bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between fasting blood glucose and subsequent vascular events in Chinese patients with mild ischaemic stroke: a cohort study
Authors: Ran Juanjuan , Cui Yu , Wang Yi , Gu Ping
Published: May 2021

Objective

To characterise the relationship between fasting blood glucose (FBG) and the incidence of subsequent vascular events (SVE) during the 6 months following a mild ischaemic stroke (MIS) in Chinese patients.

Methods

Data from patients with MIS were retrospectively analysed. The primary endpoint was an SVE during the 6-month follow-up period. The participants were allocated to three groups (tertiles), according to their FBG concentration.

Results

Of the 260 participants, 51 (19.6%) reported an SVE during the follow-up period. The incidence of SVE significantly differed among the tertiles of FBG. The odds ratio (OR) was 2.361 (95% confidence interval [CI]: 1.551–3.594) for FBG as a continuous variable and that for FBG categorised according to tertile was 13.30 (95% CI: 3.519–50.322) in the fully adjusted model. Curve fitting showed that the incidence of SVE gradually increased with increasing FBG, with the highest tertile showing the highest mean incidence (46.7%; 95% CI: 16.2%–79.9%). In addition, participants with or without diabetes mellitus, hypertension, headache, dizziness, mild cognitive impairment or anterior circulation artery lesion showed similar associations between FBG and the incidence of SVE.

Conclusion

FBG is an independent predictor of 6-month SVE risk in Chinese patients with MIS.
Leptospirosis with pulmonary haemorrhage and multiple organ failure: a case report and literature review
Authors: Dong Wei-Hua , Chen Zhi
Published: May 2021

Pulmonary haemorrhage is an important complication of leptospirosis. We herein report an uncommon case of severe pulmonary haemorrhage and multiple organ failure caused by leptospirosis in a 49-year-old man who was previously healthy. He was a farm worker who was admitted to the hospital because of haemoptysis. He had worked in a paddy field 4 days prior to admission. Chest computed tomography revealed pulmonary haemorrhage, which rapidly deteriorated into haemorrhagic shock and multiple organ failure. Based on the patient’s possible history of contact with contaminated water and the DNA sequence of Leptospira detected in his bronchoalveolar lavage fluid, the patient was diagnosed with pulmonary haemorrhagic leptospirosis. Despite the administration of a fluid bolus, norepinephrine, broad-spectrum antibiotics, and haemostatics, and even with administration of a blood transfusion and extracorporeal life support, the pulmonary haemorrhage could not be controlled effectively. The patient eventually died of haemorrhagic shock. Leptospirosis can be a life-threatening disease despite aggressive treatment, even with extracorporeal life support. Next-generation sequencing can provide important diagnostic clues for patients with atypical leptospirotic symptoms.
Efficacy and Safety of Lapatinib in Elderly Egyptian Patients with Her2 neu Positive Metastatic Breast Cancer
Authors: Abozeed WA , Zahi MS , Attia SE
Published: May 2021

Introduction:

The efficacy and safety of the lapatinib based treatment remain challenging in elderly patients with her2neu positive metastatic breast cancer (MBC). Lapatinib exhibits a good overall tolerance, but no study has yet been dedicated to elderly women. The present study is a real-world study that aimed to determine the efficacy and tolerability of the lapatinib-based treatment in the first line setting in Egyptian patients with HER2neu positive MBC who cannot get access to trastuzumab.

Patients and Methods:

In this retrospective study, 60 elderly patients (⩾ 65 years) with her2neu positive MBC and treatment naïve were included. All patients were treated with the combination of lapatinib (1,250 mg/day, continuously) and chemotherapy (either capecitabine 2,000 mg/m2 on days 1–14 of a 21-day cycle or weekly taxol 80 mg/m2), or lapatinib (1,250 mg/day, continuously) and hormonal treatment. Data on demographics, clinical outcome, and toxicity were collected form the patients’ medical records for descriptive analyses.

Results:

The median follow-up was 23.5 months (range 11–36 months). Most of the patients were hormone receptor positive (70%). About 28% of the patients had multiple sites of metastasis while 16 patients (26.7%) had bone only metastasis and 11 patients (18.3%) had lung only metastasis. Most of our patients (63.3%) had no associated comorbidities. An overall response rate of 61.7% was achieved, including 2 complete responses (3.3%), and 13 partial responses (21.7%). Median progression-free survival was 15.9 months (95% confidence interval (CI) 13.56- 18.33), and the median overall survival was 19.9 months (95% CI 17.8-21.9). Most common grade 1-2 side effects were diarrhea (43.3%), followed by hand-foot syndrome (35%), and skin rash (13.3%). Grade 3–4 toxicities were identified as hand-foot syndrome (10%), diarrhea (6.6%).There were no symptomatic cardiac events. Tolerability data show that 45% of patients needed a lapatinib dose reduction, and 30% a treatment interruption due to toxicity, while treatment discontinuation occurred in 18.3% of the cases.

Conclusion:

Lapatinib based therapy in elderly patients with her2neu positive MBC was effective. However, it was not well tolerated especially when combined with chemotherapy.
Verrucous Carcinoma of the Vulva
Authors: Agbanglanon DP , Jaba S , Kietga GG , M’barki I , Elkacemi H , Kebdani T , Elmajjaoui S , Benjaafar N
Published: May 2021

Introduction:

Vulvar verrucous carcinoma (VC) is extremely rare, accounting for less than 1% of vulvar cancer cases. Effectively, it is characterization by a slow growing, no metastasis or lymph node involvement. The aim of this study was to report our experience with this disease

Material and Methods:

This is a retrospective study of patients with vulvar VC who were treated at National Institute of Oncology between 2013 and 2018. Clinicopathological characteristics, treatment and follow-up were extracted from the medical records.

Results:

Three cases were identified in the National Institut of Oncology. The average age at diagnosis was 66 years (± 10.02). The average time from the onset of symptoms to diagnosis was 17 months (± 12,7). All patients complained of a vulvar mass or nodule, accompanied by vulvar pruritus and/or pain, which was the reason for consultation. A preliminary pathological diagnosis of squamous cell carcinoma was made in two cases. Surgical treatment included wide local excision, radical vulvectomy with lymph node dissection in the groin. Tumor size and invasion depth ranged from 50 to 105 mm and 17 to 35 mm respectively. In the final histology, VC of the vulva staged IB (2 cases) and staged III (1 case) with marginal limits in two cases. The concurrent radiochemotherapy was performed in one case, exclusive radiotherapy in one case and only surgery in one case. Regarding toxicity after concurrent radiochemotherapy and exclusive radiotherapy we had observed respectely grade 2 proctitis with renal toxicity and grade 2 radiodermatitis. The mean follow-up was 43 months with no recurrence in all cases. The prognosis is good, with low recurrent rate if wide local excision is performed.

Conclusions:

Vulvar VC is a distinct type of slow-growing, tumor with unclear etiology. Surgery is the most effective treatment. Concurrent radiochemotherapy indicated depending on disease stage and risk factors.
Correlation of Primary Tumor Metabolic Parameters with Clinical, Histopathological and Molecular Characteristics in Breast Cancer Patients at Preoperative Staging FDG-PET/CT Study
Authors: Mohamed AA , Zaher AM , Khalifa MI , AbdElhakem MM , Eloteify* Lamiaa M.
Published: May 2021

Introduction:

The aim of this prospective study was to evaluate the correlation of primary (1ry)tumor metabolic activity parameters maximum standardized uptake value (SUVmax) and tumor SUVmax/liver average SUV ratio (TLR) in initial staging 18F-fluorodeoxyglucose (FDG) positron emission tomography / computerized tomography (PET/CT) scan with clinical, histopathological and molecular characteristics of breast cancer (BC) patients.

Material and Methods:

Initial staging PET/CT was performed in 40 cases with different stages of BC in the supine position. Tumor FDG uptake was qualitatively evaluated and quantitatively assessed using SUVmax and TLR.

Results:

Forty female patients with newly diagnosed BC were enrolled in our study, age range from 31-78 (mean 50.5 +/- SD11.7). All the 1ry tumors were detected with mean SUVmax 10.8(+/-SD 7.9). The mean /median SUVmax values of 1ry tumor was higher in premenopausal, stage III& IV, Estrogen Receptors negative(ER-), Progesteron Receptors negative(PR-), Her2neu positive patients, high nuclear grade (GIII), in triple negative molecular subgroup (TN), positive axillary nodal (ALNs)metastases, and (P value = 0.003, 0.017, 0.113, 0.089 0.01,0.002, 0.007 & 0.016 respectively). The mean/median TLR values was higher in premenopausal and Her2neu positive, GIII, TN molecular subtype patients, stage III& IV and in patients with positive ALNs, ER- &PR - patients (P value = 0.002, 0.0476, 0.005, 0.018, 0.039 and 0.022, 0.095 & 0.129 respectively). SUVmax of the 1ry lesion and TLR were moderately negatively correlated with the age of the patients (P value = 0.005 and 0.008 respectively), also they were moderately positively correlated with the size of the1ry tumor (P value = 0.019 and 0.036 respectively).

Conclusion:

The SUVmax of the 1ry tumor and TLR values had similar significant associations with different prognostic factors in BC
Comparative Study Evaluating Cognitive Functions in Patients Receiving Conventional Whole Brain Radiotherapy vs Hippocampal Avoidance Whole Brain Radiotherapy
Authors: Ramadan Islam , El-Assal Shaaban , Farouk Mohamed , El-zawawy Sherif , El-Deeb Hany
Published: May 2021

Background:

Whole brain radiotherapy is the treatment of choice for patients with brain metastases. However, neurocognitive functions decline due to impaired hippocampal neurogenesis might occur thereafter. It is hypothesized that conformal hippocampal avoidance during the course of WBRT might provide meaningful neurocognitive functions preservation. Our study aims to demonstrate the impact of delivering HA‑WBRT on NCF changes in patients receiving WBRT.

Methods:

fifty patients who were referred for cranial irradiation were enrolled in the study. Before the HA‑WBRT course and randomly assigned to two equal groups, the first group will receive conventional whole brain palliative radiotherapy and the second group will receive hippocampal sparing whole brain radiotherapy, assigned to 30 Gy over 10 fractions over two weeks, all participants should receive baseline neurocognitive assessment, including memory, executive functions, and psychomotor speed,the primary endpoint was delayed recall, as determined by the change/decline in Hopkins Verbal Learning Test (HVLT-R) and The One Card Learning Test (OCLT) from the baseline assessment to 4 months after the start of HA‑WBRT.

Results:

Regarding neurocognitive outcomes, no statistically significant differences were found between various NCF scores obtained at baseline and at post‑radiotherapy intervals, in immediate verbal memory and non‑verbal memory, except for delayed recall memory on HVLT-R Hopkins Verbal Learning Test -Revised for delayed recall Learning, p =0.008.

Conclusions:

Functional preservation by hippocampal sparing during WBRT could largely be achieved in this study, which also suggests that HA‑WBRT should be a feasible technique preserving neurocognitive functions while maintaining intracranial control.
Prognostic role of standard uptake value according to pathologic features of lung adenocarcinoma
Authors: Bertoglio Pietro , Ventura Luigi , Aprile Vittorio , Cattoni Maria Angela , Nachira Dania , Lococo Filippo , Rodriguez Perez Maria , Guerrera Francesco , Minervini Fabrizio , Gnetti Letizia , Bacchin Diana , Franzi Francesca , Querzoli Giulia , Rindi Guido , Bellafiore Salvatore , Femia Federico , Viti Andrea , Kestenholz Peter , Ruffini Enrico , Paci Massimiliano , Margaritora Stefano , Imperatori Andrea Selenito , Lucchi Marco , Carbognani Paolo , Terzi Alberto Claudio
Published: May 2021

Objective:

To evaluate the influence of lung adenocarcinoma second predominant pattern on the maximal standard uptake value (SUVmax) and its prognostic effect in different histologic groups.

Methods:

We retrospectively collected surgically resected pathologic stage I and II lung adenocarcinoma from nine European institutions. Only patients who underwent preoperative PET-CT and with available information regarding SUVmax of T (SUVmaxT) and N1 (SUVmaxN1) component were included.

Results:

We enrolled 344 patients with lung adenocarcinoma. SUVmaxT did not show any significant relation according to the second predominant pattern ( p = 0.139); this relationship remained nonsignificant in patients with similar predominant pattern. SUVmaxT influenced the disease-free survival in the whole cohort ( p = 0.002) and in low- and intermediate-grade predominant pattern groups ( p = 0.040 and p = 0.008, respectively). In the high-grade predominant pattern cohort and in the pathologic N1 cases, SUVmaxT lost its prognostic power. SUVmaxN1 did not show any significant correlation with predominant and second predominant patterns and did not have any prognostic impact on DFS.

Conclusions:

SUVmaxT is influenced only by the adenocarcinoma predominant pattern, but not by second predominant pattern. Concurrently, in high-grade predominant pattern and pN1 group the prognostic power of SUVmaxT becomes nonsignificant.
Adult attachment, stress-coping, and resilience in first-generation immigrants in the United States
Authors: Fang Chiao-Ju , Tong Nenette , Villa Rosely J , Flores Ana M , Lim Elaine , Tu Alexandria
Published: May 2021

Introduction

Previous studies have shown correlations between adult attachment, stress-coping, and resilience, but little is known about how attachment and stress-coping affect resilience, particularly among first-generation immigrants. This study explored relationships among adult attachment, stress-coping, and resilience for first-generation immigrants.

Method

A quantitative cross-sectional design was used to assess associations between adult attachment and stress-coping with resilience among first-generation immigrants. Thirty-five participants answered an online Qualtrics survey. A simple linear regression analysis was conducted to analyze the results.

Results

The results indicated statistically significant correlations between avoidance scores and annual household income but not between resilience and education, resilience and income, and stress-coping scores and education and income. Positive reinterpretation growth was positively correlated with resilience, while denial and behavioral disengagement were negatively correlated. Adult attachment and number of years in the United States were not significantly statistically related to resilience.

Conclusion

The findings indicate high income may be associated with attachment avoidance, and increases in positive coping strategies and decreases in negative coping strategies are associated with resilience among first-generation immigrants. Understanding influences on first-generation immigrants to engage in stress-coping skills may inform the development and implementation of occupational therapy, including programs and interventions for successful client-centered outcomes.
Risk to Bicyclists in a Separated Path from Left Turns across Multiple Lanes: A Case for Protected-Only Left Turns
Authors: Saeidi Razavi Ray , Furth Peter G.
Published: May 2021

At signalized intersections, permitted left turns (i.e., on a green ball, after yielding) across multiple through lanes and across a separated bike lane or bike path present a threat to bicyclist safety. A conflict study of two such intersections with a bidirectional bike path found that when cyclists cross while a vehicle is ready to turn left and there is no opposing through traffic to block it, the chance of the left-turning motorist yielding safely was only 9%, and the chance of their yielding at all—including yielding only after beginning the turn, then stopping in the opposing through lanes—was still only 37%. Motorist non-yielding rates were worse toward bikes arriving during green, toward bikes approaching from the opposite direction (i.e., riding on the right side of the road), and toward bikes facing a queue with multiple left turning vehicles. Of 112 cyclists who arrived on green when there was at least one left-turning car, but no opposing through traffic blocking it, 73 had to slow or stop to avoid a collision. Although these conflicts could be essentially eliminated using protected-only left turn phasing (turn on green arrow), common existing criteria prefer permitted left turns to reduce vehicular delay. A case study shows how, by considering multiple signalization alternatives, it can be possible to convert left turns to protected-only phasing without imposing a substantial delay burden on vehicles or other road users.
Application of a Tax to E-Commerce Deliveries in Barcelona
Authors: Majoral Genís , Gasparín Francesc , Saurí Sergi
Published: May 2021

The number of e-commerce transactions is increasing worldwide. Deliveries of goods purchased online generate externalities throughout the whole supply chain and, particularly, the increasing concern about the last-mile distribution of goods. The escalating presence of vans in cities contributes to poor air quality, climate change, noise, and congestion. So far, the majority of solutions to address this issue are based on the supply side, such as electric vans, optimizing the routing and pick-up-points, and so forth. Even in other transport sectors, pricing solutions are well known, yet they have not been extended to e-commerce delivery. This paper aims to propose an environmental tax falling on the demand side and equaling the externalities from this activity. The analysis has been particularized for the case of Barcelona. A cost–benefit analysis to assess the impact of such a tax has been carried out. When revenue collection is reinvested in the logistics sector, and for subsidizing electric distribution vehicles, the results indicate that the levying of the tax can generate positive outcomes.
Incorporating Flood Hazards into Pavement Sustainability Assessment
Authors: Achebe Jessica , Oyediji Oluremi , Saari Rebecca K. , Tighe Susan , Nasir Filzah
Published: May 2021

The functional and structural performance of pavement infrastructures are at risk from climate change impacts. However, past sustainability assessment studies do not consider how the performance of infrastructure will be affected by a changing climate. The goal of this research is to investigate the impacts of flooding in a unified assessment of the resilience and sustainability of pavement. A case study of concrete pavement was evaluated for scenarios with and without flooding. The AASHTOWare Pavement ME design program was used to simulate the structural performance of typical jointed plain concrete pavement (JPCP) designs for collector roads in Canada. Predicted performance was used in the resilience and sustainability assessment under scenarios with and without flooding. The damage ratio and cost of damage were assessed to quantify the resilience of concrete pavement to floods. Life cycle costs and environmental impacts were compared across a climate change scenario with consideration of maintenance and rehabilitation activities. Results reveal that a typical Ontario JPCP design with structural slab thickness < 200 mm is less resilient than the Manitoba design for collector roads, but the 25 mm slab thickness difference in Manitoba design can lead to 50% change in damage ratio and damage cost. When estimating the social cost associated with greenhouse gas and air pollutant emissions, the additional environmental impact resulting from flooding for the Ontario road is almost seven times that of the Manitoba road. However, the life cycle economic cost and environmental impact do not yield an overall benefit with increased slab thickness.
Household Evacuation Planning and Preparation for Future Hurricanes: Role of Utility Service Disruptions
Authors: Halim Nafisa , Jiang Fan , Khan Mohammad , Meng Sisi , Mozumder Pallab
Published: May 2021

We analyzed data from a survey administered to 1,212 respondents living in superstorm Hurricane Sandy-affected areas. We estimated the effect of having experienced hurricane-induced disruptions to utility services, such as electricity, water, gas, phone service, and public transportation, on having an evacuation plan. Around 39% of respondents reported having an evacuation plan in case a hurricane affects their neighborhood this year. Respondents who had experienced disruptions to electricity supply had an approximately 11 percentage-point higher likelihood of having an evacuation plan than those who had experienced no such disruptions. Respondents who had experienced monetary losses from Hurricane Sandy had around a five percentage-point higher likelihood of having an evacuation plan compared with those who had not. Among control variables, prior evacuation, distance to the coastline, residence in a flood zone, concern about the impacts of future natural disaster events, had window protection, and household members being disabled, each had an association with residents’ future evacuation planning and hurricane preparedness. In light of these findings, we discuss the policy implications of our findings for improving disaster management in hurricane-prone areas.
Capacitated Location-Allocation-Routing Problem with Time Windows for On-Demand Urban Air Taxi Operation
Authors: Ale-Ahmad Haleh , Mahmassani Hani S.
Published: May 2021

Urban air taxi (UAT) operation has gained traction with the advancements in distributed electric propulsion and the emergence of electric vertical take-off and landing aircraft. Start-up companies and aircraft manufacturers are pursuing the possibility of operating UAT at scale in urban and suburban areas and at an affordable price. However, considerable uncertainties remain about several strategic, tactical, and operational aspects that affect UAT adoption. We envision a mature state of UAT operation in which the UAT operator offers door-to-door, multimodal, on-demand, and per-seat service. We propose the concept of flexible meeting points for UAT operation where passengers are flexible about the location of the UAT pads for boarding and deboarding, and could therefore be pooled together to share an aircraft. Consequently, we model UAT fleet operation as a capacitated location-allocation-routing problem with time windows and present a mixed integer programming formulation. The formulation addresses decisions on request acceptance and rejection, allocation of requests to flights, and aircraft routing and scheduling. Additionally, it allows for consolidating the demand to increase the aircraft’s utilization and service rate. The numerical results indicate that the demand consolidation scheme could significantly decrease the number of rejected requests and the aerial mileage. Depending on the operator’s business model, the proposed formulation could be used offline in a static and deterministic setting when all requests are known in advance, or it could be employed online by sequentially solving the static and deterministic snapshot problems with no knowledge about future requests.
Radiographic and Clinical Outcomes After Tibial Tubercle Osteotomy for the Treatment of Patella Alta: A Systematic Review and Meta-analysis
Authors: Knapik Derrick M. , Kunze Kyle N. , Azua Eric , Vadhera Amar , Yanke Adam B. , Chahla Jorge
Published: May 2021

Background:

Patella alta is a known risk factor for patellar instability and, in the setting of recurrent patellar instability with significant patella alta, correction of patellar height with a tibial tubercle osteotomy (TTO) may help decrease the failure of soft tissue–based stabilization.

Purpose:

To perform a systematic review and meta-analysis of radiographic and clinical outcomes after TTO for patella alta.

Study Design:

Systematic review and meta-analysis; Level of evidence, 4.

Methods:

PubMed, OVID/Medline, and Cochrane databases were queried in June 2020 for studies reporting outcomes of TTO for patella alta. Data pertaining to study characteristics and design, radiographic and clinical outcome values, and incidence of complications and reoperations were extracted. DerSimonian-Laird continuous and binary random-effects models were constructed to (1) perform subgroup-based analysis of mean changes in radiographic indices after TTO and (2) quantify the pooled incidence of complications and reoperations.

Results:

Eight studies including 340 patients (420 knees) with a mean age of 24.7 ± 8.4 years were included. The mean follow-up was 53.1 months (range, 3-120 months), with 1 study reporting a mean follow-up of less than 2 years. The pooled mean anterior transfer was 5.6 mm; the mean medial transfer was 8.7 ± 1.3 mm; and the pooled mean distalization of the tibial tubercle was 12.2 ± 4.5 mm. Continuous random-effects meta-analysis determined that significant reductions in the mean Insall-Salvati ratio (1.40 vs 0.98, P < .001), Caton-Deschamps index (1.26 vs 0.97, P < .001), and tibial tubercle to trochlear groove ratio (18.27 vs 10.69, P < .001) were observed after TTO. The overall incidence of complications was 7.6% (95% CI, 4.8%-10.5%), while the overall incidence of reoperations was 14.3% (95% CI 6.2%-22.4%).

Conclusion:

TTO for patellar instability in the setting of patella alta results in a significant decrease in patellar height with varying degrees of medialization depending on the utilized technique. A mean postoperative complication rate of 7.6% was reported with a reoperation incidence of 14.3%, related primarily to hardware removal.
Altered Knee Laxity and Stiffness in Response to a Soccer Match Simulation in Players Returning to Sport Within 12 Months After Anterior Cruciate Ligament Reconstruction
Authors: Nuccio Stefano , Labanca Luciana , Rocchi Jacopo Emanuele , Mariani Pier Paolo , Sbriccoli Paola , Macaluso Andrea
Published: May 2021

Background:

The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR).

Purpose/Hypothesis:

The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise.

Study Design:

Controlled laboratory study.

Methods:

A total of 13 soccer players cleared to return to sport after ACLR and 13 healthy control soccer players matched for age, physical activity level, limb dominance, and anthropometric characteristics were recruited. To assess the effects of a standardized soccer match simulation (Soccer Aerobic Field Test [SAFT45]) on AKL and AKS, an arthrometric evaluation was carried out bilaterally before and immediately after SAFT45. To conduct a comprehensive examination of the force-displacement curve, the absolute and side-to-side difference (SSD) values of both AKL and AKS were extracted at 67, 134, and 200 N.

Results:

The ACLR and control groups showed similar AKL and AKS at baseline ( P > .05). In response to SAFT45, laxity increased bilaterally at all force levels by 14% to 17% only in the control group ( P < .025). Similarly, AKS at 134 and 200 N decreased in response to SAFT45 only in the control group (10.5% and 20.5%, respectively; P < .025). After SAFT45, the ACLR group had 1.9 and 2.5 times higher SSDs of AKS at 67 and 134 N compared with the control group, respectively ( P < .025), as well as a 1.9 times higher SSD of AKS at 134 N compared with baseline ( P = .014).

Conclusion:

Soccer players at the time of return to sport after ACLR showed an altered mechanical response to a sport-specific match simulation consisting of bilaterally unchanged AKL and AKS.

Clinical Relevance:

Soccer players showing altered AKL and AKS in response to exercise after ACLR may not be ready to sustain their preinjury levels of sport, thus potentially increasing the risk of second ACL injuries.
Nasal Chondrocyte–Based Engineered Grafts for the Repair of Articular Cartilage “Kissing” Lesions: A Pilot Large-Animal Study
Authors: Šećerović Amra , Pušić Maja , Kostešić Petar , Vučković Mirta , Vukojević Rudolf , Škokić Siniša , Sasi Biljana , Vukasović Barišić Andreja , Hudetz Damir , Vnuk Dražen , Matičić Dražen , Urlić Inga , Mumme Marcus , Martin Ivan , Ivković Alan
Published: May 2021

Background:

Bipolar or “kissing” cartilage lesions formed on 2 opposite articular surfaces of the knee joint are commonly listed as exclusion criteria for advanced cartilage therapies.

Purpose:

To test, in a pilot large-animal study, whether autologous nasal chondrocyte (NC)–based tissue engineering, recently introduced for the treatment of focal cartilage injuries, could provide a solution for challenging kissing lesions.

Study Design:

Controlled laboratory study.

Methods:

Osteochondral kissing lesions were freshly introduced into the knee joints of 26 sheep and covered with NC-based grafts with a low or high hyaline-like extracellular matrix; a control group was treated with a cell-free scaffold collagen membrane (SCA). The cartilage repair site was assessed at 6 weeks and 6 months after implantation by histology, immunohistochemistry, and magnetic resonance imaging evaluation.

Results:

NC-based grafts, independently of their composition, induced partial hyaline cartilage repair with stable integrity in surrounding healthy tissue at 6 months after treatment. The SCA repaired cartilage to a similar degree to that of NC-based grafts.

Conclusion:

Kissing lesion repair, as evidenced in this sheep study, demonstrated the feasibility of the treatment of complex cartilage injuries with advanced biological methods. However, the potential advantages of an NC-based approach over a cell-free approach warrant further investigations in a more relevant preclinical model.

Clinical Relevance:

NC-based grafts currently undergoing phase II clinical trials have a high potential to replace existing cartilage therapies that show significant limitations in the quality and reproducibility of the repair method. We have brought this innovative concept to the next level by addressing a new clinical indication.
Digital Pathways to Wellness Among Youth in Residential Treatment: An Exploratory Qualitative Study
Authors: Good Bethany D.
Published: May 2021

Digital media use is central for youth as a means to facilitate identity development, social connection, and vocational competence. Emerging literature suggests that the influence of digital media use is more nuanced than the contemporary risk/benefit discourse, particularly for youth who experience social and emotional vulnerability. This youth-centered, developmentally informed study attends to the gap in literature addressing the digital media use experiences among youth in residential treatment (RT). McCracken’s Long Interview Method was utilized to conduct and analyze in-depth interviews with youth ( n = 15) aged 13 to 18 in RT. The analysis involved movement from particular to general coding, applying categorical observations, and thematic comparison of transcripts. Consistent with existing literature on other youth populations, participants reported that digital media use had both beneficial and problematic implications for their well-being. Internet access decreased experiences of isolation and stigma and increased capacity to contend with marginalized identities (e.g., disability, Lesbian, Gay, Bisexual, Transgendered, Queer, Two Spirited Plus [LGBTQ2S+], child welfare guardianship). They reported that following an initial digital disconnect and stabilization, digital media use facilitated pathways toward agency, leadership, and community engagement (e.g., LGBTQ2S+ community, recovery blogs, animal advocacy). The findings suggest that supporting youth in RT to identify their online opportunities and needs can encourage individual growth, wellness, and participation in social change.
PedsQL Multiple Sclerosis Module Domain and Item Development: Qualitative Methods
Authors: Gaudioso Cristina , Oo Samuel , Mar Soe , Hendricks-Ferguson Verna L. , Newland Pamela , Varni James W.
Published: May 2021

Background:

The objective of this qualitative methods study was to develop the domains and items to support the content validity for the Pediatric Quality of Life Inventory (PedsQL) Multiple Sclerosis Module for youth with pediatric-onset multiple sclerosis.

Methods:

A literature review of multiple sclerosis–specific questionnaires and clinical research was conducted to generate domains. An expert panel composed of 12 neurologists who were pediatric-onset multiple sclerosis specialists provided feedback on the conceptual framework. Focus interviews with 9 youth with pediatric-onset multiple sclerosis and 6 parents were conducted to develop the relevant domains and item content from the patient and parent perspective. In the cognitive interviews phase, 9 youth with pediatric-onset multiple sclerosis and 6 parents provided feedback on item content, relevance, importance, and understandability of the pediatric-onset multiple sclerosis–specific domains and items. The final interview phase with 5 youth with pediatric-onset multiple sclerosis and 5 parents comprised a pilot testing of the new PedsQL MS Module.

Results:

Eighteen domains were derived from the qualitative methods with item content saturation achieved at 100 items based on 40 interviews with 23 youth with pediatric-onset multiple sclerosis aged 10-21 years and 17 parents. The domains derived include general fatigue, sleep/rest fatigue, cognitive functioning, tingling sensations, numbness sensations, physical weakness, pain, speech, balance, fine motor, vision, urination, constipation, bowel incontinence, worry, communication, treatment, and medicines.

Conclusions:

Qualitative methods involving 23 youth with pediatric-onset multiple sclerosis and 17 parents in the domain and item development process support the content validity for the new PedsQL MS Module. Future plans include a national field test of the PedsQL MS Module scales and items.
Defining Public Interest in Planning: A Review
Authors: Dadashpoor Hashem , Sheydayi Ailin
Published: May 2021

Public interest as the main content and purpose of planning is a fuzzy concept in planning literature. The body of literature on the public interest is so complex and diverse that makes it difficult to define and use the concept. In this study, the various definitions are categorized to achieve a framework of the definition of public interest. In addition to being more comprehensive than previous studies, this categorization identifies the main dimensions of a comprehensive definition of public interest. It provides a suitable context for theorists and professionals to have a clear framework for defining the public interest.
Trauma Exposure and Mental Health Needs Among Adolescents Involved With the Juvenile Justice System
Authors: Duron Jacquelynn F. , Williams-Butler Abigail , Mattson Patti , Boxer Paul
Published: May 2021

Justice-involved adolescents typically report high levels of lifetime trauma exposure, although research on juvenile justice system-wide screenings is limited. Further, there is little evidence from research on the psychological and substance abuse treatment related needs of youth relative to the trauma levels or types of trauma experienced by justice-involved adolescents. We documented lifetime exposure to traumatic events and its relation to psychological and substance use concerns in a sample of adolescents admitted to custody in the New Jersey Juvenile Justice Commission. This study examined lifetime exposure to traumatic events experienced by justice-involved adolescents (N = 627) using negative binomial regression modeling and zero-inflated negative binomial regression modeling to identify which adolescents have the greatest trauma exposure, and determine how cumulative types of trauma relate to youths’ mental health and substance use needs. Adolescents reported experiencing an average of 4 of 17 traumatic exposures on the Life Events Checklist. The most common traumas experienced directly and indirectly were physical assault and assault with a weapon. Considering particular traumas, there were differences in exposures based on race and ethnicity, sex, child welfare involvement, and gang affiliation. Higher levels of some types of traumatic exposure were consistently related to higher levels of mental health needs. Results indicate that adolescents enter the juvenile justice system with high levels of polytraumatization. These adverse events are associated with elevated mental health and substance use needs that should be considered in case planning.
Five paths to personality coherence: Integrative implications of the Knowledge-and-Appraisal Personality Architecture
Authors: Cervone Daniel
Published: May 2021

The study of personality coherence can be grounded in an analysis of personality architecture, that is, the overall structure and dynamics of intra-individual personality systems. A personality architecture can identify, and organize the study of, interrelated phenomena that each are instances of personality coherence. It thereby can provide an integrative framework for understanding relations among distinct lines of research. This thesis is advanced by drawing on the Knowledge-and-Appraisal Personality Architecture, or KAPA model. KAPA model principles distinguish among three classes of social-cognitive knowledge structures: beliefs, goals, and evaluative standards. These distinctions, in turn, provide a foundation for understanding five aspects of personality coherence: 1) Belief-Based Coherence, 2) Goal-Based Coherence, 3) Evaluative Standards-Based Coherence, 4) Intra-Psychic Coherence (that is, coherent functional interrelations among personality systems), and 5) Phenomenological Coherence. Research documenting each of these five paths to personality coherence is reviewed. The paper also reviews the strengths and limitations of 20th-century social-cognitive formulations that provide key foundations for the KAPA model.
Preserved Extra-Foveal Processing of Object Semantics in Alzheimer’s Disease
Authors: Cimminella Francesco , D’Innocenzo Giorgia , Sala Sergio Della , Iavarone Alessandro , Musella Caterina , Coco Moreno I.
Published: May 2021

Alzheimer’s disease (AD) patients underperform on a range of tasks requiring semantic processing, but it is unclear whether this impairment is due to a generalised loss of semantic knowledge or to issues in accessing and selecting such information from memory. The objective of this eye-tracking visual search study was to determine whether semantic expectancy mechanisms known to support object recognition in healthy adults are preserved in AD patients. Furthermore, as AD patients are often reported to be impaired in accessing information in extra-foveal vision, we investigated whether that was also the case in our study. Twenty AD patients and 20 age-matched controls searched for a target object among an array of distractors presented extra-foveally. The distractors were either semantically related or unrelated to the target (e.g., a car in an array with other vehicles or kitchen items). Results showed that semantically related objects were detected with more difficulty than semantically unrelated objects by both groups, but more markedly by the AD group. Participants looked earlier and for longer at the critical objects when these were semantically unrelated to the distractors. Our findings show that AD patients can process the semantics of objects and access it in extra-foveal vision. This suggests that their impairments in semantic processing may reflect difficulties in accessing semantic information rather than a generalised loss of semantic memory.
Use of the 33-Item Hypomania Checklist (HCL-33) to Distinguish Bipolar Disorder From Major Depressive Disorder in Older Adults
Authors: Zhang Xinqiao , Li Wen , Zhao Na , Cheung Teris , Ungvari Gabor S. , Wang Gang , Xiang Yu-Tao , Angst Jules
Published: May 2021

Background:

Bipolar disorder (BD) is often misdiagnosed as major depressive disorder (MDD) in older patients. This study examined the psychometric properties of the 33-item Hypomania Checklist (HCL-33) and its accuracy to differentiate BD from MDD among older adults.

Method:

A total of 215 depressed older patients were recruited; 107 were diagnosed with BD (71 with BD-type I and 36 with BD-type II) and 108 with MDD. Principal components analysis (PCA) was used to explore the factor structure of the HCL-33. Cronbach’s alpha was calculated to test the internal consistency. Intra-class correlation coefficient (ICC) was used to measure test-retest reliability. The receiver operating characteristic (ROC) analysis was used to generate the optimal cut-off value to differentiate between BD and MDD.

Results:

Two factors were identified in the PCA analysis accounting for 33.9% of the total variance. The Cronbach’s alpha value for the HCL-33 was 0.912, with 0.922 for factor I and 0.664 for factor II. The test-retest reliability was excellent (ICC: 0.891). The optimal cut-off of the HCL-33 total score for discriminating between MDD and BD was 14, with a sensitivity of 88.8% and specificity of 82.4%.

Conclusion:

The HCL-33 had satisfactory reliability and validity and could be used to distinguish BD from MDD in older adults.
Women in higher education: A brief report on stress during COVID-19
Authors: Johnson Dimple S , Johnson Aaron D , Crossney Kristen B , Devereux Emily
Published: May 2021

Higher education institutions have evolved into a more stressful environment. Women have been experiencing higher levels of stress than their male counterparts. With higher education adopting to the onset of the pandemic, this brief report studied women’s perceived stress in relation to perceived organizational and supervisory support, and age during times of crisis. In an era of social distancing, quarantines, and lockdowns, the findings suggest that women’s perceived stress is negatively related to age, perceived organizational support, and perceived supervisory support. Society as we once knew it pre-pandemic will never be the same. Higher education is inevitably going to have to manage the aftermath, a new normal that can only be as effective as the employees that help keep the organization running.
Enhancement of the tensile shear strength for joining low-ductility aluminium to high-strength steel by using electrically-assisted mechanical clinching (EAMC)
Authors: Barimani-Varandi Abozar , Jalali Aghchai Abdolhossein
Published: May 2021

The present work studied the enhancement of the tensile shear strength for joining AA6061-T6 aluminium to galvanized DP590 steel via electrically-assisted mechanical clinching (EAMC) using an integrated 2D FE model. To defeat the difficulties of joining low-ductility aluminium alloy to high-strength steel, the electroplastic effect obtained from the electrically-assisted process was applied to enhance the clinch-ability. For this purpose, the results of experiments performed by the chamfering punches with and without electrically-assisted pre-heating were compared. Joint cross-section, failure load, failure mode, fracture displacement, material flow, and failure mechanism were assessed in order to study the failure behaviour. The results showed that the joints clinched at the EAMC condition failed with the dominant dimpled mechanism observed on the fracture surface of AA6061 side, achieved from the athermal effect of the electroplasticity. Besides, these joints were strengthened 32% with a much more fracture displacement around 20% compared with non-electrically-assisted pre-heating.
Mechanism of crack evolution in nano-indentation of single crystal silicon by atomistic simulations and theoretical analysis
Authors: Zhou Yuqi , Dai Houfu , Li Ping
Published: May 2021

The molecular dynamics (MD) model of nano-indentation process was established to study the crack evolution in single crystal during nano-indentation. Two workpieces with different cracks and one workpiece with no crack were selected for indentation simulation in this study. The parameters of atom displacement, coordination number (CN), temperature, potential energy and loading force in the indentation process are analyzed in detail. Cracks were found to close during nano-indentation. Two modes of crack closure are observed: cooperative displacement and indentation failure. The existence of cracks will affect the size of transformation zone and the coordination number of atoms after indentation. Besides, the existence of cracks will reduce the increase of temperature and potential energy, and the closing mode of cracks is found to affect the value of indentation load. In addition, the change of stress with indentation depth at crack tip is calculated by theoretical model. The calculated stress curves reveal the evolution trend of cracks during indentation. These results provide guidance for the production of silicon wafer with higher surface quality.
Evaluation and application of advanced CFD models for rotating disc flows
Authors: Gao Feng , Chew John W
Published: May 2021

This paper addresses limitations of widely used Reynolds-averaged turbulence models (RANS) for prediction of gas turbine internal air systems. Results from direct numerical simulation (DNS), wall-resolved large-eddy simulation (LES), wall-modelled large-eddy simulation (WMLES), and RANS for benchmark test cases are compared. For rotor-stator disc cavity flows results for mean velocities, velocity fluctuations, rotor torque and laminar-turbulent transition are considered and compared with published data. For cavities between co-rotating discs attention is focused on buoyancy-driven convection in the centrifugal force field. It is concluded that WMLES is suitable for application in engine conditions, offering better accuracy than RANS in some critical applications. This confirms recently published results for turbine rim sealing and is further illustrated by application to convection in a sealed cavity at higher Rayleigh number than is practical with DNS or wall-resolved LES. The results show that the approximate near-wall treatment gives reasonable results for complex flows and extend previous studies to higher speed rig conditions where Eckert number effects become significant.
Investigation of the different particle size dust releases from rigid filter candles during pulse-jet cleaning
Authors: Luan Xin , Ji Zhongli , Liu Longfei , Wang Ruifeng
Published: May 2021

Rigid filters made of ceramic or metal are widely used to remove solid particles from hot gases at temperature above 260 °C in the petrochemical and coal industries. Pulse-jet cleaning of fine dust from rigid filter candles plays a critical role in the long-term operation of these filters. In this study, an experimental apparatus was fabricated to investigate the behavior of a 2050 mm filter candle, which included monitoring the variation of pressure dynamic characteristics over time and observing the release of dust layers that allowed an analysis of the cleaning performance of ISO 12103-1 test dusts with different particle size distributions. These results showed the release behavior of these dusts could be divided into five stages: radial expansion, axial crack, flaky release, irregular disruption and secondary deposition. The cleaning performance of smaller sized dust particles was less efficient as compared with larger sized dust particles under the same operating conditions primarily because large, flaky-shaped dust aggregates formed during the first three stages were easily broken into smaller, dispersed fragments during irregular disruption that forced more particles back to the filter surface during secondary deposition. Also, a “low-pressure and long-pulse width” cleaning method improved the cleaning efficiency of the A1 ultrafine test dust from 81.4% to 95.9%.