bluuebunny/crossref_metadata_2025 huggingface dataset:
Computed Tomography Study of the Retrosigmoid Craniotomy Keyhole Approach Using Surface Landmarks
Authors: Hu Wei , Zhou Jiang , Liu Zheng-Min , Li Ye , Cai Qing-Feng , Hu Xiao-Ming , Yu Yan-Bing
Published: March 2023

Background. Due to a lack of accessibility and individual differences in surgical procedures, many previous studies on keyholes are not practical. Objective. To study the surface landmarks for optimal keyhole placement in the retrosigmoid approach. Methods. The three-dimensional (3D) skull images of 79 patients were reconstructed using workstations, with a total of 149 hemiskull base 3D images then analyzed. Skull-surface landmarks were marked, the lateral-skull surface was observed, and the positional relationships between the asterion and the extension line of the posterior margin of the mastoid process were measured. The position of the superior curvature of the sigmoid sinus groove was located before it was projected onto the lateral surface of the skull and defined as the keypoint. The positional relationship between the keypoint and the skull-surface landmarks was observed in an established coordinate system using spatial proportion relationships. Results. The asterion was located around the extension line of the posterior margin of the mastoid process, and the vertical distance from the extension line was <15 mm. It was found that 93.29% (139/149) of the keypoints were located in a 7 mm radius circle, with the center at (−0.41, −3.01) in the coordinate system in the 3D computed tomography images. Conclusion. When using this method, the spatial proportion relationship of the anatomical marks can accurately locate keyholes, therefore providing technical support when employing the retrosigmoid approach.
A New Method for Ivermectin Detection and Quantification through HPLC in Organic Matter (Feed, Soil, and Water)
Authors: Carrillo Heredero Alicia Maria , Segato Giulia , Menotta Simonetta , Faggionato Elena , Vismarra Alice , Genchi Marco , Bertini Simone
Published: March 2023

Ivermectin is a macrocyclic lactone widely used in veterinary medicine for its broad-spectrum antiparasitic properties. It has been proven to be effective and safe. The purpose of this study was to develop a high-performance liquid chromatography method with a diode array detector for ivermectin screening in feed and water for animal consumption. Furthermore, the objective was to quantify ivermectin levels that were higher than 0.5 mg/kg in solid matrixes and 0.1 mg/kg in water. Doramectin was used as process standard. Samples were extracted using solid phase extraction with silica and C-18 columns. The method involved the use of high-performance liquid chromatography (HPLC) with a diode array detector (DAD). The results were interpreted using a calibration curve built with ivermectin standards at multiple concentrations (0.5, 1, 2, 5, and 12.5 mg/kg). Statistical evaluation of data was done using ANOVA. The data analysis showed that the linear regression was highly significant (

P
<
0.001

), the intercept values were not significantly different from zero, and the correlation coefficient values (>0.999) indicated excellent linearity. Further tests demonstrated that this method is also useful when studying soil matrixes. The soil was dried and analyzed in the same way as feed; the same recoveries were realized on the spiked samples. The method is easy, inexpensive, precise, and repeatable; it requires very small amounts of sample.
A Maximum Entropy Species Distribution Model to Estimate the Distribution of Bushpigs on Madagascar and Its Implications for African Swine Fever
Authors: Díaz-Cao José Manuel , Grossmann Nárjara , Goodman Steven M. , Bosch Jaime , Guis Helene , Rasamoelina Miatrana , Rakotoarivony Rianja , Jori Ferran , Martínez-López Beatriz
Published: March 2023

Bushpigs (Potamochoerus larvatus) play a major role in the socio-ecosystem of Madagascar, particularly in rural areas. They are largely hunted by rural populations as a major source of income and protein. They can also represent a potential source of pathogens for domestic animals and people. For example, it is hypothesized that bushpigs might compromise African swine fever (ASF) eradication programs by sporadically transmitting the virus to domestic pigs. However, available knowledge on the distribution of bushpigs in Madagascar is limited. In this study, we estimated the distribution of bushpigs on Madagascar using a species distribution model (SDM). We retrieved 206 sightings of bushpigs in Madagascar during 1990–2016 and predicted the distribution by using 37 climatic, geographic, and agricultural/human variables related to the presence of bushpigs and running a presence-background maximum entropy SDM. Our model identified three main areas with a high suitability for bushpigs: in the north, central-western, and east of the island (AUC = 0.84). The main contributors to the model were the vegetation index (51.3%), percentage of land covered by trees (17.6%), and annual averaged monthly precipitation (12.6%). In addition, we identified areas in central Madagascar with a high density of domestic pigs and a high suitability score for bushpigs. These results may help to identify bushpig areas at the interface with domestic pigs to assess the risk of pathogen transmission and to design ecological assessments, wildlife management studies, or targeted surveillance and research studies related to many bushpig-borne pathogens, such as ASF, which is an endemic problem in the country, as well as zoonotic diseases such as cysticercosis and hepatitis E. Our approach could also be extrapolated to other species of wild swine in other countries.
Biometric Authentication and Correlation Analysis Based on CNN‐SRU Hybrid Neural Network Model
Authors: Zhang Houding , Yang Zexian
Published: March 2023

With the continuous development of computer technology, many institutions in society have higher requirements for the efficiency and reliability of identification systems. In sectors with a high‐security level, the use of traditional key and smart card system has been replaced by the identification system of biometric technology. The use of fingerprint and face recognition in biometric technology is a biometric technology that does not constitute an infringement on the human body and is convenient and reliable. The biometric technology has been continuously improved, and the existing biometric technologies are based on unimodal biometric features. The unimodal biometric technology has its own limitations such as proposing single information and checking data affected by the environment, which makes it difficult for the technology to play its advantages in practical applications. In this paper, we use CNN‐SRU deep learning to preprocess a large amount of complex data in the perceptual layer. The data collected in the perceptual layer are first transmitted to CNN convolutional neural network for simple classification and analysis and then arrives at the LSTM session to update again and optimize the screening to improve the biometric performance. The results show that the CNN‐LSTM, CNN‐GRU, and CNN algorithms show a decreasing trend in accuracy under the three error evaluation criteria of RMSE, MAE, and ME, from 0.35 to 0.07, 0.58 to 0.19, and 0.38 to 0.15, respectively. The recognition rate of multifeature fusion can reach 95.2%; the recognition efficiency of the multibiometric authentication system and accuracy rate has been significantly improved. It provides a strong guarantee for the regional standardization, high integration, generalization, and modularization of multibiometric identification system application products.
Application of Machine Learning for Cardiovascular Disease Risk Prediction
Authors: Dalal Surjeet , Goel Pallavi , Onyema Edeh Michael , Alharbi Adnan , Mahmoud Amena , Algarni Majed A. , Awal Halifa
Published: March 2023

Cardiovascular diseases (CVDs) are a common cause of heart failure globally. The need to explore possible ways to tackle the disease necessitated this study. The study designed a machine learning model for cardiovascular disease risk prediction in accordance with a dataset that contains 11 features which may be used to forecast the disease. The dataset from Kaggle on cardiovascular disease includes approximately 70,000 patient records that were used to determine the outcome. Compared to the UCI dataset, the Kaggle dataset has many more training and validation records. Models created using neural networks, random forests, Bayesian networks, C5.0, and QUEST were compared for this dataset. On training and testing data sets, the results acquired a high accuracy (99.1 percent), which is significantly superior to previous methods. Ahead‐of‐time detection and diagnosis of cardiac disease, as well as better treatment outcomes, are strong possibilities for the suggested prediction model. Additionally, it may help patients better manage their illness or life forms in order to increase their chances of recovery/survival. The result showed greater accuracy and promising signs that machine‐learning algorithms can indeed assist in early identification of the disease and improvement of the treatment outcome.
The Growing Challenge of Chronic Kidney Disease: An Overview of Current Knowledge
Authors: Borg Rikke , Carlson Nicholas , Søndergaard Jens , Persson Frederik
Published: March 2023

Chronic kidney disease (CKD) is becoming one of the world’s most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium–glucose cotransporter 2 inhibitors, there are now new effective treatments to add to standard therapy. This will also be relevant for primary care physicians as many patients with CKD have their family physician as their primary health care professional handling kidney function preservation. In the future, more precise and less invasive diagnostic methods may not only improve the determination of the underlying cause of CKD but may also carry information regarding which treatment to use (i.e. personalized medicine). This could lead to a reduced number of preventive treatments per individual, while at the same time improving the prognosis. This review summarizes ongoing efforts in this area.
Rapid Dissemination followed by Spontaneous Regression of Metastatic Hepatocellular Carcinoma after Liver Radiofrequency Thermal Ablation: A Case Report with Correlative Immune Assay
Authors: Xu Yiqing , Bayewitz Ashrei , Tary-Lehmann Magdalena
Published: March 2023

Rapid intrahepatic and distant metastasis of hepatocellular carcinoma (HCC) after locoregional treatment for early stage tumor is very rare. Descriptions of spontaneous regression of HCC exist in case reports, but its true mechanism is unclear. Here, we describe a case of rapid dissemination with lung metastasis shortly after localized RFA treatment of HCC liver lesions, followed by spontaneous, sustained regression of those lung lesions. We also show the detection of cytotoxic T lymphocytes (CTLs) specific to hepatitis B antigens by immune assay in this patient. We propose immune-related destruction as the basis for spontaneous regression.
Pure Interstitial Trisomy 11q Arising from a Nonrecurrent 11q13.1q22.3 Mosaic Intrachromosomal Duplication in a Patient with Craniofacial Dysmorphism and Genital Anomalies
Authors: Martínez Anaya Daniel , Juárez-Velázquez María del Rocío , Reyes Ruvalcaba Sinuhé , Navarrete-Meneses María del Pilar , Salas Labadía Consuelo , Lieberman Hernández Esther , Pérez-Vera Patricia
Published: March 2023

Introduction: The pure interstitial trisomy 11q11q23.2 is an uncommon genomic disorder associated with nonrecurrent intrachromosomal duplications. The phenotype is characterized by intellectual disability and craniofacial abnormalities. Given their uncommonness, a comprehensive genotype-phenotype correlation has not fully been defined. Case Presentation: We report the clinical and cytogenomic characterization of a 5-year-old boy with intellectual disability, psychomotor retardation, craniofacial dysmorphism, genital anomalies, and pure interstitial trisomy 11q arising from a nonrecurrent 11q13.1q22.3 intrachromosomal duplication in a high-mosaic state (>80%). The duplicated chromosome was characterized by cytogenetics, multicolor banding FISH, and SNP array. We demonstrated the wide mosaic distribution of the 11q duplication by interphase FISH in tissues from different embryonic germ layers. The duplication involves a copy number gain of 45.3 Mb containing 22 dosage-sensitive genes. We confirmed the overexpression of dosage-sensitive genes along the duplicated region using RT-qPCR. Discussion: Only 8 patients have been described. Our patient shares clinical features with previous reports but differs from them by the presence of genital anomalies. We provide a detailed clinical review and an accurate genotype-phenotype correlation and propose PC, NDUFV1, FGF3, FGF4, and DHCR7 as dosage-sensitive genes with a possible role in the clinical spectrum of our patient; however, expression changes of FGF3/4 were not detected since they must be regulated in a spatiotemporal way. This patient contributes to the accurate description of the pure interstitial trisomy 11q. Future reports could continue to delineate the description, considering the relationship between the chromosome segment and the genes involved.
Combined Heterozygous Genetic Variations in Complement C2 and C8B: An Explanation for Multidimensional Immune Imbalance?
Authors: Mannes Marco , Halbgebauer Rebecca , Wohlgemuth Lisa , Messerer David Alexander Christian , Savukoski Susa , Schultze Anke , Berger Bettina , Knapp Christiane Leonie , Schmidt Christoph Q. , Fürst Daniel , Hillmer Morten , Siebert Reiner , Eriksson Oskar , Persson Barbro , Nilsson Bo , Nilsson Ekdahl Kristina , Huber-Lang Markus
Published: March 2023

The complement system plays a crucial role in host defense, homeostasis, and tissue regeneration and bridges the innate and the adaptive immune systems. Although the genetic variants in complement C2 (c.839_849+17del; p.(Met280Asnfs*5)) and C8B (c.1625C>T; p.(Thr542Ile)) are known individually, here, we report on a patient carrying their combination in a heterozygous form. The patient presented with a reduced general condition and suffers from a wide variety of autoimmune diseases. While no autoimmune disease-specific autoantibodies could be detected, genetic analysis revealed abnormalities in the two complement genes C2 and C8B. Therefore, we performed a comprehensive investigation of the innate immune system on a cellular and humoral level to define the functional consequences. We found slightly impaired functionality of neutrophils and monocytes regarding phagocytosis and reactive oxygen species generation and a diminished expression of the C5aR1. An extensive complement analysis revealed a declined activation potential for the alternative and classical pathway. Reconstitution with purified C2 and C8 into patient serum failed to normalize the dysfunction, whereas the addition of C3 improved the hemolytic activity. In clinical transfer, in vitro supplementation of the patient’s plasma with FFP as a complement source could fully restore full complement functionality. This study describes for the first time a combined heterozygous genetic variation in complement C2 and C8B which, however, cannot fully explain the overall dysfunctions and calls for further complement deficiency research and corresponding therapies.
In vivo Temperature Assessment during Holmium Laser Enucleation of the Prostate
Authors: Yilmaz Mehmet , Heuring Cäcilia Elisabeth Maria , Schoeb Dominik , Suarez-Ibarrola Rodrigo , Gratzke Christian , Hein Simon , Miernik Arkadiusz
Published: March 2023

Introduction: Holmium laser enucleation of the prostate (HoLEP) has become popular worldwide for the surgical treatment of benign prostate hyperplasia. Holmium laser is considered an ideal transurethral thermomechanical device for enucleating the prostate. Although there is evidence on Ho:YAG laser-related heat generation, the studies mainly investigated ex vivo temperature generation during holmium laser lithotripsy. In this in vivo study, we aimed to assess for the first time the real-time heat generated during HoLEP. Methods: Fifteen HoLEP procedures were included. The study was conducted over a time period of 16 months. To investigate the temperature generation, a preoperatively inserted rectal temperature probe and a temperature sensor within a suprapubic bladder catheter were used to record the temperature change during enucleation and coagulation. Results: The mean values of the temperature change during the laser enucleation and coagulation were −0.35 ± 0.203 K (IQR: 0.23) and +0.14 ± 0.259 K (IQR: 0.3), respectively, in rectal measurements. Temperature differences during laser use and coagulation were <+1 K and <+5 K, respectively, in bladder measurements. We measured no temperature >37.1°C during the procedures and no temperature values considered harmful to the human body. Conclusion: Sufficient irrigation flow rates and irrigation monitoring during HoLEP are obligatory. To prevent a high and uncontrolled temperature rise, the surgeon or operating room staff should pay attention to the irrigation’s continuity.
Customized Citrate Anticoagulation versus No Anticoagulant in Continuous Venovenous Hemofiltration in Critically Ill Patients with Acute Kidney Injury: A Prospective Randomized Controlled Trial
Authors: Ratanarat Ranistha , Phairatwet Piyarat , Khansompop Suwimon , Naorungroj Thummaporn
Published: March 2023

Introduction: The use of anticoagulants during continuous renal replacement therapy (CRRT) is essential. Regional citrate anticoagulation (RCA) is recommended rather than systemic heparinization to prolong the filter’s lifespan in patients at high risk of bleeding. However, commercial citrate is expensive and may not be available in resource-limited areas. The objective of this study is comparing filter life between our locally made customized RCA and no anticoagulation. The primary outcomes were the first circuit life in hours and the number of filters used within the first 72 h of therapy. Methods: We conducted a single-center prospective randomized controlled trial in critically ill patients requiring CRRT. The participants were randomized to receive continuous venovenous hemofiltration (CVVH) with either customized RCA or no anticoagulant. Results: Of 76 patients, 38 were randomized to receive customized RCA and 38 to receive CVVH without anticoagulant. There was no significant difference in baseline characteristics between the two groups. Compared to anticoagulant-free group, the median circuit life of customized RCA group was significantly longer [44.9 (20.0, 72.0) vs. 14.3 (7.0, 22.0) hours; p < 0.001]. The number of filters used within 72 h was significant lower [2.0 (1.0, 2.0) vs. 2.5 (1.0, 3.0); p < 0.015]. RCA was prematurely discontinued in 5 patients due to citrate accumulation (2 cases) and severe metabolic acidosis requiring higher dose of CVVH (3 cases). No differences in bleeding complications were observed (p = 0.99). Conclusion: Customized citrate-based replacement solution improved filter survival in CVVH compared to anticoagulant-free strategy. This regimen is safe, feasible, and suitable for low- to middle-income countries.
Estimating the Lowest Latitude of Baroclinic Growth
Authors: Peles Oren , Lachmy Orli
Published: March 2023

Midlatitude storm tracks are the most prominent feature of the midlatitude climate. The equatorward boundary of the storm tracks marks the transition from the dry subtropics to the temperate midlatitudes. This boundary can be estimated as the lowest latitude of efficient baroclinic growth. Scaling theories for the lowest latitude of baroclinic growth were previously suggested based on the domain-averaged parameters of the Eady growth rate and supercriticality. In this study, a new estimate for the lowest latitude of baroclinic growth is proposed, based on the assumption that baroclinic growth is limited by the vertical scale of eddy fluxes. An equation for the eddy displacement flux is obtained from which the vertical scale is calculated, given the zonal-mean zonal wind and temperature profiles. It is found that the vertical scale of the eddy displacement flux and the observed baroclinic conversion rate decrease rapidly toward the equator around the same latitude. The seasonal cycle of the lowest latitude of baroclinic growth, calculated from the observed baroclinic conversion rate, is compared with the theoretical estimates. The estimates based on the vertical scale of the eddy displacement flux and supercriticality agree well with the observed lowest latitude of baroclinic growth. In contrast, the estimate based on the Eady growth rate is located around 10°–15° equatorward. The estimate of the lowest latitude of baroclinic growth may be used in future studies for explaining variations in the properties of the storm track, the Hadley cell edge, and the subtropical jet.

Significance Statement

The lowest latitude of baroclinic growth marks the transition from the dry and stable subtropics to the moist and variable midlatitudes. Estimating this latitude based on mean-flow variables can potentially advance the theoretical understanding of the latitudinal structure of the atmospheric circulation around the subtropics and midlatitudes. This study suggests a new method for estimating the lowest latitude of baroclinic growth, which is found to predict the observed lowest latitude of baroclinic energy conversion relatively well, compared with the traditional prediction based on the Eady growth rate.
Intermodel Spread of Historical Indian Monsoon Rainfall Change in CMIP6: The Role of the Tropical Pacific Mean State
Authors: Guilbert Marcellin , Terray Pascal , Mignot Juliette
Published: March 2023

Robust projections of the Indian summer monsoon rainfall (ISMR) are critical as it provides 80% of the annual precipitation to more than 1 billion people who are very vulnerable to climate change. However, even over the historical period, state-of-the-art climate models have difficulties in reproducing the observed ISMR trends and are affected by a large intermodel spread, which questions the reliability of ISMR projections. Such uncertainty could come from internal variability or model biases. Here, we study the impact of the latter on the historical forced change of ISMR in 34 models from CMIP6. First, we show that models’ biases over India do not significantly impact how they simulate the historical change of ISMR. However, we do find statistically significant relationships between ISMR historical forced changes and remote rainfall and temperature biases within the tropics by using a maximum covariance analysis (MCA). Our results highlight the key role of tropical Pacific sea surface temperature (SST) mean state biases as an important source of intermodel spread in the ISMR change. The physical mechanisms underlying these statistical relationships between ISMR change and the intermodel spread of Pacific SST biases are finally explored. We found that models having El Niño/La Niña–like mean SST bias in the Pacific tend to exhibit El Niño/La Niña–like changes over the historical period, impacting ISMR through a shift in the Walker circulation and Rossby wave propagation across the Pacific.
Developing a Methodology for Model Intercomparison and Its Application to Improve Simulated Streamflow by Land Surface Models
Authors: Tinumbang Aulia Febianda Anwar , Yorozu Kazuaki , Tachikawa Yasuto , Ichikawa Yutaka
Published: March 2023

Runoff generated by land surface models (LSMs) is extensively used to predict future river discharge under global warming. However, the structural bias of LSMs, the precipitation bias of the climate model, and other factors could cause the runoff to be biased. A model intercomparison study can help understand LSM behavior. Traditional model intercomparison can discover output variation and evaluate performance, but explaining the reason for the difference is challenging. This study developed a novel method to identify the reasons for disparities and suggest improvements. Consequently, we investigated the impacts of model settings by adopting the settings of another model in one model until it can mimic similar features in its output. Hence, we developed a process called the “emulation model.” We employed two LSMs [Simple Biosphere with Urban Canopy (SiBUC) and Meteorological Research Institute Simple Biosphere model (MRI-SiB)] in the Thai River basin. SiBUC produced a higher surface runoff than MRI-SiB, and the development of the MRI-SiB emulation revealed the cause of this variation. The differences in runoff characteristics affected streamflow estimation. For instance, the SiBUC peak discharge was faster and higher than observed in the dry year. Conversely, there was a tendency to underestimate the flow estimated by MRI-SiB runoff during the transition from dry to wet seasons. Incorporating other model settings can alleviate the shortcomings of each model. Overall, the proposed method can identify the strengths and weaknesses of a model and enhance the reproducibility of the hydrological characteristics of the observed discharge in the basin.

Significance Statement

This study aims to develop a new methodology for model intercomparison to identify the reasons for model output variation. Understanding why models behave differently is important to enhancing the reliability of model prediction. Our findings guide what affects disparities in land surface model runoff-based streamflow estimation, which will help reduce the uncertainty of future flood and drought predictions.
Not in My Schoolyard: Disability Discrimination in Educational Access
Authors: Rivera Lauren A. , Tilcsik András
Published: March 2023

Disabled people constitute the largest minority group in the United States, and disability discrimination is prohibited under federal law. Nevertheless, disability has received limited attention in the sociology of discrimination. We examine disability discrimination in an important gatekeeping interaction: access to public education. In an audit study of more than 20,000 public schools, we sent emails to principals from fictitious prospective parents asking for a school tour, varying the child’s disability status and gender and the parent’s race. Principals were significantly less likely to respond when the child had a disability, especially when the email came from a Black (rather than White) parent. A survey experiment with 578 principals revealed possible mechanisms. Principals viewed disabled students as more likely to impose a significant burden on schools, but disabled Black students faced an additional disadvantage due to stereotypes of their parents, who were perceived to be less valuable future members of the school community in terms of fundraising, volunteering, and other forms of engagement to support the school. Our results highlight that discrimination against people with disabilities begins long before the labor market and illuminate how the intersection between disability and race shapes inequalities in educational access.
A Rare Case of Extensive Basal Cell Carcinoma With Invasion of the Humerus: Excision and Immediate Reconstruction With Fibula Allograft, Plating, and Latissimus Dorsi Flap
Authors: Nakao Yuki , Fazalare Brandon , Feyh Andrew , Bown Paul , Ray Peter
Published: March 2023

Basal cell carcinoma (BCC) is the most common skin cancer, and most of the reports have involved the head and neck, but it is rare for it to be highly invasive, with an invasion of long bone being extremely rare. A 73 year old woman presented with a giant BCC on her right arm. Magnetic resonance imaging suggested the involvement of the right humerus. Biopsy confirmed the nodular type of BCC. The patient underwent BCC excision including hemicortical humerus excision with fibula allograft and latissimus dorsi flap with a split-thickness skin graft. Excluding a transient radial nerve palsy, the patient’s postoperative course was otherwise uncomplicated. Although BCC invasion into the long bone is extremely rare, the gold standard treatment is, as a rule, en bloc surgical resection with a wide variety of reconstructive techniques. This treatment is only possible through the collaboration of general surgery, orthopedics, and plastic surgery.
The Making of New Dalit Middle Class: Struggle, Aspirations and Changing Lifestyle in Navi Mumbai, India
Authors: Pankaj Ajeet Kumar , Jha Manish K.
Published: March 2023

Through delineating the struggles and challenges of Dalits in making of the Dalit middle class, this article seeks to argue that the struggle and aspiration of Dalits to live a dignified life and urban as a space of ‘liberation from caste’ represents a high point in making of the new Dalit middle class. However, existing literature about the Dalit middle class revolves around identity, provision of reservation in education, employment and cultural assertion, but many unfolded narratives of the Dalit middle class exist. This article attempts to reveal the struggle and challenges of the new Dalit middle class to achieve the status of the middle class. Keeping this in mind further, this article aims to explore the transformations in everyday life of the new Dalit middle class regarding consumer behaviour and lifestyle. Besides this, the article provides a detailed narrative of the new Dalit middle class and about their experience of caste and class in the city.
When Death Hits You in Your Face, You Have to Listen”: A Qualitative Investigation of Peer Bereavement Support Volunteers in Black American Communities
Authors: Adams Leslie , Athey Alison , Brooks Kelli , Lazarus Kimberly , DeVinney Aubrey , Leaf Phillip J.
Published: March 2023

Efforts to support grief in Black American communities are often under-recognized despite their potential to address negative mental health outcomes in this population. The aim of the current study was to qualitatively assess the community-level influence of bereavement support programs on predominantly Black communities in Baltimore, Maryland. Five focus groups ( n = 23) were conducted with volunteers from a non-profit bereavement organization. Participants were queried about how their training may be sustainably applied as a community resource in Baltimore City. Thematic analysis from focus groups revealed three main themes: (1) enhancing feelings of belongingness fosters a sense of community cohesion, (2) use of bereavement support tools as a source of personal healing, and (3) applications of bereavement support in the community. Implications of our study support the widespread influence of peer-led bereavement support training to reduce the reverberating impact of personal and collective grief in Black American communities
The equity dilemma
Authors: Rotberg Iris C.
Published: March 2023

School leaders juggle the often-inconsistent goals of maintaining support of middle- and upper-income families for public education and, at the same time, implementing policies to strengthen equity for low-income students. Author Iris C. Rotberg describes how these tradeoffs play out in different communities, the role of concentrated poverty and segregation, and potential options for making equity gains while maintaining widespread support for public education.
Career Confidential: Teacher concerned that parents don’t trust teachers anymore
Authors: Fagell Phyllis L.
Published: March 2023

In this regular Kappan column, Phyllis Fagell gives advice to educators. This month, a teacher wants to set better boundaries with parents don’t seem to trust teachers and want to have input on every decision. A principal has noticed that students are only hanging out with kids from their own social class, creating a “haves” and “have nots” culture at the school. Another teacher keeps hearing about colleagues who are looking for jobs in higher-paying districts and wonders if it’s time to jump ship, despite being generally happy in her current job.
Bookshelf: Kappan authors on their favorite reads
Authors: Dougherty Shaun M.
Published: March 2023

Shaun M. Dougherty recommends the book Of Boys and Men by Richard V. Reeves. Louie F. Rodriguez recommends the article “Cultivating Una Persona Educada: A Sentipensante (Sensing/Thinking) Vision of Education” by Laura I. Rendó, published in the Journal of College and Character.
Convertible, multiple and hidden: The inventive lives of women’s sport and activewear 1890–1940
Authors: Jungnickel Kat
Published: March 2023

Who gets to be ‘sporty’ and active in public is an enduring topic of socio-political debate. Disparities in participation continue from limited access, support and funding to ill-fitting equipment and clothing. This article focuses on the latter. Women have long been disproportionally restricted and harassed in public space not only in relation to how, where and when they move but also what they wear. I approach this issue via a unique data source – global clothing inventions for sport and athletic activities (1890–1940). Analysing convertible, multiple and hidden clothing patents, by and for women, reveals how inventors tackled ongoing socio-political restrictions to women’s freedom of movement from the ground up and, often secretly, from the inside out. I suggest these data might be read as acts of resistance, enabling wearers to move and inhabit spaces in new ways, engage in a wider range of activities and make claims to equal public participation and mobility rights. These lesser-known clothing inventions invite us below the surface of conventional sporting histories, expand ideas around the creative possibilities of sport and activewear, and spark imaginaries of what other kinds of inclusive and inventive athletic identities might be possible.
The Global Campaign Against Headache and its future relation to IHS and WHO
Authors: Olesen Jes , Jensen Rigmor Højland
Published: March 2023

Background

Preparations for the Global Campaign Against Headache done jointly with WHO started almost 25 years ago. It was officially incorporated 18 years ago. It is the story of a few dedicated individuals who, together with the World Health Organization, generated epidemiological data all over the world and made use of these data to gradually increase the position of headache disorders, until migraine became number two among all causes of years lost to disability. It is also the story of impressive development of scientific tools, their validation and use in low-income countries.

Methods

Models of care for headache patients were developed that are adaptable and hence can be implemented in future throughout the world.

Results

The last phase of the campaign shall use the impressive data set generated to cause real improvement in the healthcare for people with headache throughout the world. The recent World Health Organization initiative: Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders invites international organizations to collaborate, and headache is mentioned.

Conclusion

This calls for the International Headache Society and all its national members and all other organizations involved in headache to work together with Lifting the Burden, the organization in charge of the Global Campaign Against Headache.
Treatment pattern and response for cluster headache in Korea: A prospective multicenter observation study
Authors: Lee Mi Ji , Park Jeong Wook , Chu Min Kyung , Moon Heui-Soo , Chung Pil-Wook , Chung Jae Myun , Sohn Jong-Hee , Kim Byung-Kun , Kim Byung-Su , Kim Soo-Kyoung , Song Tae-Jin , Choi Yun-Ju , Park Kwang-Yeol , Oh Kyungmi , Ahn Jin-Young , Lee Kwang-Soo , Bae Dae Woong , Cho Soo-Jin
Published: March 2023

Background

Only limited data are available regarding the treatment status and response to cluster headache in an Asian population. Therefore, this study aimed to provide a real-world treatment pattern of cluster headache and the response rate of each treatment in an Asian population.

Methods

Patients with cluster headache were recruited between September 2016 and January 2019 from 16 hospitals in Korea. At the baseline visit, we surveyed the patients about their previous experience of cluster headache treatment, and acute and/or preventive treatments were prescribed at the physician’s discretion. Treatment response was prospectively evaluated using a structured case-report form at 2 ± 2 weeks after baseline visit and reassessed after three months.

Results

Among 295 recruited patients, 262 experiencing active bouts were included. Only one-third of patients reported a previous experience of evidence-based treatment. At the baseline visit, oral triptans (73.4%), verapamil (68.3%), and systemic steroids (55.6%) were the three most common treatments prescribed by the investigators. Most treatments were given as combination. For acute treatment, oral triptans and oxygen were effective in 90.1% and 86.8% of the patients, respectively; for preventive treatment, evidence-based treatments, i.e. monotherapy or different combinations of verapamil, lithium, systemic steroids, and suboccipital steroid injection, helped 75.0% to 91.8% of patients.

Conclusion

Our data provide the first prospective analysis of treatment responses in an Asian population with cluster headache. The patients responded well to treatment despite the limited availability of treatment options, and this might be attributed at least in part by combination of medications. Most patients were previously undertreated, suggesting a need to raise awareness of cluster headache among primary physicians.
Large Versus Small Opening Wedge High Tibial Osteotomies Performed With a Protective Wire Over the Lateral Hinge: Incidence of Lateral Hinge Fracture and Early Clinical Outcomes
Authors: Koh Don Thong Siang , Soong Junwei , Yeo William , Tan Marcus Wei Ping , Teo Shao Jin , Wilson Adrian , Lee Kong Hwee
Published: March 2023

Background:

The incidence of lateral hinge fractures (LHFs) during medial opening wedge high tibial osteotomy (MOW-HTO) is unacceptably high, especially with distractions >10 mm. LHFs result in malunion, loss of correction, and recurrence of symptoms adversely affecting clinical outcomes.

Purpose:

(1) To investigate the incidence of LHF when a protective guide wire is utilized during MOW-HTO in small and large corrections and (2) to study the effect of correction size on early clinical outcomes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A retrospective analysis was performed of 96 knees that underwent MOW-HTO between 2019 and 2020. A protective wire applied intraoperatively across the lateral hinge point before opening wedge distraction was performed for all patients. Patients were divided into 2 groups based on opening wedge sizes: group A (opening distraction <10 mm) and group B (opening distraction ≥10 mm). LHF and wound complications were recorded. Prospective Knee Score and Function Score (Knee Society), Oxford Knee Score, and Physical and Mental Component Summaries of the 36-Item Short Form Health Survey questionnaire were recorded preoperatively and at 6 months and 2 years after surgery.

Results:

Incidence of LHF was low in group A (n = 2; 6.1%) and group B (n = 3; 9.1%). A single case of intraoperative LHF was noted in each group, with each case resulting in a type 1 fracture. The incidence of postoperative fractures was comparable between groups (groups A vs B, n = 1 vs 2). At 6 months, clinical outcomes in group A were superior to those of group B (Knee Score, 85.7 ± 14.7 vs 73.1 ± 20.3, P = 0.028; Function Score, 73.5 ± 16.5 vs 63.1 ± 19.5, P = 0.047; Oxford Knee Score, 20.2 ± 4.7 vs 25.6 ± 8.5, P = 0.008; Physical Component Summary, 46.8 ± 8.1 vs 40.2 ± 10.9, P = 0.018). However, clinical outcomes were comparable at 2 years ( P > .05).

Conclusion:

A protective wire was associated with a low incidence of LHF, even in larger MOW-HTO corrections. Large corrections had poorer clinical outcomes as compared with small corrections at 6 months. However, clinical outcomes between groups were comparable at 2 years.
A Collaborative-Care Telephone-Based Intervention for Depression, Anxiety, and at-Risk Drinking in Primary Care: The PARTNERs Randomized Clinical Trial
Authors: Ishrat Husain M. , Rodie David J. , Perivolaris Athina , Sanches Marcos , Crawford Allison , Fitzgibbon Kyle P. , Levinson Andrea , Geist Rose , Kurdyak Paul , Mitchell Brian , Oslin David , Sunderji Nadiya , Mulsant Benoit H. ,   for the PARTNERs Study Group
Published: March 2023

Background

Collaborative care (CC) could improve outcomes in primary care patients with common mental conditions. We assessed the effectiveness of a transdiagnostic model of telephone-based CC (tCC) delivered by lay providers to primary care patients with depression, anxiety, or at-risk drinking.

Methods

PARTNERS was a pragmatic trial in 502 primary care adults presenting with depressive symptoms, anxiety symptoms, or at-risk drinking randomized to (1) usual care by primary care providers (PCPs) enhanced with the results of computer-assisted telephone-based assessments (at baseline and 4, 8, and 12 months later) (enhanced usual care [eUC]) or (2) tCC consisting of eUC plus frequent telephone coaching and psychoeducation provided by mental health technicians who also communicated to the PCP recommendations from a psychiatrist for evidence-based pharmacotherapy, psychotherapy, or, when indicated, referrals to mental health services. The primary analysis compared the change on the 9-item Patient Health Questionnaire (PHQ-9) in participants presenting with depression ( n = 366) randomized to tCC versus eUC. Secondary analyses compared changes on the Generalized Anxiety Disorder-7 scale (GAD-7) in those presenting with anxiety ( n = 298); or change in the number of weekly drinks in those presenting with at-risk drinking ( n = 176).

Results

There were no treatment or time×treatment effects between tCC and eUC on PHQ-9 scores for patients with depression during the 12-month follow-up. However, there was a treatment effect (tCC > eUC) on GAD-7 scores in those with anxiety and a time×treatment interaction effect on the number of weekly drinks (tCC > eUC) in those with at-risk drinking.

Conclusion

Implementing transdiagnostic tCC for common mental disorders using lay providers appears feasible in Canadian primary care. While tCC was not better than eUC for depression, there were some benefits for those with anxiety or at-risk drinking. Future studies will need to confirm whether tCC differentially benefits patients with depression, anxiety, or at-risk drinking.
The Health and Psychosocial Profiles of Adults Who Sought Mental Health and Addiction Specialty Services Through a Centralized Intake Process in Nova Scotia in 2020 and 2021
Authors: Wang JianLi , Yang Lu , Tibbo Phil , Simon Patryk , Bullerwell Michele
Published: March 2023

Objectives

(1) To calculate the proportions of people who sought mental health and addiction (MHA) specialty services in Nova Scotia, overall and by sex and age. (2) To describe the health and psychosocial profiles of the MHA Intake clients. (3) To identify factors associated with acceptance for MHA services.

Methods

The data of the Nova Scotia MHA Intake clients aged 19 to 64 years old in 2020 ( N = 10,178) and in 2021 ( N = 12,322) were used. The proportions of unique clients in the general population were calculated based on 2021 census data. The percentages of primary presenting concerns, the presence and frequency of psychiatric symptoms in the past month, suicide risk levels, current or past provisional psychiatric diagnosis, medical problems, and psychosocial stressors were calculated. Logistic regression was conducted to identify factors associated with the acceptance of MHA services after the assessment.

Results

It was found that 1.48% and 2.33% of Nova Scotians aged 19 to 64 contacted the MHA Intake in 2020 and 2021. Over 66% were self-referrals, followed by physician referrals (28.34%). Mood (28.3%), anxiety (25.17%), and substance use (19.81%) were the top three presenting concerns for the contact. Many clients had a current or past provisional psychiatric diagnosis (58.7% in 2020, 61.8% in 2021). Among the clients, 74.67% and 68.29% reported at least 1 psychosocial stressor in 2020 and 2021, respectively. The clients with a current or past psychiatric diagnosis, suicide risk, and 2 or more psychosocial stressors, those who lived outside of Central Zone, and who had employee assistance program benefits/private insurance, were more likely to be qualified and accepted for MHA services than others.

Conclusions

The Intake clients have complex health and psychosocial profiles. Future studies are needed to monitor the trajectories of the clients to reduce inequities in receiving MHA services and improve client outcomes.
Israeli Ethno-Religious Differences in Motherhood Penalties on Employment and Earnings
Authors: Budig Michelle J. , Kraus Vered , Levanon Asaf
Published: March 2023

Israeli society presents a unique context for studying motherhood’s impacts on employment and earnings: High fertility and marriage rates coincide with high rates of women’s education and employment. While past research finds low motherhood penalties in Israel, ethno-religious group differences in these penalties are unexplored. Ours is the first longitudinal study to examine simultaneously motherhood’s employment and wage penalties among Israeli ethno-religious groups. Using newly available panel data, we find that motherhood deters employment among Israeli-Palestinians more strongly than among Jews, and particularly among less-educated Israeli-Palestinians. Similarly, motherhood wage penalties and ethno-religious disparities are greatest among the least-educated women. For all groups, highly educated women incur smaller motherhood penalties in employment and earnings, and in some cases receive motherhood wage premiums. Public-sector employment, particularly for Muslims, is associated with higher postnatal employment, lower motherhood penalties, and motherhood premiums among the highly educated. The stronger enforcement of anti-discrimination and work–family policies in the public sector, along with its schoolteachers’ collective bargaining agreement that raises maternal earnings, may contribute to its more positive outcomes for Israeli-Palestinian mothers. Our findings suggest that increasing educational attainment and public-sector employment among Israeli-Palestinians may reduce ethno-religious inequality in motherhood’s impact on employment and earnings.