bluuebunny/crossref_metadata_2025 huggingface dataset:
Normative Value of the Cross-Sectional Area of the Median Nerve at the Carpal Tunnel Inlet and Distal Forearm in the Singapore Population
Authors: LIM Jin X. , WANG Feifan , HO Yih X.C. , ER Jian H. , VIJAYAN Joy , SEBASTIN Sandeep J.
Published: August 2022

Background: Ultrasonography is often used in the diagnosis of carpal tunnel syndrome (CTS). However, we were unable to find normative data regarding the cross-sectional area (CSA) of the median nerve in the Singapore population as measured by ultrasound. The aims of this study were to establish normative values of the CSA of the median nerve at the carpal tunnel inlet in a healthy population, 5 cm proximal to the carpal tunnel inlet, and to determine if the CSA correlated with side, age, gender or race.

Methods: Sixty-nine wrists of 36 healthy subjects with no history of wrist injury or any signs and symptoms of CTS were examined. The CSA of the median nerve at the carpal tunnel inlet and 5 cm proximal to the carpal tunnel inlet was determined using ultrasound by a trained operator.

Results: The mean CSA of the median nerve at the carpal tunnel inlet was 6.41 mm2 (SD 2.18 mm2). These were not significantly different from the values for mean CSA obtained 5 cm proximal to the carpal tunnel inlet. We did not find any correlation between the CSA of the median nerve and age, gender or race.

Conclusions: The mean CSA of the median nerve at the carpal tunnel inlet in normal subjects in Singapore was found to be lower than other Asian populations. Wide variations of the median nerve CSA at the carpal tunnel inlet exists in the literature, and this is probably due to the heterogeneity of the study methodology and population.

Level of Evidence: Level III (Diagnostic)
Desmoplastic Fibroma of Radius Managed with Non-Vascularised Fibular Autograft – A Case Report
Authors: GAUTAM Virender K. , GOEL Prateek , AGRAWAL Ekshit , BHATIA Nishant
Published: August 2022

Desmoplastic fibromas of bone are extremely rare, slow growing, locally invasive, benign primary bone tumours, bearing close resemblance to the extra-abdominal desmoid tumours of soft tissue. They typically occur in patients around 30 years of age, and most commonly affect the mandible, pelvis and meta-diaphyseal region of long bones. En bloc or wide resection has typically been the treatment of choice to avoid recurrence, however, recent reports support curettage with bone grafting and adjuvant therapy to minimise functional loss. We report a 9-year-old child with a desmoplastic fibroma of right radius. This is an unusual age group for this bone tumor. The tumor was managed with en bloc resection and reconstruction with a non-vascularised fibula autograft. The patient had good functional outcome and no recurrence at 1-year follow-up.

Level of Evidence: Level V (Therapeutic)
Refracture of a Regenerated Hook of Hamate in a Professional Baseball Player: A Case Report
Authors: ISHIBASHI Shigeki , KODAMA Akira , SHINOMIYA Rikuo , ADACHI Nobuo
Published: August 2022

Hook of hamate fracture occurs in baseball players during bat swing. These fractures are usually treated by excision of the fracture fragment and the players can return to the game without delay. We report a professional baseball player who presented with a hook of hamate fracture. He gave history of undergoing excision of the hook 4 years earlier for a fracture of the hook. He underwent re-excision of the regenerated hook and was asymptomatic at his final follow-up.

Level of Evidence: Level V (Therapeutic)
From the chair
Authors: Schuler Douglas
Published: August 2022

Here we are. Nearly November. What better time to talk about computers and society and SIGCAS?! This column will be mostly related to thoughts on how we might go further on making our SIG more effective and influential but first...
Noncoding RNAs and RNA-binding proteins: emerging governors of liver physiology and metabolic diseases
Authors: Sommerauer Christian , Kutter Claudia
Published: August 2022

The liver holds central roles in detoxification, energy metabolism, and whole body homeostasis but can develop malignant phenotypes when being chronically overwhelmed with fatty acids and glucose. The global rise of metabolic dysfunction-associated fatty liver disease (MAFLD) is already affecting a quarter of the global population. Pharmaceutical treatment options against different stages of MAFLD do not yet exist, and several clinical trials against hepatic transcription factors and other proteins have failed. However, emerging roles of noncoding RNAs, including long (lncRNA) and short noncoding RNAs (sRNA), in various cellular processes pose exciting new avenues for treatment interventions. Actions of noncoding RNAs mostly rely on interactions with proteins, whereby the noncoding RNA fine-tunes protein function in a process termed riboregulation. The developmental stage-, disease stage-, and cell type-specific nature of noncoding RNAs harbors enormous potential to precisely target certain cellular pathways in a spatiotemporally defined manner. Proteins interacting with RNAs can be categorized into canonical or noncanonical RNA-binding proteins (RBPs) depending on the existence of classical RNA-binding domains. Both, RNA- and RBP-centric methods have generated new knowledge of the RNA-RBP interface and added an additional regulatory layer. In this review, we summarize recent advances in how RBP-lncRNA interactions and various sRNAs shape cellular physiology and the development of liver diseases such as MAFLD and hepatocellular carcinoma.
Relations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin
Authors: Nolan Margaret B. , Piasecki Thomas M. , Smith Stevens S. , Baker Timothy B. , Fiore Michael C. , Adsit Robert T. , Bolt Daniel M. , Conner Karen L. , Bernstein Steven L. , Eng Oliver D. , Lazuk David , Gonzalez Alec , Hayes-Birchler Todd , Jorenby Douglas E. , D'Angelo Heather , Kirsch Julie A. , Williams Brian S. , Kent Sean , Kim Hanna , Lubanski Stanley A. , Yu Menggang , Suk Youmi , Cai Yuxin , Kashyap Nitu , Mathew Jomol , McMahan Gabriel , Rolland Betsy , Tindle Hilary A. , Warren Graham W. , Abu-el-rub Noor , An Lawrence C. , Boyd Andrew D. , Brunzell Darlene H. , Carrillo Victor A. , Chen Li-Shiun , Davis James M. , Deshmukh Vikrant G. , Dilip Deepika , Goldstein Adam O. , Ha Patrick K. , Iturrate Eduardo , Jose Thulasee , Khanna Niharika , King Andrea , Klass Elizabeth , Lui Michelle , Mermelstein Robin J. , Poon Chester , Tong Elisa , Wilson Karen M. , Theobald Wendy E. , Slutske Wendy S.
Published: August 2022

Background:

There is mixed evidence about the relations of current versus past cancer with severe COVID-19 outcomes and how they vary by patient and cancer characteristics.

Methods:

Electronic health record data of 104,590 adult hospitalized patients with COVID-19 were obtained from 21 United States health systems from February 2020 through September 2021. In-hospital mortality and ICU admission were predicted from current and past cancer diagnoses. Moderation by patient characteristics, vaccination status, cancer type, and year of the pandemic was examined.

Results:

6.8% of the patients had current (n = 7,141) and 6.5% had past (n = 6,749) cancer diagnoses. Current cancer predicted both severe outcomes but past cancer did not; adjusted odds ratios (aOR) for mortality were 1.58 [95% confidence interval (CI), 1.46–1.70] and 1.04 (95% CI, 0.96–1.13), respectively. Mortality rates decreased over the pandemic but the incremental risk of current cancer persisted, with the increment being larger among younger vs. older patients. Prior COVID-19 vaccination reduced mortality generally and among those with current cancer (aOR, 0.69; 95% CI, 0.53–0.90).

Conclusions:

Current cancer, especially among younger patients, posed a substantially increased risk for death and ICU admission among patients with COVID-19; prior COVID-19 vaccination mitigated the risk associated with current cancer. Past history of cancer was not associated with higher risks for severe COVID-19 outcomes for most cancer types.

Impact:

This study clarifies the characteristics that modify the risk associated with cancer on severe COVID-19 outcomes across the first 20 months of the COVID-19 pandemic.

See related commentary by Egan et al., p. 3
All-Cause Mortality and Trimethylamine N-Oxide Levels in Patients with Cardiovascular Disease
Authors: Konieczny Radosław , Żurawska-Płaksej Ewa , Kaaz Konrad , Czapor-Irzabek Hanna , Bombała Wojciech , Mysiak Andrzej , Kuliczkowski Wiktor
Published: August 2022

Introduction: Trimethylamine N-oxide (TMAO) is an organic compound with a well-established involvement in the pathogenesis of cardiovascular disease (CVD). However, data on the links between TMAO levels and cardiovascular mortality in Polish patients are lacking. Objectives: We aimed to assess the relationship between serum TMAO levels and 5-year mortality in Polish patients with CVD. Patients and Methods: We retrospectively assessed serum TMAO levels in 1,036 consecutive patients (median age, 62 years; men, 61%) hospitalized between 2013 and 2015. Correlations between TMAO levels and 5-year mortality as well as anthropometric and biochemical parameters were assessed for the whole population and the subgroups of patients with acute coronary syndrome, stable coronary syndrome (SCS), chronic heart failure (HF), and atrial fibrillation (AF). Results: In the univariate analysis, increased TMAO levels predicted 5-year mortality without clinically significant power (hazard ratio [HR], 1.01; 95% CI: 1.006–1.018; p < 0.0001). However, even this weak effect was lost in the multivariate analysis after adjustment for age, sex, comorbidities, and laboratory parameters. In the whole study group, TMAO levels in the fourth quartile of concentration (>6.01 µM) predicted 5-year mortality only in the univariate analysis (HR: 1.55; 95% CI: 1.34–1.79; p < 0.0001). In subgroup univariate analysis, TMAO levels predicted 5-year mortality in patients with SCS, chronic HF, and AF. Conclusions: Despite the promising results of previous studies, our study shows that the level of TMAO has at most moderate value in predicting all-cause mortality. TMAO levels depend on other clinical variables, which limits the use of TMAO as an independent predictor of mortality in these patients.
A Multistep Tumor Growth Model of High-Grade Serous Ovarian Carcinoma Identifies Hypoxia-Associated Signatures
Authors: More Madhuri H. , Varankar Sagar S. , Naik Rutika R. , Dhake Rahul D. , Ray Pritha , Bankar Rahul M. , Mali Avinash M. , Subbalakshmi Ayalur Raghu , Chakraborty Priyanka , Jolly Mohit Kumar , Bapat Sharmila A.
Published: August 2022

High-grade serous ovarian carcinoma (HGSC) is associated with late-stage disease presentation and poor prognosis, with a limited understanding of early transformation events. Our study analyzes HGSC tumor progression and organ-specific metastatic dissemination to identify hypoxia-associated molecular, cellular, and histological alterations. Clinical characteristics of the HGSC were replicated in orthotopic xenografts, which involve metastatic dissemination and the prevalence of group B tumors (volume: >0.0625 ≤ 0.5 cm3). Enhanced hyaluronic acid (HA) deposition, expanded tumor vasculature, and increased necrosis contributed to the remodeling of tumor tissue architecture. The proliferative potential of tumor cells and the ability to form glands were also altered during tumor growth. Flow cytometry and label chase-based molecular profiling across the tumor regenerative hierarchy identified the hypoxia-vasculogenic niche and the hybrid epithelial-mesenchymal tumor-cell state as determinants of self-renewal capabilities of progenitors and cancer stem cells. A regulatory network and mathematical model based on tumor histology and molecular signatures predicted hypoxia-inducible factor 1-alpha (HIF1A) as a central node connecting HA synthesis, epithelial-mesenchymal transition, metabolic, vasculogenic, inflammatory, and necrotic pathways in HGSC tumors. Thus, our findings provide a temporal resolution of hypoxia-associated events that sculpt HGSC tumor growth; an in-depth understanding of it may aid in the early detection and treatment of HGSC.
Coletânea de artigos sobre probabilidade básica
Authors: Kawano Alexandre
Published: August 2022

Este livro contém cinco artigos escritos no período que o autor denomina como "de reclusão", durante a pandemia de Covid-19, em 2020. Cada um dos artigos tem foco em um grande fundamento da teoria. O primeiro artigo tem como tema a enumerabilidade, que é crucial para se entender distribuições de probabilidade e a distinção entre variáveis aleatórias discretas e contínuas. No segundo analisa-se o conceito de valor esperado, que não é trivial, apesar de intuitivo. No terceiro, a ênfase é sobre a variância e a origem da distribuição normal. O quarto artigo versa sobre a questão clássica das três portas, os conceitos de independência e de correlação. E, no último artigo, aborda-se a Lei dos Grandes Números e a distribuição de “0s e “1s" na representação binária de números reais no intervalo [0, 1]. A escolha do formato, de agrupar os capítulos em artigos, deve-se à proposta de estabelecer-se conexões entre ideias apresentadas separadamente em cursos tradicionais.
Mortalidade atribuída à doença falciforme em crianças e adolescentes no Brasil, 2000–2019
Authors: Nascimento Maria Isabel do , Przibilski Ana Luísa Ferreira , Coelho Carolina Sampaio Gomes , Leite Katyslaine Frossard de Amorim , Makenze Mariana , Jesus Stella Bayer de
Published: August 2022

OBJETIVO Estimar taxas e descrever tendências de mortalidade atribuídas à doença falciforme em crianças e adolescentes no Brasil, de 2000 a 2019. MÉTODOS Este é um estudo ecológico do tipo séries temporais de taxas de mortalidade que usou o método autorregressivo, proposto por Prais-Winsten, para avaliar tendências das taxas estimadas de mortes por doença falciforme em crianças e adolescentes no Brasil. Os óbitos com código D57 foram obtidos no Sistema de Informações sobre Mortalidade, considerando as faixas etárias (0–4, 5–9, 10–14, 15–19 anos) e usados para estimar taxas específicas por idade e taxas padronizadas por sexo e idade. RESULTADOS De 2000 a 2019, houve 2.422 óbitos por doença falciforme em menores de 20 anos no Brasil, com maior frequência na região Nordeste (40,46%), seguida de Sudeste (39,02%), Centro-Oeste (9,58%), Norte (7,84%) e Sul (3,10%). As principais vítimas foram pessoas de raça/cor da pele negra (78,73%). No Brasil, a taxa média padronizada global foi de 0,20/100 mil pessoa-ano, com tendência de elevação (mudança percentual anual – APC = 5,44%; intervalo de confiança – IC95% 2,57–8,39). O padrão se repetiu no sexo masculino (APC = 4,38%; IC95% 2,17–6,64) e no sexo feminino (APC = 6,96%; IC95% 3,05–11,01). A elaboração de taxas específicas por idade mostrou que a faixa até quatro anos experimentou as maiores taxas, sem distinção por região. A faixa etária de 15 e 19 anos foi a segunda mais afetada no Brasil e nas regiões Nordeste, Sudeste e Centro-Oeste. CONCLUSÃO Houve tendência de aumento dos óbitos por transtornos falciformes em crianças e adolescentes. Considerando que a magnitude dos óbitos foi mais evidente nos primeiros anos (0–4) e no final da adolescência (15–19), o estudo sugere que abordagens específicas por faixa etária podem impactar no controle dos desfechos fatais causados pela doença falciforme no Brasil.
Fatores associados aos problemas de sono e ao uso de medicação para dormir em brasileiros
Authors: Araújo Mayonara Fabíola Silva , Souza Talita Araújo de , Medeiros Arthur de Almeida , Souza Jane Carla de , Barbosa Isabelle Ribeiro
Published: August 2022

OBJETIVO Estimar a prevalência e fatores associados a problemas de sono e uso de medicamentos para dormir na população brasileira. MÉTODOS Estudo executado com os dados da Pesquisa Nacional de Saúde realizada no Brasil, nos anos de 2019 e 2020. A amostra foi composta por 94.114 participantes e os desfechos analisados foram problemas de sono e uso de medicamentos para dormir. Aspectos sociodemográficos, de estilo de vida e condições de saúde foram explorados em uma análise descritiva e multivariada, utilizando a regressão de Poisson com variância robusta, considerando nível de significância de 5%. RESULTADOS As prevalências de problemas de sono e uso de medicamentos indutores do sono foram de 35,1% (IC95% 34,5–35,7) e 8,5% (IC95% 8,2–8,9), respectivamente. Os problemas de sono foram associados ao sexo feminino (RP = 1,41; IC95% 1,36–1,46), aos indivíduos que autoavaliam a saúde como regular/ruim/muito ruim (RP = 1,56; IC95% 1,51–1,62), aos que possuem alguma doença crônica (RP = 1,70; IC95% 1,64–1,78), aos que fazem uso excessivo de álcool (RP = 1,14; IC95% 1,09–1,20) e aos fumantes (RP = 1,16; IC95% 1,10–1,22). O uso de medicamentos para dormir foi associado ao sexo feminino (RP = 1,57; IC95% 1,43–1,73), a indivíduos divorciados (RP = 1,46; IC95% 1,30–1,65), aos que vivem no meio urbano (RP = 1,32; IC95% 1,21–1,45), que autoavaliam sua saúde como regular/ruim/muito ruim (RP = 1,79; IC95% 1,64–1,95), com diagnóstico de doença crônica (RP = 4,07; IC95% 3,48–4,77) e aos fumantes (RP = 1,49; IC95% 1,33–1,67). CONCLUSÃO As prevalências de problemas de sono e uso de medicamentos para dormir na população brasileira observadas neste estudo indicam a necessidade de atenção e cuidado com o sono dessa população, principalmente nas mulheres e aqueles que apresentam estilo de vida e condições de saúde que se associaram aos desfechos.
High-Sensitivity Cardiac Troponin and the 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guidelines for the Evaluation and Diagnosis of Acute Chest Pain
Authors: Sandoval Yader , Apple Fred S. , Mahler Simon A. , Body Richard , Collinson Paul O. , Jaffe Allan S. ,   on behalf of the International Federation of Clinical Chemistry and Laboratory Medicine Committee on the Clinical Application of Cardiac Biomarkers
Published: August 2022

The 2021 American Heart Association/American College of Cardiology/American Society of Echocardiography/American College of Chest Physicians/Society for Academic Emergency Medicine/Society of Cardiovascular Computed Tomography/Society for Cardiovascular Magnetic Resonance guidelines for the evaluation and diagnosis of acute chest pain make important recommendations that include the recognition of high-sensitivity cardiac troponin (hs-cTn) as the preferred biomarker, endorsement of 99th percentile upper reference limits to define myocardial injury, and the use of clinical decision pathways, as well as acknowledgment of the uniqueness of women and other patient subsets. Details on how to integrate hs-cTn into clinical practice are less extensively addressed. Clinicians should be aware of some of the analytical aspects related to hs-cTn assays regarding the limit of detection and the limit of quantitation and how they are used clinically, especially for the single sample strategy to rule out acute myocardial infarction. Likewise, it is important for clinicians to understand issues related to the derivation of the 99th percentile upper reference limit; the value of sex-specific 99th percentile upper reference limits; how to use changing concentrations (deltas) to facilitate diagnosis and risk stratification of patients with suspected acute coronary syndrome, including the differentiation of acute from chronic myocardial injury; and how to best integrate the use of hs-cTn with clinical decision pathways. With the use of hs-cTn, conditions such as type 2 myocardial infarction become more common, whereas others such as unstable angina become less frequent but still occur. Sections relating to these issues are included.
SEM morphological study of the Late Triassic clam shrimp Shipingia hebaozhaiensis (Spinicaudata, Crustacea) from Yunnan, southwestern China
Authors: LI GANG
Published: August 2022

A re-examination of the holotype of the Norian (Late Triassic) clam shrimp type species Shipingia hebaozhaiensis Shen in Zhang et al., 1976 has revealed that small and large sized reticulations are irregularly arranged in the dorsal part of the carapace. In the middle part of the carapace, large sized reticulations are located in the upper part, and small sized reticulations in the lower part of each growth band. Growth bands in the ventral part of the carapace have only small sized reticulations. This ornamentation pattern is different from that of the other Norian zonal species from North America and western Europe.
A new species of spiny Rineloricaria (Siluriformes: Loricariidae) from the Rio Paraíba do Sul basin and costal rivers from Rio de Janeiro State
Authors: SILVA GUILHERME JOSÉ DA COSTA , SILVA GABRIEL DE SOUZA DA COSTA E , OLIVEIRA CLAUDIO
Published: August 2022

Although the genus Rineloricaria is widely distributed in the Neotropical region, its species usually occupy single drainages with high habitat fidelity. Rineloricaria species show evident sexual dimorphism with hypertrophied odontodes in sexually mature males. Here, we describe a new species of Rineloricaria present in the Rio Paraiba do Sul basin and coastal rivers in Rio de Janeiro State. The new species has extreme sexual dimorphism making possible to differentiate it from all congeners. The new species can also be separated from other sympatric species by morphometric characteristics and dermal plates pattern.
Video-assisted thoracic surgery in critically ill COVID-19 patients on venovenous extracorporeal membrane oxygenation
Authors: Zwaenepoel Bert , Vandewiele Korneel , Peperstraete Harlinde , De Ryck Frederic , Vanpeteghem Caroline , Malfait Thomas , Herck Ingrid , Vandenberghe Wim , Van Laethem Lien , Defreyne Luc , Van Braeckel Eva , Depuydt Pieter , Schaubroeck Hannah
Published: August 2022

Introduction

Coronavirus disease 2019 (COVID-19) leads to thoracic complications requiring surgery. This is challenging, particularly in patients supported with venovenous extracorporeal membrane oxygenation (VV-ECMO) due to the need for continuous therapeutic anticoagulation. We aim to share our experience regarding the safety and perioperative management of video-assisted thoracic surgery for this specific population.

Methods

Retrospective, single-center study between November 2020 and January 2022 at the ICU department of a 1.061-bed tertiary care and VV-ECMO referral center during the COVID-19 pandemic.

Results

48 COVID-19 patients were supported with VV-ECMO. A total of 14 video-assisted thoracic surgery (VATS) procedures were performed in seven patients. Indications were mostly hemothorax (85.7%). In eight procedures heparin was stopped at least 1 h before incision. A total of 10 circuit changes due to clot formation or oxygen transfer failure were required in six patients (85.7%). One circuit replacement seemed related to the preceding VATS procedure, although polytransfusion might be a contributing factor. None of the mechanical complications was fatal. Four VATS-patients (57.1%) died, of which two (50%) immediately perioperatively due to uncontrollable bleeding. All three survivors were treated with additional transarterial embolization.

Conclusion

(1) Thoracic complications in COVID-19 patients on VV-ECMO are common. (2) Indication for VATS is mostly hemothorax (3) Perioperative mortality is high, mostly due to uncontrollable bleeding. (4) Preoperative withdrawal of anticoagulation is not directly related to a higher rate of ECMO circuit-related complications, but a prolonged duration of VV-ECMO support and polytransfusion might be. (5) Additional transarterial embolization to control postoperative bleeding may further improve outcomes.
Study on the angiogenesis ability of Polymethyl methacrylate-mineralized collagen/Mg-Ca composite material in vitro and the bone formation effect in vivo
Authors: Bao Jiaxin , Sun Xirao , Chen Zhan , Yang Jingxin , Wang Chengyue
Published: August 2022

Magnesium (Mg) and its alloys show high degrees of biocompatibility and biodegradability, used as biodegrad able materials in biomedical applications. In this study, Polymethyl methacrylate (PMMA) - mineralized collagen (nano-Hydroxyapatite/collagen; nHAC)/Mg-Ca composite materials were prepared, to study the angiogenesis ability of its composite materials on Human umbilical vein endothelial cells (HUVECs) and its osteogenesis effect in vivo. The results showed that the PMMA-nHAC reinforcement materials can promote the proliferation and adhesion in HUVECs of Mg matrix significantly, it can enhance the migration motility and VEGF expression of HUVECs. In vivo, Micro-CT examination showed that with coated samples presenting the highest bone formation. Histologically, the materials and their corrosion products caused no systematic or local cytotoxicological effects. Therefore, the Mg matrix composites prepared in the present study has good biocompatibility and PMMA-nHAC/Mg-Ca composite may be an ideal orthopedic material to improve the bone formation, and biodegradable magnesium based implants with bioactivity have potential applications in bone tissue.
Model-based microburst identification using a hybridized extended Kalman filter with genetic algorithm
Authors: Mohajeri E. , Pourtakdoust Seid H , Pazooki Farshad
Published: August 2022

Microburst (MB) wind shear is one of the most important meteorological dangers threatening the aircraft (AC) safety and the life of passengers. Though there are some ground-based 3D Lidar systems to detect low-level MB wind shears to alert the pilots, there have been fewer scientific attempts to identify model-based MB parameters via AC onboard air and position data. The latter refers to the development and identification of an acceptable MB model upon which an automatic flight control (AFC) system can be designed to control the AC through wind shear microburst. In essence, accurate knowledge of MB model is an essential prerequisite for design and analysis of AFC systems that can safely fly the AC against microbursts, especially in crucial phases of flight such as takeoff and landing. The present study focuses on online estimation of MB parameters whose results pave the way for effective MB autopilot designs for safe flights through MB. The proposed task is accomplished via a model-based approach using the AC six degrees of freedom (6 DoF) equations of motion (EOM) integrated with the latest verified model of the MB utilizing the extended Kalman filter (EKF). In addition to a sensitivity analysis to determine the key MB model parameters, the performance of the estimation process is enhanced via a hybridization of the genetic algorithm (GA) with the EKF. The results are promising and indicate that the proposed scheme can identify the MB model parameters with sufficient accuracy needed for online applications with AFC design.
Understanding the Binge-watching Phenomenon on Netflix and Its Association with Depression and Loneliness in Egyptian Adults
Authors: Tolba Abir A. , Zoghaib Shaimaa Z.
Published: August 2022

People’s viewing experience has changed dramatically in recent years, with the rise of new viewing behaviours such as binge-watching and binge-racing made possible by the new media era. This study looks at how binge-watching affects several aspects of life (physical and psychological), correlating it to depression and loneliness, to test whether it affects them psychologically in a helpful way or drags them down to worse situations. Between December 2020 and April 2021, 234 participants completed an online survey that included four credible scales: the Center for Epidemiologic Studies Depression Scale, the Watching TV Series Motives Questionnaire, the Binge-watching Engagement and Symptoms Questionnaire and the UCLA Loneliness Scale (Version 3). Reaching out that most viewers watch alone and plan before entering the binge cycle, but not all of them could succeed in perceiving the impact of binge-watching left on them after ending their binging. The findings revealed that binge-watching is more prevalent among younger age. Additionally, there was a partial positive association between binge-watching and depression and loneliness. Furthermore, some TV viewing motives were positively associated with depression and loneliness.
Metabolic Health Immersion for Medical Education: A Pilot Program with Continuous Glucose Monitors in Medical and Dental Students
Authors: Norwitz Nicholas G. , Czeisler Mark É. , Delichatsios Helen K. , Hoenig Melanie P. , Cywes Robert
Published: August 2022

Diet-related chronic diseases are increasing in prevalence and poised to dominate the future careers of current medical students. While the value of nutritionally-informed care and nutrition-based health interventions is increasingly recognized, nutrition education is inconsistently and often inadequately included in medical school curricula. One obstacle to incorporating nutrition into medical and dental school curricula is the density of existing coursework, with incorporation of new material necessitating removal of other material. One solution is to engage students outside the classroom in immersive education in nutrition and metabolism using health-wearables. We report the Metabolic Health Immersion for Medical Education pilot program, spearheaded and designed by Harvard Medical students centering on use of continuous glucose monitors (CGM). Students reported enjoyment with the study, felt encouraged to improve health behaviors, and shared that the experience enhanced their understanding of nutrition and metabolism, was valuable to their medical education, and would influence their future patient care. This study demonstrates proof-of-principle that metabolic health immersion opportunities for health care trainees provide a means of helping to address the current deficit in medical school nutrition education.
Development of a Novel Coding Scheme to Explore Interactions in the Co-Production of Public Services with Priority Populations
Authors: Gheduzzi Eleonora , Barello Serena , Graffigna Guendalina , Masella Cristina
Published: August 2022

This study focuses on the development of a reliable coding scheme (CP-CODER) for studying interaction dynamics during the co-production of a public service involving priority communities. CP-CODER addresses the need to involve priority populations in the development of public services, an approach that has been recognized as difficult because of the high possibility of their experiencing negative health, social, and economic outcomes. The coding scheme was designed to capture group dynamics and forms of public engagement by adopting and integrating existing theoretical frameworks in the public service management and qualitative method literature. Coding was conducted on the transcripts of four co-production workshops, which included 26 family caregivers, three local health and social care service provider representatives, and five researchers involved in the co-production of new community-based services. One category was added to the two theoretical frameworks. The kappa ranged from 0.70–1.00 for the eight variables and the 26 individual items. The overall kappa was 0.91, while the overall percentage of agreement was 91.16%. The results of the pilot test showed the importance of integrating and managing three dimensions in co-producing with a priority population: the turn-taking, the content, and the level of abstraction of the discussion. The findings of this study have enhanced and supported both practitioners and researchers in co-producing services, ensuring the equal contribution of all participants, even those whose voices are rarely heard.
How I Learned to Stop Worrying and Love the Eco-Apocalypse: An Existential Approach to Accepting Eco-Anxiety
Authors: Guthrie Devin
Published: August 2022

Climate crisis presents a near-term existential threat to the human species, one that society has neither the physical nor psychological infrastructure to manage. Eco-anxiety increases as awareness about climate crisis spreads. Despite an urgent need for resources on how to help people cope with the psychological ramifications of climate crisis, there is little literature that both addresses people’s apocalyptic fears and takes the scientific bases of those fears seriously. In this article, I synthesize research on existential psychology, Acceptance and Commitment Therapy, grief, and end-of-life care to present an original perspective on how people, individually and collectively, can become psychologically resilient to climate crisis. First, I establish that death anxiety underlies eco-anxiety. Second, I demonstrate that preparing psychologically for eco-apocalypse requires people to cultivate death acceptance. Finally, I illustrate how commitment to palliative values can enable people to live rich and meaningful lives despite their most likely imminent end.
The Role of the Skin in Interoception: A Neglected Organ?
Authors: Crucianelli Laura , Ehrsson H. Henrik
Published: August 2022

In the past 2 decades, interoception has received increasing attention in the fields of psychology and cognitive science, as well as neuroscience and physiology. A plethora of studies adopted the perception of cardiac signals as a proxy for interoception. However, recent findings have cast doubt on the methodological and intrinsic validity of the tasks used thus far. Therefore, there is an ongoing effort to improve the existing cardiac interoceptive tasks and to identify novel channels to target the perception of the physiological state of the body. Amid such scientific abundancy, one could question whether the field has been partially neglecting one of our widest organs in terms of dimensions and functions: the skin. According to some views grounded on anatomical and physiological evidence, skin-mediated signals such as affective touch, pain, and temperature have been redefined as interoceptive. However, there is no agreement in this regard. Here, we discuss some of the anatomical, physiological, and experimental arguments supporting the scientific study of interoception by means of skin-mediated signals. We argue that more attention should be paid to the skin as a sensory organ that monitors the bodily physiological state and further propose thermosensation as a particularly attractive model of skin-mediated interoception.
Redesigning and recomputing the future of education: The role of technology, the learning process, personality traits, and diversity in learning systems
Authors: Arar Khalid , Saiti Anna , Guajardo Miguel
Published: August 2022

The main actor in the learning process is the learner. The concept of “learner” goes beyond the educational level. The new reality in the educational environment presents challenges for the learning process, which mainly concern the adoption of new technologies in that process. The purpose of this commentary is to try to outline the future of education, taking into account the efforts of learners, the needs of the learning process, as well as the advantages and disadvantages of providing knowledge through technology. We argue that education and technology are not two separate vague and autonomous elements that suddenly sprouted into being. Humankind shapes the development of education and contributes to the evolution of technology, its management, and application in education. Diversity in the learning needs of individuals regarding new technologies is the main discussion of this commentary, while the application of social ecology is considered as a necessary element to ensure equality in, and the sustainability of, education. Educational leadership has a key role to play in social ecology. Leadership in education must be supportive and, most importantly, facilitate the liberation of the learning process from the limited and negatively biased perception of different social values.
Weekend Admission Increases Risk of Readmissions Following Elective Thoracolumbar Spinal Fusion
Authors: Rosenberg Ashley , Dominy Calista , Bueno Brian T. , Pasik Sara , Yeshoua Brandon , Cho Brian , Arvind Varun , Valliani Aly A. , Markowitz Jonathan , Kim Jun S. , Cho Samuel K.
Published: August 2022

Study Design

Retrospective database study.

Objectives

The goal of this study was to assess the influence of weekend admission on patients undergoing elective thoracolumbar spinal fusion by investigating hospital readmission outcomes and analyzing differences in demographics, comorbidities, and postoperative factors.

Methods

The 2016-2018 Nationwide Readmission Database was used to identify adult patients who underwent elective thoracolumbar spinal fusion. The sample was divided into weekday and weekend admission patients. Demographics, comorbidities, complications, and discharge status data were compiled. The primary outcomes were 30-day and 90-day readmission. Univariate logistic regression analyzed the relationship between weekday or weekend admission and 30- or 90-day readmission, and multivariate regression determined the impact of covariates.

Results

177,847 patients were identified in total, with 176,842 in the weekday cohort and 1005 in the weekend cohort. Multivariate regression analysis found that 30-day readmissions were significantly greater for the weekend cohort after adjusting for sex, age, Medicare or Medicaid status, and comorbidity status (OR 2.00, 95% CI: 1.60-2.48; P < .001), and 90-day readmissions were also greater for the weekend cohort after adjustment (OR 2.01, 95% CI: 1.68-2.40, P < .001).

Conclusions

Patients undergoing elective thoracolumbar spinal fusion surgery who are initially admitted on weekends are more likely to experience hospital readmission. These patients have increased incidence of deep vein thrombosis, postoperative infection, and non-routine discharge status. These factors are potential areas of focus for reducing the impact of the “weekend effect” and improving outcomes for elective thoracolumbar spinal fusion.
Geography vs. past climate: the drivers of population genetic structure of the Himalayan langur
Authors: Arekar Kunal , Tiwari Neha , Sathyakumar Sambandam , Khaleel Mehreen , Karanth Praveen
Published: August 2022

Background

Contemporary species distribution, genetic diversity and evolutionary history in many taxa are shaped by both historical and current climate as well as topography. The Himalayas show a huge variation in topography and climatic conditions across its entire range, and have experienced major climatic fluctuations in the past. However, very little is known regarding how this heterogenous landscape has moulded the distribution of Himalayan fauna. A recent study examined the effect of these historical events on the genetic diversity of the Himalayan langurs in Nepal Himalaya. However, this study did not include the samples from the Indian Himalayan region (IHR). Therefore, here we revisit the questions addressed in the previous study with a near complete sampling from the IHR, along with the samples from the Nepal Himalaya. We used the mitochondrial Cytochrome-b (Cyt-b, 746 bp) region combined with multiple phylogeographic analyses and palaeodistribution modelling.

Results

Our dataset contained 144 sequences from the IHR as well as the Nepal Himalaya. Phylogenetic analysis showed a low divergent western clade nested within high divergent group of eastern lineages and in the network analysis we identified 22 haplotypes over the entire distribution range of the Himalayan langurs. Samples from the Nepal Himalaya showed geographically structured haplotypes corresponding to different river barriers, whereas samples from IHR showed star-like topology with no structure. Our statistical phylogeography analysis using diyABC supported the model of east to west colonisation of these langurs with founder event during colonisation. Analysis of demographic history showed that the effective population size of the Himalayan langurs decreased at the onset of last glacial maximum (LGM) and started increasing post LGM. The palaeodistribution modelling showed that the extent of suitable habitat shifted from low elevation central Nepal, and adjoining parts of north India, during LGM to the western Himalaya at present.

Conclusion

The current genetic diversity and distribution of Himalayan langurs in the Nepal Himalaya has been shaped by river barriers, whereas the rivers in the IHR had relatively less time to act as a strong genetic barrier after the recent colonisation event. Further, the post LGM expansion could have had confounding effect on Himalayan langur population structure in both Nepal Himalaya and IHR.
Trachway® flexible stylet facilitates the correct placement of double-lumen endobronchial tube: a prospective, randomized study
Authors: Hsu Hung-Te , Kuo Yi-Wei , Ma Chao-Wei , Su Miao-Pei , Tseng Kuang-Yi , Li Chin-Ling , Cheng Kuang-I
Published: August 2022

Background

The mainstream facilitation of one-lung ventilation is using double-lumen endobronchial tubes. However, it is more difficult to be positioned properly and more likely to cause airway injuries. How to place double-lumen endobronchial tubes rapidly and correctly is important for thoracic anesthesiologists.

Methods

One hundred eight patients with an American Society of Anesthesiologists physical status of I to III were 20 years of age or over, and required one-lung ventilation for thoracic surgery. They were randomly assigned to the conventional technique group (n = 36), the flexible fiberoptic bronchoscopy group (n = 36), or the Trachway® flexible stylet group (n = 36). The primary endpoint was the time needed for intubation. T1, the time from the tip of the blade passing between the patient’s lips to identification of the vocal cords; and T2, the time from identification of the vocal cords to the bronchial lumen was in the correct position.

Results

T1 had no significant difference between groups, but T2 was significantly shorter in the Trachway® flexible stylet group (p < 0.0001) and longer in the conventional technique group (p < 0.0001).

Conclusions

Using Trachway® flexible stylet for correct placement of double-lumen endobronchial tubes not only significantly shortened the intubation time, but also reduced incidence of carinal injuries. It is an alternative, and a choice with good safety.

Trial registration

ClinicalTrials.gov Identifier: NCT02364622, 18/02/2015, Retrospectively registered.
Ultrasound-guided esophageal compression during mask ventilation in small children: a prospective observational study
Authors: Kim Eun-Hee , Cho Sung-Ae , Kang Pyoyoon , Song In-Sun , Ji Sang-Hwan , Jang Young-Eun , Lee Ji-Hyun , Kim Jin-Tae , Kim Hee-Soo
Published: August 2022

Background

The use of cricoid compression to prevent insufflation remains controversial, and its use in children is limited. This study aimed to examine the effect of real-time ultrasound-guided esophageal compression on the prevention of gastric insufflation.

Method

This prospective observational study was conducted with fifty children aged < 2 years undergoing general anesthesia. Patients were excluded if they were at an increased risk for gastric regurgitation or pulmonary aspiration. Following anesthetic induction under spontaneous breathing, ultrasound-guided esophageal compression was performed during pressure-controlled face-mask ventilation using a gradual increase in peak inspiratory pressure from 10 to 24 cm H2O to determine the pressure at which gastric insufflation occurred. The primary outcome was the incidence of gastric insufflation during anesthetic induction with variable peak inspiratory pressure after real-time ultrasound-guided esophageal compression was applied.

Results

Data from a total of 42 patients were analyzed. Gastric insufflation was observed in 2 (4.7%) patients. All patients except one had their esophagus on the left side of the trachea. Applying ultrasound-guided esophageal compression did not affect the percentage of glottic opening scores (P = 0.220).

Conclusions

The use of real-time ultrasound-guided esophageal compression pressure can aid preventing gastric insufflation during face-mask ventilation in children less than 2 years old.

Trial registration

Clinicaltrials.gov identifier: NCT04645043.
Translation and initial validation of Chinese (Cantonese) version of Modified Fatigue Impact Scale (MFIS-C) in people with stroke
Authors: Ng Shamay S. M. , Liu Tai Wa , Tsoh Joshua
Published: August 2022

Purpose

To translate and culturally adapt the Modified Fatigue Impact Scale (MFIS) to Chinese version, and to psychometrically test it in stroke population.

Methods

This study consisted of 2 phases. In phase one, we translated and culturally adopted the original English version of MFIS into Chinese (Cantonese) (MFIS-C). In phase two, the MFIS was psychometrically tested using a cohort of community-dwelling people with stroke (n = 101) and healthy control (n = 50). Among the stroke participants, 52 of them were reassessed after a 1-week interval.

Results

The MFIS-C demonstrated satisfactory content validity and good to excellent internal consistency. The overall MFIS-C and its subscales have good test-retest reliability. The MDC95 were 14.86, 7.49, and 9.70 for the overall MFIS-C physical, cognitive and psychosocial subscales, respectively. The overall MFIS-C and its 2 subscales have significant weak to moderate negative correlations with the Community Integration Measure and the 12-item Short Form Health Survey Version 2. Our findings revealed that the people with chronic stroke living in Hong Kong were reported to have high level of fatigue.

Conclusion

The MFIS-C is a reliable and valid measure for assessing the level of fatigue in people with stroke.
The relationship between the ‘‘Fujisawa point’’ and anatomical femorotibial angle following simulated open wedge high tibial osteotomy
Authors: Kobayashi Hideo , Saito Suguru , Akamatsu Yasushi , Kumagai Ken , Nejima Shuntaro , Inaba Yutaka
Published: August 2022

Background

We evaluated the relationship between the weight-bearing line (WBL) ratio and anatomical femorotibial angle (FTA) by simulated open wedge high tibial osteotomy (OWHTO). This study evaluated the correlation between the ‘‘Fujisawa point’’ and FTA, and identified factors which caused deviations between the two measurement methods. We hypothesized that the Fujisawa point corresponded with 170° of the FTA.

Methods

Preoperative antero-posterior full-length lower limb radiographs of 82 patients were obtained for the OWHTO to place the WBL ratio at a target of 62.5% of the width of the tibial plateau (Fujisawa point). The coronal alignment was measured pre- and post-planning. The patients were divided into two groups by the post-planning FTA: a correspondence group (168.5°≦FTA≦171.5°) and a non-correspondence group (FTA < 168.5°, 171.5° < FTA). The relationship between the Fujisawa point and the FTA was analyzed with multivariate regression analysis.

Results

The post-planning FTA was 169.8 ± 1.1° and within 170 ± 1.5° in 69 cases (84.1%) when the WBL ratio was 62.5%. The neck shaft angle was 128.1 ± 5.2° in the correspondence group, and 122.3 ± 6.3° in the non-correspondence group. The multivariate linear regression analysis revealed that the neck shaft angle was the only factor that predicted the correspondence of the Fujisawa point with the FTA at 170° (p = 0.006, odd 1.28).

Conclusions

The post-planning FTA converged at 170° when the WBL ratio passed through the Fujisawa point and the neck shaft angle was the only predictor.