bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of psoas and gluteus medius muscles attenuation on hip fracture type
Authors: Yerli Mustafa , Yüce Ali , Ayaz Mustafa B , Bayraktar Tahsin O , Erkurt Nazım , Dedeoğlu Süleyman S , İmren Yunus , Gürbüz Hakan
Published: June 2022

Introduction:

Sarcopenia is defined as a progressive loss of muscle mass and function with increased age. The measurement of muscle mass and attenuation on the axial computed tomography (CT) scan has been reported to be a good indicator for sarcopenia in previous literature. This study aimed to compare muscle mass between the intertrochanteric fracture and femoral neck fracture groups by accurately measuring muscle mass around the hip joint using a CT scan.

Methods:

The cases were matched according to age and gender on a 1-to-1 basis. As a result, a total of 400 patients, 200 patients in each group with the same age and gender characteristics, were included in the study. At the disc of L4-L5 level, the cross-sectional area (CSA) of the psoas muscle was evaluated, and at the disc of L5-S1 level, the CSA of the psoas, iliacus and gluteus medius muscles were evaluated. In addition, attenuation was evaluated using the average Hounsfield Unit (HU) for the specific area.

Results:

The mean age of 400 patients (262 females, 138 male) included in the study was 78.49 ± 7.67 years. It was observed that the mean HU values of the patients in the femoral neck fracture group were significantly higher than the intertrochanteric fracture group ( p < 0.001, p = 0.008; respectively). At the same time, the mean HU values of the gluteus medius muscle were higher in the femoral neck fracture group ( p < 0.001), but in contrast with the psoas muscle, the CSA values of gluteus medius muscle were significantly higher in the intertrochanteric fracture group ( p = 0.017).

Conclusions:

Fatty degeneration of the psoas muscle among the muscles around the hip may affect the type of hip fracture. Elderly patients with strong psoas muscles may experience femoral neck fracture due to contraction and torsion during falling.
Outcomes analysis of anterior and lateral approach for open repair of hip abductor tendons
Authors: Requicha Francisco , Edwards Suzanne M , Rickman Mark S , Comley Andrew S
Published: June 2022

Background:

Gluteal tendons tears are increasingly being recognised as a cause of recalcitrant trochanteric pain, but there is a paucity of robust studies analysing the type of tears, results and predictors of outcome.

Methods:

Patients with gluteal tendon tears resistant to conservative treatment who underwent isolated open repair (IR) or total hip arthroplasty and concomitant repair (THA+repair) with a minimum 1-year follow-up were retrospectively assessed separately. Type of tear, surgical approach, and fixation methods were registered. Complications and postoperative outcomes were analysed: visual analogue scale (VAS) of pain, VAS satisfaction, and activity level. Univariate regressions and multivariable models were developed.

Results:

90 cases were included: 62 cases underwent IR and 28 cases THA+repair, with an average follow-up of 3.9 years and 2.6 years, respectively. 13 complications were found ( n = 5 IR, n = 8 THA+repair), including 9 re-operations ( n = 4 IR, n = 5 THA+repair). Mean VAS pain score was 3.02 (SD 2.74) for the IR and 2.32 (SD 2.43) for THA+repair group. Mean VAS satisfaction was 7.09 (SD 3.07) and 7.68 (SD 2.71) for the IR and THA+repair group, respectively. In the IR group 61.4% returned to all pre-injury activities, whereas in the THA+repair group 79% did. Full-thickness tears had higher VAS pain scores ( p = 0.0175), and there was trend ( p > 0.05) towards higher complications, re-tears and lower VAS satisfaction in this type of tears in both groups. No statistically significant differences were found in outcomes when comparing THA+repair through direct anterior (DAA) with lateral approach (LA).

Conclusions:

Isolated gluteal tendon repair or THA+repairs seem to be safe procedures with high levels of satisfaction at short- to mid-term follow-up. The presence of a full-thickness tear is a predictor of inferior outcomes.
Host Transcriptional Signatures Predict Etiology in Community-Acquired Pneumonia: Potential Antibiotic Stewardship Tools
Authors: Siljan William W , Sivakumaran Dhanasekaran , Ritz Christian , Jenum Synne , Ottenhoff Tom HM , Ulvestad Elling , Holter Jan C , Heggelund Lars , Grewal Harleen MS
Published: June 2022

Background:

Current approaches for pathogen identification in community-acquired pneumonia (CAP) remain suboptimal, leaving most patients without a microbiological diagnosis. If better diagnostic tools were available for differentiating between viral and bacterial CAP, unnecessary antibacterial therapy could be avoided in viral CAP patients.

Methods:

In 156 adults hospitalized with CAP classified to have bacterial, viral, or mixed viral-bacterial infection based on microbiological testing or both microbiological testing and procalcitonin (PCT) levels, we aimed to identify discriminatory host transcriptional signatures in peripheral blood samples acquired at hospital admission, by applying Dual-color-Reverse-Transcriptase-Multiplex-Ligation-dependent-Probe-Amplification (dc-RT MLPA).

Results:

In patients classified by microbiological testing, a 9-transcript signature showed high accuracy for discriminating bacterial from viral CAP (AUC 0.91, 95% CI 0.85-0.96), while a 10-transcript signature similarly discriminated mixed viral-bacterial from viral CAP (AUC 0.91, 95% CI 0.86-0.96). In patients classified by both microbiological testing and PCT levels, a 13-transcript signature showed excellent accuracy for discriminating bacterial from viral CAP (AUC 1.00, 95% CI 1.00-1.00), while a 7-transcript signature similarly discriminated mixed viral-bacterial from viral CAP (AUC 0.93, 95% CI 0.87-0.98).

Conclusion:

Our findings support host transcriptional signatures in peripheral blood samples as a potential tool for guiding clinical decision-making and antibiotic stewardship in CAP.
Immune Response to SARS-CoV-2 Vaccine among Heart Transplant Recipients: A Systematic Review
Authors: Shoar Saeed , Prada-Ruiz Adriana C. Carolina , Patarroyo-Aponte Gabriel , Chaudhary Ashok , Sadegh Asadi Mohammad
Published: June 2022

Background

Heart transplant (HTX) recipients are at a significantly higher risk of adverse clinical outcomes, due to chronic immunosuppression and co-existence of other chronic conditions, when contracting the SARS-CoV-2 infection. Although vaccination against SARS-CoV-2 is currently the most promising measure for the prevention of severe Coronavirus Disease 2019 (COVID-19) among solid organ transplant recipients, the extent of immune response and its protective efficacy among patients receiving HTX has not been sufficiently studied.

Methods

We performed a systematic review of the literature by inquiring PubMed/Medline to identify original studies among HTX recipients, who had received at least one dose of the SARS-CoV-2 vaccine. Data on the measured humoral or cellular immune response was collected from all the eligible studies. Factors associated with a poor immune response were further investigated within these studies.

Results

A total of 12 studies comprising 563 HTX recipients were included. The average age of the study participants was 60.8 years. Sixty four percent of the study population were male. Ninety percent of the patients had received an mRNA vaccine (Pfizer/ BNT162b2 or Moderna/mRNA-1273). A positive immune response to SARS-CoV-2 vaccine was variably reported in 0% to 100% of the patients. Older age (> 65 years), vaccine dose (first, second, or third), time since HTX to the first dose of the vaccine, the time interval between the latest dose of the vaccine and measurement of the immune response, and the type of immunosuppressive regimen were all indicated as potential determinants of a robust immune response to the SARS-CoV-2 vaccination.

Conclusion

HTX recipients demonstrate a weaker immune response to the vaccination against SARS-CoV-2 compared to the general population. Older age, anti-metabolite agents such as mycophenolate mofetil, and vaccination during the first year following the HTX have been indicated as potential determinants of a poor immune response.
China’s evolving stance against tech monopolies: A moment of international alignment in an era of digital sovereignty
Authors: Wang Yi , Gray Joanne E
Published: June 2022

The digital environment is dominated by monopolistic companies who possess and exercise substantial economic, political and social power to varying degrees. Globally, policymakers are striving to regulate these digital platform companies to address monopoly issues. Through a content analysis of publicly available policy and government documents, company reports, trade press and news media, we investigate key moments in the evolution of anti-monopoly/oligopoly actions taken by the Chinese government against its dominant digital platforms. We then compare this analysis with a brief overview of the European Union's (EU) digital sovereignty agenda, focusing on the discourse regarding greater digital economy competition in the region. Our analysis suggests that in both jurisdictions digital sovereignty is not simply an issue of geopolitics, that is, contests between nation states, but it is also a response to the excessive power wielded by digital platform companies. We argue that in an international digital policy landscape increasingly characterised by digital sovereignty agendas, the issue of monopoly in digital platform economies is a small but potentially overlooked and undervalued point of convergence between the EU and China.
The role of the Ifá in the construction of the person in relation to death: Psychology’s interface with ideas from the Adjatado of Dogbo, in Benin
Authors: Serge Kiki Kwami Fleury , Guimarães Danilo Silva
Published: June 2022

According to the Adjatado systems of knowledge, the Ifá is a mediator between the world of the living and of the dead and this mediation depends on the funerary rites. Ifá is a word used to refer to the science of divination, the son of God, among other names. It is present from a person’s birth to death. The paper discusses the Ifá’s relation with the cultural processes of the construction of the Adjatado person, assuming its significant role in the lives of the Adjatado people in sustaining personal experience. After discussing selected cultural perspectives, about the meaning of Ifá for the Adjatado people, we propose a dialogue on the construction of the person in relation to death in the framework of Semiotic-Cultural Constructivism in psychology, in which death can be discussed from a philosophical perspective, articulated to the phenomenology of temporality, tradition, and alterity (cf. Simão, 2005; 2010; Simão, Guimarães & Valsiner, 2015), nevertheless, the subject of death has not yet been much explored. We argue that the dialogue here proposed enables an understanding of how the meanings that the Adjatado confer to the experience of death is related to processes that involve the cultivation of the person in the culture, addressing further developments concerning dialogues between diverse cultural understandings on psychological processes.
Peer reflective groups: Creating a nurturing and safe community for aspiring clinical psychologists to build their collective voice
Authors: Taylor Charlotte , Daniilidi Xeni , Tan Sarah , Huckridge Jaymie
Published: June 2022

Assistant Psychologist (AP) and Honorary Assistant Psychologist (HAP) roles provide an opportunity to gain the experience needed to progress onto the Clinical Psychology doctorate, making them very competitive to obtain. Nationally, there have been reports that people fulfilling these roles can face a number of challenges including poorly defined job descriptions, difficulty developing a voice within hierarchical organisation structures and balancing competing demands on time. This paper tells the story of a peer reflective group set up for APs and HAPs in the paediatric health psychology team, to provide a supportive space for aspiring psychologists to meet together. The evolution of the group and its impact are discussed, and recommendations for setting up similar groups in other services are made.
Being recognized in an algorithmic system: Cruel optimism in gay visibility on Douyin and Zhihu
Authors: Wang Shuaishuai , Zhou Oscar Tianyang
Published: June 2022

Drawing upon “algorithmic ethnography” (Christin, 2020), this article enrolls algorithms to gather qualitative data to examine how Chinese social media platforms and their algorithms intersect with gay visibility. By looking critically into the ways that gay romance and HIV-related content are generated on Douyin and Zhihu, respectively, we argue that algorithmic gay visibility serves as a form of cruel optimism, which becomes a profitable convenience for corporate social media platforms and operates in an exclusionary matrix. The content that ordinary Chinese gay men are presented with (for example, the able-bodied, romanticized normative gay relationship and overly optimistic self-help advice for gay men living with HIV) is economically viable, which produces trending and monetizable items, including music tracks, viral dance routines and challenges, personas, medicine promotions, as well as commercial healthcare training and marketing. In contrast, non-conforming bodies, non-monogamous and queer relationships, as well as the depression, stigma and discrimination experienced by gay men living with HIV are algorithmically invisible.
Influence of site conditions on seismic performance of isolated high-speed railroad bridges
Authors: Wu Di , Lin Jingtian , Xiong Yan , Cui Jie
Published: June 2022

Earthquakes have occurred frequently in western China (Sichuan, Tibet, etc.) while the complex site conditions in western regions bring great uncertainty to the seismic performance of isolated high-speed railroad bridges (HSRBs). By studying the relationship between structure-dependent and structure-independent seismic intensity measures, soil site conditions are taken into account in the probabilistic seismic demand model (PSDM), which is applied to analyze the failure probability of the isolated HSRB under different site conditions. Based on the design parameters and test results of a typical isolated HSRB in western region, the analysis of the finite element model of the structure was performed. Probabilistic seismic demand models of the isolated HSRB were developed. The seismic fragility curves of the isolated HSRBs were obtained and the failure probabilities under different site conditions were compared and analyzed. The evaluation of the failure probability that the failure probability of the isolated HSRBs in the site area with seismic intensity of 9 is 35.84% and 78.19% under the soil site categories D and E, respectively. Therefore, the seismic spectrum characteristics of the soil site are an important factor affecting the seismic response of isolated HSRB structures. This study provides a more effective modified PSDM for seismic performance assessment of isolated HSRBs under the different site conditions.
Prognosis and Remodeling after Endovascular Repair for Acute, Subacute, and Chronic Type B Aortic Dissection
Authors: Zhao Yang , Yao Chen , Yin Henghui , Wang Mian , Li Zilun , Wang Jingsong , Hu Zuojun , Wang Shenming , Chang Guangqi
Published: June 2022

Purpose:

Thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) is already well introduced, but the best time point to perform TEVAR has not been defined. This study was to report mid- to long-term outcomes and aortic remodeling of TEVAR in patients with TBAD.

Materials and Methods:

In total, 318 TBAD patients from June 2001 to May 2016 were retrospectively reviewed. Patients were divided into 3 groups depending on interval between dissection onset to TEVAR: acute (0–7 days), subacute (8–30 days), and chronic (>30 days). Clinical and morphological data were collected and analyzed.

Results:

The follow-up aorta-related mortality rates in the 3 groups were 17.6%, 2.6%, 4.2%, and the proximal stent-induced new entry rates were 11.8%, 1.6%, 2.8%, respectively. Aortic remodeling was satisfied in both the acute and subacute group, but the false lumen diameter did not decrease (p>0.05) in the chronic group. Compared with the VIRTUE classification (acute, 0–14 days; subacute, 15–92 days; chronic, >92 days), mid- to long-term outcomes of patients within the first overlapped interval between the 2 classifications (8–14 days) were similar to that of subacute patients (15–30 days), while aortic remodeling of patients in the second overlapped interval (31–92 days) was similar to that of chronic patients (>92 days).

Conclusions:

This study suggests that TEVAR for subacute TBAD is associated with a low long-term rate of aorta-related death. Aortic remodeling of chronic dissections is not satisfactory. Additional results suggest that the subacute phase (8–30 days) may be the optimal time to perform TEVAR for uncomplicated TBAD.
Redo Fenestrated-Branched Endovascular Aortic Repair (F-BEVAR) for Failed F-BEVAR
Authors: Driessen Anna L. , Scott Carla K. , Guardiola Gerardo G. , Baig Mirza S. , Kirkwood Melissa L. , Timaran Carlos H.
Published: June 2022

Failed fenestrated-branched endovascular aortic repair (F-BEVAR) requiring a redo F-BEVAR is a rare event. In this study, we report 2 cases of a failed F-BEVAR secondary to a type IIIb endoleak from tears on the fabric graft successfully treated with redo F-BEVAR. This is a technically challenging procedure that requires meticulous planning, advanced imaging technologies and experienced operators. Redo F-BEVAR appears to be a feasible and safe treatment option. However, larger series and long-term follow-up are needed to confirm effectiveness and durability.
Poly(vinylidene fluoride) electrospun nonwovens morphology: Prediction and optimization of the size and number of beads on fibers through response surface methodology and machine learning regressions
Authors: Trupp Federico Javier , Cibils Roberto , Goyanes Silvia
Published: June 2022

Electrospinning is one of the leading techniques for fiber development. Still, one of the biggest challenges of the technique is to control the nanofiber morphology without many trial-and-error tests. In this study, it is demonstrated that via design of experiments (DoE), response surface methodology (RSM) and machine learning regressions (MLR) it is possible to predict the beads-on-string size, size distribution and bead density in electrospun poly(vinylidene fluoride) (PVDF) mats with a small number of tests. PVDF concentration, dimethylacetamide/acetone ratio, tip-to-collector voltage and distance were the parameters considered for the design. The results show good agreement between the experimental and modeled data. It was found that concentration and solvent ratio play the main roles in minimizing bead size and number, distance tends to reduce them, and voltage does not play a significant role. As an evaluation of the potential of the method, bead-free fibers were obtained through the predicted parameter values. Comparison of the performance of the two methods is presented for the first time in electrospinning research. Response surface methodology resulted much faster, but MLR achieved a lower error and better generalization abilities. This approach and the availability of the MLR script used in this work may help other groups implement it in their research and find information hidden in the data while improving model prediction performance.
Silent Footsteps: Renga Poetry as a Collaborative, Creative Research Method Reflecting on the Immobilities of Gender-Based Violence in the Covid-19 Pandemic
Authors: Parks Mel , Holt Amanda , Lewis Sian , Moriarty Jessica , Murray Lesley
Published: June 2022

In the Covid-19 global crisis, gender-based violence (GBV) has been reshaped and reconfigured, with increases in some places and decreases in others. During our exploration of the changes in GBV through trans/feminist collaborative reflexive storying, we noticed the fragmentary nature of our storied recollections, which both represented and heightened the emotions in the work. With an intention of distilling the words even further, we challenged ourselves, as transdisciplinary researchers, to create a collaborative renga poem, which we titled, “Silent Footsteps.” An ancient Japanese form, the renga is a series of short, linked verses. This article demonstrates that renga offers an accessible, collaborative poetic research method, not only for research teams but also for non-academic groups to connect with each other. It has the ability to convey deep emotion, with an authentic personal voice, while being confined to structure and rules. Along with creating two stanzas each turn in a round of emails, we all wrote a reflection to engage with the process that identifies this method of writing research as holistic and creative, able to further connect the authors, reflect on the new knowledge and meaning that this work has motivated. Based on these reflections, which are woven throughout and on the renga poem, which is presented in full at the end, we argue that (a) renga is a timely poetic form, (b) it enhances transdisciplinary collaboration, and (c) that it offers both resistance and catharsis.
An Evaluation of the Validity of Growth on Two Computer Adaptive Tests to Predict Performance on End-of-Year Achievement Tests using Quantile Regression
Authors: Van Norman Ethan R. , Forcht Emily R.
Published: June 2022

This study explored the validity of growth on two computer adaptive tests, Star Reading and Star Math, in explaining performance on an end-of-year achievement test for a sample of students in Grades 3 through 6. Results from quantile regression analyses indicate that growth on Star Reading explained a statistically significant amount of variance in performance on end-of-year tests after controlling for baseline performance in all grades. In Grades 3 through 5, the relationship between growth on Star Reading and the end-of-year test was stronger among students who scored higher on the end-of-year test. In math, Star Math explained a statistically significant amount of variance in end-of-year scores after statistically controlling for baseline performance in all grades. The strength of the relationship did not differ among students who scored lower or higher on the end-of-year test across grades.
Isoorientin ameliorates OVA-induced asthma in a murine model of asthma
Authors: Liang Shuai , Zhao Yuanyuan , Chen Guozhen , Wang Chunxiao
Published: June 2022

Allergic asthma which is induced by ovalbumin (OVA) is a chronic airway inflammation disease. Isoorientin (Iso) is a natural C-glucosyl flavone with many biological properties. We aimed to evaluate the effectiveness of Iso on OVA-induced allergic asthma. A total of 30 C57BL/6 mice were randomly divided into five groups: control group, OVA group, Dex (dexamethasone, 10 mg/kg) group, low-dose Iso group (Iso-L, 25 mg/kg), and high-dose Iso group (Iso-H, 50 mg/kg). The serum and bronchoalveolar lavage fluid (BALF) were collected for biochemical parameters, the lung tissue was collected for hematoxylin-eosin (H&E) staining, immunohistochemistry (IHC), and western blot. The levels of IL-4, IL-5, IL-13, malondialdehyde (MDA), NO, and reactive oxygen species (ROS) in Iso-L and Iso-H groups were significantly lower than that in model group ( p < 0.05). Simultaneously, the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity were higher than that in model group ( p < 0.05). Iso significantly ameliorated airway hyperresponsiveness. Meanwhile, H&E staining revealed that mice treated with Iso resulted in the ameliorated inflammatory cell infiltration and a reduction in interstitial thickening. The nuclear factor erythroid 2-like 2 (Nrf2) and HO-1 protein expression in Iso-L and Iso-H groups were enhanced over that in model group, while p-NF-κB-p65 and p-IκB-α protein expression was decreased ( p < 0.05). Our research indicated that Iso alleviated the OVA-induced allergic asthma, and this effect can be explained by the modulation of Nrf2/HO-1 and NF-κB signaling pathway; thus, the results providing a therapeutic rationale for the treatment of Iso on allergic asthma.
Enhancing the yield of seasonal influenza viruses through manipulation of microRNAs in Madin–Darby canine kidney cells
Authors: Saengchoowong Suthat , Nimsamer Pattaraporn , Khongnomnan Kritsada , Poomipak Witthaya , Praianantathavorn Kesmanee , Rattanaburi Somruthai , Poovorawan Yong , Zhang Qibo , Payungporn Sunchai
Published: June 2022

Annual influenza vaccine is recommended to reduce the occurrence of seasonal influenza and its complications. Thus far, Madin–Darby canine kidney (MDCK) cell line has been used to manufacture cell-based influenza vaccines. Even though host microRNAs may facilitate viral replication, the interaction between MDCK cells-derived microRNAs and seasonal influenza viruses has been less frequently investigated. Therefore, this study highlighted microRNA profiles of MDCK cells to increase the yield of seasonal influenza virus production by manipulating cellular microRNAs. MDCK cells were infected with influenza A or B virus at a multiplicity of infection (MOI) of 0.01, and microRNA collections were then subjected to MiSeq (Illumina) Sequencing. The validated profiles revealed that cfa-miR-340, cfa-miR-146b, cfa-miR-197, and cfa-miR-215 were the most frequently upregulated microRNAs. The effect of candidate microRNA inhibition and overexpression on viral replication was determined using reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA). The hybridization pattern between candidate miRNAs and viral genes was performed using miRBase and RNAhybrid web-based programs. Moreover, the predicted microRNA-binding sites were validated by a 3’-UTR reporter assay. The results indicated that cfa-miR-146b could directly target the PB1 gene of A/pH1N1 and the PA gene of B/Yamagata. Furthermore, cfa-miR-215 could silence the PB1 gene of A/pH1N1 and the PB1 gene of B/Victoria. However, the PB2 gene of the A/H3N2 virus was silenced by cfa-miR-197. In addition, the HA and NA sequences of influenza viruses harvested from the cell cultures treated with microRNA inhibitors were analyzed. The sequencing results revealed no difference in the antigenic HA and NA sequences between viruses isolated from the cells treated with microRNA inhibitors and the parental viruses. In conclusion, these findings suggested that MDCK cell-derived microRNAs target viral genes in a strain-specific manner for suppressing viral replication. Conversely, the use of such microRNA inhibitors may facilitate the production of influenza viruses.
Pedunculated Thrombus in a Left Popliteal Artery Aneurysm Which Resolved On Anticoagulation Therapy
Authors: Collins Carolyn , Fitzgerald Patricia , Gowey Anwer , Elkady Ramy , Harrington Cian , McHugh Seamus , Aly Sayed , Moneley Daragh , Kheirelseid Elrasheid , Naughton Peter
Published: June 2022

Popliteal artery aneurysms (PAAs) account for approximately 70% of all peripheral artery aneurysms. Despite the exact prevalence of PAAs being unknown, it is thought to be present in about 1% of the elderly male population. Acute thrombus in a PAA can increase the risk of lower limb ischemia and amputation. We present a case documenting an incidental finding of an asymptomatic “floating” or pedunculated thrombus within a left PAA on duplex ultrasound. This thrombus resolved following a period of anticoagulation with intravenous Heparin followed by oral administration of apixaban.
Adjacent Portal Vein Collateral With Retrograde Flow
Authors: Carrion Erika , Shaver Kimberly , Wedderman David , Sales Clifford
Published: June 2022

A prominent portal vein collateral, detected on duplex examination, confirms the diagnosis of portal vein hypertension (PVHTN). We present a patient referred to the vascular laboratory for a portal vein duplex ultrasound (DUS) examination with elastography. The most significant finding was retrograde (hepatofugal) flow in a prominent portal vein collateral located immediately adjacent to the main portal vein. This DUS examination highlights the techniques that identify spontaneous portosystemic shunts, thus confirming the presence of PVHTN.
Periscyphismus and Section of the Temporal Vessels: Two Byzantine Surgical Remedies for Headache Relief
Authors: Tsagkaris Christos , Trompoukis Constantinos , Manios Andreas , Papadakis Marios
Published: June 2022

Headache is a prevalent clinical symptom and condition, whose management has been challenging from the antiquity to the 21st century. Physicians in the Greek, Roman and Byzantine antiquity employed surgical techniques to treat headache in patients presenting with persistent symptoms that were not alleviated with conservative means. A survey in the medical literature of the period reveals that two surgical procedures, periscyphismus and section of the temporal vessels, were developed for this purpose. The present study describes the techniques presented in the sources of the period and elaborates on their evolution and influence across different historical periods and contexts.
Accommodating Religious Practice at an Elementary School: A Case Study
Authors: Frid Carolyn , Lawlor Alexander Sherry
Published: June 2022

Twelve Muslim intermediate student leaders at have shared their request for afternoon prayer space with Ms. Lidd, their white principal. Aware of the school board mandate to nurture the identity of students and build social capital through bridging opportunities, Ms. Lidd reviewed the policy for religious accommodations in schools. Principal Lidd takes the request to the School Improvement Committee. The accommodation is supported, plans to make space for afternoon prayer begins, and staff are informed of the accommodation for a prayer space. In this efficient response as a culturally responsive school leader (CRSL), Principal Lidd suddenly finds herself in conflict with staff. How will the principal navigate this resistance while ensuring the religious accommodation is met? How will she lead the staff toward developing culturally responsive practice?
A Comparative Cost Analysis of Local Anesthesia versus Brachial Plexus Block for Complex Hand Surgery
Authors: Baradaran Aslan , Meng Fanyi , Jaberi Mehrad Mojtahed , Finlayson Roderick , Thibaudeau Stephanie
Published: June 2022

Background:

Local anesthesia has shown to be safe and cost-effective for elective hand surgery procedures performed outside of the operating room. The economic benefits of local anesthesia compared to regional anesthesia for hand surgeries performed in the operating room involving repair of tendons, nerves, arteries, or bones are unclear. This study aimed to compare costs pertinent to hand surgeries performed in the main operating room under local anesthesia (LA) or brachial plexus (BP) block.

Methods:

We performed a cross-sectional study on the first 70 randomized patients from a prospective controlled trial of anesthesia modalities for hand surgery. The primary objective was to determine the mean anesthesia-related cost, and the secondary objectives were to analyze block performance time, block onset time, duration of anesthesia, duration of surgery, and time in the recovery room.

Results:

The mean anesthesia-related cost of performing hand surgery under LA as a wrist and/or digital block was $236 ± 30, compared to $435 ± 43 for BP, a difference of $199 per case. The mean block performance time was shorter for LA (1.3 minutes) versus BP (7.0 minutes). The mean anesthesia-related time was longer in BP (30.7 ± 16 minutes) compared to LA (17.7 ± 6.7 minutes), and consequently the total anesthesia time was longer in BP.

Conclusions:

We demonstrated that local anesthesia compared to brachial plexus block achieved substantial cost savings in complex hand surgeries by decreasing major expenses. In an era of cost-consciousness, the use of LA represents an important modality for health systems to optimize patient flow and increase cost-effectiveness.
Hermeneutic Phenomenology: Bridging Western and Japanese Perspectives and Languages
Authors: Doering Keiko , McAra-Couper Judith , Gilkison Andrea
Published: June 2022

This article offers the reader methodological insights emerging from a hermeneutic phenomenological study that examined the meaning of the woman–midwife relationship in Japan. The methodology of hermeneutic phenomenology was chosen because it is well suited to reveal women’s and midwives’ lived experience that is often taken for granted in day-to-day maternity care settings. However, implementing the methodology was not without its challenges. These challenges included whether hermeneutic phenomenology, based on Western philosophy, could be appropriate for conducting a study involving a researcher and participants who identify as Japanese. Further, while the study required final write up in English, the interviews were conducted in Japanese. Utilizing hermeneutic phenomenology relies on language as the tool for accessing the phenomenon of enquiry. However, Japanese culture is less expressive and, relative to Western cultures, values non-verbal communication. Beyond verbal expression, language also conveys unique influences of each culture. Although it may be challenging to conduct research between different cultures, and their unique ways of thinking and languages, it is not an impossible situation and can be rewarding. The value of using hermeneutic phenomenology for a Japanese centered study helped to convey the meaning of the woman–midwife relationship in Japan. This article details the unique process of the study, in terms of the philosophical foundation and languages, to provide methodological insights and advances for future cross-cultural qualitative research.
Experimental research of wear-fatigue interaction of gears
Authors: Dong Kunpeng , Sun Zhili , Chai Xiandong , Wang Jian
Published: June 2022

Gear failures are commonly caused by wear and fatigue and past research on gear failures has primarily focused on individual failures. A gear testing machine was developed to explore the mechanism of gear wear-fatigue interaction, and four sets of wear-fatigue interaction tests were performed by changing the operating conditions of the gear drive by regulating the quantity of lubricant in the test gearbox. The K-S test method was used to investigate the gear life distribution under wear-fatigue interaction. The frequency domain properties of the wear-fatigue interaction were compiled and analyzed using Fast Fourier Transform (FFT) analysis. A coordinate measuring machine was implemented to obtain the exact amount of wear at each stage of the gear test. The mechanism of gear wear-fatigue interaction was analyzed by scanning electron microscope observation of tooth surfaces. The results are as follows. The life distribution under wear-fatigue interaction obeys a log-normal distribution. With the increase of the lubrication the pitting fault occurs, the fault gear rotation frequency and its harmonic frequency appear in the low frequency region, and its amplitude increases with the increase of the pitting fault. In the high-frequency region, a sideband with the faulty gear rotation frequency as the interval appears around the meshing frequency and its two times frequency, and its amplitude increases with the increase of the pitting fault. With the decrease of lubrication, the gear wear failure increases, the amplitude of the meshing frequency and its two times frequency increases in the high frequency region. In the gear transmission process, wear and fatigue exist in a competitive relationship of mutual constraints.
Barriers to adult vaccination in Canada: A qualitative systematic review
Authors: Stratoberdha Doris , Gobis Barbara , Ziemczonek Adrian , Yuen Jamie , Giang Annita , Zed Peter J.
Published: June 2022

Background:

In recent years, Canadian health care professionals have observed an increase in vaccine refusal. The objective of this study is to review published literature and identify the main themes related to vaccine hesitancy and barriers to vaccination in Canadian adults and recent immigrants.

Methods:

A qualitative systematic review was performed. A comprehensive search of MEDLINE (1946 to January 2021) and EMBASE (1974 to January 2021) was conducted to identify existing literature that addressed the primary research question. Studies were eligible for inclusion if the study population involved 1) the general population, 2) Indigenous populations, 3) recent immigrants to Canada or 4) Canadian health care professionals.

Results:

Thirty-four studies were included with a focus on the general population ( n = 22), health care professionals ( n = 10) and recent immigrant populations ( n = 2). The most frequently reported barriers were lack of vaccine information (41%), lack of access to vaccination (38%), fear of adverse reactions (38%), financial reasons (29%), lack of awareness of vaccine existence (29%), antivaccine sentiments (24%), notion that older adults do not need vaccination (18%), misconceptions on vaccine effectiveness (12%), potential sexual health promotion stigma (6%) and fear of needles (3%).

Interpretation:

Barriers to vaccination among Canadians and recent immigrants continue to be a challenge in the health care system.

Conclusions:

The greatest yield in improving vaccination rates is likely to come from supporting vaccine-hesitant individuals in shifting their thinking to greater vaccine acceptance. Pharmacists are well positioned to address vaccine hesitancy and involvement through education, facilitation and administration of vaccines. Can Pharm J (Ott) 2022;155:xx-xx.
Cerebral small vessel disease and intracranial bleeding risk: Prognostic and practical significance
Authors: Best Jonathan G , Jesuthasan Aaron , Werring David J
Published: June 2022

Balancing the risks of recurrent ischemia and antithrombotic-associated bleeding, particularly intracranial hemorrhage (ICH), is a key challenge in the secondary prevention of ischemic stroke and transient ischemic attack. In hyperacute ischemic stroke, the use of acute reperfusion therapies is determined by the balance of anticipated benefit and the risk of ICH. Cerebral small vessel disease (CSVD) causes most spontaneous ICH. Here, we review the evidence linking neuroimaging markers of CSVD to antithrombotic and thrombolytic-associated ICH, with emphasis on cerebral microbleeds (CMB). We discuss their role in the prediction of ICH, and practical implications for clinical decision making. Although current observational data suggest CMB presence should not preclude antithrombotic therapy in patients with ischemic stroke or TIA, they are useful for improving ICH risk prediction with potential relevance for determining the optimal secondary prevention strategy, including the use of left atrial appendage occlusion. Following ICH, recommencing antiplatelets is probably safe in most patients, while the inconclusive results of recent randomized controlled trials of anticoagulant use makes recruitment to ongoing trials (including those testing left atrial appendage occlusion) in this area a high priority. Concern regarding CSVD and ICH risk after hyperacute stroke treatment appears to be unjustified in most patients, though some uncertainty remains regarding patients with very high CMB burden and other risk factors for ICH. We encourage careful phenotyping for underlying CSVD in future trials, with the potential to enhance precision medicine in stroke.
The flame displacement speed: A key quantity for turbulent combustion and combustion instability
Authors: Palies Paul
Published: June 2022

Future combustion power and propulsion systems may operate in premixed regime enabling reduced fuel burn and reduced pollutant emissions. The turbulent premixed regime in those future combustion systems is likely to be in the corrugated regime where modeling the flame as a thin interface propagating into the fresh gas is made possible. The flame displacement speed is thus a key quantity for turbulent combustion in this regime. This quantity is also important for combustion instabilities. Indeed, the flame displacement speed [Formula: see text] combined to the flow speed [Formula: see text] determines the flame surface location by determining the flame surface speed [Formula: see text]. The flame surface location has shown to play a major role on combustion instabilities. Research work have also demonstrated the role of the flame displacement speed on the flame response which is used for subsequent combustion instability prediction. In this context, the derivation of flame speed models and flame transfer function models based on this quantity are required. This paper presents the theoretical derivation of flame transfer function coefficients for swirling premixed flames in this context. The derivation is based on the definition of the flame speed for turbulent flame, its perturbed form for oscillating flow, and the kinematic flame-flow speed budget. The obtained results are compared to previous literature data and discussed. The effect of the flame angle, id est the effect of the swirl number on the flame response is also investigated. This works motivates detailed local measurements and simulations to evaluate flow-flame speed budget terms.
Paclitaxel–bevacizumab combination in advanced non-squamous non-small-cell lung cancer (NSCLC): AVATAX, a retrospective multicentric study
Authors: Bilger Geoffroy , Toffart Anne-Claire , Darrason Marie , Duruisseaux Michaël , Ulmer Lucie , Wang Pascal , Leprieur Etienne Giroux , Girard Nicolas , Massiani Marie Ange , Bore Paul , Descourt Renaud , Pinsolle Julian , Valery Solene , Monnet Isabelle , Swalduz Aurélie , Tissot Claire , Fournel Pierre , Baranzelli Anne , Cortot Alexis B. , Decroisette Chantal
Published: June 2022

Introduction:

Compared with docetaxel, the phase-III trial, ULTIMATE, showed a signiﬁcant improvement of progression-free survival (PFS) with paclitaxel–bevacizumab combination (PB) as second- or third-line treatment in advanced non-small cell lung cancer (NSCLC). With the increase of immunotherapy treatment in ﬁrst-line settings, the optimal treatment after first-line failure must be redefined.

Methods:

This multicentric retrospective study identified all advanced NSCLC patients treated with PB as second-line therapy and beyond. The main efficacy outcomes assessed were objective response rate (ORR), disease control rate (DCR), PFS, and overall survival (OS). The adverse events were reported according to Common Terminology Criteria for Adverse Events (CTCAE).

Results:

From January 2010 to February 2020, 314 patients in 16 centers received the PB combination. Most patients were male (55%), with a median age of 60 years (19–82), 95% had adenocarcinoma, 27% had a performance status ⩾2, 45% had brain metastases at the time of inclusion. They mostly received the PB combination either in second (20%) or in third-line (39%), and 28% were treated just after ICI failure. ORR and DCR were 40% and 77%, respectively; median PFS and OS were 5.7 [interquartile range (IQR): 3.2–9.6] and 10.8 [IQR: 5.3–19.6] months, respectively. All grade adverse events concerned 82% of patients, including 53% asthenia and 39% neurotoxicity, and 25% of patients continued monotherapy (mostly with bevacizumab) alone due to toxicity. Median PFS for patients treated after ICI failure (ICI+) was significantly superior compared with those not previously treated with ICI (ICI−): 7.0 [IQR: 4.2–11.0] versus 5.2 [IQR: 2.9–8.8] months, p = 0.01, without statistically significant difference for OS between these two groups. In multivariate analysis, factors associated with superior PFS were previous ICI treatment and performance status of 0–1. Only a performance status of 0–1 was associated with superior OS.

Conclusion:

PB combination as second-line treatment or beyond for advanced non-squamous NSCLC had acceptable toxicity and a clinically relevant efficacy and is an option as salvage treatment for these patients, more particularly after ICI progression.
The Relationship Between Human-rated Errors and Tablet-based Postural Sway During the Balance Error Scoring System in Military Cadets
Authors: Ross Jeremy D. , Hoch Matthew C. , Malvasi Steven R. , Cameron Kenneth L. , Roach Megan H.
Published: June 2022

Background:

The Balance Error Scoring System (BESS) is commonly accepted as a valid measure of postural stability. However, reliability values have varied, and subtle changes undetectable with the human eye may exist postinjury. The inertial measurement unit in commercially available tablets has been used to quantify postural sway (instrumented Balance Error Scoring System [iBESS] volume). However, iBESS has not been validated in a military population, and the stability of the tests beyond 1 week is unknown.

Hypothesis:

iBESS volume is capable of objectively measuring postural sway during the traditional BESS.

Study Design:

Prospective repeated-measures study.

Level of Evidence:

Level 3.

Methods:

Eighty-three cadets (40.96% women; age 20.0 ± 1.44 years; height 68.7 ± 4.1 inches; weight 166.7 ± 30.2 lb) with no history of concussion or lower extremity injury agreed to participate. All participants completed the BESS at baseline and 6 months post baseline. During testing, a tablet equipped with an inertial measurement unit was positioned on the participant’s sacrum to capture postural sway.

Results:

Moderate to strong correlations were exhibited between baseline measurements for single-limb (SL)-firm ( r = 0.84; P < 0.01), tandem (TAN)-firm ( r = 0.85; P < 0.01), double-limb (DL)-foam ( r = 0.50; P < 0.01), SL-foam ( r = 0.59; P < 0.01), and TAN-foam ( r = 0.79; P < 0.01). Balance improved significantly at 6 months for SL-firm human-rated errors (Effect Size [ES] = 0.32) and for SL-firm (ES = 0.38), DL-foam (ES = 0.21), and SL-foam iBESS volume (ES = 0.35). Moderate to strong correlations were exhibited between human-rated and iBESS change scores for SL-firm ( r = 0.71; P < 0.01), TAN-firm ( r = 0.75; P < 0.01), and TAN-foam ( r = 0.71; P < 0.01), and a weak correlation was exhibited for DL-foam ( r = 0.29; P < 0.01) and SL-foam ( r = 0.40; P < 0.01).

Conclusion:

Moderate to strong correlations existed between human-rated BESS errors and iBESS volume at baseline and between change scores. In addition, iBESS volume may be more sensitive to balance changes than the human-rated BESS.

Clinical Relevance:

This evidence supports the use of iBESS volume as a valid measure of postural stability in military cadets. iBESS volume may provide clinicians with an objective and more sensitive measure of postural stability than the traditional human-rated BESS.
Moving from analogue to digital workflows in dentistry: Understanding undermilling and overmilling as detrimental factors in fabricating CAD/CAM crowns
Authors: Turkyilmaz Ilser , Wilkins Gregory Neil , Yun Sarah
Published: June 2022

Due to the limitations caused by the specific dimensions of milling burs, milling machines may inaccurately fabricate restorations by either over-reducing or under-reducing restorative material, respectively known as “overmilling” and “undermilling”. Overmilling occurs when the bur is unable to accommodate areas smaller than the size of the bur, especially at cusp tips and sharp line angles. This results in excess cement space and a weaker restoration. Undermilling occurs when small concavities are ignored by the larger milling bur, particularly at the margins. This results in inadequate seating of the restoration and open margins due to premature binding, which can lead to restorative failure. To prevent these processing errors, clinicians should ensure that all incisal edges and cusp tips are flattened and rounded, verify that there are no undercuts, and prepare teeth with 1mm thick, smooth finish lines. Furthermore, clinicians may use the preparation check and milling simulation step of computer-aided design/computer-aided manufacturing (CAD/CAM) software to confirm the preparation is adequate and the restorative design does not have potential areas that will lead to overmilling.