bluuebunny/crossref_metadata_2025 huggingface dataset:
Parameterizing Eddy Buoyancy Fluxes Across Prograde Shelf/Slope Fronts Using a Slope-Aware GEOMETRIC Closure
Authors: Wei Huaiyu , Wang Yan , Mak Julian
Published: November 2023

Accurate parameterizations of eddy fluxes across prograde, buoyant shelf and slope currents are crucial to faithful predictions of the heat transfer and water mass transformations in high-latitude ocean environments in ocean climate models. In this work we evaluate several parameterization schemes of eddy buoyancy fluxes in predicting the mean state of prograde current systems using a set of coarse-resolution noneddying simulations, the solutions of which are compared against those of fine-resolution eddy-resolving simulations with nearly identical model configurations. It is found that coarse-resolution simulations employing the energetically constrained GEOMETRIC parameterization can accurately reconstruct the prograde mean flow state, provided that the suppression of eddy buoyancy diffusivity over the continental slope is accounted for. The prognostic subgrid-scale eddy energy budget in the GEOMETRIC parameterization scheme effectively captures the varying trend of the domain-wide eddy energy level in response to environmental changes, even though the energy budget is not specifically designed for a sloping-bottomed ocean. Local errors of the predicted eddy energy are present but do not compromise the predictive skill of the GEOMETRIC parameterization for prograde current systems. This work lays a foundation for improving the representation of prograde current systems in coarse-resolution ocean climate models.

Significance Statement

The objective of this study is to evaluate different methods for predicting ocean volume transports caused by ocean mesoscale eddies across continental margins. This is important because these transports play a critical role in exchanges between coastal seas and open oceans, but cannot be resolved or well represented in ocean climate simulations. This study emphasizes the importance of accounting for the influence of sloping seafloors in controlling the eddy transport across the continental slope. This study also highlights the necessity of simultaneously predicting the eddy energy for better representation of the cross-slope eddy transport in ocean climate simulations.
Biogenetic Kinship in Families Formed via Reciprocal IVF: ‘It Was [My Partner]’s Egg . . . But My Blood Flowed through Her’
Authors: Bower-Brown Susie , Shaw Kate , McConnachie Anja , Jadva Vasanti , Ahuja Kamal , Golombok Susan
Published: November 2023

Reciprocal IVF is a route to parenthood that, for the first time, allows cis two-mother families (and other couples in which both partners have a uterus and egg stores) to ‘share’ biological parenthood. This family form offers a valuable opportunity for researchers to examine experiences of gestational and genetic motherhood within the same family, and this article is the first to take a sociological approach to exploring kinship within this emerging family form. Drawing upon interview data with 14 two-mother families (28 mothers) who have conceived via reciprocal IVF, we show that mothers hold complex, creative and sometimes contradictory understandings of the ‘multiple motherhoods’ within their family (i.e. genetic, epigenetic and gestational motherhood). Overall, mothers took an active and strategic approach to constructing kinship within their family, and these findings have theoretical, empirical and clinical implications.
Predictive value of triple negative breast cancer based on DCE-MRI multi-phase full-volume ROI clinical radiomics model
Authors: Qi Xuan , Wang Wuling , Pan Shuya , Liu Guangzhu , Xia Liang , Duan Shaofeng , He Yongsheng
Published: November 2023

Background

Since no studies compared the value of radiomics features of distinct phases of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for predicting triple-negative breast cancer (TNBC).

Purpose

To identify the optimal phase of DCE-MRI for diagnosing TNBC and, in combination with clinical factors, to develop a clinical-radiomics model to well predict TNBC.

Material and Methods

This retrospective study included 158 patients with pathology-confirmed breast cancer, including 38 cases of TNBC. The patients were randomly divided into the training and validation set (7:3). Eight radiomics models were built based on eight DCE-MR phases, and their performances were evaluated using receiver operating characteristic curve (ROC) and DeLong's test. The Radscore derived from the best radiomics model was integrated with independent clinical risk factors to construct a clinical-radiomics predictive model, and evaluate its performance using ROC analysis, calibration, and decision curve analyses.

Results

WHO classification, margin, and T2-weighted (T2W) imaging signals were significantly correlated with TNBC and independent risk factors for TNBC ( P<0.05). The clinical model yielded areas under the curve (AUCs) of 0.867 and 0.843 in the training and validation sets, respectively. The radiomics model based on DCEphase7 achieved the highest efficacy, with an AUC of 0.818 and 0.777. The AUC of the clinical-radiomics model was 0.936 and 0.886 in the training and validation sets, respectively. The decision curve showed the clinical utility of the clinical-radiomics model.

Conclusion

The radiomics features of DCE-MRI had the potential to predict TNBC and could improve the performance of clinical risk factors for preoperative personalized prediction of TNBC.
Serum leptin levels and relationship with maternal weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria: a comparative cross-sectional study
Authors: Enebe Joseph Tochukwu , Enebe Nympha Onyinye , Nwagha Theresa Ukamaka , Meka Ijeoma Angela , Nwankwo Malackay Ezenwaeze , Izuka Emmanuel Obiora , Egede John Okafor , Ugwu Innocent Anayochukwu , Okoro Ngozi Ijeoma , Okoye Helen Chioma , Iyoke Chukwuemeka Anthony
Published: November 2023

Objective

To determine and compare the mean maternal serum leptin levels, the prevalence of high serum leptin levels and mean gestational weight gain at term among obese and non-obese pregnant women in Enugu, Nigeria.

Methods

This cross-sectional comparative study enrolled obese and non-obese pregnant women. The serum leptin levels of the women were determined using an enzyme-linked immunosorbent assay kit. Anthropometric and sociodemographic data were obtained and compared. Mean weight gain during pregnancy was determined.

Results

A total of 170 pregnant women were included in the study. The mean ± SD serum leptin level (99.39 ± 50.2 ng/ml) and the prevalence of hyperleptinaemia (81 of 85 patients; 95.3%) among the obese pregnant women at term were significantly higher than those of the non-obese pregnant women (48.98 ± 30.35 ng/ml/65 of 85 patients; 76.5%). The mean percentage weight gain was significantly higher in the non-obese women compared with the obese women at term. The predictors of high maternal serum leptin level at term among the participants were the employment status and levels of education of the participants.

Conclusion

Maternal serum leptin level, maternal weight gain and prevalence of hyperleptinaemia at term were significantly higher in the obese compared with the non-obese pregnant women.
Naturally acquired equine parvovirus-hepatitis is associated with a wide range of hepatic lesions in horses
Authors: Jager Mason C. , Choi Eunju , Tomlinson Joy E. , Van de Walle Gerlinde
Published: November 2023

Equine parvovirus-hepatitis (EqPV-H) is the causative agent of Theiler’s disease, or severe acute hepatic necrosis, in horses. However, it is poorly understood whether EqPV-H is associated with other histologic findings in horses with clinical liver disease. The objective of this study was to examine the prevalence and severity of EqPV-H infections in diagnostic liver samples. Archived formalin-fixed, paraffin-embedded (FFPE) liver samples ( n = 98) from Cornell University and University of California, Davis, collected between 2007 and 2022 were evaluated for 15 individual histologic features and by EqPV-H in situ hybridization. EqPV-H was detected in 48% ( n = 47) of samples. The most common histologic features of EqPV-H-positive samples included individual hepatocyte death ( n = 40, 85%), lobular infiltrates ( n = 38, 80%), portal infiltrates ( n = 35, 74%), and ductular reaction ( n = 33, 70%). Centrilobular necrosis, portal infiltrate, and individual hepatocyte death were positively associated with high viral load. Neutrophil infiltrates, bridging fibrosis, and portal edema were negatively associated with a high viral load. Only 4 of 49 tested samples were positive for equine hepacivirus by polymerase chain reaction (PCR), but the PCR assay was unreliable for FFPE tissues. In summary, this study demonstrates that EqPV-H is common in a variety of liver pathologies and should be considered as a differential diagnosis in cases of hepatitis other than Theiler’s disease.
Escaping the Crowds: The Harmonious Environments of Sociability in Eighteenth-Century Writings
Authors: Uściński Przemysław
Published: November 2023

This article looks at the eighteenth-century ways of thinking about nature in connection with sociability and retirement by juxtaposing some of the poetry of the period with the discourses concerned with gardens and the aesthetics of garden design. In the writings of Anthony Ashley Cooper, 3rd Earl of Shaftesbury, Joseph Addison, William Gilpin, Elizabeth Montagu, and William Shenstone, the interest in the value of retirement as a much-needed respite from polite society is accompanied with some concern about the dangers of inactivity and idleness. Nature is thus supposed to offer an appropriately shaded, harmonious environment that provides spiritual reinvigoration and cultivation of taste, away from the tumult of urban crowds. In the poetry of Thomas Gray and William Blake, in turn, one may notice the evocation of nature as a more disturbing force, which, rather than merely confirming to the taste for harmony, seems to challenge some of the premises of polite culture. Paying attention to aesthetic thought, cultural history and poetic discourse, the article provides some insights into the complexity of the eighteenth-century aesthetics of nature.
Fostering wellbeing: Placing foster carers centre stage
Authors: Rees Alyson , Maxwell Nina , Powell Jillian , Corliss Cindy , Khan Asma , O’Donnell Chloe
Published: November 2023

This article reports on an evaluation of the Fostering Wellbeing programme, a set of five themed masterclasses delivered in two local authorities to a group of multi-disciplinary professionals in the team around the foster child. The programme also included the development of the role of the foster carer Pioneer. The evaluation found benefits of the multi-disciplinary training, but attendance and commitment from some professionals were limited. The programme demonstrated some traction in bringing the foster carer into the team around the child and strengthening their ability to advocate for the child. The Pioneer role showed promise but was yet to be fully embedded.
Innovative maximum power point tracking technique for wind energy conversion system
Authors: Tounsi Souhir
Published: November 2023

In this work, an optimal control scheme based on the Maximum Power Point tracking for the Wind Energy Conversion System using Permanent Magnet Synchronous Generator (PMSG) is proposed and also modeled. The system studied in this paper consists of wind energy system powering a battery using a buck-boost converter as an interface. By modifying the buck-boost duty cycle, we vary the reflected voltage at PMSG, and accordingly its speed. It is controlled with Perturb and Observe (P&O) Maximum Power Point Tracking (MPPT) approach. The overall system is simulated with MATLAB/SIMULINK.
Mental Health Referrals Among Medicare Advantage Enrollees Receiving Home-Based Annual Wellness Visits in Puerto Rico During the COVID-19 Pandemic
Authors: Akiya Kelley , Palacios Sofia , Silver Diana
Published: November 2023

Annual Wellness Visits (AWV) promote preventive care for older adults, yet uptake remains low. To increase AWVs, a Medicare Advantage (MA) plan in Puerto Rico contracted a medical group to provide home-based AWVs during the last quarter of 2020. Using data from 464 visits, we conducted descriptive and multivariable analysis to profile patient characteristics and identify predictors of mental health referrals. We found that 87% of patients had multiple chronic conditions, 75% were taking more than 5 medications, and the odds of a mental health referral were higher for those who also had a nutrition-related condition (AOR = 5.05, CI95: 1.76–11.88), diabetes (AOR = 3.34, CI95: 1.18–7.58), or an additional reported uncontrolled health issue (AOR = 28.18, CI95: 8.96–70.59). This strategy helped one MA plan reach high-need patients, but coordination of follow-up care is needed to ensure patients receive recommended services.
Quantifying the Systematic Bias in the Accessibility and Inaccessibility of Web Scraping Content From URL-Logged Web-Browsing Digital Trace Data
Authors: Dahlke Ross , Kumar Deepak , Durumeric Zakir , Hancock Jeffrey T.
Published: November 2023

Social scientists and computer scientists are increasingly using observational digital trace data and analyzing these data post hoc to understand the content people are exposed to online. However, these content collection efforts may be systematically biased when the entirety of the data cannot be captured retroactively. We call this often unstated assumption the problematic assumption of accessibility. To examine the extent to which this assumption may be problematic, we identify 107k hard news and misinformation web pages visited by a representative panel of 1,238 American adults and record the degree to which the web pages individuals visited were accessible via successful web scrapes or inaccessible via unsuccessful scrapes. While we find that the URLs collected are largely accessible and with unrestricted content, we find there are systematic biases in which URLs are restricted, return an error, or are inaccessible. For example, conservative misinformation URLs are more likely to be inaccessible than other types of misinformation. We suggest how social scientists should capture and report digital trace and web scraping data.
An experimental study on optimization of coolant mass flow rate in a photovoltaic/thermal system
Authors: Kayri İsmail
Published: November 2023

Steady, continuous, and homogeneous cooling of photovoltaic panels that consume less energy for circulation of coolant is extremely important for preventing higher energy loses especially in hotter conditions. In this study, a novel steady continuous active cooling application with water, as the coolant, was applied in a compact photovoltaic/thermal hybrid system in order to find out the effects of coolant mass flow rate and to optimize the required amount of cooling for maximizing electrical efficiency by measuring the real load voltage and current values formed on the resistive load designed for the selected photovoltaic module. It is found that the reduction in panel temperature for the cooled panel can be accepted to be enough, especially for 31.38 kg/h coolant mass flow rate, since the operating temperatures of the cooled panel reached quite near to the ambient temperature. The means of the temperature reduction for cooled panels were between 13.06°C and 13.74°C as compared with the referent panel. The increase rate of average power for the cooled operations were in between 6-8%, while the instantaneous power increase, especially in midday periods, were reached to its highest values between 13% and 15% in comparison to the referent panel. The highest percent increase in power output was derived as 7.62% for the ṁ = 31.38 kg/h coolant mass flow rate at 12:30 pm. The highest daily cumulative electrical energy production was observed for the coolant mass flow rate of 39.66 kg/h, with 6.3% of increase.
Electro-rheological flow of seminal fluid (K-L MODEL) induced by movement of cilia in a circular conduit
Authors: Ponalagusamy R.
Published: November 2023

The current study deals with the flow of seminal fluid through the ductus efferentes owing to electro-osmotic force and motion of cilia. The constitutive equation of semen liquid has been assumed to be described as a K-L (Kuang and Luo) fluid model. The main equations of the ciliary flow of K-L model are solved by considering the supremacy of viscous upshot over inertia influence assuming the state of long wave-length number. The analytic expressions for velocity profile, flow rate and flow impedance are derived. This is the first time to bring out to the lime light that the flow impedance is decreased and the plug core radius is enlarged with the introduction of electric force in the ciliary flow system. The effects of pertinent physiological parameters on the time-mean flow rates of rhesus monkey and human semen are thoroughly investigated. The computational mean flow rate's value over the period of time of the current mathematical model has been well matched with the corresponding experimentation values of the time-mean flow rates of rhesus monkey and humanoid semen in the path of generative and the vas deferens of the path of generative of male. Introduction of electric field into the flow ciliary system and the rheology of semen fluid described as K-L fluid model (for the values of rheological parameters of K-L fluid are considered) reduce the flow resistance, which in turn elevates the flow velocity of seminal fluid, which activates the significant and favorable changes for Oocytes getting fertilized within hours of ovulation by means of reasonable volume of semen transport into the female reproductive tract to partake a quick contact with cervical mucus and enter the cervix.
Reliability of International Normalized Ratio Results in the CoaguChek Pro II System in a Clinical Setting
Authors: Cortina-de-la-Rosa Evelyn , Izaguirre-Ávila Raúl , Ramírez-Hernández Alejandro , Romero-Arroyo María-Oliva , Cortés-Cortés Karen
Published: November 2023

The National Institute of Cardiology has previously used the CoaguChek® XS Plus system (Roche Diagnostics International Ltd), comparing capillary blood prothrombin time/international normalized ratio (PT/INR) results with those obtained using BCS-XP/Thromborel (Siemens). We assessed the reliability of PT/INR results using the third-generation CoaguChek Pro II system, the CoaguChek XS Plus system, and cobas® t 411 for citrated plasma analysis. Venous and capillary PT/INR were measured (N = 204). Spearman's correlation, Bland-Altman, and concordance analysis between methods were conducted. Spearman's correlation coefficients between venous/capillary INR were high for CoaguChek Pro II versus CoaguChek XS Plus ( r = 0.994), CoaguChek Pro II versus cobas t 411 ( r = 0.967), and CoaguChek XS Plus versus cobas t 411 ( r = 0.968). Good concordance was observed among capillary methods (concordance coefficient [κ] = 0.888) and remaining relationships ( P < .001 for all): cobas t 411 versus CoaguChek XS Plus (κ = 0.696) and cobas t 411 versus CoaguChek Pro II (κ = 0.684). In conclusion, good agreement was observed between CoaguChek Pro II, CoaguChek XS Plus, and cobas t 411.
Effective Preventative Measures are Essential to Lower Disease Burden From Dengue and COVID-19 Co-infection in Bangladesh
Authors: Das Proma Rani , Khan Sakif Ahamed , Rahman Jannatul Mabia , Dewan Syed Masudur Rahman
Published: November 2023

Bangladesh is widely recognized as one of the dengue prone nations, and empirical evidence has consistently demonstrated an upward trend in the severity of the disease over time. With the persistent occurrence of dengue in Bangladesh and the ongoing presence of COVID-19, which has not been fully eradicated and may persist for an uncertain period of time, there is a high probability of co-infection between these 2 illnesses. Given the circumstances, the concurrent occurrence of the COVID-19 and dengue epidemics, along with the potential co-infection, may pose an overwhelming burden on healthcare systems that are already grappling with challenges in meeting the existing demand. Due to a lack of awareness, an inadequate health infrastructure, and ineffective disease prevention initiatives, the country is now more susceptible to the threat posed by a co-infection that has been found to be associated with more severe outcomes, marked by significant morbidity and mortality. The objective of this opinion piece is to explore the gravity of co-infection in Bangladesh, as well as the potential challenges to overcome and the preventative measures that need to be implemented to address the severity. This opinion piece proposes a set of modern preventative strategies that, when integrated with conventional methods, have the potential to mitigate disease severity, avert the occurrence of co-infection between COVID-19 and dengue, and halt the co-epidemics of COVID-19 and dengue.
Navigating competing demands in monitoring and evaluation: Five key paradoxes
Authors: Faling Marijn , Schouten Greetje , Vellema Sietze
Published: November 2023

Evaluation in complex programs assembling multiple actors and combining various interventions faces contradictory requirements. In this article, we take a management perspective to show how to recognize and accommodate these contradictory elements as paradoxes. Through reflective practice we identify five paradoxes, each consisting of two contradicting logics: the paradox of purpose—between accountability and learning; the paradox of position—between autonomy and involvement; the paradox of permeability—between openness and closedness; the paradox of method—between rigor and flexibility; and the paradox of acceptance—between credibility and feasibility. We infer the paradoxes from our work in monitoring and evaluation and action research embedded in 2SCALE, a program working on inclusive agribusiness and food security in a complex environment. The intractable nature of paradoxes means they cannot be permanently resolved. Making productive use of paradoxes most likely raises new contradictions, which merit a continuous acknowledging and accommodating for well-functioning monitoring and evaluation systems.
Paediatric orthopaedic expert system
Authors: Lau Chia Fong , Malek Sorayya , Gunalan Roshan , Saw Aik , Milow Pozi , Song Cheen
Published: November 2023

The paediatric orthopaedic expert system analyses and predicts the healing time of limb fractures in children using machine learning. As far we know, no published research on the paediatric orthopaedic expert system that predicts paediatric fracture healing time using machine learning has been published. The University Malaya Medical Centre (UMMC) offers paediatric orthopaedic data, comprises children under the age of 12 radiographs limb fractures with ages recorded from the date and time of initial trauma. SVR algorithms are used to predict and discover variables associated with fracture healing time. This study developed an expert system capable of predicting healing time, which can assist general practitioners and healthcare practitioners during treatment and follow-up. The system is available online at https://kidsfractureexpert.com/ .
Private attributes: The meanings and mechanisms of “privacy-preserving” adtech
Authors: McGuigan Lee , Sivan-Sevilla Ido , Parham Patrick , Shvartzshnaider Yan
Published: November 2023

This study analyzes the meanings and technical mechanisms of privacy that leading advertising technology (adtech) companies are deploying under the banner of “privacy-preserving” adtech. We analyze this discourse by examining documents wherein Meta, Google, and Apple each propose to provide advertising attribution services—which aim to measure and optimize advertising effectiveness—while “solving” some of the privacy problems associated with online ad attribution. We find that these solutions define privacy primarily as anonymity, as limiting access to individuals’ information, and as the prevention of third-party tracking. We critique these proposals by drawing on the theory of privacy as contextual integrity. Overall, we argue that these attribution solutions not only fail to achieve meaningful privacy but also leverage privacy rhetoric to advance commercial interests.
Digital compensation: Smartphone use in the emotion socialisation of left-behind children in rural China
Authors: Wang Qinghua , Zheng Xin , Zhang Shuling
Published: November 2023

Through field investigations in two populous Chinese provinces, this study proposes a grounded theory of digital compensation afforded by smartphone usage in the emotion socialisation of left-behind children. Our interviews found that these children suffer from emotional deficiencies or deficits caused by the absence of parents’ emotional companionship, a lack of emotional education within the family and a decline in playmates in their rural communities. Our study also revealed the dialectical tension between the possibilities and ramifications of digital compensation. In a miniature media ecology constructed by smartphones, migrant parents provide virtual companionship and peers help build social capital, while stay-at-home grandparents perform a scaffolding or gatekeeping role, providing a symbolic sense of emotional compensation. Instead of addressing the root causes of the children’s emotional distress, the compensatory affordances of smartphone use have had concerning consequences of intense feelings of deprivation and social reversal that exacerbate their loneliness and isolation.
Lebensraum, geopolitics and race—Palestine as a feminist issue in German-speaking academia
Authors: Al-Taher Hanna , Younes Anna-Esther
Published: November 2023

Palestine continues to be a contentious issue in and for Western higher education particularly in Germany and, by extension, in German-speaking academia. In this article we take figurations of Palestine as an analytical lens through which to trouble German-centric epistemologies, understandings of history and their applications inside academic structures. We specifically tackle the silence on and ideological erasure of Palestine in German-speaking academic environments and read this erasure as colonially constituted and stemming from a German Lebensraum ideology, ruling over space and race ‘through science’. We propose to understand contemporary erasures of Palestine through this transnational and transhistorical space-race-and-education-nexus. First, we delineate Lebensraum ideology and its policing barriers and apply it to today’s structures of higher education and the territorial exclusion of Palestinians from those structures by way of education. Within this epistemic nationalist framework—which evicts politicized Palestinians qua Palestinians as (too) political—we discuss how Palestine has become a central tool for the maintenance of white academia, and as such is a decolonial feminist issue relevant for the investigation of power structures in higher education and German political discourses. We finally discuss our theoretical approach vis-à-vis commentaries from and by Palestinians in German-speaking higher education. The authors situate their personal and professional experience on the inside, outside, and on the margins of German academia. In a political landscape that disavows BDS on campuses, brands solidarity with Palestinians as anti-Semitic, and a state doctrine that calls for an uncritical and ‘unconditional support of Israel’, this article is of crucial importance to understand modern knowledge production in Germany and Europe. Our methodology is based on literature reviews, new feminist theorization around issues of silence and solidarity, and preliminary (auto-) ethnographic explorations of Palestinians in and out of German-speaking academia.
Commentary: Sofia Zaragocin
Authors: Carvajal Sofia Zaragocin
Published: November 2023

Repair is about doing, (re)doing, and materiality. This plenary makes it very clear that repair means taking action, building relations, and a continuous attention to the material. The authors stress the methods of land-as-pedagogy, Black place making and the afterlives of slavery as political and cultural practices. The emphasis is on action and building relations that sustain the materiality of repair. I’d like to take up the four intersecting points mentioned in this paper that can act as a roadmap for geographers and others who are looking to do repair.
Digital implementations for determination of temporal light artefacts of LED luminaires
Authors: Mantela V , Nordlund R , Askola J , Kärhä P , Ikonen E
Published: November 2023

Flicker and stroboscopic effects caused by a temporally modulated light source may be harmful for the human visual system. Standardized measurement methods have been developed for the related temporal light artefacts of LED luminaires. It was found out that the performance of the International Electrotechnical Commission (IEC) recommended flickermeter implementation is highly dependent on sampling frequency. Novel digital implementations for the flickermeter and stroboscopic effect visibility measure (SVM) were created to remove any inaccuracies. The performance of the novel Aalto implementations does not depend on the sampling frequency when running the test waveforms of the IEC standard through the implementations. As compared with the IEC recommended digital implementations, Aalto flickermeter decreases the average error related to the test waveforms from −0.05 to +0.003, and Aalto SVM meter also decreases the average error by almost two orders of magnitude.
Tips and Tricks to Facilitate the Combined Iliofemoral Endarterectomy With Stenting for Heavily Calcified Common Femoral Artery Atherosclerosis With Involvement of the External Iliac Artery
Authors: Georgakarakos Efstratios , Dimitriadis Konstantinos , Parisidis Stavros , Triantafyllou Nikolaos , Argyriou Christos , Georgiadis George S.
Published: November 2023

Background

Management of a heavily calcified atherosclerotic occlusive disease involving the common femoral artery (CFA) and external iliac artery (EIA), poses a surgical challenge. Though the current guidelines recommend open surgical therapy for such lesions, this approach is neither easy nor represents the current real-life practice.

Purpose

To describe tips and tricks facilitating the hybrid technique for the management of distal iliofemoral atherosclerotic disease, where classic endarterectomy is inadequate or ill-performed.

Technique

A contralateraly inserted guidewire reaches the distal iliac artery via the crossover technique and is directly retrieved from the femoral arteriotomy immediately after removal of the anterior plaque segment. The retrieved and secured guidewire enables extensive retrograde CFA endarterectomy over the wire with avusion proximally to the inguinal ligement, followed by patch arterioplasty. Externalizing the guidewire from the patch enables traction on it and facilitates advancement of the stent through tortuous or stenosed iliac vessels as well as accurate stent deployment to cover the margin of the EIA residual plaque. Moreover, this manipulation enables ipsilateral placement of a sheath and passage of a second, retrograde guidewire to perform kissing stenting in the common iliac vessels. Chronic thrombotic lesions require covered stents to avoid thrombus propagation and meticulous flushing before completion of the femoral patching.

Conclusions

The combined iliofemoral endarterectomy with stenting does not require advanced endovascular skills and prevents complications associated with incomplete femoral endarterectomy. Extensive avulsion endarterectomy proximal to the inguinal ligament is efficiently and safely performed over a retrieved crossover guidewire, enabling precise residual stenting above the flexion site.
Mixed Reality Surgical Navigation System; Positional Accuracy Based on Food and Drug Administration Standard
Authors: Morley Christopher T. , Arreola David M. , Qian Long , Lynn Amy L. , Veigulis Zachary P. , Osborne Thomas F.
Published: November 2023

Background

Computer assisted surgical navigation systems are designed to improve outcomes by providing clinicians with procedural guidance information. The use of new technologies, such as mixed reality, offers the potential for more intuitive, efficient, and accurate procedural guidance. The goal of this study is to assess the positional accuracy and consistency of a clinical mixed reality system that utilizes commercially available wireless head-mounted displays (HMDs), custom software, and localization instruments.

Methods

Independent teams using the second-generation Microsoft HoloLens© hardware, Medivis SurgicalAR© software, and localization instruments, tested the accuracy of the combined system at different institutions, times, and locations. The ASTM F2554-18 consensus standard for computer-assisted surgical systems, as recognized by the U.S. FDA, was utilized to measure the performance. 288 tests were performed.

Results

The system demonstrated consistent results, with an average accuracy performance that was better than one millimeter (.75 ± SD .37 mm).

Conclusion

Independently acquired positional tracking accuracies exceed conventional in-market surgical navigation tracking systems and FDA standards. Importantly, the performance was achieved at two different institutions, using an international testing standard, and with a system that included a commercially available off-the-shelf wireless head mounted display and software.
Contemporary Incidence of Synchronous Multiple Primary Lung Cancers and Survival in the Era of Lung Cancer Screening
Authors: Samadzadeh Tabrizi Nika , Gallant Ben , Harris Erin , Arnold Brian N. , Fabian Thomas
Published: November 2023

Objective:

Up to 15% of lung cancer patients have multiple suspicious nodules. While some of these nodules may represent metastatic lung cancer, others represent synchronous multiple primary lung cancer (SMPLC). The incidence of SMPLC ranges from 0.8% to 8.4% and appears to be increasing. Inconsistent identification of SMPLC can be detrimental for patients who are misdiagnosed as having intrapulmonary metastasis and not offered stage-based treatment. We sought to identify the contemporary incidence of SMPLC at a tertiary institution.

Methods:

From January 2018 to September 2019, patients who underwent lung cancer resection were retrospectively reviewed. Patients with SMPLC were identified using the modified Martini-Melamed criteria.

Results:

During the 21-month period, 227 patients underwent lung cancer resection. There were 47 patients (20.7%) who had 119 pathologically confirmed SMPLC. Most patients had ipsilateral tumors ( n = 24, 51.1%) with at least 1 adenocarcinoma ( n = 40, 85.1%). Considering histologic subtyping, 38 (80.9%) had histologically distinct tumors. Overall and cancer-specific survival at 4 years was 86% and 90%, respectively. Only patients with 3 or more SMPLC had poor 4-year overall ( P = 0.002) and cancer-specific survival ( P = 0.043) compared with those with 2 SMPLC. Patient demographics, histology, tumor location, and highest pathologic staging did not affect survival outcomes.

Conclusions:

Using a strict inclusion criterion, the incidence of SMPLC is higher than previously reported. SMPLC patients have favorable survival outcomes, suggesting that they behave like primary lung cancer, not intrapulmonary metastasis. Awareness of SMPLC by thoracic surgeons is critical in optimizing outcomes in this patient population.
Tenzing 7 delivery catheter with or without a leading microwire for single pass aspiration thrombectomy: A multicenter experience
Authors: Tonetti Daniel A , Koneru Manisha , Bhattacharyya Meghna , English Joey D , Settecase Fabio , Kim Warren T , Khalife Jane , Patel Pratit , Thomas Ajith , Jovin Tudor , Hanel Ricardo , Benalia Victor H C , Cortez Gustavo M , Aghaebrahim Amin , Sauvageau Eric , Abdalkader Mohamad , Nguyen Thanh N , Klein Piers , Dmytriw Adam A , Shaikh Hamza
Published: November 2023

Introduction

Aspiration mechanical thrombectomy traditionally includes use of an inner microcatheter and leading microwire to navigate an aspiration catheter (AC) to the site of occlusion. Early clinical experience suggests that a leading microwire is often not needed with the Tenzing 7 (T7, Route 92 Medical, San Mateo, CA), a soft tapered tip ledge-reducing delivery catheter. This multicenter experience aims to describe AC delivery success in single-pass thrombectomy using T7 with and without a leading microwire.

Methods

A retrospective review was conducted of consecutive patients who underwent single-pass thrombectomy with T7 at six institutions between 2020 and 2022. We examined the percentage of successful AC delivery, puncture-to-revascularization time, and procedural complication rate.

Results

A leading microwire with T7 was used in 19/89 (21%) of patients, and it was not used with T7 in 70/89 (79%) of patients. Successful AC delivery was similar with and without microwires (97% vs. 90%, p = 0.15). Median puncture-to-revascularization times were similar (17 min microwire vs. 16 min no-microwire, p = 0.12). No complications were associated with microwire use; one (1.4%) patient had a T7-related vasospasm resolved with verapamil during thrombectomy without a leading microwire. Differences in complication rates were not statistically significant (p = 0.46).

Conclusion

In our real-world clinical experience, leading microwire use was infrequently necessary with the T7 delivery catheter. Successful AC delivery and complication rates were similar with and without microwire use in single-pass T7 thrombectomies. Initial pass with T7 may be performed without use of leading microwire, reserving microwire use for refractory cases or known difficult-to-navigate vasculature.
The future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease in various GOLD groups: a focus on the GOLD 2017 and GOLD 2023 reports
Authors: Song Qing , Cheng Wei , Liu Cong , Li Xueshan , Lin Ling , Peng Yating , Zeng Yuqin , Yi Rong , Liu Yi , Li Xin , Chen Yan , Cai Shan , Chen Ping
Published: November 2023

Background:

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report revised the combined assessment, merged the C and D groups into the E group, and revised the initial inhalation therapy recommendation.

Objectives:

This study aimed to analyze the future exacerbation and mortality of different inhalation therapies among patients with chronic obstructive pulmonary disease (COPD) in various groups based on the GOLD 2017 and GOLD 2023 reports.

Design:

This is a multicenter and retrospective study.

Methods:

Stable COPD patients from the database setup by 12 hospitals were enrolled. The patients were divided into Groups A, B, C, D, and E according to the GOLD 2017 and GOLD 2023 reports. Then, the patients were classified into long-acting muscarinic antagonist (LAMA), long-acting β2-agonist (LABA) + inhaled corticosteroid (ICS), LABA + LAMA, and LABA + LAMA + ICS subgroups. Data on exacerbation and death during 1 year of follow-up were collected.

Results:

A total of 4623 patients were classified into Group A (15.0%), Group B (37.8%), Group C (7.3%), Group D (39.9%), and Group E (47.2%). The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies in Groups A and C. Patients treated with LABA + LAMA or LABA + LAMA + ICS had a lower incidence of exacerbation and frequent exacerbation than patients treated with LAMA or LABA + ICS in Groups B, D, and E. The exacerbation, frequent exacerbation, and mortality showed no differences between different inhalation therapies after combining Groups A with C.

Conclusion:

Patients in Group A should be recommended to undergo mono-LAMA, while patients in Groups B and E should be recommended treatment with LABA + LAMA, which is consistent with the GOLD 2023 report. However, it is worth considering merging Groups A and C into a single group and recommending mono-LAMA as the initial inhalation therapy.
Clinical examination and imaging resources in children and adolescent back pain
Authors: León-Domínguez Ana , Cansino-Román Rocío , Martínez-Salas Jose M , Farrington David M
Published: November 2023

Back pain is a relatively common complaint in children and adolescents. The pediatric patient presenting with back pain can often be challenging, and there are many well-known organic diagnoses that should not be missed. In younger children, an organic cause of back pain can often be found. However, back pain in older children and adolescents is often “non-specific.” The differential diagnosis of back pain in children includes neoplasms, developmental, and inflammatory conditions. Basic steps should include an in-depth anamnesis, a systematic physical examination, and standard spine radiographs (anteroposterior and lateral). Nevertheless, advanced diagnostic imaging and laboratory studies should be included when indicated to avoid missing or delaying a serious diagnosis. If other types of imaging tests are necessary (magnetic resonance imaging, computed tomography, bone scan, or single photon emission computed tomography), they should be guided by diagnostic suspicion.
Conceptualizing digital sanctions as a new type of economic sanctions in the digital era: Digital-related sanctions measures against Russia and their consequences
Authors: Park Jiyoun , Shin Boram
Published: November 2023

In the era of digital transformation, the structure and application of economic sanctions have evolved, expanding from traditional trade embargoes to sophisticated digital and financial sanctions. The recent conflict in Ukraine triggered a spectrum of responses from the Western powers, targeting Russia’s digital sectors. The sanctions include restrictions on quantum computing, IT services, manufacturing, aerospace technology, and other measures that may impede the country’s digital transformation. This study aims to understand if these emerging digital-technology related measures can be perceived as a novel form of economic sanctions and to explore the potential economic implications for Russia. Two primary research questions are addressed in this paper: First, we ask whether sanctions targeting digital technology and development can be seen as an advanced form of economic sanctions, and what would be the subsequent economic losses incurred by Russia. We also explore possible Russian responds or adapt to these economic pressures. As digital transformation continues to revolutionise economies globally, this research posits that digital-technology sanctions hold substantial economic ramifications for targeted countries. By analysing the features and outcomes of the recent sanctions against Russia, the study provides insights into the evolving landscape of sanctions mechanisms and diplomacy in the digital age.
Prevention of Dental trauma
Authors: Kalsi Hasneet K. , Burns Beth
Published: November 2023

Traumatic dental injuries (TDIs) occur commonly in children and young adults with one in three adults having experience of a TDI to their permanent dentition. Although the management of TDIs have evolved vastly, the consequences of TDIs can still be profound and generally carry a high burden for the patient, family, or carer, as well as the clinician and healthcare services. Hence, prevention of TDIs where possible is key. It is important to ensure that all risk factors for dental trauma are fully explored to allow preventative advice to be tailored to each patient. General Dental Practitioners are well placed to establish a rapport with patients owing to the continuity of care that is commonly seen in dentistry, however, it is imperative that the appropriate questions are asked.

This article aims to review dental trauma highlighting the significance of identification of clinical and social risk factors and prevention of TDIs. These risk factors are further divided into modifiable and non-modifiable risk factors which can guide the clinician on what further action is required and when other members of the dental or medical team should be involved. The importance of patient education in prevention of TDIs, including use of mouthguards in sport, and mouthguard design will be discussed.
Knowledge and attitudes of school principals towards childhood hearing loss and hearing services: A cross-sectional survey to support the implementation of inclusive education in Samoa
Authors: Kaspar Annette , Afutiti-Pemila Jennifer Seipua , Driscoll Carlie , Pifeleti Sione
Published: November 2023

Objectives:

To assess the knowledge and attitudes among school principals towards childhood hearing loss and hearing services to support the implementation of inclusive education in Samoa. Educators are uniquely positioned to advocate for inclusive education in their classrooms, and may be among the first professionals to suspect hearing loss in their young students. Given the well-known impacts of childhood hearing loss on learning and development, educators therefore play a vital role in referring students for an ear and hearing health assessment.

Methods:

A cross-sectional convenience sampling design and bilingual questionnaire were used (English/Samoan). School principals attending the annual conference for educators of Samoa over 4 days in June 2022 were invited to anonymously complete a 23-item questionnaire on childhood hearing loss and hearing services. Participants were required to respond to each statement with either ‘yes’, ‘no’ or ‘unsure’. The questionnaire investigated general knowledge of healthy hearing and hearing loss, knowledge of causes and risk factors of hearing loss, knowledge of identification and intervention for hearing loss and the attitudes towards students with hearing loss.

Results:

95.4% of the 109 participants agreed that healthy hearing is important, and 97.2% felt that childhood hearing loss is an important problem in Samoa. Participants agreed that hearing loss adversely impacts the interaction with peers (95.4%), listening in the classroom (94.5%), speech and language development (93.6%), classroom behaviour (88.1%) and reading skills (85.3%). 97.2% of participants felt that students with hearing loss should have the same opportunities as their normal-hearing counterparts, and 92.7% would include students with hearing loss in their classroom. 94.5% were keen to learn more about childhood hearing loss. There were no significant differences in response proportions between variable subgroups.

Conclusion:

Overall, the results displayed high levels of knowledge and very positive attitudes among school principals in Samoa towards their students with hearing loss.
The politics of eco-anxiety: Anthropocene dread from depoliticisation to repoliticisation
Authors: Davidson Joe PL
Published: November 2023

Eco-anxiety has become increasingly widespread in recent years. Many people are suffering from intense feelings of distress in the face of the horrors of life in the Anthropocene. This article explores the political implications of eco-anxiety. For some commentators, eco-anxiety contributes to the depoliticisation of the climate crisis. It produces fearful subjects who are unable to discern alternative socioenvironmental pathways and distracts attention from the structural forces contributing to the unfolding ecological catastrophe. I contend that this critique of eco-anxiety is mistaken. It is argued that eco-anxiety has the potential to heighten political consciousness on the climate crisis. Drawing on Jean-Paul Sartre’s account of anguish and Karl Marx’s account of alienation, I suggest that eco-anxiety, first, highlights the contingency of political life in the Anthropocene by demonstrating the variety of possible climate futures and, second, articulates a longing for a collective subject that can exercise effective political agency.