bluuebunny/crossref_metadata_2025 huggingface dataset:
Robustness evaluation for rolling gaits of a six-strut tensegrity robot
Authors: Zheng Yanfeng , Li Yi , Lu Yipeng , Wang Meijia , Xu Xian , Zhou Chunlin , Luo Yaozhi
Published: February 2021

Locomotive robots based on tensegrities have recently drawn much attention from various communities. A common strategy to realize long-distance locomotion is combining several basic gaits that are designed in advance. Considering the unavoidable uncertainties of the environment and the real locomotive system, selecting the gaits with high robustness is essential to the implementation of long-distance locomotion of tensegrity robots. However, no quantitative approach for robustness evaluation of rolling gaits is reported in recent research work. In this study, a practical and quantitative method is proposed for the robustness evaluation of rolling gaits of tensegrity robots. A mathematical model is built to describe the evaluation process, and the success rate of rolling is adopted as an indicator of robustness. Sensitivity analysis and robust evaluation are conducted on the rolling gaits of a typical six-strut tensegrity robot. Specifically, the sensitivities of the rolling gaits to five uncertain parameters (i.e. tendon stiffness, initial tendon prestress, the equivalent mass of nodes, actuation lengths of actuators, and slope of ground) are investigated and discussed in detail, and the robustness of the rolling gaits is evaluated by correlated random sampling. Experiments on a physical prototype of the six-strut tensegrity robot are carried out to verify the proposed concept and method.
Self-management of vocational skills for people with significant intellectual disabilities: A systematic review
Authors: Barczak Mary A , Cannella-Malone Helen I
Published: February 2021

Access to employment opportunities is associated with increased quality of life for people with intellectual and developmental disabilities; however, many adults with intellectual and developmental disabilities struggle to find employment. One reason they may have difficulty achieving employment is an inability to work independently. Self-management interventions have been used to promote independence in the workplace for people with intellectual and developmental disabilities by involving them in changing their own behavior. In this literature review, we identified 47 peer-reviewed, single-case design studies in which researchers investigated the use of self-management interventions as an intervention component to improve the vocational skills for people with intellectual and developmental disabilities. Visual analysis of the data indicated that most participants were successful at improving skills related to on-task behavior, task completion, independent transitions, and self-initiations. Potential directions for future research and implications for practice are discussed.
Synthesis and electrochemical performance of an electroactive nitrogen-doping SnO2 nanoarray supported on carbon fiber
Authors: Xie Yibing
Published: February 2021

An electroactive nitrogen-doping tin dioxide nanorod array (N-SnO2 NRA) is designed as an effective energy-storage electrode material for supercapacitor applications. N-SnO2 supported on a carbon fiber substrate is prepared using SnCl4 as a precursor through hydrolysis, hydrothermal growth, and an NH3-nitriding process. Electroactive N-SnO2 is formed by an N-doping reaction between Sn(OH)4 and NH3, revealing a high nitrogen-doping level of 12.5% in N-SnO2. N-SnO2/carbon fiber reveals a lower ohmic resistance and charge transfer resistance than SnO2/carbon fiber, which is consistent with its higher current response and lower voltage drop in electrochemical measurements. N-SnO2 NRA has an independent nanoarray structure and a small side length of a quadrangular nanorod, contributing to a more accessible interspace, reactive sites, and feasible electrolyte ion diffusion. The N-SnO2/carbon fiber NRA electrode shows higher specific capacitance (105.4 F g−1 at 0.5 A g−1) and rate capacitance retention (45.0% from 0.5 to 5 A g−1) than a SnO2/carbon fiber NRA electrode (58.6 F g−1, 38.4%). Significantly, the cycling capacitance retention after 2000 cycles increases from 78.1% of SnO2/carbon fiber to 98.8% of N-SnO2/carbon fiber, presenting a superior electrochemical cycling stability. The N-SnO2 supercapacitor maintains stable power working at an output voltage of 1.6 V. The specific capacitance decreases from 75.2 to 55.1 F g−1 when the current density increases from 1 to 10 A g−1. The corresponding energy density decreases from 24.23 to 9.81 Wh kg−1, presenting a reasonable rate capability. So, the prepared N-SnO2 nanorod array demonstrates superior capacitance performance for energy-storage applications.
Changing practice to increase rates of spinal anaesthesia for total joint replacement
Authors: Eklund Susan E , Vodonos Alina , Ryan-Barnett Sheila M
Published: February 2021

Background

Neuraxial anaesthesia for lower extremity total joint replacement surgery has several advantages over general anaesthesia; however, we encountered resistance to routine use of spinal anaesthesia and standardised analgesic regimens at our large, tertiary hospital. Our Perioperative Surgical Home led to multidisciplinary education and enhanced communication to change practice, with the purpose of increasing rates of neuraxial anaesthetics for these surgeries.

Methods

Team members from anaesthesia, nursing and surgery participated in the development and adoption of the care pathway. After implementation, we performed a retrospective analysis to examine the impact of the pathway on primary anaesthetic choice. Data were analysed using Student’s t-test and interrupted time series analysis.

Results

The rate of neuraxial anaesthetics increased following implementation of the total joint pathway.

Conclusion

With multidisciplinary collaboration, we were able to change practice towards spinal anaesthesia, despite a large and diverse group of practitioners.
Born translated memories: Transcultural memorial forms, domestication and foreignisation
Authors: Laanes Eneken
Published: February 2021

This article offers translation as a new model for conceptualising the transnational travel of memories that operates through transcultural memorial forms. It draws on translation studies, world literature studies and receptions studies to describe the domesticating and foreignising effects of memories that are ‘born translated’ and the ways they are received. The second part of the article discusses Sofi Oksanen’s novel Purge as a translation of memories of Soviet state terror through the transcultural memorial form of war rape and its foreignising effects in the local context of remembering of these events.
Entangled memories of violence: Jean Améry and Frantz Fanon
Authors: Fareld Victoria
Published: February 2021

In this article I discuss the entangled memories of the Holocaust and the anticolonial struggles in Western Europe in the 1960s by relating the writings of Jean Améry and Frantz Fanon. My aim is to show how Améry’s retrospective narrative of his lived experience in the Nazi camp was formed by his reading of Fanon’s experiences of colonialism, and how Fanon’s narrative of the colonial trauma was transposed and translated into Améry’s public testimony as a Holocaust survivor. The article argues that Améry’s individual memories found a certain mediated cultural form and narrative frame in the contemporaneous situation of decolonisation. The multilayered weave of fascist and colonial violence constituting Améry’s testimony highlights questions of memory’s multidirectionality and casts new light on how cultural memorial forms are shaped and shared.
Influence of the socio-economic environment on the entrepreneurs behavior. Cases of cuba and ecuador
Authors: Pérez-Campdesuñer Reyner , García-Vidal Gelmar , Sánchez-Rodríguez Alexander , Martínez-Vivar Rodobaldo , de Miguel-Guzmán Margarita , Guilarte-Barinaga Elizabeth
Published: February 2021

Entrepreneurship is an important part of any economy today regardless of its level of development. However, not in all contexts do entrepreneurs operate in the same way, nor are they motivated by the same factors. This research seeks to identify possible coincidence factors and differences between entrepreneurs that operate in different contexts from the point of view of their historical evolution, the duration of these and the economic and social model applied in the countries. Specifically, a comparative study is carried out between entrepreneurs from the republics of Ecuador and Cuba considering various variables such as: personality characteristics (attitude to failure, risk, perseverance and innovation), use of the available time fund for work in entrepreneurship; Impact of the environment in relation to: government regulations, taxes, level of competition and availability of suppliers, as well as the structure of personal expenses projected in the short and long term that entrepreneurs assume as a stimulus for their actions. For the development of the study, a description of the behavior of the variables was initially made and later, by hypothesis testing, to verify differences and similarities between both populations. The study allowed us to identify common and divergent aspects between both populations analyzed. Similarly, it showed how differences in the administrative and financial environment in which entrepreneurs operate generate changes in their priorities and projections.
SARS-CoV-2 Viability on 16 Common Indoor Surface Finish Materials
Authors: Ronca Shannon E. , Sturdivant Rodney X. , Barr Kelli L. , Harris Debra
Published: February 2021

Aim:

This study investigated the stability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on 16 common environmental surface materials.

Background:

SARS-CoV-2 is the causative agent of severe coronavirus disease, a significant public health concern that quickly led to a pandemic. Contamination of environmental surface materials is of concern, with previous studies identifying long-term detection of infectious particles on surfaces. These contaminated surfaces create an increased risk for contact transmission.

Methods:

Surface materials were inoculated with 10,000 plaque forming units and samples were collected 4, 8, 12, 24, 30, 48, and 168 hours post infection (hpi). Viral titers were determined for each sample and time point using plaque assays. Nonparametric modeling utilized the Turnbull algorithm for interval-censored data. Maximum likelihood estimates for the survival curve were calculated. Parametric proportional hazards regression models for interval censored data were used to explore survival time across the surface materials.

Results:

There was a sharp decline in recoverable virus after 4 hpi for all tested surfaces. By 12 hpi, infectious SARS-CoV-2 was recoverable from only four surfaces; and by 30 hr, the virus was recoverable from only one surface. There were differences in survival curves based on the materials although some groups of materials are similar, both statistically and practically.

Conclusions:

While very low amounts of infectious SARS-CoV-2 are recoverable over time, there remains a risk of viral transmission by surface contamination in indoor environments. Individuals and institutions must follow appropriate procedures to decontaminate indoor environment and increase diligence for hand hygiene and personal protective equipment.
Static and Dynamic Quadriceps Stretching Exercises in Patients With Patellofemoral Pain: A Randomized Controlled Trial
Authors: Lee Jin Hyuck , Jang Ki-Mo , Kim Eunseon , Rhim Hye Chang , Kim Hyeong-Dong
Published: February 2021

Background:

Limited data are available on the effect of stretching exercise in patients with patellofemoral pain (PFP) who have inflexible quadriceps, which is one of the various causes of PFP syndrome. This study compares quadriceps flexibility, strength, muscle activation time, and patient-reported outcomes after static and dynamic quadriceps stretching exercises in patients with PFP who had inflexible quadriceps.

Hypothesis:

Quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes would improve with dynamic quadriceps stretching as compared with static quadriceps stretching exercises.

Study Design:

Randomized controlled trial.

Level of Evidence:

Level 2.

Methods:

Of the 44 patients included in the study, 20 performed static stretching and 24 performed dynamic stretching. Quadriceps flexibility was assessed by measuring the knee flexion angle during knee flexion in the prone position (the Ely test). Muscle strength and muscle activation time were measured using an isokinetic device. The patient-reported outcomes were evaluated using the visual analogue scale for pain and anterior knee pain scale.

Results:

No significant differences in quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes in the involved knees were found between the 2 groups ( P values > 0.05).

Conclusion:

Quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes in patients with PFP who had inflexible quadriceps showed no significant differences between the static and dynamic quadriceps stretching exercise groups.

Clinical Relevance:

Both static and dynamic stretching exercises may be effective for improving pain and function in patients with PFP who have inflexible quadriceps.
Updating Long-Held Assumptions About Fat Stigma: For Women, Body Shape Plays a Critical Role
Authors: Krems Jaimie Arona , Neuberg Steven L.
Published: February 2021

Heavier bodies—particularly female bodies—are stigmatized. Such fat stigma is pervasive, painful to experience, and may even facilitate weight gain, thereby perpetuating the weight-stigma cycle. Leveraging research on functionally distinct forms of fat (deposited on different parts of the body), we propose that body shape plays an important but largely underappreciated role in fat stigma, above and beyond fat amount. Across three samples varying in participant ethnicity (White and Black Americans) and nation (United States, India), patterns of fat stigma reveal that, as hypothesized, participants differently stigmatized equally overweight or equally obese female targets as a function of target shape, sometimes even more strongly stigmatizing targets with less rather than more body mass. Such findings suggest value in updating our understanding of fat stigma to include body shape and in querying a predominating, but often implicit, theoretical assumption that people simply view all fat as ‘bad’ (and more fat as ‘worse’).
Concurrent application of blinatumomab and haploidentical donor leukocyte infusions for refractory primary mediastinal large B-cell lymphoma
Authors: Smith Jasmine , Kumar Abhijeet , Stanton Natalie A. , Katsanis Emmanuel
Published: February 2021

Primary mediastinal large B-cell lymphoma (PMBCL) is a rare hematologic malignancy with distinct clinical and immunopathological features. We report a case of a young male with disease refractory to multiple lines of therapy, including chimeric antigen receptor-T cells, who achieved his first complete remission after haploidentical bone marrow transplantation (haplo-BMT), following donor leukocyte infusions (DLIs) given concurrently with blinatumomab. While DLI has been used after T-replete haplo-BMT with post-transplant cyclophosphamide, there are no reports on its use for PMBCL. Similarly, blinatumomab is active against B-cell lymphomas, but literature is lacking in patients with PMBCL. Our experience illustrates that blinatumomab can be used concurrently with DLI in a haploidentical setting to achieve disease response in PMBCL. Despite our encouraging experience with this case, we would not recommend this approach outside of a clinical trial as blinatumomab may exacerbate the graft versus host disease risks of DLI, especially in a haploidentical setting. Evaluating this treatment combination in high-risk patients in the setting of a clinical trial may be meaningful.
Optimal cut-off points for adherence measure among patients with type 2 diabetes in primary care clinics: a retrospective analysis
Authors: Lim Ming Tsuey , Ab Rahman Norazida , Teh Xin Rou , Chan Chee Lee , Thevendran Shantini , Ahmad Hamdi Najwa , Lim Ka Keat , Sivasampu Sheamini
Published: February 2021

Background:

Medication adherence measures are often dichotomized to classify patients into those with good or poor adherence using a cut-off value ⩾80%, but this cut-off may not be universal across diseases or medication classes. This study aimed to examine the cut-off value that optimally distinguish good and poor adherence by using the medication possession ratio (MPR) and proportion of days covered (PDC) as adherence measures and glycated hemoglobin (HbA1c) as outcome measure among type 2 diabetes mellitus (T2DM) patients.

Method:

We used pharmacy dispensing data of 1461 eligible T2DM patients from public primary care clinics in Malaysia treated with oral antidiabetic drugs between January 2018 and May 2019. Adherence rates were calculated during the period preceding the HbA1c measurement. Adherence cut-off values for the following conditions were compared: adherence measure (MPR versus PDC), assessment period (90-day versus 180-day), and HbA1c target (⩽7.0% versus ⩽8.0%).

Results:

The optimal adherence cut-offs for MPR and PDC in predicting HbA1c ⩽7.0% ranged between 86.1% and 98.3% across the two assessment periods. In predicting HbA1c ⩽8.0%, the optimal adherence cut-offs ranged from 86.1% to 92.8%. The cut-off value was notably higher with PDC as the adherence measure, shorter assessment period, and a stricter HbA1c target (⩽7.0%) as outcome.

Conclusion:

We found that optimal adherence cut-off appeared to be slightly higher than the conventional value of 80%. The adherence thresholds may vary depending on the length of assessment period and outcome definition but a reasonably wise cut-off to distinguish good versus poor medication adherence to be clinically meaningful should be at 90%.
Pharmacokinetics of Tobramycin Administered at the Beginning of Intermittent Hemodialysis Session (ESRD Study)
Authors: Giroux Marjolaine , Bouchard Nicolas , Henderson Anik , Lam Lesly , Tran Van Anh Sylvie , Projean Denis , Tessier Jean-François , Lepage Laurence , Gavra Paul , Ouellet Georges , Vallée Michel , Lafrance Jean-Philippe
Published: February 2021

Background and Objectives:

There is a renewed interest in the successful use of aminoglycosides due to increasing resistance in gram-negative infections. Few studies to date have examined the pharmacokinetics (PK) of intradialytic infusions of tobramycin. This study sought to characterize the pharmacokinetic profile of intradialytically administered tobramycin in infected patients receiving chronic intermittent hemodialysis and to determine whether it is possible to achieve favorable PK targets.

Design, Setting, Participants, and Measurements:

In this prospective pharmacokinetic study, a single dose (5 mg/kg) of tobramycin was administered intradialytically to 11 noncritically ill patients undergoing chronic intermittent hemodialysis. Blood samples were collected at selected time to determine tobramycin serum concentrations. The PK analysis was performed using Phoenix™ NLME. The efficacy exposure outcome for nonsevere gram-negative infections sensitive to tobramycin with a minimum inhibitory concentration ≤1 were maximum concentration (Cmax ≥ 10 mg/L) and area under the curve (AUC24 h > 30 mg⋅h/L). For toxicity, the goal was to identify plasma trough concentrations <2 mg/L.

Results:

Tobramycin disposition was best described by a one-compartment model using a total clearance composed of the systemic clearance and a transitory hemodialysis clearance. Tobramycin mean (SD) Cmax, trough levels, and AUC24h were 13.1 (1.3) mg/L, 1.32 (0.47) mg/L, and 61 (23) mg⋅h/L, respectively. Monte Carlo simulation run with 1000 virtual patients showed that a 5 mg/kg dose of tobramycin administered intradialytically can outperformed the usual low-dose postdialysis dosing (80% meeting all targets versus <1%, respectively).

Conclusions:

A single high dose of tobramycin can achieve favorable PK outcome when administered using intradialytic infusions in hemodialysis patients. This practical dosing regimen may represent an effective and safer alternative to the usual dosing in the treatment of nonsevere gram-negative infections.
Surgical Treatment of Diffuse Idiopathic Skeletal Hyperostosis (DISH) Involving the Cervical Spine: Technical Nuances and Outcome of a Multicenter Experience
Authors: Lofrese Giorgio , Scerrati Alba , Balsano Massimo , Bassani Roberto , Cappuccio Michele , Cavallo Michele A. , Cofano Fabio , Cultrera Francesco , De Iure Federico , Biase Francesco Di , Donati Roberto , Garbossa Diego , Menegatti Marta , Olivi Alessandro , Palandri Giorgio , Raco Antonino , Ricciardi Luca , Spena Giannantonio , Tosatto Luigino , Visani Jacopo , Visocchi Massimiliano , Zona Gianluigi , De Bonis Pasquale
Published: February 2021

Study Design:

Retrospective multicenter.

Objectives:

diffuse idiopathic skeletal hyperostosis (DISH) involving the cervical spine is a rare condition determining disabling aero-digestive symptoms. We analyzed impact of preoperative settings and intraoperative techniques on outcome of patients undergoing surgery for DISH.

Methods:

Patients with DISH needing for anterior cervical osteophytectomy were collected. Swallow studies and endoscopy supported imaging in targeting bone decompression. Patients characteristics, clinico-radiological presentation, outcome and surgical strategies were recorded. Impact on clinical outcome of duration and time to surgery and different surgical techniques was evaluated through ANOVA.

Results:

24 patients underwent surgery. No correlation was noted between specific spinal levels affected by DISH and severity of pre-operative dysphagia. A trend toward a full clinical improvement was noted preferring the chisel ( P = 0.12) to the burr ( P = 0.65), and whenever C2-C3 was decompressed, whether hyperostosis included that level ( P = 0.15). Use of curved chisel reduced the surgical times ( P = 0.02) and, together with the nasogastric tube, the risk of complications, while bone removal involving 3 levels or more ( P = 0.04) and shorter waiting times for surgery ( P < 0.001) positively influenced a complete swallowing recovery. Early decompressions were preferred, resulting in 66.6% of patients reporting disappearance of symptoms within 7 days. One and two recurrences respectively at clinical and radiological follow-up were registered 18-30 months after surgery.

Conclusion:

The “age of DISH” counts more than patients’ age with timeliness of decompression being crucial in determining clinical outcome even with a preoperative mild dysphagia. Targeted bone resections could be reasonable in elderly patients, while in younger ones more extended decompressions should be preferred.
Posterior Cruciate Ligament Reconstruction With Independent Suture Tape Reinforcement: An In Vitro Biomechanical Full Construct Study
Authors: Levy Bruce A. , Piepenbrink Marina , Stuart Michael J. , Wijdicks Coen A.
Published: February 2021

Background:

Posterior cruciate ligament (PCL) reconstruction is commonly performed to restore joint stability and prevent posterior tibial translation at higher flexion angles. However, persistent knee laxity after reconstruction is often reported.

Purpose:

To biomechanically evaluate the effect of independent suture tape (ST) reinforcement on different PCL reconstruction techniques.

Study Design:

Controlled laboratory study.

Methods:

PCL reconstruction using porcine bones and quadrupled bovine tendons was performed using 2 techniques: (1) an all-inside method using suspensory adjustable loop devices (ALDs) in the tibia and femur and (2) a method using an interference screw on the tibial and an ALD on the femoral site. Both were tested with and without an additional ST for 4 groups (n = 8 per group). Each construct underwent biomechanical testing involving 3000 loading cycles in 3 stages. After position-controlled cycles simulating full range of motion, force-controlled loading from 10 to 250 N and then from 10 to 500 N were performed before pull-to-failure testing. Elongation, stiffness, and ultimate strength were evaluated.

Results:

The highest ultimate load (1505 ± 87 N), a small total elongation (2.60 ± 0.97 mm), and stiffness closest to the native human ligament (156.3 ± 16.1 compared with 198.9 ± 33.5 N/mm; P = .192) was seen in the all-inside technique using ST. Intragroup comparison revealed that reinforcement with ST produced a smaller total elongation for the screw fixation (Screw-ALD, 6.06 ± 3.60 vs Screw-ALD ST, 2.50 ± 1.28 mm; P = .018) and all-inside techniques (ALD-ALD, 4.77 ± 1.43 vs ALD-ALD ST, 2.60 ± 0.97 mm; P = .077), albeit the latter was not significantly different. Elongation for constructs without ST increased more rapidly at higher loads compared with elongation for ST constructs. The ultimate strength was significantly increased only for constructs using the all-inside technique using ST (ALD-ALD, 1167 ± 125 vs ALD-ALD ST, 1505 ± 87 N; P = .010).

Conclusion:

Adding an independent ST to PCL reconstruction led to improvement in the studied metrics by reducing the total elongation and increasing the ultimate strength, independent of the technique used.

Clinical Relevance:

PCL reconstruction using additional ST reinforcement was biomechanically favorable in this study. ST reinforcement in the clinical setting could decrease knee laxity after PCL reconstruction, providing better joint stability and improved functional outcomes.
Temporal Utilization of Physical Therapy Visits After Anterior Cruciate Ligament Reconstruction
Authors: Burroughs Patrick J. , Kahan Joseph B. , Moore Harold G. , Grauer Jonathan N. , Gardner Elizabeth C.
Published: February 2021

Background:

Physical therapy (PT) rehabilitation is critical to successful outcomes after anterior cruciate ligament reconstruction (ACLR). Later-stage rehabilitation, including sport-specific exercises, is increasingly recognized for restoring high-level knee function. However, supervised PT visits have historically been concentrated during the early stages of recovery after ACLR.

Purpose/Hypothesis:

To assess the number and temporal utilization of PT visits after ACLR in a national cohort. We hypothesized that PT visits would be concentrated early in the postoperative period.

Study Design:

Descriptive epidemiological study.

Methods:

The Humana PearlDiver database was searched to identify patients who underwent ACLR between 2007 and 2017. Patients with additional structures treated were excluded. The mean ± SD, median and interquartile range (IQR), and range of number of PT visits for each patient were determined for the 52 weeks after ACLR. PT visits over time were also assessed in relation to patient age and sex.

Results:

In total, 11,518 patients who underwent ACLR met the inclusion criteria; the mean age was 32.62 ± 13.70 years, and 42.7% were female patients. Of this study cohort, 10,381 (90.4%) had documented PT postoperatively; the range of PT visits was 0 to 121. On average, patients had 16.90 ± 10.60 PT visits (median [IQR], 16 [9-22]) after ACLR. Patients completed a mean of 52% of their PT visits in the first 6 weeks, 75% in the first 10 weeks, and 90% in the first 16 weeks after surgery. Patients aged 10 to 19 years had the highest number of PT visits (mean ± SD, 19.67 ± 12.09; median [IQR], 18 [12-25]), significantly greater than other age groups ( P < .001).

Conclusion:

PT after ACLR is concentrated in the early postoperative period. Physicians, therapists, and patients may consider adjusting the limited access to PT to optimize patient recovery.

Clinical Relevance:

As supervised PT visits may be limited, the appropriate temporal utilization of supervised PT visits must be maximized. Strategies to ensure sessions for later neuromuscular and activity-specific rehabilitation are needed.
Drivers of Carbon Price Adoption in Wealthy Democracies: International or Domestic Forces?
Authors: Driscoll Daniel
Published: February 2021

Is carbon price adoption in wealthy democracies driven more by international or domestic forces? Event history analyses reveal that carbon price adoption is more likely in countries with less fossil fuel energy use (and, by proxy, less powerful fossil fuel business-elite actors) and with less encumbered democratic institutions (i.e., fewer institutional veto points). These findings are triangulated through cross-sectional comparisons and case studies. In short, wealthy democracies enact carbon prices according to the degree to which domestic actors or costs constrain or enable enactment and implementation. The author argues that the global free-rider problem, posed by nonbinding international climate agreements and lack of enforcement, and fossil fuel business-elite power undermine the force of international values and norms. World society scholarship should attend more to (1) whether international participation incurs substantial local costs or powerful stakeholder opposition and (2) whether the benefits of such participation are more domestically or globally distributed.
Navigating the Dual Role of Clinician-Researcher in Qualitative Dental Research
Authors: Geddis-Regan A.R. , Exley C. , Taylor G.D.
Published: February 2021

In qualitative research, the researcher is the research instrument. Therefore, a qualitative researcher who is also a clinician must consider how their dual position informs participant consent, data collection, and analysis. This reflexivity is essential in research design to effectively respond to ethical questions around role, authenticity, trust, and transparency around disclosing their clinician status to participants.
Arthroscopic Suture Fixation of Tibial Eminence Fracture
Authors: Treme Gehron P. , Richter Dustin L.
Published: February 2021

Background:

Tibial eminence fractures account for up to 5% of knee injuries with an effusion in the pediatric population. Displaced fractures require reduction and operative fixation via arthroscopic or open techniques.

Indications:

Arthroscopic suture fixation and screw fixation are 2 of the most commonly described techniques for tibial eminence fracture treatment. We describe our preferred technique of arthroscopic suture fixation given the versatility of this technique and decreased risks of hardware irritation or impingement, need for reoperation, and minimal risk of physeal damage.

Technique Description:

The arthroscopic suture fixation technique uses a standard anteromedial and anterolateral portal. After the fracture bed and hematoma are debrided and any interposing structures (ie, meniscus) are removed from the fracture site, 2 nonabsorbable sutures are passed through the substance of the anterior cruciate ligament (ACL). Using an ACL guide, 2 separate transtibial tunnels are drilled with a bone bridge in between—one at the anterolateral aspect of the fracture base and one at the anteromedial aspect. One limb from each suture is pulled out from each of the bone tunnels. The fragment is then reduced, and the sutures are tensioned and fixated using knotless suture anchors.

Results:

Overall prognosis following tibial eminence fracture fixation is favorable with more than 80% of patients returning to prior level of activity. Arthrofibrosis may occur in up to 25% of patients. Although some residual laxity may remain, there is a high return to sport and no difference in rate of subsequent ACL injury or surgery compared with a match cohort of pediatric ACL reconstructions.

Discussion:

Arthroscopic suture fixation of displaced tibial eminence fractures is a reliable technique with high return to sport and low risk of reoperation. Arthrofibrosis is common; thus, early, controlled knee range of motion following surgery is critical.
When the impossible becomes possible: COVID-19’s impact on work and travel patterns in Swedish public agencies
Authors: Hiselius Lena Winslott , Arnfalk Peter
Published: February 2021

Background

The COVID-19 pandemic has rapidly led to some of the most revolutionary changes in private and professional life around the world. While the extent and duration of these changes are not certain, they have already had a great impact on travel patterns. This is also the case in Sweden, despite its relatively liberal approach to restrictions, which relies on voluntary measures such as social distancing and self-monitoring for symptoms.

Methodology

Due to the pandemic, a shift to telework and virtual meetings is being tested in what can be seen as a large-scale experiment, and the knowledge and experience from that experiment may have lasting effects on everyday life. This study seeks to analyse the effects of government and public agencies’ recommendations on meeting and travel behaviour on employees at five public agencies in Sweden.

Results

The results indicate that the public authorities surveyed were well prepared and had a ‘backup collaboration solution’, at least technically, to make a rapid behavioural shift when travel was not an option. Though the Swedish government’s and Public Health Authority’s strong recommendations have led to the most dramatic reductions in work-related travel in modern times, the operations in Swedish agencies continue to function, along with the employees’ communications and collaborations. These results indicate that there is great potential for digital tools to influence if and how we commute and make business trips. The COVID-19 pandemic has shown that such tools can make the impossible possible.
Role of PGE2 in colonic motility: PGE2 attenuates spontaneous contractions of circular smooth muscle via EP4 receptors in the rat colon
Authors: Karaki Shin-Ichiro , Tanaka Ryo
Published: February 2021

Colonic motor activity is important for the formation and propulsion of feces. The production of prostaglandins (PGs) in colonic tissue is considered to play a critical role in the generation and regulation of colonic motility. In this study, we investigated the inhibitory effects of PGE2 and selective agonists of four EP receptors on the spontaneous phasic contractions, called ‘giant contractions’ (GCs), of mucosa-free circular smooth muscle strips from the rat middle colon. Neural blockade with tetrodotoxin (TTX) increased the frequency and amplitude of the GCs by about twofold. However, inhibiting PG production with piroxicam reduced the GC frequency in the presence of TTX, but did not affect the GC amplitude. In the presence of both TTX and piroxicam, exogenous PGE2 and each EP receptor agonist were cumulatively added to the tissue bath. In this setting, PGE2, the EP2 agonist ONO-AE1-259, and the EP4 agonist ONO-AE1-329, but not the EP1 agonist ONO-AE-DI-004 or the EP3 agonist ONO-AE-248, concentration-dependently reduced the GC frequency and amplitude. The PGE2-induced inhibition of GC frequency and amplitude was inhibited by the EP4 antagonist ONO-AE3-208, but not by the EP1/2 antagonist AH6809. Immunohistochemistry revealed the EP2 and EP4 receptors were localized in perinuclear sites in circular smooth muscle cells. EP2 immunoreactivity was also located in GFAP-immunoreactive enteroglia, whereas EP4 immunoreactivity was also located in HU (embryonic lethal, abnormal vision [ELAV] protein; a marker of all myenteric neurons)-immunoreactive myenteric nerve cell bodies. These results suggest that the PGs produced in the colonic tissue inhibit the GC frequency and amplitude of circular muscle in the rat middle colon, and is mediated by EP4 receptors expressed in the smooth muscle cells.
Analgesic efficacy and safety of erector spinae plane block in breast cancer surgery: a systematic review and meta-analysis
Authors: Zhang Ying , Liu Tieshuai , Zhou Youfa , Yu Yijin , Chen Gang
Published: February 2021

Background

Surgical resection is considered to be the primary and most effective therapy for breast cancer, postoperative pain is an issue gaining significant attention. In recent years, erector spinae plane block (ESPB) has attracted much attention in postoperative analgesia, but its effectiveness is still controversial. This meta-analysis was implemented to verify the clinical analgesic efficacy and safety of erector spinae plane block in patients undergoing breast cancer surgery.

Methods

We searched PubMed, EMBASE, Web of Science, the Cochrane Library and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing ESPB with general anesthesia (GA) in breast cancer surgery that were published before December 25, 2020. The primary outcome was opioid consumption at the first 24 h after surgery, while secondary outcomes included pain scores at 1, 6,12 and 24 h after surgery, opioid consumption at 1, 6 and 12 h after surgery, intraoperative opioid consumption, number of patients who need for rescue analgesia, and the incidence of postoperative nausea and vomiting (PONV).

Results

Eleven randomized controlled trials involving 679 patients met the study inclusion criteria and were included in this study. In comparison to GA group, the ESPB group showed a significant reduction in morphine consumption at the first 24 h after surgery by a mean difference (MD) of − 7.67 mg [95% confidence interval (CI) − 10.35 to − 5.00] (P <  0.01). In addition, the ESPB group showed lower pain scores than the GA group in the four time periods (1, 6, 12 and 24 h after surgery). ESPB group significantly reduce the intraoperative consumption of fentanyl, the need for postoperative rescue analgesia, and the incidence of PONV.

Conclusions

Ultrasound-guided ESPB is an effective approach for reducing morphine consumption and pain intensity within the first 24 h after breast cancer surgery, compared with GA alone.
Spinal anaesthesia with Chloroprocaine HCl 1% for elective lower limb procedures of short duration: a prospective, randomised, observer-blind study in adult patients
Authors: Ghisi Daniela , Boschetto Giorgia , Spinelli Alessandra Maria , Giannone Sandra , Frugiuele Jacopo , Ciccarello Marcello , Bonarelli Stefano
Published: February 2021

Background

This prospective, randomised, observer-blinded study has been conducted in patients undergoing procedures of the lower extremities to evaluate the time to complete block resolution of 2-chloroprocaine 1% at three intrathecal doses (30, 40 and 50 mg).

Methods

After informed consent, we enrolled 45 male and female patients, aged 18–65 years, ASA score I-II, BMI 18–32 kg/m2, undergoing elective lower limb procedures lasting ≤40 min and with a requested dermatomeric level of sensory block ≥ T12.

The patients were randomised in a 1:1:1 ratio to receive Chloroprocaine HCl 1% at one of the three different intrathecal doses (Group 30 = 30 mg, Group 40 = 40 mg or Group 50 = 50 mg). The progression and regression of both sensory and motor blocks were evaluated blindly. Urine and venous blood samples were collected for pharmacokinetic analysis.

Results

Times to regression of spinal blocks were 1.76 ± 0.35 h, 2.13 ± 0.46 h and 2.23 ± 0.38 h, in Group 30, 40 and 50 respectively: the 30 mg dose showed a significantly faster resolution of spinal block than the 40 mg (p = 0.034) and the 50 mg (p = 0.006). Time to readiness for surgery was significantly reduced with the dose of 50 mg when compared to dose of 30 mg (p = 0.0259).

Conclusions

The doses of 50 mg and 40 mg yielded a longer resolution of spinal block than the dose of 30 mg. Nevertheless, the dose of 30 mg resulted in a higher secondary failure rate.

Trial registration

Registration of clinical trial: clinicaltrials.gov (NCT02481505).
Disaster safety assessment of primary healthcare facilities: a cross-sectional study in Kurdistan province of Iran
Authors: Yari Arezoo , Zarezadeh Yadolah , Fatemi Farin , Ardalan Ali , Vahedi Siamak , Yousefi-Khoshsabeghe Homa , Boubakran Mohsen Soufi , Bidarpoor Farzam , Motlagh Mohamad Esmaeil
Published: February 2021

Background

Kurdistan province of Iran is among disaster prone areas of the country. The Primary Health Care facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of such facilities is essential.

Methods

In this cross-sectional study, the instrument used to evaluate four sections of functional, structural, non-structural, and total safety of 805 healthcare facilities in Kurdistan Province was the safety evaluation checklist of primary healthcare centers, provided by the Iranian Ministry of Health and Medical Education. Each section scored from 0 to 100 points, and each section of the safety was classified to three safety classes according to their total score: low (≤34.0), average (34.01–66.0) and high (> 66.0).

Results

The levels of functional, structural, non-structural and total safety were equal to 23.8, 20.2, 42.3 and 28.7, out of 100, respectively. Regarding the functional safety, rapid response team scored the highest, while financial affairs scored the lowest. Nevertheless, in structural and non-structural sections, the scores of different items were almost similar.

Conclusions

The results of the study revealed that safety score of primary healthcare facilities in general was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery of these facilities are essential to response to disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard.
Patient perceptions, opinions and satisfaction of telehealth with remote blood pressure monitoring postpartum
Authors: Thomas Nicole A. , Drewry Anna , Racine Passmore Susan , Assad Nadia , Hoppe Kara K.
Published: February 2021

Background

Our aim was to conduct a post participation survey of respondent experiences with in-home remote patient monitoring via telehealth for blood pressure monitoring of women with postpartum hypertension. We hypothesized that the in-home remote patient monitoring application will be implemented with strong fidelity and have positive patient acceptability.

Methods

This analysis was a planned secondary analysis of a non-randomized controlled trial of telehealth with remote blood pressure patient monitoring for postpartum hypertension compared to standard outpatient monitoring in women with a hypertension-related diagnosis during pregnancy. In collaboration with survey experts, we developed a 41-item web-based survey to assess 1) perception of quality of care received, 2) ease of use/ease to learn the telehealth program, 3) effective orientation of equipment, 4) level of perceived security/privacy utilizing telehealth and 5) problems encountered. The survey included multiple question formats including Likert scale responses, dichotomous Yes/No responses, and free text. We performed a descriptive analysis on all responses and then performed regression analysis on a subset of questions most relevant to the domains of interest. The qualitative data collected through open ended responses was analyzed to determine relevant categories. Intervention participants who completed the study received the survey at the 6-week study endpoint.

Results

Sixty six percent of respondents completed the survey. The majority of women found the technology fit easily into their lifestyle. Privacy concerns were minimal and factors that influenced this included age, BMI, marital status, and readmissions. 95% of women preferred remote care for postpartum follow-up, in which hypertensive type, medication use and ethnicity were found to be significant factors in influencing location of follow-up. Most women were satisfied with the devices, but rates varied by hypertensive type, infant discharge rates and BMI.

Conclusions

Postpartum women perceived the telehealth remote intervention was a safe, easy to use method that represented an acceptable burden of care and an overall satisfying method for postpartum blood pressure monitoring.

Trial registration

ClinicalTrials.gov identification number: NCT03111095 Date of registration: April 12, 2017.
Microbial yield from infectious tissues pretreated by various methods: an invitro study
Authors: Cai Yuanqing , Fang Xinyu , Zhang Lvheng , Yang Xurong , Nie Lixiong , Huang Zida , Li Wenbo , Zhang Chaofan , Yang Bin , Guan Zhenpeng , Zhang Wenming
Published: February 2021

Background

This study aimed to evaluate the effects of different pretreatment methods on the microbial yield from infectious tissues.

Methods

Strains of Staphylococcus aureus (SA), Escherichia coli (EC) and Candida albicans (CA) were used to construct single-surface, full-surface, and internal infection models in sterile pork tissue. Manual milling (MM), mechanical homogenization (MH), sonificated (SF), dithiothreitol (DTT), and direct culture (DC) were used to pretreat these tissues, the microbial yield from different pretreatment methods were recorded and compared. Moreover, periprosthetic tissues collected intraoperatively from periprosthetic joint infection (PJI) patients were used as a verification.

Results

The study showed that the microbial yield from MH pretreatment was significantly higher than that of MM (P < 0.01) and SF pretreatment method (P < 0.01). Furthermore, in the internal infection model, the microbial yield from MH group was also significantly higher than that of SF (P < 0.01), DTT (P < 0.01), and DC group (P < 0.01). Moreover, the number of bacterial colonies obtained from periprosthetic tissues pretreated by MH was significantly higher than pretreated by other pretreatment methods (P = 0.004).

Conclusions

The effects of MH and DTT in microbial yield were significantly higher than that of DC, SF and MM, and these methods can be used to process multiple tissue samples at the same time, which might further improve the diagnostic sensitivity of infectious disease.
Ureteral urothelial carcinoma with squamous cell carcinoma and sarcomatoid carcinoma differentiation: a case report
Authors: Ren Shangqing , Feng Hualin , Bao Yige , Wei Yi , Ou Yong , Wang Yaoqian , Lv Qian , Zhong Shan , Zhou Fang , Fan Shida , Wang Qiang , Luo Cheng , Chen Zhengjun , Nie Yu , Wang Dong
Published: February 2021

Background

Upper urinary tract urothelial carcinoma (UTUC) with multiple pathological types is extremely rare in the clinic, but the recurrence rate and mortality these patients are high. At present, there is no standard treatment for such cases.

Case presentation

We reported a case of ureteral urothelial carcinoma with squamous cell carcinoma and sarcomatoid carcinoma differentiation and rapid ileal metastasis and reviewed the literature related to different pathological types of upper urinary tract tumours to explore the diagnosis, treatment and prognosis characteristics of the disease, enhance our understanding of its clinical manifestations and history of evolution and provide guidance for avoiding missed diagnosis and misdiagnosis.

Conclusion

There is no standard treatment for urinary malignant tumours with multiple pathological types; radical surgery is considered a suitable choice. Chemotherapy, targeted drug therapy and immunotherapy may be beneficial to the survival of patients. In short, these patients have a high risk of recurrence and metastasis and a poor prognosis.