bluuebunny/crossref_metadata_2025 huggingface dataset:
Tensile properties and micromechanical modeling of polypropylene composites reinforced with alfa fibers
Authors: Messaoui Saker , Ghali Lassaad , Guermazi Noamen , Haddar Nader , Msahli Slah
Published: March 2022

The performance of polyolefin composite materials reinforced with lignocellulosic fibers in terms of properties and mechanical behavior is strongly influenced by the strength of the interphase between the matrix and the reinforcements. The creation of a strong interface is hampered by the hydrophilicity and hydrophobicity of the reinforcing material and that of the matrix, respectively. Alkali treatment and the addition of compatibilizers have been a common solution to solve the interfacial problem. In this work, untreated short alfa fibers, treated with 3% sodium hydroxide (NaOH), polypropylene (PP), and compatibilizer (MAPP) were extruded and then injection molded to obtain tensile specimens. The alfa fiber length distributions in the composite were obtained by dissolving the matrix of the composite in a Soxhlet apparatus to extract the fiber. The results obtained for the composite at 30% by weight and with a combined treatment (NaOH + MAPP), showed a higher tensile strength compared to untreated composites. In addition, the morphology and the chemical composition of the fiber were analyzed to further discuss the results of micromechanical models. The interfacial shear strength (τ) and orientation factor (η0) of the alfa fibers in the polypropylene matrix were determined during the analysis of the modified Kelly and Tyson model. The results obtained from these models showed that the ([Formula: see text]) of the combined treatment composites was higher compared to the untreated composites.
Hemangioma of the External Auditory Canal and Temporal Bone: A Case Report and Comprehensive Literature Review
Authors: Marzouqi Salamah , Roa Halawani
Published: March 2022

Although hemangiomas are common in the head and neck area, they are uncommon in the temporal bone. External auditory canal (EAC) hemangiomas are a relatively uncommon otologic condition. In the English literature, only 29 cases of temporal bone hemangioma have been reported. We also present the case of a 32-year-old male patient who presented with an 8-month history of decreased hearing, tinnitus, and aural fullness on the right side. Otoscopic examination of the right ear revealed a smooth, oval, well-circumscribed, reddish, pulsatile, nontender mass, which was about 1 cm in diameter and occupied two-thirds of the EAC. It was soft in consistency, compressible, and appeared to be arising from the right posterior-superior portion of the bony canal wall; the tympanic membrane seemed to be uninvolved. The patient had mild conductive hearing loss of the right ear with an average air-bone gap of 20 dB; the left side was normal. High-resolution contrast-enhanced computed tomographic scanning of the temporal bone showed well-defined, rounded, homogenously enhancing lesions at the posterior-superior aspect of right EAC measuring 0.7 × 0.8 cm. Angiography was performed and there was evidence of vascular blush in the region of the right EAC. Three blood vessels were identified and embolized. The mass was completely removed by the endaural approach, and a retroauricular skin graft to restore cutaneous integrity was not required. Histopathology indicated a capillary hemangioma without cytological atypia or mitotic activity. There was no recurrence 1 year after the surgery.
Refusing to relinquish: How settler Canada uses race, property, and jurisdiction to undermine urban Indigenous land reclamation
Authors: Sylvestre Paul , Castleden Heather
Published: March 2022

Critiques of settler colonial urbanism have paid close attention to the political work that property and racism do in materializing settler colonial cities and naturalizing settler control over urban land and resources. We contribute to these debates by examining how the co-production of property and race intersects with jurisdiction to secure white possession against the demands of an urban Indigenous land reclamation in Canada’s national capital. Drawing on an analysis of government records obtained using Access to Information and Privacy requests, key informant interviews, and a three-year engagement with land defenders and allies, we demonstrate how property and jurisdiction carved the contested space into distinct spheres of settler governing authority. The need to confront the singularity of each governing authority on its own terms made it impossible to directly contest ongoing dispossession as a singular process involving the entire site. Instead, organizers and activists were forced to fight for separate pieces of land, dividing limited time, energy, and resources across multiple facets of a settler colonial structure of invasion. We argue that this process of jurisdictional fragmentation, which organized the co-production of property and race in defence of white possession, can be productively understood as a process of fortification.
Multiparametric MRI-based radiomics for the prediction of microvascular invasion in hepatocellular carcinoma
Authors: Jiang Tao , He Shuai , Yang Huazhe , Dong Yue , Yu Tao , Luo Yahong , Jiang Xiran
Published: March 2022

Background

Preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is essential in obtaining a successful surgical treatment, in decreasing recurrence, and in improving survival.

Purpose

To investigate the value of multiparametric magnetic resonance imaging (MRI)-based radiomics in the prediction of peritumoral MVI in HCC.

Material and Methods

A total of 102 patient with pathologically proven HCC after surgical resection from June 2014 to March 2018 were enrolled in this retrospective study. Histological analysis of resected specimens confirmed positive MVI in 48 patients and negative MVI in 54 patients. Radiomics features were extracted from four MRI sequences and selected with the least absolute shrinkage and selection operator (LASSO) regression and used to analyze the tumoral and peritumoral regions for MVI. Univariate logistic regression was employed to identify the most important clinical factors, which were integrated with the radiomics signature to develop a nomogram.

Results

In total, 11 radiomics features were selected and used to build the radiomics signature. The serum level of alpha-fetoprotein was identified as the clinical factor with the highest predictive value. The developed nomogram achieved the highest AUC in predicting MVI status. The decision curve analysis confirmed the potential clinical utility of the proposed nomogram.

Conclusion

The multiparametric MRI-based radiomics nomogram is a promising tool for the preoperative diagnosis of peritumoral MVI in HCCs and helps determine the appropriate medical or surgical therapy.
Ireland and the Marshall Plan: E.C.A.'s Manoeuvring to Promote Dollar Tourism
Authors: Groutel Anne
Published: March 2022

When the Economic Cooperation Administration (E.C.A.), the American agency in charge of the implementation of the Marshall Plan, was faced with an increasing balance of payments deficit in Ireland, it focused on the development of dollar tourism to bridge it. But at the beginning of the 1950s, tourism development had become an extremely sensitive topic in Irish political and government circles as well as in public opinion. Thus, from the start, the ECA's efforts were bound to meet some opposition even though the American agency had the active support of the Minister of External Affairs of the First Inter-Party Government (1948–1951). Based on unpublished American archive documents, this paper reveals the backdoor tactics used by the E.C.A. mission in Ireland to circumvent the resistance of part of the Irish government. The E.C.A.'s ruses did not succeed. However, by facilitating the exposure of some forward-looking hoteliers to the ‘American way’, familiarisation trips to the U.S. organised under the aegis of the Marshall Plan helped set a dynamic in motion. This exposure was instrumental in the development of several innovations in Irish tourism and the economic sector which attracted the attention of powerful Irish-American businessmen. The latter were subsequently to collaborate closely with the Irish government to attract strategic American investments to the country from the 1960s onwards.
Bony Apprehension Test for Identifying Bone Loss in Patients With Traumatic Anterior Shoulder Instability: A Validation Study
Authors: James Michael , Kwong Cory A. , More Kristie D. , LeBlanc Justin , Lo Ian K.Y. , Bois Aaron J.
Published: March 2022

Background:

The presence of bone loss has important implications for the surgical treatment of patients with recurrent shoulder instability. The bony apprehension test (BAT) is a physical examination maneuver that was designed to improve specificity from the anterior apprehension test (AAT) in detecting critical bone loss.

Purpose:

The purpose of this study was to compare the BAT with the AAT and relocation test based on their abilities to predict critical bone loss. Several well–described criteria were utilized to capture critical (≥25%) and subcritical (≥13.5%) glenoid defects, as well as Hill-Sachs defects (≥19%). The ability of the BAT to predict bipolar bone loss was also assessed, as indicated by engaging Hill-Sachs defects and off–track lesions.

Study Design:

Cohort study (diagnosis); Level of evidence, 1.

Methods:

The study cohort included patients ≥18 years of age who were scheduled to undergo arthroscopic stabilization for traumatic anterior shoulder instability. Notable exclusion criteria included multidirectional shoulder instability, connective tissue disorders, and workers’ compensation or litigation cases. Patients underwent physical examination immediately before surgery by the treating surgeon (ie, before the induction of anesthesia). Critical glenoid and humeral bone defects were measured on preoperative computed tomography scans. Hill-Sachs engagement and on- or off–track determination of bone loss were assessed arthroscopically and via computed tomography, respectively.

Results:

A total of 52 patients were included in the study. In cases of subcritical glenoid bone loss (≥13.5%) and critical Hill-Sachs defects (≥19%), the BAT had good and fair specificity (82% and 72%, respectively) but poor sensitivity (40% and 39%). The BAT also had poor sensitivity (0%), specificity (67%), and positive predictive value (0%) for higher percentages of glenoid bone loss (≥25%). When engaging Hill-Sachs lesions were assessed, the BAT had excellent specificity (94%) and positive predictive value (94%) but poor sensitivity (43%) and negative predictive value (44%). Furthermore, the BAT performed poorly at predicting off–track humeral lesions. The AAT demonstrated 100% sensitivity and 0% specificity in detecting all measures of bone loss.

Conclusion:

The BAT performed poorly at identifying subcritical and critical bone loss and was not found to have any clinical value. Future work is needed to identify a physical examination test that could complement advanced imaging for preoperative assessment of critical bone loss.
Using computational fluid dynamic for hemodialysis air chamber design modification
Authors: Torabi Amir , Dehkordi Mohammad Amin Shahrokhian
Published: March 2022

Design modification is a main step in developing machines and artificial organ. A new dialysis apparatus air chamber detects clot formation and interruption of blood refining circuit. Due to using enough anticoagulant, thrombosis may occur because of vortex formed by turbulent flow. Turbulent blood flow causes to endothelial injury thus supporting the formation of a thrombus. Computational fluid dynamics can estimate the flow velocity and turbulence distribution and it can be used as applicable tool to design diagnosis and modifying. In this paper CFD simulation used to find the high turbulent intensity region within the chamber and an optimization method is adopted based on the geometry changing and trying the simulation results. The turbulent intensity is chosen as a criterion to achieving to an optimized condition. Finally, a best geometry is derived for the chamber entrance by this process and modified prototype is manufactured. This refined chamber maintains on the dialysis machine and tested for several patients with different blood characteristics. The results show that no more clot formation has been observed in this new designed chamber.
Pedagogy of Planning Studios for Multidisciplinary, Research-Oriented, Personalized, and Intensive Learning
Authors: Galan Juanjo , Kotze D. Johan
Published: March 2022

Through this paper, we investigate the key characteristics of planning studios and how they relate to new demands in planning education. The research is conducted through an analytical framework that is applied to a highly transferable case study (iWater Summer Schools). Results confirm that the prototypical characteristics of planning studios can support the design of multidisciplinary, research-oriented, personalized, and intensive courses, and that all these demands can be simultaneously satisfied. In addition, results indicate that positive alignments and connections can be established between different pedagogical variables (e.g., learning methods, assessment methods, provided skills) and the educational demands mentioned above.
Valuable Informal Bereavement Support Strategies for Bereaved Parents of Stillborn, Young Children, and Adult Children: A Scoping Review
Authors: Schoonover Kimberly L. , Prokop Larry , Lapid Maria I.
Published: March 2022

Background: Informal support of a bereaved parent is common after the loss of a child (stillborn, young or adult child); however, it is not clear which aspects of informal support were perceived to be helpful by the bereaved parent. The aim of this scoping review is to clarify from the standpoint of bereaved parents what are considered helpful and unhelpful characteristics of informal support given by the support network of bereaved parents. Methods: A comprehensive search of databases from 2000 to April 20, 2020 was conducted for clinical studies published in English on informal bereavement support of adult bereaved parents of stillborn to adult children; 52 articles met criteria for the scoping review. The databases included Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations, and Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Ovid PsycINFO, and Scopus. Results: Specific supportive strategies reported by parents as helpful more frequently included talking with other supportive persons felt to be supportive, meeting another person with a similar type of loss, and a loss-specific peer support group. Other support included peer support groups in general, tangible aid, talking with the spouse about the child who died and/or accepting each other's different grieving styles, and remembrance gestures. Specific supportive strategies reported by parents as unhelpful more frequently included feeling of stigma or blame due to type of death or feeling that the type of death was not considered equal to other deaths and platitudes & insensitive comments. Other unhelpful support included talking with others felt to be unsupportive about discussing the loss, others stating a time limit to grief, others actively avoiding or stopping all communication with the bereaved parent, and one spouse not accepting the grieving style of the other or the spouse not willing to discuss the loss. Conclusion: Support focused on supportive verbal and nonverbal communication towards the bereaved parent and tangible aid were noted to be helpful informal support. Feeling stigma for or judged by others due to the type of death or the death not being considered equal (such as in deaths due to suicide and stillborn deaths) to other types of deaths as well as informational support (utilization of clichés/platitudes, advice giving, statements about the process and end point of grieving) were noted to be unhelpful informal support.
Adolescent Peer Victimization and Deliberate Self-Harm: A Three-Wave Moderated Mediation Model
Authors: Wei Yi , Ren Ping , Qin Xingna , Zhang Yunyun , Luo Fang , Chen Chuansheng
Published: March 2022

Background: Identifying deliberate self-harm (DSH) and peer victimization in adolescents is a public health issue. The present study evaluates a three-wave longitudinal model to examine the effect of peer victimization on DSH and the roles of internalizing problems (depression and anxiety) and perceived peer and teacher support climate in this relationship. Methods: The participants were 2381 adolescents (51.2% boys, Mage = 13.38, SD = .59) from Chinese middle schools. Self-report measures were used to collect data every 6 months in three waves. Results: (1) Peer victimization at T1 positively predicted DSH at T3. (2) Depression at T2, rather than anxiety, mediated the relationship between peer victimization at T1 and DSH at T3. (3) Perceived peer support climate at T1 played a moderating role between peer victimization at T1 and depression and anxiety at T2, but perceived teacher support climate did not. Peer victimization had a stronger predictive effect on depression and anxiety for students with high level of perceived peer support climate. Limitations: Study limitations include the short interval (6 months) of the longitudinal design, the reliance on self-report questionnaires, the inclusion of only one aspect of student-student and teacher–student relationships, and the age limitation. Conclusions: The results demonstrated the importance of prevention for improving social and emotional skills to reduce peer victimization and of interventions to promote a peer support climate in the classroom. The findings highlight the need to consider different types of internalizing problems and perceived support in studies of DSH in adolescents.
Exposure to Parental Violence During Childhood and Later Psychological Distress Among Arab Adults in Israel: The Role of Gender and Sense of Coherence
Authors: Sokar Shireen , Greenbaum Charles W. , Haj-Yahia Muhammad M.
Published: March 2022

Exposure to parental violence in childhood is a significant predictor of psychological distress in adulthood. Factors at the individual level may explain the variance in psychological distress among adults exposed to parental violence. The current study examined the effect of exposure to different forms (i.e., physical violence and psychological aggression) and different patterns of parental violence (i.e., witnessing interparental violence, experiencing parental violence) on later psychological distress. The mediating role of sense of coherence (SOC) and the moderating role of gender in this relationship were also examined. A cross-sectional survey was conducted among 604 married Arab adults in Israel (age = 20–60, M = 33.5, SD = 6.52) using a retrospective, self-administered questionnaire. Results indicate a significant positive relationship between all forms and types of parental violence explored in the current study with levels of psychological distress. Furthermore, exposure to parental violence correlated negatively with SOC, and low levels of SOC predicted higher levels of psychological distress. SOC was found to partially mediate the relationship between exposure to parental violence and psychological distress. Gender differences were found only with regard to experiencing physical violence as a predictor of psychological distress, indicating that the relationship between these variables is stronger in females. These results highlight the importance of SOC as a personal resource and its role in promoting psychological wellbeing. Healthcare practitioners should be aware of possible gender differences in psychological distress among Arab adults exposed to parental violence.
Making Waves: Districts as Policy Mediators in the Flow of School Gentrification
Authors: Green Terrance L. , Latham-Sikes Chloe , Horne Jeremy , Castro Andrene , Germain Emily
Published: March 2022

Gentrification is happening in cities all across the United States. Consequently, some Black communities that were intentionally segregated and under-resourced are experiencing capital investments and demographic changes. These gentrification-induced racial and socioeconomic shifts impact many local institutions, namely school districts. Given this, there is an emerging body of research on schools and gentrification. However, less research has examined the actions of school districts as institutional actors in gentrification. This study examines how two school districts’ actions mediate school gentrification. Using a theorization of gentrification as a process of racial capitalism, we draw on interviews with 26 principals across both districts. Our findings suggest that districts’ actions influence school gentrification by mediating the movement of Black and other youth of color to various schools through cycles of differential investments across the districts. We conclude with implications for future research.
Gastrointestinal biopsy in the horse: overview of collection, interpretation, and applications
Authors: Hostetter Jesse M. , Uzal Francisco A.
Published: March 2022

Evaluation of gastrointestinal (GI) biopsies is a multistep process that includes reviewing an appropriate history, determining sample quality, and evaluating histologic sections. Selected diagnostic parameters that, in combination with intestinal histopathology, can be useful to localize disease to the intestinal tract in the horse include hypoproteinemia and hypoalbuminemia, ultrasound evidence of increased thickness of the small intestinal wall, and alterations in glucose or D-xylose absorption tests. Biopsies may be acquired either endoscopically, or via laparoscopy or standing flank incisional approaches. GI sections should be evaluated using a systematic approach that includes both architectural changes and inflammatory cell infiltrates. Although strategies have been developed for assessment of GI biopsies from the dog and cat, a standardized approach to interpretation of the equine GI biopsy has yet to be developed. GI biopsies pose several challenges to the pathologist, especially for endoscopic biopsies in which the quality of the specimen and its orientation may vary greatly. Architectural changes are arguably the most critical changes to evaluate. In a horse with chronic GI inflammation, such as occurs in idiopathic inflammatory bowel disease (IBD), the cell types encountered frequently are macrophages, eosinophils, lymphocytes, and plasma cells. Increased numbers of these cell types are categorized loosely as mild, moderate, and severe. Specific forms of idiopathic IBD have been further classified by this infiltrate as granulomatous enteritis, eosinophilic enteritis, and lymphoplasmacytic enteritis; there is limited information on microscopic changes with each. Unfortunately, microscopic GI lesions are usually nonspecific, and determination of etiology requires further investigation.
Penal diversity, penality and community sanctions in Australia
Authors: Freiberg Arie , Bartels Lorana
Published: March 2022

This article explores Australian penal diversity, through the lens of community sanctions. We first examine what is meant by ‘community sanctions’ and suggest that the problem of definition provides one of the reasons for the dearth of comparative studies on their use, compared with prison studies. The article then examines the concept of punitiveness, ‘penal reach’ or ‘penal load’. This is followed by examination of the use of community corrections (CC) in Australia and differences between jurisdictions and over time. We consider the relationship between imprisonment and CC rates and attempt to explain these differences. Our analysis suggests there is a need to expand the notion of punitiveness, to include non-custodial sanctions. Further exploration of Australia's trends in the use of CC and interjurisdictional variation is required. However, we suggest that becoming less fixated on imprisonment, as the primary measure of punitiveness, and instead understanding how the various community sanctions operate – not as alternatives to imprisonment, but as independent sanctions appropriate to a wide range of less serious offences – may enable us to better understand the true penal impact of a jurisdiction's criminal justice system and consequently craft more effective and appropriate penal policies.
A content awareness module for predictive lossless image compression to achieve high throughput data sharing over the network storage
Authors: Rajput Asif , Li Jianqiang , Akhtar Faheem , Hussain Khand Zahid , Hung Jason C , Pei Yan , Börner Anko
Published: March 2022

The idea of applying integer Reversible Colour Transform to increase compression ratios in lossless image compression is a well-established and widely used practice. Although various colour transformations have been introduced and investigated in the past two decades, the process of determining the best colour scheme in a reasonable time remains an open challenge. For instance, the overhead time (i.e. to determine a suitable colour transformation) of the traditional colour selector mechanism can take up to 50% of the actual compression time. To avoid such high overhead, usually, one pre-specified transformation is applied regardless of the nature of the image and/or correlation of the colour components. We propose a robust selection mechanism capable of reducing the overhead time to 20% of the actual compression time. It is postulated that implementing the proposed selection mechanism within the actual compression scheme such as JPEG-LS can further reduce the overhead time to 10%. In addition, the proposed scheme can also be extended to facilitate network-based compression–decompression mechanism over distributed systems.
Improvement on the passive method based on dampers for the vibration control of spacecraft solar panels
Authors: Liu Changxi , Li Hao , Zhang Fengfa , Wang Xiaohong
Published: March 2022

In this study, a passive vibration control method termed as translational root mounting method is proposed and investigated, for suppressing the low frequency vibrations of spacecraft solar panels. The translational root mounting method employs dampers installed at the roots of solar panels to dissipate the dynamic energy. The key of translational root mounting method is that translational root mounting method modifies the fundamental mode shape of the solar panel, by releasing the translation freedoms at its root. The root of the solar panel then has translational freedom instead of rotational freedom. As a result of mode shape modification, the translational root mounting method enables the root dampers to have sufficient working stroke, however without obviously reducing the solar panel’s fundamental frequency. Finite element model of a satellite solar panel with the length of 7 [Formula: see text] is established. Applying the finite element model, the limitation of a conventional passive vibration control method based on rotational root mounting is illustrated. To verify and illustrate the principle of translational root mounting method, the free vibration of the 7 [Formula: see text]-length satellite solar panel controlled by translational root mounting method is analyzed by finite element method. Finite element analysis (FEA) results indicate that the effect of a conventional passive control method is not obvious unless dampers with quite large damping coefficients are employed. In contrast, applying dampers with much smaller damping coefficients, the effect of translational root mounting method is fantastic comparing with the conventional passive method. To optimize the translational root mounting method and theoretically compare it to the conventional passive vibration control method, the solar panel is simplified into a non-linear one-degree of freedom system, and the analytical solution of its low frequency vibration is derived. Applying the analytical solution, it is found that damping ratio of the whole solar panel system does not increase with the damper’s damping coefficient, instead there are optimum values of damping coefficient. Applying the translational root mounting method, for the discussed 7 [Formula: see text]-length satellite solar panel, the damping ratio of which can be elevated from 0.0027 to 0.326.
Multistep thrust allocation method based on priority idea for remotely operated underwater vehicle with horizontal thrusters configured as X shape
Authors: Sun Gongwu , Xie Jirong , Qu Junqi , Li Xinguang
Published: March 2022

The horizontal thrusters located as X shape is a commonly used configuration in remotely operated underwater vehicle (ROV). To improve the motion performance of the remotely operated underwater vehicle with this configuration for some typical operation tasks, a multistep thrust allocation method based on priority idea is proposed. Firstly, the thrust allocation result of every single force/moment among the horizontal thrusters is obtained by using a piecewise calculation method. Then, a thrust allocation function of multiple forces and moment is constructed, transforming the thrust allocation problem into a multiparameter optimization problem. The objective function of the optimization problem is established based on priority idea, and limits of the thrusters are considered as constraints. Finally, a thrust redistribution method is adopted in order to further utilize the unsaturated thrusters in the propulsion system. Simulation results show that the proposed thrust allocation method has various advantages over the pseudo-inverse method, which makes the remotely operated underwater vehicle perform perfectly in the given operation task. The proposed method has important practical value and application prospects.
Whole-brain mapping of efferent projections of the anterior cingulate cortex in adult male mice
Authors: Shi Wantong , Xue Man , Wu Fengyi , Fan Kexin , Chen Qi-Yu , Xu Fang , Li Xu-Hui , Bi Guo-Qiang , Lu Jing-Shan , Zhuo Min
Published: March 2022

The anterior cingulate cortex (ACC) is a key cortical region that plays an important role in pain perception and emotional functions. Previous studies of the ACC projections have been collected primarily from monkeys, rabbits and rats. Due to technological advances, such as gene manipulation, recent progress has been made in our understanding of the molecular and cellular mechanisms of the ACC-related chronic pain and emotion is mainly obtained from adult mice. Few anatomic studies have examined the whole-brain projections of the ACC in adult mice. In the present study, we examined the continuous axonal outputs of the ACC in the whole brain of adult male mice. We used the virus anterograde tracing technique and an ultrahigh-speed imaging method of Volumetric Imaging with Synchronized on-the-fly-scan and Readout (VISoR). We created a three-dimensional (3D) reconstruction of mouse brains. We found that the ACC projected ipsilaterally primarily to the caudate putamen (CPu), ventral thalamic nucleus, zona incerta (ZI), periaqueductal gray (PAG), superior colliculus (SC), interpolar spinal trigeminal nucleus (Sp5I), and dorsal medullary reticular nucleus (MdD). The ACC also projected to contralateral brain regions, including the ACC, reuniens thalamic nucleus (Re), PAG, Sp5I, and MdD. Our results provide a whole-brain mapping of efferent projections from the ACC in adult male mice, and these findings are critical for future studies of the molecular and synaptic mechanisms of the ACC and its related network in mouse models of brain diseases.
Immunosensing the rheumatoid arthritis biomarker through bifunctional aldehyde-amine linkers on an iron oxide nanoparticle seeded voltammetry sensor
Authors: Zhou Bowei , Yan Yonglong , Xie JingBo , Huang Hongbo , Wang Heyun , Gopinath Subash CB , Anbu Periasamy , He Sanshan , Zhang Lijun
Published: March 2022

An immunosensor was developed on an interdigitated electrode (IDE) by voltammetry sensing for the early identification of the autoimmune disease ‘rheumatoid arthritis (RA)’ by detecting the biomarker anti-cyclic citrullinated peptide antibody (anti-CCP). Higher immobilization of cyclic citrullinated peptide (CCP) as a probe was achieved by using green synthesized iron oxide nanoparticles (IONPs). Field-emission scanning electron microscopy and field-emission transmission electron microscopy observations revealed that the polydispersed material displayed multifaceted features. X-ray photoelectron spectroscopy analysis confirms the occurrence of Fe, O, and C groups on the synthesized IONPs. IONPs were immobilized with a probe on IDE through bifunctional aldehyde-amine linkers. Due to the elevated occupancy of CCP and the highly efficient electric transfer from IONPs, higher changes in current are observed upon binding of anti-CCP with CCP. In the linear range from 8 to 250 pg/mL, the sensitivity and detection limit of anti-CCP were 8 and 15 pg/mL, respectively, with a regression coefficient of y = 1E−06x−3E−07; R2= 0.9637. Control experiments with nonimmune antibody and anti-carcinoembryonic antigen indicate the specific detection of anti-CCP. Furthermore, spiking of anti-CCP in human serum does not interfere, representing the specific detection of anti-CCP. This CCP-immobilized IDE through IONP helps to quantify anti-CCP levels in the biological fluid for diagnosing RA.
Comparison of angiographic results and clinical outcomes of no-reflow after stenting in left anterior descending (LAD) versus non-LAD culprit STEMI
Authors: Khan Kamran Ahmed , Kumar Rajesh , Shah Jehangir Ali , Farooq Fawad , Shaikh Quratulain , Kumar Dileep , Sial Jawaid Akbar , Saghir Tahir , Achakzai Abdul Samad , Karim Musa
Published: March 2022

Objectives:

No-reflow is a complication that frequently occurs after stenting during primary percutaneous coronary intervention. In this study, we focused on angiographic results and clinical outcomes after no-reflow in the left anterior descending (LAD) artery versus non–left anterior descending artery ST-elevation myocardial infarction (STEMI).

Methods:

In this prospective study, a total of 201 patients who had developed no-reflow during primary percutaneous coronary intervention were enrolled. The patients were divided into left anterior descending artery culprit and non-left anterior descending artery culprit groups. The primary endpoints were final thrombolysis in myocardial infarction flow, corrected thrombolysis in myocardial infarction frame count and final myocardial blush grade. Secondary endpoints were major adverse cardiovascular events in-hospital and at 1 month.

Results:

Out of the 201 patients, 60.19% had culprit left anterior descending artery. Pulse rate, baseline systolic and diastolic blood pressure, single-vessel disease, left ventricular ejection fraction <30%, baseline thrombolysis in myocardial infarction I flow and final thrombolysis in myocardial infarction II flow (24.8% vs 11.3%, p = .017), and thrombolysis in myocardial infarction frame count (28.17 ± 11.86 vs 24.38 ± 9.05, p = .016) were significantly higher in the left anterior descending artery group. In contrast, baseline Killip Class I, three-vessel disease, baseline thrombolysis in myocardial infarction II flow, final thrombolysis in myocardial infarction III flow (74.4% vs 87.5%, p = .024) and left ventricular ejection fraction >40% were significantly greater in the non–left anterior descending artery group. However, for both in-hospital and at 30 days, overall major adverse cardiovascular event was similar in the two groups. The demographics, clinical and medication profiles and the routes used to treat no-reflow were all comparable in both groups.

Conclusions:

No-reflow in left anterior descending artery ST-elevation myocardial infarction is associated with lower final thrombolysis in myocardial infarction III flow, higher thrombolysis in myocardial infarction frame count and relatively lower Grade III myocardial blush than non-left anterior descending artery ST-elevation myocardial infarction with subsequent lower left ventricular ejection fraction and a higher frequency of in-hospital heart failure and hospitalisation due to heart failure.
Caudal and middle segmental mandibulectomies for the treatment of unilateral temporomandibular joint ankylosis in cats
Authors: Villamizar-Martinez Lenin A , Ferro Daniel G , Carvalho Vanessa G , Ferreira Jonathan , Reiter Alexander M
Published: March 2022

Case series summary

Three cats affected by unilateral temporomandibular joint ankylosis underwent segmental mandibulectomy, while one cat with bilateral ankylosis underwent right temporomandibular joint gap arthroplasty and left segmental mandibulectomy. Minimal intraoperative complications were linked to the segmental mandibulectomies in the cases reported. All cats recovered their ability to open the mouth, and the vertical range of motion was unaltered during the postoperative period. Mandibular drift and dental malocclusion were the main postoperative complications related to the segmental mandibulectomies.

Relevance and novel information

Surgical excision of ankylotic tissue at the temporomandibular joint region may be technically challenging and associated with severe iatrogenic trauma of surrounding tissues. The results of this case series suggest that middle or caudal segmental mandibulectomy is a safe, feasible and effective surgical procedure to treat unilateral temporomandibular ankylosis in cats and could be considered as an alternative surgical technique to surgical excision of ankylotic tissue at the temporomandibular joint.
Will the EU Medical Device Regulation help to improve the safety and performance of medical AI devices?
Authors: Niemiec Emilia
Published: March 2022

Concerns have been raised over the quality of evidence on the performance of medical artificial intelligence devices, including devices that are already on the market in the USA and Europe. Recently, the Medical Device Regulation, which aims to set high standards of safety and quality, has become applicable in the European Union. The aim of this article is to discuss whether, and how, the Medical Device Regulation will help improve the safety and performance of medical artificial intelligence devices entering the market. The Medical Device Regulation introduces new rules for risk classification of the devices, which will result in more devices subjected to a higher degree of scrutiny before entering the market; more stringent requirements on clinical evaluation, including the requirement for appraisal of clinical data; new requirements for post-market surveillance, which may help spot early on any new, unexpected side effects and risks of the devices; and requirements for notified bodies, including for expertise of the personnel and consideration of relevant best practice documents. The guidance of the Medical Device Coordination Group on clinical evaluation of medical device software and the MEDDEV2.7 guideline on clinical evaluation also attend to some of the problems identified in studies on medical artificial intelligence devices. The Medical Device Regulation will likely help improve the safety and performance of the medical artificial intelligence devices on the European market. The impact of the Regulation, however, is also dependent on its adequate enforcement by the European Union member states.
Bi-parametric MRI/TRUS fusion targeted repeat biopsy after systematic 10-12 core TRUS-guided biopsy reveals more significant prostate cancer especially in anteriorly located tumors
Authors: Häggman Michael , Dahlman Pär , Ahlberg Mats , Liss Per , Cantera Ahlman Rafaele , Dragomir Anca , Ladjevardi Sam
Published: March 2022

Background

MRI and fusion guided biopsy have an increased role in the diagnosis of prostate cancer.

Purpose

To demonstrate the possible advantages with Bi-parametric MRI fusion-guided repeat biopsy over systematic 10–12-core biopsy for the diagnosis of prostate cancer.

Material and Methods

Four hundred and twenty-three consecutive men, with previous systematic 10–12-core TRUS-guided biopsy, and with suspicion of, or diagnosis of, low-risk prostate cancer underwent fusion-guided prostate biopsy between February 2015 and February 2017. The material was retrospectively assessed. In 220 cases no previous cancer was diagnosed, and in 203 cases confirmatory fusion guided biopsy was performed prior to active monitoring. MRI was classified according to PI-RADS. Systematic biopsy was compared to fusion guided biopsy for the detection of cancer, and PI-RADS was compared to the Gleason score.

Results

Fusion guided biopsy detected significantly more cancers than systematic ( p < .001). Gleason scores were higher in the fusion biopsy group ( p < .001). Anterior tumors were present in 54% of patients. Fusion biopsy from these lesions showed cancer in 53% with previously negative biopsy in systematic biopsies and 66% of them were upgraded from low risk to intermediate or high-risk cancers.

Conclusion

These results show superior detection rate and grading of bi-parametric MRI/TRUS fusion targeted repeat biopsy over systematic 10–12 core biopsies. Fusion guided biopsy detects more significant cancers despite using fewer cores. The risk group was changed for many patients initially selected for active surveillance due to upgrading of tumors. Bi-parametric MRI shows promising results in detecting anterior tumors in patients with suspected prostate cancer.
A Situation Assessment of Community Health Workers’ Preparedness in Supporting Health System Response to COVID-19 in Kenya, Senegal, and Uganda
Authors: Chengo Rehema , Esho Tammary , Kuria Shiphrah , Kimani Samuel , Indalo Dorcas , Kamanzi Lilian , Mouhamed Bachir , Wabwire Andrew , Camara Khaltoume , Kapsandui Tonny , Kagurusi Patrick , Nankanja Maureen , Oele Gorge , Osur Joachim
Published: March 2022

Background:

Coronavirus disease (COVID-19) caused socio-economic disruptions across the globe. The pandemic disrupted the health system (HS) calling for reengineering in response to high infection rates, deaths, and resultant containment measures. To deal with COVID-19 and promote resilience, community health workers (CHWs) were engaged across countries.

Objective:

Assess the preparedness of CHWs in supporting health system response in prevention and management of COVID-19 in Kenya, Senegal, and Uganda.

Methods:

A mixed methods design study involving national and subnational jurisdictions in the 3 countries. Key informant interviews were conducted with policy actors (16) and health care workers (24) while in-depth interviews involved CHWs (14) and community members (312) subjected to survey interviews.

Results:

Most (>50%) households survived on <USD 100/month during COVID-19 announced in March 2020 through national TV (57%), FM (42%), and radio station (27%). Community members interactions with CHWs increased during the pandemic through home visits as health educators, basic counseling providers and distributors of pandemic information tools, personal protective equipments, and social support commodities. The CHWs faced challenges during pandemic prevention and management including lack of: protective gear, salary, refresher courses, and identification tools; limited supervision and training; hostile reception during home visits; misconception and politicking about the pandemic. To effectively support prevention and manage of COVID-19, priority needs for CHWs were identified namely: provision of resources, protective gear, transport reimbursement, stipends, identification cards, and tools for recording and reporting; empowerment with adequate skills, trainings on provision of psychosocial support, first aid, and sensitization on policies.

Conclusion:

COVID-19 linked disruptions to optimal functioning of HS necessitated engagement of CHWs in the pandemic prevention and management. Findings underscore the important role CHWs play in supporting HS during crisis like COVID-19 to mitigate disruptions and stabilize the system for effective response. The CHWs can improve resilience of social and HS during unplanned disruptions for optimal functioning and attainment of universal health care. Policy makers should develop structured mechanisms for engaging CHWs while committing resources to address challenges that affect seamless synergy between health and CHWs Systems.
Bilateral Gastrocnemius Muscle Flap for Bilateral Defects of Knee Joint in Schatzker Type V & VI Proximal Tibial Condyle Fractures
Authors: Manas Raj Kumar , Chinta Kavya
Published: March 2022

Bilateral defects around the knee joint following fracture of the proximal tibia (Schatzker type V & VI) are difficult to reconstruct because of the unavailability of local tissue. A bicondylar proximal tibial fracture requires a bilateral approach and dual plates for fracture fixation. Because of extensive dissection during plating and extended zone of trauma, the suture lines occasionally dehisce resulting in soft tissue defects on both sides of the proximal tibia. Because of its bilateral nature, the defect requires 2 flaps. We are reporting 2 cases of suture dehiscence after fixation of bicondylar fracture of the proximal tibia which required reconstruction with bilateral gastrocnemius flaps. This reconstruction is a simple option that helps in providing stable coverage. The first case was followed up for a period of 5 years and the second case was followed up for a minimum period of 6 months. Both cases demonstrated well-healed flaps, united bone and no donor side morbidity. Bilateral gastrocnemius muscle flaps can be used simultaneously for 2 separate defects on both sides of the knee without significant donor site morbidly. This reconstructive option provides stable coverage, reduces the infection and promotes bony union thus helping in early ambulation.
Demographic Factors Associated With an Increased Incidence of Intra-articular Injuries After Delayed Anterior Cruciate Ligament Reconstruction
Authors: Riepen Dietrich , Kanski Gregory , Chavez Audrie Aliza , Tavakolian Paul , Gronbeck Christian , Khazzam Michael , Coyner Katherine J.
Published: March 2022

Background:

Delays from the time of an anterior cruciate ligament (ACL) tear to surgical reconstruction are associated with an increased incidence of meniscal and chondral injuries.

Purpose:

To evaluate the association between delays in ACL reconstruction (ACLR) and risk factors for intra-articular injuries across 8 patient demographic subsets.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

We performed a retrospective chart review of all patients who underwent ACLR from January 2009 to May 2015 at a single institution. Variables collected were age, sex, body mass index, time from injury to surgery, and presence of meniscal tears and chondral injuries. Demographic subsets were created according to sex, age (<27 vs ≥27 years), body mass index (<25 vs ≥25 kg/m2), and injury setting (sports vs non–sports related). Subsets were divided by time from injury to ACLR: 0 to <6 months (control group), 6 to <12 months, and ≥12 months. Multivariate logistic regression–generated odds ratios (ORs) were calculated.

Results:

Overall, 410 patients were included. ORs were significant for an increased incidence of medial meniscal tears (MMTs) (OR, 1.12-3.72; P = .02), medial femoral condyle (MFC) injuries (OR, 1.18-4.81; P = .02), and medial tibial plateau (MTP) injuries (OR, 1.33-31.07; P = .02) with surgical delays of 6 to <12 months. With ≥12-month delays, significance was found for MMTs (OR, 2.92-8.64; P < .001), MFC injuries (OR, 1.86-5.88; P < .001), MTP injuries (OR, 1.37-21.22; P = .02), lateral femoral condyle injuries (OR, 2.41-14.94; P < .001), and lateral tibial plateau injuries (OR, 1.15-5.27; P = .02). In the subset analysis, differences in the timing, location, rate, and pattern of chondral and meniscal injuries became evident. Female patients and patients with non–sports-related ACL tears had less risk of associated injuries with delayed surgery, while other demographic groups showed an increased injury risk.

Conclusion:

When analyzing patients who were symptomatic enough to eventually require surgery, an increased incidence of MMTs and medial chondral injuries was associated with ≥6-month delays in ACLR, and an increased incidence of lateral chondral injuries was associated with ≥12-month delays. Female patients and patients with non–sports-related ACL tears had less risk of injuries with delayed ACLR.