bluuebunny/crossref_metadata_2025 huggingface dataset:
Recommendations From the Society for the Advancement of Transplant Anesthesiology Fellowship Committee: Core Competencies and Milestones for the Kidney/Pancreas Component of Abdominal Organ Transplant Anesthesia Fellowship
Authors: Souki Fouad G. , Chadha Ryan , Planinsic Raymond , Zerillo Jeron , Nguyen-Buckley Christine , Smith Natalie , Mandell M. Susan , Sakai Tetsuro , Nicolau-Raducu Ramona
Published: December 2021

The Society for the Advancement of Transplant Anesthesia (SATA) is dedicated to improving patient care in all facets of transplant anesthesia. The anesthesia fellowship training recommendations for thoracic transplantation (heart and lungs) and part of the abdominal organ transplantation (liver) have been presented in previous publications. The SATA Fellowship Committee has completed the remaining component of abdominal transplant anesthesia (kidney/pancreas) and has assembled core competencies and milestones derived from expert consensus to guide the education and overall preparation of trainees providing care for kidney/pancreas transplant recipients. These recommendations provide a comprehensive approach to pre-operative evaluation, vascular access procedures, advanced hemodynamic monitoring, assessment of coagulation and metabolic abnormalities, operative techniques, and post-operative pain control. As such, this document supplements the current liver/hepatic transplant anesthesia fellowship training programs to include all aspects of “Abdominal Organ Transplant Anesthesia” recommended knowledge.
Developmental Prevention of Prejudice: Conceptual Issues, Evidence-Based Designing, and Outcome Results
Authors: Beelmann Andreas , Lutterbach Sebastian
Published: December 2021

This article reviews conceptual and empirical issues on the developmental prevention of prejudice in childhood and adolescence. Developmental prejudice prevention is defined as interventions that intentionally change and promote intergroup attitudes and behavior by systematically recognizing theories and empirical results on the development of prejudice in young people. After presenting a general conception of designing evidence-based interventions, we will discuss the application of this model in the field of developmental prejudice prevention. This includes the legitimation, a developmental concept of change, and the derivation of intervention content and implementation. Finally, we summarized recent evaluations results by reviewing meta-analytical evidence of programs and discuss important issues of future research and practice.
The Role of the Family for Racism and Xenophobia in Childhood and Adolescence
Authors: Aral Tuğçe , Juang Linda P. , Schwarzenthal Miriam , Rivas-Drake Deborah
Published: December 2021

Racism and xenophobia are not just the problems of the adult world. As systems of beliefs, practices, and policies, racism and xenophobia influence children’s perceptions and experiences at early ages. Because families can be significant sources of information regarding race and ethnicity, we focus on the family to understand the broader context of racism and xenophobia in childhood and adolescence. In this paper, we first provide an overview of research conducted among BIPOC (Black, Indigenous, and People of Color) and ethnic/religious minority families that has focused on family ethnic–racial socialization to support children and adolescents’ capabilities for resisting racism and xenophobia. We then review research conducted among white and ethnic/religious majority families that has mainly taken an intergroup relations perspective and has examined associations between parents’ and children’s ethnic–racial attitudes, biases, and prejudice. Finally, we discuss the role of family for racism and xenophobia through the lens of family ethnic–racial socialization and intergroup relations perspectives, highlight areas that are currently understudied, and offer recommendations concerning future research directions.
The Effects of Employer Branding on Value Congruence and Brand Love
Authors: Kim Yunsik , Legendre Tiffany S.
Published: December 2021

This study examines the effect of employer brand on employees’ brand love by applying value congruence theory. A survey was conducted with employees of well-known hotel brands in South Korea. The results show that not all employer brand dimensions equally contribute to the formation of brand love. While economic, social, and development values positively influence brand love, interest value and application value did not affect brand love formation. Employees’ value congruence perceptions mediate this effect because employees could infer what values employers care about based on the benefits that a hotel brand offers. This study contributes to the literature by linking value congruence with employer branding and brand love. Based on our findings, hospitality managers can redesign all work activities and apply employer branding principles to reflect employment value to achieve employee’s brand love.
Evolutionary Dynamics of Indels in SARS-CoV-2 Spike Glycoprotein
Authors: Rao R Shyama Prasad , Ahsan Nagib , Xu Chunhui , Su Lingtao , Verburgt Jacob , Fornelli Luca , Kihara Daisuke , Xu Dong
Published: December 2021

SARS-CoV-2, responsible for the current COVID-19 pandemic that claimed over 5.0 million lives, belongs to a class of enveloped viruses that undergo quick evolutionary adjustments under selection pressure. Numerous variants have emerged in SARS-CoV-2, posing a serious challenge to the global vaccination effort and COVID-19 management. The evolutionary dynamics of this virus are only beginning to be explored. In this work, we have analysed 1.79 million spike glycoprotein sequences of SARS-CoV-2 and found that the virus is fine-tuning the spike with numerous amino acid insertions and deletions (indels). Indels seem to have a selective advantage as the proportions of sequences with indels steadily increased over time, currently at over 89%, with similar trends across countries/variants. There were as many as 420 unique indel positions and 447 unique combinations of indels. Despite their high frequency, indels resulted in only minimal alteration of N-glycosylation sites, including both gain and loss. As indels and point mutations are positively correlated and sequences with indels have significantly more point mutations, they have implications in the evolutionary dynamics of the SARS-CoV-2 spike glycoprotein.
Changes in Substance Use Among People Seeking Alcohol and Other Drug Treatment During the COVID-19 Pandemic: Evaluating Mental Health Outcomes and Resilience
Authors: Carlyle Molly , Leung Janni , Walter Zoe C. , Juckel Jennifer , Salom Caroline , Quinn Catherine A. , Davidson Lily , Ellem Rhiannon , Newland Grace , Hides Leanne
Published: December 2021

Background:

Alcohol and other drug (AOD) use patterns have altered as a result of the coronavirus (COVID-19) pandemic restrictions. This study aimed to: (i) determine the impact of the pandemic on patterns of AOD use among individuals seeking treatment, (ii) identify which mental health and resilience factors were associated with changes in patterns of AOD use and (iii) evaluate changes in the contextual factors (eg, motivations) associated with use.

Methods:

Cross-sectional surveys were completed by clients (n = 325) who had sought AOD treatment from January 2020 onwards. We measured quantity and frequency of AOD use now compared to before the pandemic, mental health (depression, anxiety, trauma exposure), resilience and contextual factors related to AOD use.

Results:

Quantity of tobacco and cannabis use increased post-pandemic, while methamphetamine and alcohol did not change. Depression was associated with more frequent alcohol use now compared to before the pandemic, while anxiety and lower resilience were associated with less frequent cannabis use now. Lower resilience was associated changes in methamphetamine use. Depression was associated with using more frequently for enjoyment and to alleviate loneliness following the pandemic, and anxiety was associated with using earlier in the day and to alleviate boredom.

Conclusions:

The pandemic has led to increased frequency of AOD use for a subset of individuals seeking treatment. Depression, anxiety and resilience are important factors associated with altered AOD use, and changes in the motivations and control surrounding use. Special consideration of this should be considered during AOD treatment through the pandemic.
Static and dynamic characteristics of a Rayleigh-steps mechanical seal with reverse steps
Authors: Wang Yunlei , Wu Jiu Hui , Xu Lushuai , Liu Hongjun
Published: December 2021

This paper presents a Rayleigh-steps mechanical seal with reverse steps (RS-MS), and the governing equation was solved by the finite difference method (FDM). The effects of angular misalignment, working condition parameters, and film thickness on sealing performance were discussed, including the opening force, cavitation ratio, leakage rate, frictional torque, stiffness and damping coefficients. The results indicate that the cavitation phenomenon in the reverse step groove can restrain the leakage, while it also affects the stability of the seal. The angular misalignment makes the seal have greater stiffness and damping coefficients. The stiffness and damping coefficients decrease rapidly with the increase of the film thickness, and the dynamic stability of the mechanical seal decreases with the increase of the film thickness, which is not conducive to the stable operation of the seal. The research results can guide the optimization design of mechanical seals.
More than a makeover: Discourses of masculinity, hyposexuality, and marriage in Queer Eye: We’re in Japan!
Authors: Gershon Daphne
Published: December 2021

This article examines Anglo-American portrayals of sexual inactivity in Japan, a media narrative that has been critically overlooked, yet offers much insight into how the regulation of sexuality and masculinity is tied to global power relations and nationalist ideologies. Global fascination with the rise of sexual inactivity in Japan has mostly been confined to news media; however, the topic has also begun to appear in popular media texts such as Netflix's makeover show Queer Eye: We’re in Japan!, presenting a valuable opportunity to expand our understanding of this narrative and the questions it raises about sexual normativity. Drawing from a comparative textual analysis, I argue that while both news coverage and Queer Eye consistently frame Japan as a site of dysfunctional sexuality and masculinity, differences in aesthetic, narrative, and industrial conventions lead these texts to create divergent common-sense understandings about sex, masculinity and Japaneseness that formulate their Orientalist narrative.
Building sympathy: Waiting-with digital fabrication machines as a form of architectural labor
Authors: Cohen Zach
Published: December 2021

Many digital fabrication machines have potential dangers, for example, sudden fires or projectile debris; thus, architects are generally required to supervise these machines when they employ them to make things. It is unlikely that further mechanization will ever completely eliminate such dangers since they result from unpredictable material processes. Therefore, as digital fabrication machines proliferate throughout architecture schools and practices, architects will find themselves spending increasingly more time supervising them, and waiting. In this paper, I argue that architects should then not only embrace waiting-with digital fabrication machines as a new form of architectural labor, but also begin to explore the ways in which such waiting can be productive. I begin with a critique of many architects’ impatience with digital fabrication processes. I then use the continental philosopher Henri Bergson’s concept of “intuition” to discuss the productive potential of waiting-with. Finally, I use a speculative 3D printing workflow to present additional creative possibilities that can arise if architects intentionally build waiting into digital fabrication processes.
Promising Interventions to Prevent Liver Cancer in Idaho
Authors: Momin Behnoosh , Nielsen Danielle , Schaff Spencer , Mezzo Jennifer L. , Cariou Charlene
Published: December 2021

Introduction

The Idaho Comprehensive Cancer Control Program (ICCCP) collaborated with the Idaho Immunization Program (IIP) to plan and implement activities to increase knowledge and awareness of liver cancer prevention through tailored hepatitis B immunization messaging to the Idaho community and health care providers.

Purpose and Objectives

In this article, we report findings from an evaluation of these activities.

Interventions Approach

The two programs implemented liver cancer prevention activities between May 2017 and December 2017; strategies included a social media vaccination awareness campaign and health care provider education.

Evaluation Methods

Facebook Insights was used to report, and descriptive statistics were used to analyze, data from the social media campaign. Descriptive statistics were used to analyze data collected from a retrospective pre–post survey for the health care provider presentations and paired t-tests were conducted to detect differences between pre- and postexposure.

Results

For the social media campaign, ICCCP and IIP posted a total of 32 liver cancer and hepatitis B vaccination posts on their respective Facebook pages, which reached 42,804 unique users. For the health care provider presentations, there was a statistically significant increase in awareness, knowledge, ability, and intention among health care providers.

Implications for Public Health

Our evaluation serves as an example of how public health social media can reach consumers and how educating providers can raise awareness on the importance of hepatitis B vaccination as a means of preventing liver cancer.
Management of Ascending Aorta and Aortic Arch: Similarities and Differences Among Cardiovascular Guidelines
Authors: Spanos Konstantinos , Nana Petroula , von Kodolitsch Yskert , Behrendt Christian-Alexander , Kouvelos George , Panuccio Giuseppe , Athanasiou Thanos , Matsagkas Miltiadis , Giannoukas Athanasios , Detter Christian , Kölbel Tilo
Published: December 2021

Background:

Ascending aorta and aortic arch diseases have an increasing interest among cardiovascular specialists regarding diagnosis and management. Innovations in endovascular surgery and evolution of open surgery have extended the indications for treatment in patients previously considered unfit for surgery. The aim of this systematic review of the literature was to present and analyze current cardiovascular guidelines for overlap and differences in their recommendations regarding ascending aorta and aortic arch diseases and the assessment of evidence.

Methods:

The English medical literature was searched using the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases from January 2009 to December 2020. Recommendations on selected topics were analyzed, including issues from definitions and diagnosis (imaging and biomarkers) and indications for treatment to management, including surgical techniques, of the most important ascending aorta and aortic arch diseases.

Results:

The initial search identified 2414 articles. After exclusion of duplicate or inappropriate articles, the final analysis included 5 articles from multidisciplinary, cardiovascular societies published between 2010 and 2019. The definition of non-A-non-B aortic dissection is lacking from most of the guidelines. There is a disagreement regarding the class of recommendation and level of evidence for the diameter of ascending aorta as an indication. The indication for treatment of aortic disease may be individualized in specific cases while the growth rate may also affect the decision making. The role of endovascular techniques has not been established in current guidelines except by 1 society. Supportive evidence level in the management of aortic arch diseases remains limited.

Conclusion:

In current recommendations of cardiovascular societies, the ascending aorta and aortic arch remain a domain of open surgery despite the introduction of endovascular techniques. Recommendations of the included societies are mostly based on expert opinion, and the role of endovascular techniques has been highlighted only from 1 society. The chronological heterogeneity apparent among guidelines and the inconsistency in evidence level should be also acknowledged. More data are needed to develop more solid recommendations for the ascending aorta and aortic arch diseases.
Spot Stenting Combined With False Lumen Endovascular Occlusive Repair for Post-dissection Abdominal Aortic Aneurysm
Authors: Zhou Min , Liu Fei , Shu Xiaolong , Shi Zhenyu , Guo Daqiao , Wang Lixin , Fu Weiguo
Published: December 2021

Purpose:

To introduce a new spot stenting, combined with a false lumen endovascular occlusive repair (SS-FLEVOR) technique for treating post-dissection abdominal aortic aneurysms.

Technique:

This technique is demonstrated in a 74-year-old man who received an initial thoracic endovascular aortic repair 7 years ago and suffered from distal aortic expansion during the follow-up session. All the tears located more than 15 mm away from the orifice of visceral arteries were excluded by spot stenting in the aortic true lumen. Then, a compliant stent-graft was implanted in the false lumen to seal the tears near the visceral arteries orifice from the outside. In addition, coils were deployed to block the potential backflow from the intercostal arteries and to induce false lumen thrombosis. Moreover, visceral arteries originated from false lumen were repaired by covered-stents implanted from the true lumen. The distal iliac arteries were sealed either with iliac extensions or cover-stents. This new technique has been applied in 5 patients, resulting in 100% technical success and encouraging intermediate outcomes.

Conclusion:

SS-FLEVOR is a feasible and safe technique to promote false lumen thrombosis in selected cases.
Firearm Injuries to the Wrist and Hand in Children and Adults: An Epidemiologic Study
Authors: Tarkunde Yash R. , Clohisy Clayton J. , Calfee Ryan P. , Halverson Schuyler J. , Wall Lindley B.
Published: December 2021

Background:

Gunshot wounds (GSWs) to the wrist and hand are a major health and economic burden in the United States. There are few studies examining the circumstances and epidemiological factors surrounding these injuries. This study assesses the epidemiological factors, as well as the shooting circumstances, injury details, and surgical management of wrist and hand GSWs in children and adults.

Methods:

Medical records and radiographs were reviewed for all patients with ballistic injury to the wrist or hand treated at an urban academic level 1 trauma center from 2016 to 2019. Fisher exact and Pearson χ2 tests were used to assess differences between groups.

Results:

Two hundred forty-nine victims (29 children, 220 adults) with complete documentation were identified. Among 180 victims with known shooting circumstances, 132 (70%) were shot by another person and 110 (65%) were injured by intentional gunfire. Eighty-seven victims (35%) suffered a concurrent GSW to another body region. Metacarpal fracture was the most commonly diagnosed bony injury (37%), followed by proximal phalanx fracture (25%). One hundred twenty-nine victims (52%) underwent surgery following their injuries. Nerve discontinuity was diagnosed in 27 victims (11%), while 20 victims (8%) had vascular disruption. There was no significant difference between children and adult victims’ type of fracture, concurrent injuries, rates of surgery, or in the most common fracture fixation method.

Conclusions:

Most wrist and hand GSW victims were injured due to intentional, non-self-inflicted gunfire. Most patients present with hand fractures, and fortunately, nerve and vascular disruptions are uncommon.
Expert opinion on COVID-19 vaccination and the use of cladribine tablets in clinical practice
Authors: Rieckmann Peter , Centonze Diego , Giovannoni Gavin , Hua Le H. , Oreja-Guevara Celia , Selchen Daniel , Sørensen Per Soelberg , Vermersch Patrick , Wiendl Heinz , Salloukh Hashem , Yamout Bassem
Published: December 2021

Background:

Gaps in current evidence and guidance leave clinicians with unanswered questions on the use of cladribine tablets for the treatment of multiple sclerosis (MS) in the era of the COVID-19 pandemic, in particular relating to COVID-19 vaccination.

Objective:

We describe a consensus-based program led by international MS experts with the aim of supplementing current guidelines and treatment labels by providing timely recommendations relating to COVID-19 vaccination and the use of cladribine tablets in clinical practice.

Methods:

A steering committee (SC) of 10 international MS experts identified 7 clinical questions to answer concerning the use of cladribine tablets and COVID-19 vaccination, which addressed issues relating to patient selection, timing and efficacy, and safety. Clinical recommendations to address each question were drafted using available evidence combined with expert opinion from the SC. An extended faculty of 28 MS experts, representing 19 countries, in addition to the 10 SC members, voted on the recommendations. Consensus on recommendations was achieved when ⩾75% of respondents expressed an agreement score of 7–9, on a 9-point scale.

Results:

Consensus was achieved on all 13 recommendations. Clinical recommendations are provided on whether all patients with MS receiving cladribine tablets should be vaccinated against COVID-19, and whether they should be prioritized; the timing of vaccination around dosing of cladribine tablets (i.e. before and after a treatment course); and the safety of COVID-19 vaccination for these patients.

Conclusion:

These expert recommendations provide timely guidance on COVID-19 vaccination in patients receiving cladribine tablets, which is relevant to everyday clinical practice.
Arthroscopic reduction and internal fixation of capitellar and trochlear fractures: A case series
Authors: Zhang Yiyang , Chang Nicholas , Athwal George S , King Graham JW
Published: December 2021

Background

In a simple isolated capitellar/trochlear fracture without extensive posterior comminution, arthroscopic reduction and internal fixation (ARIF) can provide an alternative option to open reduction internal fixation. The purpose of this retrospective case series was to report on the technique and outcomes of arthroscopic reduction and internal fixation of capitellar/trochlear fractures.

Methods

All patients that underwent ARIF at a single upper extremity referral centre in the last twenty years were reviewed. Patient demographics, preoperative, intraoperative, and postoperative records were obtained through chart review and telephone followup.

Results

Ten cases of ARIF were identified over a twenty year period performed by two surgeons. The average age of patients was 37 years (17–63 years), with nine females and one male. With an average followup of eight years, nine of ten patients had a mean range of motion from 0 to 142 degrees. Their average MEPI and PREE score were 93 ± 7 and 8 ± 14, respectively. Four patients had focal cartilage collapse with three that required a reoperation. There were no infections, nonunions, or arthroscopy related complications.

Conclusion

ARIF offers an alternative to ORIF for capitellar/trochlear fractures producing good results while providing better visualization of the fracture reduction and minimizing soft tissue dissection.
Shoulder joint arthroplasty in young patients: Analysis of 8742 patients from the Australian Orthopaedic Association National Joint Replacement Registry
Authors: McBride Andrew Phillip , Ross Mark , Duke Phil , Hoy Greg , Page Richard , Dyer Chelsea , Taylor Fraser
Published: December 2021

Background

Shoulder replacement is a reliable treatment for the relief of pain and improvement of function in patients with glenohumeral arthritis, rotator cuff arthropathy, osteonecrosis and fracture. Limited data is available comparing revision rates for the different types of shoulder replacement when used in younger patients. This study aims to compare the survivorship of hemi resurfacing, stemmed hemiarthroplasty, total shoulder arthroplasty and reverse total shoulder arthroplasty in younger patients using data from a large national arthroplasty registry.

Methods

Data from the Australian Orthopaedic Association National Joint Replacement Registry was obtained for the period 16 April 2004–31 December 2018. The study population included all shoulder arthroplasty patients aged <65 years. These were stratified into two groups: <55 years and 55–64 years. A total of 8742 primary shoulder arthroplasty procedures were analysed (1936 procedures in the <55 years and 6806 in the 55–64 years age group).

Results

In the <55 years age group, there was no difference in revision rate for total shoulder arthroplasty versus reverse total shoulder arthroplasty at any time point. Reverse total shoulder arthroplasty had a lower revision rate after six months when compared to hemi resurfacing (HRA) (p = 0.031). Also, reverse total shoulder arthroplasty had a higher early rate of revision in the first 12 months compared to hemiarthroplasty (p = 0.018). However, from 2 years reverse total shoulder arthroplasty had a lower revision rate overall (p = 0.029). In the 55–64 years patient age group, reverse total shoulder arthroplasty had a lower earlier revision rate. This was statistically significant compared to hemi resurfacing (HRA) (p = 0.028), hemiarthroplasty (p = 0.049) and total shoulder arthroplasty (p < 0.001).

Conclusion

This study demonstrated that for patients aged <55 years there was no significant difference in the rate of revision when total shoulder arthroplasty and reverse total shoulder arthroplasty were compared. reverse total shoulder arthroplasty had a lower rate of revision when compared to hemi resurfacing and hemiarthroplasty after 2 years. reverse total shoulder arthroplasty had the lowest comparative revision rate in patients aged 55–64 years overall.
System Threat during a Pandemic: How Conspiracy Theories Help to Justify the System
Authors: Mao Jia-Yan , van Prooijen Jan-Willem , Yang Shen-Long , Guo Yong-Yu
Published: December 2021

During the COVID-19 pandemic, many people have endorsed conspiracy theories about foreign governments yet shown increased trust and support for their own government. Whether there is a potential correlation between these social phenomena and the psychological mechanisms behind them is still unclear. Integrating insights from the existential threat model of conspiracy theories and system justification theory, two experimental studies were conducted to investigate whether belief in out-group conspiracy theories can play a mediating role in the effects of system threat on people's system justification beliefs against the background of the pandemic. The results show that system threat positively predicts individuals’ system-justifying belief, and belief in out-group conspiracy theories mediated this relationship.
Chinese Pharmacopoeia Revisited: A Review of Anti-Depression Herbal Sources
Authors: Hu Dongyi , Gao Jiayu , Yang Xiao , Liang Ying
Published: December 2021

Depression, which can be accompanied by many fatal diseases and a low life quality, has become the leading cause of ill health and disability worldwide. However, Chinese Pharmacopoeia, the most authoritative and evidence-based encyclopedia of Traditional Chinese Medicine (TCM), could contain leads and insights into the development of new antidepressant drugs. In this work, nine herbal medicines with ‘dispel melancholy functions’ specifically documented in Chinese Pharmacopoeia have been comprehensively reviewed with respect to clinical trials, and phytochemical and pharmacological aspects. The nine drugs are Rosae Chinensis Flos, Croci Stigma, Albiziae Cortex and Flos, Roase Rugosae Flos, Curcumae Radix, Hyperici Perforati Herba, Cyperi Rhizoma and Bupleuri Radix. The mechanisms of action of their functional antidepressant compounds, including gallic acid, hypericin, kaempferol, crocetin, crocin, quercetin, luteolin, isorhamnetin, curcumin, hyperforin, adhyperforin, catechin, rutin, puerarin, and saikosaponins A and D, have been collected and discussed. These traditional Chinese herbs and their active compounds provide a promising resource to develop effective new antidepressant drugs in future. Moreover, mechanistic investigations, safety verification and large-scale clinical trials are still expected to finally transform such TCM-based antidepressant resources to new drugs for patients suffering from depression.
Lateral Instability in Total Ankle Arthroplasty: A Comparison Between the Brostrom-Gould and Anatomic Lateral Ankle Stabilization (ATLAS)
Authors: Rushing Calvin J. , Mckenna Bryon J. , Berlet Gregory C.
Published: December 2021

Background

Lateral ankle instability is not uncommon after osseous cuts and soft tissue releases are performed during Total Ankle Arthroplasty (TAA), particularly with varus malalignment. The purpose of the present study was to compare the outcomes of ankles that underwent TAA with concurrent Brostrom-Gould (BG) or Anatomic Lateral Ankle Stabilization (ATLAS) at a minimum of 1-year follow-up.

Methods

Thirty-eight TAAs underwent BG (21 INFINITY, 4 CADENCE) or ATLAS (13 INBONE-2) between August 2015 and February 2019 at a single institution and were at least 1 year postoperative (mean 18.3 months, range: 12-40). Baseline patient demographics, characteristics, and operative factors were assessed via medical record and chart reviews. Radiographs parameters were measured preoperatively, at 6 weeks postoperative, and during the latest follow-up. Revisions, reoperations, and complications were classified according to the criteria established by Vander Griend et al and Glazebrook et al, respectively. Univariate and multivariate analyses were performed.

Results

Survivorship for TAA with concurrent BG/ATLAS was 97%. Overall, TAA with concurrent BG had higher incidences of early TAA revision (4%), recurrent instability (4%), reoperation (16%), and complications (29%) compared to ATLAS. Postoperative coronal and sagittal tibiotalar alignment changes were significant for both groups (P < .001, P = .014); however, the differences were greater for ATLAS (P = .045, P < .001).

Conclusion

The present study is the first to compare outcomes between techniques for addressing ankle instability in the TAA population. At short-term follow-up, anatomic reconstruction produced better outcomes than the traditional BG procedure. Additional comparative studies between techniques to address instability in the TAA population are warranted.

Level of Evidence:

Level III: Retrospective cohort study
The Value of SPECT-CT in Diagnosing Complex Non-Arthritic and Non-Neoplastic Conditions of the Foot and Ankle
Authors: Ghani Yaser , Najefi Ali-Asgar , Bernasconi Alessio , Welck Matthew , Cullen Nick , Patel Shelain
Published: December 2021

Introduction

There is little information on the value of using single photon emission computerized tomography–computed tomography (SPECT-CT) in non-arthritic and non-neoplastic conditions of the foot and ankle (F&A). The vast majority of studies have investigated the role of SPECT-CT in degenerative conditions, bony pathology, and neoplastic conditions. The diagnostic value of SPECT-CT in purely non-arthritic and non-neoplastic conditions, in the absence of other conclusive radiological findings, is yet to be clarified. The aim of this study was to evaluate the value of SPECT-CT in a cohort of patients with complex F&A pathology, in whom diagnostic uncertainty existed after conventional imaging techniques, and to assess its added value in routine clinical practice.

Methodology

A retrospective analysis of 297 SPECT-CTs from 2010 to 2017 found 18 SPECT-CTs (age = 16-56 years) performed for non-arthritic F&A pathology. Changes in diagnosis, management, and clinical outcome scores were recorded before and after SPECT-CT imaging.

Results

The results demonstrated that the provisional diagnosis was different from the SPECT-CT diagnosis in 10 (56%) out of the 18 patients and led to a modified treatment plan, which was successful in 8 (80%) out of the 10 patients. The post-intervention Manchester Oxford Foot Questionnaire (MOX-FQ) and Visual Analogue Scale (VAS) score improved from 76 ± 18 to 58 ± 24 ( P = .02), and from 72 ± 17 to 49 ± 32 ( P = .01), respectively. The SPECT-CT scan was useful in confirming the provisional diagnosis in the remaining 8 patients where a diagnostic uncertainty existed after conventional imaging techniques. Overall, a total of 15 out of 18 patients (83%) showed an improvement in their symptoms after management led by SPECT-CT diagnosis.

Conclusion

Our study highlights the added value of SPECT-CT in patients presenting with non-arthritic and non-neoplastic F&A conditions in which there is diagnostic uncertainty after conventional imaging. In 80% of cases, a change in management driven by the SPECT-CT findings led to a successful outcome. We have found SPECT-CT to be a useful investigative modality in assessing these complex F&A cases.

Levels of Evidence

Level IV
Beyond Disciplines: Spoken Word as Participatory Arts-based Research
Authors: Johnson Helen F.
Published: December 2021

For many, the arts and sciences stand at opposite ends of an unbridgeable divide: the sciences, rigid, objective, systematic and authoritative; the arts, fluid, subjective, dynamic and capricious. Yet, there is a long history of productive dialogue and interconnection between these fields. Arts-based research represents a particularly fertile form of arts/science interaction. This paper interweaves poetry, theoretical discussion and empirical research to make the case for spoken word poetry as an arts-based method of inquiry that can provide a radically different way of doing, being and collaborating in and through research. With reference to the innovative method of ‘collaborative poetics’ and to the work of youth slam/spoken word educators, I argue that social scientists and spoken word practitioners can learn much from one another’s tools, techniques and ways of thinking, creating new forms of knowledge, redefining the audience/author relationship, and facilitating a ‘critical resilience’ which enables both individual fortitude in the face of adversity and a means through which to challenge the conditions that give rise to this adversity. The paper thus considers how spoken word as participatory poetic inquiry enables participants, researchers and poets to address the critical complexities and challenges of contemporary life.
Understanding the role of indoleamine-2,3-dioxygenase and stromal differentiation in rare subtype endometrial cancer
Authors: Wu Dongling , Hacking Sean , Cao Jin , Nasim Mansoor
Published: December 2021

Endometrial cancer (EC) is a disease with good and poor prognostic subtypes. Dedifferentiated endometrial carcinoma (DEC), undifferentiated endometrial carcinoma (UEC), and clear cell endometrial carcinoma (CEC) are rare high-grade tumors, associated with a poor prognosis and high pathologic stage. Many studies have been performed on the programmed death-ligand 1 (PD-L1) axis mainly focus on endometrioid adenocarcinomas and little research has been done on rare subtypes. The present body of work aims to evaluate the role of indoleamine-2,3-dioxygenase (IDO-1) and stromal differentiation (SD), their correlation with clinicopathologic features and overall survival. Here we found that positive IDO-1 expression in immune cells correlated with worse disease-free survival ( p = 0.02), recurrence ( p = 0.03), high pathologic tumor stage ( p = 0.024), lymph node metastasis ( p = 0.028), and myometrial invasion ( p = 0.03). Our findings suggest IDO-1 to be relevant in both MMR intact and deficient tumors; however, >20% immune cell staining was restricted to MMR deficient cancers. For the stroma, immature, myxoid differentiation was found to correlate with worse disease-free survival ( p = 0.04). We also found the correlation between IDO-1 expression and immature stroma. Looking forward, IDO-1 could be promising for immunotherapy and SD could be the answer to clinical heterogeneity.
Patients’ experiences of occupational therapy within a multidisciplinary pain management programme: A qualitative study
Authors: Goodall Jacqueline , Brown Terence
Published: December 2021

Background

Occupational problems are common for adults experiencing chronic pain, but occupational therapists are not always accessed as part of the multidisciplinary team. Despite evidence of benefit for work-focused interventions, there is limited evidence for broader benefit from occupational therapy interventions within the context of multidisciplinary pain management. The aim of this study was to explore the experiences of programme attendees who received structured intervention from an occupational therapist as part of a multidisciplinary pain management programme, and gain an understanding as to how they felt it influenced changes they made to occupational participation.

Method

A qualitative approach was undertaken with 9 individual patients recruited from a group pain management programme for adults with chronic low back pain. Semi-structured interviews were carried out, recorded and transcribed. Thematic analysis was used to identify themes in the data.

Results

Three key themes were identified: 1) the helpfulness of activity pacing techniques 2) the value of participating in a therapeutic activity-based session and 3) an increased understanding of the importance of leisure and creative activities in the context of their lives.

Conclusion

Participants perceived the specific occupational therapy content of the programme to be helpful in a number of different ways. The findings suggest that occupational therapy can be important in facilitating patients to apply theoretical techniques in the real world, thereby increasing the likelihood of long term benefit.
Challenges of implementing transitional justice in the Lake Chad Basin and the integration/reintegration of displaced persons
Authors: Ibekwe Sixtus Obioma
Published: December 2021

This work contributes to the few case studies that have examined the challenges of implementing transitional justice in displacement contexts by using the specific case of the displacement trend in the Conventional Basin of Lake Chad to further underscore the dynamics of the problems involved in the issue. The work finds that lack of commitment to the implementation of regional policy frameworks and also the numerous weaknesses of the demobilization, deradicalization and reintegration (DDR) programmes implemented in the region have all had specific hindrances, especially in the social and political (re)integration of displaced persons in the region. The work therefore calls for more regional efforts that take into account clearer screening methods, accountability measures, as well as the (re)integration of displaced persons in the study area into the wider systems of their various home countries.
Clinical Outcome of Coccygectomy Using a Paramedian Curvilinear Skin Incision in Adults and Children With Meta-Analysis of the Literature Focusing on Postoperative Wound Infection
Authors: Nagappa Satish , Alshameeri Zeiad , Elmajee Mohammad , Hashmi Yousuf , Bowry Ajay , Jones Morgan , Spilsbury Jonathan
Published: December 2021

Study Design

A single surgeon case series and meta-analysis of literature

Objective

To evaluate the clinical outcome and patient satisfaction following coccygectomy for coccygodynia in adults and children using a curvilinear paramedian skin incision and to conduct a meta-analysis of the literature to determine the associated infection rate with different surgical factors.

Methods

45 consecutive patients (40 adults and 5 children) underwent surgical coccygectomy for persistent coccygodynia symptoms using a paramedian curvilinear incision. Postoperative clinical outcome scores, patients’ satisfaction and wound complications were assessed. A systematic literature search using specific MesH terms was then conducted covering the period from 1980 to 2020. Only those studies reporting infection rates post coccygectomy were included in a meta-analysis.

Results

The average age of patients was 39 years with a mean duration of symptoms prior to surgery of 7.4 years. The mean Oswestry Disability Index improved from 29 to 7.7 ( P < .001). The mean pain Visual analogue scale improved from 8 to 2 ( P < .001) and the median patient satisfaction score was 8 (out of 10) suggesting good to excellent outcome. The clinical improvement was the same in children and adults. There was a total of 5 (11%) wound infections, 2 of which needed surgical debridement. Meta-analysis of the included studies showed that the use of prophylactic antibiotics for 24 hours, nonabsorbable skin sutures and glue were associated with low infection rate.

Conclusions

Coccygectomy using curvilinear paramedian skin incision for chronic coccygodynia is an effective procedure with similar or lower complication rates as reported in the literature.
Relationship between talofibular impingement and increased talar tilt in incongruent varus ankle osteoarthritis
Authors: Kyung Min Gyu , Cho Yun Jae , Lee Junpyo , Lee Wonik , Kim Dae-Yoo , Lee Dong-Oh , Lee Dong Yeon
Published: December 2021

Purpose

This study aimed to evaluate the relationship between talofibular impingement and increased talar tilt in incongruent varus ankle osteoarthritis. Methods: Incongruent varus ankle osteoarthritis was defined as a talar tilt of more than 4° on standard ankle anteroposterior radiographs. We retrospectively reviewed 30 patients with unilateral incongruent varus ankle osteoarthritis with normal alignment of the contralateral ankle. All patients underwent bilateral weightbearing computed tomography and standing plain radiographs. The talar tilt and the distance between the talar lateral process and lateral malleolar tip were measured from a standing ankle anteroposterior radiograph of both sides. Talar and fibular spurs were assessed on the coronal and axial views of weightbearing computed tomography. After simulating the correction of the talar tilt in varus ankle osteoarthritis, talofibular bony impingement was reassessed. Results: On the varus side, the distance between the talar lateral process and the lateral malleolar tip was significantly shorter than that on the contralateral side ( p < .001). Talar spur was present in the varus side of all 30 patients on the axial view of weightbearing computed tomography and in the control side of 10 patients. After the simulation of talar tilt correction, talofibular impingement (overlap) occurred in all 30 patients with a larger extent in the severe talar tilt subgroup ( p < .001). Conclusion: Talofibular impingement by lateral gutter osteophytes is closely related to increased talar tilt in patients with incongruent varus ankle osteoarthritis. Therefore, lateral gutter osteophytes should be resected to stabilize mortise and improve clinical outcomes.
Comparison of the efficacy of the tension band wiring with eyelet wire versus anatomical locking plate fixation for the treatment of displaced olecranon fractures
Authors: Shimura Haruhiko , Nimura Akimoto , Fujita Koji , Kaburagi Hidetoshi
Published: December 2021

Background

This retrospective study was conducted to assess the clinical outcome and complications between tension band wiring (TBW) with eyelet wire and locking plate fixation used for the treatment of displaced olecranon fractures.

Methods

A total of 58 patients (36 males and 22 females; mean age: 63 years) were reviewed between April 2014 and September 2020. TBW with Ring Pin (RP group) was applied in 24 patients, including 15 Mayo type ⅡA and 9 Mayo type ⅡB patients. Anatomical locking plate (ALP group) was used in 34 patients, including 22 Mayo type ⅡA and 12 Mayo type ⅡB patients. Clinical outcome was evaluated using the Mayo Elbow Performance Score (MEPS), and active range of motion of the elbow and forearm and postoperative complications were reviewed.

Results

General characteristic of the patients and the fracture type were similar in the two groups. The mean MEPS values were 96.5 ± 7.3 in the RP group and 94.9 ± 9.4 in the ALP group. The mean elbow flexion arc was 127°±11 in the RP group. The mean elbow flexion arc was 122°±18 in the ALP group. No significant differences in clinical outcomes were observed between the two groups. Complication rates were significantly higher in the ALP group (19/34: 56%) than in the RP group (6/24: 25%).

Conclusion

Although there were no statistically significant differences in clinical outcomes between the two groups, the ALP group had a higher proportion of any complication than the RP group.
The effect of body mass index on blood loss and complications in simultaneous bilateral total hip arthroplasty: A multicenter retrospective study
Authors: Cao Guorui , Yang Xiuli , Yue Chen , Tan Honglue , Xu Hong , Huang Zeyu , Quan Songtao , Yang Minglu , Pei Fuxing
Published: December 2021

Background

The effect of body mass index (BMI) on blood loss in simultaneous bilateral total hip arthroplasty (SBTHA) was still undetermined. The purpose of the study was to evaluate the blood loss, transfusion and incidence of complications in normal, overweight, and obese patients undergoing SBTHA.

Methods

A total of 344 patients following SBTHA were enrolled into this study. The patients were assigned into three groups on the basis of their BMI, including normal (BMI 18.0–24.9 kg/ [Formula: see text]), overweight (BMI 25.0–29.9 kg/ [Formula: see text]), or obese group (BMI ≥ 30.0 kg/ [Formula: see text]). The primary outcome was total blood loss (TBL), and secondary outcomes were intraoperative blood loss, drain volume, ratio of TBL and patient’s blood volume (PBV), transfusion rate and volume, hemoglobin and hematocrit drop, length of stay, expenses, and complications.

Results

The PBV and TBL increased significantly along with the elevated BMI ( p < 0.001; p = 0.019, respectively). There was no significant difference in intraoperative blood loss, drain volume, transfusion volume, length of stay, expenses, or incidence of complications among the three groups. In addition, the transfusion rate in normal group was higher than that in overweight (58.3% vs 39.6%, p = 0.001) and obese group (58.3% vs 31.9%, p = 0.001). The maximum hemoglobin drop in obese group was the highest ( p = 0.001).

Conclusion

Obesity could increase perioperative blood loss but not increase transfusion risk in the setting of SBTHA. Conversely, obese and overweight patients maybe have lower transfusion need compared with normal patients because of more blood volume. In addition, obesity did not affect the incidence of complications.