 67 femoropopliteal lesions were included; 78% suffered from diabetes and 84% had chronic limb-threatening ischemia (CLTI). Of those with ischemic wounds, 79% did not have run-off to the foot. Mean lesion length was 193 ± 128 mm and 52% were severely calcified. Primary patency at 1 year was 84% in the overall cohort and 91% in patients with complete lesion coverage with the Eluvia stent. Technical success was achieved in 100% of the cases and 30-day complications occurred in six patients. Twelve-month freedom from CD-TLR, limb salvage, survival, and AFS were 92%, 93%, 85%, and 80%, respectively. In 80% of patients, complete wound healing was experienced and 84% had clinical improvement after 1 year. The Eluvia stent showed promising 12-month patency and clinical results for femoropopliteal treatment in this CLTI-dominant patient population with severely calcified, long lesions. Patient numbers were, however, small; larger trials are required to validate these findings. Aneurysmal change seen in some cases also needs further investigation.
Sclerotherapy of telangiectasias: A prospective, randomized, comparative clinical trial of hypertonic glucose versus sodium tetradecyl sulfate
Authors: Bukina Oksana Vasilyevna , Sinitsyn Aleksander Aleksandrovich , Pelevin Andrey Viktorovich
Published: March 2021

To compare the disappearance of the telangiectasias after sclerotherapy with 75% glucose (HG) versus 0.2% sodium tetradecyl sulfate (STS). This prospective, randomized clinical trial compared the results of sclerotherapy of the telangiectasias with HG and STS. The primary efficacy end point was telangiectasia disappearance within 14, 28, 42, and 56 days following treatment. The clearing of the vessels was assessed using a six-point scale (from 0 to 5). A total of 159 women were treated (81 in the STS group; 78 in the HG group). The median score of the vessels clearing (IQR) was significantly lower in the STS group than in the HG group: 3 (2–4) versus 4 (3–5) after 56 days, p < 0.001. Pigmentation was frequently observed in the STS group (38.3% vs 2.6%; p < 0.001). In conclusion, throughout the entire follow-up period, sclerotherapy of telangiectasias with glucose was significantly superior to that with STS. Moreover, pigmentation and intravascular clots frequently occurred with STS treatment. Russian Registry of Treatment of Chronic Venous Diseases (RRT CVD) ID: VRCVD 1.005.
Varieties of economic dependence
Authors: Cockburn Patrick Joseph Luke
Published: March 2021

For several decades, public political discourses on ‘welfare dependency’ have failed to recognise that welfare states are not the source of economic dependence, but rather reconfigure economic dependencies in a specific way. This article distinguishes four senses of ‘economic dependence’ that can help to clarify what is missing from these discourses, and what is at stake in political and legal decisions about how we may economically depend upon one another. While feminist, republican and egalitarian philosophical work has examined the problems of dependence on states, in families and in markets, the present approach adds a further dimension to our cultural and political concerns with economic dependence: it argues that it is reasonable and useful to consider the economic dependence of the economically powerful. Doing so requires a clarification of the ‘varieties of dependence’ that exist in contemporary societies and economies, and the recognition that legal and political choices regarding social and economic justice are often about choosing between varieties of dependence, not about escaping dependence entirely.
Democratising South African universities: From activism to advocacy
Authors: Davids Nuraan
Published: March 2021

The segregation enforced during apartheid has not only ensured widely disparate South African university landscapes, but also framed constructions of activism in historical discourses of racial disenfranchisement and marginalisation. As a result, activism is implicitly and explicitly associated with disadvantaged universities; with black students; and specifically directed at an apartheid government. If there were expectations – certainly on the side of government – that the transition to a democratic state would allay student activism, this was not the case. Instead, student activism – still manifested in a critical mass of black students – has not only intensified but has degenerated into disturbing displays of destruction and violence. The recent spate of student protests, which centred on matters of access, free education and decolonisation, and more recently, gender-based violence, has provoked defensive, and at times, antagonistic and discouraging responses from universities – placing students firmly in an opposing discourse. Seemingly, while the political climate has shifted, universities have yet to reconceptualise their institutional, academic and spatial environments into contexts conducive to open and mutual deliberation. Current impressions from university responses suggest that activism, as symbolised through student protests, is out of place in democratic spaces. In considering the relational positioning of universities to activism and, hence, to students, the interest of this article resides, firstly, in how notions of activism might be reimagined within democratic contexts and, secondly, in how universities might reposition themselves from being sites of activism, to being advocates of social, economic and ethical reform.
Ideal Body Weight-Based Dosing of Rabbit Antithymocyte Globulin for Cost Minimization in Kidney Transplantation
Authors: Bubik Rachel J. , Peterson Kristen T. , Myhre Laura J. , Bernard Stacy A. , Dean Patrick , May Heather P.
Published: March 2021

Introduction:

Contemporary dosing strategies for rabbit anti-thymocyte globulin (rATG) in kidney transplantation aim to reduce cumulative exposure, minimizing long-term adverse events. The use of ideal body weight-based dosing has been trialed, however concern for increased rejection post-transplant exists due to lower doses of rATG. Research Questions: The primary aim of this study was to compare rejection rates between rATG dosing protocols using actual body weight and ideal body weight and secondarily to evaluate cost savings following protocol implementation.

Design:

This was a retrospective study surrounding implementation of an ideal body weight-based dosing protocol for rATG. We compared 75 kidney transplant recipients in whom rATG was dosed based on actual body weight (pre-protocol group) to 64 in whom dosing was based on ideal body weight (post-protocol group), following a nine-month washout.

Results:

The mean cumulative rATG dose in the pre-protocol group was 6.3 mg/kg of actual body weight. When ideal body weight was used in the post-protocol group, the mean dose was 4.5 mg/kg of actual body weight. The rejection rate was 18.7% pre-protocol and 23.4% postprotocol, which did not represent a statistically significant difference (p = 0.491). The actual annual cost savings after protocol implementation exceeded $162,000, approximately $2,500 per patient.

Conclusion:

Results suggest ideal body weight-based dosing of rATG may reduce exposure and cost, without significantly impacting the risk of rejection in kidney transplant recipients. More studies are needed to confirm these findings.
Overexpression of Long Noncoding RNA LBX2-AS1 Promotes the Proliferation of Colorectal Cancer
Authors: Li Qing , Xie Hui , Jin Zefu , Huang Jing , Wang Shuting , Zhang Zijian
Published: March 2021

Background:

LBX2 antisense RNA 1 (LBX2-AS1), a long noncoding RNA, has been identified to be closely associated with the progression of various cancers. However, the role of LBX2-AS1 in colorectal cancer (CRC) is still poorly understood. In this study, we aimed to investigate the expression and function of LBX2-AS1 in CRC.

Material and Methods:

Expression data from the Gene Expression Omnibus (GEO) and Gene Expression Profiling Interactive Analysis (GEPIA) databases and results obtained from clinical samples/patients were used to determine the correlation between LBX2-AS1 expression and pathological stages, overall survival (OS). Furthermore, knockdown of LBX2-AS1 in CRC cells using the short interfering RNA (siRNA) technique, and observed its biological functions using western blotting, quantitative reverse transcription-polymerase chain reaction (qRT-PCR), cell counting kit-8 (CCK-8) and flow cytometry assay in the CRC cell line.

Results:

Our study demonstrated that the expression levels of LBX2-AS1 were higher in CRC cell lines than in normal colon mucosal cell lines. Bioinformatics analysis revealed that CRC patients with high LBX2-AS1 expression levels had poor OS. Furthermore, knockdown of LBX2-AS1 in CRC cells could attenuate the proliferative ability of CRC cells in vitro, which is associated with decreased expression of cyclin-dependent kinase (CDK) 3, CDK6, and CCND1 and enhanced expression of cyclin-dependent kinase inhibitor 1A.

Conclusions:

LBX2-AS1 plays a crucial role in the tumorigenesis of CRC, providing a potential therapeutic target for CRC patients.
What Did Chaplains Do During the Covid Pandemic? An International Survey
Authors: Snowden Austyn
Published: March 2021

Chaplains’ unique contribution is to healthcare is to respond to the spiritual, religious and pastoral needs of patients and staff. This is their sole purpose, to provide a presence and space to meet individual need and promote healing, even when cure isn’t possible. Their value is priceless to families in desperate times. However, despite growing evidence for their impact, chaplains are commonly undervalued and misunderstood by their organisations, and the global pandemic revealed the consequences of this confusion. Whilst some chaplains were applauded as heroes along with their fellow health colleagues, others were seen as little more than an infection risk. A survey was designed to capture and learn from the full range of chaplain experiences of the impact of the pandemic across the globe. In June 2020, 1657 chaplains responded from 36 countries. They all experienced considerable disruption to their usual practice, with enforced social distancing having the biggest impact. Out of necessity they embraced technology to maintain contact with patients and families, and shifted focus of their support to staff. Whilst some chaplains were viewed as essential employees by their organisations, most were not. Despite the majority thinking that their organisations understood what they did, chaplains themselves were neither clear or unclear about their role during and post pandemic. More surprisingly, they felt similarly unclear about their role before the pandemic. This paper concludes that in general chaplains lack leadership skills, and confusion about their role will persist until this changes.
Scared but Powerful: Healthcare Chaplains’ Emotional Responses and Self-Care Modes during the SARS-Cov-19 Pandemic
Authors: Desjardins Cate Michelle , Bovo Anna , Cagna Mario , Steegen Martijn , Vandenhoeck Anne
Published: March 2021

Drawing from both the qualitative free-text responses and quantitative responses to an international survey of 1657 chaplains serving during the SARS-Cov-19 pandemic, we explore chaplains' emotional responses to the pandemic and how emotion connects to self-care. This paper reports on the modes of self-care practiced by chaplains, including modes reported as unavailable due to pandemic restrictions. Lastly, we explore how effective spiritual care leadership may mediate chaplain emotions and ultimately chaplain self-care.
Chaplaincy in a Free-Standing Psychiatric Hospital During the COVID-19 Pandemic
Authors: Zollfrank Angelika A.
Published: March 2021

This Special Issue discusses the results of the international COVID-19 survey that took place during the first wave of the pandemic. This contribution discusses chaplaincy in a psychiatric hospital during the COVID-19 pandemic. Chaplaincy vignettes with patients and interventions with staff are described, showing how chaplaincy changed and remained the same during this time. The focus here is on acknowledging disturbed and broken connections, as well as intervening to sustain community.
How Should Transcranial Direct Current Stimulation be Used in Populations With Severe Alcohol Use Disorder? A Clinically Oriented Systematic Review
Authors: Bollen Zoé , Dormal Valérie , Maurage Pierre
Published: March 2021

Background and rationale. Severe alcohol use disorder (SAUD) is a major public health concern, given its massive individual, interpersonal, and societal consequences. The available prevention and treatment programs have proven limited effectiveness, as relapse rates are still high in this clinical population. Developing effective interventions reducing the appearance and persistence of SAUD thus constitutes an experimental and clinical priority. Among the new therapeutic approaches, there is a growing interest for noninvasive neuromodulation techniques, and particularly for transcranial direct current stimulation (tDCS) as an adjunctive treatment in neuropsychiatric disorders, including SAUD. Methods. We propose a systematic review, based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, evaluating the available evidence on the effectiveness of tDCS to improve clinical interventions in SAUD. Results. We provide an integrative overview of studies applying tDCS in clinical populations with SAUD, together with a standardized methodological quality assessment. We show that the currently available data remain inconsistent. Some data suggested that tDCS can (1) reduce craving, relapse or alcohol-cue reactivity and (2) improve cognitive control and inhibition. However, other studies did not observe any beneficial effect of tDCS in SAUD. Conclusions. Capitalizing on the identified strengths and shortcomings of available results, we present evidence-based clinical guidelines to integrate tDCS in current clinical settings and to combine it with neurocognitive training.
Boundaries Between Research Ethics and Ethical Research Use in Artificial Intelligence Health Research
Authors: Samuel Gabrielle , Chubb Jenn , Derrick Gemma
Published: March 2021

The governance of ethically acceptable research in higher education institutions has been under scrutiny over the past half a century. Concomitantly, recently, decision makers have required researchers to acknowledge the societal impact of their research, as well as anticipate and respond to ethical dimensions of this societal impact through responsible research and innovation principles. Using artificial intelligence population health research in the United Kingdom and Canada as a case study, we combine a mapping study of journal publications with 18 interviews with researchers to explore how the ethical dimensions associated with this societal impact are incorporated into research agendas. Researchers separated the ethical responsibility of their research with its societal impact. We discuss the implications for both researchers and actors across the Ethics Ecosystem.
The Surgical Role in the Management of Persistent Coccygodynia in Adolescent and Pediatric Patients: A Retrospective Case Series
Authors: Shalaby Mohamed M.
Published: March 2021

Background: Coccygodynia has been described as a disabling pain in the coccyx usually associated with sitting or with changing position from a sitting to a standing position. Pain may radiate to the sacrum, to the lumbar spine, or laterally to the buttocks. Treatment has rarely been studied in the adolescent population. Purposes/Questions: This study aimed to assess pain relief and satisfaction after partial or total coccygectomy in pediatric and adolescent patients suffering from coccygodynia that was resistant to conservative treatment. Methods: A retrospective, consecutive case series was performed to review the data from the hospital records of 29 patients who underwent partial or total coccygectomy from January 2016 to January 2020 in a university hospital setting. Patients suffered from coccygodynia resistant to conservative treatment. The study included 16 female (55%) and 13 male (45%) patients who ranged in age from 3 to 15 years. Patient records were assessed for postoperative complications, period of hospital stay, time to regain normal activity, postoperative pain improvement (using a 4-point Likert scale), and patients’ or parents’ satisfaction (using a 5-point questionnaire). Results: Total coccygectomy was performed in 19 patients and partial coccygectomy in 10 patients. Only 1 patient had a superficial infection after surgery. The length of hospital stay was 1.44 ± 0.97 days. Time to regain normal activity was 24.68 ± 4.32 days. Pain relief was excellent (complete pain relief) in 23 cases (79.3%) and good (relief of most pain but mild discomfort after prolonged sitting) in 6 cases (20.7%). There were no reports of fair (minimal or no pain relief) or poor (pain worse than before surgery) pain relief. In terms of patient or parent satisfaction, no one reported being “absolutely dissatisfied,” 1 person was “dissatisfied” (3.4%), 3 people were “neither dissatisfied nor satisfied” (10.4%), 9 were “satisfied” (31%), and 16 were “absolutely satisfied” (55.2%). Conclusion: This case series suggests that coccygectomy may be a feasible management option for pediatric and adolescent patients, with favorable outcomes including pain relief, patient or parent satisfaction, and early return to activity.
Caution Before Embracing Team Mentoring in Academic Medical Research Training: Recommendations from a Qualitative Study
Authors: Mancuso Carol A. , Berman Jessica R. , Robbins Laura , Paget Stephen A.
Published: March 2021

Background: Multidisciplinary team mentoring increasingly is being advocated for biomedical research training. Before implementing a curriculum that could include team mentoring, we asked faculty about their opinions of this mentoring approach. Questions/Purposes: The goals of this study were to ask faculty about the benefits, challenges, and drawbacks of team mentoring in research training. Methods: Twenty-two experienced mentors representing all academic departments at a single institution were interviewed about perceived benefits, drawbacks, and their willingness to participate in team mentoring. Responses were analyzed with qualitative techniques using grounded theory and a comparative analytic strategy. Results: Faculty noted academic pursuits in medicine usually occur within, and not across, specialties; thus, multidisciplinary team mentoring would require coordinating diverse work schedules, additional meetings, and greater time commitments. Other challenges included ensuring breadth of expertise without redundancy, skillfully managing group dynamics, and ensuring there is one decision-maker. Potential drawbacks for mentees included reluctance to voice preferences and forge unique paths, perceived necessity to simultaneously please many mentors, and less likelihood of establishing a professional bond with any particular mentor. Conclusions: Faculty recommended caution before embracing team mentoring models. An acceptable alternative might be a hybrid model with a primary mentor at the helm and a selected group of co-mentors committed to a multidisciplinary effort. This model requires training and professional development for primary mentors.
Clinical Feasibility of Multi-Acquisition Variable-Resonance Image Combination–Based T2 Mapping near Hip Arthroplasty
Authors: Cheung Jacky , Neri John P. , Gao Madeleine A. , Lin Bin , Burge Alissa J. , Potter Hollis G. , Koch Kevin M. , Koff Matthew F.
Published: March 2021

Background: Hip arthroplasty is increasingly prevalent, and early detection of complications can improve outcomes. Quantitative magnetic resonance imaging (qMRI) methods using multi-acquisition variable-resonance image combination (MAVRIC) may allow for the assessment of soft tissues in close proximity to hip arthroplasty devices. Question/Purposes: We sought to determine the clinical feasibility of MAVRIC-based T2 mapping as a qMRI approach for assessing synovial reactions in patients with a hip arthroplasty device. We hypothesized that there would be differences in T2 metrics by synovial type, clinical impression, and clinical findings related to synovitis. Methods: We conducted a cross-sectional study of 141 subjects with 171 hip arthroplasties with greater than 1 year post-implantation. We enrolled subjects who had had a primary total hip arthroplasty or hip resurfacing arthroplasty between May 2019 and March 2020, excluding those with a revision hip arthroplasty and those with standard safety contraindications for receiving an MRI. Institutional standard 2D fast spin echo (FSE), short-tau inversion recovery (STIR), and susceptibility-reduced MAVRIC morphological MR images were acquired for each hip and followed by a dual-echo acquisition MAVRIC T2 mapping sequence. Results: While 131 subjects (81%) were classified as having a “normal” synovial reaction, significantly longer T2 values were found for fluid synovial reactions compared with mixed reactions. In addition, subjects with synovial dehiscence and decompression present had T2 prolongation. Larger synovial volumes were found in subjects with low-signal intensity deposits. Conclusions: MAVRIC-based T2 mapping is clinically feasible and there are significant quantitative differences based on type of synovial reaction. Patients undergoing hip arthroscopy revision surgery will warrant comparison of T2 values with direct histologic assessment of a tissue sample obtained intraoperatively. The approach used in this study may be used for a quantitative evaluation and monitoring of soft tissues around metal implants.
Design, Fabrication, and Accuracy of a Novel Noncovering Lock-Mechanism Bilateral Patient-Specific Drill Guide Template for Nondeformed and Deformed Thoracic Spines
Authors: Ashouri-Sanjani Mehran , Mohammadi-Moghadam Shima , Azimi Parisa , Arjmand Navid
Published: March 2021

Background: Pedicle screw (PS) placement has been widely used in fusion surgeries on the thoracic spine. Achieving cost-effective yet accurate placements through nonradiation techniques remains challenging. Questions/Purposes: Novel noncovering lock-mechanism bilateral vertebra-specific drill guides for PS placement were designed/fabricated, and their accuracy for both nondeformed and deformed thoracic spines was tested. Methods: One nondeformed and 1 severe scoliosis human thoracic spine underwent computed tomographic (CT) scanning, and 2 identical proportions of each were 3-dimensional (3D) printed. Pedicle-specific optimal (no perforation) drilling trajectories were determined on the CT images based on the entry point/orientation/diameter/length of each PS. Vertebra-specific templates were designed and 3D printed, assuring minimal yet firm contacts with the vertebrae through a noncovering lock mechanism. One model of each patient was drilled using the freehand and one using the template guides (96 pedicle drillings). Postoperative CT scans from the models with the inserted PSs were obtained and superimposed on the preoperative planned models to evaluate deviations of the PSs. Results: All templates fitted their corresponding vertebra during the simulated operations. As compared with the freehand approach, PS placement deviations from their preplanned positions were significantly reduced: for the nonscoliosis model, from 2.4 to 0.9 mm for the entry point, 5.0° to 3.3° for the transverse plane angle, 7.1° to 2.2° for the sagittal plane angle, and 8.5° to 4.1° for the 3D angle, improving the success rate from 71.7% to 93.5%. Conclusions: These guides are valuable, as the accurate PS trajectory could be customized preoperatively to match the patients’ unique anatomy. In vivo studies will be required to validate this approach.
Intravascular ultrasound-supported percutaneous angioplasty of post-kidney transplant renal artery bifurcation stenosis
Authors: Vijayvergiya Rajesh , Kasinadhuni Ganesh , Bootla Dinakar , Rajan Palanivel , Sharma Ashish , Lal Anupam
Published: March 2021

Background

Transplant renal artery stenosis (TRAS) is an uncommon complication following renal transplantation. Its usual clinical presentation includes worsening hypertension and/or renal function, without any evidence of graft rejection. Bifurcation renal artery stenosis of the transplanted renal artery is rarely encountered.

Methods

Percutaneous transluminal renal angioplasty (PTRA) with or without stenting is the procedure of choice to treat TRAS. We hereby describe a patient, who presented with impaired renal functions, four months following the renal transplantation. He underwent intravascular ultrasound-guided PTRA of the bifurcation lesion of TRAS. Results and conclusion: Superior renal artery had coronary drug-eluting stent implantation, while inferior renal artery and side branch of the superior renal artery had balloon angioplasty, alone. Post-intervention, the raised serum creatinine level decreased from 2.9 mg% to 1.7 mg%. The index case described the successful PTRA and stenting of the bifurcation lesion of TRAS, the technical results of which was optimized with the use of intravascular ultrasound.
Are two plates better than one? A systematic review of dual plating for acute midshaft clavicle fractures
Authors: Sheth Ujash , Fernandez Claire E , Morgan Allison M , Henry Patrick , Nam Diane
Published: March 2021

Background

The rate of operative fixation of acute midshaft clavicle fractures has exponentially increased in recent years; however, the rate of reoperation for symptomatic hardware removal remains high and the optimal fixation strategy unknown. This systematic review aimed to summarize available evidence for dual plating of acute displaced midshaft clavicle fractures.

Methods

EMBASE, MEDLINE, and PubMed searches identified clinical studies evaluating dual plate fixation of acute midshaft clavicle fractures. Pooled analysis was performed using a random-effects model in RevMan 5.3.

Results

Eleven studies including 672 patients were included. Hardware removal occurred in 4.4% and 12.3% of patients undergoing dual and single plate fixation, respectively. Compared to single plating, dual plating had significantly lower odds of hardware removal ( P = 0.001) with no difference in union rates. There were no significant differences in reoperation (excluding hardware removal), complications, and patient-reported outcomes between the two groups ( P > 0.05).

Conclusions

This study suggests that dual plating of acute displaced midshaft clavicle fractures may lead to lower rates of reoperation for symptomatic hardware removal without compromising fracture healing. Ultimately, well-designed randomized trials are needed to further investigate the findings from this systematic review.
FDA’s Strategies to Close the Health Equity Gap among Diverse Populations
Authors: Spinner Jovonni , Araojo RADM Richardae
Published: March 2021

This commentary provides an overview of the Food and Drug Administration’s Office of Minority Health and Health Equity.
A Point-of-Care Serum Lactate Level and Mortality in Adult Sepsis Patients: A Community Hospital Setting
Authors: Charoentanyarak Suraphan , Sawunyavisuth Bundit , Deepai Sansanee , Sawanyawisuth Kittisak
Published: March 2021

Introduction:

Sepsis is a serious and emergency condition that may lead to acute circulatory failure associated with infection. Serum lactate level of over 4 mmol/L is associated with sepsis mortality. However, there is limited data on using a point of care (POC) for fingertip lactate level on sepsis mortality in community hospital setting. This study aimed to evaluate roles of POC for serum lactate with combination of clinical factors on mortality prediction in sepsis patients.

Methods:

This was a retrospective cohort study conducted at 7 community hospitals. The inclusion criteria were adult patients with diagnosis of sepsis who were tested for POC lactate level. Electronic chart reviews of eligible patients were performed. Predictors for mortality were computed using clinical factors and POC lactate level.

Results:

There were 1641 patients met the study criteria. The mortality rate was 8.96% (147 patients). There were 3 independent factors associated with mortality: age, co-morbid diseases, and POC lactate level. The adjusted odds ratio (95% CI) of POC lactate level was 1.025 (1.002, 1.048). The cut point of serum lactate was 1.6 mmol/L gave sensitivity of 79.59% and specificity of 32.10%.

Conclusion:

POC serum lactate level may be associated with mortality in sepsis patients at community hospitals. Lactate level of 1.6 mmol/L may be an indicator for mortality with good sensitivity. Physicians may consider more aggressive and prompt management in individuals with sepsis and POC serum lactate of 1.6 mmol/L or over.
There Can Be More Than One: A Black Man’s Journey Through the Academy
Authors: Brown Robert A.
Published: March 2021

The underrepresentation of Black Americans as graduate students and faculty in Criminology and Criminal Justice programs is well-recognized. This essay discusses some of the dynamics of the academy that potentially contribute to the lack of Black representation at the highest levels of the academy. Through the sharing of various experiences, this essay sheds light on how the dearth of Black men in the academy creates challenges for the few Black men that do exist in the academy.
Is Routine Use of Drain Really Necessary for Posterior Lumbar Interbody Fusion Surgery? A Retrospective Case Series with a Historical Control Group
Authors: Jang Hae-Dong , Park Seong San , Kim Kyungbum , Kim Eung-Ha , Lee Jae Chul , Choi Sung-Woo , Shin Byung-Joon
Published: March 2021

Study Design:

A retrospective case-control study.

Objectives:

The usefulness of a drain in spinal surgery has always been controversial. The purposes of this study were to determine the incidence of hematoma-related complications after posterior lumbar interbody fusion (PLIF) without a drain and to evaluate its usefulness.

Methods:

We included 347 consecutive patients with degenerative lumbar disease who underwent single- or double-level PLIF. The participants were divided into 2 groups by the use of a drain or not; drain group and no-drain group.

Results:

In 165 cases of PLIF without drain, there was neither a newly developed neurological deficit due to hematoma nor reoperation for hematoma evacuation. In the no-drain group, there were 5 (3.0%) patients who suffered from surgical site infection (SSI), all superficial, and 17 (10.3%) patients who complained of postoperative transient recurred leg pain, all treated conservatively. Days from surgery to ambulation and length of hospital stay (LOS) of the no-drain group were faster than those of the drain group ( P < 0.001). In a multiple regression analysis, a drain insertion was found to have a significant effect on the delayed ambulation and increased LOS. No significant differences existed between the 2 groups in additional surgery for hematoma evacuation, or SSI.

Conclusions:

No hematoma-related neurological deficits or reoperations caused by epidural hematoma and SSI were observed in the no-drain group. The no-drain group did not show significantly more frequent postoperative complications than the drain use group, hence the routine insertion of a drain following PLIF should be reconsidered carefully.
Accuracy of Pedicle Screw Placement Methods in Pediatrics and Adolescents Spinal Surgery: A Systematic Review and Meta-Analysis
Authors: De Vega Brigita , Navarro Aida Ribera , Gibson Alexander , Kalaskar Deepak M.
Published: March 2021

Study Design:

Systematic review and meta-analysis.

Objective:

Various methods of pedicle screw (PS) placement in spinal fusion surgery existed, which can be grouped into conventional freehand (FH), modified freehand (MF), and image-guided methods (including fluoroscopy-based navigation (FL), computed tomography-based navigation (CT-nav), robot-assisted (RA), and ultrasound-guided (UG)). However, the literature showed mixed findings regarding their accuracy and complications. This review aimed to discover which method of PS placement has the highest accuracy and lowest complication rate in pediatric and adolescent spinal fusion surgery.

Methods:

A comprehensive search in MEDLINE (PubMed), EMBASE (OVID), CENTRAL, and Web of Science was conducted until May 2020 by 2 independent reviewers, followed by bias assessment with ROB 2 and ROBINS-I tools and quantification with meta-analysis. Overall evidence quality was determined with GRADE tool.

Results:

Four RCTs and 2 quasi-RCTs/CCTs comprising 3,830 PS placed in 291 patients (4-22 years old) were analyzed. The lowest accuracy was found in FH (78.35%) while the highest accuracy was found in MF (95.86%). MF was more accurate than FH (OR 3.34 (95% CI, 2.33-4.79), P < .00 001, I2 = 0%). Three-dimensional printed drill template (as part of MF) was more accurate than FH (OR 3.10 (95% CI, 1.98-4.86), P < .00 001, I2 = 14%). Overall, complications occurred in 5.84% of the patients with 0.34% revision rate. Complication events in MF was lower compared to FH (OR 0.47 (95% CI, 0.10-2.15), P = .33, I2 = 0%).

Conclusions:

Meta-analysis shows that MF is more accurate than FH in pediatric and adolescent requiring PS placement for spinal fusion surgery.
Hirayama Disease: An Important Cause of Focal Hand Weakness in Young Adults
Authors: Jiang Nan , Ubogu Eroboghene E.
Published: March 2021

Patients with progressive hand weakness may be seen in ambulatory medical clinics or in emergency rooms due to direct effects on activities of daily living or inadvertent injury associated with overuse or attempts to maintain normal function. It is important to recognize potential cause(s) and perform appropriate diagnostic tests and referrals that aid guide appropriate treatment that may lead to good outcomes. Hirayama disease is an underrecognized disorder in young adults due to an asymmetric growth-associated cervical spinal cord compression injury. Awareness of this disorder by internists, emergency room physicians, and radiologists would prevent unnecessary tests and interventions that may contribute to disease progression by delaying appropriate treatments or treating inappropriately, with consequential effects on outcomes. In this article, we describe 3 Hirayama disease cases from a single tertiary care institution and demonstrate how delayed diagnosis affected outcomes in 2 patients and early recognition facilitated improved outcomes in a patient.
Improvements After Arthroscopic Treatment for Femoroacetabular Impingement Syndrome in High-Level Ice Hockey Players: 2-Year Outcomes by Player Position
Authors: Lindman Ida , Abrahamsson Josefin , Öhlin Axel , Wörner Tobias , Eek Frida , Ayeni Olufemi R. , Senorski Eric Hamrin , Sansone Mikael
Published: March 2021

Background:

Ice hockey players often undergo arthroscopic treatment for femoroacetabular impingement syndrome (FAIS); however, only a few studies have reported postoperative patient-reported outcomes. It has been debated whether player position is related to FAIS.

Purpose:

To evaluate the change in patient-reported outcome measures (PROMs) in high-level ice hockey players from presurgery to 2 years after arthroscopic treatment for FAIS. The secondary aim was to evaluate differences in outcomes among player positions and whether stick handedness is related to the side of the symptomatic hip.

Study Design:

Case series; Level of evidence, 4.

Methods:

Ice hockey players undergoing treatment for FAIS between 2011 and 2019 were prospectively included. Preoperative and 2-year follow-up scores were collected for the following PROMs: HAGOS (Copenhagen Hip and Groin Outcome Score), iHOT-12 (12-item International Hip Outcome Tool), EQ-5D (EuroQol–5 Dimensions) and EQ-VAS (EuroQol–Visual Analog Scale), Hip Sports Activity Scale, and visual analog scale for overall hip function. Player position and stick handedness were collected from public sources. Preoperative and follow-up outcomes were compared for the entire cohort and among player positions.

Results:

The cohort included 172 ice hockey players with a mean age of 28 years, a mean body mass index of 25.6, and a mean symptom duration of 46.3 months. In the 120 players with 2-year follow-up data, there was significant improvement in all PROMs as compared with presurgery: HAGOS subscales (symptoms, 47.5 vs 68.0; pain, 57.0 vs 75.8; activities of daily living, 62.5 vs 81.0; sports, 40.0 vs 64.7; physical activity, 30.9 vs 57.2; quality of life, 32.5 vs 57.8), iHOT-12 (45.2 vs 66.7), EQ-5D (0.59 vs 0.75), EQ-VAS (68.3 vs 73.2), and visual analog scale for overall hip function (49.6 vs 69.2) ( P < .0001 for all). At 2-year follow-up, 83% reported satisfaction with the procedure. There was no difference in the improvement in PROMs among player positions. Further, there was no significant relationship between stick handedness and side of symptomatic hip; however, because of the number of bilateral procedures and large number of left-handed shooters, no conclusions could be drawn.

Conclusion:

High-level ice hockey players undergoing arthroscopic treatment for FAIS reported improvements in PROMs 2 years after surgery, regardless of player position.