bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and Outcomes of Reoperative Robotic Tricuspid Valve Surgery
Authors: Vardas Panos N. , Daughtry Brock , West James Lee , Xie Rongbing , Singh Gagandip , Williams Lamario , Davies James , Lewis Clifton
Published: September 2024

Objective:

Reoperative surgery for isolated tricuspid valve (TV) pathology has been associated with high morbidity and mortality rates; however, the current guidelines recommend intervention for severe, symptomatic TV regurgitation or mild to moderate symptoms with progressive right ventricular dysfunction. There are minimal data regarding reoperative intervention for TV disease. Similarly, there are no large series describing robot-assisted reoperative TV surgery.

Methods:

Institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database data were used to identify patients with previous cardiac surgery undergoing robot-assisted TV surgery from 2017 to 2022 from 2 tertiary referral hospitals. Patient demographics, preoperative characteristics, disease progression, operative details, and outcomes were analyzed. The primary outcome was 30-day mortality. Secondary outcomes were 30-day readmission, length of stay, and adverse events. Descriptive and summative statistics were used to describe clinical data and examine differences in outcomes of patients with primary versus secondary etiology using bivariate analyses.

Results:

Twenty-four patients were divided into 2 arms, primary TV pathology and secondary dysfunction due to comorbid cardiac conditions. The overall mortality was 8.3%. Major complications, including respiratory failure, renal failure, and reoperation were 12.5%, 8.3%, and 8.3%, respectively. No permanent pacemakers were required, and the 30-day readmission rate was 4.5%.

Conclusions:

Reoperative robotic TV surgery is a safe and viable alternative to traditional sternotomy for both primary and secondary TV pathology. TV repair and replacement are possible using the minimally invasive technique. The morbidity and mortality rates are acceptable when compared with traditional approaches with decreased need for pacemaker placement in the minimally invasive approach.
Retrograde Ejaculation Due to Posterior Urethral Stricture: A Rare Case Report
Authors: Zheng Lei , Wang Lihong , Jiang Hui , Jiang Tao
Published: September 2024

Pelvic fracture is a serious injury, which has a profound impact on sexual function due to concurrent nervous and urethral injuries. In this case report, we describe a 29-year-old single man who had retrograde ejaculation as a result of a pelvic fracture-related posterior urethral stricture. The patient wanted to improve his ejaculatory ability after experiencing urethral stricture for 8 years and retrograde ejaculation for 3 years following the pelvic fracture. We precisely located and measured the patient’s urethral stricture using a retrograde urethrogram, and we used transrectal color Doppler ultrasound to track the patient’s ejaculation process in real time. Next, we used urethral balloon dilatation to relieve the urethral stricture. Urinary obstruction symptoms have completely resolved, and the patient was able to urinate without any obstructions. Meanwhile, the real-time transrectal color Doppler ultrasound result showed that some semen might ejaculate externally by passing through the initial stricture area, while some semen continued to flow retrogradely into the bladder.
1-Year outcomes of Resolute Onyx Zotarolimus-Eluting Stent for symptomatic intracranial atherosclerotic disease: A multicenter propensity score–matched comparison with stenting versus aggressive medical management for preventing recurrent stroke in intracranial stenosis trial
Authors: Ravi Saisree , Bhatti Ibrahim A , Nunna Ravi S , Khalid Syed , Tekle Wondwossen G , Tanweer Omar , Burkhardt Jan-Karl , Jabbour Pascal M , Tjoumakaris Stavropoula I , Herial Nabeel A , Siddiqui Adnan H , Grandhi Ramesh , Qureshi Adnan I , Siddiq Farhan , Hassan Ameer E
Published: September 2024

Background

Intracranial atherosclerotic disease (ICAD) is one of the most prevalent causes of stroke across the world. Endovascular treatment has gained prominence but remains a challenge with unfavorable results. Recent literature has demonstrated that the Resolute Onyx Zotarolimus-Eluting Stent (RO-ZES) is a technically safe option with low complication rates along with 30-day outcomes associated with intracranial stent placement for ICAD with RO-ZES compared to results from the Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. Here, we aim to compare outcomes at one year with the SAMMPRIS trial with a multicenter longitudinal study.

Materials and methods

Prospectively maintained databases across seven stroke centers were analyzed for adult patients undergoing RO-ZES placement for ICAD between January 2019 and May 2023. The primary endpoint was composite of one-year stroke, ICH, and/or death. These data were propensity score matched using age, sex, hypertension, diabetes mellitus, smoking status, and impacted vessel for comparison between RO-ZES and the SAMMPRIS percutaneous angioplasty and stenting groups (S-PTAS).

Results

A total of 104 patients were included, mean age ± SD: 64.9 ± 10.9 years, 25.5% female. Propensity score match analysis of the 104 patients with S-PTAS demonstrated one-year stroke, ICH, and/or death rate of 11.5% in the RO-ZES group and 28.1% in the S-PTAS group (odds ratio 4.17, 95% CI 2.06–8.96, p = 0.001).

Conclusion

The RO-ZES system demonstrates strong potential to reduce long-term complications at one year compared with the S-PTAS group. Further prospective multicenter studies are needed to corroborate and build upon these findings.
Research and application of a coupled wheel-track off-road robot based on separate track structure
Authors: Jin Chengke , Wang Chao , Tang Kai , Jiao Chenhang , Wang Yongjuan
Published: September 2024

A novel coupled wheel/track mechanism is proposed to overcome the complexity and limited applicability of conventional coupled wheel/track robots. The mechanism is based on the design of a tracked off-road robot, where the track is separated from the driving wheel and the load-bearing wheel by a fork fixed on the frame. The tension-wheel compensates for the shortening of the track winding length by moving along the frame. The chain transmission between the first pair of load-bearing wheels and the driving wheel enables the wheeled operation. The coupling mechanism is characterized by only one set of walking mechanism, and the coupling is realized by separating part of the walking mechanism, avoiding the use of the clutch. The advantages of this mechanism are its simple and reliable structure, low cost, and easy installation of the suspension system. A simulation experiment is conducted to verify the performance of the mechanism, and a prototype is designed and manufactured for testing. The structure was used to design simulation experiments, and a test model of the vehicle was designed and fabricated. The design specifications were achieved by the results.
Gyroscopic rotor dynamics simulation with anisotropy of elastic and damping characteristics of the support
Authors: Abduraimov Azizbek , Iskakov Zharilkassin , Kamal Aziz , Kalybayeva Akmaral
Published: September 2024

In the work, the differential equations of motion of the gyroscopic rotor, built taking into account the anisotropy of stiffness and damping of the flexible support, are solved analytically, by the method of harmonic balance, convenient for obtaining separately amplitude-frequency and phase-frequency characteristics in the direction of oscillations. The equations of the non-stationary process are obtained by the method of changing amplitudes. It has been found that when the linear stiffness of the elastic support is different in two orthogonal directions, two critical velocities and the corresponding resonant regions arise. In the area of each critical speed, there are two amplitude-frequency curves of oscillations of the main direction and the direction perpendicular to it, respectively. The geometric nonlinearity of damping suppresses the elevations of these amplitude-frequency curves more significantly than linear damping. If only one of the two directions has a damping nonlinearity, then its effect is on the amplitude-frequency curves of the corresponding critical speed. It is more efficient to control resonant amplitudes for smooth resonant transitions by enhancing the linear damping with geometrically nonlinear damping. The results of the analytical solution of the equations of motion agree well with the results of direct modeling and experimental studies.
Research on energy consumption evaluation and energy-saving design of cranes in service based on structure-mechanism coupling
Authors: Qu Xiaogang , Zhao Maojie , Qi Qisong
Published: September 2024

Aiming at the problem that the life cycle energy consumption index of hoisting machinery is difficult to be objectively quantified, a crane energy consumption evaluation calculation method based on the working cycle of the service period is proposed, the typical service working mode of the crane is analyzed, and the working cycle process of the mechanism is clarified. On this basis, the stress cycle characteristics of the crane structure during the service period are determined based on the coupling relationship between the mechanism and the structure, which lays the foundation for accurately evaluating the life index of the crane. According to the relationship between the load rate and effective power of each mechanism during the service period of the crane, the calculation method for the evaluation and calculation of the structure energy consumption during the service period of the crane is studied. Finally, the crane is designed based on the concept of absolute service safety, and an optimal design model of the main girder structure of the crane with the goal of the lowest energy consumption in service is established. Using the research method of this paper to study a certain type of bridge crane, the energy consumption of the hoisting machinery during its service period is not only related to the accumulation of the operating characteristics of the mechanism but also related to the characteristic parameters such as the structure self-weight. The comprehensive evaluation of energy consumption provides an effective quantitative method and a reliable green design theory for crane design.
Investigating a Metrical Hebb Effect for lists of words
Authors: Paice Andrew W. , Johnson Andrew J. , Legg Rebecca , Smalle Eleonore , Page Michael P.A.
Published: September 2024

In four experiments, we describe the first finding of a Metrical Hebb Effect. Participants are shown to exhibit a Hebb Repetition Effect for repeating list-wide stress patterns across sequences of familiar words, even though the lexical items within the “repeating” lists do not themselves repeat. Experiment 1 established the presence of a Hebb effect for metrical patterns, demonstrating significant learning of list-wide metrical patterns over successive presentations. Experiment 2 investigated the effect’s longevity, showing the persistence of learned metrical information after a spacing of three non-repeating lists. Experiment 3 revealed that the effect did not persist over a longer spacing of eight intervening lists. Experiment 4 investigated the learning mechanism, suggesting that chunking, rather than item-position binding, might account for the observed learning of metrical patterns. The authors propose that metrical-pattern learning represents a process of gradual integration of sequences of weak and strong stress accents into higher-level units representing the stress patterns within, and across, words. We briefly discuss some implications of the Metrical Hebb Effect for phonological word-form learning and for speech perception and production.
Insights into coaching effectiveness: Perspectives from coaches and players in South African Women's Rugby
Authors: Solomons Jocelyn , Bekker Sheree , Groom Ryan , Kraak Wilbur
Published: September 2024

Sports coaching involves navigating ambiguity and uncertainty in stakeholders’ perspectives and managing a dynamic micro-political environment. This study explores the relationship between coaching efficacy and effectiveness in South African Women's Rugby. It examines how a coach's belief in their ability to influence athlete learning and performance (coaching efficacy) correlates with the actual impact on athletes (coaching effectiveness). By aligning coaches’ perceived competence with tangible athlete outcomes, the study provides insights into factors influencing coaching practices and athlete development. The study involved 28 women players (mean age: 24.8 ± 4.0 years) and 8 coaches (mean age: 41 ± 3.8 years) who participated in semi-structured online interviews. The interview script, derived from the Coaching Effectiveness Survey (CES) tool, was analysed using Braun and Clarke's 6-step process of thematic content analysis. Under the four efficacy dimensions, sub-themes emerged as follow: 1) motivation (climate created by the coach and a motivational climate experienced by the players), 2) technique (coaching physical, technical, and tactical aspects of rugby), 3) game strategy (guiding players to successful outcomes), and 4) character-building efficacy (cultivating a positive environment for sportswomanship and holistic development). The findings incorporate feedback from players and coaches, highlighting firsthand experiences of coaching effectiveness. This approach enables experts to identify effective coaching strategies and those needing refinement within Women's Rugby. The study's findings promise to inform future coach development frameworks and foster a comprehensive understanding of coaching effectiveness in the dynamic landscape of Women's Rugby worldwide.
‘Have you insured yourself in any way?’ Salespersons’ mapping questions and their follow-ups in insurance sales negotiations
Authors: Niemi Jarkko , Heinonen Pilvi
Published: September 2024

This study examines how insurance salespeople employ a mapping question to promote life insurance as an additional service to their customers. The mapping question serves a double function, asking about the customer’s situation and creating a context in which transaction-related negotiation is projected to occur. Applying conversation analysis to study video-recorded insurance meetings in Finland, we explore how the mapping question is designed according to the customer’s estimated fit with the target group criteria and their assumed level of understanding of life insurance. We also discuss the trajectories of the negotiation after the customer’s response that expresses interest, conveys hesitation, or rejects the offer. It was found that only a customer’s justified blocking response forestalls further life insurance promotion. The study contributes to the research on questions as agenda-driving actions in institutional interaction and to the literature on question-answer sequences in service encounters.
Combining double antegrade intramedullary pinning with proximal interphalangeal joint transfixation in a bicondylar proximal phalangeal fracture
Authors: Wang Jui-Chien , Huang Yen-Chun , Wang Jung-Pan
Published: September 2024

The combination of double antegrade intramedullary pinning with proximal interphalangeal joint transfixation offers an effective and minimally invasive approach to reduce the complications of joint stiffness and functional disability.

Level of evidence: V
The reliability of clinical assessment of distal radioulnar joint instability among non-United Kingdom European surgeons
Authors: Giddins Grey , Knapper Thomas , Fine Nicola , Pickering Greg
Published: September 2024

Clinical assessment of distal radioulnar joint (DRUJ) instability has been shown to be unreliable among experienced hand surgeons in the United Kingdom (UK). The aim of this study was to test the reliability of assessing DRUJ stability in European surgeons outside the UK. Four participants (eight wrists) with four unstable and four stable DRUJs as measured with a proven jig were assessed by 34 surgeons (22 men and 12 women) with a mean age of 43 years (range 29–61). Clinical assessment of DRUJ instability had a sensitivity of 32%, specificity of 88%, a positive predictive value of 72% and a negative predictive value of 56%. Surgeons who had attended a 1-hour workshop on clinical assessment of DRUJ stability the day before the testing were no more reliable at assessing DRUJ instability when compared with those who did not. This further highlights the need for better training with feedback when assessing the DRUJ and the need for objective assessment of DRUJ instability when reported in scientific studies.

Level of evidence: V
Three-dimensional computed tomography evaluation of the ulnocarpal joint under stress loading
Authors: Park Ho Youn , Kwak Dai-Soon , Park Il-Jung , Lee Jin-Woo , Kim Seung Hyo , Lee Joo-Yup
Published: September 2024

We investigated which stress position of the wrist would result in the most significant reduction in the ulnocarpal distance using three-dimensional computed tomography (3DCT) images. 3DCT scans of 10 normal individuals and 19 patients with ulnar impaction syndrome were taken in neutral, radial/ulnar deviation and weightbearing pronation/supination wrist positions, and the shortest ulnolunate and ulnotriquetral distances were evaluated separately in each position. Both the ulnolunate and the ulnotriquetral distances were shortest in the weightbearing supination position in all participants. The ulnolunate distance was significantly decreased ( p = 0.00) in the weightbearing supination position compared with the neutral position in the ulnar impaction syndrome (UIS) group. However, the change in ulnotriquetral distance did not differ between the normal group and the UIS group. This study demonstrated that supination may be more vulnerable than pronation to UIS.

Level of evidence:

IV
Amandys® versus four-corner fusion in patients aged over 50 years: long-term retrospective study in stage 3 wrist osteoarthritis
Authors: Lozano Aude , Cointat Caroline , Bouju Yves , Kerjean Yves , Lecoq Flore-Anne , Bellemère Philippe
Published: September 2024

We compared the outcomes of the Amandys® implant and four-corner fusion in patients aged over 50 years with grade 3 wrist osteoarthritis and a mean follow-up of 5 years. Clinical assessments were of pain, mobility, strength, functional scores and satisfaction. Radiographs were taken. A total of 46 patients (mean age 63 years; 28 four-corner fusion and 21 Amandys®) were included. Pain relief, mobility and functional scores were not significantly different in the two groups at inclusion. At the last follow-up, wrist extension and grip were improved after Amandys® arthroplasty. Flexion decreased after four-corner fusion. One patient in the Amandys® group was not satisfied and one dislocation required repositioning of the implant. There were six nonunions, of which one required revision surgery in the four-corner fusion group. With the Amandys®, immobilization was shorter and mobility improved, making it a valid alternative to four-corner fusion especially in older patients.

Level of evidence: IV
Changes in hand function and health state utility after cubital tunnel release using the United Kingdom Hand Registry
Authors: Teunissen Joris S. , Griffiths Timothy T. , van der Heijden Brigitte E. P. A. , Wade Ryckie G. , Lane Jennifer C. E. , Hovius Steven E. R. , Bourke Grainne , Issa Fadi , Rodrigues Jeremy N. , Harrison Conrad J.
Published: September 2024

This study aimed to analyse and contrast changes in health-related quality of life (HR-QoL) and hand symptoms in the first 6 months after surgical treatment for primary cubital tunnel syndrome. Data originated from the United Kingdom Hand Registry. HR-QoL was assessed using the generic EuroQol five-dimensional assessment tool (EQ-5D-5L) and hand symptoms using the Patient Evaluation Measure (PEM). In total, 281 patients were included in the statistical analysis. Cubital tunnel release resulted in clinically relevant relief of hand symptoms. However, no improvement in HR-QoL was detected by the EQ-5D-5L. As a result, current health economic models, such as those used by the National Institute for Health Care Excellence (NICE) in the UK, might conclude that cubital tunnel release is not cost-effective. This discrepancy requires exploration, and hand-specific preference-based measures might be needed for value-based healthcare in hand surgery.

Level of evidence: III
Results of spinal accessory nerve to suprascapular nerve transfers in children with brachial plexus birth injury
Authors: Hyttinen Maria , Rönkkö Henrikki , Paavilainen Pasi , Helminen Mika , Jokihaara Jarkko
Published: September 2024

Shoulder external rotation after brachial plexus birth injury can be restored by transfer of the spinal accessory nerve to the suprascapular nerve, or more distally to its infraspinatus branch. We studied the outcome of these nerve transfers in 52 patients with a minimum postoperative follow-up of 12 months (mean 7.3 years). The median postoperative improvement in shoulder external rotation was 120° (interquartile range [IQR] 45–135) after anterior and 110° (IQR 83–120) after dorsal spinal accessory nerve transfer to the suprascapular nerve main trunk, and 110° (IQR 80–125) after transfer to the infraspinatus branch. Patients operated after 20 months obtained external rotation ≥90° less frequently. The results of this study suggest that a decision about distal nerve transfer for shoulder external rotation is recommended at 1.5 years of age.

Level of evidence: III
Trapezial ridge nonunion treated with excision and ligamentous tissue repair
Authors: Shimoyama Kohei , Emori Makoto , Iba Kousuke
Published: September 2024

We describe the challenge associated with obtaining an initial correct diagnosis of trapezial ridge fracture and the importance of repairing the detached ligamentous tissue after excision of the trapezial ridge fragment to obtain a favourable postoperative outcome for this rare fracture.
Efficacy and safety of rozanolixizumab in patients with muscle-specific tyrosine kinase autoantibody-positive generalised myasthenia gravis: a subgroup analysis of the randomised, double-blind, placebo-controlled, adaptive phase III MycarinG study
Authors: Habib Ali A. , Sacconi Sabrina , Antonini Giovanni , Cortés-Vicente Elena , Grosskreutz Julian , Mahuwala Zabeen K. , Mantegazza Renato , Pascuzzi Robert M. , Utsugisawa Kimiaki , Vissing John , Vu Tuan , Wiendl Heinz , Boehnlein Marion , Greve Bernhard , Woltering Franz , Bril Vera
Published: September 2024

Background:

Muscle-specific tyrosine kinase (MuSK) autoantibody-positive (Ab+) generalised myasthenia gravis (gMG) is a rare and frequently severe subtype of gMG.

Objectives:

To assess the efficacy and safety of rozanolixizumab in the subgroup of patients with MuSK Ab+ gMG in the MycarinG study.

Design:

A randomised, double-blind, placebo-controlled phase III study.

Methods:

Patients with acetylcholine receptor (AChR) Ab+ or MuSK Ab+ gMG (aged ⩾18 years, Myasthenia Gravis Foundation of America Disease Class II–IVa, Myasthenia Gravis Activities of Daily Living [MG-‍ADL] score ⩾3.0 [non-ocular symptoms], Quantitative Myasthenia Gravis score ⩾11.0) were randomly assigned (1:1:1) to receive once-weekly subcutaneous infusions of rozanolixizumab 7 mg/kg, rozanolixizumab 10 mg/kg or placebo for 6 weeks, followed by an 8-week observation period. Randomisation was stratified by AChR and MuSK autoantibody status. The primary study endpoint was change from baseline to Day 43 in MG-ADL score. Treatment-emergent adverse events (TEAEs) were also assessed.

Results:

Overall, 200 patients were randomised, of whom 21 had MuSK Ab+ gMG and received rozanolixizumab 7 mg/kg ( n = 5), 10 mg/kg ( n = 8) or placebo ( n = 8). In patients with MuSK Ab+ gMG, reductions from baseline to Day 43 in MG-ADL scores were observed: rozanolixizumab 7 mg/kg least squares mean (LSM) change (standard error), –7.28 (1.94); 10 mg/kg, –4.16 (1.78); and placebo, 2.28 (1.95). Rozanolixizumab 7 mg/kg LSM difference from placebo was −9.56 (97.5% confidence interval: −15.25, −3.87); 10 mg/kg, −6.45 (−11.03, –1.86). TEAEs were experienced by four (80.0%), five (62.5%) and three (37.5%) patients with MuSK Ab+ gMG receiving rozanolixizumab 7 mg/kg, 10 mg/kg and placebo, respectively. No patients experienced serious TEAEs. No deaths occurred.

Conclusion:

This subgroup analysis of adult patients with MuSK Ab+ gMG enrolled in the MycarinG study supports the use of rozanolixizumab as an effective treatment option for patients with gMG who have MuSK autoantibodies.

Trial registration:

ClinicalTrials.gov: NCT03971422 ( https://clinicaltrials.gov/study/NCT03971422 ); EU Clinical Trials Register: EudraCT 2019-000968-18 ( https://www.clinicaltrials‌register.eu/ctr-search/trial/2019-000968-18/GB ).
Pharmacokinetics, safety, and efficacy of an alternative dosing regimen of sasanlimab in participants with advanced NSCLC and other malignancies
Authors: Penkov Konstantin , Bondarenko Igor , Saenko Daria Viktorovna , Kulyaba Yaroslav , Guo Jun , Gong Yi , Yamamoto Noboru , Hotko Yevhen Stepanovych , Boyko Vasyl , Fadeeva Natalya Vladimirovna , Ursol Grygorii Mykolaiovych , Ahn Hee Kyung , Kislov Nikolay Viktorovich , Shen Chia-I , Davis Craig , Kowalski Karey , Michelon Elisabete , Pavlov Dmitri , Hirohashi Tomoko , Cho Byoung Chul
Published: September 2024

Background:

Sasanlimab (PF-06801591), a humanized immunoglobulin G4 monoclonal antibody, binds to programmed cell death protein-1 (PD-1), preventing ligand (PD-L1) interaction.

Objectives:

To evaluate pharmacokinetics (PK), safety, tolerability, and efficacy of two subcutaneous sasanlimab dosing regimens.

Design:

An open-label study consisting of phases Ib and II. Phase Ib: non-randomized, dose escalation, and expansion study in Asian participants with advanced malignancies.

Phase II:

conducted globally in participants with non-small-cell lung cancer with PD-L1 positive or PD-L1 status unknown tumors; participants were randomized 1:2 to receive subcutaneous sasanlimab 300 mg once every 4 weeks (300 mg-Q4W) or 600 mg once every 6 weeks (600 mg-Q6W).

Methods:

Primary endpoint in phase Ib: dose-limiting toxicity (DLT) occurring in first treatment cycle; in phase II: Ctrough and AUC.

Results:

A total of 155 participants (phase Ib, n = 34; phase II, n = 121) received sasanlimab. Phase Ib: no DLT reported. Phase II: ratio of adjusted geometric mean for AUCtau was 231.2 (90% CI, 190.1–281.2) and Ctrough was 111.5 (90% CI, 86.3–144.0) following 600 mg-Q6W (test) versus 300 mg-Q4W (reference). Phase Ib: grade 3 treatment-related adverse events (TRAEs) occurred in 1/4 (25%) and 3/12 (25%) participants treated in 300 mg-Q4W dose escalation and expansion cohorts, respectively. Phase II: grade 3 TRAEs occurred in 3/41 (7.3%) and 3/80 (3.8%) participants treated with 300 mg-Q4W and 600 mg-Q6W, respectively; no grade 4/5 TRAEs. Phase II: confirmed objective response was observed in 11/41 (26.8% (95% CI, 14.2–42.9)) and 12/80 (15.0% (95% CI, 8.0–24.7)) participants treated with 300 mg-Q4W and 600 mg-Q6W, respectively.

Conclusions:

Phase Ib regimens were considered safe with no DLTs reported. In phase II, 600 mg-Q6W regimen criteria were met for AUCtau and Ctrough metrics to support PK-based extrapolation of efficacy of alternative regimen. Regimens were well tolerated, showing anti-tumor activity in participants with advanced solid tumors. Administration of sasanlimab at a dose of 600 mg-Q6W subcutaneously may serve as a convenient alternative to 300 mg-Q4W administration.

Trial registration:

NCT04181788 (ClinicalTrials.gov); 2019-003818-14 (EudraCT).
Cardiovascular comorbidities in psoriatic arthritis: state of the art
Authors: Dey Mrinalini , Nikiphorou Elena
Published: September 2024

Psoriatic arthritis (PsA) is a complex multi-system immune-mediated condition, characterised by a high comorbidity burden, one of the most prevalent of which is cardiovascular disease (CVD), affecting up to 80% of patients. This narrative review explores the current understanding of cardiovascular comorbidities in PsA, focusing on mechanistic pathways, risk assessment, and the impact of treatment choices on cardiovascular health. Here, we outline the role of inflammatory cytokines, immune system dysregulation, and genetic predispositions in PsA, not only as drivers of musculoskeletal manifestations but also atherosclerosis and endothelial dysfunction, giving rise to cardiovascular pathology. Given these insights, accurately assessing and predicting cardiovascular risk in PsA patients is a critical challenge. This review evaluates traditional risk calculators as well as innovative biomarkers and imaging techniques, emphasising their utility and limitations in capturing the true cardiovascular risk profile of PsA patients. There are multiple complexities surrounding the treatment of PsA in the context of concurrent CVD, and therapeutic choices must carefully balance efficacy in managing PsA symptoms with the potential cardiovascular implications. A multidisciplinary approach, integrating dermatological, rheumatological, and cardiological perspectives, amongst others, to optimise patient outcomes, is key. Overall, a heightened clinical awareness and research focus on cardiovascular comorbidities in PsA is warranted, aiming to refine risk assessment strategies and therapeutic interventions that holistically address the multifaceted needs of patients with PsA.
The forgotten NATO enlargement dove in the Kremlin
Authors: Banka Andris
Published: September 2024

Has Vladimir Putin always stood against NATO’s eastward enlargement? Detractors claim that Moscow has invariably objected to the transatlantic organisation moving towards its borders. This article challenges the prevailing orthodoxy by demonstrating that at the turn of the century, the Russian head of state was quite comfortable with NATO ‘setting up shop’ in Eastern Europe. Drawing upon declassified US diplomatic cables and other historical sources, the presented material speaks to selective forgetfulness on the part of the Russian leadership. The first years of ‘Putinism’ were not marked by assertions that NATO’s eastward expansion complicated relations with the West. On the contrary, his public remarks suggested that Russia was not opposed to this process. Simply put, Putin’s own words at that time refute his present-day arguments and display of grievances.
The Normative Influence of the Belt and Road Initiative in Europe
Authors: Comerma Laia
Published: September 2024

This article analyses how the Belt and Road Initiative (BRI) is used as a tool to spread Chinese normative language and soft power in the European Union (EU), as well as the potential governance effects of the BRI. Through in-depth elite interviews and comparative qualitative analysis of the BRI Memoranda of Understanding (MoUs) between EU countries and China, it provides a comprehensive overview of the content of the MoUs, most of which are not publicly available. It finds that, while little normative influence can be seen, the MoUs represent a partially successful exercise of soft power. However, growing scepticism and even resentment towards China are emerging among EU BRI countries. This, paired with the securitisation of Chinese foreign direct investment that originated from the paradigm shift in EU trade policy towards economic security, has led to greater unity in the EU and a more antagonistic vision of China by its Member States.
Interventions to Reduce Psychosocial Burden in Head and Neck Cancer Patients: A Narrative Review
Authors: Chen Tanya , Grose Elysia , Noel Christopher W. , Villemure-Poliquin Noemie , Eskander Antoine
Published: September 2024

Background

The diagnosis and treatment of head and neck cancer (HNC) is associated with several life-altering morbidities including change in appearance, speech, and swallowing, all of which can significantly affect quality of life and cause psychosocial stress.

Commentary

The aim of this narrative review is to provide an overview of the evidence on psychosocial interventions for patients with HNC. Evidence regarding screening tools, psychological interventions, smoking and alcohol cessation, and antidepressant therapy in the HNC population is reviewed.

Conclusion

There is a large body of evidence describing various psychosocial interventions and several of these interventions have shown promise in the literature to improve psychosocial and health outcomes in the HNC population. Psychosocial interventions should be integrated into HNC care pathways and formal recommendations should be developed.
Does Tribe Trump Facts? Novel Measures of Hostile Media
Authors: Kaufhold Kelly
Published: September 2024

A national panel survey (n = 1,332) oversampled partisans (40% Democrat, 40% Republican, 20% Independent) and exposed them to an experiment showing partisan news sources (Fox News Channel and MSNBC) and partisan content, in a test of hostile media perception. Partisans did not find the news outlets to be hostile but did find out-group content to be hostile. The study also compared partisan cable news with broadcast TV news and found that viewers of traditional broadcast news (both network and local) were more moderate and viewed the news, and news sources, as less hostile. This study is also one of the first to examine the role of emerging social media outlets which have reportedly been embraced on the right, including Parler, Telegram, MeWe, Gab, Gettr, and Rumble.
The Components of Buyang Huanwu Decoction with UPLC-MS
Authors: Fang Shijian , Ma Yuxue , Yang Shuaihu , Yang Ruihong , Chen Xingtong , Yang Jinbiao , Zhou Yunyue , Xiao Hongbin , Zhang Yukun , Niu Wenying
Published: September 2024

Objective: Buyang-Huanwu Decoction is often used as an adjuvant therapy for ischemic stroke in clinical practice. At the same time, various laboratories have found that it has the potential to treat ischemic heart failure, lower extremity varicose veins, pulmonary hypertension, pulmonary fibrosis, and hyperlipidemia. Previous studies in our laboratory have found that different concentrations of ethanol were used to separate the polar components of Buyang-Huanwu decoction, and the therapeutic effects of each group on pulmonary fibrosis and hyperlipidemia were different. Therefore, we analyzed and explored Buyang Huanwu decoction and its products. Methods: The isolated components were obtained by treatment with absolute ethanol, 30% (v/v), 50% (v/v), 75% (v/v), and 90% (v/v) ethanol, and the components were analyzed by UPLC-MS. Results: The separation method used in our laboratory could well separate the components of Buyang Huanwu Decoction, and simply enrich carbohydrates, organic acids, phenylpropanoid compounds, lipids, nucleotides, and lignans. Conclusions: The products treated with different concentrations of ethanol have different therapeutic potentials. The high content components of 30% ethanol eluate and 50% ethanol eluate have good therapeutic effects on osteoarthritis and bone loss, while the high content components of the precipitate components and 75% eluate are more likely to be related to glucose and lipid metabolism disorders and cardiovascular diseases.
No Place to Go: The Relationship Between Care Partner Inclusion Practices and the Hospital Environment
Authors: Still Catherine , Hoel Sydney , Strayer Andrea , Werner Nicole E. , Fields Beth
Published: September 2024

Objective

The objective of this was to explore how the physical environment in a hospital contributes to care partner inclusion practices.

Background

Despite their vital efforts in caring for people living with dementia (PLWD), care partners of PLWD often report feeling not included in their loved ones’ hospitalizations. This phenomenon goes against research, policy initiatives, and hospital design frameworks that underscore the importance of including care partners in hospital care. To ensure that care partners are systematically included in hospital care, health systems must create an environment that prioritizes care partners’ presence.

Methods

This descriptive qualitative design employs a multimethod approach to data collection. Our team conducted direct observations in a large academic hospital and interviewed 23 clinicians/administrators and 15 care partners of PLWD to understand the relationship between hospital environments and care partner inclusion. Observational data were analyzed using a framework analysis, and interview data were analyzed through thematic analysis.

Results

Direct observations revealed an underutilization of environmental resources such as family-centered spaces and environmental communication tools. Interview data revealed that adequate space for care partners, the layout of patient rooms, parking accessibility, room personalization, and comfort level of the hospital space all impact care partner inclusion.

Conclusion

Our findings highlight opportunities for health systems to create hospital environments that support PLWD and their care partners. In pursuit of systematic care partner inclusion, health systems can make adequate space for care partners, allocate dementia-friendly parking spaces, increase utilization of environmental communication tools, and increase comfort level of the environment.
Harmony in Nature: Exploring the Multisensory Impact of Classical Gardens on Individuals’ Well-Being
Authors: Yinan Li , Li Guo , Elsadek Mohamed , Manqing Yao , Hassan Ahmad , Jiayan Yun , Juan Ding , Chuanyu Zang , Deshun Zhang
Published: September 2024

Objectives: Chinese classical gardens, designated as a vital world cultural heritage, embody a lasting legacy transcending generation. Despite the cultural importance of these gardens, a notable research gap exists in deciphering the nuanced emotional and physiological responses triggered by individual elements within classical garden landscapes. Our research question aims to uncover the specific emotional and physiological impacts of key garden elements—plants, architecture, waterscape, and rockery—on visitors, with a particular focus on the Humble Administrator's Garden. These elements serve as the primary subjects for video capture at four sites. Study Design: A within-subject design experiment was used. Methods: Videos were recorded at these sites, encompassing visual, auditory, and tactile elements. Ninety-five participants watched these videos in an indoor setting. While viewing, we measured participants’ physiological responses, including heart rate variability, skin conductance, and skin temperature, will be monitored alongside subjective assessments obtained through self-reported questionnaires such as the Emotional Perception Scale and State-Trait Anxiety Scale. Results: Findings suggest that while all landscape types evoke positive emotions, natural elements exert a more profound influence. Additionally, the Large Rockery emerges as a focal point, indicating enhanced emotional relaxation through auditory and tactile stimuli, particularly among younger individuals. Conclusions: This research contributes to the broader understanding of how classical gardens impact human emotions and well-being, offering insights that can inform future landscape design and promote mental health in diverse cultural contexts.
Umbilical nodule, a rare presentation of primary cutaneous endometriosis: Case report and literature review
Authors: Ashindoitiang John Adi , Canice Nwagbara Victor Ikechukwu , Ugbem Theophilus Ipeh , Ukam Joseph Stephen , Asuquo Maurice Efana
Published: September 2024

Umbilical endometriosis or Villar’s nodule is defined as the presence of endometrial tissue within the umbilicus and represent 0.5%–1% cases of endometriosis ectopia. It is classified as primary or secondary based on the surgical history. The important symptoms that characterize primary umbilical endometriosis were cyclical pain and a palpable mass that may be associated with bleeding. These features have temporal association with catamenia. Presented is a 30 year old woman with clinical features that suggested primary umbilical endometriosis in the past 5 years. It was confirmed by histology and coexisted with uterine fibroid. In the absence of previous surgery, primary umbilical endometriosis should be considered in the differential diagnosis in females of reproductive age with umbilical pain and nodule related to catamenia. Surgery is the treatment of choice and this should be individualized as some lesions can be managed by local excision with satisfactory outcome regarding the cessation of the presenting symptoms with good cosmetic outcome.
Analytical expressions for forces on structures due to spherical blast waves
Authors: Goel Tusshar , Pathak Shashank
Published: September 2024

The blast-resistant design of structures is becoming important due to the enhanced security requirements. The estimation of net forces and moments is essential to proportioning the design section of homogeneous structures such as blast-walls. The current design procedures consider the planar wave assumption, which is true when the structure is either small compared to the shock front or located very far from the explosion. Furthermore, due to the reflections of the shock waves, the structures experience reflected overpressure, which depends on the angle of incidence and incident overpressure of the shock wave front on the exposed structural surface. Under the planar wave assumption, the angle of incidence will always be normal, however, it will be significantly different from normal for spherical blast waves. Therefore, this study investigates the interaction of an unyielding straight structural surface with spherical blast waves and develops an exact solution for the blast pressures and net forces on the rigid surface. For direct design applications, the approximate closed-form approximations are also developed and compared with the exact solutions. The detailed discussions indicate that below a certain scaled distance, the planar wave solutions significantly overestimate the forces, and in those cases, the proposed closed-form approximations can be conveniently used. The applicability and limitations of the developed solution are illustrated through respective examples.
Pirfenidone-induced liver injury, a case report of a rare idiosyncratic reaction
Authors: Fortunati Florent , Froidure Antoine , Baldin Pamela , Horsmans Yves , Lanthier Nicolas , Dahlqvist Géraldine , Delire Bénédicte
Published: September 2024

Nearly all medications carry the risk of drug-induced liver injury (DILI). Idiosyncratic reactions are rare and poorly predictable, and the mechanisms are not always well understood. Pirfenidone is an oral antifibrotic drug used to treat idiopathic pulmonary fibrosis. While elevation of liver enzymes is a common adverse reaction during therapy, it rarely leads to discontinuation or reduction of the drug. Although isolated cases of liver damage or liver failure have been reported, they are infrequent. This report presents the case of a 70-year-old woman with known idiopathic pulmonary fibrosis, depression, hypothyroidism, and hypercholesterolemia who presented at our emergency department with jaundice, anorexia, and asthenia. The patient’s medication regimen included lamotrigine, simvastatin, levothyroxine, and pirfenidone, which had been introduced 6 months prior. Laboratory testing revealed elevated liver enzyme levels consistent with acute hepatocellular hepatitis. Following a medical workup, which included anamnesis, laboratory testing, iconographic investigations, and liver biopsy, we concluded that the patient had suffered from pirfenidone-induced liver injury. Pirfenidone was withdrawn, and liver tests gradually improved. The purpose of this clinical case report is to highlight this rare adverse reaction and to make clinicians aware of its assessment and management. In 2018, only one other case of severe liver failure leading to the death of the patient was reported. Early detection of potential DILI during the workup is crucial to discontinue the suspected medication promptly. Any drug-induced hepatitis must be reported for registration.
Characterizing medication safety incidents in surgical patients: a retrospective cross-sectional analysis of incident reports
Authors: Sagua Noah , Carson-Stevens Andrew , James Kathryn Lynette
Published: September 2024

Background:

Medication-related safety incidents (MSIs) are among the most frequent contributors to preventable harm in hospital patients. There is a paucity of research that explores the factors that contribute to MSIs across the departments of high-risk specialties such as surgery.

Objectives:

To characterize MSIs involving surgical patients across two secondary care sites at a University Health Board.

Design:

Retrospective cross-sectional convergent analysis of anonymous MSI reports extracted from the risk management system between 1st January 2017 and 31st October 2020 was undertaken.

Methods:

Incident reports contained categorical data pertaining to the type and nature of the incident as well as free-text reporter accounts. Categorical data were analyzed quantitatively, undergoing descriptive analysis using IBM SPSS Statistics © software (Version 26.0.01; 2019). Content analysis of free-text responses was undertaken using the Organizational Accident Causation model as the underpinning theoretical framework.

Results:

Of a total of 670 incidents, most MSIs did not result in harm ( n = 495, 73.9%). Most MSIs occurred during administration ( n = 439, 65.5%). Half of the incidents ( n = 335, 50%) were related to one of three medication types: opioids, antimicrobials, and antithrombotic agents. Communication failures were the most frequent error-producing condition ( n = 39, 5.8%) and drug omission was the most frequent active failure ( n = 156, 23.3%).

Conclusion:

To the knowledge of the authors, this is the first study in the United Kingdom that reports the medications most frequently involved in MSI reports for surgical patients. Staff in the surgical setting should be informed of the high frequency of incidents involving opioids, antimicrobials, heparin, and other antithrombotic agents as they appear in half of MSI reports in the surgical setting. Further research should explore administration error reduction strategies as well as tools to improve communication between staff to mitigate the risk of medicines-related harm associated with key medications.