bluuebunny/crossref_metadata_2025 huggingface dataset:
TUI Conta Zumbi: a montagem de Arena Conta Zumbi pelo Teatro Universitário Independente de Santa Maria (1968)
Authors: Corrêa Atílio Alencar de Moura , Fontana Fabiana Siqueira
Published: November 2022

O trabalho apresenta um momento específico da história do Teatro Universitário Independente (TUI) de Santa Maria: a montagem de Arena Conta Zumbi, de 1968, por ocasião do I Festival Latinoamericano de Teatro Universitário de Manizales, Colômbia. O estudo contextualiza o espetáculo na trajetória do grupo gaúcho, partindo de uma perspectiva que privilegie o teatro local e suas questões territoriais. Nesse sentido, visa contribuir para as discussões sobre a escrita da história do teatro no Brasil a partir da adoção de temas frequentemente negligenciados, porém indispensáveis na ampliação de fenômenos abordados. Além disso, estes temas se mostram fundamentais quando se trata da análise de experiências localizadas fora dos grandes centros culturais do país.
Histórias apagadas do teatro no Brasil: o caso das mágicas na cidade do Rio de Janeiro
Authors: Guedes Ana Paula Brasil
Published: November 2022

Este artigo apresenta resultados da investigação que examinou a mágica teatral, no Rio de Janeiro, entre 1850 e 1920. Aponta um caminho de pesquisa, levantando a discussão sobre a ausência dos estudos dos gêneros híbridos na historiografia das artes cênicas no Brasil. Para o estudo, de base exploratória, foi aplicado o método indiciário, sob quadro teórico da História Cultural. Uma abordagem qualitativa permitiu a análise sobre as narrativas visuais de gêneros fronteiriços, no âmbito das alegorias, para ilustrar aspectos da mágica.
A hora de Quatro Quadras de Terra: por uma leitura a partir dos pressupostos do teatro épico
Authors: Protazio Beatriz Yoshida
Published: November 2022

Este artigo busca analisar, sob a luz do materialismo histórico-dialético, a dramaturgia de Quatro Quadras de Terra, de 1963, escrita por Oduvaldo Vianna Filho. Para tanto, realizou-se a leitura cerrada do texto, de modo que fosse possível empreender uma análise em relação dialógica com os seus contextos de produção e de circulação, garantindo o primado do objeto literário, que é fundamental para o campo dos estudos literários a que este trabalho responde. O resultado deve ser a confirmação da obra como objeto incontornável para o entendimento da cultura em geral e da literatura e do teatro brasileiros em especial.
O MST e o Teatro: o processo de criação da peça A Farsa da Justiça Burguesa
Authors: Pechincha Dieymes
Published: November 2022

Esta pesquisa pretende analisar o processo de criação da peça A farsa da justiça burguesa. A obra é fruto da construção da Marcha Nacional pela Reforma Agrária realizada pelo Movimento dos Trabalhadores Rurais Sem Terra, em 2005. A escolha do objeto parte da hipótese de que essa experiência retoma características pertencentes às tradições do teatro político e do teatro de agitação e propaganda. Além disso, foi analisado o processo de construção do debate até a produção cultural, no Movimento Sem Terra, e quais as suas implicações em sua produção estética. Parte da pesquisa é fundamentada em entrevistas com intelectuais que contribuíram com a assessoria ao movimento. Por fim, da interação do movimento social com artistas da cena artística foi possível notar a dinâmica de formação de novos intelectuais orgânicos no Movimento Sem Terra.
Mean Coronary Cross‐Sectional Area as a Measure of Arterial Remodeling Using Noncontrast CT Imaging in Persons With HIV
Authors: Werede Ayoda T. , Terry James G. , Nair Sangeeta , Temu Tecla M. , Shepherd Bryan E. , Bailin Samuel S. , Mashayekhi Mona , Gabriel Curtis L. , Lima Morgan , Woodward Beverly Owen , Hannah LaToya , Mallal Simon A. , Beckman Joshua A. , Li Jonathan Z. , Fajnzylber Jesse , Harrison David G. , Carr John Jeffrey , Koethe John R. , Wanjalla Celestine N.
Published: November 2022

Background

Persons with HIV have a higher prevalence of coronary artery disease compared with their HIV‐negative counterparts. Earlier identification of subclinical atherosclerosis may provide a greater opportunity for cardiovascular disease risk reduction. We investigated coronary cross‐sectional area (CorCSA) by noncontrasted computed tomography imaging as a noninvasive measure of arterial remodeling among virally suppressed persons with HIV.

Methods and Results

We assessed 105 persons with HIV with a spectrum of cardiometabolic health. All participants underwent computed tomography imaging to assess the mean corCSA of the proximal left anterior descending artery and 28 participants underwent additional coronary computed tomography angiography. Partial Spearman rank correlations adjusted for cardiovascular disease risk factors were used to assess relationships of corCSA with anthropometric measurements, HIV‐related factors, and plasma cytokines. Mean corCSA measured by noncontrast computed tomography and coronary computed tomography angiography were strongly correlated (ρ=0.91,
P
<0.0001). Higher mean corCSA was present in those with coronary artery calcium (
P
=0.005) and it correlated with participants' atherosclerotic cardiovascular disease risk score (ρ=0.35,
P
=0.01). After adjusting for established cardiovascular disease risk factors, we observed an inverse relationship between corCSA and CD4
+
T‐cell count (ρ=−0.2,
P
=0.047). Removal of age from the model strengthened the relationships between corCSA and antiretroviral therapy duration (from ρ=0.19,
P
=0.08 to ρ=0.3,
P
=0.01). CorCSA was also inversely correlated with plasma IL‐10 (ρ=−0.25,
P
=0.03) but had no relationship with IL‐6 (ρ=0.11,
P
=0.4) or IL‐1β (ρ=0.08,
P
=0.5).

Conclusions

Positive coronary arterial remodeling, an imaging marker of subclinical atherosclerosis, is associated with a lower CD4 T‐cell count, lower circulating IL‐10, and possibly a longer antiretroviral therapy duration in persons with HIV.

Registration

Clinicaltrials.gov; Unique identifier: NCT04451980.
Fifty Years of Declining Confidence & Increasing Polarization in Trust in American Institutions
Authors: Brady Henry E. , Kent Thomas B.
Published: November 2022

Except for the military and science, confidence in most American political and non-political institutions has fallen precipitously over the past fifty years. Declines in trust are partly the result of dissatisfaction with governmental and institutional accountability and concomitant skepticism about the competency and responsiveness of institutions. Declines are also the result of a polarization in trust in institutions, as Republicans trust business, the police, religion, and the military much more than Democrats, whose confidence in these institutions, except the military, has fallen. In turn, Democrats trust labor, the press, science, higher education, and public schools much more than Republicans, whose confidence in these institutions has fallen. Declines and polarization in confidence may be traceable to political polarization stemming from increasing income inequality and segregation in America. With polarization and decreasing trust in institutions, it becomes more difficult to fight epidemics, maintain faith in policing, and deal with problems such as climate change.
Trust & Models of Policing
Authors: Meares Tracey L.
Published: November 2022

The notion of trust has become central to the discussion of policing and its transformation over the last decade. Scholars, policy-makers, and the agents who purport to carry out public safety projects on behalf of the public now commonly point to trust as one of the central goals of the relationship between policing agencies and members of the public they serve, in contrast to the more common and familiar notion of crime reduction. This essay highlights three common mechanisms agencies and the individuals they comprise use to attempt to improve the public's trust in police: changing policy, training of police, and citizen oversight boards. Focusing on the conceptual framework that the social psychology of procedural justice offers, the essay then turns to a less common target for change: the very laws police enforce. Changing the police will require not only transforming how its members carry out the job but also the laws they are sworn to uphold.
Race & Political Trust: Justice as a Unifying Influence on Political Trust
Authors: Wu Cary , Wilkes Rima , Wilson David C.
Published: November 2022

Americans’ trust in government is lower than ever. However, while all groups have seen a decline in trust since the 1960s, the gap in trust between racial and ethnic minorities and Whites in this period has varied not only in size but also in direction. At times, racial and ethnic minorities have actually had higher rates of trust than Whites, contradicting the broad assumptions in research about race and political trust. Explanations of the causes of trust in government that emphasize institutional experience and early socialization would not predict this outcome. We propose that an underutilized component in the study of race and political trust is perceived justice. On one hand, racial and ethnic minorities’ sensitivity to institutional injustice often leads to lower rates of trust. On the other hand, when racial and ethnic minorities perceive there are greater opportunities for racial progress, which signal that widespread harm can be repaired, their political trust tends to increase, sometimes to levels that exceed those for Whites. The interplay between political realities that shape perceived justice as well as political hope for racial progress likely creates the variable longitudinal patterns of racial and ethnic differences in trust.
Numerical Study About Nanofluids of Spherical and Tube-Shaped TiO2 Nanomaterials on the Thermal Performance and Entropy Generation of Different Cross-Section Microchannel Heat Sinks
Authors: Hurtado-Venegas Ignacio , Martínez Víctor A. , Diego A. Vasco , Ortega-Aguilera Roberto , Zapata Paula A. , Cataño Francisco A. , Mestra Alifhers S.
Published: November 2022

We numerically evaluated the thermal performance of microchannel heat sinks, considering rectangular, hexagonal, and circular cross-sections. Moreover, as a passive heat transfer augmentation technique, dimples were added to improve the rectangular microchannel heat sinks. These simulations
use nanofluids based on TiO2 nanoparticles or nanotubes dispersed in bidistilled water as working fluids. The mathematical model considered variable thermophysical properties of the nanofluids; for this purpose, polynomial fittings correlate the dependence of the thermophysical
properties on the temperature. We considered a heat flux of q″ = 50 W/cm2 at the microchannel’s lower surface as a boundary condition along with laminar flow conditions. The numerical simulations allowed the Nusselt numbers and entropy generation calculation,
which were the basis for the thermal performance calculation. Regarding the effect of TiO2 nanoparticles shape, spherical TiO2 nanoparticles based nanofluids using rectangular microchannels improve the Nusselt number. Moreover, the frictional entropy decreases with nanofluids
based on TiO2 nanotubes, but the thermal entropy decreases with nanofluids based on TiO2 nanotubes. Incorporating dimples in the rectangular microchannel enhances the Nusselt numbers and lowers the entropy generation. Considering the Reynolds number range and from the
perspective of Nusselt number and entropy generation, we concluded that the microchannels must be operated at a high Reynolds number to improve the microchannel heat sinks thermal performance.
Unsteady Finite Amplitude Magneto-Convection of Oldroyd-B Nanofluids with Internal Heat Source
Authors: Kaur Jeevanpreet , Gupta Urvashi , Sharma Ram Prakash
Published: November 2022

This work presents a numerical and an analytical review of analysis of the convective phenomenon in a non-Newtonian nanofluid layer with the applied vertical magnetic field and having an internal heating source. Buongiorno model is used to examine the convective instability considering
the impacts of thermophoresis, Brownian diffusion, and viscoelasticity of the nanofluid. The effect of significant parameters concerning stability is visualized through graphs and further interpreted. For the non-linear study, the fundamental PDEs are converted into non-linear simultaneous
autonomous ODEs. The solutions are computed by taking the help of the software Mathematica. Nusselt number and Sherwood number are graphed for numerous parametric situations to offer a clear outlook of heat and mass transfer rate. The magnetic field parameter stabilizes the system and diminishes
heat and mass transfer. Elevating the internal heat parameter promotes heat and mass transfer significantly. Viscoelasticity of the fluid affects prominently since non-Newtonian fluid yields lower heat and mass transfer coefficients than Newtonian fluid due to advancement of the convection.
Entropy Study of Hybrid (Al2O3–Cu/H2O) Nano-Fluid in a Cylindrical Cavity with Wavy Sides Under the Effect of a Parallel Magnetic Field
Authors: Redouane Fares , Jamshed Wasim , Uma Devi S. Suriya , Prakash M. , Mahammed Amine Belhadj , Abdelhak Roubi
Published: November 2022

The convection and entropy of a hybrid nanofluid were investigated in a cylindrical chamber. Inside the cylinder, we have added a rectangular fin with a temperature of Th. Tc applied on the right waving wall. Insulation installed on both the top and bottom walls. The induction of a
steady magnetic field is included in this research. Governing equations are resolved by Galerkin finite element method (GFEM) and it’s utilized to treat the controlling equations obtained by giving different characteristics of fluid like The porosity, cylinder rayon and the size of the
nano particles with Rayleigh, Hartmann and Darcy numbers. This information is crucial for controlling both fluid flow and the heat transfer rate for normal convection. The results of the solution demonstrate that Da influences the entropy and leads to a decrease in the generation of entropy.
The Nusselt mean differs in a straight line with the dynamic. The domain of flows through the sublime modes while it acts contrary with the magnetic force. The use of a rectangular fin inside a cylindrical enclosure rather than traditional ones, as well as the evaluation of its optimal dimensions,
was novel in this paper. Moreover, the novelty of this study is that it fills a research gap by looking into the effect of the specific shape of the walls of the porous chamber on heat flux.
Role of Atmosphere–Ocean–Ice Interaction in the Linkage between December Bering Sea Ice and Subsequent February Surface Air Temperature over North America
Authors: Zhao Jiazhen , He Shengping , Wang Huijun
Published: November 2022

This study revealed that the interannual variations of December Bering Sea ice and subsequent February surface air temperature (SAT) over North America are significantly correlated during 2000/01–2020/21, which is not the case during 1966/67–1999/2000. During 2000/01–2020/21, reduced December Bering Sea ice is generally followed by a February meridional dipole pattern in the atmospheric circulation over North America, which provides favorable conditions for colder temperatures. Further analysis elucidates that the intensified persistence of December Bering Sea ice anomaly might be responsible for the identified change in such a lead–lag sea ice–SAT linkage. During 2000/01–2020/21, the Bering Sea ice anomaly in December can persist into the subsequent February during which the sea ice anomaly exerts a thermal effect on the atmosphere aloft, stimulates an eastward-propagating Rossby wave train, and causes the meridional dipole pattern over North America. The longer persistence of December Bering Sea ice anomaly during 2000/01–2020/21 is attributed to the interdecadal intensified atmosphere–ocean–ice interaction over the Bering Sea—a positive feedback loop that favors the persistence of the sea ice anomaly. A negative sea ice concentration anomaly with more open water in the Bering Sea would allow the ocean to release more heat and warm more the air aloft. This will further lead to more downward longwave radiation, preventing the sea ice growth and helping maintain the sea ice anomaly. Results of this study indicates that the intensity of atmosphere–ocean–ice interaction in the Bering Sea may modulate the linkage between the February SAT over North America and the preceding December Bering Sea ice.
Before or After? The Effects of Payment Decision Timing in Pay-What-You-Want Contexts
Authors: KC Raghabendra P. , Mak Vincent , Ofek Elie
Published: November 2022

This research studies how payment decision timing—before versus after product delivery—influences consumer payment under pay-what-you-want (PWYW) pricing. The authors focus on situations where there is minimal change in consumer uncertainty regarding the product before versus after receiving it. The theoretical development suggests that people pay more after (vs. before) receiving the product when product value is high, but the effect is mitigated when product value is low and reversed when product value is sufficiently low. Results from a laboratory experiment and a field experiment lend support to the theoretical predictions, with preliminary evidence for the moderating effect of product value. An online experiment demonstrates the predicted payment decision timing effect at high product value and a reversal of the effect at low product value. Another online experiment extends the scope of the previous studies by examining PWYW transactions in a charitable donation context (which the authors label “contribute what you want”): the authors obtain evidence for the predicted payment decision timing effect for high product value and a mitigation of the effect for low product value, as well as process evidence for the theoretical mechanism. This work has implications for the management of PWYW schemes for firms, including nonprofits, social enterprises, and charities.
Purtscher-like retinopathy-unusual initial presentation of rheumatoid arthritis
Authors: Kumar Ashok , Singh Ankita , Shankar Sandeep , Ambiya Vikas , Tripathi Abhishek , Dubbaka Srujana
Published: November 2022

Purtscher-like retinopathy is a rare phenomenon reported in disorders including acute pancreatitis, collagen vascular diseases, fat embolism, chronic renal failure, amniotic fluid embolism, battered baby syndrome and several autoimmune diseases. We report an atypical initial feature of rheumatoid arthritis in a middle-aged male. This case will raise awareness among generalists to recognize this disease early.
Enhanced heat transmission in hydrodynamic Maxwell and Jeffrey cylindrical film flows: A computational numerical simulation
Authors: Nabwey Hossam A , Reddy Minnam Reddy Vasudeva , Suresh Babu R , Sandeep N
Published: November 2022

Solar energy is a leading energy source to reduce greenhouse gas radiation and other types of air pollution. In particular, solar energy is widely used to generate electric power. The rheological behavior of various non-Newtonian liquids plays an active role in heat transferal processes. This study examines the heat conduction in water-based Jeffrey and Maxwell cylindrical film flows suspended with magnetite (Fe3O4) nanoparticles. The radiative heat, uneven heat sink/source, and magnetohydrodynamic effects are considered. A precise model is developed and determined mathematically. The influence of pertinent constraints on flow and thermic profiles is explored using pictorial and numerical outcomes. The drag force generated by magnetohydrodynamics effectively regulates the wall friction and heat transmission rate. The temperature profiles of Maxwell ferrofluid are more active than Jeffrey ferrofluid. The heat diffusion rate of Jeffrey ferrofluid is more progressive than the Maxwell ferroliquid.
Comparing the Prevalence of Probable DSM-IV and DSM-5 Posttraumatic Stress Disorder in a Sample of U.S. Military Veterans Using the PTSD Checklist
Authors: Bovin Michelle J. , Mahoney Colin T. , Klein Alexandra B. , Keane Terence M. , Marx Brian P.
Published: November 2022

Posttraumatic stress disorder (PTSD) changed substantially when Diagnostic and Statistical Manual of Mental Disorders transitioned from fourth ( DSM-IV) to fifth ( DSM-5) edition. Hoge et al. found that although diagnostic prevalence remained consistent across nomenclatures, diagnostic concordance was low (55%). Study goals were to examine both the generalizability of these findings and whether either diagnosis systematically excluded patients. U.S. veterans ( N = 1,171) who completed the PTSD Checklist for DSM-IV (PCL-S) and DSM-5 (PCL-5) were classified as: probable PTSD on both measures; probable PTSD on PCL-S only; probable PTSD on PCL-5 only; or no PTSD on either measure. Diagnostic prevalence was equivalent. Unlike Hoge et al.’s findings, diagnostic concordance was high (91.3%). Furthermore, observed demographic and severity differences were driven by disparities between veterans in the no PTSD versus the probable PTSD groups, not diagnostic changes. Findings suggest translatability across measures and that diagnostic changes do not systematically exclude patients.
Challenges of Integrated Home-Based Palliative Care Services for Cancer Patients during the COVID-19 Pandemic: A Qualitative Content Analysis
Authors: Alizadeh Zahra , Rohani Camelia , Rassouli Maryam , Ilkhani Mahnaz , Hazrati Maryam
Published: November 2022

Given the situation of cancer patients as vulnerable patients and the threat of COVID-19 in the society, integration of home-based palliative care services into the healthcare system is essential. The aim of this qualitative study was to explore the current barriers of integration of palliative care services from hospital to home for cancer patients during the COVID-19 Pandemic and to provide suggestions to resolve them. Semi-structured interviews were conducted with 25 stakeholders in the healthcare system, including health policy makers, healthcare providers, clinical home healthcare experts, home healthcare researchers, university faculty members, clergy, family caregivers, and cancer patients. Data were analyzed using directed content analysis method based on the World Health Organization Public Health Strategy for Palliative Care. Challenges were extracted in 4 main categories, containing education barriers (3 subcategories), implementation barriers (9 subcategories), policy barriers (5 subcategories), and drug availability barriers (2 subcategories). Based on the results, removing the barriers and establishing a strong infrastructure for home-based palliative care services is recommended in the healthcare system by concentrating on 4 essential factors, that is, utilizing a coordinating nurse during the process of patient’s hospital discharge, establishment of connecting outpatient palliative care clinics to home healthcare centers, access to palliative care tele-medicine and development of a comprehensive and flexible home-based palliative cancer care model in our context.
Advancing measurement of zero-group-velocity Lamb waves using PVDF-TrFE transducers: first data and application to in situ health monitoring of multilayer bonded structures
Authors: Liu Qijian , Li Yehai , Guan Ruiqi , Yan Jiajia , Liu Menglong , Luo Guojie , Su Zhongqing , Qing Xinlin , Wang Kai
Published: November 2022

Driven by the rapid advancement in manufacturing technologies, engineering structures with complex geometries are increasingly applied in various industries, posing challenges to the applicability and adaptability of existing structural health monitoring methods based on guided ultrasonic waves. To fulfill the characterization of defects in complex structures, a novel approach featuring a conjunction of zero-group-velocity (ZGV) Lamb waves and polarized poly(vinylidenefluoride-co-trifluoroethylene) (PVDF-TrFE) transducers is proposed. In this approach, the PVDF-TrFE solvent is deposited and in situ polarized on the structure surface to form thin and flexible coatings, with which the ZGV waves can be excited efficiently and measured reliably. On this basis, the defect can be characterized by investigating the defect-induced alteration in ZGV wave features. In experimental validations, disbond defects in multilayer bonded structures are evaluated using the ZGV waves measured with fabricated PVDF-TrFE transducers. For the first time, the ZGV waves are measured in a contact and in situ manner. Compared with conventional noncontact measurement of ZGV waves, the proposed approach features a remarkably improved reliability, convenience for narrowband excitation, immunity to measurement uncertainty and capability of in situ monitoring. The proposed approach can advance the ZGV wave-based methods toward the in situ health monitoring and enable the defect evaluation in emerging complex structures.
A Systematic Review of Omega-3 Fatty Acid Consumption and Cognitive Outcomes in Neurodevelopment
Authors: Sherzai Dean , Moness Roman , Sherzai Sophia , Sherzai Ayesha
Published: November 2022

Introduction: This systematic review addresses the effects of n-3 long-chain polyunsaturated fatty acids consumption on human neurodevelopment. It evaluates articles published between 2000 and 2022 investigating the cognitive outcomes during the period of neurodevelopment: from fetal development to adolescence. For the purpose of this review the terms LC PUFA and omega-3 fatty acid will be used interchangeably. Method: Data were sourced from several major databases including PubMed (MEDLINE), Web of Science, and ProQuest Central. Randomized controlled trials (RCTs), nonrandomized controlled trials, prospective or retrospective cohort studies, and observational studies investigating the effects of omega-3 fatty acid consumption from dietary supplements, multiple-nutrient supplement, or food questionnaire on neurodevelopment were considered. Study population was separated in three developmental phases: (1) in-utero, (2) lactation/infancy, and (3) childhood/adolescence. Each article was evaluated for several key factors such as study type, type/dosage of PUFAs, number of subjects, length of intervention, participant age range, population characteristics, outcome measure (both primary/cognitive and secondary/other), results, conclusion, and confounding variables/limitations. Results: A total of 88 articles were included in the review, 69 RCTs and 19 longitudinal or observational studies. The results indicate equivocal effect of intervention, with some short-term benefits observed in the areas of visual attention, working memory, executive function, and communication. Omega-3 supplement might have a short-term positive impact on neurodevelopment in all three phases. Supplementation is recommended throughout life, rather than only during the earliest developmental stage.
What’s COVID-19 Got to Do With It? Implementing the 2020 Connecticut Comprehensive School Counseling Framework
Authors: Trombly Christopher E. , Parzych Jennifer L. , Generali Margaret M. , Yavuz Olcay
Published: November 2022

The Connecticut Comprehensive School Counseling Framework was released in November 2020—8 months into the COVID-19 pandemic. The purpose of this mixed-methods study was to explore the progress made by principals and school counselors in implementing the new framework, and to understand the impact of the pandemic on their efforts to do so. We found significant overlap between the perceptions and priorities expressed by participating principals and school counselors. Particularly noteworthy was the fact that both groups described increased collaboration within their schools.
Chronic Achilles Tendon Repair: Minimally Invasive Turn-Down Technique with Flexor Hallucis Longus Tendon Transfer
Authors: Meyers Andrew , Pyle Casey W.
Published: November 2022

Category:

Sports; Ankle; Trauma

Introduction/Purpose:

Chronic achilles tendon injuries present several technical considerations. A reported 20-25% of acute ruptures may be missed and lead to late diagnosis. A commonly faced problem with chronic ruptures is the amount of tendon retraction that occurs, leading to the inability to perform a direct end-to-end repair. Previous studies have demonstrated that central turndown lengthening with addition of flexor hallucis longus (FHL) augmentation can be performed with good results, although it has been associated with post-surgical wound complications and infection. The following description is a turndown technique with FHL tendon transfer augmentation for chronic achilles rupture that allows increased fixation with a tendon to bone construct, accomplished with a minimally invasive approach.

Methods:

Dissection is made down to the Achilles rupture site. Scar tissue is debrided down to two stable ends. The residual gap is then measured and 2cm is added. This distance is then used to make a proximal incision. Dissection is performed to gastrocnemius tendinous raphe. The central third of this segment is incised perpendicularly. A quadriceps tendon harvester (Arthrex, Naples, FL) is utilized to cut in an antegrade fashion down the tendon portion percutaneously, leaving a 1-1.5cm of tendon spared distally. The tendon is pulled under and through the distal incision. A percutaneous achilles repair system (PARS, Arthrex, Naples, FL) Jig is used to span proximal tendon. FHL tendon transfer is then completed in usual fashion. Suture tails from proximal tendon are then passed through the distal end. Tension is pulled through the sutures, approximating repair. The suture is loaded onto anchors and secured into the calcaneus under tension.

Results:

Favorable outcomes have been observed following the 2 patients that have had chronic achilles repair with utilization of this minimally invasive turn-down technique with FHL transfer. At a follow up of at least 6 months, no patient has demonstrated wound dehiscence or breakdown. There have been no reports of re-rupture. All patients have been satisfied with the procedure and their level of returned function.

Conclusion:

Our method of repair with combination of central turndown procedure and FHL tendon transfer provides a suitable option for improved functional outcomes in the treatment of chronic achilles ruptures while providing a minimally invasive approach and avoiding the need for allograft tissue. By using the quadricep tendon harvester in a subcutaneous fashion, incision length can be reduced by nearly 50%. This technique can be performed with existing technologies and is readily reproducible. Using the tendon to bone fixation along with intra-tendinous shuttling, allows for excellent fixation strength, a knotless construct, and almost complete intra-substance suture placement.
Sustained barcode medication administration rates less than 2 percent in a large healthcare system
Authors: Boehme Sabrina , Wohlt Paul , Valentine John , Ensign Richard
Published: November 2022

Purpose

Implementation of bar code medication administration (BCMA) technology is an effective strategy to decrease medication administration errors. Consistent use of BCMA technology within a hospital system should result in improved patient safety through the reduction of medication related administration errors. Based on this premise, a large health system established an annual goal to reduce BCMA override rates to less than 2%.

Methods

A large health system located in the Intermountain West developed a BCMA override reporting tool to assist with reducing BCMA override rates. An essential component of the reporting tool is the visual management strategy which allows caregivers to easily identify goal progress. The tool also includes information that managers can use to determine how often their direct reports override medications. Pharmacy caregivers can also use the data from the reporting tool to address specific issues related to medications that do not scan properly.

Results

Implementation of the tool and education on its use, resulted in individual follow up with nursing units and nurses, ultimately producing sustained barcode overrides less than 2%.

Conclusion

By implementing reporting systems that identifies specific opportunities for improvement, barcode override rates can be decreased to less than 2% in a large healthcare system.
The emplacement, alteration, subduction and metamorphism of metagranites from the Tso Morari Complex, Ladakh Himalaya
Authors: Bidgood Anna K. , Waters David J. , Dyck Brendan J. , Roberts Nick M.W.
Published: November 2022

Eclogite-facies mineral assemblages are commonly preserved in mafic protoliths within continental terranes. It is widely accepted that the entirety of these continental terrains must also have been subducted to eclogite-facies conditions. However, evidence that the felsic material transformed at eclogite-facies conditions is lacking. Low-strain metagranites of the ultrahigh-pressure metamorphic Tso Morari Complex in Ladakh, Himalaya, are host to eclogite-facies mafic sills and preserve evidence of subduction to eclogite-facies conditions. Following the eclogite-facies metamorphism, the granites and their gneissic equivalents were overprinted by amphibolite-facies Barrovian metamorphism, obscuring their earlier metamorphic history. We present evidence that the Tso Morari metagranites preserve a complex magmatic, hydrothermal and polymetamorphic history that involved four stages. Stage 1 was magmatic crystallisation, a record of which is preserved in the primary igneous mineralogy and relict igneous microstructures. Monazite grains record a U–Pb age of 474.0 ± 11.6 Ma, concurrent with a published zircon crystallisation age. Stage 2 represents pervasive late-magmatic hydrothermal alteration of the granite during emplacement and is evident in the mineral composition, particularly in the white micas preserved in the igneous domains. Stage 3 involved the (ultra)high-pressure metamorphism of these granite bodies during the Himalayan subduction of continental material. The high-pressure stage of the metamorphic history (>25 kbar at 550–650°C) is preserved as thin coronas of garnet and phengite around igneous biotite, garnet with kyanite inclusions in pseudomorphs after cordierite, and rare palisade quartz textures after coesite. Stage 4 was a result of Barrovian metamorphism of the Tso Morari Complex and is evident in the replacement of garnet by biotite. Many of these features are preserved in localised textural domains in the rock, where local equilibrium was important and the anhydrous conditions limited reaction progress, though aided preservation potential. Collectively, these four stages record a 480 Myr history of metamorphism and reworking of the northernmost Indian plate.
Modeling and cleaning RNA-seq data significantly improve detection of differentially expressed genes
Authors: Deyneko Igor V. , Mustafaev Orkhan N. , Tyurin Alexander А. , Zhukova Ksenya V. , Varzari Alexander , Goldenkova-Pavlova Irina V.
Published: November 2022

Background

RNA-seq has become a standard technology to quantify mRNA. The measured values usually vary by several orders of magnitude, and while the detection of differences at high values is statistically well grounded, the significance of the differences for rare mRNAs can be weakened by the presence of biological and technical noise.

Results

We have developed a method for cleaning RNA-seq data, which improves the detection of differentially expressed genes and specifically genes with low to moderate transcription. Using a data modeling approach, parameters of randomly distributed mRNA counts are identified and reads, most probably originating from technical noise, are removed. We demonstrate that the removal of this random component leads to the significant increase in the number of detected differentially expressed genes, more significant pvalues and no bias towards low-count genes.

Conclusion

Application of RNAdeNoise to our RNA-seq data on polysome profiling and several published RNA-seq datasets reveals its suitability for different organisms and sequencing technologies such as Illumina and BGI, shows improved detection of differentially expressed genes, and excludes the subjective setting of thresholds for minimal RNA counts. The program, RNA-seq data, resulted gene lists and examples of use are in the supplementary data and at https://github.com/Deyneko/RNAdeNoise.
Impact of a prospective feedback loop on care review activities in older patients at the end of life. A stepped-wedge randomised trial
Authors: Brown Christine , Lee Xing J. , Farrington Alison , Shield Carla , Carter Hannah E. , McPhail Steven M. , Cardona Magnolia , Hillman Kenneth , Callaway Leonie , Willmott Lindy , White Ben P. , Harvey Gillian , Graves Nicholas , Barnett Adrian G.
Published: November 2022

Background

Hospitalisation rates for older people are increasing, with end-of-life care becoming a more medicalised experience. Innovative approaches are warranted to support early identification of the end-of-life phase, communicate prognosis, provide care consistent with people’s preferences, and improve the use of healthcare resources. The Intervention for Appropriate Care and Treatment (InterACT) trial aimed to increase appropriate care and treatment decisions for older people at the end of life, through implementation of a prospective feedback loop. This paper reports on the care review outcomes.

Methods

A stepped-wedge randomised controlled trial was conducted in three large acute hospitals in Queensland, Australia between May 2020 and June 2021. The trial identified older people nearing the end of life using two validated tools for detecting deterioration and short-term death. Admitting clinical teams were provided with details of patients identified as at-risk with the goal of increasing awareness that end of life was approaching to facilitate appropriate patient centred care and avoid non-beneficial treatment. We examined the time between when the patient was identified as ‘at-risk’ and three outcomes: clinician-led care review discussions, review of care directive measures and palliative care referrals. These were considered useful indicators of appropriate care at the end of life.

Results

In two hospitals there was a reduction in the review of care directive measures during the intervention compared with usual care at 21 days (reduced probability of − 0.08; 95% CI: − 0.12 to − 0.04 and − 0.14; 95% CI: − 0.21 to − 0.06). In one hospital there was a large reduction in clinician-led care review discussions at 21 days during the intervention (reduced probability of − 0.20; 95% CI: − 0.28 to − 0.13). There was little change in palliative care referrals in any hospital, with average probability differences at 21 days of − 0.01, 0.02 and 0.04.

Discussion

The results are disappointing as an intervention designed to improve care of hospitalised older people appeared to have the opposite effect on care review outcomes. The reasons for this may be a combination of the intervention design and health system challenges due to the pandemic that highlight the complexity of providing more appropriate care at the end of life.

Trial registration

Australia New Zealand Clinical Trial Registry, ACTRN12619000675123 (registered 6 May 2019).
Exploring the connection between parental bonding and smartphone addiction in Chinese medical students
Authors: Xin Chunyu , Ding Ning , Jiang Nan , Li Honghe , Wen Deliang
Published: November 2022

Background

Smartphone addiction bodes adverse consequences, affecting different populations, including medical students. Parental bonding in childhood had been associated with addiction and recovery in later life. Therefore, this study aimed to examine the associations between parental bonding and smartphone addiction among Chinese medical students.

Method

Binary logistic regressions were used to investigate the associations between parental bonding with mothers and fathers, respectively, and smartphone addiction. Interaction terms of care and protection were included in the models.

Results

A total of 517 medical students were included in the study. The prevalence of smartphone addiction was 48.16% (n = 249). The estimated effects of maternal and paternal parenting on smartphone addiction differed. Maternal protection was positively associated with smartphone addiction (OR, 1.046;95% CI, 1.005-1.087), and maternal care enhanced the estimated effect of protection on smartphone addiction. Paternal care was negatively associated with smartphone addiction (OR, 0.954;95% CI, 0.919-0.989).

Conclusions

Chinese medical students with overprotective mothers or with indifferent fathers tended to exhibit traits of smartphone addiction. Further studies on factors influencing the associations between parental bonding and smartphone addiction may pave the way for potential family-oriented interventions for smartphone addiction.
Unlocking the potential for engaging men to improve reproductive, maternal, and neonatal health in Karnali Province, Nepal
Authors: Pokhrel Khem Narayan , Thakuri Dipendra Singh , Dagadu Nana Apenem , Balami Roma , Sharma Matrika , Bhandari Rajan
Published: November 2022

Background

Adolescent girls and young women (AGYW) often experience early childbearing and have poor utilization of reproductive, maternal, and neonatal health (RMNH) services in Nepal. Involving men in such services has been increasingly recognized globally to improve gender-equitable reproductive health behaviour in husbands. This qualitative study assessed the implementation of Healthy Transitions’ male engagement interventions in Karnali Province, Nepal which were implemented to improve gender-equitable attitudes, and supportive RMNH care-seeking behaviors among the husbands of young women.

Methods

We conducted a summative qualitative study that included in-depth interviews with 12 AGYW as primary beneficiaries and their husbands (N = 12) and in-laws (N = 8). In addition, key informant interviews were conducted with health workers (N = 8), local government representatives (N = 4), members of Health Facility Operation and Management Committee (N = 8) and project implementers (N = 12). Due to COVID-19-related travel restrictions and lockdowns, all interviews were conducted via phone calls and online consultation. Data were analyzed using multistage coding and thematic content analysis.

Results

AGYW, their husbands, in-laws and health workers were receptive to the Healthy transitions’ male engagement initiatives. They perceived that the project contributed a momentum to facilitate men’s gender-responsive behaviour. Many participants reported that male engagement interventions, including home visits, community dialogues, and social events improved husbands’ support for their wives during menstruation, pregnancy, and childbirth. The activities also facilitated spousal communication and improved the couple’s decision-making for family planning use. Women reported that improved support from their husbands increased their self-confidence.

Conclusions

This study sheds light on the role of male engagement strategies to improve RMNH in a context where inequitable gender norms and roles are highly prevalent. Our findings highlight the potential to improve RMNH by addressing barriers to male engagement.
Aspergillus tracheobronchitis with Birt-Hogg-Dubè syndrome as a rare cause of chronic cough
Authors: Huang Lianrong , Yi Fang , Zhan Chen , Lai Kefang
Published: November 2022

Background

Aspergillus tracheobronchitis (ATB) is confined as a condition of chronic superficial infection of tracheobronchial tree. Its diagnosis is difficult due to atypical manifestations and low detective rate of Aspergillus thus far.

Case presentation:

Herein, we presented a 45-year-old male patient with a sole chronic productive cough for five years referred to our cough specialist clinic. Chest high-resolution computed tomography showed multiple lung cysts predominantly located in the subpleural lesions and near the mediastinum. Neither bacteria nor fungi were identified by sputum culture. However, metagenomic next-generation sequencing in sputum detected Aspergillus fumigatus DNA. The genetic testing of whole blood suggested the germline mutation of the tumor suppressor gene folliculin, supporting a diagnosis of Birt-Hogg-Dubé (BHD) syndrome. His productive cough symptom significantly improved after receiving itraconazole treatment for 2 months. After discontinuation of antifungal treatment, there was no relapse for four months follow-up. A diagnosis of ATB with BHD syndrome was eventually established in this patient.

Conclusion

ATB should be considered in any patient with prolonged unexplained productive cough. Next-generation sequencing technologies may be useful to identify ATB which is uncommon and easily ignored in clinical practice.
Association between metabolic control and oral health in children with type 1 diabetes mellitus
Authors: Ferizi Lulëjeta , Bimbashi Venera , Kelmendi Jeta
Published: November 2022

Background

Type 1 diabetes mellitus is the most common chronic disease and can be reflected in the oral cavity. The aim of this study was to analyze the impact of metabolic control on saliva, dental caries, dental plaque, gingival inflammation, and cariogenic bacteria in saliva.

Methods

A case–control epidemiologic study was performed on children with type 1 diabetes (ages 10–15 years) separated into two groups: 34 children with good metabolic control of glycated hemoglobin (HbA1c < 7.5%) and 46 children with poor metabolic control of glycated hemoglobin (HbA1c > 7.5%). Oral status was assessed using the Decay, Missing, and Filled Teeth index for permanent teeth (DMFT), plaque index and gingival index. The stimulated salivary flow rate was measured, and the colonies of Streptococcus mutans and Lactobacillus in saliva were determined. The observed children answered questions related to their frequency of brushing habits, dental visits and parents’ education. Mann–Whitney U Test, Chi-Square test and Fisher’s exact test were used in the statistical analyses. The significance level was set at p < 0.05.

Results

The children with diabetes with poor metabolic control had significantly higher values of the DMFT index, plaque index, and gingival index, more colonies, and a higher risk of Streptococcus mutans and Lactobacillus than the children with diabetes with good metabolic control (p < 0.001). The level of metabolic control of diabetes had no influence on salivary flow rates (p > 0.05). The majority of both groups with good and poor metabolic control brushed their teeth once per day, and they visited the dentist only when necessary (61.3%). However, the parents of children in both groups had medium to low levels of education, without any significant difference between groups (p > 0.05).

Conclusion

The results indicate that children with diabetes have a lower level of oral hygiene and are potentially to dental caries and periodontal diseases, mainly when their metabolic disorder is uncontrolled.