bluuebunny/crossref_metadata_2025 huggingface dataset:
Weaponizing Urban Development: Critical Geographies of Militarism in Rio de Janeiro
Authors: Müller Frank I.
Published: July 2023

Access to land and to adequate housing—a constitutionally granted right in Brazil—is currently under attack by non-state armed actors, the so-called militias, in Rio de Janeiro. In their attempts to widen territorial control, “militias” weaponize urban development. To understand such form of militarization, I argue that we need to add a geographical perspective to literatures on criminal governance: Terrain and its political materiality is the basis and not only the outcome of spatial claims to power. To sustain this contribution, I turn to local scales and add insights from ethnographic studies on how paramilitary groups affect the lives of residents. I trace the paramilitary influence along their terrain-shaping and urban development activities. The empirical basis of my argument is drawn from the northern periphery of Rio de Janeiro, looking at how “militias”—emerging as armed developers out of a past as Death Squads—expand their influence by investing in urban development. In this paper, “militia” is conceived as a floating signifier. As such, the meaning of militia is contested, as it encompasses a wide range of practices including civil construction, laying infrastructure, and landscaping. This way, the term “militia” becomes a cornerstone of a militarized urban development discourse and practice. “Militia,” as the encompassing center of a narrative cluster, bolsters bellicose forms of governing urban expansion, thereby further militarizing the everyday life of a large part of the marginalized urban society.
Early occupational therapy in mechanically ventilated patients improves functional status: Study protocol
Authors: Álvarez Evelyn , Garrido Maricel , Salech Felipe , Rojas Verónica , Jara Nicole , Farías José I. , Ponce Daniela , Tobar Eduardo
Published: July 2023

Background:

Experts suggest implementing measures that include analgesia, sedation, delirium prevention and early mobilization (ASDM) in patients undergoing mechanical ventilation (MV) to reduce complications. However, there is limited evidence of occupational therapy in these patients. The aim of the research is to compare functional independence in patients undergoing MV of an intensive and early occupational therapy protocol versus to standard ASDM strategy.

Method/Design:

A prospective, multicenter, randomized clinical trial, with parallel groups (control and intervention groups). Participants will be hospitalized patients, over 18 years of age, admitted to the intensive care unit (ICU) and with the need of invasive MV. The intervention group will receive two daily 30-minute sessions of occupational therapy for 10 days. This study will research the effect of occupational therapy on functional independence, motor and cognitive status, evaluating at days 28 and 90.

Discussion:

This work contributes to the theoretical and practical work of occupational therapists who work in the ICU. The implementation of protocols of occupational therapy in mechanically ventilated patients can contribute to the independence and functionality of patients.

Conclusion:

Our research aims to contribute to the generation of systematized, organized, and feasible protocols that can be implemented in ICU.

Trial Registration:

ClinicalTrials.gov NCT04819529
Study on Tram Travel-Time Reliability Characteristics for Optimal Traffic Signal Control
Authors: Shi Lijuan , Zhou Siqi , Chang Yuntao , Zhang Qirui
Published: July 2023

This paper quantitatively investigates the effects of the number of intersections between adjacent stations [Formula: see text] and different periods on tram travel-time reliability to provide a decision basis for adopting optimal signal-control methods. Station spacing data, intersection information on the line, 10 day planned operation schedules, and actual operation data of Zhangjiang tram line 1 were collected. The tram travel-time distributions were analyzed under seven typical scenarios (i.e., N = 0, 1, 2, 3, off-peak hours, morning peak hours, and evening peak hours). The results showed that the lognormal distribution described the tram travel time better than did the normal and gamma distributions. It was demonstrated that scenarios [Formula: see text], [Formula: see text], and off-peak hours were of high reliability; morning peak hours and evening peak hours were of medium reliability; and scenarios [Formula: see text] and [Formula: see text] were of low reliability. The unreliability of travel time increased along with the increase of the mean and the fluctuation of travel time. An optimized signal-control strategy based on travel-time reliability was put forward and VISSIM simulation of an interval was conducted, verifying the effectiveness of the proposed strategy. The findings will help tram-management agencies to adopt suitable and flexible signal-control strategies according to the actual varying condition.
Effect of Anterior Tibial Closing Wedge Osteotomy on Coronal Tibial Alignment in Relation to Preoperative Medial Proximal Tibial Angle and Wedge Height
Authors: Mayer Philipp , Schuster Philipp , Schlumberger Michael , Michalski Stefan , Geßlein Markus , Beel Wouter , Immendörfer Micha , Richter Jörg
Published: July 2023

Background:

The posterior tibial slope has been identified as an anatomic risk factor for anterior cruciate ligament insufficiency and reruptures after anterior cruciate ligament reconstruction. Anterior tibial closing wedge osteotomy for correction of sagittal plane deformities has the potential to cause an unintended change in coronal plane alignment.

Purpose:

To evaluate the effects of anterior tibial closing wedge osteotomies for correction of posterior tibial slope on coronal plane alignment using an infratuberosity surgical approach and to identify predictive factors for a change in medial proximal tibial angle (MPTA).

Study Design:

Case series; Level of evidence, 4.

Methods:

This study reports on retrospectively obtained data from radiographic measurements of 38 anterior tibial closing wedge osteotomies. All patients underwent revision anterior cruciate ligament reconstruction and had undergone ≥1 previous anterior cruciate ligament reconstruction. In all patients, an infratuberosity approach was used with angular stable plate fixation. Pre- and postoperative radiographs were examined retrospectively to detect changes in the sagittal and coronal plane alignment (posterior tibial slope and MPTA). A multivariate regression analysis was used to identify predictors for a change in MPTA.

Results:

The study group consisted of 14 women and 24 men whose mean ± SD age at the index procedure was 31.6 ± 8.7 years (range, 17-51 years). Posterior tibial slope decreased significantly (by 7.2° ± 2.3°; P < .001) from 14.6° ± 2.0° preoperatively to 7.4° ± 2.1° postoperatively. MPTA decreased significantly by 1.3° ± 1.5° ( P = .005) from pre- to postoperative measurement. Mean wedge height was 9.3 ± 1.1 mm. A lower preoperative MPTA (coefficient = 0.32; P = .017; 95% CI, 0.06-0.59) and larger wedge height (coefficient = 0.48; P = .029; 95% CI, 0.05-0.9) were significant predictive factors for a decrease in MPTA.

Conclusion:

Anterior tibial closing wedge osteotomy for posterior tibial slope reduction resulted in a slight but significant decrease of the MPTA in the coronal plane. These changes were dependent on the preoperative MPTA and the wedge height.
A Rapid Access Brief Psychotherapy Intervention to Respond to Healthcare Workers in Ontario Whose Mental Health was Negatively Impacted During the COVID-19 Pandemic: Une brève intervention de psychothérapie à accès rapide pour répondre aux travailleurs de la santé de l'Ontario dont la santé mentale a été affectée négativement pendant la pandémie de COVID-19
Authors: Laposa Judith M. , Cameron Duncan , Corace Kim , Quick Natalie , Rowa Karen , Kogan Cary , Carter Stephanie , Milosevic Irena , de la Salle Sara , Stergiopoulos Vicky , Pellizzari Joseph , Haber Erika , Kurdyak Paul , McCabe Randi E.
Published: July 2023

Objective

Although the coronavirus disease 2019 (COVID-19) pandemic has had widespread negative impacts on the mental health of healthcare workers (HCWs), there has been little research on psychological interventions during the pandemic for this population. The current study examines whether a brief coping-focused treatment intervention delivered in a virtual individual format would be associated with positive changes in Canadian HCWs’ mental health during the pandemic.

Method

Three hundred and thirty-three HCWs receiving the intervention at 3 large specialty tertiary care hospitals in Ontario, Canada, completed measures of anxiety, depression, perceived stress, work/social impairment, insomnia and fear of COVID-19. After completing treatment, HCWs rated their satisfaction with the treatment.

Results

The intervention was associated with large effect size improvements in anxiety, depression, perceived stress, insomnia and fear of COVID-19, and moderate effect size improvements in work/social impairment. At treatment session 1, prior mental health diagnosis and treatment were both significantly correlated with depression, anxiety, and work/social impairment scores. Secondary analyses of data from one of the sites revealed that treatment-related changes in anxiety, depression, perceived stress and work/social impairment were independent of age, gender, occupational setting, profession and the presence of a previous mental health diagnosis or treatment, with the exception that nurses improved at a slightly greater rate than other professions in terms of work/social impairment. HCWs were highly satisfied with the treatment.

Conclusions

A large number of HCWs experiencing significant distress at baseline self-referred for assistance. Timely and flexible access to a brief virtual coping-focused intervention was associated with improvements in symptoms and impairment, and treatment response was largely unrelated to demographic or professional characteristics. Short-term psychological interventions for HCWs during a pandemic may have a highly positive impact given their association with improvement in various aspects of HCWs’ mental health improvement.
High-Definition Abdominal Body Scale
Authors: Mowlavi Arian , Mirzania Hamid , Sin Zachary , Sahami Chelsea
Published: July 2023

Introduction: High-definition liposuction (HDL) has been coined to identify liposuction results that are superior to traditional liposuction. The HDL Body scale has been previously described to help objectify changes required to achieve HDL results (that range from 2 to 10 score) with the ultimate goal of achieving a near perfect 9 or 10 body score. Materials/Methods: We present the High-Definition (HD) Abdominal Body Scale that is intended to assist with attaining HD abdominal contouring outcomes. High-definition abdominal contouring outcomes require comprehensive correction of abdominal contour concerns as well as creation of abdominal muscle highlights and natural shadows. HD Abdominal Body Scale assigns scores ranging from 2 to 10 with the ultimate goal of achieving a near perfect 9 or 10 body score indicative of HD outcomes. Results: The HD Abdominal Body Scale and subsequent surgical algorithm for HD abdominal contouring and case studies are presented. Discussion: Considerations for achieving HD abdominal contouring outcomes include assessing degree of fat excess, integrity of abdominal muscles, amount of skin redundancy, as well as quality and extent of skin texture changes. Evaluation of these factors provides the premise for determining HD abdominal contouring scores. HD abdominal contouring scores are used to establish proper patient selection, appropriate surgical design, and objective assessment of outcomes. Conclusion: This article presents an abdominal HDL Body Scale that helps expand patient populations who are candidates for HD body contouring. Surgeons’ outcomes may be improved using the HDL body scale and surgical algorithm presented.
State-Level Policies to Incentivize Workplace Learning: Impacts of a California Publicly Funded Employee Training Program
Authors: Negoita Marian , Goger Annelies
Published: July 2023

The inability of labor markets to function effectively to satisfy the needs of employers and workers suggests that there is a growing need for policy interventions to promote workplace cultures of learning and innovation. Past research suggests that publicly funded incumbent worker training programs are a promising antidote against market failures. With only a handful of studies published in the last two decades, however, this is one of the least-researched types of business support programs. This paper examines the impact of a state program in California that uses a pay-for-performance approach to reimburse employers that train their employees: the California Employment Training Panel (ETP). Based on a mixed-methods study of ETP, the authors found that, overall, ETP had positive and significant impacts on company sales and firm size. The study suggests the need to abandon ideological debates and engage in more evidence-based policy discussions about incumbent worker training programs.
Making sense of each other: Relations between social enterprises and the municipality
Authors: Muftugil-Yalcin Seda , Mooijman Anouk
Published: July 2023

Social Entrepreneurs address ‘wicked’ societal problems and achieve social impact using innovative practices. This study contributes to the analysis of the role of government in the ecosystem of Dutch social entrepreneurs by looking at the support initiatives that the Amsterdam municipality offers. Our paper reveals how municipal officials and social entrepreneurs position themselves in this ecosystem and how they make sense of their collaboration. We think that these issues are important to dwell on to be able see the limits of collaborative governance approaches in the Dutch Social Entrepreneurship eco-system. The results of qualitative interviews conducted with municipality officials, social entrepreneurs and members of network organizations show that the ties between the municipality of Amsterdam and social entrepreneurs are not strong enough to overcome the institutional barriers and that the relationship between them is disrupted by the different logics used. Social entrepreneurs operate from both a social as well as a commercial logic. Social entrepreneurs see themselves as running noble social enterprises that put impact first, but the municipality values a commercial logic when granting subsidies. This means that the social enterprises do not always fit within the frameworks offered by the municipality because their commercial logic is seen as less legitimate when it comes to support. The results of this study confirm that in the governance of wicked problems, there is an ongoing actor positioning process where, in this case, social enterprises and municipalities, hold on to their actor-based understanding of the nature of issues and collaboration.
Drug-induced liver injury secondary to increased levonorgestrel exposure in a patient taking ritonavir
Authors: Oddie Philip D , Heskin Joseph , Leung Suki , Naous Nadia , Garvey Lucy , Cohen Charlotte E
Published: July 2023

We report the first published case of a drug induced liver injury (DILI) presumed secondary to a drug-drug interaction between ritonavir and levonorgestrel progestogen-only emergency contraception (POEC). Our patient is a 25-year-old female living with human immunodeficiency virus (HIV), taking antiretroviral therapy (ART) containing tenofovir alafenamide/emtricitabine and darunavir/ritonavir. She was found to have elevated transaminases at a routine clinic appointment consistent with hepatocellular DILI. Further investigation found the most likely cause of this was a drug-drug interaction (DDI) between the ritonavir component of her ART and recent use of levonorgestrel POEC 3 days earlier. Evidence suggests that ritonavir increases levonorgestrel exposure, yet our patient received double the usual dose as per dispensing guidance at the time. We review the pharmacokinetics of ritonavir-levonorgestrel DDIs and highlight the need for consistent guidelines on this topic.
Book review: Ucheoma Nwagbara, The Struggles of Post-Independence Nigeria: Missed Opportunities and a Continuing Crisis
Authors: Anand Rashmi Rani
Published: July 2023

Ucheoma Nwagbara, The Struggles of Post-Independence Nigeria: Missed Opportunities and a Continuing Crisis, Lexington Books, 2022, 372pp.
Superficial venous morphometry in the antecubital fossa: An autonomous robotic ultrasound-based analysis
Authors: Park Seoyeon , Kim Yunmyeong , Nam Deokgeun , Lee Jooran , Song Sang Hoon
Published: July 2023

Background:

The antecubital fossa is an important site for venepuncture and intravenous procedures. The size and location of a vein can affect the success of venepuncture and intravenous access. Several studies have investigated the superficial vein morphometry, but they had small sample sizes or focused on specific populations or groups. Therefore, we conducted a prospective study with large participants in general population to analyse the morphology of the antecubital superficial vein and identify the association of sex, age and body mass index (BMI) with the size and location of the vein.

Methods:

This study collected images of superficial veins prospectively using autonomous robotic ultrasound on the antecubital area between October and November 2020. We measured the superficial vein depth, vertical diameter and horizontal diameter at the antecubital area, extracted population characteristics (sex, age and BMI), and analysed a relationship between the vein dimensions and the characteristics.

Results:

In this study, data from 461 participants (201 males and 260 females) with mean age of 41.1 years were produced. The mean vein depth, mean vertical diameter and mean horizontal diameter (±standard deviation) were 4.81 (±2.17), 3.01 (±1.10) and 4.46 (±1.60) mm, respectively. We found significant differences in vein dimensions between males and females, with males having larger vertical and horizontal diameters than females ( p < 0.001). The study also revealed significant differences in vein depth and dimensions among age groups and BMI subgroups ( p < 0.001).

Conclusions:

These findings revealed that the superficial vein in the antecubital area was oval, with a larger horizontal diameter than vertical diameter. Morphometry revealed differences in sex, age and BMI. Understanding variations in vein dimensions among different subgroups can help medical professionals improve success rate of venous access and patient safety.
Interstices of Dis/abling Experiences in Times of Crises
Authors: Schillmeier Michael
Published: July 2023

It is the very lived experiences of crises that draw attention to the situated relations of dis/embodied, spatial, and cultural practices that constitute dis/abling experiences that this Special Issue wishes to address and critically engage with. How are crises lived and experienced by disabled people and how can we learn from the experiences of disabled people in dealing with spatio-culturally situated differences and related specific constraints and requirements in situations of crises? How may these experiences allude to the diversity of embodied life? Understood as precarious interstices, crises experiences not only tell us much about how we live and think by troubling of how we think and live, but they also make us think, hesitate, imagine, and tinker of how we do and may wish to live differently. By unfolding these interstitial experiences, this Special Issue wishes to contribute to the emergence of “publics” (Dewey) which draw attention to the diversity of dis/abling experiences and related modes of existence.
Experimental and analytical approaches for load rating reinforced concrete slab bridge
Authors: Mirdad Md Abdul Hamid , Andrawes Bassem
Published: July 2023

Load testing of bridges is often used as a reliable method for assessing the capacity of in-service bridges with low analytical load rating factors. This paper presents a detailed load rating study of an 82-year-old concrete slab bridge with an unusually large aspect ratio of 3.73 by performing non-destructive diagnostic and proof load tests. The test-based modified rating factor is evaluated based on the American Association of State Highway and Transportation Officials (AASHTO) approach and the structural effective strip width approach which is then compared with the analytical rating factor from a simplified 1-D beam-line model. Field data is also used to evaluate the impact of the rotational stiffness of the bridge on its global response and load rating factor. The field test results based on the AASHTO approach reveal that the rating factor improves by up to 53% compared to the analytical rating factor. Monitoring the rotational residual response at the bridge supports is proven to be an effective method for assessing the global response of the bridge during field testing. The study shows that adding a rotational spring with a field-calibrated rotational stiffness to the 1-D analytical model of the bridge can significantly increase the load rating factor.
Constructing the Muslim “other”: A critical discourse analysis of Indian news coverage of the tablighi jamaat congregation during the COVID-19 pandemic
Authors: Amanullah Arshad , Nadaf Arif Hussain , Neyazi Taberez Ahmed
Published: July 2023

This paper analyzes the representation of Indian Muslims in national news coverage during the COVID-19 pandemic. By deploying Critical Discourse Analysis (CDA), the paper examines how hegemonic news discourses in four Indian daily newspapers published in English and Hindi constructed the image of a Muslim “other” across various discursive moments in relation to the news coverage of a Tablighi Jamaat (TJ) congregation and its link to the spread of COVID-19 in India. Describing the congregation’s Muslim participants as anti-nationals, insensitive to the suffering of their compatriots, disrespectful of the law of the land, super-spreaders of the virus and jihadis, the image of the Muslim “other” was constructed and conveyed to the public by using such appellations. These conformed to many beliefs of Hindutva, the right-wing Hindu ideology, that seeks to infuse in public discourse feelings of the “other” – an other which needs to be criminalized and ostracized. The mediated reality produced is embedded in the power structure and is an ideologically driven exercise. The way hegemonic power operates is clearly reflected in the discourses about Muslims that circulated in the media during the first wave of COVID-19 in 2020.
Effect of Early Rehabilitation on Walking Independence and Health-Related Quality of Life in Patients With Chronic Foot Wounds: A Multicenter Randomized Clinical Trial
Authors: Maeshige Noriaki , Hayashi Hisae , Kawabe Nobuhide , Imaoka Shinsuke , Sakaki Satoko , Matsumoto Junichi , Kondo Eriko , Ishii Tatsuya , Kiyota Naruaki , Furukawa Masahide , Terashi Hiroto , Sonoda Yuma
Published: July 2023

Rehabilitation is usually provided to patients with chronic foot wounds (CFWs) after surgery. This study aimed to assess whether early postoperative rehabilitation could maintain walking independence in hospitalized patients with CFWs. This single-blind, randomized clinical trial was performed between September 10, 2018 and March 2019, involving 60 patients who underwent both surgical procedures and rehabilitation. Participants were randomly allocated into the early rehabilitation (EG, n = 30) or the control (CG, n = 30) groups. EG received early rehabilitation immediately after surgery, while CG received late rehabilitation after wound closure. Both groups received rehabilitation sessions 5 times per week until discharge. The primary outcome was walking independence, measured via Functional Independence Measure (FIM)-gait scores. Secondary outcomes included health-related quality of life (HRQoL) using EuroQol 5 dimensions 5-level (EQ-5D-5L) and the presence of rehabilitation-related adverse events, including dehiscence of wounds and falls. Differences in intervention timing effects were analyzed using nonparametric split-plot factorial design analysis, including Fisher's exact test, Mann-Whitney U test, and Wilcoxon signed-rank test ( P < .05). Out of the 60 participants, 53 patients completed the discharge follow up. Three participants (10.0%) from the EG and 4 (13.3%) from the CG dropped out due to postoperative complications unrelated to rehabilitation intervention. No rehabilitation-related adverse events were found. Participants in the EG maintained greater FIM-gait scores during hospitalization than the CG (difference, −1; P = .0001), with a difference of 0 ( P = .109) at discharge. EQ-5D-5L significantly improved in both groups (EG: difference, 0.13 [ P = .014], CG: difference, 0.17 [ P = .0074]). The EG intervention was associated more with maintaining walking independence at discharge than CG intervention. Postoperative rehabilitation improved HRQoL without adverse events, indicating that clinicians should recommend early rehabilitation for patients with CFW to enhance walking independence.
Ultrasound for suspected Baker’s cyst: A test of limited clinical value?
Authors: Charnock Mark , Kinsella Matthew , Chopra Annu
Published: July 2023

Introduction:

Patients with posterior knee swellings are commonly encountered in clinical practice with the vast majority referred for an ultrasound scan to assess for a clinically suspected Baker’s cyst.

Aims:

Our aim was to determine the incidence of different pathologies in patients investigated for a posterior knee swelling of a clinically suspected Baker’s cyst using ultrasound. We also wanted to investigate the incidence of significant pathologies in the popliteal fossa to assess whether the ultrasound scan findings influenced patient management.

Methodology:

Retrospective analysis was performed on all patients who underwent an ultrasound scan for a suspected Baker’s cyst or posterior knee swelling at our institution, between January 2017 and December 2018. Patient demographics, ultrasound findings, further imaging investigations and histopathology were recorded. Patient records were followed up for a minimum period of 3 years after ultrasound.

Results:

A total of 680 patients had a posterior knee ultrasound scan. Of that, 51% (347/680) had a Baker’s cyst and 40% (273/680) had a normal ultrasound scan. Sixty (9%) patients had other abnormalities identified within the popliteal fossa. Four patients had significant findings on ultrasound that required a change of management. No malignancies identified.

Conclusion:

This study confirms the high incidence of Baker’s cysts in patients presenting with a posterior knee swelling. In the absence of red flag symptoms, ultrasound of the posterior knee for a clinically suspected Baker’s cyst is of limited clinical value.
Effects of long-term oxygen therapy on the mental state of patients with chronic obstructive pulmonary disease: A systematic review
Authors: Zhang Xiaohan , Fei Fei
Published: July 2023

Objectives

This systematic review aimed to examine the effects of long-term oxygen therapy on the mental state of patients with chronic obstructive pulmonary disease.

Methods

Web of Science, Medline, CINAHL, EMBASE, ProQuest, and Cochrane Library were selected to search for relevant studies. We followed the Cochrane Handbook for Systematic Reviews of Interventions, adopted the Cochrane risk-of-bias tool and Risk Of Bias In Non-randomized Studies of Interventions tool, and synthesized the outcomes narratively with Grading of Recommendations, Assessment, Development and Evaluations evidence profile.

Results

Six studies were included. Moderate quality of evidence supported no effects of long-term oxygen therapy on the mental state in patients with severe resting hypoxemia and moderate resting hypoxemia (or exertional desaturation) at follow-up of 6 to 12 months; however, adverse effects on mental state among patients with moderate resting or exertional desaturation were reported at the follow-up of 36 to 48 months.

Discussion

Nurses should focus on the mental state of patients treated with long-term oxygen therapy, especially those who use it for a prolonged time. Due to ethical constraints in this study, a quasi-experimental study with faithful consideration of internal validity can be commenced in the future.
Clinical characteristics of myositis patients with isolated anti-U1 ribonucleoprotein antibody resemble immune-mediated necrotizing myopathy
Authors: Ge Yongpeng , Yang Hongxia , Jiang Wei , Tian Xiaolan , Lu Xin , Wang Guochun
Published: July 2023

Background:

Anti-U1 ribonucleoprotein (U1RNP) antibodies were associated with connective tissue diseases (CTDs), but the clinical characteristics of this antibody in Chinese myositis patients have not been studied.

Objective:

We aim to analyze the clinical features of myositis patients who test positive for anti-U1RNP antibodies and delineate a subgroup of myositis.

Design:

This is a retrospective cohort study.

Methods:

We reviewed the clinical data of myositis patients with anti-U1RNP antibodies and compared them to those with anti-signal recognition particle (SRP) and hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibody-associated immune-mediated necrotizing myopathy (IMNM).

Results:

A total of 30 adult cases were identified; median age was 47.5 years and 24 (80%) were females, and 12 patients did not coexist with myositis-specific antibodies (MSAs) (isolated anti-U1RNP). The serum creatine kinase (CK) was significantly higher in patients with isolated anti-U1RNP (2182.5 U/L versus 289 U/L, p = 0.01), and the number of patients with CK > 2000 U/L was higher compared to that in anti-U1RNP antibody patients coexisting with MSAs (66.7% versus 16.7%, p = 0.009). The prevalence of IMNM in patients’ muscle pathology with isolated anti-U1RNP was significantly higher (75%, p = 0.003). Skin rashes were less common in isolated anti-U1RNP group ( p < 0.05). Of the 25 individuals with available pulmonary high-resolution CT (HRCT), 14 (56%) were diagnosed with interstitial lung disease (ILD). The incidence of muscular weakness, dysphagia, or levels of CK was not different between the isolated anti-U1RNP antibody individuals and the anti-HMGCR or SRP-IMNM groups ( p > 0.05). But the frequency of Raynaud’s phenomenon, arthritis, and membrane attack complex (MAC) deposits in myositis patients with isolated anti-U1RNP antibodies were higher than in anti-HMGCR and SRP-IMNM (all p < 0.005). There was no difference between anti-U1RNP patients with and without Ro-52 ( p > 0.05). Isolated anti-U1RNP individuals showed marked improvements in muscle strength, and the remission rate in 1 and 2 years was significantly higher than that in anti-HMGCR and SRP-IMNM ( p < 0.05).

Conclusions:

The clinical and pathological features of myositis patients with isolated anti-U1RNP antibodies were similar to IMNM. Arthritis and ILD are the most common extramuscular clinical features. Most respond well to treatment and have a good prognosis.
Coexistence of Multiple Writing Systems: Classifying Digraphia in Post-Socialist Countries
Authors: Jung Youngjoo , Kim Bora
Published: July 2023

This study aims to specify the definitions of two terms, bigraphia and digraphia, and examine how these phenomena appear in post-socialist countries. It is currently a global phenomenon to use two or more writing systems in one country, due to the spread of English and the Internet. Bigraphia means when the function and prestige of two writing systems (or two varieties of one system) are equal. On the other hand, when there is a difference in the function and/or prestige between two writing systems, it is defined as digraphia. The paper examines the combination of writing systems in post-socialist countries such as Russia, Belarus, Serbia, and Uzbekistan. In-digraphia refers to a situation in which variations of one writing system coexist, and out-digraphia refers to a situation in which two different writing systems coexist. A narrower sense of digraphia is observed in Belarus today: Belarusian Cyrillic-Т(BC-T) is used to write Tarashkievitsa and Belarusian Cyrillic-N (BC-N) is used to write Narkamaŭka. Out-digraphia is observed in Serbia and Uzbekistan. In these countries, Cyrillic and Latin scripts are used to write Serbian and Uzbek. Out-digraphia is also confirmed in Russian texts: It is commonly thought that only Cyrillic letters are used to write Russian, but recently the use of the so-called “macaronic alphabet,” which is a mix of Cyrillic and Latin letters, has become common.
Antiviral and Therapeutic Effects of a Mixture of Boswellia serrata, Commiphora myrrha, and Propolis for SARS-CoV-2
Authors: Yang Myeon-Sik , Lim Yun-Sook , Oh Byungkwan , Park Seok-Chan , Yang Daram , Hwang Soon B , Kim Bumseok
Published: July 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly affects respiratory tracts including the trachea and lungs. As inflammation and cytokine storm are major pathological features in a Syrian hamster for SARS-CoV-2 infection, reducing inflammatory responses or antiviral therapy is an effective strategy for treating SARS-CoV-2 infections. Herbal medicines and natural substances are applied worldwide due to their health-beneficial effects. Although chemical and pharmacological verifications have not been made for all substances, the pharmacological effects of many substances are being studied. In this study, Boswellia serrata, Commiphora myrrha, and propolis known to have anti-inflammatory and antimicrobial properties were selected as candidates for therapeutic herbal medicine targeting SARS-CoV-2. When this herbal mixture was treated to SARS-CoV-2 infected Vero E6 and Calu-3 cells, effective antiviral effects were demonstrated. Next, this herbal mixture was administered to SARS-CoV-2-infected Syrian hamsters, and histopathological lesions were significantly reduced. Viral spike protein and viral enzyme gene were also significantly less detected in immunohistochemistry and quantitative real-time PCR results, respectively. Thus, it can be concluded that a mixture of Boswellia serrata, Commiphora myrrha, and propolis as natural substances has the potential to reduce lesions of respiratory tracts upon SARS-CoV-2 infection.
Patient definitions of transplant success in upper extremity vascularized composite allotransplantation: A mixed-methods study
Authors: Downey Max C , Gacki-Smith Jessica , Kuramitsu Brianna , Vanterpool Karen B , Nordstrom Michelle , Luken Michelle , Langlee Whitney , Riggleman Tiffany , Fichter Shannon , Altema Withney , Jensen Sally E , Dumanian Gregory A , Cooney Carisa M , Levan Macey L , Tintle Scott , Brandacher Gerald , Gordon Elisa J
Published: July 2023

Objective:

Upper extremity vascularized composite allotransplantation is an innovative treatment option for people with upper extremity amputations. Limited patient-relevant long-term outcomes data about transplant success may impede patients’ informed treatment decision-making. We assessed perceptions of what constitutes upper extremity vascularized composite allotransplantation success among individuals with upper extremity amputations.

Methods:

This multisite study entailed interviews and focus groups with individuals with upper extremity amputations and upper extremity vascularized composite allotransplantation candidates, participants, and recipients. We examined perceptions of transplant success and preferences for five upper extremity vascularized composite allotransplantation outcomes. Qualitative data were analyzed using thematic analysis; and quantitative data were analyzed using descriptive statistics.

Results:

In all, 50 individuals participated in interviews (61.7% participation rate), and 37 participated in nine focus groups (75.5% participation rate). Most were White (72%, 73%), had a mean age of 45 and 48 years, and had a unilateral amputation (84%, 59%), respectively. Participants conceptualized upper extremity vascularized composite allotransplantation success as transplant outcomes: (1) restoring function and sensation to enable new activities; (2) accepting the transplanted limb into one’s identity and appearance; (3) not having transplant rejection; (4) attaining greater quality of life compared to prosthetics; and (5) ensuring benefits outweigh risks. Participants rated their most important upper extremity vascularized composite allotransplantation outcomes as follows: not having transplant rejection, not developing health complications, grasping objects, feeling touch and temperature, and accepting the upper extremity vascularized composite allotransplantation into your identity.

Conclusion:

Individuals with upper extremity amputations maintain several conceptions of vascularized composite allotransplantation success, spanning functional, psychosocial, clinical, and quality of life outcomes. Providers should address patients’ conceptions of success to improve informed consent discussions and outcomes reporting for upper extremity vascularized composite allotransplantation.
Assessing Medical Students’ Attitudes and Knowledge Regarding LGBTQ Health Needs Across the United States
Authors: Karpel Hannah C. , Sampson Amani , Charifson Mia , Fein Lydia A. , Murphy Devin , Sutter Megan , Tamargo Christina L. , Quinn Gwendolyn P. , Schabath Matthew B.
Published: July 2023

Background:

The lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community experiences health disparities. It is thus imperative that medical trainees receive training in the care of LGBTQ community. The objective of this study was to identify gaps in knowledge and comfort among medical school students in providing care for the LGBTQ community.

Methods:

An online survey was administered to medical students at 3 institutions in the United States from December 2020 to March 2021. Using a Likert scale, the survey assessed attitudes, comfort, and knowledge in providing care for the LGBTQ community. The survey included questions for each specific LGBTQ population. Results were quantified using descriptive and stratified analyses, and an exploratory factor analysis was used to calculate attitude summary measure (ASM) scores. A total knowledge score was calculated, with higher values indicating greater knowledge.

Results:

Among the 300 medical students who completed the survey, the majority were female (55.7%), White (54.7%), and heterosexual (64.3%). The majority of medical students felt comfortable (strongly agree/agree) participating in the care of lesbian (94.3%), gay (96.0%), and bisexual (96.3%) patients; this percentage dropped to 82.3% for non-binary and 71.3% for transgender patients. Only 27.0% of medical students reported confidence in their knowledge of health needs of transgender patients. LGBTQ self-identification, percent of core rotations completed in school, region of country, and friends and/or family who are part of the LGBTQ community were significantly associated with various ASM scores. Knowledge questions yielded high percentages of “neutral” responses, and medical students who identified as LGBTQ had significantly higher total knowledge scores.

Conclusions:

Overall, the surveyed medical students feel comfortable and willing to provide care for LGBTQ persons. But, there is limited knowledge about specific LGBTQ health needs. More education and training in the needs of transgender and non-binary patients, in particular, is indicated.
Online Banking Service Practices and Its Impact on E-Customer Satisfaction and E-Customer Loyalty in Developing Country of South Asia-Nepal
Authors: Gautam Dhruba Kumar , Sah Gunja Kumari
Published: July 2023

The aim of this paper is to investigate the association and impact between online banking service practices on e-customer satisfaction, and e-customer loyalty. In addition, it aims to analyze mediating role of e-satisfaction to online banking service practices and e-loyalty. The research followed the E-S-QUAL model to measure the online banking service quality (OBSQL) by five dimensions: e-customer service, site of the organization, website efficiency, user-friendliness, security, and privacy. It is based on quantitative research approach with a structured questionnaire through primary data collection by stratified random sampling. Out of 475 questionnaires distributed, 384 usable questionnaires were used, and SPSS and AMOS were used to analyze. An exploratory factor analysis was used to confirm the online banking service quality dimensions and structural equation modeling was employed to estimate the parameters and structure. The result explained that the efficiency of the website and e-customer service were highly influential dimensions of online banking service practices, followed by user-friendliness, security and privacy, and the organization’s site. E-customer satisfaction significantly influences e-customer loyalty, and e-satisfaction mediates the association between online banking services and e-customer loyalty, which is a prime concern to bankers, users, and policymakers for continuous development. This research presents a model to recognize the quality of online banking services that affects electronic customer loyalty and satisfaction in developing countries of South Asia.
Effects of Statin Treatment on the Development of Tendinopathy: A Nationwide Population-Based Cohort Study
Authors: Kwak Donghee , Moon Seok-joo , Park Jong Woong , Lee Duk Hee , Lee Jung Il
Published: July 2023

Background:

Previous longitudinal cohort studies have reported the conflicting results of the relationship between statin use and the development of tendinopathy disorder. It is unclear if there is a relationship between statin use, particularly the type or cumulative doses, and the development of tendinopathy disorder.

Purpose:

To investigate an association between statin treatment and the development of tendinopathy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 594,130 participants were enrolled in this study in 2002 and evaluated until 2015. There were 84,102 statin users and 168,204 nonusers (controls) selected at a ratio of 1:2 using propensity score matching analysis. The types of included tendinopathy were as follows: (1) trigger finger, (2) radial styloid tenosynovitis, (3) elbow epicondylitis, (4) rotator cuff tendinopathy, and (5) Achilles tendinitis. Cox proportional hazards models with time-varying covariates were constructed to identify the association between statin use and tendinopathy development.

Results:

Statin treatments regardless of statin types were associated with a significantly greater risk of all types of tendinopathy development (hazard ratio, 1.435; 95% CI, 1.411-1.460) compared with no statin treatment. A trend toward risk reduction was observed according to cumulative statin doses, which was indicated by hazard ratios of 2.337 (95% CI, 2.269-2.406), 2.210 (95% CI, 2.132-2.290), and 1.1 (95% CI, 1.098-1.146) in patients with cumulative defined daily doses of 90, 91-180, and >180, respectively.

Conclusion:

This nationwide population-based cohort study suggests that statin use regardless of the statin type was associated with a greater risk of tendinopathy compared with that of nonusers. The risk of tendinopathy development was diluted with the increasing cumulative defined daily dose.
Factors Important to Patient Decision-Making After Ulnar Collateral Ligament Injury in Competitive High School and Collegiate Baseball Players
Authors: Bixby Elise C. , Ahmed Rifat , Skaggs Kira , Swindell Hasani W. , Fortney Thomas A. , Ahmad Christopher S.
Published: July 2023

Background:

Patients are faced with several treatment decisions after an ulnar collateral ligament (UCL) injury: nonoperative versus operative treatment, repair versus reconstruction, and immediate versus delayed surgery.

Purpose/Hypothesis:

The aim of this study was to investigate the factors important to patients when deciding which treatment to pursue after a UCL injury. We hypothesized that (1) length of time away from sports and seasonal timing would be important to patients and (2) treatment decision-making would be heavily influenced by how many and which seasons of their baseball career would be missed.

Study Design:

Cross-sectional study.

Methods:

High school and collegiate baseball players with UCL tears treated at an academic institution were surveyed retrospectively on their sports participation at the time of injury and their UCL injury treatment decisions. Respondents rated the influence of various factors on a 5-point Likert scale, and they selected the top 3 factors and the single most important factor influencing their treatment decisions. Multiple logistic regression analysis was used to assess the relationship between player characteristics and factors important to their treatment decision.

Results:

A total of 83 athletes completed the survey; 40 were in high school and 43 were in college at the time of injury; 7 were treated nonoperatively and 76 underwent surgery (66 immediately and 10 in a delayed fashion), 10 with UCL repair and 66 with UCL reconstruction. The ability to play competitive baseball in the long term was very important or extremely important to 90% of players, while the ability to play in the short term was very important or extremely important to 17%. Length of recovery and seasonal timing were also important factors for 53% and 54% of players, respectively, and almost all (90%) highly valued advice from a surgeon. Possible failure of nonoperative treatment leading to increased time away and the possible loss of 2 consecutive baseball seasons heavily influenced decision-making in 41% of respondents.

Conclusion:

Survey respondents were driven by the desire to play baseball in the long term. Treatment decisions were influenced by the length of recovery and by the seasonal timing of their injury, both of which affect how many and which seasons of baseball a player may miss. Patients found advice from their surgeon to be extremely important to decision-making.
Momelotinib long-term safety and survival in myelofibrosis: integrated analysis of phase 3 randomized controlled trials
Authors: Verstovsek Srdan , Mesa Ruben , Gupta Vikas , Lavie David , Dubruille Viviane , Cambier Nathalie , Platzbecker Uwe , Hus Marek , Xicoy Blanca , Oh Stephen T. , Kiladjian Jean-Jacques , Vannucchi Alessandro M. , Gerds Aaron , Egyed Miklos , Mayer Jiří , Sacha Tomasz , Kawashima Jun , Morris Marc , Huang Mei , Harrison Claire
Published: July 2023

Momelotinib is the first inhibitor of Janus kinase 1 (JAK1) and JAK2 shown to also inhibit activin A receptor type 1 (ACVR1), a key regulator of iron homeostasis, and has demonstrated improvements in splenomegaly, constitutional symptoms, and anemia in myelofibrosis (MF). This long-term analysis pooled data from 3 randomized phase 3 studies of momelotinib (MOMENTUM, SIMPLIFY-1, and SIMPLIFY-2), representing MF disease from early (JAK inhibitor–naive) to late (JAK inhibitor–experienced) stages. Patients in the control arms (danazol in MOMENTUM, ruxolitinib in SIMPLIFY-1, and best available therapy in SIMPLIFY-2) could cross over to receive momelotinib at the end of the 24-week randomized period, and all patients could continue momelotinib treatment after the completion of these studies via an extended access protocol (XAP). Across these studies, 725 patients with MF received momelotinib; 12% remained on therapy for ≥5 years, with a median treatment exposure of 11.3 months (range, 0.1-90.4 months). The most common nonhematologic treatment-emergent adverse event (AE) occurring in ≥20% of patients was diarrhea (any grade, 27% and grade ≥3, 3%). Any-grade thrombocytopenia, anemia, and neutropenia occurred in 25%, 23%, and 7% of patients, respectively. The most common reason for momelotinib discontinuation was thrombocytopenia (4% discontinuation rate). The incidence of AEs of clinical importance (eg, infections, malignant transformation, peripheral neuropathy, and hemorrhage) did not increase over time. This analysis of one of the largest randomized trial databases for a JAK inhibitor to date in MF demonstrated a consistent safety profile of momelotinib without long-term or cumulative toxicity. These trials were registered at www.clinicaltrials.gov as: MOMENTUM (#NCT04173494), SIMPLIFY-1 (#NCT01969838), SIMPLIFY-2 (#NCT02101268), and XAP (#NCT03441113).