bluuebunny/crossref_metadata_2025 huggingface dataset:
MR vessel-encoded arterial spin labeling with the placement of metallic items to visualize the territorial blood flow after extracranial–intracranial bypass surgery: a proof-of-concept study
Authors: Hayashi Tetsuji , Fujima Noriyuki , Harada Taisuke , Hamaguchi Akiyoshi , Kodera Shuichi
Published: January 2023

Background

Depiction of bypass blood flow in patients who received extracranial–intracranial (EC–IC) bypass surgery is important for patient care.

Purpose

To develop a vessel-encoded arterial spin labeling (VE-ASL) method using surgical staples as a magnetic resonance (MR)-conditional product in patients who received EC–IC bypass surgery.

Material and Methods

Pseudo-continuous labeling was used for VE-ASL acquisition with a 3-T MR unit. First, an experimental study was conducted to determine the appropriate number of surgical staples to obtain a spatially sufficient saturation effect. Thereafter, four healthy normal volunteers underwent a VE-ASL study to confirm the sufficiency of the saturation effect to the right or left common carotid artery. Finally, VE-ASL scanning was performed in seven patients after EC–IC bypass surgery to confirm the ability of VE-ASL to visualize the territorial bypass perfusion. All qualitative evaluation was performed by two neuroradiologists using a 3-point grading system (2 = good, 1 = moderate, 0 = poor).

Results

A quantity of 200 staples was found to be appropriate for VE-ASL scanning. In healthy volunteers, one neuroradiologist rated the images of all four cases as good, while the other rated three cases as good and one case as moderate. For the seven patients after EC–IC bypass surgery, one neuroradiologist rated all seven cases as good, and the other rated six cases as good and one case as moderate.

Conclusion

VE-ASL using surgical staples might be useful for the evaluation of territorial bypass perfusion in patients after EC–IC bypass surgery.
Effect of zinc supplementation on immunotoxicity induced by subchronic oral exposure to glyphosate-based herbicide (GOBARA®) in Wistar rats
Authors: Tizhe Emmanuel V , Igbokwe Ikechukwu O , Njoku Celestine O , Fatihu Mohammed Y , Tizhe Ussa D , Ibrahim Najume DG , Unanam Essienifiok S , Korzerzer Rachel M
Published: January 2023

Objectives

To evaluate the effect of zinc supplementation on immunotoxicity induced by subchronic oral exposure to glyphosate-based herbicide (GBH).

Methods

Sixty adult male Wistar rats randomly divided equally into six groups were exposed to GBH by gavage daily for 16 weeks with or without zinc pretreatment. Group DW rats received distilled water (2 mL/kg), group Z rats received zinc (50 mg/kg), and group G1 and G2 rats received 187.5 and 375 mg/kg GBH, respectively. Group ZG1 and ZG2 rats were pretreated with 50 mg/kg zinc before exposure to 187.5 and 375 mg/kg GBH, respectively. Tumor necrosis factor alpha (TNF-α) and immunoglobulin (IgG, IgM, IgE) levels were measured by enzyme-linked immunosorbent assay. Spleen, submandibular lymph node, and thymus samples were processed for histopathology.

Results

Exposure to GBH (G1 and G2) significantly increased serum TNF-α concentrations and significantly decreased serum IgG and IgM concentrations compared with the control levels. Moderate-to-severe lymphocyte depletion occurred in the spleen, lymph nodes, and thymus in the GBH-exposed groups. Zinc supplementation mitigated the immunotoxic effects of GBH exposure.

Conclusions

GBH exposure increased pro-inflammatory cytokine responses, decreased immunoglobulin production, and depleted lymphocytes in lymphoid organs in rats, but zinc supplementation mitigated this immunotoxicity.
Understanding Violent Extremism: Identifying Motivational Classes in Male Jihadist Detainees
Authors: Thijssen Gaby , Masthoff Erik , Sijtsema Jelle J. , Bogaerts Stefan
Published: January 2023

An important step in understanding violent extremist behavior is to identify its underlying motivations. Insights into what drives violent extremists to their behavior may indicate what is needed to reduce existing risk factors. To this end, this study investigated violent extremist motivations in 124 male jihadi suspects and convicts residing in Dutch prison terrorism wings. A Latent Class Analysis resulted in three motivation profiles. The low motivated class scored in general low on risk and motivational indicators of violent extremism. The morally driven class adhered to an ideology justifying violence, experienced some degree of grievances but often saw limitations in the use of violence to achieve ideological goals. The hardened ideologically driven class had an ideology justifying violence, feelings of frustrations and criminal history of violence. This descriptive study provides an important stepping-stone for future studies on how motivation profiles can be used to reduce the risk of violent extremist (re)offending.
Microencapsulation based fire retardant eco-friendly jute composite
Authors: Jalalah Mohammed , Zulfiqar Sumra , Afzal Ayesha , Khaliq Zubair , Qadir Muhammad B , Abid Ayesha , Faisal M , Alsaiari Mabkhoot , Irfan Muhammad , Harraz Farid A
Published: January 2023

Natural fiber reinforced composites (NFCs) are a promising replacement for conventional wood materials in furniture and households. However, the flammability of natural fibers limits their practical application. The composite matrix structure can be modified to enhance flame resistance. In this study, eco-friendly and cost-effective fire-retardants (FRs), micro-integrated Triphenyl Phosphate (m-TPP), and Aluminum Trihydroxide (ATH) were added physically in different concentrations to the epoxy resins (EPs). Underwriter Laboratories 94 (UL-94) flammability test revealed that the fire resistance of FR epoxy, EP88%m-TPP9%ATH3%, increased by increasing the TPP quantity with the highest V-0 rating. The thermo-gravimetric analysis (TGA) indicated a better internal structure of EP100%. However, no char residue was observed for EP100%. The highest char residue was found for EP88%m-TPP9%ATH3%, which confirmed its highest FR resistance. However, EP88%m-TPP9%ATH3% showed poor tensile, flexural, and compressional strengths. The m-TPP was a better FR than ATH. However, the mechanical stability of FR samples containing ATH is better than those containing m-TPP. Also, the addition of FRs reduced the tensile and flexural strengths; however, the compressional strength and modulus were significantly improved, which implied a potential use in the furniture industry.
Beneficial, Harmful, or Both? Effects of Corporate Venture Capital and Alliance Activity on Product Recalls
Authors: Bendig David , Hensellek Simon , Schulte Julian
Published: January 2023

Despite growing numbers of corporate venture capital (CVC) deals and alliances, their effectiveness is not guaranteed. This paper investigates the positive and negative impacts of CVC and alliance activity on product safety under different levels of market turbulence. Using a resource-based learning perspective and panel data from large U.S. firms, we find that both CVC and alliance activity have inverted U-shaped relationships with product recall likelihood. Market turbulence moderates both relationships, but differently. We discuss how learning theory complements the resource-based view to understand why no or rather bold external venturing are less harmful than small-scale “stuck-in-the-middle” initiatives.
Effect of Acellular Dermal Matrix on Long-Term Speech Outcomes in Primary Palatoplasty with Radical Intravelar Veloplasty
Authors: Kim Young Chul , Oh So Min , Park Bo Ra , Oh Tae Suk
Published: January 2023

Objective

This study investigates whether the use of acellular dermal matrix (ADM) affects the long-term speech outcomes in patients undergoing primary palatoplasty with radical intravelar veloplasty.

Design

Retrospective cohort study.

Setting

Tertiary university-affiliated hospital.

Participants

A consecutive cohort of 112 patients who underwent primary palatoplasty with radical intravelar veloplasty from August 2014 to March 2018 were included.

Main outcome measures

A 2 × 2 cm-sized ADM was incorporated as an interpositional graft between the oral and nasal lining at the soft-hard palate junction. The perceptual analysis of hypernasality and articulation was performed when the age of the patient reached at least 36 months. Cleft-related characteristics and surgical factors affecting the speech outcomes were investigated.

Results

The ADM was applied in 57 patients with a mean follow-up of45.76 months (SD, 10.69), while no ADM was used in 55 patients with a mean follow-up of 48.43 months (SD, 14.98). Regarding the hypernasality outcome, 33.3% (19 of 57 patients) of the ADM group and 27.3% (15 of 55 patients) of the control group showed a greater than mild-to-moderate degree. The distribution of hypernasality and articulation grade showed no significant difference between the two groups. After controlling for potential risk factors that may affect the speech outcomes, the use of ADM showed no significant relationship with velopharyngeal insufficiency.

Conclusion

The use of ADM use in primary palatoplasty with radical intravelar veloplasty is not associated with the alteration of speech function in early childhood.
Design and Validation of a 3D Printed Cranio-Facial Simulator: A Novel Tool for Surgical Education
Authors: Wright Joshua M. , Ford Jonathan M. , Qamar Fatima , Lee Matthew , Halsey Jordan N. , Smyth Matthew D. , Decker Summer J. , Rottgers S. Alex
Published: January 2023

Objective

To assess the ability of current 3D printing technology to generate a craniofacial bony and soft tissue anatomical model for use in simulating the performance of a fronto-orbital advancement (FOA) osteotomy and then to further assess the value of the model as an educational tool.

Design

Anatomic models were designed with a process of serial anatomic segmentation/design, 3D printing, dissection, and device refinement. A validation study was conducted with 5 junior and 5 senior plastic surgery residents. The validation study incorporated a multiple-choice Knowledge Assessment test (KA), an Objective Structured Assessment of Technical skills (OSATs), a Global Rating Scale (GRS) and a Michigan Standard Simulation Experience Scale (MiSSES). We compared the scores of both the junior and senior residents and compared junior resident scores, before and after viewing a lecture/demonstration.

Results

MiSSES showed high face validity with a score of 85.1/90, signifying high satisfaction with the simulator learning experience. Simulation and the lecture/demonstration improved the junior resident average KA score from 5.6/10 to 9.6/10 ( P = .02), OSATs score from 32.4/66 to 64.4/66 ( P < .001) and GRS score from 13.9/35 to 27.5/35 ( P < .001). The senior residents OSATs score of 56.3/66 was higher than the pre-lecture juniors (32.4/66) ( P < .001), but lower than the post-lecture juniors (64.4/66) ( P < .001).

Conclusion

We have successfully fabricated a 3D printed craniofacial simulator capable of being used as an educational tool alongside traditional surgical training. Next steps would be improving soft tissue realism, inclusion of patient and disease specific anatomy and creation of models for other surgical specialties.
On How I Got Through COVID-19 Lockdown: An Autoethnographic Approach to Resilience in Disability
Authors: Hall Karen A. E. , Djurdjevic Marija , Deusdad Blanca
Published: January 2023

I explore how I—a person born with a physical disability living alone in a foreign country—was able to cope with COVID-19 lockdown. I used the autoethnographic method (Chang, 2016) to scrutinize sources of my resilience. Through evocative autoethnography, I reviewed risks/coping strategies recalling the lessons drawn from my childhood in the care of two supportive women. Then, performing analytical autoethnography, I self-assessed my lived experiences through a social science lens. A theoretical validation of my personal story helped me to acknowledge how resilience in my life had been built and was mobilized in the face of the pandemic.
Fronto-Cerebellar Neurometabolite Alterations After Methylphenidate in Children and Adolescents With ADHD: A Proton Magnetic Resonance Spectroscopy Study
Authors: Bakhshi Soroush , Tehrani-Doost Mehdi , Batouli Seyed Amir Hossein
Published: January 2023

Objective:

The fronto-cerebellar circuit is involved in ADHD pathophysiology. Methylphenidate, as a first-line medication for ADHD, affects different brain regions, however, its effect on the fronto-cerebellar circuit is not investigated sufficiently. We aimed to investigate the effect of 8-week treatment with methylphenidate on neurometabolite ratios in the fronto-cerebellar circuit in ADHD participants using magnetic resonance spectroscopy (MRS).

Methods:

Fifteen drug-naïve ADHD children and adolescents were enrolled in the present study. Two single-voxel MR spectra were acquired from the right dorsolateral prefrontal cortex (DLPFC) and left Crus 1, before and after the medication. Also, neuropsychological and behavioral assessments were administered.

Results:

After medication, the glutamate/creatine in the DLPFC and the choline/creatine in the Crus 1 decreased in the ADHD participants.

Conclusion:

These findings propose that methylphenidate-induced metabolite changes in the fronto-cerebellar circuit could be associated with improvement in cognitive/behavioral characteristics in ADHD. Also, results highlighted cerebellar engagement in ADHD pathophysiology.
Tourism Demand Interval Forecasting Amid COVID-19: A Hybrid Model With a Modified Multi-Objective Optimization Algorithm
Authors: Wang Jianzhou , Zhang Lifang , Liu Zhenkun , Huang Xiaojia
Published: January 2023

A hybrid tourism demand interval forecasting system is proposed consisting of two parts: the construction of forecasting interval based on lower and upper bound estimates, and the forecasting interval adjustment based on an optimized reduction coefficient. Coronavirus factors are added as input variables to improve forecasting performance. A new multi-objective optimization algorithm is proposed to construct a feature selection method, optimize the forecasting model, and estimate the optimal reduction coefficient. The results of the experiments show that the proposed system has a powerful interval forecasting ability, which provides crucial guidance for balancing the recovery of the tourism industry and the control of the epidemic spread during the COVID-19 pandemic, and contributes to contingency planning for tourism practitioners and managers.
Green Marketing Versus Demarketing: The Impact of Individual Characteristics on Consumers’ Evaluations of Green Messages
Authors: Shao Xiaolong , Jeong EunHa (Lena) , Zhang Xingyi , Jang SooCheong (Shawn)
Published: January 2023

Green demarketing is defined as a marketing technique that promotes a brand as environmentally friendly and health conscious by moderately lowering product consumption. Even though the influence of demarketing techniques have previously been explored, how personal characteristics influence customers’ green behavioral intentions under the effects of green demarketing remains unknown. This study explored whether the effectiveness of a demarketing technique varies based on customers’ skepticism (high vs. low), gender (male vs. female), age (young vs. old), and income level (high vs. low). Therefore, four 2 × 2 between subject designs were used, and the median split method was adopted to determine participants’ level of green skepticism and age. The results confirmed significant relationships for green skepticism, age, and income level in response to message type. The study also identified implications for effective marketing communications regarding green marketing and demarketing strategies in the foodservice industry.
Effect of crack and vibration of waste tyre rubber hybrid composite for energy absorption applications
Authors: Sermaraj M , Ramanathan K , Rajkumar D R , Alphin M S
Published: January 2023

Composites reinforced with landfill waste materials have find the applications in engineering materials and they can lead to reduce the environmental pollutions. Waste tyre rubber, broken ceramic tiles and wood particles are creating the environmental hazard to the surroundings. In particular, the recycling of used tyre rubber is highly challenging, but it has very good property to absorb the energy. The reinforcement of rubber as single filler in composite has the limitations in processing and applications. Hence, the above waste materials are incorporated to prepare the composite in the present work. The fracture toughness and shear strength of composites were evaluated and compared with other combinations along with pure epoxy specimen. In order to find the application of composite in dynamic conditions the vibration analysis were done. The presents of rubber decreased the fracture toughness and at the same time the incorporation of ceramic largely improved the fracture toughness of epoxy composite. The shear strength of composites increased with the addition of ceramic and wood particles. But the rubber particle has the great influence on the damping behavior of ceramic base epoxy composites. The addition of ceramic with the epoxy increased the natural frequency and decreased the damping factor. This can be compensated by the inclusion of rubber with ceramic in epoxy resin matrix. 15 wt % addition of rubber with ceramic and epoxy increased the natural frequency of 18.52% and damping factor of 288% than 5 wt % of rubber with ceramic and epoxy. The natural frequency and damping factor of ceramic and rubber based epoxy composite have the highest amount of all combinations and can be used for vibration applications to absorb the energy at high frequencies.
A Worksite Health Promoting Program for Early Head Start and Head Start Workforce
Authors: Guerrero Alma D. , Herman Ariella
Published: January 2023

Introduction

Early Head Start (EHS) and Head Start (HS) staff comprise a large segment of the public sector workforce and experience numerous risk and chronic factors for medical conditions or symptoms. Few health and wellness workplace interventions, however, specifically focus on EHS/HS staff.

Methods

A train-the-trainer (TTT) approach was used to build capacity among directors and staff from 57 EHS/HS programs on how to strategically plan and implement a health promoting worksite program focusing on improving nutrition and physical activity practices among EHS/HS staff. Baseline and 3-month post-training questionnaires assessed EHS/HS staff changes on knowledge and practices related to nutrition and physical activity. Paired t-tests or chi2 statistics assessed changes in questionnaire responses over time.

Results

1,363 staff from 57 programs completed baseline and follow-up surveys. Staff had high knowledge regarding healthful dietary patterns at baseline. Over one-third of staff reported drinking soda with meals and almost 50% identified soda as their most common drink. Roughly one-third of staff also reported no physical activity in the prior week at baseline. Staff demonstrated significant improvements in dietary, nutrition, and physical activity practices. Staff also improved grocery shopping behaviors.

Implications for Practice

The TTT approach to disseminate an EHS/HS staff-focused health promotion program, “Eat Healthy, Stay Active!’ provides a potentially promising strategy to build upon and disseminate more broadly to reach the over >300,000 EHS/HS staff workforce.
Evaluation of Dose Calculation Based on Cone-Beam CT Using Different Measuring Correction Methods for Head and Neck Cancer Patients
Authors: Gong Hanshun , Liu Bo , Zhang Gaolong , Dai Xiangkun , Qu Baolin , Cai Boning , Xie Chuanbin , Xu Shouping
Published: January 2023

Purpose: To investigate and compare 2 cone-beam computed tomography (CBCT) correction methods for CBCT-based dose calculation. Materials and Methods: Routine CBCT image sets of 12 head and neck cancer patients who received volumetric modulated arc therapy (VMAT) treatment were retrospectively analyzed. The CBCT images obtained using an on-board imager (OBI) at the first treatment fraction were firstly deformable registered and padded with the kVCT images to provide enough anatomical information about the tissues for dose calculation. Then, 2 CBCT correction methods were developed and applied to correct CBCT Hounsfield unit (HU) values. One method (HD method) is based on protocol-specific CBCT HU to physical density (HD) curve, and the other method (HM method) is based on histogram matching (HM) of HU value. The corrected CBCT images (CBCTHD and CBCTHM for HD and HM methods) were imported into the original planning system for dose calculation based on the HD curve of kVCT (the planning CT). The dose computation result was analyzed and discussed to compare these 2 CBCT-correction methods. Results: Dosimetric parameters, such as the Dmean, Dmax and D5% of the target volume in CBCT plan doses, were higher than those in the kVCT plan doses; however, the deviations were less than 2%. The D2%, in parallel organs such as the parotid glands, the deviations from the CBCTHM plan dose were less than those of the CBCTHD plan dose. The differences were statistically significant ( P < .05). Meanwhile, the V30 value based on the HM method was better than that based on the HD method in the oral cavity region ( P = .016). In addition, we also compared the γ passing rates of kVCT plan doses with the 2 CBCT plan doses, and negligible differences were found. Conclusion: The HM method was more suitable for head and neck cancer patients than the HD one. Furthermore, with the CBCTHM-based method, the dose calculation result better matches the kVCT-based dose calculation.
Tranexamic Acid in Hip Hemiarthroplasty Surgery: A Retrospective Analysis of Perioperative Outcome
Authors: Wilharm Arne , Wutschke Isabell , Schenk Philipp , Hofmann Gunther Olaf
Published: January 2023

Introduction: Implantation of a dual-head hip prosthesis to treat medial femoral neck fractures is often associated with significant blood loss. In elective endoprosthetics procedures, it has already been demonstrated that administration of tranexamic acid (TXA) reduces blood loss and need for postoperative transfusions, as well as reducing the frequency of postoperative complications. The aim of this study is to show whether the administration of TXA also leads to a reduction in perioperative blood loss and haemorrhage-associated complications when applied as part of treatment of femoral neck fractures using a dual-head prosthesis. Methods: In a single-centre retrospective cohort study, 1 g TXA i.v. was administered preoperatively to 93 patients who had suffered from femoral neck fractures. This group was compared to a comparison group of 65 patients who did not receive TXA (nonTXA). Outcomes were evaluated on the basis of perioperative blood loss, frequency of transfusion, and frequency of specific complications occurring. Results: The transfusion rate in the TXA group was 6% lower, whereby the volume of blood transfused was 26.7% lower than in the nonTXA group. However, neither result was significant. The calculated perioperative blood loss remained the same. Similarly, the incidence of postoperative renal failure was not significantly lower in the TXA group, at 6.5%, as compared to the nonTXA group (7.7%). A higher rate of complications or deaths as a result of TXA administration was not observed. The tranexamic acid effect seems to be related to the dose. Conclusion: Preoperative administration of TXA during implantation of a dual-head prosthesis for treatment of a femoral neck fracture does not lead to an increased complication rate. The study revealed a trend towards fewer transfusions required, but a significant reduction in blood loss could not be demonstrated. There should be further investigation of other factors influencing blood loss, in particular the dosing regimen followed for perioperative administration of TXA. Level of Evidence: Level 4: retrospective case-control study
Effectiveness of Motivational Interviewing in Increasing Use of Hearing Protection Devices Among Agricultural Producers
Authors: Trautner Keane L. , Ridge Laura J. , Stefanovsky Nathan J. , Veliz Philip , McCullagh Marjorie C.
Published: January 2023

Background:

Agricultural producers are frequently exposed to noise that is hazardous to their hearing and cardiovascular health, and have among the highest rates of noise-induced hearing loss of all occupations. However, despite information-sharing approaches, few producers wear sufficient hearing protection. There is a need to develop effective methods of protecting producers from their noise exposure.

Methods:

We provided a series of 2 to 3 short (30-minute) telephone-based motivational interviewing (MI) sessions to noise-exposed agricultural producers. We assessed intervention effectiveness through changes in measuring hearing protector use pre- and post-intervention using a one-group pre/posttest design.

Results:

The sample ( N = 29) predominantly consisted of crop producers from Michigan. The mean percentage of time hearing protection was used increased from 44.9% to 51.8% after the intervention, approximately a 7% increase (p =.105). Regression analysis suggested the relationship between intervention dose and use of hearing protection was not correlative.

Discussion/Conclusion:

There was a marginal increase in the use of hearing protection after the intervention, although setting-specific increases in use were uneven. Intervention dose did not correlate with a change in hearing protection use. Further research is warranted to determine the effectiveness of MI, how it compares to information sharing, and to identify intervention dose parameters that promote efficiency.
Effectiveness of continuous passive motion in total knee replacement patients with slow rehabilitation under ERAS pathway
Authors: Hong Chau Ming , Jid Lee Qunn , Yee Esther Chang Wai
Published: January 2023

Background: Although we know routine use of continuous passive motion (CPM) has no clinical benefit on patients’ outcome after total knee replacement (TKR), the effect of CPM on patients with poor rehabilitation progress under ERAS (Enhanced Recovery after Surgery) pathway is unclear. We aimed to evaluate the clinical outcomes by using CPM in these patients under ERAS pathway. Methods: We performed a retrospective study for patients who had TKR done between 2017 and 2019 under ERAS pathway. Patients who were not able to reach 45 degrees of active range of movement (ROM) on postoperative day (POD) 3 would be reviewed to see if any CPM was used. Primary outcomes were the length of hospital stay and the active ROM upon discharge. Other outcomes were the active ROM in POD4 and the latest follow-up, pain score, and quadriceps power. Result: After exclusion, total of 68 patients were included in the study, with 30 were given CPM and 38 were not. Both groups had matched demographics. The study (CPM) group had significantly higher mean active ROM upon discharge (76.00 vs 68.42 degrees, p = 0.02) and longer hospital stay (7.3 vs 5.9 days, p =0.01). There were no significant effects on pain score, quadriceps power, and the active ROM in POD4 and the latest follow-up. Conclusion: For post TKR patients with limited rehabilitation progress under ERAS pathway, the use of CPM could attain better active ROM upon discharge with no adverse effect on pain control and quadriceps power, but at the expense of an increase in the length of stay.
The Utility of MRI in Evaluating Ruptures of the Patellar Tendon
Authors: Otlans Peters , Heimur Juliana , Sonnier John Hayden , Gibby Devyn , Freedman Kevin B.
Published: January 2023

Background:

Although the identification of patellar tendon rupture is a clinical diagnosis aided by standard radiography, magnetic resonance imaging (MRI) may aid in identifying the location of the rupture and concomitant pathology.

Purpose:

To evaluate the characteristics of patellar tendon tears needing surgical repair and to determine whether patient or injury factors were predictive of tear location.

Study Design:

Case series; Level of evidence, 4.

Methods:

Consecutive patients who underwent primary patellar tendon repair for rupture between May 15, 2017, and April 10, 2020, were reviewed retrospectively. Exclusion criteria included age <18 years, surgical treatment of multiligamentous knee injury, laceration injury, and knee arthroplasty. Radiographs, MRI scans, MRI reports, clinic notes, and operative notes were evaluated. Statistical analysis was performed to determine factors associated with tear location, complications, and reoperation.

Results:

In total, 147 patients and 156 tendon tears were included; 82.1% of the tears were patellar avulsions, 14.7% were midsubstance or complex tears, and 3.2% were tibial avulsions. Patient and injury characteristics (body mass index, race, medical comorbidities, presence of patellar tendinitis, mechanism of injury, Insall-Salvati ratio, and the presence of infrapatellar bone fragments) were not predictive of tear location ( P > .05). Patellar tendon ruptures were able to be clinically diagnosed correctly in >99% of cases. MRI was used to evaluate 77 (49.4%) knees. Patients who underwent MRI before surgery were more likely to have a history of preexisting tendinitis ( P = .015) and a lower preoperative Insall-Salvati ratio (1.68 vs 1.52; P = .017).

Conclusion:

Patient and injury factors were not predictive of tear location. The majority of patellar tendon tears were avulsion-type injuries from the inferior patella. MRI was not necessary to aid in the diagnosis of patellar tendon rupture, as 99.4% of tears were able to be diagnosed clinically without advanced imaging.
Scheimpflug imaging for evaluation of intraocular lens position in modified flanged scleral fixated intraocular lens
Authors: Oli Avadhesh , Yadav Anil , Babu J. Ganesh , Balakrishnan Divya
Published: January 2023

Background:

Scleral fixation of intraocular lens (IOLs) is the most preferred technique for the management of aphakia and the techniques have evolved over the years. These methods have their advantages and disadvantages, however, the major concern being the position of the intraocular lens, its stability and complications. The final IOL position is the major determinant of the final visual acuity, and various imaging modalities have been used to quantify the IOL tilt.

Objectives:

Use of Scheimpflug imaging to evaluate the IOL tilt in modified flanged scleral-fixated intraocular lens (MFSIOL).

Design:

Retrospective chart review of 41 consecutive patients who underwent MFIOL.

Methods:

We conducted a retrospective chart review of 41 consecutive patients who underwent MFIOL. The baseline and final best-corrected visual acuity (BCVA), refractive error, and clinical examination findings were recorded. The vertical and horizontal tilts of the IOLs were calculated using the Scheimpflug image. The IOL tilt (in degrees) in the vertical and horizontal axes was the primary outcome and the BCVA, residual refractive error, intraocular pressure, and surgical complications were secondary outcome measures.

Results:

The mean baseline BCVA was logMAR 0.49, which improved to logMAR 0.356 ( p < .005) after the surgery. The mean IOL tilt in the vertical axis was 3.40° (range of 0.0°–8.5°, interquartile range: 1.21–5.66) and in the horizontal axis was 1.35° (range of 0.60°–4.620°, interquartile range: 0.44–1.86), respectively. There was no correlation between angle of IOL tilt and UCVA ( r = 0.089, p = 0.580), BCVA ( r = 0.109, p = 0.498), final spherical error ( r = 0.081, p = 0.615), cylindrical error ( r = 0.207, p = 0.195), axial length ( r = 0.105, p = 0.514), and IOL power ( r = –0.139, p = 0.388)

Conclusion:

Modified flanged IOL (MFIOL) is an alternative technique for intrascleral fixation of IOL resulting in good lens stability. The IOL tilt achieved by this technique is minimal and did not influence the final visual outcome or spectacle correction. Scheimpflug imaging is simple and non-invasive method to measure the IOL tilt.

Plain Language Summary: Scheimpflug imaging for modified flanged scleral fixated lens position

This study on 41 eyes was aimed to analyze the lens tilt using Scheimpflug imaging in cases of modified flanged scleral fixation of intraocular lens (MFSFIOL), which is a novel technique to minimize the complications and simplify the procedure. The intraocular lens (IOL) remained stable with an acceptable range of vertical and horizontal tilt. There was no significant effect of IOL tilt on the final best-corrected visual acuity (BCVA) or spectacle correction. Scheimpflug imaging is an accurate and non-invasive technique for assessment of lens position in the patients with intrascleral fixation of IOL.
Dispelling Myths Surrounding AAC Use for Children: Recommendations for Professionals
Authors: Jensen Emily , Douglas Sarah N. , Gerde Hope K.
Published: January 2023

Augmentative and alternative communication (AAC) includes methods and technologies to support communication and aid individuals with limited speech. There are many widespread misconceptions about AAC use, however, that can negatively impact how children with disabilities are taught in classrooms. In this article, we describe the main types of AAC systems and how they are used to promote child success. Then, we identify and dispel common myths about AAC use and provide evidence-based recommendations for practitioners to support children who use AAC in the classroom.
Synthesis of Fe-deficient eudialyte analogues: Relationships between the composition of the reaction system and crystal-chemical features of the products
Authors: Kovalskaya Tatiana N. , Ermolaeva Vera N. , Chukanov Nikita V. , Varlamov Dmitry A. , Kovalskiy Georgy A. , Zakharchenko Egor S. , Kalinin Georgy M. , Chaichuk Korney D.
Published: January 2023

Eudialyte-related compounds have been synthesised hydrothermally at T = 600°C and P = 2 kbar from a stoichiometric mixture of Na2CO3, CaO, Fe2O3, ZrOCl2 and SiO2 using the Na:Ca:Fe:Zr:Si ratios corresponding to the eudialyte end-member Na15Ca6Fe3Zr3Si(Si25O73)(OH)Cl2⋅H2O, in the presence of 1 M aqueous solutions of NaCl and NaF. The synthesis was carried out in platinum ampoules over 10 days. Natural raslakite (a Ca-deficient member of the eudialyte group) was used as a seed and added in amounts corresponding to 2 wt.% of the whole charge. The products were characterised by powder X-ray diffraction, IR and Raman spectroscopy, morphological features, and electron probe microanalyses. In experiments with NaCl, almost pure eudialyte-type compounds were obtained. Synthesis in the presence of a NaF solution resulted in the formation of a F-dominant eudialyte-type compound related to raslakite as the main product and aegirine, vlasovite and lalondeite as by-products. All synthesised eudialyte-type compounds are Zr-rich and Fe-deficient, similar to eudialyte-group minerals from hyperagpaitic rocks related to foyaites. The increased NaCl contents in the reaction system results in increased Ca content in the synthesised eudialyte-related compounds. The crystal-chemical formulae of the synthesised eudialyte-type compounds are derived based on general regularities established earlier for eudialyte-group minerals.
A hybrid machine learning framework to improve prediction of all-cause rehospitalization among elderly patients in Hong Kong
Authors: Guan Jingjing , Leung Eman , Kwok Kin-on , Chen Frank Youhua
Published: January 2023

Background

Accurately estimating elderly patients’ rehospitalisation risk benefits clinical decisions and service planning. However, research in rehospitalisation and repeated hospitalisation yielded only models with modest performance, and the model performance deteriorates rapidly as the prediction timeframe expands beyond 28 days and for older participants.

Methods

A temporal zero-inflated Poisson (tZIP) regression model was developed and validated retrospectively and prospectively. The data of the electronic health records (EHRs) contain cohorts (aged 60+) in a major public hospital in Hong Kong. Two temporal offset functions accounted for the associations between exposure time and parameters corresponding to the zero-inflated logistic component and the Poisson distribution’s expected count. tZIP was externally validated with a retrospective cohort’s rehospitalisation events up to 12 months after the discharge date. Subsequently, tZIP was validated prospectively after piloting its implementation at the study hospital. Patients discharged within the pilot period were tagged, and the proposed model’s prediction of their rehospitalisation was verified monthly. Using a hybrid machine learning (ML) approach, the tZIP-based risk estimator’s marginal effect on 28-day rehospitalisation was further validated, competing with other factors representing different post-acute and clinical statuses.

Results

The tZIP prediction of rehospitalisation from 28 days to 365 days was achieved at above 80% discrimination accuracy retrospectively and prospectively in two out-of-sample cohorts. With a large margin, it outperformed the Cox proportional and linear models built with the same predictors. The hybrid ML revealed that the risk estimator’s contribution to 28-day rehospitalisation outweighed other features relevant to service utilisation and clinical status.

Conclusions

A novel rehospitalisation risk model was introduced, and its risk estimators, whose importance outweighed all other factors of diverse post-acute care and clinical conditions, were derived. The proposed approach relies on four easily accessible variables easily extracted from EHR. Thus, clinicians could visualise patients’ rehospitalisation risk from 28 days to 365 days after discharge and screen high-risk older patients for follow-up care at the proper time.
Predictors of incident reversible and potentially reversible cognitive frailty among Taiwanese older adults
Authors: Hwang Hei-Fen , Suprawesta Lalu , Chen Sy-Jou , Yu Wen-Yu , Lin Mau-Roung
Published: January 2023

Background

Few studies emphasize on predictors of incident cognitive frailty (CF) and examine relationships between various gait characteristics and CF. Therefore, we conducted a 2-year prospective study to investigate potential predictors, including gait characteristics, of incident reversible CF (RCF) and potentially RCF (PRCF) among Taiwanese older adults.

Methods

Eligible participants were individuals aged ≥ 65 years, who could ambulate independently, and did not have RCF/PRCF at the baseline. The baseline assessment collected information on physical frailty and cognitive measures, in addition to sociodemographic and lifestyle characteristics, preexisting comorbidities and medications, gait characteristics, Tinetti’s balance, balance confidence as assessed by Activities-specific Balance Confidence (ABC) scale, and the depressive status as assessed by the Geriatric Depression Scale. The Mini-Mental State Examination (MMSE), Mattis Dementia Rating Scale, and Digit Symbol Substitution Test were used to evaluate cognitive functions. Incident RCF and PRCF were ascertained at a 2-year follow-up assessment.

Results

Results of the multinomial logistic regression analysis showed that incident RCF was significantly associated with older age (odds ratio [OR] = 1.05) and lower ABC scores (OR = 0.97). Furthermore, incident PRCF was significantly associated with older age (OR = 1.07), lower ABC scores (OR = 0.96), the presence of depression (OR = 3.61), lower MMSE scores (OR = 0.83), slower gait velocity (OR = 0.97), and greater double-support time variability (OR = 1.09).

Conclusions

Incident RCF was independently associated with older age and lower balance confidence while incident PRCF independently associated with older age, reduced global cognition, the presence of depression, slower gait velocity, and greater double-support time variability. Balance confidence was the only modifiable factor associated with both incident RCF and PRCF.
A case of novel, rapidly-growing Mycolicibacter kumamotonensis infection in a patient with severe pulmonary disease treated in New York City
Authors: Weidmann Maxwell D. , Wu Yuexiu , Wu Fann , Hapani Dhrupa D. , Green Daniel A. , Aaron Justin G. , Berry Gregory J.
Published: January 2023

Introduction

Mycolicibacter kumamotonensis is a slowly growing, non-chromogenic non-tuberculous mycobacteria (NTM) that was initially distinguished from the M. terrae complex in 2006. Since then it has been rarely reported as the cause of pulmonary and soft-tissue infections in both immunocompromised and immunocompetent patients.

Case presentation

We present a case of severe pulmonary disease due to Mycolicibacter kumamotonensis in a 57-year-old male who was immunocompetent at time of diagnosis, with a history of interstitial lung disease and a prior diagnosis of tuberculosis (TB). After initial treatment for TB in 2017, his condition stabilized until a recurrence in September 2021, leading to an evaluation for lung transplant in the setting of pulmonary fibrosis and emphysema which led to the identification of Mycolicibacter kumamotonensis. A lung transplant was completed, and the patient was successfully treated with a combination of Ethambutol, Azithromycin, and Rifabutin.

Conclusions

This represents the first case reported of M. kumamotonensis in a patient undergoing lung transplant, and the first case with rapid culture growth during identification of the organism (4 days). This report highlights the need for consideration of M. kumamotonensis as a pathogen in humans, with the potential for rapid growth in liquid media, and the importance of early identification to inform empiric therapy.
Ultrasound measurement of optic nerve sheath diameter in a healthy adult Colombian population
Authors: Trocha Guillermo , Bonilla Andrés , Romero Camilo , Palacios Jonathan , Molano-Gonzalez Nicolas
Published: January 2023

Background

Measurement of the optic nerve sheath diameter (ONSD) provides a rapid, safe, and easy method for detecting increased intracranial pressure (ICP). However, the normal mean and upper limit values may vary according to sex, age, ethnicity, and ultrasound technique.

Aim

We aimed to obtain the mean ONSD in a healthy Colombian adult population and to correlate it with demographic and anthropometric measures.

Methods

In a prospective study using a 10–13 MHz linear ultrasound probe, eye transverse diameter (ETD) and ONSD in the transverse (ONSD-TP) and sagittal planes (ONSD-SP) were measured in healthy adult volunteers in Bogota, Colombia.

Results

A total of 100 healthy subjects were included, with a mean age of 26,7 ± 8,3 years and 62 women. The mean ETD, ONSD-TP and ONSD-SP was 23.11 mm (95% confidence interval (CI): 22.90 mm-23.32 mm), 3.96 mm (95% CI: 3.85 mm-4.07 mm) and 4.0 mm (95% CI: 3.90 mm-4.11 mm), respectively. The ONSD in both planes ranged from 2.35 mm to 5.20 mm. There was a significant correlation between ONSD-SP and ONSD-TP (p < 0.0001) but no correlation between the ocular measures and demographic or anthropometric variables (p > 0.05). The intraclass correlation between the eyes was statistically significant.

Conclusion

Our study shows that ultrasound-measured ONSD in healthy adults in Colombia is similar to that found worldwide. An ONSD of 5.5 mm may be considered the upper limit for healthy adults in Colombia. ONSD can be measured in either plane; there is a good correlation between the two eyes; and ONSD is not modified by demographic or anthropometric characteristics.
Fetal pharyngeal glial heterotopia manifested as polyhydramnios: a rare case with difficult prenatal diagnosis
Authors: Ke Xiaoting , Cai Huaijie , Wang Wei , Lai Qingquan
Published: January 2023

Background

Glial heterotopia is a rare congenital developmental malformation that presents as tumor-like lesions of the nerve tissue that grow outside the nervous system, but are not true tumors. At present, most cases are reported in neonates and children and are very rarely found in fetuses. The present report describes a case of fetal pharyngeal glial heterotopia and associated imaging findings to better understand the disease in the future.

Case presentation

A 32-year-old pregnant woman was admitted to the hospital with polyhydramnios. An ultrasound examination revealed a hypoechoic mass in the neck of the fetus. Magnetic resonance imaging showed a well-defined mass with significant compression of the esophagus and airway. The amniotic fluid index was approximately 40 cm. Considering that difficulty swallowing and breathing may occur due to compression by the mass after birth, tracheotomy and mass resection should be performed immediately. The difficulty of the tumor resection procedure and the nature of the tumor are both factors affecting the prognosis of the fetus. The pregnant woman eventually chose to induce labor. The fetal pharyngeal mass was then resected and its pathological examination indicated pharyngeal glial heterotopia.

Conclusions

Polyhydramnios due to pharyngeal glial heterotopia is extremely rare and accurate prenatal diagnosis is challenging. Clinical diagnosis of glial heterotopia in preterm fetuses is difficult. Therefore, understanding glial heterotopia is helpful to improve clinical treatment options.
Porphyromonas gingivalis predicts local recurrence after endoscopic submucosal dissection of early esophageal squamous cell carcinoma or precancerous lesion
Authors: Gao She-Gan , Qi Zhi-Peng , Qi Yi-Jun , Hou Ying-Yong , Liu Yi-Wen , Li Meng-Xiang , Li Bing , Sun Di , Shi Qiang , Cai Shi-Lun , Zhou Ping-Hong , Zhong Yun-Shi
Published: January 2023

Background

Porphyromonas gingivalis plays an oncogenic role in development and progression of esophageal squamous cell carcinoma (ESCC). However, the impact of P. gingivalis on local recurrence of early ESCC or precancerous lesion after ESD treatment remains unknown. The present study aimed to evaluate the impact of P. gingivalis on local recurrence after ESD treatment of early ESCC or high-grade dysplasia (HGD).

Methods

The amount of P. gingivalis was assessed by immunohistochemistry in 205 patients with early ESCC or HGD. Univariate and multivariate Cox regression analyses were performed to determine the effect of P. gingivalis on local recurrence. Propensity score matching analysis was performed to reduce the imbalance of baseline characteristics. A nomogram integrating significant prognostic factors was built for local recurrence prediction.

Results

The amount of P. gingivalis increased significantly in neoplasms that invaded up to muscularis mucosa and submucosa compared with lesions confined to epithelium or lamina propria. Overabundance of P. gingivalis was positively associated with invasion depth, post-ESD stricture and local recurrence. Univariate and multivariate Cox regression analyses revealed that P. gingivalis, longitudinal length of lesion and lymphovascular invasion were independent predictors for post-ESD recurrence. A nomogram comprising P. gingivalis, lymphovascular involvement, and lesion length performed well for prediction of post-ESD local recurrence with the concordance indices of 0.72 (95%CI, 0.62 to 0.80), 0.72 (95%CI, 0.63 to 0.80), and 0.74 (95%CI, 0.65 to 0.83) in the validation cohort, the entire cohort, and the subcohort after PSM, respectively.

Conclusion

P. gingivalis overabundance is a risk factor and a potential predictor for local recurrence of early ESCC or HGD after ESD treatment. Thus, clearance of P. gingivalis represents an attractive strategy for prognosis improvement and for prevention of ESCC.