bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Industrial Agglomeration Promote Carbon Efficiency? A Spatial Econometric Analysis and Fractional-Order Grey Forecasting
Authors: Sun Zuoren , Liu Yi
Published: July 2021

In theory, the industrial agglomeration is a double-edged sword as there are both positive and negative externalities. China’s cities, with great disparities on degrees of the industrial agglomeration, often face different energy and carbon dioxide emission problems, which raise the question whether the industrial agglomeration promotes or inhibits energy efficiency and carbon dioxide emission. This paper explored the effects of the industrial agglomeration on carbon efficiency in China. Spatial econometric methods were implemented using panel data (2007–2016) of 285 cities above the prefecture level. The results revealed that industrial agglomerations have significant impacts on the urban carbon efficiency with significant spatial spillover effects. The agglomerations of the manufacturing and high-end productive service industries take positive effects on carbon efficiency while the low-end productive and living service industries take negative effects. As a comparison, we found that the agglomeration effects at the level of the megalopolis are greater than those at the national level, especially for the living services industry, in which the higher levels of agglomeration make the effects on carbon efficiency change from negative to positive. The divisions of labor for the central and common cities in the megalopolises are integrated into the industrial agglomeration. Furthermore, the fractional-order grey forecasting model is used in this paper. By the virtue of its advantage in dealing with small sample data which lack statistical rules, this paper makes an out-of-sample prediction of carbon efficiency and industrial agglomeration degree of Chinese cities. By adding the predicted results to the spatial correlation test, new evidence on the spatial correlation of carbon efficiency and spatial division of labor between cities is obtained. Based on the empirical results of the present study, we have proposed some policy recommendations.
Spectral Energy Density in an Axisymmetric Galaxy as Predicted by an Analytical Model for the Maxwell Field
Authors: Arminjon Mayeul
Published: August 2021

An analytical model for the Maxwell radiation field in an axisymmetric galaxy, proposed previously, is first checked for its predictions of the spatial variation of the spectral energy distributions (SEDs) in our Galaxy. First, the model is summarized. It is now shown how to compute the SED with this model. Then the model is adjusted by asking that the SED predicted at our local position in the Galaxy coincides with the available observations. Finally, the first predictions of the model for the spatial variation of the SED in the Galaxy are compared with those of a radiation transfer model. We find that the two predictions do not differ too much. This indicates that, in a future work, it should be possible with the present model to check if the “interaction energy” predicted by an alternative, scalar theory of gravitation, contributes to the dark matter.
Extraction and Evaluation of Corpus Callosum from 2D Brain MRI Slice: A Study with Cuckoo Search Algorithm
Authors: Manic K. Suresh , Biju Roshima , Patel Warish , Khan Muhammad Attique , Raja N. Sri Madhava , Uma S.
Published: August 2021

The work proposes a computer-based diagnosis method (CBDM) to delineate and assess the corpus callosum (CC) segment from the 2-dimensional (2D) brain magnetic resonance images (MRI). The proposed CBDM consists of two parts: (1) preprocessing and (2) postprocessing sections. The preprocessing tools have a multithreshold technique with the chaotic cuckoo search (CCS) algorithm and a preferred threshold procedure. The postprocessing employs a delineation process for extracting the CC section. The proposed CBDM finally extracts the vital CC parameters, such as total brain area (TBA) and CC area (CCA) to classify the considered 2D MRI slices into the control and autism spectrum disorder (ASD) groups. This attempt considers the benchmark brain MRI database which includes ABIDE and MIDAS for the experimental investigation. The results obtained with ABIDE dataset are further confirmed against the fuzzy

C

-means driven level set (FCM + LS) and multiphase level set (MLS) technique and the proposed CBDM with Shannon entropy along with active contour (SE + AC) presented improved result in comparison to the existing methodologies. Further, the performance of CBDM is confirmed on MIDAS and clinical dataset. The experimental outcomes approve that the proposed CBDM extracts the CC section from the 2D MR brain images that have higher accuracy compared to alternative techniques.
Near-Infrared Reflectance Imaging in Retinal Diseases Affecting Young Patients
Authors: Abdolrahimzadeh Solmaz , Ciancimino Chiara , Grassi Flaminia , Sordi Edoardo , Fragiotta Serena , Scuderi Gianluca
Published: July 2021

Near-infrared reflectance (NIR) is a noninvasive, contactless, and rapid in vivo imaging technique for visualizing subretinal alterations in the photoreceptor layer, retinal pigment epithelium, and choroid. The present report describes the application of this imaging method in retinal and choroidal pathologies affecting young patients where scarce cooperation, poor fixation, and intense glare sensation can result in a challenging clinical examination. A literature search of the MEDLINE database was performed using the terms “near-infrared reflectance” and “spectral-domain optical coherence tomography.” Articles were selected if they described the diagnostic use of NIR in children or young adults. Of 700 publications, 42 manuscripts published between 2005 and 2020 were inherent to children or young adults and were considered in this narrative literature review. The first disease category is the phakomatoses where NIR is essential in visualizing choroidal alterations recognized as cardinal biomarkers in neurofibromatosis type 1, microvascular retinal alterations, and retinal astrocytic hamartomas. Another diagnostic application is the accurate visualization of crystals of various nature, including the glistening crystals that characterize Bietti crystalline dystrophy. Acute macular neuropathy and paracentral acute middle maculopathy represent a further disease category with young adulthood onset where NIR is not only diagnostic but also essential to monitor disease progression. A further interesting clinical application is to facilitate the detection of laser-induced maculopathy where funduscopic examination can be normal or subnormal. In conclusion, NIR imaging has a noninterchangeable role in diagnosing certain retinal diseases, especially in children and young adults where there is scarce collaboration and a lack of evident clinical findings. Moreover, this technique can reveal unique retinal and choroidal biomarkers highly specific to rare conditions.
Neurologic Imaging in a Patient with Cirrhosis and Altered Mental Status: To CT or Not to CT
Authors: Polyak Alexander , Bannykh Serguei , Klein Andrew , Sundaram Vinay
Published: July 2021

Hepatic encephalopathy represents a continuum of neuropsychiatric symptoms among patients with end-stage liver disease. When a patient with cirrhosis presents with altered mental status (AMS), routine neurologic imaging is not typically recommended, due to low diagnostic yield. Guidance from the American Association for the Study of Liver Disease states that, on initial presentation, brain imaging is not required unless there are other signs of intracranial pathology, including focal neurologic deficits. We present a case of a 61-year-old female with cirrhosis presenting with AMS without focal deficits, in whom neurological imaging revealed a meningioma and subsequent resection led to symptom improvement.
Predicting Independence 6 and 18 Months after Ischemic Stroke Considering Differences in 12 Countries: A Secondary Analysis of the IST-3 Trial
Authors: Vieira André , Soares Patrícia , Nunes Carla
Published: July 2021

Objectives. This study is aimed at identifying the best clinical model to predict poststroke independence at 6 and 18 months, considering sociodemographic and clinical characteristics, and then identifying differences between countries. Methods. Data was retrieved from the International Stroke Trial 3 study. Nine clinical variables (age, gender, severity, rt-PA, living alone, atrial fibrillation, history of transient ischemic attack/stroke, and abilities to lift arms and walk) were measured immediately after the stroke and considered to predict independence at 6 and 18 months poststroke. Independence was measured using the Oxford Handicap Scale. The adequacy, predictive capacity, and discriminative capacity of the models were checked. Countries were added to the final models. Results. At 6 months poststroke, 35.8% (

n
=
1088

) of participants were independent, and at 18 months, this proportion decreased to 29.9% (

n
=
747

). Both 6 and 18 months poststroke predictive models obtained fair discriminatory capacities. Gender, living alone, and rt-PA only reached predictive significance at 18 months. Poststroke patients from Poland and Sweden showed greater chances to achieve independence at 6 months compared to the UK. Poland also achieved greater chances at 18 months. Italy had worse chances than the UK at both follow-ups. Discussion. Six and eight variables predicted poststroke independence at 6 and 18 months, respectively. Some variables only reached significance at 18 months, suggesting a late influence in stroke patients’ rehabilitation. Differences found between countries in achieving independence may be related to healthcare system organization or cultural characteristics, a hypothesis that must be addressed in future studies. These results can allow the development of tailored interventions to improve the outcomes.
Optimization Model for Integrated Municipal Solid Waste System Using Stochastic Chance-Constraint Programming under Uncertainty: A Case Study in Qazvin, Iran
Authors: Zaeimi Mehdi Bavaghar , Rassafi Amir Abbas
Published: July 2021

Municipal solid waste management (MSW) is a factor that affects environmental pollution and the spread of diseases in cities. Therefore, an efficient MSW management system results in reducing the cost of environmental impact by tackling the processes of waste collection, recycling, and disposal. In this study, a biobjective optimization model is developed which aims to minimize the costs of facility location and transportation planning and the emission of environmental pollutants. Furthermore, to consider the uncertain nature of the problem, demand or the volume of the generated waste is considered as a random parameter. As a result, a stochastic mathematical programming model with probable constraints is developed. To solve and validate the model, the ε-constraint approach has been employed. Moreover, for a real-world application of the proposed model, a case study is implemented in Qazvin, Iran. Finally, various problems are solved for different levels of reliability and an efficient MSW system is designed for each of them. Results show that the proposed method was able to achieve Pareto solutions where managers can decide to choose one of them based on their priorities in comparison with the current status. Moreover, results revealed cost and emission would be reduced by increasing confidence level. Finally, a comparison is made between our proposed ε-constraint method and one of the recently used solution approaches.
Mathematical Modeling and Mutational Analysis Reveal Optimal Therapy to Prevent Malignant Transformation in Grade II IDH-Mutant Gliomas
Authors: Aoki Kosuke , Suzuki Hiromichi , Yamamoto Takashi , Yamamoto Kimiyo N. , Maeda Sachi , Okuno Yusuke , Ranjit Melissa , Motomura Kazuya , Ohka Fumiharu , Tanahashi Kuniaki , Hirano Masaki , Nishikawa Tomohide , Shimizu Hiroyuki , Kitano Yotaro , Yamaguchi Junya , Yamazaki Shintaro , Nakamura Hideo , Takahashi Masamichi , Narita Yoshitaka , Nakada Mitsutoshi , Deguchi Shoichi , Mizoguchi Masahiro , Momii Yasutomo , Muragaki Yoshihiro , Abe Tatsuya , Akimoto Jiro , Wakabayashi Toshihiko , Saito Ryuta , Ogawa Seishi , Haeno Hiroshi , Natsume Atsushi
Published: July 2021

Isocitrate dehydrogenase-mutant low-grade gliomas (IDHmut-LGG) grow slowly but frequently undergo malignant transformation, which eventually leads to premature death. Chemotherapy and radiotherapy treatments prolong survival, but can also induce genetic (or epigenetic) alterations involved in transformation. Here, we developed a mathematical model of tumor progression based on serial tumor volume data and treatment history of 276 IDHmut-LGGs classified by chromosome 1p/19q codeletion (IDHmut/1p19qcodel and IDHmut/1p19qnoncodel) and performed genome-wide mutational analyses, including targeted sequencing and longitudinal whole-exome sequencing data. These analyses showed that tumor mutational burden correlated positively with malignant transformation rate, and chemotherapy and radiotherapy significantly suppressed tumor growth but increased malignant transformation rate per cell by 1.8 to 2.8 times compared with before treatment. This model revealed that prompt adjuvant chemoradiotherapy prolonged malignant transformation-free survival in small IDHmut-LGGs (≤ 50 cm3). Furthermore, optimal treatment differed according to genetic alterations for large IDHmut-LGGs (> 50 cm3); adjuvant therapies delayed malignant transformation in IDHmut/1p19qnoncodel but often accelerated it in IDHmut/1p19qcodel. Notably, PI3K mutation was not associated with malignant transformation but increased net postoperative proliferation rate and decreased malignant transformation-free survival, prompting the need for adjuvant therapy in IDHmut/1p19qcodel. Overall, this model uncovered therapeutic strategies that could prevent malignant transformation and, consequently, improve overall survival in patients with IDHmut-LGGs.

Significance:

A mathematical model successfully estimates malignant transformation-free survival and reveals a link between genetic alterations and progression, identifying precision medicine approaches for optimal treatment of IDH-mutant low-grade gliomas.
Real-Life Experience of Monoclonal Antibody Treatments in Chronic Rhinosinusitis with Nasal Polyposis
Authors: Meier Eva C. , Schmid-Grendelmeier Peter , Steiner Urs C. , Soyka Michael B.
Published: August 2021

Introduction: Few studies assess biologicals such as, omalizumab, mepolizumab, benralizumab, and dupilumab in patients suffering from chronic rhinosinusitis with nasal polyposis (CRSwNP). The reported success rate in these studies differ, and it remains uncertain if there are any biomarkers to predict successful therapy. Our aim was to analyze the therapeutic outcome in a real life setting and to identify predictive biomarkers for successful treatment. Methods: Data from patients with CRSwNP treated with a monoclonal antibody between November 2014 and January 2020 were analyzed retrospectively. Improvement in the polyp score and clinical symptoms like nasal obstruction, sense of smell, nasal discharge, and facial pain were evaluated. Other characteristics, including use of nasal or systemic steroids, comorbidities, previous history of sinus surgery, eosinophilia tissue, blood values (eosinophils, total immunoglobulin E, eosinophilic cationic protein, and interleukin 5), and allergic sensitization in serum were also investigated to identify possible predictive biomarkers. Results: Forty-eight treatments in 29 patients (m/f = 15/14) aged 27–70 years were reviewed. Treatments with mepolizumab showed the best success rates (78.9%), followed by omalizumab (50%) and benralizumab treatments (50%). However, a correlation between biomarkers and treatment success could not be found. Discussion/Conclusion: Treatment of CRSwNP with biologicals is a promising option for severe cases not responding to conventional therapy, including difficult-to-treat patients. Predictive biomarkers for a successful treatment could not be identified, but the reduction of eosinophilic cationic protein was linked with the response.
A Staged Operation as a Surgical Strategy for a Patient with Type VI Isolated Superior Mesenteric Artery Dissection
Authors: Nishi Ryosuke , Fujita Yasuhiko , Amagai Teruyoshi
Published: August 2021

An isolated superior mesenteric artery (SMA) dissection (ISMAD) is extremely rare among visceral artery dissections. Its diagnosis is made by abdominal contrast CT scan which shows SMA occlusion partially or completely. The ISMAD is classified into 6 types: type I–V has partial occlusion and treated medically using antiplatelets or anticoagulants. On the other hand, type VI has complete occlusion and must be treated by urgent surgical operation. We present a 67-year-old female who presented with sudden onset abdominal pain and melena. An urgent contrast CT revealed type VI ISMAD. She underwent 3 staged operations as follows: (1) first, as laparotomy showed pale color in almost the extensive length of the small intestine, arterial bypassing of SMA was undertaken using SMA to the right common iliac artery bypass; (2) as the second-look operation on the next day, the terminal ileum was resected, and the remaining small intestine was able to be preserved. However, when the abdomen was tried to be closed, systemic blood pressure decreased to pre-shock condition, so the abdominal wall was closed at skin level with silastic sheet. (3) As the third-look operation on the 7th day, ileostomy was created, and the abdominal wall was safely closed. The postoperative course was uneventful. This case study shows that SMA grafting and staged operations might be an option to preserve the length of the small intestine when ISMAD is diagnosed as type VI.
Cinema, doença infecciosa e teoria da evolução: uma estratégia possível ao Ensino Médio
Authors: Frey Daniela , Waizbort Ricardo
Published: August 2021

Nosso objetivo é fomentar a articulação entre o ensino de doenças infectocontagiosas e de evolução, a partir do filme (como estratégia de ensino) “O despertar de uma paixão” (2006), que retrata uma epidemia de cólera na China. A metodologia envolveu uma abordagem qualitativa, de intervenção, com alunos de um curso técnico integrado ao Ensino Médio, de uma escola pública, em Petrópolis (RJ). Após responderem a um questionário inicial, eles assistiram ao referido filme e a trechos do documentário “A corrida das espécies”, que apresenta aspectos evolutivos de doenças. Depois, houve um debate e um estudo sobre possíveis relações entre Epidemiologia e Evolução. Por fim, aplicamos outro questionário para tentar reconhecer mudanças nas respostas. Os resultados indicam que certos conceitos evolutivos passaram a coexistir com conceitos prévios.
Análise da arquitetura das oficinas ferroviárias da Companhia Paulista em Jundiaí, São Paulo
Authors: Silva Tainá Maria , Oliveira Eduardo Romero de
Published: August 2021

O presente texto tem por finalidade analisar como se deu a construção das oficinas ferroviárias da Companhia Paulista em Jundiaí, São Paulo. O recorte temporal é limitado ao século XIX, compreendendo os anos entre 1892 e 1896, período em que foi construída a edificação original. Esse tipo de estudo se justifica pelo fato de que as oficinas de Jundiaí detinham uma construção singular para o período em comparação com as demais estruturas do tipo existentes no estado de São Paulo. Por meio da observação visual e do conhecimento de bibliografia específica, foram analisados elementos como implantação, materiais, sistemas, aberturas e ornamentos. A partir dessa análise, pode-se ampliar o conhecimento sobre algumas das técnicas construtivas utilizadas, além de elucidar aspectos do patrimônio industrial edificado.
Entre volutas, talões e contravolutas: o “informe” na historiografia da Igreja Jesuítica de Santo Alexandre em Belém do Pará
Authors: Nunes Mateus Carvalho
Published: August 2021

O artigo analisa estudos de caso historiográficos sobre os elementos compostos por volutas, talões e contravolutas presentes no frontão da fachada principal da Igreja Jesuítica de Santo Alexandre em Belém do Pará. Busca, a partir de uma perspectiva decolonialista, rever as matrizes epistemológicas e historiográficas das obras de John Bury (1991), Lúcio Costa (1941), Joaquim José Codina (1784) e Philip L. Goodwin (1943, no catálogo da exposição Brazil Builds do MoMA, em Nova York). Objetiva contribuir para a lacuna teórica na historiografia de objetos artísticos frutos de hibridismos e intercâmbios culturais no contexto da atuação da Companhia de Jesus na Amazônia Colonial, além de discutir possibilidades metodológicas contemporâneas para suas análises
Essential Hypertension Is Associated With Changes in Gut Microbial Metabolic Pathways: A Multisite Analysis of Ambulatory Blood Pressure
Authors: Nakai Michael , Ribeiro Rosilene V. , Stevens Bruce R. , Gill Paul , Muralitharan Rikeish R. , Yiallourou Stephanie , Muir Jane , Carrington Melinda , Head Geoffrey A. , Kaye David M. , Marques Francine Z.
Published: August 2021

Recent evidence supports a role for the gut microbiota in hypertension, but whether ambulatory blood pressure is associated with gut microbiota and their metabolites remains unclear. We characterized the function of the gut microbiota, their metabolites and receptors in untreated human hypertensive participants in Australian metropolitan and regional areas. Ambulatory blood pressure, fecal microbiome predicted from 16S rRNA gene sequencing, plasma and fecal metabolites called short-chain fatty acid, and expression of their receptors were analyzed in 70 untreated and otherwise healthy participants from metropolitan and regional communities. Most normotensives were female (66%) compared with hypertensives (35%,
P
<0.01), but there was no difference in age between the groups (59.2±7.7 versus 60.3±6.6 years old). Based on machine learning multivariate covariance analyses of de-noised amplicon sequence variant prevalence data, we determined that there were no significant differences in predicted gut microbiome α- and β-diversity metrics between normotensives versus essential or masked hypertensives. However, select taxa were specific to these groups, notably
Acidaminococcus spp
.,
Eubacterium fissicatena, and Muribaculaceae
were higher, while
Ruminococcus
and
Eubacterium eligens
were lower in hypertensives. Importantly, normotensive and essential hypertensive cohorts could be differentiated based on gut microbiome gene pathways and metabolites. Specifically, hypertensive participants exhibited higher plasma acetate and butyrate, but their immune cells expressed reduced levels of short-chain fatty acid-activated GPR43 (G-protein coupled receptor 43). In conclusion, gut microbial diversity did not change in essential hypertension, but we observed a significant shift in microbial gene pathways. Hypertensive subjects had lower levels of GPR43, putatively blunting their response to blood pressure-lowering metabolites.
Harmonisation of Pharmaceutical Take-Back Systems in the EU
Authors: Mitkidis Kateřina , Obolevich Viktoria , Chrysochou Polymeros , Mitkidis Panagiotis
Published: July 2021

When medicines enter the environment, they harm living species and ecosystems. Improper disposal of household pharmaceutical waste increases the concentration of pharmaceuticals in the environment and thus their detrimental impacts. Since 2004, the EU has obliged its Member States to establish ‘an appropriate collection system’ for unused and/or expired medication. However, as no implementation guidelines exist, large differences in the systems and their use remain. Pressure for adoption of guidelines harmonising the systems across the EU has been increasing. We address the question whether such harmonisation could mitigate pharmaceutical pollution, and which regulatory measures would be appropriate. To answer this, we conduct a comparative investigation of the systems’ regulation and an empirical study of citizens’ beliefs and behaviour across four European countries. We find a potential for increasing the effectiveness of pharmaceutical take-back systems through their harmonisation and conclude that the EU has the competence and tools to regulate this.
Development and Validation of an Instrument to Assess Horseback Mobility in Hippotherapy
Authors: Prieto Alessandra V. , Ayupe Kênnea Martins Almeida , Abreu Ana C. A. , Filho Paulo J. B. Gutierres
Published: August 2021

Improvement in rider mobility represents an important functional gain for people with disabilities undergoing hippotherapy. However, there is no validated measuring instrument to track and document the rider's progress in riding activities. In this study, we aimed to develop and establish validity evidence for an instrument to assess hippotherapy participants’ mobility on horseback. We report on this development through the stages of: (a) content validation, (b) construct validation, (c) inter- and intra-rater reliability and (d) internal consistency analysis. We evaluated its factor structure with exploratory factor analyses, calculated values for inter- and intra-rater reliability using the intra-class correlation coefficient, and calculated its internal consistency using Cronbach's alpha. We followed recommendations by the Guidelines for Reporting Reliability and Agreement Studies. We found good inter-rater reliability (intra-class correlation coefficient – ICC = 0.991–0.999) and good intra-rater reliability (ICC = 0.997–1.0), and there was excellent internal consistency (Cronbach's α = 0.937–0.999). The instrument’s factor structure grouped its three domains into one factor. As this instrument is theoretically consistent and has been found to be appropriate and reliable for its intended use, it is now available for the measurement of horseback mobility among hippotherapy riders.
Snap Judgements and Availability Bias in Travel Decisions
Authors: Riggs William , Yudowitz Louis
Published: July 2021

Past research has explored how travelers make economic decisions, but only a small number of papers look at financial nudges and price anchoring—how they might cause travelers to make snap judgements about value that undermine rational economic principles. This research explores the behavioral response to different kinds of incentives. It finds that, consistent with theory, when presented with two numbers certain individuals will anchor to a higher number and be willing to pay more. Likewise, it finds that certain consumers are not able to quickly make judgements about the cost of travel. When the survey participants were offered daily or monthly payment plans, payments each day were valued almost twice as much as a single payment each month. This offers important policy considerations for public agencies seeking to reduce driving, particularly as new disruptive platforms emerge and new technology allows for more dynamic and curated data to be used to nudge travel behavior.
Management of Patellar Instability: A Network Meta-analysis of Randomized Control Trials
Authors: Hurley Eoghan T. , Colasanti Christopher A. , Anil Utkarsh , McAllister Delon , Matache Bogdan A. , Alaia Michael J. , Strauss Eric J. , Campbell Kirk A.
Published: August 2021

Background:

Multiple surgical options exist for the treatment of patellar instability; however, the most common procedures involve either a reconstruction of the medial patellofemoral ligament (MPFL) or a repair/plication of the MPFL and medial soft tissues.

Purpose:

To perform a network meta-analysis of the randomized controlled trials (RCTs) in the literature to compare MPFL reconstruction, MPFL repair, and nonoperative management for patellar instability.

Study Design:

Systematic review and network meta-analysis; Level of evidence, 1.

Methods:

The literature search was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RCTs comparing MPFL reconstruction, MPFL repair, and nonoperative management for patellar instability were included. Clinical outcomes included recurrent instability (including both dislocations and subluxations), redislocation, and Kujala score. Clinical outcomes were compared using a frequentist approach to network meta-analysis, with statistical analysis performed using the statistical software R. The treatment options were ranked using P scores.

Results:

There were 13 RCTs with a total of 789 patients, all with a minimum follow-up of 24 months. There were 150 patients treated using MPFL reconstruction, 353 treated using MPFL repair, and 286 treated nonoperatively. Overall, MPFL reconstruction had the highest P score (0.9967) and resulted in a significantly lower recurrence rate than did MPFL repair (odds ratio [OR], 0.42; 95% CI, 0.07-0.72) and nonoperative management (OR, 0.09; 95% CI, 0.03-0.32). In addition, MPFL repair resulted in a significantly lower recurrence rate than did nonoperative management (OR, 0.42; 95% CI, 0.25-0.70). MPFL reconstruction had the highest P score (0.9651) and resulted in a significantly higher Kujala score than did nonoperative management (mean difference, 10.45; 95% CI, 0.41-20.49) but not MPFL repair (mean difference, 0.15; 95% CI, 0.03-0.68). Subgroup analysis revealed that MPFL reconstruction had the highest P score for all outcomes in those with first-time dislocation.

Conclusion:

The current study demonstrated that MPFL reconstruction results in the lowest rate of recurrent patellar instability and best functional outcomes as measured using the Kujala score.
The Role of Intergroup Threat in Support of Punitive Policies Toward Mexican Immigrants
Authors: Guillermo Steffanie , Zuniga Jose , Quiroz Angela D.
Published: July 2021

The present research examined the degree to which symbolic and realistic threat perceptions of documented and undocumented Mexican immigrants predicted support for willingness to provide basic resources (e.g., food, water) in detention centers and agreement with policies that restrict Mexican immigration through detention and deportation. Our study recruited 191 participants online via Amazon Mechanical Turk. Results showed that undocumented immigrants were more realistically, but not symbolically threatening than their documented counterparts. Intergroup threat predicted lower willingness to provide basic resources in detention centers and greater support of punitive policies. This finding was not moderated by whether participants evaluated documented or undocumented immigrants. Once we accounted for social dominance orientation (SDO), political attitudes, and contact with Mexican immigrants, only SDO remained a significant predictor of attitudes toward resources in detention centers, while all variables predicted more support for punitive policies. These findings highlight the roles of symbolic and realistic threats, SDO, political attitudes, and intergroup contact in endorsing punitive immigration policies.
Constructing Authentic Spectatorship at an Esports Bar
Authors: Cumming David Jian-Jia , Gibbs Martin , Smith Wally
Published: July 2021

Spectatorship is a core element of esports. Short for “electronic sports,” esports encompasses organized, professional competitive videogaming practices produced and consumed as a spectator sport. Esports’ computerized nature grants it a placeless quality, which creates ambiguities around what authentic esports spectatorship ought to be. Notably, some notions theorized prior to the emergence of contemporary esports imply that authenticity and placelessness are incompatible. We address this conundrum by presenting an ethnographic study conducted at an esports bar; a venue designed for the spectatorship of esports alongside other fans and alcohol consumption. While embodying seemingly placeless qualities, esports spectatorship nevertheless takes place in situated places. We found spectators at the bar worked to authenticate their spectatorship by drawing on conventions of legitimacy, professionalism, and spectacle from elsewhere, particularly spectator sports. Through their spectatorship, those at the bar constructed and affirmed a convention of authenticity for esports.
The gesture enigma: Reconciling the prominence and insignificance of choral conductor gestures
Authors: Jansson Dag , Haugland Balsnes Anne , Durrant Colin
Published: August 2021

Curious as to why conducting gesture are both acknowledged and ignored by choral singers, this article investigates the enigmatic nature of the act of conducting. Education and research are biased toward gestural aspects of the choral conductor role. At the same time, research shows that gestural skills rank strikingly low compared with other musical skills and interpersonal skills. This study endeavors to unpack this enigma, based on 40 interviews with choral singers and conductors in Norway and Sweden. Taking a phenomenological approach, analysis of the fieldwork reveals that singers are more aware of gesture when something out of the ordinary happens, is unclear, or is even particularly appealing. The enigmatic role of gesture is partly due to conceptual ambiguity—gestures are signals that conductors “do” as well as embody the integral conductor “being.” Moreover, four “enigma busting” contextual dimensions were found: complexity of the music, the irreplaceability of gestures in the specific situation, singers’ receptiveness to gestures, and the gestural proficiency of the conductor. The article points at some implications for education as well as future research.
Uncensored journalism in censored times: Challenges of reporting on Azerbaijan
Authors: Geybulla Arzu
Published: August 2021

Azerbaijan is an authoritarian regime, whose government maintains a tight grip over the media landscape. Independent and opposition media are regularly persecuted, with journalists and their family members intimidated by law enforcement agencies via arrests, beating, threats and other forms of persecution. Defamation is considered a criminal offence. This paper addresses the impact of this restrictive media environment on reporting about Azerbaijan. As scores of journalists have fled the country in search of safety, a community of exiled journalists has emerged and a number of news media websites operate in exile. Together they continue reporting on Azerbaijan with the help of a handful of journalists remaining on the ground. This paper explores how reporting on Azerbaijan continues despite a highly restricted media environment and what this means for other media systems facing authoritarian rule.
Development and Validation of Crosswalks Between FIM® and SCIM III for Voluntary Musculoskeletal Movement Functions
Authors: Jones Linda A. T. , Li Chih-Ying , Weitzenkamp David , Steeves John , Charlifue Susie , Whiteneck Gale
Published: July 2021

Background. In spinal cord injury, there are multiple databases containing information on functional recovery, but data cannot be pooled or compared due to differences in how function is measured. A crosswalk is needed to link or convert scores between instruments. Objectives. To create a crosswalk between the voluntary musculoskeletal movement items in the Functional Independence Measure (FIM®) and the Spinal Cord Independence Measure III (SCIM III) for spinal cord injury. Methods. Retrospective datasets with FIM® and SCIM III on the same people were used to develop (Swiss dataset, n = 662) and validate (US, n = 119, and Canadian datasets, n = 133) the crosswalks. Three different crosswalk methods (expert panel, equipercentile, and Rasch analysis) were employed. We used the correlation between observed scores on FIM® and SCIM III to crosswalked scores as the primary criterion to assess the strength of the crosswalk. Secondary criteria such as score distributions, Cohen’s effect size, point differences, and subgroup invariance were also evaluated. Results. All three methods resulted in strong correlation coefficients, exceeding the primary criterion value of r = .866 (.897–.972). Assessment of secondary criteria suggests the equipercentile and Rasch methods produced the strongest crosswalks. Conclusions. The Rasch FIM®/SCIM III crosswalk is recommended because it is based on co-calibration of linearized measures, allowing for more sophisticated parametric analyses. The crosswalk will allow comparisons of voluntary musculoskeletal functional recovery across international databases using different functional measures, as well as different systems of care and rehabilitation approaches.
Anomalous Aortic Origin of a Coronary Artery Repair Through an Anterior Minithoracotomy
Authors: Nellis Joseph R. , Drysdale Nicolas D. , Evans Megan A. , Habermann Alyssa C. , Meza James M. , Andersen Nicholas D. , Daneshmand Mani A. , Turek Joseph W.
Published: August 2021

Objective

The benefits of minimally invasive adult cardiac surgery are well established. Nevertheless, minimally invasive congenital cardiac procedures, even for adult patients, are uncommon. In 2018, we started repairing anomalous aortic origin of a coronary artery (AAOCA) through a 5 cm anterior minithoracotomy when possible to improve cosmesis and avoid sternal precautions. We hypothesized this approach was safe and reliable.

Methods

A 5 cm incision was made in the right second intercostal space. The incision was carried down to the pericardium while preserving the internal mammary artery. With the pericardium in view, the second and third ribs were disarticulated. Central cardiopulmonary bypass was established, and the repair was carried out based on the patient’s anatomy. The technique was modified to a left anterior minithoracotomy for 1 patient who required pulmonary artery translocation. At any point, if the dissection or repair was not progressing appropriately, the minimally invasive exposure was converted to a partial or traditional median sternotomy.

Results

Between June 2018 and June 2019, 11 patients underwent minimally invasive anomalous coronary repair. Four patients (3 with body mass index >30) were converted to traditional sternotomy due to poor visualization. Postoperatively, 1 patient required coronary artery bypass after 335 days, due to extensive collaterals and stable angina. Otherwise, at a median follow-up of 437 days (IQR 340 to 480), patients had resumed baseline activity without recurrent symptoms.

Conclusions

Minimally invasive AAOCA repair may be appealing, although surgeons should be cautious given the high conversion rate.
A critical self-reflexive account of a privileged researcher in a complicated setting: Kakuma refugee camp
Authors: Bilotta Neil
Published: July 2021

As a white, Western-educated man, undertaking research in Kakuma refugee camp, Kenya, I encountered ethical dilemmas related to my privileged racial and gender status. These include power imbalances between researchers and refugees and conducting research in the face of human suffering. Through critical self-reflexivity, I analyze my own experiences to reveal the personal and professional vulnerabilities that researchers from high-income countries (HICs) may encounter when working in contexts where oppression and forced displacement are prominent. I conclude that researchers who work in contexts of forced migration must extend beyond the boundaries of procedural research ethics and include components of relational ethics. This involves close collaboration with refugee participants to develop more culturally relevant research ethics guidelines for refugee-specific populations.
Robotic-assisted genitourinary reconstruction: current state and future directions
Authors: Shakir Nabeel A. , Zhao Lee C.
Published: July 2021

With the widespread dissemination of robotic surgical platforms, pathology previously deemed insurmountable or challenging has been treated with reliable and replicable outcomes. The advantages of precise articulation for dissection and suturing, tremor reduction, three-dimensional magnified visualization, and minimally invasive trocar sites have allowed for the management of such diverse disease as recurrent or refractory bladder neck stenoses, and radiation-induced ureteral strictures, with excellent perioperative and functional outcomes. Intraoperative adjuncts such as near-infrared imaging aid in identification and preservation of healthy tissue. More recent developments include robotics via the single port platform, gender-affirming surgery, and multidisciplinary approaches to complex pelvic reconstruction. Here, we review the recent literature comprising developments in robotic-assisted genitourinary reconstruction, with a view towards emerging technologies and future trends in techniques.
Factors Associated With Achilles Tendon Rupture in Women’s Collegiate Gymnastics
Authors: Bonanno Joseph , Cheng Jennifer , Tilley Dave , Abutalib Zafir , Casey Ellen
Published: July 2021

Background:

Achilles injury risk in women’s collegiate gymnastics is 10-fold higher than in all other collegiate sports. This study aims to identify risk factors for Achilles tendon ruptures in collegiate female gymnasts.

Hypothesis:

Gymnasts with Achilles tendon ruptures will be more likely to report early gymnastics specialization, elite-level training before college, and performance of high-difficulty skills on floor and vault.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 4.

Methods:

Anonymous surveys were distributed to current and former collegiate female gymnasts, aged 18 to 30 years, via coaches, athletic trainers, Twitter, and ResearchMatch. Information about Achilles tendon ruptures, gymnastics-related injuries, sport specialization, event/skills participation, and medication use were collected.

Results:

A total of 581 gymnasts were included. One hundred gymnasts (17.2%; 95% CI: 14.1%-20.3%) reported Achilles tendon ruptures during collegiate training or competition. Most ruptures (91%) occurred on floor exercise; 85.7% of these occurred during back tumbling-take-off. Compared with gymnasts without ruptures during college, a greater percentage of gymnasts with ruptures competed at a Division I program, trained elite, competed difficult vaults and floor passes before and during college, competed in all 4 events during college, identified as Black/African American, and used retinoid medications.

Conclusion:

Achilles tendon ruptures are more common in women’s collegiate gymnastics than other sports. Competing at the elite level, performing difficult floor and vault skills, and competing in all 4 events may increase the risk for an Achilles tendon rupture. Potential nontraining risk factors include retinoid exposure and Black/African American race. Future studies regarding the mechanisms of Achilles tendon ruptures in female collegiate gymnasts are warranted.

Clinical Relevance:

Collegiate gymnasts who compete at the elite level, perform high levels of difficulty on floor and vault, and compete in all 4 events may be at increased risk for Achilles tendon ruptures.
Recent advancements in pulmonary arterial hypertension and right heart failure research: overview of selected abstracts from ATS2020 and emerging COVID‐19 research
Authors:   ATS Pulmonary Circulation Early Career Working Group, Potus Francois , Frump Andrea L. , Umar Soban , R. Vanderpool Rebecca , Al Ghouleh Imad , Lai Yen‐Chun
Published: August 2021

Each year the American Thoracic Society (ATS) Conference brings together scientists who conduct basic, translational and clinical research to present on the recent advances in the field of respirology. Due to the Coronavirus Disease of 2019 (COVID‐19) pandemic, the ATS2020 Conference was held online in a series of virtual meetings. In this review, we focus on the breakthroughs in pulmonary hypertension research. We have selected 11 of the best basic science abstracts which were presented at the ATS2020 Assembly on Pulmonary Circulation mini‐symposium “What’s New in Pulmonary Arterial Hypertension (PAH) and Right Ventricular (RV) Signaling: Lessons from the Best Abstracts,” reflecting the current state of the art and associated challenges in PH. Particular emphasis is placed on understanding the mechanisms underlying RV failure, the regulation of inflammation, and the novel therapeutic targets that emerged from preclinical research. The pathologic interactions between pulmonary hypertension, right ventricular function and COVID‐19 are also discussed.
In-hospital mortality and its predictors among stroke patients in sub-Saharan Africa: A systemic review and meta-analysis
Authors: Mohammed Ammas Siraj , Degu Amsalu , Woldekidan Nigist Alemayehu , Adem Fuad , Edessa Dumessa
Published: July 2021

Objective:

To assess the in-hospital mortality from acute stroke and its predictors in sub-Saharan Africa.

Method:

The literature search was conducted in the databases of PubMed/Medline, Embase, CINAHL, and Google Scholar. The retrieved studies were screened by titles and abstracts, and then full texts were assessed for eligibility. The methodological quality of the included studies was assessed using the Joanna Briggs Institute’s critical appraisal checklist. The publication bias was assessed using the funnel plot asymmetry and the Egger tests. Data were analyzed using Stata software version 15.0 in a random-effect model.

Result:

A total of 27 studies with a total sample size of 6331 were included in this systematic review and meta-analysis. The pooled estimated prevalence of in-hospital mortality due to stroke was 22% (95% confidence interval = 0.17–0.27). Stroke mortality in Western Africa (37%, 95% confidence interval = 0.24–0.50) was higher than in Eastern Africa (15%, 95% confidence interval = 0.12–0.19) and Southern Africa (18%, 95% confidence interval = 0.06–0.19). In three studies, mortality was higher in hemorrhagic stroke (25%) than ischemic stroke (14%). Risk factors associated with higher mortality were admission Glasgow Coma Scale, stroke severity, age, sex, presence of hypertension, and declined renal function.

Conclusion:

The in-patient mortality of stroke in sub-Saharan Africa was high. Therefore, there is an urgent need for further stroke epidemiology studies in stroke subtypes and the performance of patient-level meta-analysis to understand the risk factors associated with mortality and herald appropriate intervention to curb the high mortality rate in the region.
Rhino-orbital cerebral mucormycosis in a child with type 1 diabetes: A case report
Authors: Masmoudi Mohamed , Hasnaoui Mehdi , Ben Abdeljalil Nouha , Guizani Rihab , Lahmar Rihab , Jaoued Oussema , Ben Sik Ali Habiba , Rassas Ahmed , Mighri Khalifa
Published: July 2021

Rhino-orbital cerebral mucormycosis is a rare but potentially severe fungal infection in children with high rate of morbidity and mortality. In pediatric patients, uncontrolled diabetes mellitus is considered to be a predisposing factor only in 15% of cases. To prevent and reduce mortality rate of this severe disease, early diagnosis based on clinical findings and biopsy is highly recommended. Herein, we report a case of rhino-orbital cerebral mucormycosis in a 12-year-old girl with type 1 diabetes to demonstrate that a multimodal management approach, involving early surgery which consists in frequent endoscopic sinus debridement and appropriate antifungal therapy, is essential to effectively reduce the spread of infection and achieve effective outcome.